Spanish-Speaking Caregivers' and Clinicians' Perspectives on Barriers to Equitable Asthma Care: A Qualitative Study

Authors

Mickey A. Emmanuel, Children's National Hospital.
Eden Efrem, Center for Translational Research.
Eileen Engh, Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, DC.
Michael Ruiz, Department of Nursing Science, Professional Practice, and Quality, Children's National Hospital, Washington, DC.
Meleah Boyle, Department of Pediatrics, The George Washington University.
Asha S. Payne, Children's National Hospital.
Denice Cora-Bramble, Department of Pediatrics, The George Washington University.
Monika K. Goyal, Children's National Hospital.
Pamela S. Hinds, Department of Pediatrics, The George Washington University.

Document Type

Journal Article

Publication Date

7-21-2025

Journal

Pediatric emergency care

DOI

10.1097/PEC.0000000000003451

Keywords

asthma; health equity; language equity

Abstract

BACKGROUND AND OBJECTIVES: Asthma is one of the most common chronic diseases of childhood, with notable racial and ethnic disparities in the United States. Spanish-speaking families experience barriers to receiving quality asthma care. No studies have concurrently explored the perspectives of Spanish-speaking caregivers and clinical staff on the delivery of equitable asthma care in the pediatric emergency department. METHODS: This qualitative study was conducted at a single urban, pediatric emergency department located within a tertiary care, freestanding children's hospital. We facilitated 2 focus groups between June 2022 and July 2022, one consisting of Spanish-speaking caregivers and one of emergency department clinical staff. Each 60-minute focus group was conducted and recorded through Zoom, transcribed verbatim, and coded using thematic analysis by teams of 2 study team members. RESULTS: Focus groups included a total of 9 Spanish-speaking caregivers and 7 clinical staff. Seven themes emerged in the Spanish-speaking group and 6 themes in the clinical staff group. Overlapping themes across groups were those regarding delays in care, desiring accuracy in communication and value in bilingual providers. Notable unique themes to Spanish-speaking caregivers were perceived discrimination toward Spanish-speaking families and the importance of tone when communicating. CONCLUSION: In this qualitative study, Spanish-speaking caregivers and clinical staff identified several barriers to equitable asthma care for Spanish-speaking families in the emergency department. This study creates a foundation for future work that can improve care, communication and mitigate inequities in asthma care for Spanish-speaking families in the emergency department.

APA Citation

Emmanuel, Mickey A.; Efrem, Eden; Engh, Eileen; Ruiz, Michael; Boyle, Meleah; Payne, Asha S.; Cora-Bramble, Denice; Goyal, Monika K.; and Hinds, Pamela S., "Spanish-Speaking Caregivers' and Clinicians' Perspectives on Barriers to Equitable Asthma Care: A Qualitative Study" (2025). GW Authored Works. Paper 7560.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7560

Department

Pediatrics