Mobile Video Interpretation to Optimize Communication Across Language Barriers

NCT05591586 | Active Not Recruiting

• 1 other identifier: STUDY00003332
• Study Type: interventional
• Target: 6,669
• Locations: 1 country
• Sites: 1

Brief Summary

Patients and families with limited English proficiency (LEP) and/or who use a language other than English for medical care (LOE) experience substantial barriers to communication in the healthcare setting, leading to medical care that is less safe, less efficient, less effective, and inequitable. Professional interpreter use has repeatedly been shown to improve outcomes and reduce disparities, yet it remains widely underused. This study will test two discrete, scalable implementation strategies for improving professional interpreter use in primary care, while collecting detailed information about mechanisms of action and costs that will be applicable to many sites of care and contribute meaningfully to the goal of reducing communication-based disparities. The investigators hypothesize that improving provider knowledge, confidence, and interpreter access will change behavior under real-world conditions.

Conditions

Limited English Proficiency

Outcome Measures

Primary Outcomes (1)

• Interpreter Use per Clinic Visit with Patient with LOE

  Dichotomous variable per visit for patients with a language other than English (LOE), constructed by matching professional interpreter vendor invoices to LOE clinic visits with enrolled providers; calculated overall and as assigned (e.g., mVI for mVI providers).

  at 9 months

Secondary Outcomes (1)

• Patient/Parent Comprehension

  Within 7 days of the clinic visit

Study Arms (2)

Web based educational modules

ACTIVE COMPARATOR

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.

Behavioral: Web based educational modules

Mobile video interpreting access (mVI)

EXPERIMENTAL

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.

Behavioral: mobile video interpreting (mVI) access

Interventions

Web based educational modules BEHAVIORAL

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 6 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 6) 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.

Web based educational modules

mobile video interpreting (mVI) access BEHAVIORAL

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.

Mobile video interpreting access (mVI)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

Providers: * Primary clinical site at a participating clinic * needs interpretation for at least 7 visits per month For LOE population 1 (administrative cohort): * preferred language for care listed as anything besides English or sign language (e.g., ASL) * clinic visit (any reason) during study with an enrolled provider For LOE populations 2 and 3 (survey and interview respondents): * preferred language for care one of the top 7 non-English languages across enrolled clinics (listed in chart and confirmed by research coordinator) * clinic visit for an acute concern (e.g., sore throat, injured ankle, new headaches) during study with an enrolled provider * if patient under age 18, accompanied by a parent or legal guardian For LOE population 4 (video/audio-recording): * preferred language for care listed as anything besides sign language (e.g., ASL) * clinic visit for any reason during study with an enrolled provider * if patient under age 18, accompanied by a parent or legal guardian

Contact the study team to discuss eligibility requirements. They can help determine if this study is right for you.

Sponsors & Collaborators

• Seattle Children's Hospital: lead

Study Sites (1)

Seattle Children's

Seattle, Washington, 98105, United States

Location

Related Publications (1)

• Lion KC, Zhou C, Fishman P, Senturia K, Cole A, Sherr K, Opel DJ, Stout J, Hazim CE, Warren L, Rains BH, Lewis CC. A sequential, multiple assignment randomized trial comparing web-based education to mobile video interpreter access for improving provider interpreter use in primary care clinics: the mVOCAL hybrid type 3 study protocol. Implement Sci. 2023 Mar 13;18(1):8. doi: 10.1186/s13012-023-01263-6.

  PMID: 36915138 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Investigator

Study Record Dates

• First Submitted: September 22, 2022
• First Posted: October 24, 2022
• Study Start: October 24, 2022
• Primary Completion: September 2, 2025
• Study Completion (Estimated): August 31, 2026
• Last Updated: January 23, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)