Factors Associated With Accuracy of Self-Assessment Compared With Tested Non–English Language Proficiency Among Primary Care Providers

Diamond, Lisa; Bejarano, Marcela Toro; Chung, Sukyung; Ferguson, Warren J.; González, Javier; Garzon, Margaux Genoff; Mujawar, Imran; Gany, Francesca

doi:10.1097/mlr.0000000000001105

Cited by 18 publications

(11 citation statements)

References 29 publications

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“…1). Because health care providers overestimate their Spanish bilingualism, 43 health care systems could also require formal language testing of staff who identify as bilingual. In addition, though patient navigators serve an important role separate from interpretation, patient navigators whose bilingual fluency has been confirmed and who are willing to expand their professional role could be trained as interpreters.…”

Section: Discussionmentioning

confidence: 99%

Philadelphia Latine Immigrant Birthing People’s Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization

Montoya-Williams,

Barreto,

Laguna-Torres

et al. 2024

Medical Care

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Research Design: Community-engaged qualitative study using inductive thematic analysis of semistructured interviews. Objective: To understand Latine immigrants’ recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization. Background: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the “chilling effect”) has been well-documented among Latine birthing people both pre and postnatally. Patients and Methods: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants’ pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants. Results: Participants’ recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants’ rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants’ rights to health care. Participants also suggested training non-medical office staff in the use of interpreters. Conclusion: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants’ suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.

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Section: Discussionmentioning

confidence: 99%

Philadelphia Latine Immigrant Birthing People’s Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization

Montoya-Williams,

Barreto,

Laguna-Torres

et al. 2024

Medical Care

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“…Strategies to improve access to quality interpretation in safety-net clinics could include conducting a validated oral proficiency test such as the Clinician Cultural and Linguistic Assessment for staff, providers, and volunteers to evaluate their non-English language skills and provide training for those who need to increase proficiency. 27 Efforts to teach medical conversation language skills in non-English languages, such as Spanish, in health care professional education programs, while not an ideal solution, may hold some promise. 28 While these programs, namely medical Spanish, have been integrated in medical school curricula, 28 efforts to teach non-English medical language skills across the health professions are expanding and should be promoted.…”

Section: Discussionmentioning

confidence: 99%

Language Assistance Services in Nonfederally Funded Safety-Net Medical Clinics in the United States

Denson

Graves

2022

Health Equity

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Background: In the United States, nonfederally funded safety-net clinics provide health care services to underserved populations, including patients with limited English proficiency. Unlike clinics that receive federal funding, which requires provision of qualified interpreters, these clinics are not required to provide such services. Objective: The aim of this study was to describe the types of language assistance services used by safety-net clinics and their approaches to medical interpreter training for volunteers and staff. Methods: A survey was administered by mail and email to nonfederally funded medical safety-net clinics identified from publicly available directories. The survey collected information on clinic characteristics, interpreter modalities used, and interpreter training and could be completed on paper or online. Results: Among 859 eligible clinics, 216 completed the survey (24% response rate). Few clinics reported timely access to professional interpreter services in-person (18.5%), by phone (23%), or by video (7%), while 80% of clinics used ad hoc family member or friend to interpret and 53% used ad hoc child to interpreter. Seventy-eight percent of clinics reported using bilingual staff, providers, and/or volunteers. Staff/volunteer training was provided by 22 clinics (11%). Conclusion: Most safety-net clinics relied upon ad hoc interpreters, contrary to best practices. Use of ad hoc interpreters can lead to errors in interpretation, contributing to inequities in quality of health care services. Future efforts should identify economical strategies to improve access to qualified interpreter services at nonfederally funded safety-net clinics.

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“…27 Fluency should be confirmed through formal language testing for all multilingual team members who interact with participants who prefer a language other than English, as language proficiency is often overestimated by health professionals. 28…”

Section: Building the Study Teammentioning

confidence: 99%

“…For research among immigrant communities, teams must also consider including members who are proficient in the target languages or have been trained to work with interpreters 27 . Fluency should be confirmed through formal language testing for all multilingual team members who interact with participants who prefer a language other than English, as language proficiency is often overestimated by health professionals 28 …”

Section: Applying the Framework: A Case Examplementioning

confidence: 99%

Overcoming barriers to the recruitment of immigrant Hispanic people in perinatal research

Laguna-Torres

Velosa

Barreto

et al. 2023

Health Services Research

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Factors Associated With Accuracy of Self-Assessment Compared With Tested Non–English Language Proficiency Among Primary Care Providers

Abstract: Background: There are no accepted best practices for clinicians to report their non-English language (NEL) fluencies. Language discordance between patients with limited English proficiency and their clinicians may contribute to suboptimal quality of care.

Cited by 18 publications

References 29 publications

Philadelphia Latine Immigrant Birthing People’s Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization

Philadelphia Latine Immigrant Birthing People’s Perspectives on Mitigating the Chilling Effect on Prenatal Care Utilization

Language Assistance Services in Nonfederally Funded Safety-Net Medical Clinics in the United States

Overcoming barriers to the recruitment of immigrant Hispanic people in perinatal research

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