613 - A Qualitative Investigation of Caregiver Communication Preferences and Disparities by Primary Language in a Level IV Neonatal Intensive Care Unit

Effective communication between clinical providers and infant caregivers is vital to family centered care and engagement in the neonatal intensive care unit (NICU). Infants in the NICU often have complex medical needs and prolonged length of stay, leading to challenges maintaining effective and consistent communication, particularly for families with Limited English Proficiency (LEP). Despite the importance of communication, little is known about caregivers’ experiences and preferences for communication with NICU providers, nor is it understood how these preferences may vary for parents with LEP.

Objective:

The objective of this qualitative study is to understand caregiver preferences for communication and determine the facilitators and barriers to effective parent-provider communication in a level IV NICU.

Design/Methods:

In this phenomenology qualitative study of caregivers of infants admitted to a level IV NICU, parents were eligible to participate if they had an infant currently admitted for >7 days and reported a primary language of English or Spanish. Interviews were conducted using a semi-structured interview guide that sought to understand the lived experience of parents communicating with doctors and neonatal nurse practitioners (NNPs). The interview guide was developed to understand facilitators and barriers to perceived adequate communication, experiences with communication-related technology, and preferences for mode and frequency of communication. Themes from coded interview transcripts were identified using inductive thematic analysis.

Results:

Fifteen interviews were conducted in participants’ primary language. The mean gestational age of infants whose parents participated was 33 weeks (range 23w-38w), with 33% (5/15) inborn. 20% (3/15) of interviews were completed with Spanish-speaking parents. The five themes that emerged from the analysis were: personal connection matters, parents prefer that communication about clinical changes comes from doctors/NNPs, caregivers want to be updated daily, technology is being used to augment communication, and challenges exist in updating parents with LEP in their primary language (Table 1).

Conclusion(s):

In this qualitative study, we identified several parental preferences for communication from providers and demonstrate disparate experiences for caregivers with LEP. Future work should focus on developing interventions that address individual-, unit-, and systems-level factors that influence parent-provider communication, particularly with parents with LEP, in order to equitably improve parental experience and engagement in the NICU.