Barral Romina L, Clark Nicholas A, Zapata Fernando, Vargas Collado Lines M, Cuevas July Jean, Fernandez Cristina
From the Division of Adolescent Medicine Children's Mercy Hospital and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Mo.; University of Kansas Medical Center, School of Medicine, Kansas City, Kans.
Division of Pediatric Hospital Medicine, Department of Pediatrics, Children's Mercy Hospital and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, Mo.
Pediatr Qual Saf. 2024 Jul 10;9(4):e744. doi: 10.1097/pq9.0000000000000744. eCollection 2024 Jul-Aug.
Disparities exist in access to coronavirus disease 2019 (COVID-19)-related health information. We aimed to close a gap in online traffic between English and Spanish COVID-19-related health information on our institution's publicly-facing website by 50% within ten months.
We used A3 improvement methodology. Outcome measures were the mean monthly difference between English and Spanish COVID-19 online traffic vis-a-vis (1) total webpage views and (2) unique webpage visits. Process measures were stratification of outcome measures by language. Plan-Do-Study-Act cycles included: Recurring advertisements on a local Spanish television station disseminating up-to-date COVID-19 information, including our institution's Spanish COVID-19 online resources, incorporation of QR codes into clinic discharge paperwork linking to institutional Spanish COVID-19 resources, and leveraging social media to expand reach. Control charts assessed impact over time.
There were 1,226,196 total webpage views (369,983 Spanish; 856,213 English) and 1,065,536 unique webpage visits (350,518 Spanish; 715,018 English). Both outcome measures displayed sustained, special cause improvement from a mean monthly difference of 25,397 to 11,321 webpage views (55.4% reduction, June 2021) and 25,066 to 7080 unique webpage visits (71.8% reduction, February 2021) corresponding to special cause improvements in process measures. Improvements were not temporally associated with an intervention but coincided with emergency use approval of the COVID-19 vaccine for children aged 12-15 years (May 2021).
Although our interventions did not directly show improvements in our measures, we noted increased page views of Spanish COVID-19-related health information on our institution's publicly-facing website in times of high demand for linguistically appropriate services, including pediatric vaccine roll-out.
在获取2019冠状病毒病（COVID-19）相关健康信息方面存在差异。我们的目标是在十个月内将本机构面向公众的网站上英语和西班牙语COVID-19相关健康信息的在线流量差距缩小50%。
我们采用了A3改进方法。结果指标是英语和西班牙语COVID-19在线流量在（1）网页总浏览量和（2）唯一网页访问量方面的月平均差异。过程指标是按语言对结果指标进行分层。计划-执行-研究-行动循环包括：在当地一家西班牙语电视台反复播放传播最新COVID-19信息的广告，包括本机构的西班牙语COVID-19在线资源，在诊所出院文件中加入指向机构西班牙语COVID-19资源的二维码，并利用社交媒体扩大覆盖面。控制图评估了随时间的影响。
网页总浏览量为1,226,196次（西班牙语369,983次；英语856,213次），唯一网页访问量为1,065,536次（西班牙语350,518次；英语715,018次）。两项结果指标均显示出持续的特殊原因改进，网页总浏览量的月平均差异从25,397次降至11,321次（减少55.4%，2021年6月），唯一网页访问量从25,066次降至7,080次（减少71.8%，2021年2月），这与过程指标中的特殊原因改进相对应。改进与一项干预措施在时间上没有关联，但与12至15岁儿童COVID-19疫苗的紧急使用批准（2021年5月）同时发生。
虽然我们的干预措施并未直接显示出我们所测量指标的改善，但我们注意到，在对语言适宜服务有高需求的时候，包括儿科疫苗推出期间，本机构面向公众的网站上与西班牙语COVID-19相关的健康信息的页面浏览量有所增加。
