P2.F118: Exploring the experience of limited English proficiency, Spanish speaking families in the NICU

Purpose/Objectives: Ongoing systemic inequities, including management of language barriers, have led to significant neonatal outcome disparities in the US. Hispanic infants are over-represented in preterm birth and suffer disparately worse outcomes, such as neonatal mortality rates and quality of NICU care, than their White, non-Hispanic counterparts. Language barriers create opportunity for miscommunication, which reduces satisfaction of care, quality of care, and patient safety. Hispanic families are less likely to engage in medical research. Without data on these families’ experiences, we are unable to create successful strategies that can improve this inequitable care and subsequent NICU infant outcomes. The objective of this research will be to elucidate disparities in the NICU experience of limited English proficiency, Spanish speaking parents in Women and Infant’s Hospital NICU, located in Providence, RI where 42.5% of the population is Hispanic/Latino and 48% speak a primary language other than English at home.

Design/Methods: Adults who identify as a parent, guardian, or primary caretaker of a NICU graduate ("parents"), and as limited English proficiency, Spanish speakers were recruited. These parents participated in a recorded focus group on Zoom or a phone interview. Participants were given $15 gift cards. Focus group and interview texts were transcribed, translated from Spanish to English, and analyzed by three members of the research team for thematic patterns. Theme identification was directed by the content of the data and the most prevalent themes were selected. The study is IRB exempt.

Results: Over 30 parents were contacted. Of these, nine parents agreed to participate in the study-- three in a focus group and six via semi-structured interview. Major themes identified from their experience in the NICU were: difficulty in obtaining or properly utilizing translation services; a lack of effort to obtain translation services; shame to advocate for oneself; gratitude for care provided in the US compared to their country of origin; and gratitude masking or delaying parent complaints.

Conclusion/Discussion: Linguistically appropriate care is imperative, particularly in a stressful environment such as the NICU, yet families continue to perceive inequalities of care related to language differences. Access to interpreters, both in person and virtual, is challenging, and should be a focus for improving the care of NICU families whose preferred language is not English.