Video Consent Improves Satisfaction in a Safety-Net Multi-Lingual Population

Video Consent Improves Satisfaction in a Safety-Net Multi-Lingual Population
Gabriel Castillo, Zoe Lawrence, Janice Jang, Timothy A. Zaki, Adam J. Goodman, Demetrios Tzimas, Andrew Dikman, Renee Williams
Gastrointestinal Endoscopy, 2020; 91(6S) Tu1095
Open Access
Introduction
Informed consent for endoscopy is traditionally done verbally, which places an emphasis on auditory comprehension. Language discordance between providers and patients can negatively impact this process. Studies have shown that patients with low health literacy may prefer other methods of information delivery, such as visual media which may be more meaningful. The use of videos during informed consent for procedures may improve patient satisfaction and more sufficiently address pre-procedural concerns in comparison to verbal consent. Data on the use of video consent for endoscopy is limited, with recent studies focusing on the pediatric population. Our quality improvement project aimed to assess if the addition of an educational video to the consent process for endoscopy and colonoscopy improves patient comprehension and satisfaction in a safety-net setting with a diverse, underserved population.
Methods
We identified English and Spanish-speaking outpatients presenting for upper endoscopy and colonoscopy in our inner-city, public hospital. Videos detailing the procedures, risks, benefits, and alternatives were produced in both languages. All participants underwent a traditional verbal consent process, and a subset were randomly chosen to watch the video in their preferred language. All patients completed a questionnaire in their preferred language to assess comprehension and satisfaction. Unpaired t-test analysis was applied to the data.
Results
156 questionnaires were collected: 83 colonoscopy specific (58 English, 25 Spanish) and 73 endoscopy specific questionnaires (37 English, 36 Spanish). 80 patients provided education data, 64% reported an education level of high school or less. Among participants who viewed the colonoscopy video, 79% rated the information provided as excellent compared to 38% of participants who underwent only the traditional verbal consent (p Z <0.05). Among participants who viewed the endoscopy video, 88% rated the information provided as excellent compared to 35% of participants who did not watch the video (p < 0.05). In both cohorts, video consent patients reported improved satisfaction. Our prior results demonstrate a significant improvement in comprehension scores in video consent patients compared to traditional verbal consent (77% vs. 51%, p <0.0001).
Discussion
Our results demonstrate a significant improvement in patient satisfaction with the use of video consent for endoscopic procedures in a multi-lingual population with low educational levels and health literacy. Including a video in the consent process may satisfy multiple learning needs this population. Based on this data, we have obtained a patient care grant which will be used to incorporate this process within our endoscopy suite and compose videos in other languages in order to improve care for our patients.

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