Molina Rose L, Bellegarde Kasey, Long Meghan, Bazan Maria, Moyal-Smith Rachel, Karlage Ami, Schoenherr Karen, Spigel Lauren, DiMeo Amanda, Herencia Yessamin Pazos, Chakraborty Saugata, Guise Jeanne-Marie, Bitton Asaf
Ariadne Labs at Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, 401 Park Dr, 3rd Floor, Boston, MA 02215, USA.
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Kirstein 3, Boston, MA 02215, USA.
PEC Innov. 2024 Dec 25;6:100366. doi: 10.1016/j.pecinn.2024.100366. eCollection 2025 Jun.
Engaging patients in quality improvement and innovation projects is increasingly important, yet challenges persist with involving patients who speak languages other than English. This article presents design activities our team used to engage Spanish-speaking patients and cultural brokers.
To develop a clinician communication tool to enhance patient trust in pregnancy care clinicians, especially among minoritized populations who face language and cultural barriers, using human-centered design (HCD).
We centered end-user experiences, including clinicians, Spanish-speaking patients, and Spanish-speaking cultural brokers, in our design process through multiple feedback sessions and modalities.
We used a HCD process to understand the problem, co-design a tool, and prepare for testing of a clinician tool. Design activities included a critical literature review, user interviews, design principles, solution sketching, rapid cycle feedback with subject matter experts, and field experience with pregnancy clinicians.
We innovated on a widely used clinical communication tool, the Four Habits Model, and developed the Five Habits for Pregnancy Care to support pregnancy care clinicians in building trust by bridging cultural and language differences. We added an equity-focused habit "Pause and Reflect" to bookend the Four Habits. We refined the tool to meet different needs across pregnancy care visits based on feedback from 7 clinicians.
We applied equity principles in a HCD process to understand a problem, co-design a tool, and prepare for testing by engaging with patients and cultural brokers in Spanish. Balancing the differing approaches for designers and researchers yielded important insights for enhancing equitable processes and outcomes in healthcare improvement.
Communication tools designed with and for minoritized populations are critical for improving trust in all patient-clinician dyads during pregnancy care.
让患者参与质量改进和创新项目变得越来越重要，但在让说英语以外语言的患者参与方面仍然存在挑战。本文介绍了我们团队用于让说西班牙语的患者和文化经纪人参与的设计活动。
使用以人为本的设计（HCD）方法开发一种临床医生沟通工具，以增强患者对孕期护理临床医生的信任，尤其是在面临语言和文化障碍的少数族裔人群中。
我们在设计过程中通过多次反馈会议和方式，将最终用户体验（包括临床医生、说西班牙语的患者和说西班牙语的文化经纪人）作为核心。
我们使用HCD流程来理解问题、共同设计工具并为临床医生工具的测试做准备。设计活动包括批判性文献综述、用户访谈、设计原则、解决方案草图绘制、与主题专家的快速循环反馈以及与孕期临床医生的实地经验。
我们对广泛使用的临床沟通工具“四习惯模型”进行了创新，开发了“孕期护理五习惯”，以支持孕期护理临床医生通过弥合文化和语言差异来建立信任。我们添加了一个以公平为重点的习惯“暂停并反思”来衔接四习惯。根据7位临床医生的反馈，我们对工具进行了完善，以满足孕期护理就诊过程中的不同需求。
我们在HCD流程中应用公平原则，通过与说西班牙语的患者和文化经纪人合作来理解问题、共同设计工具并为测试做准备。平衡设计师和研究人员的不同方法，为改善医疗保健改进中的公平流程和结果提供了重要见解。
为少数族裔人群设计并供其使用的沟通工具对于在孕期护理中提高所有患者与临床医生二元组之间的信任至关重要。
