Perceptions and Experiences of Latinx Parents with Language Barriers in a Pediatric Emergency Department: A Qualitative Study

Background: Prior research has shown disparities exist among Latinx children who present to the pediatric emergency department (PED) for respiratory illnesses. Limited data exist regarding Latinx families’ perspectives on healthcare for their children in PEDs within non-traditional destination areas. Their perspective can identify areas of improvement for reducing healthcare disparities among pediatric patients within this population. The purpose of this qualitative study was to explore the perceptions and experiences of Latinx families with language barriers in the PED. Methods: Study staff screened the electronic health records of a purposive sample of patients. Families were considered eligible for the study if they: 1) presented to the PED with their 0-2 year-old child for a respiratory illness, 2) affirmed that their preferred language was Spanish at triage, and 3) requested a Spanish interpreter during registration. Semi-structured, one-on-one qualitative interviews were conducted via telephone, audiotaped, translated, and transcribed. All transcripts were reviewed using a thematic analysis. Results: Interviews were conducted with 16 Latinx parents. Thematic analysis revealed four major themes: (1) Uncertainty - Families expressed uncertainty regarding how to care for a child with distressing symptoms, (2) Communication – Families favored in-person interpreters which enhanced communication and allowed families to feel more informed, (3) Resources – Families reported that the unfamiliarity with the US health system and lack of resources are additional burdens, and (4) Closure – The emergency department visits garnered confidence and reassurance for families. Conclusions: The PED can be a key area of the health system that can help reduce disparities among the Latinx population. Further areas of intervention should focus on support beyond providing access to an interpreter, including identifying potential provider bias, improving information delivery, and enhancing education on community resources for families who face language barriers in the PED.