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Implementation of a bilingual and bicultural navigation program for Hispanic children with traumatic brain injuries

Celeste N Garcia1,2, Magaly Ramirez1, Tasnia Alam2

  • 1Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA.

Brain Injury
|March 28, 2025
PubMed

Insights

Implementing bilingual, bicultural patient navigation for Hispanic children with traumatic brain injury (TBI) shows promise. Adaptability and navigator skills facilitate implementation, while policy and training gaps present barriers to care access.

Area of Science:

  • Health Services Research
  • Implementation Science
  • Pediatric Neurology

Background:

  • Traumatic brain injury (TBI) disproportionately impacts Hispanic children, leading to severe injuries and poorer outcomes.
  • Patient navigation improves health outcomes in Hispanic populations, but culturally tailored pediatric TBI programs are scarce.
  • Understanding implementation factors for culturally specific TBI navigation is crucial for reducing health disparities.

Purpose of the Study:

  • To examine facilitators and barriers in implementing a bilingual and bicultural navigation program for caregivers of Hispanic children with TBI.
  • To identify key contextual factors influencing the successful adoption of culturally tailored patient navigation.

Main Methods:

  • In-depth interviews with 12 personnel involved in the 1st Brain Injury Education and Outpatient Navigation (1st BIEN) program.
  • Directed content analysis guided by the Consolidated Framework for Implementation Research (CFIR).

Main Results:

  • Facilitators: program adaptability, navigator bilingual/bicultural skills, alignment with organizational values.
  • Barriers: restrictive healthcare policies, incomplete medical records, insufficient behavioral support training.

Conclusions:

  • Optimizing patient navigation implementation can enhance care access for Hispanic children with TBI.
  • Addressing identified barriers is essential for reducing disparities in pediatric TBI outcomes.
Abstract

Keywords:
Consolidated Framework for Implementation Research (CFIR)Hispanic childrenTraumatic brain injurypatient navigationpediatric rehabilitation

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