TOP 48 - Evaluating the Impact of Professional Telephonic Language Interpretation on Therapeutic Alliance in a Pediatric Inpatient Setting

Publication Number: 3777.TOP 48

John McCarthy, The Children's Hospital at Montefiore, Bronx, NY, United States; Nisha Sheikh, The Children's Hospital at Montefiore, New York, NY, United States; Esteban Gamboa, The Children's Hospital at Montefiore, Bronx, NY, United States; Allie Liebmann, Albert Einstein College of Medicine, Bronx, NY, United States; Tanner W. Mercer, Albert Einstein College of Medicine, The Bronx, NY, United States; Anne J. Bolt, Albert Einstein College of Medicine, Madison, NJ, United States; Rithika Sriram, Albert Einstein College of Medicine, EDISON, NJ, United States; Jacob Tabs, Albert Einstein College of Medicine, The Bronx, NY, United States; Brenda I.. Anosike, Albert Einstein College of Medicine, Bronx, NY, United States

Background: Patients with limited English proficiency (LEP) face persistent barriers to equitable healthcare, including higher rates of misdiagnosis, medication errors, and suboptimal disease management-even when professional interpretation is available. While objective outcomes across language concordant groups have been well documented, less is known about how interpretation modality affects caregiver perceptions of therapeutic alliance in pediatric inpatient settings, where communication quality and trust are integral to care and adherence.

Objective: To evaluate the impact of limited English proficiency requiring professional interpretation on Spanish-speaking caregivers' perceptions of therapeutic alliance vs English-speaking caregivers who do not require interpreter services. In addition, the study aims to assess how the modality of professional interpretation-telephonic versus in-person-influences Spanish-speaking caregivers' perceptions of therapeutic alliance.

Design/Methods: This IRB-approved, prospective observational study is being conducted at a large children's hospital in the Bronx, NY. The study enrolls caregivers of pediatric inpatients stratified into three cohorts: (1) English-speaking caregivers, (2) Spanish-speaking LEP caregivers utilizing professional telephonic interpretation, and (3) Spanish-speaking LEP caregivers utilizing professional in-person interpretation.

Participants were recruited during hospitalization and complete the Kim Alliance Scale-Revised (KAS-R) at discharge, a validated measure of therapeutic alliance assessing engagement, communication quality, and provider respect. Surveys and consents were administered in the caregiver's preferred language. Families requiring interpretation were communicated with using the Propio telephonic interpretation service, the same platform utilized by inpatient hospital teams to communicate with LEP patients. The study examined overall caregiver perceptions of therapeutic alliance, with a specific focus on assessing differences based on the modality of professional interpretation-comparing telephonic, app based, and in-person interpreter services among Spanish-speaking caregivers.

Quantitative analyses include descriptive statistics and between-group comparisons using independent t-tests or Mann-Whitney U tests, depending on data distribution. KAS-R scores can be further analyzed based on subgroups involving themes of Integration, Communication, Collaboration, and Empowerment.

Data collection and analysis are ongoing, with study completion anticipated by January 31, 2026.

Kim Alliance Scale - Revised
English language copy of the KAS-R questionnaire used in study.

Telephonic Interpretation Use Data
Metrics of telephonic interpretation use over the course of the year at a large children's hospital in the Bronx, NY.