Creating a Tool to Assess Interpretive Services Perceptions at a Hospital System Level.

The importance of using professional interpretive services (IS) when communicating with patients and families with limited English proficiency (LEP) is well described in the literature. There is no standardized tool to reliably evaluate IS from the point of view of bedside care providers. Collected local qualitative data and literature review informed an anonymous electronic survey that was distributed to physicians and nursing staff at a tertiary care children's hospital. Authors then used exploratory factor analysis to analyze results. Survey response rate was 27%. Seven key factors were identified; the original survey was revised using the two most impactful questions contributing to each factor. Re-analysis showed Pearson correlation coefficients at or above 0.9. Using this simplified 14 question questionnaire, hospital systems can assess the knowledge, attitudes, self-reported utilization and perceived barriers around IS, allowing for targeted interventions to improve the care of LEP patients.

Access to Care for Children under five in Oklahoma: a Geographic Imputation Application.

OBJECTIVE: Geographic access to primary care can be a barrier to receiving appropriate preventative services. Oklahoma has been identified as having relatively few primary care providers per capita to care for its population compared to the US. The goal of this analysis was to identify the areas in Oklahoma with significant concentrations of children under five, no pediatrician within reasonable driving distance, and whether other primary care providers are present. METHODS: The 2016 American Community Survey was used to estimate the total population of children under five years of age for each Census Block Group in Oklahoma. Access was defined as a thirty-minute drive time radius computed around each child's imputed location. The National Provider Identifier database was used to identify and locate pediatricians, family medicine physicians, and mid-level providers in Oklahoma. Areas of high concentrations of children with no pediatrician access were identified and non-pediatrician provider locations were superimposed. RESULTS: Of the estimated 265,818 children under five in Oklahoma, approximately 7% were outside of a thirty-minute drive from a pediatrician. These children are concentrated in northwestern and southeastern Oklahoma, with several smaller additional groupings. There are multiple non-pediatrician primary care providers operating in many of these areas. CONCLUSION: There are areas in the state where a paucity of pediatricians and high concentrations of young children lend themselves to collaborations using technology and education to improve the care of children.

Implementation of Reach Out and Read by Health Departments Increases Rural Access.

BACKGROUND: Reach Out and Read is an evidence based early literacy program used in primary care practices. In 2014, the program expanded to County Health Departments in Oklahoma. OBJECTIVE: To evaluate how implementation of the program in Health Departments affects access for at risk children. METHODS: Oklahoma program sites were classified as either Health Department or practice, geocoded, and mapped to census tract, census block group, and county subdivision maps. Sites were classified as rural or urban, and census data was used to classify sites as high or low poverty prevalence and education level. Sites were compared to determine their accessibility to at risk children as defined by living in rural areas, high poverty, and low educational level. RESULTS: There were 18 Health Department and 67 practice sites. Health Department sites were more likely to be in rural areas: 13 of 18 sites versus 16 of 67 practices (p<0.001). They were less likely to be in areas of high poverty: 10 of 18 versus 61 of 67 practices (p<0.001), and they were not more likely to be in areas of lower education, with 8 of 18 sites in low education areas versus 34 of 67 practices (p=0.8342). CONCLUSIONS: Implementation of Reach Out and Read in Health Departments in Oklahoma increased the number of rural program sites. Health Department locations were less likely to be in areas of poverty and lower education. Use of the program in Health Departments is an effective way to expand the program to serve rural children.

Abusive head trauma in Spanish language medical literature.

Anecdotal experiences raise concerns that abusive head trauma (AHT) is significantly underdiagnosed and perhaps poorly recognized in Latin American settings. With increasing interest in international collaboration in pediatrics, differences in perspectives regarding complex diagnoses should be explored to facilitate a productive exchange of knowledge and ideas. The purpose of this study was to describe the medical literature pertaining to AHT available to physicians who read only in Spanish. In this review, LILACS, SciELO (major Spanish language databases) and Pubmed were searched with appropriate terms and filters in English, Spanish, and Portuguese for Spanish language articles on AHT. Identified articles' reference lists were then examined for possible additional articles on AHT. All relevant articles were sorted by country and examined for article type and content. Thirty-four unique articles were located for review from 8 of 21 countries. Most of the articles identified were case reports, case series, or educational, and there were no studies regarding overall incidence or prevalence of AHT. Some scientific information contained in the articles varied considerably from that in the English language literature in the areas of etiology and preventive strategies. This survey highlights that the Spanish language literature regarding AHT is sparse and variable. This must be considered when working collaboratively in a global setting. Additionally, identification of this gap presents an opportunity for education and information exchange among global medical communities.