What is the test for establishing that the primary purpose was to create an out-of-court substitute for trial testimony?

declarant's medical condition; (5) whether the focus of the interrogation had shifted from addressing an ongoing emergency to obtaining evidence for trial; and (6) the relative formality of the statement and the circumstances under which it was obtained. (Id. at p 1289.) " 'In the end, the question is whether, in light of all the circumstances, viewed objectively, the "primary purpose" of the conversation was to "create an out-of-court substitute for trial testimony." ' " (People v. Rangel (2016) 62 Cal.4th 1192, 1214-1215.)