Do Standardized Scripts Improve Interpreter Use by Spanish-Speaking Patients?

Patients with limited English-proficiency (LEP) who need but do not receive interpreters have lower satisfaction and poorer understanding. A knowledge gap remains regarding the optimal way to offer interpreters. Using standardized scripts, we will determine whether the questions we use to offer interpreters increase utilization. Pilot prospective cohort study of postpartum mothers with LEP. Subjects were assigned one of three unique scripted question offering an interpreter. Data were analyzed using ANOVA, chi-square test, and Fisher's exact test. Fifty-five LEP patients were randomized into three study arms with similar sociodemographics. Overall interpreter use was 80% (44/55). There was a significant difference in interpreter utilization: 82.4%, 63.6%, 100%, respectively by arm (p = 0.015). Highest interpreter utilization occurred with "In what language do you prefer to receive your medical care?". There is opportunity for providers to refine the way they offer interpreters to optimize utilization.

Overcoming cultural barriers to implementing oral HIV self-testing with high fidelity among Tanzanian youth.

Tanzanian youth have high levels of HIV risk and poor access to HIV-testing. Oral self-implemented testing (Oral-SIT) provides an alternative that reduces barriers to HIV-testing. We examined adaptations to Oral-SIT training components in a randomized experiment to evaluate a "train-the-trainer" strategy for improving comprehension of graphic training materials. Participants (N = 257, age = 14-19 years) were randomly assigned to one of two self-training conditions: graphic instruction book (GIB) or Video-GIB. Outcomes included behavioral performance fidelity, self-reported comprehension, and intentions to seek treatment. Video-GIB participants, relative to GIB-only participants, had higher performance fidelity scores, made fewer performance errors, had better instruction comprehension, and were more likely to intend to seek treatment. Oral-SIT timing errors were significantly more common among GIB-only participants. Graphic training materials in conjunction with a "train-the-trainer" video has significant potential for increasing Oral-SIT's reach by overcoming technological and literacy barriers.