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.
