Funded Projects

Addressing Language Barriers to G-Tube Decision-Making

Project Year

2026

City & State

San Diego, California

Program Name

Resident

Topic

Access/Barriers to Health Care (LHI)

Program Description

Patients and families who are refugees with preferred language other than English (PLOE) face language and cultural barriers that impact their medical care, including increased adverse events and decreased trust in the system. Furthermore, much of the literature and resources focus on Spanish and even less exists for other languages. In San Diego, the top two countries for refugee arrivals are Afghanistan, the official languages being Pashto and Dari, and Haiti, the official languages being Haitian Creole and French. In addition to PLOE, lower rates of literacy can also contribute to difficultly utilizing written resources and understanding medically complex topics, such as gastronomy tubes (G-tubes). In palliative care, words are chosen carefully and specifically during goals of care discussions to best understand and meet the needs of the family. When interpreters are involved, it can add another layer of difficulty. In addition, cultural influences can play a role in families' decisions. The goal of this project is to bridge the language and cultural gaps in refugee and PLOE families during G-tube discussions. The first step will be understanding the needs and barriers through interviews with caregivers who speak Haitian/Creole, Dar, and Pashto and have a child with a G-tube. The interviews will be conducted during home visits with Rady Children’s Palliative Home Care and Enhanced Care Management both of which will serve as community partners. Using interview responses and input from Afghan and Haitian/Creole care navigators a tool will be created, such as a video, to best address the holes that exist among current resources. The effectiveness of this tool will then be assessed through care team and family feedback. The tool will then be implemented into patient care for this specific community. Residents in the UCSD/RCHSD pediatric program while receive training on how and when to use the tool.

Project Goal

Explore and address barriers to G-tube discussions among families who speak Haitian/Creole, Dari, or Pashto and improve future discussions by developing a tool to provide to families. 

Project Objective 1

Assess the experience of learning about and having a child with a G-tube in 10 families who speak either Haitian/Creole, Pashto, or Dari by June 2026. 

Project Objective 2

Use interview responses to guide the development of a language congruent tool that can be used to aid G-tube discussions with families who speak either Haitian/Creole, Pashto, or Dari by August 2026. 

Project Objective 3

Increase the percent of families who speak Haitian Creole, Pashto, or Dari and receive the “Understanding Feeding Tubes” tool during G-tube discussions (inpatient or home-based care) 0% to 30% of families reached by January 2027.

AAP District

District IX

Institutional Name

Rady Children's Hospital 

Contact 1

Kiera Blawn, MD