Project Grant R43MD018240

MIASANO: MOBILE HEALTH APP FOR IMPROVED EVIDENCE-BASED REHABILITATION OUTCOMES AND MULTI-LINGUAL CLINICAL INTERACTIONS - PROJECT SUMMARY THIS SBIR PHASE I PROJECT WILL CREATE A PROOF-OF-CONCEPT APP FOR IMPROVING CLINICAL INTERACTIONS AND USE OF EVIDENCE-BASED PRACTICE BETWEEN PATIENTS AND CLINICIANS WHO MAY HAVE DIFFERENT PREFERRED LANGUAGES. WE CALL OUR PROPOSED APP MIASANO (DERIVED FROM THE PHRASE "MY HEALTH" IN THE ESPERANTO UNIVERSAL LANGUAGE). THE PRIMARY PROBLEM THAT OUR APP ADDRESSES IS THAT PATIENT-REPORTED OUTCOME MEASURES (PROMS) ARE COLLECTED LESS OFTEN IN RACIAL/ETHNIC MINORITIES. PROVIDERS MAY NOT ASK PATIENTS TO COMPLETE PROMS DUE TO LANGUAGE BARRIERS. FOR EXAMPLE, THE PATIENT WOULD NOT BE ABLE TO COMPREHEND A PROM IN ENGLISH AND THE PROVIDER MAY NOT BE ABLE TO EFFECTIVELY COMMUNICATE WITH THE PATIENT ABOUT THE RESULTS. BECAUSE OF THE LANGUAGE BARRIER, PATIENTS MAY BE HESITANT OR SIMPLY UNABLE TO EXPRESS THEIR HEALTH CONCERNS OR STATUS. MANY MEDICAL CLINICS CAN OFFER INTERPRETERS TO ASSIST WITH LANGUAGE BARRIERS, BUT THIS CREATES A RELIANCE ON INTERPRETER AVAILABILITY. WHEN AN INTERPRETER IS PRESENT, THERE IS A POSSIBILITY THAT THE BUSY INTERPRETER CREATES UNINTENTIONAL BIAS WHEN INTERPRETING PROM QUESTIONS OR RELAYING PROVIDER MESSAGES TO THE PATIENT. THESE PATIENT POPULATIONS EXPERIENCE POORER HEALTH OUTCOMES. THIS LEADS TO HEALTH DISPARITIES BECAUSE THEIR HEALTH NEEDS ARE NOT BEING PROPERLY EVALUATED OR UNDERSTOOD AND EVIDENCE-BASED CLINICAL CARE CANNOT TAKE PLACE. FURTHER, MIASANO PROVIDES THE OPPORTUNITY TO BE MORE INCLUSIVE IN RESEARCH STUDIES BY INCLUDING PROMS IN DIFFERENT LANGUAGES. INDIVIDUALS WITH DIFFERENT RACIAL/ETHNIC BACKGROUNDS WOULD BE MORE EASILY INCLUDED TO PARTICIPATE IN SCIENTIFIC RESEARCH THAT USES PROMS. THEREFORE, THE DISPARITY IN RESEARCH INCLUSION WOULD BE REDUCED AND COULD BE ULTIMATELY ELIMINATED THROUGH BETTER REPRESENTATION IN CLINICAL TRIALS AND INCREASED APPLICABILITY OF THE RESEARCH RESULTS. OUR MIASANO APP SOLUTION TO THESE PROBLEMS COMBINES SEVERAL UNIQUE FEATURES: USER APPROPRIATE LANGUAGE SWITCHING WHICH ALLOWS DIRECT AND INSTANTANEOUS COMMUNICATION OF HEALTH OUTCOMES AND STATUS BETWEEN TWO DIFFERENT LANGUAGES, PROVIDING HEALTH ASSESSMENT IN THE PATIENT'S PREFERRED LANGUAGE AND INTERPRETATION OF RESULTS IN THE HEALTH CARE PROVIDER'S PREFERRED LANGUAGE, ALL IN THE SAME APP; TEXT-TO-SPEECH ACCESSIBILITY AND USE OF VISUAL CONTROLS ON THE MOBILE DEVICE WHICH ENHANCES ACCESSIBILITY TO THE PERSONS WHO MIGHT HAVE SOME LEVEL OF ILLITERACY AND WHO PREFER TO COMMUNICATE ORALLY. THE PROMS QUERIES CAN BE DICTATED BY THE MOBILE DEVICE AND THE USER CAN RESPOND BY TAPPING ON THE SCREEN. THE HEALTH CARE PROVIDER RECEIVES THE SAME COMPLETE ASSESSMENT AS IF THE PATIENT HAD BEEN ABLE TO READ; AND DEFINING MEDICAL TERMS WITH POP-UP WINDOWS THAT DISPLAY COMMON LANGUAGE DESCRIPTIONS IS IMPORTANT AS MEDICAL TERMS MAY NOT BE FAMILIAR EVEN TO THOSE WHO ARE QUITE LITERATE. THE KEY DIFFERENTIATOR OF MIASANO FROM CURRENT AD HOC CLINICAL METHODS IS EMPOWERING THE PATIENT WHO PREFERS A LANGUAGE OTHER THAN ENGLISH TO COMMUNICATE THEIR HEALTH NEEDS AND TO BE CONFIDENT WHEN CONVEYING IMPORTANT HEALTH INFORMATION.