Developing an audio-based communication tool for NICU discharge of Latino families with limited English proficiency

Sara Munoz-Blanco; Renee D Boss; Lisa Ross DeCamp; Pamela K Donohue

doi:10.1016/j.pec.2021.10.005

Developing an audio-based communication tool for NICU discharge of Latino families with limited English proficiency

Patient Educ Couns. 2022 Jun;105(6):1524-1531. doi: 10.1016/j.pec.2021.10.005. Epub 2021 Oct 9.

Authors

Sara Munoz-Blanco¹, Renee D Boss², Lisa Ross DeCamp³, Pamela K Donohue⁴

Affiliations

¹ Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States. Electronic address: sara.munoz-blanco@utsouthwestern.edu.
² Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States; Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Ave, Baltimore, MD 21205, United States. Electronic address: rboss1@jhu.edu.
³ Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States. Electronic address: lisa.decamp@childrenscolorado.org.
⁴ Johns Hopkins School of Medicine, Department of Pediatrics, 1800 Orleans St., Baltimore, MD 21287, United States; Johns Hopkins Bloomberg School of Public Health, 615N Wolfe St., Baltimore, MD 21205, United States. Electronic address: pdonohu2@jhmi.edu.

PMID: 34674921
DOI: 10.1016/j.pec.2021.10.005

Abstract

Objective: Research shows NICU Latino parents with limited English proficiency (LEP) feel less comfortable asking questions and participating in medical decision-making, which may negatively affect transition to community healthcare. Question prompt lists (QPL), suggested questions sometimes drawn from families and providers, can improve family-centered communication. We explored clinician and parent perceptions to inform development of and pilot a NICU discharge QPL.

Methods: Focus groups with NICU and primary care providers explored perceived educational needs of Latino parents LEP and barriers to effective transition to community healthcare. Semi-structured interviews with Latino parents LEP explored perceptions of knowledge gaps and recommendations to improve the transition process. A Spanish audio QPL for parents and an English written version for providers were developed and pilot tested for acceptability.

Results: Provider focus groups (n = 27) and parent interviews (n = 19) identified themes: decreased parent activation, knowledge gaps, limited-use interpreters, unfamiliarity with healthcare system, and social isolation as barriers to smooth NICU-to-home transition. Providers (n = 11) and parents (n = 10) favored QPL introduction early in NICU admission, finding it useful to improve communication and transition processes for families.

Conclusion: Our QPL may address challenges faced by Latino parents LEP when transitioning home.

Practice implications: QPLs may improve Latino NICU infants' healthcare outcomes.

Keywords: LEP; Latino; NICU; NICU Latino parent; NICU discharge; NICU parent; QPL; Question Prompt List; communication; limited English proficiency.

MeSH terms

Communication
Communication Barriers
Hispanic or Latino
Humans
Infant
Infant, Newborn
Intensive Care Units, Neonatal
Limited English Proficiency*
Parents
Patient Discharge*