JMIR Publications

ABSTRACT

Background:

Automated telephone self-management support (ATSM) programs, which rely on patient activation, have improved outcomes among individuals with chronic disease. It is not clear whether ATSM programs are similarly applicable to limited English proficient (LEP) patients compared to English proficient patients.

Objective:

This study was conducted to evaluate whether automated telehealth interventions could be used effectively in both English speaking and LEP patients.

Methods:

We assessed patient engagement with health and change in systolic blood pressure (SBP) among limited (vs. adequate) English proficient participants of an ATSM pilot trial for CKD patients. Patient engagement was defined by self-reported use of educational materials, completion of a health coaching action plan, and duration of automated phone calls.

Results:

Of 137 study participants, 53 (38.7%) reported LEP. While LEP and English speaking patients similarly used the program’s educational materials (82% vs 87%, p= 0.69) and completed an action plan (81% vs 74%, p=0.49), participants with LEP had significantly longer average call duration (P<0.01), potentially indicating higher patient engagement. LEP patients had a larger, though non-statistically significant, change in SBP (-4.5 mmHg CI [-9.4, 0.3]) compared to English proficient patients (-2.1 mmHg CI [-8.6, 4.3]).

Conclusions:

LEP patients with CKD were equally or more engaged with a language concordant telehealth intervention compared to their English-speaking counterparts. Augmented telehealth may be useful in engaging LEP patients in their health. Clinical Trial: NCT01530958