Current Research at the Jimenez Lab
An Innovative Program for Hispanic Parents of Children With TBI
We developed an innovative program called Brain Injury Education and outpatient care Navigation (1st BIEN) to equip Hispanic parents with tools for helping their children recover from TBIs. This program is based on our research and informed by Hispanic parents, community organizations, and clinicians from Seattle Children’s and the University of Washington. The program aims to:
- Help Hispanic parents understand the health challenges associated with TBIs.
- Empower parents to participate in their child’s rehabilitation.
- Make it easier for Hispanic children with TBIs to receive outpatient rehabilitation services by using bilingual community care coordinators.
Preliminary research suggests high satisfaction levels among parents who received care coordination through our program. These parents demonstrated a better understanding of their child’s injury and reported increased self-efficacy in meeting their child’s needs. Now funded by the NIH, we are testing 1st BIEN in a multicenter, randomized controlled clinical trial. If effective, 1st BIEN could serve as a model for assisting families in other vulnerable populations. Learn more:
Studying the implementation of culturally tailored interventions in clinical practice settings
Current healthcare systems are not equipped to meet the needs of diverse populations. Contextual factors significantly influence the adoption and sustainability of patient-centric navigation programs.
This administrative supplement to the 1stBIEN project aims to evaluate real-time contextual factors in implementing a bicultural/bilingual navigation program for Hispanic children with traumatic brain injury. We will examine factors related to the implementation of patient-centric programs in clinical practice, focusing on culturally and linguistically responsive approaches.
Identifying institutional and community contextual barriers and facilitators can inform strategies for effectively adopting interventions for Hispanic children.
Understanding Traumatic Brain Injury Outcomes in Hispanic Children
Traumatic brain injury (TBI) is a major cause of death and disability among children in the United States, with particularly severe effects on Hispanic children.
Our group was the first to document large differences in disability after TBIs among Hispanic children. We have shown that:
- Hispanic children have lower quality of life, participate in fewer childhood activities and are less able to communicate and take care of their daily needs than non-Hispanic white children with TBIs.
- These differences were not present at discharge from inpatient rehabilitation facilities, and Hispanic children recovered at the same pace as non-Hispanic children when receiving equal inpatient care.
- Many Medicaid-insured children with TBI do not receive sufficient rehabilitation services; only 29% of 9,361 received outpatient therapy in the year following their injury. Hispanic children with TBI are less likely to receive speech therapy than non-Hispanic White children.
- In Washington state, children with TBIs from households with limited English proficiency face significant barriers to rehabilitation services, as less than 20% of providers accept Medicaid and offer language interpretation. Also, Spanish-speaking families experience longer travel times to available services.
Exploring Factors Associated With Post-Surgery Follow-Up Care
- Follow-up after surgery is critical to check for signs of poor function, pain and infection.
- Families that experience barriers to attending appointments are at risk for lack of follow-up care and potentially poor surgical outcomes.
- Prior research demonstrates that 28% to 62% of families miss follow-up appointments after hospital discharge, with up to 64% of parents unaware of need for appointments.
- Minoritized racial and ethnic groups and non-English speaking patients have higher rates of missed follow-up appointments compared to the general population.
- Existing research is limited- most studies focus on emergency department discharge rather than post-surgical care, and pediatric studies are procedure-specific or single specialty.
- We are conducting a retrospective cohort study using 2022 data from Seattle Children’s 14,790 surgeries to explore factors associated with follow-up by race/ethnicity and language of care.
Rethinking Community-Engaged Research Through Storytelling
Through digital storytelling, Project BRIDGE (Bi-directional Research + Digital Engagement) aims to cultivate genuine and sustainable partnerships among the health community of academics, researchers, providers and the larger Latinx community to increase understanding of community health needs and to improve community-centered research.
Our inaugural storytelling series highlighted the disproportionate impact of COVID-19 on our Latinx communities, where community members and allies shared their experiences navigating the burden of COVID-19 in their personal lives and in their communities in Washington state.
We are currently working on a new series highlighting pediatric health issues.