Alejandra Casillas, MD, MSHS Awarded National Institute for Minority Health and Health Disparities Grant to Pilot Telehealth Interventions for Limited English Proficient Patients
Dr. Casillas' K23 will study telemedicine use in the Los Angeles County Department of Health Services (LAC DHS), the second largest safety net system in the United States. The study will focus on a particularly vulnerable population with need for frequent, interval care: patients with diabetes mellitus (DM), of which 62% are limited English proficient (LEP) Spanish-speakers. The K23 proposal will use quantitative (Aim 1) and qualitative (Aim 2) methods to investigate factors affecting telemedicine use among English and Spanish speakers. In partnership with the LAC DHS Virtual Care Workgroup, the study's analyses will inform the tailored design of a Spanish/English patient health coaching intervention to increase and facilitate telemedicine use (Aim 3a) and conduct a pilot/feasibility study of the bilingual intervention (Aim 3b).
These aims will be achieved using an NIMHD-driven conceptual framework, rigorous mixed methods, and implementation science to address the NIMHD research priority areas of developing interventions that improve access to care for vulnerable patients and reducing health disparities. The research is novel given the timely focus on telemedicine implementation for vulnerable patient populations, specifically LEP patients with diabetes, and the proposed use of mixed methods to develop a stakeholder-engaged intervention. The proposed studies are informed by Dr. Casillas’ role as a primary care physician and her patient portal research experience in diverse, urban primary care settings. Dr. Casillas’ long-term goal is to develop interventions that reduce digital health disparities, increase health access, and improve health outcomes for racial/ethnic minority and LEP patients. During the course of this award, Dr. Casillas will undertake didactic and experiential training to improve knowledge and skills in three areas: (1) mixed methods in digital health disparities research, (2) telemedicine delivery in the safety net, and (3) design and evaluation of interventions in real-world clinical settings using implementation science methods.
Dr. Casillas has assembled a multi-institutional mentorship team of academic and health system stakeholders with the complementary expertise to ensure successful completion of the proposed research and training and successful transition to independence. This K23 will position Dr. Casillas, as an early career investigator, to use her findings from the Aim 1 telemedicine trends EHR analyses, Aim 2 telemedicine patient experiences, and Aim 3 intervention development and evaluation, to develop future NIMHD-R01 studies to improve use of telemedicine and other digital strategies for multilingual and multiethnic populations with chronic conditions.