Mixed methods evaluation of pediatric telehealth equity for patients/families who communicate in languages other than English.

Autor:	DeCamp LR; Children's Hospital Colorado, Aurora, CO, USA.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.; Adult and Child Center for Outcomes Research and Delivery Science, Aurora, CO, USA., Williams L; Children's Hospital Colorado, Aurora, CO, USA.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA., Palmer C; Children's Hospital Colorado, Aurora, CO, USA.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA., Gorman C; Adult and Child Center for Outcomes Research and Delivery Science, Aurora, CO, USA., Olson C; Children's Hospital Colorado, Aurora, CO, USA.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA., Thompson DA; Children's Hospital Colorado, Aurora, CO, USA.; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.; Adult and Child Center for Outcomes Research and Delivery Science, Aurora, CO, USA.
Jazyk:	angličtina
Zdroj:	MHealth [Mhealth] 2023 May 08; Vol. 9, pp. 24. Date of Electronic Publication: 2023 May 08 (Print Publication: 2023).
DOI:	10.21037/mhealth-22-43
Abstrakt:	Background: Emerging research demonstrates telehealth disparities for patients who communicate in languages other than English. A better understanding of pediatric telehealth use with families who communicate in languages other than English is needed to inform interventions to promote telehealth equity. Methods: We conducted a mixed methods study of telehealth care in a children's hospital health system using electronic health record data for outpatient video telehealth encounters from April 2020 to July 2021 and qualitative interviews with clinical staff and Spanish-speaking parents of telehealth patients. Results: The 16-month study period included 102,387 telehealth encounters; 5% of which were encounters in languages other than English. 83% of languages other than English encounters were with patients/families with a preferred healthcare language of Spanish. 11% of providers conducted ≥10 languages other than English telehealth encounters. This subset of providers conducted 71% of all languages other than English encounters. We conducted 25 interviews with clinical staff (n=13) and parents (n=12). Common themes identified across interviews were: (I) technology barriers affect access to and quality of telehealth; (II) clinical staff and parents are uncertain about the future role of telehealth for patients/families who communicate in languages other than English; (III) the well-known impact of language barriers on in-person healthcare access and quality for patients who communicate in languages other than English is also evident in telehealth. Conclusions: Patients who communicate in languages other than English were underrepresented among telehealth encounters and encounters were concentrated among few providers. Promoting equitable telehealth care requires investment to address technology barriers, increase the readiness of providers and clinics to provide telehealth care in languages other than English, and continued attention to reducing the healthcare impact of language barriers. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://mhealth.amegroups.com/article/view/10.21037/mhealth-22-43/coif). This project was funded by the Children’s Hospital Colorado Clinical and Operational Effectiveness and Patient Safety Small Grants Program (Principal Investigators: LRD/DAT). This funding provided salary support for CG and CP to fulfill their role in the proposed work. CO was supported to complete this work by the work by the NIH/ NCATS SPROUT-CTSA Collaborative Telehealth Network Grant, #U01TR002626. Effort on this project was provided in-kind by LRD, DAT, LW. DAT reports receiving an honoraria and reimbursement of travel costs in 2022 by Johns Hopkins All Children’s Hospital to teach pediatric residents as part of a curriculum on health equity in which she discussed the care of patients/families whose healthcare communication is in a language other than English. DAT also serves as the Associate Medical Director of the Children’s Hospital Colorado Research Institute and as part of her duties co-chairs the Diversity, Health Equity, and Inclusion in Research Committee for the Research Institute. The authors have no other conflicts of interest to declare. (2023 mHealth. All rights reserved.)
Databáze:	MEDLINE
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