Impact of Qualified Bilingual Staff on Emergency Department Research Enrollment

Emergency Department (ED) visits by patients with non-English language preference (NELP) have been increasing. To provide language-concordant care, language interpreter services (LIS) and language certifications are imperative. Within clinical research, these resources can aid in recruiting NELP subjects, ensuring a more diverse sample population. Our objective was to evaluate the performance of recruitment and enrollment done by qualified bilingual staff (QBS) research assistants (RAs) compared to non-QBS RAs using LIS.

We conducted a secondary analysis of 18 months of recruitment data of an ongoing multicenter randomized controlled trial. We included subjects that identified Spanish as their preferred language in their electronic health record, excluding English preferring subjects. Data for the parent study were collected in the Research Electronic Data Capture (REDCap) Database. We compared the proportion of subjects who were approached and successfully enrolled by RA type (QBS vs. RA with LIS) using descriptive statistics and two-sample tests of proportions.

There were 1,299 potential subjects approached across three recruitment sites, by 5 QBS RAs, who approached 822 (63%) NELP subjects, and 4 non-QBS RAs, who approached 477 (37%) NELP subjects. A total of 371 (29%) declined to complete the screening process (QBS: n=283/822, 34%; RAs with LIS: n=88/477, 18%, p<0.001). Of those screened eligible for the parent study (n=464), there was no significant difference between enrollment rates for QBS (n=188/291, 65%) and RAs with LIS (n=105/173, 61%, p=0.40).

Our results support that language-concordant research recruitment can lead to favorable outcomes when enrolling NELP subjects across both strategies. Findings showed that enrollment rates did not differ significantly for QBS and non-QBS RAs. Providing access to language certifications and training researchers to use LIS may improve the inclusion of NELP patients in research. Additionally, language diversification within research teams should continue to be explored.