Overview

The study will be conducted in 2 overlapping phases. In Phase 1, there will be a 3-arm randomized controlled trial of Remote Simultaneous Medical Interpreting/RSMI (Arm 1), versus Remote Consecutive Medical Interpreting/RCMI (Arm 2) and versus Remote Consecutive Video Medical Interpreting/RCVI (Arm 3) in breast cancer outpatient clinical encounters with Spanish- and Mandarin-speaking patients with Limited English Proficiency/LEP (Stages II and III disease) and English- speaking providers (who do not speak Spanish/Mandarin). In Phase 2, there will be a sequential mixed-methods explanatory, multi-stakeholder process evaluation to gather implementation potential data.

Eligibility

Inclusion Criteria:

Phase I Patients

• Age >=18 years (per EMR)
• Preferred language for healthcare is Spanish or Mandarin (per self-report)
• Limited English Proficient; cannot speak English "very well" (per self-report)
• Diagnosis of Stage I, II, III, or IV breast cancer or gastrointestinal (per EMR)
• Will be visiting MSK oncologist for the first or second appointment (per EMR)
• Will be continuing medical oncology visits at MSK (per EMR, patient's care team, and/or self-report)
• Agrees to be audio-recorded (per self-report)

Phase 1 Providers

• Breast or gastrointestinal cancer provider who sees patients (e.g., breast or gastrointestinal oncologists, advanced practice providers, and/or nurses)
• Does not speak Spanish and/or Mandarin; providers who speak one language and not the other may participate (e.g., speaks Spanish but not Mandarin) (per self-report)
• Agrees to be audio-record (per self-report) Phase 2 (clinic staff only; patient participants will be drawn from Phase 1)
• Is a staff member who works/worked in one of the study clinic sites during the period of Phase 1 RCT study activities
• Agrees to be audio-recorded (per self-report)

Exclusion Criteria:

Phase 1 Patients

• Has significant psychiatric disturbance (i.e., acute psychiatric symptoms) sufficient to preclude completion of the assessments, interviews, or informed consent (per EMR, patient's care team, or study team)
• Presence of cognitive impairment disorder (i.e., delirium or dementia) sufficient to preclude meaningful informed consent and/or data collection (per EMR, patients, care team, or study team)

Phase I Providers

• None

Phase 2 (clinic staff only; Phase 1 patient participants follow above criteria)

• None