Language access research for community health: provider perspectives on language access techniques and the role of communication technology

ABSTRACT

Background:

In the United States, 66 million people speak a language other than English at home. Patients with diverse language needs often face significant health disparities. Information and communication technologies have expanded the realm of modalities for patient-provider communication. However, the extent to which digital language access tools are utilized by healthcare providers is unknown. This research examines provider perspectives on language assistance techniques and the role of communication technology when serving patients with non-English language preference (NELP).

Methods:

Between April and July 2019, an online survey was administered to 3,033 healthcare providers (doctors, nurse practitioners, pharmacists, and dentists) in Washington State. Providers reported on their language access practices and perspectives on communication technology.

Results:

Most providers reported using ad hoc language access techniques when engaging patients with NELP, such as a patient’s family member or friend (75.8%), a patient’s child specifically (61.9%), or a bilingual staff member (64.3%). Professional techniques, such as in-person interpretation (53.5%), phone interpretation (57%), and video remote interpretation (38.8%), were used less often. Dissatisfaction with the language access processes of healthcare providers’ place of work was associated with a higher reliance on a patient’s family or friend for language interpretation.

Conclusions:

Findings suggest that providers might be under-utilizing professional and digital interpreter services while relying on ad hoc techniques. Such practices reveal systemic constraints on language access that might make it difficult for providers to access timely and reliable options for professional language interpretation, despite federal regulations that mandate such services for patients with NELP.

KEYWORDS:

• Language access
• patient-provider communication
• communication technology

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

This study was reviewed and approved by the Institutional Review Board at the University of Washington in February 2019 (00006713).

Authors contribution

All authors contributed to the study design, implementation, and manuscript development.

Data availability

Access to the dataset for this manuscript is available upon request.

Notes

1 Although the term ‘limited English proficiency’ (LEP) has been widely used to refer to individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English, recent considerations of a more patient-centered framework suggest ‘non-English language preference (NELP)’ as a more appropriate and less deficit-oriented term [2].

Additional information

Funding

This work was funded by the University of Washington Latino Center for Health.

Notes on contributors

Carmen Gonzalez

Dr. Carmen Gonzalez is an associate professor in the Department of Communication at the University of Washington.

Janessa M. Graves

Dr. Janessa Graves is an associate professor in the College of Nursing at Washington State University.

Joana Ramos

Joanna Ramos is chair of the healthcare committee for the Washington State Coalition for Language Access (WASCLA).

Monica S. Vavilala

Dr. Monica Vavilala is a professor of anesthesiology and pediatrics in the School of Medicine at the University of Washington.

Megan Moore

Dr. Megan Moore is an Associate Professor in the School of Social Work at the University of Washington.