Translating Anesthesia Care Throughout

Study Overview
=================
Brief Summary
-----------------
Patients with limited English proficiency (LEP) are at significant risk of receiving care different from those who are English proficient. Through Translating Anesthetic Care Throughout (TACT), the investigators aim to reduce the disparities experienced by participants with LEP undergoing anesthesia by continuing language translation from the preoperative area into the operating room, where participants will be better able to understand what is happening in an otherwise foreign environment. At this time, some participants receive translation in the preoperative area using an interpreter. No further translation is provided beyond the preoperative area unless there is a provider with language concordance or interpretation skills within the perioperative team. The investigators plan to study how extended translation changes a participant's understanding of and feelings about the perioperative period. Supporting language translation for LEP participants from the preoperative area into their operating room (OR) experience will enable providers to better understand how to care for participants from different cultural and language backgrounds and will help us understand how to better serve our community at large. The investigators hypothesize that participants who receive continual translation will have improved informed consent, have improved trust of their anesthesia providers, and be more satisfied with patient care. In addition, they anticipate that the care team also will benefit by the enhanced communication with the participant.

Official Title
-----------------
Translating Anesthetic Care Throughout: A Feasibility Randomized Trial

Conditions
-----------------
Limited English Proficiency, Perioperative Care

Intervention / Treatment
-----------------
* Behavioral: Extended translation
* Behavioral: Standard translation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Participants who identify another language other than English as their preferred language Participants with planned general anesthesia Exclusion Criteria: Participants whose preferred language is documented as English Participants with planned sedation or monitored anesthesia care

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>Translator in preoperative area | Behavioral: Standard translation<br>* Translation in the preoperative area<br>|
| Experimental: Intervention<br>Translator in preoperative area, continued through transport to the operating room, and in the operating room until the patient is under general anesthesia | Behavioral: Extended translation<br>* Translation extended beyond the preoperative area<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Informed consent success as assessed by Likert scale | The participant will be asked how well their anesthesia provider prepared them for their general anesthesia experience. A 5-point Likert scale response will be used for the assessment ranging from 1 (not at all) to 5 (extremely well). | One week after general anesthesia | 
| Participant trust as assessed by survey | Participants will be asked whether they trusted their provider(s) using a yes/no response. | One week after general anesthesia | 
| Participant satisfaction as assessed by Likert scale | Participants will be asked whether they were satisfied with their anesthesia experience using a yes/no response. | One week after general anesthesia | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Participant anxiety as assessed by the Amsterdam Preoperative Anxiety and Information Scale | The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a 6-question validated tool used to generate a score to assess a patient's level of preoperative anxiety. Questions 1, 2, 4, and 5 represent anxiety. Each of these questions is assessed with a Likert scale in which 1 rpresents agreement of not at all and 5 represents extremely. Scores from the four anxiety-representing questions are totaled with a possible range from 4 to 20 with a lower score indicating less anxiety and a higher score more anxiety. A score of greater than or equal to 11 signifies participant anxiety. | The day before surgery |