P0687 - Perceptions and Experiences of Latinx Parents with Language Barriers in a Pediatric Emergency Department: A Qualitative Study

Background
There is evidence that language barriers are associated with differences in diagnostic testing and clinical interventions in clinical settings. Understanding the family’s point of view can help target areas of improvement for reducing disparities, especially within a non-traditional destination area (NDA). The purpose of this qualitative study was to explore the perceptions and experiences of Latinx families with language barriers regarding their care after a PED visit with their child for respiratory complaints.

Methods
We performed a qualitative study of Latinx parents who presented to the PED with their 0-2 year-old child who was diagnosed with a viral upper or lower respiratory illness. Latinx parents were included in the study if they had a preferred language of Spanish and a Spanish interpreter was requested during registration. We used a purposeful, convenience sample via recruitment in the PED or over the phone if a family had already been discharged from the PED. We conducted semi-structured, in-depth, one-on-one qualitative interviews from May 2019 through January 2020. All interviews were conducted via telephone, and interviews were audio-taped then translated and transcribed. All transcripts were reviewed by the research team using a thematic analysis.

Results
Interviews were conducted with 16 Latinx parents (15 mothers, 1 father). The length of interviews ranged from 11 minutes to 26 minutes (median, 20 minutes). Most pediatric patients were male (Table 1). Thematic analysis revealed four major themes regarding parent perceptions and experiences in the PED: (1) Uncertainty - fear and uncertainty regarding how to care for a child with distressing symptoms, (2) Communication – the presence of in-person interpreters enhanced communication, allowing parents to feel more informed, (3) Resources - unfamiliarity with the US health system and lack of resources are additional burdens, (4) Closure - despite limited understanding, “successful” visits garnered confidence and provided parents with needed reassurance (Table 2).

Conclusions
This qualitative study explored the perceptions and experiences of Latinx families after a PED visit within a NDA. All the interviewed families were fearful of their child’s illness, but they appreciated being informed via an interpreter and felt reassured by the end of the PED visit. However, families did have difficulty navigating the health system. The PED can be a key area of the health system that can help reduce disparities among the Latinx population within a NDA. Further areas of intervention should focus on support beyond providing access to an interpreter, such as identifying potential provider bias, improving information delivery, and enhancing education on community resources for families who face language barriers in the PED.