Mobile Video Interpretation for Limited English Proficiency

(mVOCAL Trial)

Overseen By Casey Lion, MD, MPH

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Seattle Children's Hospital

Disqualifiers: English speakers, ASL users, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve healthcare communication for patients who prefer languages other than English. It tests two strategies: mobile video interpreting, which provides real-time language translation via video on personal devices, and web-based educational modules for providers. These strategies help healthcare providers use professional interpreters more effectively, leading to safer and more effective care. Individuals who frequently need interpretation during medical visits and prefer a language other than English might be a good fit for this trial. As an unphased trial, this study offers the chance to contribute to innovative solutions that enhance healthcare communication for diverse language speakers.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these strategies are safe for improving interpreter use in healthcare?

Research has shown that mobile video interpretation (mVI) in healthcare helps families with limited English proficiency better understand their child's health issues, improving safety and communication. Although some studies have mentioned problems with video-based telehealth, such as technical glitches, no specific evidence indicates that mVI causes harm when used for interpreting.

Direct safety data for the web-based educational modules is not available. However, these modules aim to improve communication skills and teach effective interpreter use, which should enhance the safety of healthcare interactions.

In summary, mobile video interpretation is generally well-received and aids in better understanding of medical information. The educational modules aim to enhance this by training healthcare providers. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these methods for improving communication with patients who have limited English proficiency because they leverage modern technology to enhance understanding and accessibility. The mobile video interpreting (mVI) offers real-time interpretation via a personal device, making it more convenient and potentially more effective than traditional in-person or telephonic interpretation services. On the other hand, the web-based educational modules provide interactive and tailored content to healthcare providers, increasing their ability to communicate effectively by teaching them the nuances of working with interpreters. Both approaches aim to reduce communication barriers, improve patient outcomes, and address disparities in healthcare access for non-English speakers.

What evidence suggests that this trial's treatments could be effective for improving communication for patients with limited English proficiency?

Research has shown that professional interpreters help patients who don't speak English well. In this trial, one group of participants will use mobile video interpretation (mVI), which allows real-time video communication to effectively bridge language gaps. This method can enhance patient experiences and communication during medical visits. It ensures correct interpreter use for patients with limited English, reducing disparities in care. By providing easy access to interpreters, mVI aims to make healthcare safer and more effective for everyone involved. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for patients and families who prefer to communicate in a language other than English or sign language during medical care. They must visit a participating clinic, have an acute concern like a sore throat, and if under 18, be with a parent or guardian. Providers need to work at least 40% full-time and require interpretation often.

Inclusion Criteria

Providers: Primary clinical site at a participating clinic needing interpretation for at least 7 visits per month

I prefer a language other than sign language and will visit the clinic with an enrolled provider. If I'm under 18, I'll be with a parent or guardian.

My preferred language is one of the top 7 non-English languages, and I visited the clinic for an acute issue.

Timeline for a Trial Participant

Phase 0

Enrollment of primary care providers and baseline data collection

15 months

Baseline survey and interview

Phase 1

Randomization and implementation of strategies with data collection

9 months

Weekly and monthly follow-ups

Phase 2

Continuation and adjustment of strategies with ongoing data collection

9 months

Regular check-ins and interviews

Phase 3

Final data collection and development of sustainment plans

9 months

Final survey and interviews

Phase 4

Analysis and dissemination of results

18 months

What Are the Treatments Tested in This Trial?

Interventions

• Mobile Video Interpretation
• Web-based Educational Modules

Trial Overview The study tests two strategies: web-based educational modules for providers and mobile video interpreting (mVI) access for non-English speakers. It aims to improve the use of professional interpreters in primary care, hoping this will lead to safer and more equitable healthcare.

How Is the Trial Designed?

Group I: Mobile video interpreting access (mVI) Experimental Treatment 1 Intervention

This strategy will involve giving assigned providers access to mobile video interpreting (mVI) on a personal device, installation and support as needed, a tip sheet, and an extra charger, optional shock-resistant case, disposable antimicrobial sleeves, and a positioning stand to support use of their personal device for clinical care. mVI-assigned providers can opt for a study-issued smartphone in lieu of using their own. Access to mVI is achieved by downloading the application from the relevant location (e.g., Apple App Store), then entering an access code that links to a billing account. The study staff would then demonstrate use and answer questions. Technical support will be offered in-person following randomization; we will then email mVI-assigned providers weekly for the first month, then monthly, to offer additional support. A tip-sheet will be sent via email during the first week of the study that will include mVI instructions and best-practices.

Group II: Web based educational modules Active Control 1 Intervention

This strategy will consist of 6 web-based modules, clinic-specific interpreter access information, and 4 booster modules, all delivered via the internet. The online modules will cover 5 topics: 1) the importance and fundamentals of good communication; 2) the importance of professional interpreter use and disparities for LEP populations; 3) how to use an interpreter effectively; 4) what to do when the encounter is not going well; and 5) special challenges and solutions related to remote interpreter use. Modules will be interactive, with tailoring to the learner, and each will be \<15 minutes long. All modules will be available at once, but assigned providers will be prompted to view a new one each week. Every month for months 3-6 after randomization, a booster module will be released. The brief (\<10 min) boosters will review crucial points from initial modules and feature video vignettes. Providers will be reminded to view these weekly until they are complete.

Who Is Running the Clinical Trial?

Seattle Children's Hospital

Lead Sponsor

Trials

319

Recruited

5,232,000+

Published Research Related to This Trial

In a study involving 241 Spanish-speaking patients and 24 health providers, in-person medical interpretation was rated significantly higher by providers and interpreters compared to remote methods, although patients rated all methods equally.

Providers and interpreters preferred video conferencing over telephone interpretation for remote services, highlighting potential concerns about miscommunication in phone interviews due to the lack of visual cues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing in-person, video, and telephonic medical interpretation. Locatis, C., Williamson, D., Gould-Kabler, C., et al.[2022]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05591586

Mobile Video Interpretation to Optimize Communication Across ... Patients and families with limited English proficiency (LEP) and/or who use a language other than English for medical care (LOE) experience substantial ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11082683/

Telehealth Experience Among Patients With Limited ... This cross-sectional study assesses the implication of patients' English language skills for telehealth use and visit experience.

3. withpower.com withpower.com/trial/phase-limited-english-proficiency-9-2022-93b31

Mobile Video Interpretation for Limited English Proficiency ... Mobile video interpretation is unique because it allows for real-time communication with patients who have limited English proficiency through video, which can ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8677944/

Improving Equity of Care for Patients with Limited English ... The aim was to eliminate gaps by increasing appropriate interpreter use and documentation (AIUD) for Spanish-speaking LEP (LEP-SS) patients from 35.7% baseline.

5. sciencedirect.com sciencedirect.com/science/article/pii/S073839912500134X

Effectiveness of interpreters and other strategies for ... Abstract. Objective. To examine the effectiveness of different communication strategies for mitigating language barriers on patient-, provider- and context- ...

6. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK597805/

Potential Harms Resulting From Patient-Clinician Real-Time ... Fourteen studies reported on adverse events or unintended effects of real-time use of video-based telehealth. Adverse events such as death, surgery, infection, ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7488494/

Factors influencing the use of video interpretation ... This study has identified a range of factors that are perceived to influence the use of interpreters in hospitals.

8. jamanetwork.com jamanetwork.com/journals/jamapediatrics/fullarticle/2463124

Effect of Telephone vs Video Interpretation on Parent ... Families with limited English proficiency who received video interpretation were more likely to correctly name the child's diagnosis and had fewer lapses in ...

9. globalinterpreting.com globalinterpreting.com/blog/the-critical-role-of-interpretation-services-in-patient-outcomes/

The Link Between Interpretation and Better Health Outcomes The impact of language services on healthcare directly affects patient safety, understanding, and satisfaction. Recent studies by Ju (2021) and Schlange et al.

10. martti.io martti.io/articles/understanding-vri

Understanding VRI: Video Remote Interpretation - Martti Communication errors can have serious consequences in a medical setting. Patients need to understand their diagnoses, treatment options, and ...