Evaluating pain communication and understanding in interpreted medical encounters in a pediatric emergency department - Project Summary/Abstract The goal of this application is to support the candidate in developing advanced and specialized skills necessary to build an independent program of research, with a focus on improving the implementation of culturally relevant pain assessment and management for language-diverse patients and families who use interpretation services in pediatric medical settings. The F32 candidate will be a Postdoctoral Research Fellow at the University of California-Irvine Center on Stress and Health (UCI-CSH) which is currently funded by 5-NIH awards (including a K-23) and has an excellent history with mentorship of early career faculty. This application proposes a mixed methods design study to identify sociocultural factors that influence pain communication and evaluate the concordance of pain understanding among multiple stakeholders (caregivers, children, interpreters, and clinicians) in a linguistically and ethnically diverse sample of children 1-6 years old who present to the emergency department (ED) with pain-related complaints. Indeed, millions of children present to the ED setting each year in pain and although current guidelines emphasize the need to address such pain, inadequate pain assessment and management remains prevalent. Latinx children are at a particularly high risk for experiencing pain disparities and Spanish-speaking families are at particularly high risk because of additional linguistic barriers. The first aim of the application calls for a quantitative approach to identify the congruence of pain reporting across all stakeholders (child-parent-interpreter-clinician). The second aim is focused on a qualitative approach to understand the perspective of the stakeholders regarding communication of pain using interpreters. With enthusiastic and material support from UCI-CSH and Children’s Hospital of Orange County (CHOD) ED senior leadership, the project will be conducted in a high-volume pediatric department where a large proportion of patients are Spanish-speaking Latinx and are part of an innovative population health program. The candidate’s training plan capitalizes on the expertise of a highly experienced multidisciplinary mentorship team, integrating key training in pain in the ED, NIMHD Minority Health and Health Disparities Research Frameworks, sociocultural factors in pediatric pain and healthcare disparities, mixed methods research, and professional development. The training plan will incorporate didactic coursework, one-on-one mentoring, and seminars focused on career development, training evaluation and research ethics. UCI-CSH is a highly productive, well-established research environment that incorporates a unique multidisciplinary approach to training and clinical research. UCI-CSH is embedded within CHOC, where the study will be implemented. Collectively, this will provide an exceptional training and research environment to characterize sociocultural contributors to pain in a population at-risk for experiencing care disparities and provide a strong foundation for a Career Development Award focused on developing and piloting an intervention to train diverse stakeholders to improve cross-cultural and cross-linguistic pain communication during interpreted medical encounters.
