Background: When patients speak a different language than their healthcare clinicians, they are more likely than those who speak the same language as their clinicians to receive incorrect treatment, take medications improperly, or feel dissatisfied with their health care. Engagement between limited English proficiency (LEP) patients and healthcare clinicians to plan for patient-centered outcomes research (PCOR) should be patient centered and focus on health care that is appropriate with respect to a patient’s culture and language. While US standards have been developed for providing these services, there has been little research about how to implement them in practice.

Proposed Solution to the Problem: In this project, the team will engage LEP patients and clinicians across a network of primary care practices to: agree on a common approach to doing PCOR that is responsive to LEP patients and the clinicians who serve them; and vet and prioritize a common set of resources that should be included in that approach.

Objectives: The long-term objective of this project is to foster PCOR that benefits LEP patients served by primary care practices. The project’s specific aims are to:

• Expand an existing advisory panel, launched during an earlier series of PCORI Pipeline to Proposal projects, to include clinicians and patients from primary care practices affiliated with the American Academy of Family Physicians National Research Network
• Develop an operational plan to engage and collaborate with clinicians and LEP patients so that they are ready to participate in the codesign of PCOR, monitor its conduct, and share its results widely
• Select training resources and other tools to include in that plan that have potential to be culturally relevant, accessible, and adapted to the needs of practices that serve LEP patients

 Activities:

• Recruit clinicians and LEP patient advocates from seven practices to join the existing advisory panel
• Host a kickoff meeting to train panel members to explore and prioritize project-related issues
• Help participating practices develop a cross-project approach (the operational plan) to conduct PCOR and specify a core set of training or other resources from earlier PCORI studies to use in PCOR
• Complete and share the operational plan widely so it can be used to develop and conduct PCOR studies relevant to primary care practices serving LEP patients

Outcomes: The project’s main outcome will be the completion and publicizing of the operational plan. Also, participating practices will be committed and ready to conduct PCOR relevant to the care of LEP patients.

Patient and Stakeholder Engagement Plan: Project stakeholders include LEP patients, clinicians responsible for their care, and agencies that support the clinics or patients. As well as activities described above, the project team will hold regular advisory panel meetings to monitor progress on project milestones and solve emerging problems. Annually, the team will assess its engagement processes. In year 2, the researchers will meet in person to finalize the operational plan and set priorities for next steps.

Project Collaborators: Seven primary care practices will work on this project together. Each will send representatives to the project’s advisory panel. Experts in the field of patient engagement science will provide technical advice on the project’s engagement methods and process evaluation and connect the team to their own networks of patients, clinicians, and stakeholders.