AzTrials
AzTrials

Communication BarriersNCT03149276

Limited English Proficiency Occupational Therapy Patients Receiving Interpreter Services Perception of Quality of Care

An observational study of Communication Barriers and Occupational Therapy, run by Rush University Medical Center.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

A systematic literature review from March through June 2014 supports the premise that limited English proficiency (LEP) persons face barriers and disparities to medical care that English-speaking persons do not face. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Communication Barriers, Occupational Therapy
What is being tested?
Interpreter services
How many people
8 participants
Where
No sites listed yet
Study dates
6 Jan 2015to 15 Apr 2015
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Four limited English proficient persons that require occupational therapy services for four or more weeks and four English-speaking persons that require occupational therapy services, for four or more weeks, to serve as a comparison group

Who may be able to join

  • Must be age 18 or older
  • Must have a current prescription for occupational therapy (OT) that requires service for four weeks or more that span the six-week length of the project
  • Agree to sign the project informed consent form
  • Agree to complete the pre-OT satisfaction survey in its entirety at the conclusion of their OT initial evaluation and the post-4 weeks OT satisfaction survey at the end of four weeks of OT service
  • Additional inclusion criteria for limited English proficiency (LEP) group:
  • Agree to use professional interpreter services
  • Agree to an interview at the end of four weeks of OT service

Who cannot join

  • Under 18 years of age
  • Does not have a current prescription for occupational therapy (OT) that requires service for four weeks or more that span the six-week length of the project
  • Refusal to sign the project informed consent form
  • Refusal to complete the pre-OT satisfaction survey in its entirety at the conclusion of their OT initial evaluation and the post-4 weeks OT satisfaction survey at the end of four weeks of OT service
  • Refusal of LEP participants to use professional interpreter services
  • Refusal of LEP participants to be interviewed at the end of four weeks of OT service

About this study

A systematic literature review from March through June 2014 supports the premise that limited English proficiency (LEP) persons face barriers and disparities to medical care that English-speaking persons do not face. Language barriers have a negative impact on health and health care, including lower health status, lower likelihood of having a primary care provider, lower rate of preventative care, higher use rate of diagnostic tests, higher rate of severe psychopathology diagnoses, and higher risk of drug complications . Additionally, LEP persons experience problems with effective communication with providers, inappropriate diagnoses and treatments, lower comprehension of medication instructions and adherence to regimens, fewer follow up visits, low quality care, poorer health outcomes, and low patient satisfaction.

Research has proven a relationship between LEP and health care outcomes, specifically a relationship between positive outcomes and use of professional interpreters. Not sharing a common language creates a barrier to providing safe, effective, client-centered Occupational Therapy (OT) and knowledge of outcome satisfaction for this population. Using trained interpreters would reduce the barriers created by language discordance.

Read more

This evidence-based project intends to measures the influence of interpreter service on LEP patients' perceived quality of care using a satisfaction survey. Gathered data will be used to consider development and implementation of practice guidelines for use of professional interpreter services for LEP patients receiving OT services at Midwest Orthopaedics at Rush. Development and implementation of practice guidelines that include use of trained interpreters when providing OT services to LEP patients will facilitate a client-centered approach and improve quality of care for this population.

The project is also being implemented as part of a degree requirement for the Doctorate of Occupational Therapy Program at Chatham University.

Read the detailed description

The sampling frame will consist of adults, age 18 or older, with limited English proficiency (LEP), with an upper extremity injury or disorder, that have been referred to occupational therapy (OT) at Midwest Orthopaedics at Rush (MOR), require services that span four weeks or more, agree to use of interpreter services, agree to completing a paper and pencil survey at the end of four weeks, and agree to be interviewed after four weeks of occupational therapy services, following completion of the survey. LEP is determined by a preference to receive medical information in a non-English language. Sampling frame is four participants. The sampling frame will be purposive. As LEP individuals present for OT services they will be recruited for participation. Recruitment could happen simultaneously or in tandem.

The comparison group sampling frame will consist of adults, age 18 or older, proficient in English, with an upper extremity injury or disorder, that have been referred to OT at MOR, and require services that span four weeks or more. English proficiency is determined by use of English as preferred language. Sampling frame is four participants. For each LEP individual recruited, the following English-speaking individual will be asked to participate. When participants in each group are recruited, further recruitment will cease. The total sampling frame will be eight. Enlisting an English proficient individual following recruitment of an LEP individual ensures having equal participation in each group.

A paper and pencil survey will be administered in person at MOR after the initial occupational therapy visit and at the end of four weeks of OT services to the 4 Limited English proficient subjects and 4 English-speaking subjects, for 16 completed surveys. Completion will take place in a private room in the OT department. Subjects will self-select a 4 digit identification code that they will write in at the top of the survey. The sole purpose of the code is to match the pre-OT satisfaction survey with the post-OT satisfaction survey. No personal identification markers will be used on the surveys. Interviews will be conducted with each LEP individual following four weeks of OT services and after completion of the paper survey. No personal identification markers will be placed on the interview form. The interviews will be conducted in person at MOR, in a private room in the OT department. The primary investigator will present the open-ended questions with the assistance of Rush University Medical Center (RUMC) interpreter services. The documented data will be reviewed by the primary investigator for emerging themes that may provide insight and additional information.

Being tested
Interpreter services

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Interpreter servicesOther

    Also called Occupational Therapy

Study groups in NCT03149276
Study groupRoleWhat they receive
Limited English Proficiency GroupLEP persons were identified by asking, "What language would you like to receive medical information and services in?" Patients were considered limited English proficient when a non-English language was preferred. Interventions included professional interpreter services and occupational therapy.
Receives: Other: Interpreter services
English Speaking GroupEnglish speaking persons were identified by asking, "What language would you like to receive medical information and services in?" Patients were considered English speaking when the English language was preferred. Intervention included occupational therapy.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pre-Occupational Therapy Satisfaction Survey

    The pre-Occupational Therapy satisfaction survey was developed for this project by the primary investigator to measure perceived satisfaction. The pre-OT satisfaction survey consists of five demographic items and four items that employ a Likert scale rating method. The total quantitative scoring range for the survey is four to twenty, with a score of four indicating the lowest satisfaction and a score of 20 indicating the highest satisfaction. The paper and pencil survey was completed in person by all participants after the initial OT visit. Survey scores of the LEP group were compared to the English-speaking group. Equal or better scores reflect agreement that LEP OT perceive quality of care and satisfaction equal to English-speaking patients.

    Measured: Baseline

  2. Post-4 weeks Occupational Therapy Satisfaction Survey

    The Post-4 weeks OT satisfaction survey was developed for this project by the primary investigator to measure perceived satisfaction. The survey consists of five demographic items and four items that employ a Likert scale rating method. The total quantitative scoring range for the survey is 4 to 20, with a score of 4 indicating the lowest satisfaction and a score of 20 indicating the highest satisfaction. The post-4 weeks OT satisfaction survey contains three additional items, using a Likert scale rating method to explore qualitative experiences. Total qualitative scoring range for the survey is 3 to 15, with a score of 3 indicating a low belief in the benefits of OT and a score of 15 indicating a high belief in the benefits of OT. Scores of the LEP group were compared to the English-speaking group. Equal or better scores reflect agreement that LEP OT patients receiving IS perceive quality of care and satisfaction equal to English-speaking patients.

    Measured: 4 weeks from baseline

  3. Occupational Therapy Satisfaction Interview

    Interviews were conducted by the primary investigator, Eileen Turgeon, assisted by Interpreter Services (IS), with each LEP individual following four weeks of OT services and after completion of the post-4 weeks OT satisfaction survey. The interviews were conducted in person. The interview consisted of seven open-ended questions meant to capture the qualitative experience of the use of Interpreter Services during OT service delivery. The literature supports the use of surveys and interviews to gather feedback on LEP patients' perceived quality of care and satisfaction (González et al., 2010; Green et al., 2005; Lee et al., 2002; Shi et al., 2009; Wilson et al., 2005). The primary investigator presented the open-ended questions with the assistance of IS. The recorded interviews were reviewed by this primary investigator for emerging themes to provide insight and additional information.

    Measured: 4 weeks from baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 May 2017
  2. Study start6 Jan 2015
  3. Primary completion15 Apr 2015
  4. Study completion15 Apr 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
8 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03149276
Sponsor's protocol ID
14110802-IRB01
Status last verified
May 2017
First submitted
1 May 2017
Last updated
12 May 2017
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain & process (3rd ed.) [Supplemental Section]. American Journal of Occupational Therapy, 68(Supl. 1), S1-S48.

  • Zuniga GC, Seol YH, Dadig B, Guion WK, Rice V. Progression in understanding and implementing the cultural and linguistic appropriate services standards: five-year follow-up at an academic center. Health Care Manag (Frederick). 2013 Apr-Jun;32(2):167-72. doi: 10.1097/HCM.0b013e31828ef655.

    PubMed 23629039
  • Wilson E, Chen AH, Grumbach K, Wang F, Fernandez A. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005 Sep;20(9):800-6. doi: 10.1111/j.1525-1497.2005.0174.x.

    PubMed 16117746
  • Wells, S. (2011). American Occupational Therapy Association advisory opinion for the ethics commission: Cultural competency and ethical practice. Bethesda, MD: American Occupational Therapy Association.

  • Wardin K. A comparison of verbal evaluation of clients with limited English proficiency and English-speaking clients in physical rehabilitation settings. Am J Occup Ther. 1996 Nov-Dec;50(10):816-25. doi: 10.5014/ajot.50.10.816.

    PubMed 8947374
  • U.S. News & World Report. (2015). Top-ranked hospitals for orthopedics. Retrieved from http://health.usnews.com/best-hospitals/rankings/orthopedics/data

  • U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. (2013). Language use in the United States: 2011 American community survey report (ACS-22). Retrieved from http://www.census.gov/hhes/socdemo/language/

  • U.S. Census Bureau, 2008-2012 American Community Survey. Retrieved from http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml

  • The Kawa Model: Culturally Relevant Occupational Therapy. (2010). Retrieved from: http://individual.utoronto.ca/michaeliwama/index.htm

  • Suarez-Balcazar Y, Rodawoski J, Balcazar F, Taylor-Ritzler T, Portillo N, Barwacz D, Willis C. Perceived levels of cultural competence among occupational therapists. Am J Occup Ther. 2009 Jul-Aug;63(4):498-505. doi: 10.5014/ajot.63.4.498.

    PubMed 19708479
  • Shi L, Lebrun LA, Tsai J. The influence of English proficiency on access to care. Ethn Health. 2009 Dec;14(6):625-42. doi: 10.1080/13557850903248639.

    PubMed 19953393
  • Sentell T, Braun KL. Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California. J Health Commun. 2012;17 Suppl 3(Suppl 3):82-99. doi: 10.1080/10810730.2012.712621.

    PubMed 23030563
  • Schier JS, Chan J. Changes in life roles after hand injury. J Hand Ther. 2007 Jan-Mar;20(1):57-68; quiz 69. doi: 10.1197/j.jht.2006.10.005.

    PubMed 17254909
  • McLeod, S. (2008). Likert scale. Retrieved from http://www.simplypsychology.org/likert-scale.html

  • Lion KC, Mangione-Smith R, Martyn M, Hencz P, Fernandez J, Tamura G. Comprehension on family-centered rounds for limited English proficient families. Acad Pediatr. 2013 May-Jun;13(3):236-42. doi: 10.1016/j.acap.2012.12.002. Epub 2013 Mar 13.

    PubMed 23491584

Questions about this trial

What is this clinical trial studying?

An observational study of Communication Barriers and Occupational Therapy, run by Rush University Medical Center.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 May 2017. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pre-Occupational Therapy Satisfaction Survey (time frame: Baseline). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03149276, which also lists 36 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 May 2017.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in