PICOT and Purpose
PICOT statement is as follows: Adult hypertensive patients whose language is Akan, an African language. (P) Could providing written treatment education materials in their primary language Akan (I) be more effective than using an interpreter, (C) Leading to improved controlled blood pressure (O) and avoiding possible complications associated with the disease progression and preventing mistrust between healthcare providers and patients (T) over a period of 4 months. The purpose is to evaluate the effectiveness of written treatment education materials for Akan-speaking patients.
Setting, Subjects, and Consent
It is important to note that the setting involves Montefiore Medical Center, which translates to a clinical setting. The potential subjects include adult hypertensive patients whose language is Akan, an African language. Access will be provided after the consent form is signed by the participants. The latter is necessary because patients’ personal health data will be used to make the comparative measurements between the efficacy of the written treatment education material and interpreter on the basis of blood pressure and level of trust.
Timeline
The timeline will be comprised of five consecutive steps, and the entirety of the project will be completed in five months. The first step is to obtain consent from the participants by informing them about the risks, benefits, and need for personal health data on blood pressure, as well as surveying them about trust in the initial week. The second step is to provide the written treatment education materials to healthcare providers in order to ensure the equal use of an interpreter in both predetermined groups the following week. The third step is to collect the data about the current level of trust in healthcare providers among patients and blood pressure measurements during the next week. The fourth step is to enable the observation of subjects across a four-month period. The last step is to collect data about two measurement metrics with subsequent comparative analysis a week after the observation.
Budget and Resource List
Since Montefiore Medical Center already has interpreters, only written treatment education materials will be needed as a fiscal expense unrelated to human resources. In the case of the latter, an Akan expert will be hired for the entire duration of the project, and a cardiologist will be hired as well to conduct the measurements of blood pressure. A physician’s involvement will be necessary in the assessment in order to provide additional information about the state of hypertension among the patients.
All supplies and equipment will be provided by Montefiore Medical Center after the administration provides permission to use them within a specified timeline. It is estimated that it will require $6000, whereas the written treatment education material will be developed by a physician and Akan expert. The creation of the easy-to-use hardcopy of the final material will cost $3500. However, the majority of costs will be allocated to professionals. A physician will be involved in three separate occasions for $5000, which will include initial and final assessment as well as the development of the written treatment material. A cardiologist will conduct the blood pressure measurements in two instances for $10000 at the beginning and the end of the observation. The center’s interpreter will be hired to partake in the project for $5000 as a standard control group factor. Lastly, the researcher will be tasked with other analytical and presentation-related works for which the compensation will be $10000. Detailed resourcing and budgeting details can be accessed in Table 1.
Table 1
Research Project Design
A quantitative study design will be selected because the comparison requires precise measurements, which can be conducted through blood pressure values and trust level scores. When it comes to nursing-related studies, “the guidance provided by current mixed-methods research is inconsistent and incomplete, and this compounds the lack of available direction” (Bressan et al., 2017, p. 2878). In other words, such studies should either choose qualitative or quantitative designs, and the comparison will be more accurate with numerical data. The effectiveness will be evaluated with a one-way analysis of variance, which is useful in determining the significance of differences (Moore, 2021). These assessments will be conducted by the main researcher of the project.
Methods and Instruments
The methodological framework will involve the measurement of blood pressure with a sphygmomanometer, which will be provided by the cardiologist. The level of trust of patients towards their healthcare providers will be analyzed with the use of a simple questionnaire. The differences between initial and final measurements will be compared by the use of a one-way analysis of variance. Thus, the proposed solution will be monitored through these three metrics.
Intervention Delivery
The process of delivering the intervention will be conducted within the second and fourth steps of the timeline. In the case of the former, it is important to provide a brief training session for the healthcare workers since the written treatment education material will be a novelty within the care provision protocol. The first group of Akan-speaking subjects must be given the written form of treatment, whereas the second group will work with an interpreter. During the fourth step, the center will provide its services in a regular and established manner with an addition of the written treatment education material.
Stakeholders
It is important to note that the key stakeholders are Akan-speaking patients and Montefiore Medical Center’s administration or management. Other important stakeholders will involve the cardiologist, interpreter, physician, Akan expert, and the researcher. The beneficiaries of the research will be the center, patients, and healthcare professionals, where improved patient outcomes will directly benefit the former two, and the latter will obtain a more effective method of communication.
Barriers, Challenges, and Strategies
The potential barriers will be the refusal of participation by any of the essential healthcare professionals. In other words, the team involved in the research project will need to be willing to do additional work for the pay offered. The center’s management might also refuse or limit what they can provide in terms of equipment, supplies, and personnel. These challenges will be overcome with the use of an interprofessional collaborative approach focused on organizing their input in a structured format (Al Shamsi et al., 2020). It is stated that the given strategy is effective in improving adherence to the recommended practices and functional status among patients (Reeves et al., 2017). The former part is critical since healthcare providers in the experimental group must stick to the written treatment educational resource. Another critical part is to minimize unnecessary interactions between various health experts involved in the project to eliminate potential points of conflict, which means that conflict avoidance is appropriate in this case. Thus, the strategies are interprofessional collaboration when avoidance is impossible.
Feasibility
The implementation plan is feasible as long as Montefiore Medical Center agrees to make the necessary arrangements. Since the health experts and Akan experts will be compensated, their engagement is likely, and the latter is true for the center due to their interest in providing better care. However, the certainty of the plan can be impacted by low participation by Akan-speaking patients because they already comprise a rather small portion of the total patient base.
References
Al Shamsi, H. Almutari, A.G., Al Mashrafi, S., &Al Kalbani, T. (2020) Implications of language barriers for healthcare: A systemic review, Oman Medical Journal, 35(2), 1-9. Web.
Bressan, V., Bagnasco, A., Aleo, G., Timmins, F., Barisone, M., Bianchi, M., Pellegrini, R., & Sasso, L. (2017). Mixed-methods research in nursing – A critical review. Journal of Clinical Nursing, 26(19-20), 2878–2890. Web.
Mackie, H., Macmillan, A., Witten, K., Baas, P., Field, A., Smith, M., Hosking, J., King, K., Sosene, L., & Woodward, A. (2018). Te Ara Mua – Future Streets suburban street retrofit: A researcher-community-government co-design process and intervention outcomes. Journal of Transport & Health, 11, 209–220. Web.
Moore, W. L. (2021). Does faculty experience count? A quantitative analysis of evidence-based testing practices in baccalaureate nursing education. Nursing Education Perspectives, 42(1), 17-21. Web.
Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 6, 1-50. Web.