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Healthcare 411 External Web Site Policy

U.S. Health and Human Services, Agency for Healthcare Research and Quality (Producer), & Clancy, C. (Director) (2011). Healthcare 411 [Audio podcast]. Retrieved from http://www.ahrq.gov/

Healthcare 411 is an audio podcast series produced by the HHS Agency for Healthcare Research and Quality (AHRQ) as part of its effort to improve the quality, safety, efficiency, and effectiveness of healthcare for all Americans. AHRQ launched Healthcare 411 in Spanish to offer news and information on current research and on important healthcare topics to a growing population in our country.

Keywords:    Tools | Clinical & Mental Health | Patients & Consumers | Population-Based | Communication and Language Assistance |

Examining Effectiveness of Medical Interpreters in Emergency Departments for Spanish-Speaking Patients With Limited English Proficiency External Web Site Policy

Bagchi, A. D., Dale, S., Verbitsky-Savitz, N., Andrecheck, S., Zavotsky, K., & Eisenstein, R. (2010). Examining effectiveness of medical interpreters in emergency departments for Spanish-speaking patients with limited English proficiency: results of a randomized controlled trial. Annals of Emergency Medicine, 57(3), 248-256.e4. doi:10.1016/j.annemergmed.2010.05.032

This study, published in the Annals of Emergency Medicine, examines the impact on patient and provider satisfaction of emergency department use of medical interpreters for limited-English-proficient Spanish speakers. The researchers conclude that the use of in-person, professionally trained medical interpreters significantly increases satisfaction with communication during emergency department visits for both Spanish-speaking, limited-English-proficient patients and their health providers.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Population-Based | Profession-Based | Communication | Communication and Language Assistance |

Culturally Competent Care: Some Examples of What Works External Web Site Policy

Commission on the Public's Health System. (2010). Culturally competent care: some examples of what works! Retrieved from http://www.cphsnyc.org/cphs/reports/august_2010-_culturally_competen/

"Culturally Competent Care: Some Examples of What Works!" was published by the Commission on the Public's Health System of New York City. The initiative surveyed 659 parents in 12 languages about their children's health and access to care and reveals many cultural and linguistic barriers in access to care for children. A Cultural Checklist was developed, incorporating these findings to be used to interviews and while touring provider sites.

Keywords:    Tools | Public Health | Population-Based | Profession-Based | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

HHS launches first of its kind consumer focused website in Spanish External Web Site Policy

HHS launches first of its kind consumer focused website in Spanish. (2010, September 8). U.S. Department of Health & Human Services. Retrieved from http://www.hhs.gov/

The HHS launched CuidadodeSalud.gov, the first website in Spanish of its kind to connect consumers to information and resources that will help them access quality, affordable healthcare coverage. HHS Secretary Kathleen Sebelius noted that the website "will give Latinos across the nation better information about the choices they have, how much they cost, and what they can expect from their doctor-specific to their life situation and local community."

Keywords:    Tools | Patients & Consumers | Communication | Communication and Language Assistance |

Patient Protection And Affordable Care Act Of 2010: Advancing Health Equity for Racially and Ethnically Diverse Populations External Web Site Policy

Andrulis, D. P., Siddiqui, N. J., Purtle, J. P., & Duchon, L. (2010). Patient protection and affordable care act of 2010: advancing health equity for racially and ethnically diverse populations. Retrieved from Joint Center for Political and Economic Studies website: http://www.jointcenter.org/sites/default/files/upload/research/files/Patient%20Protection%20and%20Affordable%20Care%20Act.pdf

The Joint Center for Political and Economic Studies has published a report detailing the implications of 2010's healthcare reform on health equity. It states that recent healthcare reform legislation offers an unprecedented opportunity to improve health equity in the United States.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Race, culture may play role in Alzheimer's disease External Web Site Policy

Brophy Marcus, M. (2010, July 14). Race, culture may play role in Alzheimer's disease. USA Today. Retrieved from http://www.usatoday.com/

This article discusses research presented at the Alzheimer's Association International Conference. It examines the effect of racial and cultural differences on Alzheimer's patients' outcomes and the attitudes of their family members. The study finds that more culturally tailored resources could benefit African Americans, Latinos, and other minority groups.

Keywords:    Research | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Racial and Ethnic Disparities in Health Care External Web Site Policy

American College of Physicians. (2010).Racial and ethnic disparities in health care, updated 2010. Retrieved from http://www.acponline.org/advocacy/where_we_stand/access/racial_disparities.pdf

The American College of Physicians released a 2010 update to its policy paper, "Racial and Ethnic Disparities in Health Care." It calls for the healthcare system to adapt to meet the needs of an increasingly multicultural patient base. Recommendations include that healthcare professionals need to acknowledge the cultural, informational, and linguistic needs of their patients as our society increasingly becomes more racially and ethnically diverse.

Keywords:    Research | Education & Training | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Health Literacy | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance |

Irvine's Hoag Hospital works to bridge cultural barriers External Web Site Policy

Reicher, M. (2010, September 8). Irvine's Hoag Hospital works to bridge cultural barriers. Los Angeles Times. Retrieved from http://articles.latimes.com/2010/sep/08/local/la-me-hoag-hospital-20100908

This article details a California hospital's efforts to incorporate culturally competent practices into its services and system. Hoag Hospital in Irvine, CA, took many steps to adapt to its patients' cultural beliefs, traditions, and languages. These preparations include creating patient rooms arranged according to the principles of feng shui, serving steamed rice for breakfast, and using gestures such as presenting documents respectfully with two hands and speaking to patients with more formality.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Communication | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

At Hospitals, New Methods With a Focus on Diversity External Web Site Policy

Santos, F. (2010, September 6) At hospitals, new methods with a focus on diversity. The New York Times. Retrieved from http://www.nytimes.com/

This New York Times article discusses the ways that hospitals nationwide are adopting practices intended to improve care for an increasingly diverse patient population beyond language access services. Making immigrant and minority individuals feel more at ease can translate into improved health outcomes according to health providers.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

How Well Do Doctors Know their Patients? Factors Affecting Physician Understanding of Patients External Web Site Policy

Street, R. L., & Haidet, P. (2010). How well do doctors know their patients? Factors affecting physician understanding of patients' health beliefs. Journal of General Internal Medicine, 26(1), 21-27. doi: 10.1007/s11606-010-1453-3

This study examines the features of patient-centered care; specifically, a physician's understanding of his or her patients' health beliefs and values. The results indicate that physicians' perceptions of their patients' health beliefs differ significantly from patients' actual beliefs. This study indicates that strategies for increasing physicians' awareness of patients' health beliefs include implementing culturally appropriate patient activation programs.

Keywords:    Tools | Research | Clinical & Mental Health | Patients & Consumers | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Cancer study sees cultural factors in racial disparities External Web Site Policy

Avery, S. (2010, June 16). Cancer study sees cultural factors in racial disparities. The News & Observer. Retrieved from http://www.newsobserver.com/

The Journal of the American Medical Association has published a study from the University of North Carolina-Chapel Hill about the cultural factors present in the racial disparities of lung cancer. The scientists concluded that, despite a high likelihood of death, Black patients are much less inclined to have surgery for early stage lung cancer than White patients, often because of a communication gulf between them and their doctors.

Keywords:    Research | Clinical & Mental Health | Public Health | Population-Based | Profession-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Ending health disparities takes interdisciplinary approach External Web Site Policy

Lewis, C., & Stout, J. (2010). Toothache in US children. Archives of Pediatrics & Adolescent Medicine, 164, 1056-1063. doi:10.1001/archpediatrics.2010.206

In this message from the American Medical Association (AMA) president to all physicians, Dr. Rohack notes that an interdisciplinary approach to patient-centered care may help reduce health disparities by addressing challenges in communication such as low health literacy and medication mismanagement. He commits to helping guide the changes needed to ensure culturally competent patient care. When patients do not understand their medical conditions or what to do to control them, unnecessary healthcare costs only will increase, a situation he notes the AMA is committed to avoiding.

Keywords:    Policy | Clinical & Mental Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Future Directions for the National Healthcare Quality and Disparities Reports External Web Site Policy

Institute of Medicine. (2010). Future directions for the national healthcare quality and disparities reports. Retrieved from http://iom.edu/

The Institute of Medicine (IOM) released in Spring 2010 a report that discusses future directions for the AHRQ National Healthcare Quality Report (NHQR) and National Healthcare Disparities Report (NHDR). The IOM concludes that the NHQR and NHDR can be improved in ways that would make them more influential in promoting change in the healthcare system.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Government | Population-Based | Profession-Based | Disease-Based | Quality Improvement | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health Disparities Education External Web Site Policy

Lypson, M. L., Bussey-Jones, J., Glick, S., Brown, A. F., & Jacobs, E. A. (2010). Health disparities education. Journal of General Internal Medicine, 25(2), 79-81. doi: 10.1007/s11606-010-1312-2

The Journal of General Internal Medicine dedicated its May 2010 supplement to health disparities education. This supplement focuses on approaches to teaching health disparities and health disparities curriculums for students. It contains 27 articles, including "Medical Students' Perceptions of Their Teachers' and Their Own Cultural Competency: Implications for Education" and "Beyond Knowledge, Toward Linguistic Competency: An Experiential Curriculum."

Keywords:    Research | Education & Training | Clinical & Mental Health | Governance & Leadership | Profession-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

HHS Launches Oral Health Initiative

HHS Launches Oral Health Initiative. (2010, April 26). U.S. Department of Health and Human Services. Retrieved from http://minorityhealth.hhs.gov/

In April 2010, Dr. Howard Koh (Assistant Secretary for Health, HHS) announced an initiative to expand oral health services, education, and research in America ("Oral Health Is Integral to Overall Health"). Through the initiative, the department is increasing support for access to oral healthcare and the delivery of services to underserved populations.

Keywords:    Policy | Government | Profession-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Language Use in the United States: 2007

U.S. Census Bureau. (2010). Language use in the United States: 2007. Retrieved from http://www.census.gov/prod/2010pubs/acs-12.pdf

Language Use in the United States: 2007, a Census Bureau report, analyzes the Nation's linguistic diversity through the U.S. Census decennial data and the 2007 American Community Survey. The report finds that the percentage of speakers of non-English languages increased by 140 percent from 1980 to 2007. Of the 281 million people that were 5 years old and older in the United States in 2007, 55.4 million individuals-or 20 percent-report speaking a language other than English at home.

Keywords:    Tools | Governance & Leadership | Government | Population-Based | Communication | Communication and Language Assistance |

National Healthcare Disparities Report

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. National Healthcare Disparities Report (AHRQ Publication No. 10-0004). Retrieved from http://www.ahrq.gov/qual/nhdr09/nhdr09.pdf

The AHRQ produced the 2009 NHDR. The NHDR tracks the healthcare system through quality measures and summarizes healthcare quality and access among various racial, ethnic, and income groups and other priority populations, such as children and older adults.

Keywords:    Research | Policy | Clinical & Mental Health | Government | Disease-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Organ Transplant Program 'mistrust' studied External Web Site Policy

Conte, A. (2010, May 2). Organ transplant program 'mistrust' studied. Pittsburgh Tribune-Review. Retrieved from http://www.pittsburghlive.com/x/pittsburghtrib/

Researchers at the University of Pittsburgh School of Medicine have shown that patients who think healthcare providers discriminate against them take more time to get approved for kidney transplant surgery. Blacks are four times more likely than Whites to have kidney failure, but they are less than half as likely to receive transplants from living donors. The lead researcher notes that doctors should identify patients who perceive discrimination in order to help them navigate the process.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

American Journal of Public Health External Web Site Policy

American Public Health Association. (2010). American Journal of Public Health, 100(5). Retrieved from http://ajph.aphapublications.org/content/vol100/issue5/

The first issue of any major public health journal devoted to Asian American, Native Hawaiian and Pacific Islander populations, the May issue of the American Journal of Public Health (AJPH) explores an array of new research on both alarming disparities and significant successes in care.

Keywords:    Research | Policy | Public Health | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Commentary: Linking Cultural Competence Training to Improved Health Outcomes: Perspectives From the Field. External Web Site Policy

Betancourt, J. R., & Green, A. R. (2010). Commentary: linking cultural competence training to improved health outcomes: perspectives from the field. Academic Medicine, 85(4), 583-585. doi: 10.1097/ACM.0b013e3181d2b2f3

This article explores the impact cultural competency may have on health outcomes. Cultural competence training should be evaluated in a stepwise fashion by using the tools of health services research and the principles of quality improvement, and it should be held to the same standards as other educational interventions and activities.

Keywords:    Research | Education & Training | Clinical & Mental Health | Governance & Leadership | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care External Web Site Policy

The Joint Commission (2010). Topic Library Item: Advancing effective communication, cultural competence, and patient-and family-centered care. Retrieved from http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf

The Joint Commission proposes accreditation requirements for hospitals. These standards aim to improve communication, cultural competence, and patient-centered care. The standards will be published in the 2011 Comprehensive Accreditation Manual for Hospitals (CAMH): The Official Handbook. Compliance with the patient-centered communication standards will be included in the accreditation decision no earlier than January 2012.

Keywords:    Policy | Clinical & Mental Health | Governance & Leadership | Government | Communication | Quality Improvement | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Cultural competence in oncology: Where do we stand? External Web Site Policy

Surbone, A. (2010). Cultural competence in oncology: where do we stand? Annals of Oncology, 21(1), 3-5. doi: 10.1093/annonc/mdp546

This article in Annals of Oncology discusses the importance and relevance of culturally competent services in oncology. The author emphasizes that cultural differences are a major determinant of unequal access to cancer care. She concludes that provider practice of cultural competence can improve the quality of care offered to all cancer patients and can also foster reciprocal understanding and tolerance in the patient-doctor-institution relationship.

Keywords:    Research | Clinical & Mental Health | Profession-Based | Disease-Based | Communication | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws External Web Site Policy

The Joint Commission (Producer). (2009). Improving Patient-Provider Communication: Joint Commission Standards and Federal Laws [Video]. Available from http://www.jointcommission.org/

"Improving Patient-Provider Communication" is a video created by the Joint Commission along with HHS and the Office for Civil Rights as part of their efforts to eliminate racial, ethnic, and language disparities in healthcare. The video educates healthcare providers in providing language access in healthcare organizations. Language access is critical in providing safe, quality patient care.

Keywords:    Tools | Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Talking With Patients: How Hospitals Use Bilingual Clinicians and Staff to Care for Patients with Language Needs External Web Site Policy

Huang, J., Jones, R. C., & Regenstein, M. (2009). Talking with patients: how hospitals use bilingual clinicians and staff to care for patients with language needs. Abstract retrieved from The George Washington University website: http://www.gwumc.edu/sphhs/departments/healthpolicy/dhp_publications/?mdl=pubSearch&evt=view&PublicationID=2AD9B782-5056-9D20-3D85DD1E4BD4272B

This report from The George Washington University presents findings from a survey about bilingual clinicians who interact with limited-English-proficient patients. The survey reveals that many hospitals have bilingual clinicians but often do not adequately assess their language proficiency, meaning that the language access services provided are of unknown quality. The report concludes that proper assessment and use of bilingual staff will allow health systems to meet the needs of linguistically diverse communities.

Keywords:    Research | Clinical & Mental Health | Governance & Leadership | Profession-Based | Communication | Communication and Language Assistance |

The New Era of Professional Healthcare Interpreters External Web Site Policy

Birz, S. (2009, October 23). The new era of professional healthcare interpreters. AMN Healthcare. Retrieved from http://www.amnhealthcare.com/Default.aspx

This article discusses the need for language access service criteria, such as having interpreters professionally trained and credentialed to better guarantee effective communication between healthcare providers and patients. It also recommends that within the next year, healthcare organizations should begin using the Certification Commission for Healthcare Interpreters to find credentialed interpreters.

Keywords:    Research | Policy | Profession-Based | Communication | Communication and Language Assistance |

Eliminating Health Disparities: What Works? External Web Site Policy

Anderson, J. (2009, April to present). Eliminating health disparities: what works? Journal of the American Academy of Physician Assistants. Retrieved from http://www.jaapa.com/

"Eliminating Health Disparities: What Works?" is a series of articles in the Journal of the American Academy of Physician Assistants. Each month, the journal examines a pertinent topic within the field of health disparities and discusses tools that can help healthcare providers assess and eliminate health disparities in their practice. The column tackles issues such as bias and the role of race in health.

Keywords:    Tools | Research | Policy | Clinical & Mental Health | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Protection of Racial/Ethnic Minority Populations During an Influenza Pandemic External Web Site Policy

Hutchins, S. S., Fiscella, K., Levine, R. S., Ompad, D. C., & McDonald, M. (2009). Protection of racial/ethnic minority populations during an influenza pandemic. American Journal of Public Health, 99(S2), S261-S270. doi: 10.2105/AJPH.2009.161505

This study examines the disproportionate impact of an influenza pandemic on racial and ethnic minority populations. The research recommends that pandemic interventions implement culturally competent preparedness and response that address the specific needs of racial/ethnic minority populations as well as relevant, practical, and culturally and linguistically tailored communications.

Keywords:    Research | Clinical & Mental Health | Public Health | Governance & Leadership | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Informacion en espanol External Web Site Policy

Agency for Healthcare Research and Quality. (n.d.). Informacion en espanol. Retrieved from http://www.ahrq.gov/consumer/espanoix.htm

The AHRQ's website called Informacion en Espanol provides a variety of publications and other resources on healthcare issues, including audio and video, in Spanish. Informacion en Espanol includes a monthly online health advice column titled "Consejos de Salud Para Ti" ("Health Advice for You"), which provides evidence-based tips on preventive health, safe and appropriate use of medications, ways to get better healthcare, and more.

Keywords:    Tools | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Communication | Communication and Language Assistance |

Multicultural Health Care: A Quality Improvement Guide

National Committee for Quality Assurance, & Lilly USA, LLC. (2011). Multicultural health care: a quality improvement guide. Retrieved from http://www.clashealth.org/

The National Committee for Quality Assurance and Lilly USA, LLC, have developed Multicultural Health Care: A Quality Improvement Guide, a free, online resource for healthcare professionals. The website helps those seeking to undertake quality improvement initiatives to improve culturally and linguistically appropriate services and to reduce disparities in care.

Keywords:    Tools | Policy | Clinical & Mental Health | Profession-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

CSMS issues results of health disparities survey External Web Site Policy

CSMS issues results of health disparities survey. (2009, October 28). Connecticut State Medical Society. Retrieved from http://www.csms.org/index.php?option=com_content&task=view&id=2415&Itemid=222

This article discusses the results of a survey conducted by the Connecticut State Medical Society (CSMS) about physicians' views on ways to reduce disparities in healthcare, including cultural competency training. The results indicate that Connecticut physicians believe they could provide better care to patients of minority communities if they had better access to training. As a result of these findings, CSMS has committed to providing cultural competency training to physicians to help eliminate healthcare disparities in Connecticut.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Government | Profession-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Studying State Legislation of Cultural and Linguistic Competence External Web Site Policy

Robert Wood Johnson Foundation. (2009). Studying state legislation of cultural and linguistic competence. Retrieved from http://www.rwjf.org/

The Robert Wood Johnson Foundation (RWJF) funded a study by the National Center for Cultural Competence at Georgetown University that assessed State efforts to integrate cultural competence into continuing education and licensure requirements for healthcare professionals. The study reveals characteristics common between those States with legislation and States with barriers to the passage of legislation, and the study offers several strategic planning ideas.

Keywords:    Policy | Education & Training | Clinical & Mental Health | Public Health | Government | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Non-Native English Speakers Face Numerous Linguistic, Cultural Barriers to Medical Care External Web Site Policy

California Healthline. (2009). Non-Native English Speakers Face Numerous Linguistic, Cultural Barriers to Medical Care [Audio report]. Retrieved from http://www.californiahealthline.org/

This is an audio report that discusses a study conducted at the University of California-Berkley. The study finds that many non-native English speakers encounter difficulties in communicating with their healthcare providers, which can lead to lower quality healthcare. The researchers interviewed several key experts, who recommend that policymakers address health access issues by investing in telemedicine-based interpretation services and by recruiting bilingual medical professionals.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Improving Access to Language Services in Health Care: A Look at National and State Efforts

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. (2009). Improving access to language services in health care: a look at national and state efforts. Retrieved from http://www.ahrq.gov/

The issue brief explores national efforts to address language barriers for patients with limited English proficiency. It identifies challenges to delivering language services and highlights successes and implications for future policy as well as activities related to providing language services.

Keywords:    Tools | Policy | Clinical & Mental Health | Patients & Consumers | Government | Population-Based | Communication | Disparities | Communication and Language Assistance |

When the Patient Gets Lost in Translation External Web Site Policy

Chen, P. W. (2009, April 23). When the patient gets lost in translation. New York Times. Retrieved from http://www.nytimes.com/

This article in the New York Times is a firsthand account from a surgeon interacting with limited-English-proficient patients combined with a summary of the literature on the effects of a language barrier on healthcare. Dr. Chen regrets providing inadequate language access services in the interest of expediency. With this awareness, she explains strategies that doctors should use to overcome these challenges and ensure that each patient is receiving equal care.

Keywords:    Tools | Education & Training | Clinical & Mental Health | Patients & Consumers | Population-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance |

Speaking the Same Language: Medical Providers Struggle to Communicate With Immigrant Patients External Web Site Policy

Barclay, E. (2009, April 21). Speaking the same language: medical providers struggle to communicate with immigrant patients. The Washington Post. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2009/04/20/AR2009042002466_pf.html

This Washington Post article discusses the effect of the Washington area's high immigration rates on its healthcare providers and the quality of care offered to patients. The author describes the medical errors and discrimination that can result from inadequate language services, and she provides doctors' and patients' points of view.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Population-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

California's Emergency Preparedness Efforts for Culturally Diverse Communities: Status, Challenges and Directions for the Future External Web Site Policy

Andrulis, D., Siddiqui, N., & Purtle, J. (2009). California's emergency preparedness efforts for culturally diverse communities: status, challenges and directions for the future. Retrieved from Drexel University Center for Health Equality and HHS Office of Minority Health website: http://www.diversitypreparedness.org/

This report conducts a systematic assessment of emergency preparedness programs and initiatives for racially and ethnically diverse communities in California, examining barriers to care as well as opportunities for improvement. While this report focuses on the State of California, it provides a methodological framework that allows for similar assessments to be conducted at national, State, and local levels.

Keywords:    Tools | Research | Public Health | Patients & Consumers | Government | Population-Based | Profession-Based | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Journal of Health Care for the Poor and Underserved External Web Site Policy

Brennan, V. M. (Ed.). (2009). Journal of Health Care for the Poor and Underserved. doi: 10.1353/hpu.0.0146

The May 2009 issue of the Journal of Health Care for the Poor and Underserved offers a variety of articles that address issues of health disparities and access to care. It highlights medical education issues regarding obstacles and supports for different minority groups during the application process for medical school. It includes a section on immigrant health, which contains articles on a variety of racial and ethnic groups, including Chinese and Latinos.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Population-Based | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

National Pharmacy Benefit Manager to Strengthen How it Provides Language Assistance Services External Web Site Policy

National pharmacy benefit manager to strengthen how it provides language assistance services. (2009, June 15). U.S. Department of Health and Human Services. Retrieved from http://www.hhs.gov/

The HHS announced that Medco, a national pharmacy benefit management company, will significantly improve its language access services for limited-English-proficient individuals. The acting director of the HHS Office for Civil Rights noted that this development will combat health disparities, promote healthcare reform, and improve access to care.

Keywords:    Research | Education & Training | Clinical & Mental Health | Patients & Consumers | Government | Population-Based | Profession-Based | Quality Improvement | Disparities | Communication and Language Assistance |

One Size Does Not Fit All: Meeting The Health Care Needs of Diverse Populations External Web Site Policy

Wilson-Stronks, A., Lee, K. K., Cordero, C. L., Kopp, A. L., & Galvez, E. (2008). One size does not fit all: meeting the health care needs of diverse populations. Retrieved from The Joint Commission website: http://www.jointcommission.org/assets/1/6/HLCOneSizeFinal.pdf

This report provides insight into the ways in which hospitals meet diverse patient needs and reduce health disparities. It examines the challenge that healthcare organizations face when addressing cultural and language issues, and it provides a general framework for developing organizational cultural competence. The report stresses that each hospital is responsible for tailoring an approach to cultural competence that addresses its needs rather than relying on a "one size fits all" solution.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Governance & Leadership | Profession-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health External Web Site Policy

Commission on the Social Determinants of Health (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Retrieved from the World Health Organization website: http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf

This is the final report by the World Health Organization's Commission on Social Determinants of Health, which set out to examine ways to achieve health equity around the world. The report determines that the problem of health disparities can be tackled by developing strategies to influence policies and organizations that affect entire societies. The Commission has succeeded in its goal to create a global movement to promote health equity by establishing partnerships with governments and global organizations. The Commission concludes that achieving health equity within a generation is achievable.

Keywords:    Research | Policy | Public Health | Governance & Leadership | Government | Population-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

National Consensus Statement on Integrating Racially and Ethnically Diverse Communities into Public Health Emergency Preparedness External Web Site Policy

U.S. Department of Health & Human Services Office of Minority Health and Drexel University, Center for Health Equality National Consensus Panel on Emergency Preparedness and Cultural Diversity. (2008). National consensus statement on integrating racially and ethnically diverse communities into public health emergency preparedness. Retrieved from http://www.diversitypreparedness.org/SiteData/docs/National%20Consensus%20Statement%20%26%20Guiding%20Principles%20%26%20Panel%20List%20508/695132ab58eb36a7c2f67ba98d5a72ec/National%20Consensus%20Statement%20%26%20Guiding%20Principles%20%26%20Panel%20List%20508.pdf

This statement provides a framework for integrating racially and ethnically diverse communities into emergency preparedness. It was developed by the National Consensus Panel on Emergency Preparedness and Cultural Diversity, an initiative of the Drexel University School of Public Health's Center for Health Equality and the HHS Office of Minority Health.

Keywords:    Tools | Policy | Public Health | Governance & Leadership | Government | Profession-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Racial and Ethnic Disparities in U.S. Health Care: A Chartbook External Web Site Policy

Mead, H., Cartwright-Smith, L., Jones, K., Ramos, C., Woods, K., & Siegel, B. (2008). Racial and ethnic disparities in U.S. health care: a chartbook. Retrieved from the Commonwealth Fund website: http://www.commonwealthfund.org/~/media/Files/Publications/Chartbook/2008/Mar/Racial%20and%20Ethnic%20Disparities%20in%20U%20S%20%20Health%20Care%20%20A%20Chartbook/Mead_racialethnicdisparities_chartbook_1111%20pdf.pdf

This chartbook provides a framework through which policymakers, teachers, researchers, and practitioners may understand health disparities and formulate solutions. The chartbook presents data regarding health disparities, including their nature and etiology, and seeks to provoke thought about why disparities exist and how they can be eliminated.

Keywords:    Tools | Research | Policy | Education & Training | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Educating Physicians to Provide Culturally Competent, Patient-Centered Care External Web Site Policy

Like, R. C., Barrett, T. J., & Moon, J. (2008, Summer). Educating physicians to provide culturally competent, patient-centered care. Perspectives: A View of Family Medicine in New Jersey, 7(2), 10-20. Retrieved from http://www.njafp.org/publications/archive

This article in a New Jersey family medicine publication discusses the history of, rationale for, and effects of the legislation in New Jersey enacted in March 2005 that requires all physicians to complete cultural competency training for re-licensure and mandates the inclusion of relevant curricular content in the State's medical schools. It also outlines the development of cultural competency in legislation throughout the country on both State and national levels.

Keywords:    Policy | Clinical & Mental Health | Public Health | Governance & Leadership | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health Disparities: Barriers to a Culture of Preparedness External Web Site Policy

Honore, R. L. (2008). Health Disparities: Barriers to a Culture of Preparedness. Journal of Public Health Management & Practice, 14(6), S5-S7. doi: 10.1097/01.PHH.0000338381.29071.d6

This article discusses the ways that inequalities in health and healthcare present a barrier to the United States' disaster preparedness and response activities. The article sets out to show that individuals, communities, the private sector, nonprofits, and all levels of government need to work together to reduce health inequalities to improve the Nation's level of preparedness and response to a crisis.

Keywords:    Research | Policy | Public Health | Patients & Consumers | Government | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Physician Implicit Attitudes and Stereotypes About Race and Quality of Medical Care External Web Site Policy

Sabin, J. A., Rivara, F. P., & Greenwald, A. G. (2008). Physician implicit attitudes and stereotypes about race and quality of medical care. Medical Care, 46(7), 678-685. doi: 10.1097/MLR.0b013e3181653d58

This study used a social psychological perspective to examine what effects healthcare providers' implicit attitudes about race have on healthcare and racial and ethnic healthcare disparities. The data indicate that most doctors in all racial and ethnic groups show an implicit preference of Whites over Blacks except for Black doctors, who show no preference for either race.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Population-Based | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Journal of Public Health Management & Practice External Web Site Policy

Graham, G. N., Honore, P. A., & Beadle, M. (Eds.). (2008). Supplement 6. In Novick, L. F. (Journal Ed.) Journal of Public Health Management & Practice, 14(6), S1-S87. Retrieved from http://journals.lww.com/jphmp/pages/toc.aspx?year=2008&issue=11001

This supplemental issue of the Journal of Public Health Management & Practice is dedicated to health disparities. It contains articles on a wide variety of topics relating to health disparities and includes an editorial from Dr. Garth Graham, Deputy Assistant Secretary for Minority Health.

Keywords:    Research | Education & Training | Clinical & Mental Health | Public Health | Governance & Leadership | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Integrating Immigrant Families in Emergency Response, Relief and Rebuilding Efforts External Web Site Policy

Wang, T., & Yasui, L. (2008). Integrating immigrant families in emergency response, relief and rebuilding efforts. The Annie E. Casey Foundation and Grantmakers Concerned with Immigrants and Refugees. Retrieved from the Grantmakers Concerned with Immigrants and Refugees website: http://www.gcir.org/system/files/Integrating%20Immigrant%20Families%20in%20Emergency%20Response%2C%20Relief%20and%20Rebuilding%20Efforts.pdf

This report examines the disparities faced by immigrants and limited-English-proficiency communities during times of disaster. It focuses on emergency management at the local level since, oftentimes, the local government is the first on the scene during a disaster event.

Keywords:    Research | Policy | Education & Training | Clinical & Mental Health | Public Health | Patients & Consumers | Governance & Leadership | Government | Population-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Roadmap to diversity: Key legal and educational policy foundations for medical schools External Web Site Policy

Coleman, A. L., Palmer, S. R., Winnick, S. Y., & Holland & Knight, L.L.P. (2008). Roadmap to diversity: key legal and educational policy foundations for medical schools. Association of American Medical Colleges. Retrieved from http://www.cossa.org/diversity/reports/Key_Legal_and_Policy_Foundations_for_Medical_Schools.pdf

This report, published by the Association of American Medical Colleges, seeks to provide hands-on guidance to medical schools that seek to improve diversity among their students, their missions, and their policies. The report is designed to guide all medical schools in their quest for increased diversity.

Keywords:    Tools | Policy | Education & Training | Clinical & Mental Health | Governance & Leadership | Government | Profession-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

The influence of physicians' demographic characteristics and their patients' demographic characteristics on physician practice: Implications for education and research External Web Site Policy

Berger, J. T. "The influence of physicians' demographic characteristics and their patients' demographic characteristics on physician practice: Implications for education and research." Academic Medicine, 83.1 (2008): 100-105.

Demographic differences, specifically race, gender, and religion, have been shown to affect the diagnosis, type of treatment, and prevention methods provided to patients. This study from Academic Medicine highlights the necessity of cultural self-awareness and individualized patient care.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Population-Based | Profession-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Viewpoint: Physician, know thyself: The professional cultural of medicine as a framework for teaching cultural competence External Web Site Policy

Boutin-Foster, C., Foster, J. C., & Konopasek, L. (2008). Viewpoint: physician, know thyself: the professional cultural of medicine as a framework for teaching cultural competence. Academic Medicine, 83(1), 106-111. doi: 10.1097/ACM.0b013e31815c6753

Medical schools are emphasizing the importance of cultural competency education, but its emphasis is often overshadowed by a number of challenges, which are addressed in this article. The article discusses several curricula changes for teaching cultural competence to physicians that will assist medical professionals in becoming more adequate in providing care to culturally and linguistically diverse populations.

Keywords:    Research | Education & Training | Clinical & Mental Health | Profession-Based | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Demographics and Health Care Access and Utilization of Limited-English-Proficient and English-Proficient Hispanics

U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality. (2008). Research findings #28: demographics and health care access and utilization of limited-English-proficient and English-proficient Hispanics. Retrieved from http://www.meps.ahrq.gov/mepsweb/data_files/publications/rf28/rf28.pdf

Using data from the 2004 Household Component of the Medical Expenditure Panel Survey, researchers examined the use and access of healthcare among Hispanic adults with limited English proficiency as well as English-proficient Hispanic adults. In comparison to English-proficient Hispanic adults, it was found that limited-English-proficiency Hispanic adults are more likely to be less educated, have a lower income, be unemployed, be without private insurance or uninsured, use health services less often, and have a lower satisfaction rate with the healthcare they receive.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Population-Based | Profession-Based | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Race, medical researcher distrust, perceived harm, and willingness to participate in cardiovascular prevention trials External Web Site Policy

Braunstein, J. B., Sherber, N. S., Schulman, S. P., Ding, E. L., & Powe, N. R. (2008). Race, medical researcher distrust, perceived harm, and willingness to participate in cardiovascular prevention trials. Medicine 87(1), 1-9. doi: 10.1097/MD.0b013e3181625d78

Using a tool called the Medical Researcher Distrust Index, researchers examined individuals' perceived risk of engaging in medical research, specifically in cardiovascular clinical trials. This study presents medical professionals and researchers with a number of intervention approaches that may help alleviate racial and ethnic disparities in research methodology.

Keywords:    Research | Education & Training | Clinical & Mental Health | Patients & Consumers | Population-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

National Resource Center External Web Site Policy

Drexel University School of Public Health's Center for Public Health Readiness & Communication, & U.S. Department of Health & Human Services Office of Minority Health. National resource center on advancing emergency preparedness for culturally diverse communities. (2011, June 10). Retrieved from http://www.diversitypreparedness.org/

The National Resource Center is a database of resources on the public health preparedness needs of diverse communities. The National Resource Center aims to serve as a clearinghouse for those stakeholders who are working to eliminate disparities among minority communities before, during, and following disasters.

Keywords:    Tools | Research | Policy | Education & Training | Public Health | Profession-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health Disparities Report 2008: A County-Level Look at Health Outcomes for Minorities in Georgia

Georgia Department of Community Health Office of Health Improvement and Minority Health Advisory Council. (2008). Health disparities report 2008: a county-level look at health outcomes for minorities in Georgia. Retrieved from http://dch.georgia.gov/vgn/images/portal/cit_1210/5/49/111684019Georgia_Health_Equity_Initiative_
Health_Disparities_Report_2008.pdf

The Georgia Health Disparities Report examines minority health outcomes in each of the counties throughout the State of Georgia. The findings illustrate the need for additional collaborative efforts to truly reduce disparities in health in Georgia. One of the goals of the report is to illustrate what practices are working in certain counties so that others may adapt them to fit in their own counties.

Keywords:    Research | Clinical & Mental Health | Public Health | Government | Population-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Racial disparities in cancer therapy External Web Site Policy

Gross, C. P., Smith, B. D., Wolf, E., & Andersen, M. (2008). Racial disparities in cancer therapy. Cancer, 112(4), 900-908. doi: 10.1002/cncr.23228

This study, published by the American Cancer Society, analyzes whether racial disparities in cancer therapy received by Medicare beneficiaries had been reduced between the early 1990s and 2002 as a result of the increase of disparities reduction initiatives. The study shows no noticeable decrease in racial disparities between 1992 and 2002.

Keywords:    Research | Policy | Clinical & Mental Health | Patients & Consumers | Government | Population-Based | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Community variation: Disparities in health care quality between Asian and white Medicare beneficiaries External Web Site Policy

Moy, E., Greenberg, L. G., & Borsky, A. E. "Community variation: Disparities in health care quality between Asian and white Medicare beneficiaries." Health Affairs 27.2 (2008): 538-549.

This study focused on disparities in quality of health care received between Asian and white Medicare recipients. The researchers found that, overall, Asian Medicare beneficiaries were less likely than whites to receive any of the services examined.

Keywords:    Research | Policy | Clinical & Mental Health | Government | Population-Based | Profession-Based | Disease-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

In the absence of words: A compilation of personal stories addressing the language barrier in health care External Web Site Policy

PALS for Health, & the California Endowment. (2008). In the absence of words: A compilation of personal stories addressing the language barrier in health care. Retrieved from http://tcenews.calendow.org/pr/tce/document/In_the_Absence_of_Words.pdf

By presenting individual stories and narratives, this document seeks to educate and raise awareness about language barriers that exist in the U.S. healthcare system. The stories presented here come from interpreters and language ambassadors from the PALS for Health Program. Each story provides a real experience of a limited-English-proficiency individual and their struggles in the healthcare system.

Keywords:    Research | Education & Training | Clinical & Mental Health | Patients & Consumers | Population-Based | Disparities | Communication and Language Assistance |

Summary of state law requirements addressing language needs in health care External Web Site Policy

Perkins, J., & Youdelman, M. (2008). Summary of state law requirements addressing language needs in health care. Retrieved from the National Health Law Program website: http://www.healthlaw.org/images/stories/issues/nhelp.lep.state.law.chart.final.0319.pdf

The National Health Law Program published a report detailing all existing State law requirements relating to language access needs in healthcare settings. Each State's data are presented in a unique chart with citation to the legislation, a brief description, and coding that indicates the subject matter being addressed.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Government | Communication | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Evaluating interventions to reduce health care disparities: An RWJF program External Web Site Policy

Schlotthauer, A. E., Badler, A., Cook, S. C., Perez, D. J., & Chin, M. H. (2008). Evaluating interventions to reduce health care disparities: An RWJF program. Health Affairs 27(2), 568-573. Retrieved from http://www.rwjf.org/

The RWJF's Finding Answers Program provides funding for programs seeking to reduce and eliminate healthcare disparities. This article, published in the March/April 2008 issue of Health Affairs, provides an overview of some of the current interventions that have the potential to reduce or eliminate health disparities in real-world applications.

Keywords:    Research | Education & Training | Clinical & Mental Health | Public Health | Governance & Leadership | Communication | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Primary-care clinician perceptions of racial disparities in diabetes care External Web Site Policy

Sequist, T. D., Ayanian, J. Z., Marshall, R., Fitzmaurice, G. M., & Safran, D. G. (2008). Primary-care clinician perceptions of racial disparities in diabetes care. Journal of General Internal Medicine 23(5), 678-684. doi: 10.1007/s11606-008-0510-7

This study analyzes racial disparities within the diagnosis and treatment of diabetes. The findings from this study indicate the need to incorporate strategies such as clinical education about healthcare disparities to improve the treatment of minority patients and to help eliminate healthcare disparities among many racial and ethnic minorities.

Keywords:    Research | Clinical & Mental Health | Patients & Consumers | Disease-Based | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Health care in the aftermath of Hurricane Katrina: Health care in New Orleans before and after Hurricane Katrina External Web Site Policy

Shartzer, A. (Author), & kaiserEDU.org (Producer). (2008). Health care in the aftermath of Hurricane Katrina: Health care in New Orleans before and after Hurricane Katrina [Video tutorial]. Retrieved from http://www.kaiseredu.org/tutorials/katrina/player.html

This is a narrated tutorial from the Kaiser Family Foundation that discusses the state of healthcare in New Orleans both before Hurricane Katrina and following it. Much of the information presented discusses the effect that Katrina had on low income individuals, many of whom are minorities.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Government | Population-Based | Communication | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Identifying and Evaluating Equity Provisions in State Health Care Reform External Web Site Policy

Smedley, B., Alvarez, B., Panares, R., Fish-Parcham, C., & Adland, S. (2008). Identifying and evaluating equity provisions in state health care reform (Volume 90). Retrieved from The Commonwealth Fund website: http://www.commonwealthfund.org/

This report examines barriers to healthcare primarily among racial and ethnic minorities, immigrants, and those who are limited English proficient through the lens of insurance and State-level policies and reforms. The report evaluates existing or proposed policies in five States-Massachusetts, Washington, California, Illinois, and Pennsylvania. It also identifies existing State-level policies for equal access to care.

Keywords:    Research | Policy | Clinical & Mental Health | Public Health | Patients & Consumers | Population-Based | Communication | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

The medical tongue: U.S. laws and policies on language access. External Web Site Policy

Youdelman, M. (2008). The medical tongue: U.S. laws and policies on language access. Health Affairs, 27(2), 424-433. doi: 10.1377/hlthaff.27.2.424

Despite many Federal- and State-level laws regarding language access services, language barriers in healthcare are still prevalent for many individuals with limited English proficiency. The existing laws are not always sufficiently implemented or enforced. This article examines the current legislation and makes suggestions for improving language access for limited-English-proficiency individuals through a variety of lenses, including implementation and enforcement, funding, education, interpreters and translators, and accountability.

Keywords:    Research | Policy | Public Health | Government | Communication | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Creating Equity Reports: A Guide for Hospitals. Boston, MA External Web Site Policy

Weinick, R. M., Flaherty, K., & Bristol, S. J. (2008). Creating Equity Reports: A Guide for Hospitals. Retrieved from The Disparities Solutions Center, Massachusetts General Hospital website: http://www2.massgeneral.org/disparitiessolutions/z_files/Disparities%20Hospital%20guide.qxp.pdf

The findings in this report indicate that although many hospitals collect information about their patients' demographics, race, and ethnicity, they often do not make use of the information. This resource is a guide designed to assist hospitals in using that information to develop an equity report.

Keywords:    Tools | Policy | Education & Training | Clinical & Mental Health | Patients & Consumers | Governance & Leadership | Profession-Based | Communication | Quality Improvement | Health Literacy | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

DiversityRx: Improving Health Care in a Diverse World External Web Site Policy

TIDES. (2011). Diversity Rx: Improving Health Care in a Diverse World. Retrieved from http://diversityrx.org/

DiversityRx informs, educates, and supports healthcare providers, policymakers, researchers, and advocates who work to improve quality of care for minority, immigrant, and indigenous communities.

Keywords:    Tools | Research | Education & Training | Clinical & Mental Health | Public Health | Governance & Leadership | Patients & Consumers | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Cultural Competence in Health Education and Health Promotion External Web Site Policy

Perez, M. A., & Luquis, R. (Eds.). (2008). Cultural competence in health education and health promotion. San Francisco, CA: Jossey-Bass, & the American Association for Health Education.

This book describes essential theories, models, and practices for working with race, ethnicity, gender, and social issues.

Keywords:    Tools | Research | Education & Training | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Culture, Illness, and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research External Web Site Policy

Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88(2), 251-258. Abstract retrieved from http://www.annals.org/content/88/2/251.abstract

This landmark publication from 1978 explains that concepts derived from anthropologic and cross-cultural research may provide an alternative framework for identifying issues that require resolution. "The Eight Questions" in this article, an explanatory model of illness that is designed to elicit the patient's perspective of illness, is the foundation for the field of cultural and linguistic competency.

Keywords:    Research | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Guidance for Integrating Culturally Diverse Communities into Planning for and Responding to Emergencies: A Toolkit External Web Site Policy

Andrulis, D. P., Siddiqui, N. J., & Purtle, J. (2011). Guidance for integrating culturally diverse communities into planning for and responding to emergencies: a toolkit. Retrieved from the National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities website: http://www.texashealthinstitute.org/files/OMHDiversityPreparednessToolkit.pdf

This toolkit from the Office of Minority Health assists agencies in working with diverse communities to address a broader set of priorities to improve health and quality of life that are central to effective emergency event strategies and actions. It offers recommendations, resources, and practical strategies for engaging and integrating culturally diverse communities across emergency planning and response actions.

Keywords:    Tools | Government | Public Health | Profession-Based | Communication | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Medical Interpreters Are a Patient's Right External Web Site Policy

Krtiz, F. L. (2010, December 27). Medical interpreters are a patient's right. The Los Angeles Times. Retrieved from http://www.latimes.com/

This article documents language access requirements and advancements that help the healthcare system facilitate communication between providers and those who are limited English proficient. It discusses technological improvements, nationwide certification bodies, and Federal and State laws.

Keywords:    Policy | Communication and Language Assistance | Governance & Leadership | Research | Profession-Based |

State Works to Improve Indian Health External Web Site Policy

Uken, C. (2011, January 8). State works to improve Indian health. The Billings Gazette. Retrieved from http://billingsgazette.com/news/state-and-regional/montana/article_efcf15bc-85d1-5af5-b396-eac182a2d146.html

This article details Montana's comprehensive efforts to address health disparities suffered by the State's American Indian population. Montana is implementing culturally competent services and partnering with tribal governments to improve the health of this population.

Keywords:    Population-Based | Policy | Profession-Based | Clinical & Mental Health | Public Health | Quality Improvement | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

With Poem, Broaching the Topic of Death External Web Site Policy

Daitz, B. (2011, January 24). With poem, broaching the topic of death. The New York Times. Retrieved from http://www.nytimes.com/

This article presents an Arizona hospital's efforts to provide culturally and linguistically appropriate geriatric and end-of-life services to its American Indian population.

Keywords:    Clinical & Mental Health | Public Health | Population-Based | Disease-Based | Quality Improvement | Disparities | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability |

Multicultural HIV/AIDS and Hepatitis Service External Web Site Policy

A public site where people can access multilingual information on HIV and Hepatitis C.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Clinical & Mental Health | Communication | Governance, Leadership, and Workforce | Disease-Based | Disparities | Education & Training | Government | Health Literacy | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Patients & Consumers | Policy | Population-Based | Profession-Based | Public Health | Quality Improvement | Research | Tools |

Holistic Honu Wellness Center - Bridging the Gap between Traditional Healing and Western Medicine External Web Site Policy

The Holistic Honu Wellness Center is a very small health and wellness center in Berkeley, California where they address the issue of Native Hawaiian health disparities by acting as a conduit between traditional healing practices and the western medical communities everyday. Their current program has been the development and execution of a culturally competent education curriculum designed to address health disparity issues within Native Hawaiian communities that consists of four distinct levels.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Clinical & Mental Health | Communication | Governance, Leadership, and Workforce | Disparities | Education & Training | Health Literacy | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Patients & Consumers | Population-Based | Public Health | Quality Improvement | Research | Tools |

CCATHFieldTest.pdf (PDF - 123KB)

Overview of the Cultural Competency Assessment Tool for Hospitals (CCATH) - a survey designed to assess hospital's adherence to the CLAS standards. The development and testing of the CCATH was funded by U.S.Department of Health and Human Services' (DHHS) Office of Minority Health (OMH) and the Commonwealth Fund. Organizational assessments, such as the CCATH, provide a useful tool to evaluate the structures (policies, programs) and processes (practices, culture) for cultural competency. The CCATH was subject to extensive qualitative testing, including pilot testing, focus groups, and cognitive interviews (Hays et al. 2006).

Keywords:    Governance & Leadership | Clinical & Mental Health | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Tools |

CCATHOverview.pdf (PDF - 45KB)

Survey of cultural competency activities in hospitals. Part of the Cultural Competency Assessment Tool for Hospitals (CCATH) - a survey designed to assess hospital's adherence to the CLAS standards. The development and testing of the CCATH was funded by U.S. Department of Health and Human Services' (DHHS) Office of Minority Health (OMH) and the Commonwealth Fund. Organizational assessments, such as the CCATH, provide a useful tool to evaluate the structures (policies, programs) and processes (practices, culture) for cultural competency. The CCATH was subject to extensive qualitative testing, including pilot testing, focus groups, and cognitive interviews (Hays et al. 2006).

Keywords:    Governance & Leadership | Clinical & Mental Health | Governance, Leadership, and Workforce | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Tools |

NCQA Multicultural Healthcare Distinction fact sheet External Web Site Policy

A fact sheet describing how NCQA's Multicultural Healthcare Distinction program can help health care organizations meet Office of Minority Health CLAS standards.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance, Leadership, and Workforce | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Policy | Quality Improvement | Tools |

National Council on Interpreting in Health Care External Web Site Policy

National Council on Interpreting in Health Care. (2011). Retrieved from http://www.ncihc.org

This website provides links to NCIHC publications and training programs. Links are available to other relevant sites, such as state interpreter associations, educational programs, and sites discussing cultural competency or legal and regulatory issues. Member benefits include quarterly webinars, interpreter trainer mentorship programs, annual meetings, and access to a members' Listserv. The site offers a discussion of the history of the NCIHC's efforts toward the creation of a nationally recognized certification for health care interpreters. Interpreting in the mental health care environment is also specifically discussed.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Policy |

Speaking Together Toolkit External Web Site Policy

Robert Wood Johnson Foundation. (2008). Speaking together toolkit. Retrieved from http://www.rwjf.org/pr/product.jsp?id=29653

The toolkit offers advice for improving the quality and accessibility of language services in hospitals. Topics discussed include written and spoken language needs, screening patients to determine their language needs, building a language services workforce, getting appropriate interpreter services to the patient, the education of clinical staff, documentation, and performance measurement.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Tools |

2004 U.S. Census test: Language identification flashcard External Web Site Policy

U.S. Department of Commerce, Census Bureau. (2004). 2004 U.S. Census test: Language identification flashcard. Retrieved from http://www.lep.gov/ISpeakCards2004.pdf

A sentence (translating as "Mark this box if you read or speak ...") is repeated in 38 written languages, in scripts varying appropriately with the language.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Tools | Communication and Language Assistance | Government |

Health literacy universal precautions toolkit

U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (2010). Health literacy universal precautions toolkit (AHRQ Publication No. 10-0046-EF). Retrieved from http://www.ahrq.gov/qual/literacy/healthliteracytoolkit.pdf

This toolkit was designed to be used by staff at all levels of a primary care practice. It contains 20 tools, each two to five pages long, to improve spoken and written communication and improve patient self-management. A quick-start guide is provided. Background information on health literacy is included. Links to videos are available. An appendix offers forms, PowerPoint presentations, worksheets, and posters.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Health Literacy | Government | Tools |

Guidance to federal financial assistance recipients regarding Title VI and the prohibition against national origin discrimination affecting limited English proficient persons: Summary

U.S. Department of Health and Human Services, Office for Civil Rights. (n.d.). Guidance to federal financial assistance recipients regarding Title VI and the prohibition against national origin discrimination affecting limited English proficient persons: Summary. Retrieved from http://www.hhs.gov/ocr/civilrights/resources/laws/summaryguidance.html

This summary of the full 2003 guidance briefly discusses the use of patients' family members and friends as interpreters, the translation of vital documents, interpreter and translator competence, the elements of an effective language assistance plan, and the factors used to determine the obligation under Title VI of recipients of federal funding to ensure meaningful access to programs for persons with limited English proficiency. It is noted that what constitute reasonable steps to be required of large providers "may not be reasonable where small providers are concerned."

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Government | Policy |

National Center for Deaf Health Research External Web Site Policy

University of Rochester Medical Center. (2012). National Center for Deaf Health Research. Retrieved from http://www.urmc.rochester.edu/ncdhr/

The center is guided by a cultural model of deafness (i.e., that deaf people are a minority group who share a common language and culture), not a clinical model. Links are provided to relevant literature, training, and research projects pertinent to the health needs of culturally deaf people.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Population-Based |

Promising practices for patient-centered communication with vulnerable populations: Examples from eight hospitals External Web Site Policy

Wynia, M., & Matiasek, J. (2006). Promising practices for patient-centered communication with vulnerable populations: Examples from eight hospitals (Commonwealth Fund Publication No. 947). Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2006/Aug/Promising%20Practices%20for%20Patient%20Centered%20Communication%20with%20Vulnerable%20Populations%20%20Examples%20from%20Ei/Wynia_promisingpracticespatientcentered_947%20pdf.pdf

The study identified eight hospitals that have demonstrated a commitment to patient-centered communication with vulnerable patient populations. The authors discuss several promising practices in use by these hospitals, including advocates for communication programs, data collection on patient needs, community and patient engagement, a diverse workforce, awareness of cultural diversity, effective language assistance services, addressing the problem of health literacy, and assessing performance.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Health Literacy | Research |

Promising practices for small health care providers. In Providing language services in small health care provider settings: Examples from the field External Web Site Policy

Youdelman, M., & Perkins, J. (2005). Promising practices for small health care providers. In Providing language services in small health care provider settings: Examples from the field (pp. 3-11) (Commonwealth Fund Publication No. 810). Retrieved from http://www.commonwealthfund.org/usr_doc/810_Youdelman_providing_language_services.pdf

Small provider settings, especially, may be hampered by limited resources in their efforts to provide effective care to an increasing number of patients who have limited proficiency in English. The National Health Law Program conducted interviews and site visits to learn how small providers are coping with this problem. Certain practices emerged as promising and replicable. These include the recruitment of bilingual staff to serve in dual capacities, ongoing training for interpreters, use of community resources, and capitalizing on underutilized funding sources. The authors offer an eight-step plan for development of a strategy to allow providers to meet the needs of their patients and communities.

Keywords:    Provide effective, equitable, understandable, and respectful quality care and services | Communication and Language Assistance | Research |

Skills based courses External Web Site Policy

American Academy on Communication in Healthcare. (n.d.). Skills based courses [Course summaries]. Retrieved from http://www.aachonline.org/?page=SkillsBasedCourses

The American Academy on Communication in Healthcare offers a number of institutional courses on such topics as enhancing effective clinician-patient communication and managing medical malpractice risk with improved communication skills. Courses may be tailored to meet an institution's particular needs.

Keywords:    Governance, Leadership, and Workforce | Education & Training | Communication and Language Assistance |

C-CAT: Patient centered communication External Web Site Policy

American Medical Association. (n.d.). C-CAT: Patient centered communication. Retrieved from http://www.ama-assn.org/go/ccat

C-CAT stands for Communication Climate Assessment Toolkit, a set of staff, patient, and leadership surveys developed by the AMA's Ethical Force Program to assist organizations in meeting the needs of diverse patient populations. This website offers numerous links to information relevant to C-CAT, such as field testing, survey components, and contact information for consultants trained in the implementation and scoring of the surveys.

Keywords:    Governance, Leadership, and Workforce | Communication and Language Assistance | Governance & Leadership |

A world of differences: Understanding cross-cultural communication External Web Site Policy

Archer, D. (Producer), & Silver, J. (Director). (1997). A world of differences: Understanding cross-cultural communication [DVD]. United States: University of California Extension Center for Media and Independent Learning.

This 30-minute video examines 14 areas of possible cross-cultural miscommunication. Not only language, but values and norms, the meaning of gestures, the expression of emotion, the sense of personal space, patterns of touch, and matters of etiquette will vary among cultures. The video demonstrates that cross-cultural communication can be successful provided that differences are recognized and understood within their cultural context.

Keywords:    Governance, Leadership, and Workforce | Education & Training | Communication and Language Assistance |

Course information: Bridging the gap External Web Site Policy

Cross Cultural Health Care Program. (n.d.). Course information: Bridging the gap [Online training course summary]. Retrieved from http://www.xculture.org/BTGclassdesc.php

This 40-hour training program is designed to prepare bilingual individuals for work as medical interpreters in hospitals or clinics. Topics covered include basic interpreting skills, ethics, and medical vocabulary. Classes are limited to 20 students.

Keywords:    Governance, Leadership, and Workforce | Education & Training | Communication and Language Assistance |

Worlds apart: A four-part series on cross-cultural healthcare External Web Site Policy

Grainger-Monsen, M., & Haslett, J. (2004). Worlds apart: A four-part series on cross-cultural healthcare [Film series]. Brooklyn, NY: Fanlight Productions.

The series consists of four short films, totaling 47 minutes combined running time. Filmed in patients' homes and neighborhoods as well as in clinical settings, each part follows one patient and his or her family as they are faced with critical medical decisions. The series highlights the tensions between modern medicine and traditional beliefs, problems of communication, and mistrust of the health care system.

Keywords:    Governance, Leadership, and Workforce | Patients & Consumers | Communication and Language Assistance |

Training: Institute for Healthcare Communication External Web Site Policy

Institute for Healthcare Communication. (2012). Training. Retrieved from http://healthcarecomm.org/training

This site contains links to courses offered by the Institute for Healthcare Communication. Continuing education credit is available for some courses. A train-the-trainer approach in some courses will qualify participants to teach the course in their own organizations.

Keywords:    Governance, Leadership, and Workforce | Education & Training | Communication and Language Assistance |

Cultural competency in health care: Evaluating the outcomes of a cultural competency training among health care professionals

Khanna, S. K., Cheyney, M., & Engle, M. (2009). Cultural competency in health care: Evaluating the outcomes of a cultural competency training among health care professionals. Journal of National Medical Association, 101, 886-892.

The authors conducted a study of 43 health care providers and administrators who attended a four-hour cultural competency workshop. A post-then-pre self-report was used to evaluate the effectiveness of the training. Participants reported an improved ability to work effectively in cross-cultural situations. The authors conclude that a cultural competency training program integrating key topics recommended by the Institute of Medicine and the National CLAS Standards improves the knowledge and skills of health care professionals.

Keywords:    Governance, Leadership, and Workforce | Research | Communication and Language Assistance |

Retreats that work: Everything you need to know about planning and leading great offsites External Web Site Policy

Liteman, M., Campbell, S., & Liteman, J. (2006). Retreats that work: Everything you need to know about planning and leading great offsites. San Francisco, CA: Pfeiffer.

Offers information on how to design and lead retreats, including guidance on establishing effective working relationships with clients, tools for conflict management, and tips for follow-up. An accompanying CD makes it possible to duplicate templates and produce handouts.

Keywords:    Governance, Leadership, and Workforce | Communication and Language Assistance | Tools |

Quality interactions: A patient-based approach to cross-cultural care External Web Site Policy

Quality interactions: A patient-based approach to cross-cultural care. (2011). Retrieved from http://www.qualityinteractions.org

This is an evidence-based, case-based e-learning program on cultural competency and cross-cultural communication for physicians, nurses, and other health care staff. Versions of the program are available tailored for particular needs or groups. A course demo is available.

Keywords:    Governance, Leadership, and Workforce | Communication and Language Assistance | Clinical & Mental Health |

A patient-centered guide to implementing language access services in healthcare organizations

U.S. Department of Health and Human Services, Office of Minority Health. (2005). A patient-centered guide to implementing language access services in healthcare organizations. Retrieved from https://hclsig.thinkculturalhealth.hhs.gov/

This guide provides practical suggestions on how health care organizations and providers can implement language access services. It is intended to meet the needs of clinics, community health centers, hospitals, health maintenance organizations, mental health institutions, dental offices, long-term care facilities, substance abuse treatment centers, and individual physicians' offices. Information is offered on assessing patients' language needs, assessing organizational capabilities, and planning and implementing language services. "Resource units" address issues such as interpretation services, written materials and signage, and community involvement.

Keywords:    Governance, Leadership, and Workforce | Communication and Language Assistance | Government |

Communicating through health care interpreters External Web Site Policy

Virtual Lecture Hall. (2012). Communicating through health care interpreters [Online training course summary]. Retrieved from http://www.vlh.com/shared/courses/course_info.cfm?courseno=155

This online tutorial offers instruction for those working with interpreters in the context of patient care. Topics include the value of presession time with the interpreter, establishing rapport with the patient through the interpreter, modifying speech patterns to optimize the accuracy of interpretation, choosing interpreters appropriate for various circumstances, seeing the interpreter as cultural broker, understanding the consequences of using unqualified interpreters, and factoring cultural differences into assessments of abnormal behavior or development. Continuing medical education credits are available.

Keywords:    Governance, Leadership, and Workforce | Communication and Language Assistance | Education & Training |

Validation of an organizational communication climate assessment toolkit External Web Site Policy

Wynia, M. K., Johnson, M., McCoy, T. P., Griffin, L. P., & Osborn, C. Y. (2010). Validation of an organizational communication climate assessment toolkit. American Journal of Medical Quality, 25(6), 436-443. doi:10.1177/1062860610368428

The authors report findings from a prospective multisite validation study of an organizational communication climate assessment toolkit and find that most of the nine communication domains assessed "were significant predictors of patient-reported quality of care and trust." They conclude that these tools "provide a valid empirical assessment of organizational communication climate" in these domains.

Keywords:    Governance, Leadership, and Workforce | Communication and Language Assistance | Public Health |

Title VI for healthcare and healthcare-related organizations External Web Site Policy

Adelson, B. L., & Bromberg & Associates, LLC. (2010). Title VI for healthcare and healthcare-related organizations [Online training module]. Hamtramck, MI: Bromberg Translation Services.

This online training module discusses the implications of Title VI for health care organizations receiving federal funding.

Keywords:    Communication and Language Assistance | Government | Education & Training |

Health literacy and patient safety: Help patients understand External Web Site Policy

American Medical Association Foundation. (2007). Health literacy and patient safety: Help patients understand [Educational kit]. Chicago, IL: American Medical Association Foundation.

This self-study kit for health care professionals and patient advocates contains an instructional video on DVD and CD-ROM (VHS format available separately), a manual for clinicians, discussions of cases, evaluation materials, and a continuing medical education questionnaire. The estimated time to complete the activity is two and a half hours.

Keywords:    Communication and Language Assistance | Health Literacy | Patients & Consumers |

Office guide to communicating with limited English proficient patients

American Medical Association. (2007). Office guide to communicating with limited English proficient patients. Retrieved from http://www.ama-assn.org/ama1/pub/upload/mm/433/lep_booklet.pdf

This concise guide, addressed to health care providers, offers strategies for meeting the language needs of patients who have limited proficiency in the English language. Topics discussed include the relation between language assistance and cultural competency, telephone calls from patients with limited English, on-site and telephonic interpreter services, trained bilingual staff, voice-activated software translation, and the financing of language assistance services.

Keywords:    Communication and Language Assistance | Education & Training |

National Joint Committee for the Communication Needs of Persons with Severe Disabilities (NJC) External Web Site Policy

American Speech-Language-Hearing Association. (2012). National Joint Committee for the Communication Needs of Persons with Severe Disabilities (NJC). Retrieved from http://www.asha.org/njc

Organized in 1985 and currently composed of representatives from eight organizations, the NJC plays an advocacy role "for individuals with significant communication support needs resulting from intellectual disability, that may coexist with autism, sensory and/or motor limitation." Links from the site give access to guidelines, frequently asked questions, presentations, articles, a communication support checklist, and information about eligibility for communication support.

Keywords:    Communication and Language Assistance | Tools |

Linguistically appropriate access and services: An evaluation and review for healthcare organizations External Web Site Policy

Anderson, C. C., & National Council on Interpreting in Health Care (2002). Linguistically appropriate access and services: An evaluation and review for healthcare organizations. Retrieved from http://data.memberclicks.com/site/ncihc/NCIHC%20Working%20Paper%20-%20Linguistically%20Appropriate%20Access%20and%20Services.pdf

This paper provides a checklist to aid in the evaluation of existing organizational structures and the capacity to provide linguistically appropriate patient care and access to language services.

Keywords:    Communication and Language Assistance | Tools |

Integrating literacy, culture, and language to improve health care quality for diverse populations

Andrulis, D. P., & Brach, C. (2007). Integrating literacy, culture, and language to improve health care quality for diverse populations. American Journal of Health Behavior, 31, S122-S133. Retrieved from http://www.cpehn.org/pdfs/Integrating%20Literace%20Paper%20-%20Andrulis.pdf

This article discusses the importance of an integrated approach by providers and organizations to address literacy, culture and language. The authors find that strategies aimed at improving health literacy are very often distinct from those addressing cultural and linguistic diversity. They assert that this lack of integration results in health care that is unresponsive to the needs of some vulnerable groups.

Keywords:    Communication and Language Assistance | Health Literacy | Quality Improvement | Public Health |

Health literacy: A review

Andrus, M. R., & Roth, M. T. (2002). Health literacy: A review. Pharmacotherapy, 22(3), 282-302. Retrieved from www.cce.uri.edu/pharmacy/rotationdescriptions/Andrus_Wk2.pdf

The authors note that nearly half of English-speaking patients lack functional health literacy, defined as the ability to read, understand, and act on health information. The consequences of this state of affairs include poor health status, lack of understanding and use of preventive services, poor compliance, an increase in hospitalizations, and higher costs. Topics discussed include measuring literacy and health literacy, the prevalence of illiteracy and of inadequate functional health literacy, the readability of patient education materials and dosing instructions, cultural literacy, patient experiences, and proposed solutions.

Keywords:    Communication and Language Assistance | Health Literacy |

Universal symbols in health care workbook External Web Site Policy

Berger, C., (2005). Universal symbols in health care workbook. Retrieved from Hablamos Juntos website http://www.hablamosjuntos.org/signage/PDF/Best%20Practices-FINALDec05.pdf

This document discusses the importance and practical advantages of easily interpreted and widely applied symbols in signage and offers a set of 28 symbols specifically designed for use in health care facilities.

Keywords:    Communication and Language Assistance | Governance & Leadership |

Low health literacy and health outcomes: An updated systematic review External Web Site Policy

Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J., & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97-107.

In a review of the medical, allied health, and psychological literature, the authors found 96 studies of good-to-fair quality of health outcomes affected by low health literacy or numeracy. They found low health literacy to be consistently associated with increased hospitalizations, greater use of emergency services, fewer vaccinations or mammograms, and, among the elderly, poorer overall health and higher mortality. No conclusions were possible regarding numeracy because of the limited number of studies (22 articles since 1966).

Keywords:    Communication and Language Assistance | Health Literacy | Public Health |

Crossing the language chasm External Web Site Policy

Brach, C., Fraser, I., & Perez, K. (2005). Crossing the language chasm. Health Affairs, 24(2), 424-434. doi:10.1377/hlthaff.24.2.424

The authors review evidence for a link between linguistic competence and the quality of health care delivered. Language assistance strategies are discussed. The authors also examine the experiences, in regard to linguistic competence, of 14 health plans and draw conclusions as to how the availability and quality of interpreter services might be improved.

Keywords:    Communication and Language Assistance | Quality Improvement |

California Healthcare Interpreting Association External Web Site Policy

California Healthcare Interpreting Association. (n.d.). Retrieved from http://chiaonline.org/

Association membership is open to individuals or organizations. The site provides standards for interpreters, training opportunities, a job board for members, and notice of events and conferences.

Keywords:    Communication and Language Assistance | Profession-Based | Governance & Leadership |

The toolkit for making written material clear and effective: Overview

Centers for Medicare and Medicaid Services. (2011). The toolkit for making written material clear and effective: Overview. Retrieved from https://www.cms.gov/WrittenMaterialsToolkit/

This toolkit offers guidelines, using a reader-centered approach, to the writing and design of brochures, pamphlets, booklets, flyers, fact sheets, posters, application forms, comparison charts, instruction sheets, questionnaires, and websites. Contents include readability formulas, a before-and-after example of a brochure with discussion of the differences, and guidelines for culturally appropriate translation.

Keywords:    Communication and Language Assistance | Government | Tools |

Certification Commission for Healthcare Interpreters External Web Site Policy

Certification Commission for Healthcare Interpreters. (n.d.). Retrieved from http://www.healthcareinterpretercertification.org/

Established in 2009, CCHI offers a certification created by health care interpreters for health care interpreters. The certification program is vendor neutral, meaning that it is "based on data from the field regarding ... knowledge, skills, performance and employers' expectations" rather than on completion of a specific training program. The website offers a fact sheet, FAQs, a resources page of pertinent sites, and access to webinars, all having a focus on interpreter credentialing.

Keywords:    Communication and Language Assistance | Tools | Profession-Based |

Doctoring across the language divide External Web Site Policy

Chen, A. (2006). Doctoring across the language divide. Health Affairs, 25(3), 808-813. doi:10.1377/hlthaff.25.3.808

The author, who speaks three languages, recounts her experience with a patient who spoke none of those three and the difference made by a trained medical interpreter.

Keywords:    Communication and Language Assistance | Patients & Consumers |

The legal framework for language access in healthcare settings: Title VI and beyond

Chen, A. H., Youdelman, M. K., & Brooks, J. (2007). The legal framework for language access in healthcare settings: Title VI and beyond. Journal of General Internal Medicine, 22(Supplement 2), 362-367. doi:10.1007/s11606-007-0366-2

The authors discuss federal mandates and offer an overview of state laws and recent legal decisions in the field of language rights in health care. The article also includes the authors' analysis of policy initiatives that could improve the health care of patients with limited proficiency in English.

Keywords:    Communication and Language Assistance | Government | Policy |

Best practice recommendations for hospital-based interpreter services External Web Site Policy

Commonwealth of Massachusetts Executive Office of Health and Human Services, Massachusetts Department of Public Health. (2004). Best practice recommendations for hospital-based interpreter services. Retrieved from http://www.mass.gov/eohhs/docs/dph/health-equity/best-practices.pdf

The Massachusetts Department of Public Health, in consultation with a broad array of organizations within the state, has sought to identify the components of an optimal interpreter services program for hospitals. Some characteristics were found to be common to all successful programs: that they are structured rather than ad hoc, with written policies and procedures; include regular and systematic review of community language needs and facility resources; have specific training and competency protocols for interpreters and providers; include a means of monitoring and evaluation; and offer a delivery system appropriate to the needs of those served.

Keywords:    Communication and Language Assistance | Government | Governance & Leadership | Public Health |

Cross-Cultural Communication Systems, Inc. External Web Site Policy

Cross-Cultural Communication Systems, Inc. (2010). Retrieved from http://www.embracingculture.com

CCCS provides cultural-linguistic services (e.g., interpretation, translation, and training) to health care, legal, business, and academic organizations. Round-the-clock emergency interpreter service is available. Approximately 150 languages are represented at the present time. Training manuals, videos, and courses are available through the website.

Keywords:    Communication and Language Assistance | Tools |

Language proficiency and adverse events in US hospitals: A pilot study External Web Site Policy

Divi, C., Koss, R. G., Schmaltz, S. P., & Loeb, J. M. (2007). Language proficiency and adverse events in US hospitals: A pilot study. International Journal of Quality in Health Care, 19(2), 60-67. doi:10.1093/intqhc/mzl069

Adverse event data were collected on English-speaking patients and on patients with limited proficiency in English from six hospitals in 2005. Patients with limited English had a higher percentage of adverse events than did English-speaking patients, and, of these events, a higher percentage were traceable to communication errors in the case of patients with limited English skills than was the case among those who spoke fluent English.

Keywords:    Communication and Language Assistance | Research |

Translation as a strategy for effective communication with patients and clients: A how-to guide External Web Site Policy

Downing, B., & Bogoslaw, L. (2003). Translation as a strategy for effective communication with patients and clients: A how-to guide. Retrieved from Hablamos Juntos website: http://www.hablamosjuntos.org/pdf_files/BruceDowningHow-To_Guide_FINAL.pdf

This concise document offers step-by-step guidance for those with responsibility for the written communication, across language barriers, of health care organizations to patients and clients. Topics covered include needs and resource assessment, prioritization of value considerations (e.g., need versus cost), whether to translate an existing document or create a new one, the responsibilities of the initiator and manager of translation, and jointly undertaken translation projects.

Keywords:    Communication and Language Assistance | Education & Training | Engagement, Continuous Improvement, and Accountability |

Health literacy: the road to improved health outcomes External Web Site Policy

Ferguson, L. A., & Pawlak, R. (2011). Health literacy: the road to improved health outcomes. Journal for Nurse Practitioners, 7(2), 123-129. doi:10.1016/j.nurpra.2010.11.020

The authors note that people's behavior and decisions are affected by their levels of health literacy, with low health literacy leading to poor health outcomes. They review research on health literacy and discuss ways in which it might be improved.

Keywords:    Communication and Language Assistance | Health Literacy | Quality Improvement |

Process of inquiry: Communicating in a multicultural environment External Web Site Policy

Gilbert, M. J., Partida, Y., Goode, T., & Dunne, C. (2005). Process of inquiry: Communicating in a multicultural environment. In Curricula enhancement module series. Retrieved from the National Center for Cultural Competence website: http://www.nccccurricula.info/communication/index.html

This free Web-based curriculum-enhancement module is part of a series designed to facilitate incorporation of the principles and practices of cultural and linguistic competence into all levels of leadership training. The process of inquiry, as an approach to communication, will lead health care personnel to inquire gently into their patients' understanding of themselves, their families, their environments, and their symptoms as a way to establish a basis for cross-cultural communication. Teaching tools, skill-building exercises, strategies, case studies, and resources are included.

Keywords:    Communication and Language Assistance | Governance & Leadership | Education & Training |

Effect of awareness of language law on language access in the health care setting

Grubbs, V., Chen, A. H., Bindman, A. B., Vittinghoff, E., & Fernandez, A. (2006). Effect of awareness of language law on language access in the health care setting. Journal of General Internal Medicine, 21(7), 683-688. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924696/?tool=pubmed

A telephone survey was conducted in 11 non-English languages with 1,000 participants who had limited proficiency English to determine whether awareness of federal law regarding access to language services affected their use of interpreters. The authors found that awareness of the law was not associated with interpreter utilization, although it was associated with having a provider who speaks one's own language. The authors conclude that awareness of the law is insufficient to resolve linguistic barriers.

Keywords:    Communication and Language Assistance | Policy | Research |

Language testing options 2008 External Web Site Policy

Hablamos Juntos. (2008). Language testing options 2008. Retrieved from http://www.imiaweb.org/uploads/pages/218.pdf

This document lists 35 resources available on the Internet to assess the foreign language proficiency of interpreters. These are organized into four categories: (1) language proficiency testing, (2) proficiency testing required for interpreter training programs, (3) proprietary proficiency tests offered by commercial agencies, and (4) tests of other interpreter skills beyond language proficiency. Contact information and URLs are supplied; fees and time required to take the test are noted for each. There is also a discussion of various approaches to language testing.

Keywords:    Communication and Language Assistance | Tools |

Hablamos Juntos: Language policy and practice in health care External Web Site Policy

Hablamos Juntos: Language policy and practice in health care. (n.d.). Retrieved from http://www.hablamosjuntos.org

Hablamos Juntos ("We Speak Together") is developing affordable models of language services in health care organizations through the funding of 10 demonstration sites in regions, both rural and urban, with fast-growing Latino populations. Information is available on interpreter services and signage. The website also offers an extensive resource library.

Keywords:    Communication and Language Assistance | Policy | Population-Based |

Health literacy studies: Assessing and developing health materials External Web Site Policy

Harvard School of Public Health. (2010). Health literacy studies: Assessing and developing health materials. Retrieved from http://www.hsph.harvard.edu/healthliteracy/practice/innovative-actions/index.html

This website offers access to readability tools and guidelines for creating, assessing, and rewriting print materials.

Keywords:    Communication and Language Assistance | Health Literacy | Tools |

Qualified Interpreting for Quality Health Care External Web Site Policy

Health Care Interpreter Network, Kaiser Permanente, & Casa Madre Films. (2009). Qualified Interpreting for Quality Health Care [DVD]. Retrieved from http://vimeo.com/7225401

This 19-minute training video for clinical staff covers such topics as the importance of using qualified interpreters, confidentiality and other key protocols for interpreters, the role of culture, and tips for using remote interpreters.

Keywords:    Communication and Language Assistance | Education & Training |

The health literacy & plain language resource guide External Web Site Policy

Health Literacy Innovations. (2008). The health literacy & plain language resource guide. Retrieved from http://www.healthliteracyinnovations.com/information/RGdownload

Writing that is clear, to the point, and directed to the target audience is presented as a good strategy to improve health literacy. This guide offers links to Web pages, initiatives, action plans, reports, toolkits, and other resources appropriate for achieving that end.

Keywords:    Communication and Language Assistance | Health Literacy | Tools |

Language Access and the Law: Caring for the LEP Patient External Web Site Policy

Hunt, D., & Walker, P. F. (2010). Language Access and the Law: Caring for the LEP Patient [E-learning program]. Minneapolis, MN: Critical Measures.

This interactive e-learning course was designed to increase the understanding of medical professionals about the reasons (e.g., business, legal, and medical) for providing language services. The course may help clinicians to avoid common problems, identify cross-cultural medical issues and integrate them into the practice, work with interpreters, and avoid litigation. Continuing education credit is available.

Keywords:    Communication and Language Assistance | Policy | Education & Training |

Medical interpreting standards of practice External Web Site Policy

International Medical Interpreters Association. (2007). Medical interpreting standards of practice. Retrieved from http://www.imiaweb.org/uploads/pages/102.pdf

As the introduction points out, although it is contrary to common belief, the clinical interview relies heavily on language. This document delineates the core performance standards for professional interpreters and may serve as a tool for the evaluation of practice and competence. The 27 standards are divided among three broad areas of focus: interpretation, cultural interface, and ethical behavior.

Keywords:    Communication and Language Assistance | Policy |

International Medical Interpreters Association External Web Site Policy

International Medical Interpreters Association. (2012). Retrieved from http://www.imiaweb.org/default.asp

This professional association's website offers links to a wide variety of information and services: training; an ethical code in many languages; standards of practice; advocacy activities; research; employment opportunities and opportunities for pro bono disaster relief; a Listserv; and information about legal matters, upcoming events, and health literacy, to name a few.

Keywords:    Communication and Language Assistance | Health Literacy | Tools |

Telephone interpreting in health care settings: Some commonly asked questions External Web Site Policy

Kelly, N. (2007). Telephone interpreting in health care settings: Some commonly asked questions. Retrieved from The ATA Chronicle website: http://www.atanet.org/chronicle/feature_article_june2007.php

The author poses and answers questions related to telephone interpreting, such as: When is face-to-face interpreting preferable to telephone interpreting? When is telephone interpreting preferable? What type of equipment should be used? What about nonverbal cues? How should medical records be documented when telephone interpreters are used? Does video interpretation have the potential to replace both on-site and telephone interpreting altogether? A resources section directs readers interested in working with interpreters to relevant books, websites, and training.

Keywords:    Communication and Language Assistance | Tools |

A medical interpreter's guide to telephone interpreting External Web Site Policy

Kelly, N. (2008). A medical interpreter's guide to telephone interpreting. Retrieved from International Medical Interpreters Association website: http://www.imiaweb.org/uploads/pages/307_2.pdf

The author provides answers to questions often asked by medical interpreters about interpreting via telephone. The article addresses such topics as the quality of telephonic versus in-person or video interpreting; nonverbal information; necessary qualifications; employment; work locations; compensation; the relation between fatigue and break time between calls; the equipment used; reference materials; training; how patients feel about telephone interpreting; how providers feel; and the settings in which telephone interpreting is preferable to on-site interpreting and vice versa.

Keywords:    Communication and Language Assistance | Tools |

Pediatricians' use of language services for families with limited English proficiency External Web Site Policy

Kuo, D. Z., O'Connor, K. G., Flores, G., & Minkovitz, C. S. (2007). Pediatricians' use of language services for families with limited English proficiency. Pediatrics 119(4), e920-e27. doi:10.1542/peds.2006-1508.

The authors' objective was to study pediatricians' use of language services and the characteristics of the practice and the state associated with the use of these services. Bilingual family members and bilingual staff were the most frequently reported language services. Forty percent of respondents use professional interpreters; 35 percent supply translated written materials. Those in small and rural practices or in states having a large proportion of persons with limited English skills tend to use professional interpreters less often. Pediatricians in states with third-party reimbursement for language services report more frequent use of professional interpreters.

Keywords:    Communication and Language Assistance | Public Health | Research |

Limited English proficiency: A federal interagency website

Limited English proficiency: A federal interagency website. (n.d.). Retrieved from http://www.lep.gov

This site exists to promote understanding of the importance of language access to all federal and federally assisted programs and to support "a fair, reasoned and consistent" implementation of Executive Order 13166 and related regulations. The website is also a clearinghouse, offering access to an extensive array of tools and information relating to language access.

Keywords:    Communication and Language Assistance | Government |

Responding to the language challenge: Kaiser Permanente's approach

Meyers, K. Tang, G., & Fernandez, A. (2009). Responding to the language challenge: Kaiser Permanente's approach. The Permanente Journal, 13(3), 77-83. Retrieved from http://www.thepermanentejournal.org/files/Summer2009/language_challenge.pdf

The authors outline the history of Kaiser Permanente's efforts to develop linguistically and culturally appropriate care and services with the expectation that the lessons derived from an understanding of the approaches taken, the barriers encountered, and the decision-making processes and drivers may guide other health systems, policymakers, or insurers to implement appropriate and effective language services.

Keywords:    Communication and Language Assistance | Public Health | Engagement, Continuous Improvement, and Accountability |

National Association of the Deaf External Web Site Policy

National Association of the Deaf. (2012). Retrieved from http://www.nad.org/

The National Association of the Deaf is an advocacy group for deaf and hard-of-hearing individuals. Individual or organizational memberships are available. The association recognizes that access to language is a human right and that American Sign Language is "the backbone of American deaf culture." The website provides information on sign language, advocacy activities, legal representation, emergency preparedness, community resources and events, as well as access to member blogs.

Keywords:    Communication and Language Assistance | Population-Based | Tools |

National Board of Certification for Medical Interpreters External Web Site Policy

National Board of Certification for Medical Interpreters. (2012). Retrieved from http://www.certifiedmedicalinterpreters.org/

Candidates who meet the prerequisites of age, experience, and education may apply for certification as medical interpreters. Certification will demand passage of written and oral exams. A Certified Medical Interpreter Candidate Handbook is available to help candidates prepare for the tests.

Keywords:    Communication and Language Assistance | Tools | Education & Training |

Guide to initial assessment of interpreter qualifications External Web Site Policy

National Council on Interpreting in Health Care. (2001). Guide to initial assessment of interpreter qualifications. Retrieved from http://data.memberclicks.com/site/ncihc/NCIHC%20Working%20Paper%20Guide%20to%20Initial%20Assessment%20of%20Interpreter%20Qualifications.pdf

This guide is intended to outline a strategy for an initial evaluation of interpreter qualifications in the absence of certification by an accrediting body. In addition to basic language skills, areas for assessment include ethical issues, cultural understanding, sight translation (written to oral), and translation of simple texts (written to written).

Keywords:    Communication and Language Assistance | Tools |

Guide to interpreter positioning in health care settings External Web Site Policy

National Council on Interpreting in Health Care. (2003). Guide to interpreter positioning in health care settings. Retrieved from http://data.memberclicks.com/site/ncihc/NCIHC%20Working%20Paper%20-%20Guide%20to%20Interpreter%20Positioning%20in%20Health%20Care%20Settings.pdf

This guide examines the pros and cons of various physical positionings of the interpreter relative to the patient, physician, family members, or others who may be present and the factors (such as room configuration, whether a physical exam is to be performed, the emotional state of the patient, and whether signing will be needed) that influence the decision.

Keywords:    Communication and Language Assistance | Tools |

National Standards of Practice for Interpreters in Health Care External Web Site Policy

National Council on Interpreting in Health Care. (2005). National standards of practice for interpreters in health care. Retrieved from http://mchb.hrsa.gov/training/documents/pdf_library/National_Standards_of_Practice_for_Interpreters_in_Health_Care%20(12-05).pdf

Thirty-two standards are offered divided among the following areas: (1) accuracy, (2) confidentiality, (3) impartiality, (4) respect, (5) cultural awareness, (6) role boundaries, (7) professionalism, (8) professional development, and (9) advocacy. An objective is given for each of the areas. Each standard is followed by an example.

Keywords:    Communication and Language Assistance | Policy | Tools |

Sight translation and written translation: Guidelines for healthcare interpreters External Web Site Policy

National Council on Interpreting in Health Care. (2010). Sight translation and written translation: Guidelines for healthcare interpreters. Retrieved from http://data.memberclicks.com/site/ncihc/Translation%20Guidelines%20for%20Interpreters%20REVISED%2031710.pdf

Interpreting and translation rely upon different skill sets and are generally conducted in different settings and contexts. This short work addresses the "small but troublesome area of overlap" in which interpreters may be called upon to provide an oral rendition of text or a written summary of a verbal exchange.

Keywords:    Communication and Language Assistance | Policy |

Language Access External Web Site Policy

National Health Law Program. (2010). Language Access. Retrieved from http://www.healthlaw.org/index.php?option=com_content&id=239&Itemid=196

This Web page serves as a gateway to numerous resources on the subject of language access. These resources are organized into the following broad areas: publications, research studies, federal administrative activities, federal and state legislation, health care disparities, and links to other websites.

Keywords:    Communication and Language Assistance | Policy | Tools |

What's in a word? A guide to understanding interpreting and translation in health care External Web Site Policy

National Health Law Program. (2010). What's in a word? A guide to understanding interpreting and translation in health care. Retrieved from http://www.healthlaw.org/images/stories/Whats_in_a_Word_Guide.pdf

The topics of discussion include the differences and commonalities of interpreting and translation, the requisite skills and qualifications of each, and their respective standards of practice, certification requirements, and methodologies. Guidance is also offered on the hiring of interpreters and translators.

Keywords:    Communication and Language Assistance | Tools |

Can they understand? Testing patient education materials with intended readers External Web Site Policy

Osborne, H. (2001, November). Can they understand? Testing patient education materials with intended readers. Retrieved from http://www.healthliteracy.com/article.asp?PageID=3811 (Reprinted from the Boston Globe On Call magazine)

The author demonstrates the need to test written material intended for patients to make sure it can be readily understood by its audience. She offers hints for successfully testing written material intended for patient use.

Keywords:    Communication and Language Assistance | Tools |

Straight talk: Model hospital policies and procedures on language access External Web Site Policy

Paras, M. (2005). Straight talk: Model hospital policies and procedures on language access. Retrieved from http://www.calendow.org/uploadedFiles/straight_talk_model_hospital_policies.pdf

The introduction notes that the adoption of policies and procedures has, historically, proven to be the primary means of making significant changes in the hospital industry. While the model policies and procedures presented here were based on California public hospitals, they are intended to be "applicable and adaptable" to hospitals throughout the United States.

Keywords:    Communication and Language Assistance | Policy |

How to choose and develop written educational materials

Pierce, L. (2010). How to choose and develop written educational materials. Rehabilitation Nursing, 35(3), 99-105. Retrieved from http://www.rehabnurse.org/pdf/rnj320.pdf

The author offers guidelines to help nurses and other health care professionals select appropriately readable, authoritative, informative, and unbiased health education materials for patients and their families. When suitable materials are not already available, the author shows how they may be developed or adapted.

Keywords:    Communication and Language Assistance | Profession-Based | Health Literacy |

Plain Language Association International External Web Site Policy

Plain Language Association International. (2011). Retrieved from http://www.plainlanguagenetwork.org/

This is a nonprofit organization promoting the use of plain language in business, science, journalism, law, technical writing, and public discourse generally. The site provides links to articles, writing tutorials, websites, conference information, news, and opportunities for networking. Before and after writing samples are given. A page of literacy resources is available, including resources on health literacy.

Keywords:    Communication and Language Assistance | Health Literacy |

The high costs of language barriers in medical malpractice External Web Site Policy

Quan, K., & Lynch, J. (2010). The high costs of language barriers in medical malpractice. Retrieved from National Health Law Program website: http://www.healthlaw.org/images/stories/High_Costs_of_Language_Barriers_in_Malpractice.pdf

The authors note that, in 2008, nearly 20 percent of people living in the United States spoke a language other than English at home. In the Western U.S., the figure rose to 32 percent, and, in California, to 42 percent. Of those populations, more than 40 percent spoke English "less than very well." This study examines the malpractice claims of one insurer, across four states, in which language barriers may have had an effect on patients' health outcomes. Topics covered in the course of the analysis include, broadly, failure to provide competent interpreters, defective informed consent and lack of written translations, inadequate documentation, and allegations of discrimination. The authors conclude with recommendations for insurance carriers and for providers.

Keywords:    Communication and Language Assistance | Policy | Public Health |

Registry of Interpreters for the Deaf External Web Site Policy

Registry of Interpreters for the Deaf. (2012). Retrieved from http://www.rid.org

The Registry of Interpreters for the Deaf represents "professionals who facilitate communication between people who are deaf or hard of hearing and people who hear." It offers its members continuing education courses, certification, professional standards, networking opportunities, conferences, publications, and advocacy.

Keywords:    Communication and Language Assistance | Population-Based |

Standard practice papers External Web Site Policy

Registry of Interpreters for the Deaf. (2012). Standard practice papers. Retrieved from http://www.rid.org/interpreting/Standard%20Practice%20Papers/index.cfm

This Web page offers links to standard practices and positions reflecting the consensus of the organization's members. The many topics covered include professional sign language interpreting, business practices and billing considerations, mentoring, team interpreting, coordination of interpreters for conferences, interpreting in health care settings, use of a certified deaf interpreter, interpreting in legal settings and mental health care settings, interpreting for individuals who are deaf-blind, and video remote interpreting.

Keywords:    Communication and Language Assistance | Population-Based |

Addressing language access issues in your practice: A toolkit for physicians and their staff members External Web Site Policy

Roat, C. E. (2005). Addressing language access issues in your practice: A toolkit for physicians and their staff members. Retrieved from The California Endowment website: www.calendow.org/uploadedFiles/language_access_issues.pdf

This guide presents a systems approach to the redesign of physician office practices to maximize the quality of care provided for patients with limited English proficiency. It encourages small steps toward the goal of a complete language access system. Among the many topics discussed are the tracking of language preferences, the pros and cons of various language assistance options, working with on-site or remote interpreters, and identifying the right mix of services for a particular office and patient population.

Keywords:    Communication and Language Assistance | Quality Improvement | Profession-Based |

Kaiser Permanente's Health Care interpreter certificate program External Web Site Policy

Robert Wood Johnson Foundation. (2008). Kaiser Permanente's Health Care interpreter certificate program. Retrieved from http://www.rwjf.org/pr/product.jsp?id=34036

In 2000, as a response to a noted inconsistency of quality among health care interpreters, Kaiser Permanente, in collaboration with the City College of San Francisco, offered a formal 15-credit health care interpreter certificate program. Since that time, Kaiser Permanente has established internship programs and 10 additional program sites, trained and certified more than 100 instructors and staff, and graduated more than 900 students. Languages spoken by graduates include Arabic, Chinese (Mandarin and Cantonese dialects), Farsi, Japanese, Khmer, Korean, Laotian, Portuguese, Russian, Spanish, Tagalog, and Vietnamese. Such partnerships of health care organizations and academic institutions appear to be sustainable, mutually beneficial, and replicable.

Keywords:    Communication and Language Assistance | Education & Training |

Kaiser Permanente's qualified bilingual staff model External Web Site Policy

Robert Wood Johnson Foundation. (2008). Kaiser Permanente's qualified bilingual staff model. Retrieved from http://www.rwjf.org/pr/product.jsp?id=34030

This article discusses the Qualified Bilingual Staff model developed by Kaiser Permanente as a cost-effective way to meet the needs of its multilingual and multicultural patient population and reduce dependence on outside sources. The model includes an internally developed training curriculum and materials, is open to all members of the workforce, and targets the plan's threshold languages, which include Spanish, Cantonese, Mandarin, Vietnamese, Tagalog, Russian, Hmong, Punjabi, and American Sign Language. Additional languages will depend on patient demand.

Keywords:    Communication and Language Assistance | Governance, Leadership, and Workforce | Education & Training |

Shared decision making when an interpreter is needed: A case study with Latino men at risk for prostate cancer External Web Site Policy

Robert Wood Johnson Foundation. (n.d.). Shared decision making when an interpreter is needed: A case study with Latino men at risk for prostate cancer (Grant details). Retrieved from http://www.rwjf.org/grants/grant.jsp?id=63830

This project was designed to develop measures specific to interpreter-mediated shared decision-making and to produce easy-to-use tools for use by health care providers, interpreters, or patients.

Keywords:    Communication and Language Assistance | Disease-Based | Population-Based | Patients & Consumers | Public Health |

Case study: The language of diversity External Web Site Policy

Tang, G., Lanza, O., & Rodriguez, F.M. (2011). Case study: The language of diversity. Diversity Executive, 44-46. Retrieved from http://diversity-executive.com/articles/view/1160

Kaiser Permanente's Qualified Bilingual Staff model makes the most of workforce diversity to provide qualified, cost-effective, and operationally efficient linguistic services. Trained bilingual staff serve Kaiser's members at all points of contact.

Keywords:    Communication and Language Assistance | Governance, Leadership, and Workforce | Policy |

The Kaiser Permanente Clinician Cultural and Linguistic Assessment Initiative: Research and development in patient-provider language concordance

Tang, G., Lanza, O., Rodriguez, F. M., & Chang, A. (2011). The Kaiser Permanente Clinician Cultural and Linguistic Assessment Initiative: Research and development in patient-provider language concordance. American Journal of Public Health, 101(2), 205-208.

The authors share lessons learned and promising practices resulting from Kaiser Permanente's development of the Clinician Cultural and Linguistic Assessment Initiative to measure clinicians' ability to communicate directly with patients in the absence of an interpreter.

Keywords:    Communication and Language Assistance | Tools |

Communicating effectively through an interpreter External Web Site Policy

The Cross Cultural Health Care Program. (n.d.). Communicating effectively through an interpreter [DVD]. Seattle, WA: The Cross Cultural Health Care Program.

This 28-minute DVD was designed to help health care providers choose an appropriate interpreter, recognize unprofessional interpretation, and work effectively with a trained interpreter or guide an untrained interpreter.

Keywords:    Communication and Language Assistance | Education & Training |

Advancing effective communication, cultural competence, and patient- and family-centered care: A roadmap for hospitals External Web Site Policy

The Joint Commission. (2010). Advancing effective communication, cultural competence, and patient- and family-centered care: A roadmap for hospitals. Retrieved from http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf

This monograph from the Joint Commission is intended to help hospitals to make effective communication, cultural competence, and patient- and family-centered care part of their daily operations. The chapters present issues and examples related to admission, patient assessment, treatment, end-of-life care, discharge and transfer, and organizational readiness. The various appendices contain a checklist of practices designed to improve communication, cultural competence, and patient- and family-centered care; Joint Commission requirements; laws and regulations; and a guide to relevant resources.

Keywords:    Communication and Language Assistance | Governance & Leadership | Quality Improvement | Tools | Clinical & Mental Health | Public Health |

IMIA guide on medical translation External Web Site Policy

Txabarriaga, R. (2009). IMIA guide on medical translation. Retrieved from International Medical Interpreters Association website: http://www.imiaweb.org/uploads/pages/438.pdf

The purpose of this guide is "to provide an easy to use set of translation management and quality control guidelines for those in the medical field." Topics of discussion include stakeholder identification, the role(s) of interpreters and practitioners in translation, interpreters as translators, qualifications of translators, process management, quality standards, and document formatting.

Keywords:    Communication and Language Assistance | Tools |

CAHPS item set for addressing health literacy

U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (2011). CAHPS item set for addressing health literacy. Retrieved from https://www.cahps.ahrq.gov/Surveys-Guidance/Item-Sets/Health-Literacy.aspx

The principal goal of this Consumer Assessment of Healthcare Providers and Systems item set "is to measure, from the patients' perspectives, how well health information is communicated to them by health professionals." This item set contains 29 supplemental items to be used with the CAHPS Clinician and Group Survey and covers the following topic areas: (1) communication with doctors, (2) communication about health problems and concerns, (3) communication about medicines, (4) communication about tests, (5) communication about forms, and (6) disease self-management.

Keywords:    Communication and Language Assistance | Health Literacy | Government | Patients & Consumers |

Health literacy online: A guide to writing and designing easy-to-use health web sites

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). Health literacy online: A guide to writing and designing easy-to-use health web sites. Retrieved from http://www.health.gov/healthliteracyonline

This guide, "written for Web designers, content specialists, and other public health communication professionals," offers guidance on creating websites that are easy to use for people with limited literacy skills and limited Internet experience, with content that is engaging and on which readers can act. The guide is structured according to six strategies: (1) learn about the users and their goals, (2) write actionable content, (3) display content clearly, (4) organize content to simplify navigation, (5) engage users with interactive content, and (6) evaluate and revise the site. Examples of writing and design are included.

Keywords:    Communication and Language Assistance | Health Literacy | Government | Public Health |

National action plan to improve health literacy

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2010). National action plan to improve health literacy. Retrieved from http://health.gov/communication/HLActionPlan/

The plan is based on the principles that everyone has the right to health information and that health services should be delivered in ways that are understandable. Seven goals and strategies to achieve them are outlined. These goals include promoting changes in the health care system that improve health information, communication, informed decision-making, and access to health services; supporting and expanding local efforts to provide adult education, English language instruction, and culturally and linguistically appropriate health information services in the community; increasing basic research and the development, implementation, and evaluation of practices and interventions to improve health literacy; and increasing the dissemination and use of evidence-based health literacy practices and interventions.

Keywords:    Communication and Language Assistance | Health Literacy | Government | Public Health |

Federal agency LEP guidance & language access plans

U.S. Department of Justice, Civil Rights Division. (n.d.). Federal agency LEP guidance & language access plans. Retrieved from http://www.lep.gov/guidance/guidance_index.html

Each federal agency that provides financial assistance must develop guidance for its recipients on their obligation to provide meaningful access to persons having limited proficiency in English. This website offers links to such guidance from most departments and many agencies of the U.S. government.

Keywords:    Communication and Language Assistance | Government |

Working on common cross-cultural communication challenges External Web Site Policy

DuPraw, M., & Axner, M. (2011). Working on common cross-cultural communication challenges. Retrieved from http://www.pbs.org/ampu/crosscult.html

The authors outline six fundamental patterns of cultural difference: communication styles, attitudes toward conflict, approaches to completing tasks, decision-making styles, attitudes toward disclosure, and approaches to knowledge. They conclude with the suggestion of several guidelines for multicultural collaboration.

Keywords:    Engagement, Continuous Improvement, and Accountability | Communication and Language Assistance | Tools |

Lahey Clinic Foundation External Web Site Policy

Lahey Clinic Foundation. (2012). Retrieved from http://www.lahey.org/

The website of this teaching hospital affiliated with Tufts University is notable for the extensive and multileveled list of informational and service links under the heading of patient and visitor information. These include the opportunity to request an interpreter for any of 30 languages; a patient bill of rights; social services that may include counseling for patients and family from social workers trained in cultural diversity; and, for visitors, a list of local lodging and restaurants. A Community Benefits Report is also available from the site.

Keywords:    Engagement, Continuous Improvement, and Accountability | Patients & Consumers | Communication and Language Assistance |

Mediation and multicultural reality External Web Site Policy

LeBaron, M. (1998). Mediation and multicultural reality. Retrieved from http://www.lahey.org/

The author examines a connection between mediation and multiculturalism in three ways: "(1) by summarizing implications of multiple cultures for the study and design of conflict resolution processes; (2) by examining communication frameworks for understanding cultural difference for their usefulness in advancing practice; and (3) by exploring how intercultural capacity can be built by third parties."

Keywords:    Engagement, Continuous Improvement, and Accountability | Communication and Language Assistance | Governance & Leadership |

Conflict resolution: Resolving conflict rationally and effectively External Web Site Policy

Mind Tools. (n.d.). Conflict resolution: Resolving conflict rationally and effectively. Retrieved from http://www.mindtools.com/pages/article/newLDR_81.htm

Effective conflict resolution can lead to increased understanding of complex situations, increased group cohesion, and improved self-knowledge of individuals' goals. Two theories of conflict resolution are discussed and a five-step conflict resolution process is presented. A four-minute video is included with the article.

Keywords:    Engagement, Continuous Improvement, and Accountability | Public Health | Communication and Language Assistance |

Bridging the cultural divide in health care settings: The essential role of cultural broker programs External Web Site Policy

National Center for Cultural Competence. (2004). Bridging the cultural divide in health care settings: The essential role of cultural broker programs. Retrieved from http://gucchd.georgetown.edu/products/CulturalBrokerGuide_English.pdf

Cultural brokers "can bridge the gap between health care providers and the communities they serve." This guide discusses the role of cultural brokers; the benefits of cultural brokers to health care delivery systems; guiding principles for cultural broker programs in health care settings; the essential values, knowledge, skills, and awareness required of cultural brokers; and guidance in the implementation of a sustainable cultural broker program.

Keywords:    Engagement, Continuous Improvement, and Accountability | Public Health | Communication and Language Assistance |

Cultural competence health practitioner assessment (CCHPA) External Web Site Policy

National Center for Cultural Competence. (n.d.). Cultural competence health practitioner assessment (CCHPA). Retrieved from http://nccc.georgetown.edu/features/CCHPA.html

The CCHPA is an online self-assessment tool. It has six subscales: values and belief systems, cultural aspects of epidemiology, clinical decision-making, life cycle events, cross-cultural communication, and empowerment/health management. The CCHPA has not been validated for use in research.

Keywords:    Engagement, Continuous Improvement, and Accountability | Tools | Communication and Language Assistance |

Getting the word out: Effective health outreach to cultural communities

Ohmans, P., & Cushing, M. (2000). Getting the word out: Effective health outreach to cultural communities. Retrieved from The Medtronic Foundation website: http://www.medtronic.com/downloadablefiles/outreach_brochure.pdf

Effective outreach depends on understanding the culture of the communities one is trying to reach. Getting the Word Out provides step-by-step guidance for health care organizations seeking to make their services known to people of other cultural communities in ways that are meaningful and appropriate to them. The steps covered in this short guide include learning about the community, assessing one's own organization, building relationships with the community, and planning and implementing a program. Each of these broad topics is fleshed out in some detail. Tips and techniques are offered.

Keywords:    Engagement, Continuous Improvement, and Accountability | Communication and Language Assistance | Tools |

Hospital language services: Quality improvement and performance measures External Web Site Policy

Regenstein, M., Huang, J., West, C., Mead, H., Trott, J., & Stegun, M. (2008). Hospital language services: Quality improvement and performance measures. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK43719/pdf/advances-regenstein_54.pdf

Hospitals belonging to the Speaking Together collaborative have developed and implemented performance measures for the delivery of language services. These hospitals "are poised to set benchmarks for hundreds of other hospitals that are struggling with the challenges of providing high-quality language services." The authors note that, for the first time, "hospitals are gathering information to estimate true demand for language services and to determine whether they are effectively meeting that demand."

Keywords:    Engagement, Continuous Improvement, and Accountability | Quality Improvement | Communication and Language Assistance |

How to choose and use a language agency: A guide for health and social service providers who wish to contract with language agencies External Web Site Policy

Roat, C. (2003). How to choose and use a language agency: A guide for health and social service providers who wish to contract with language agencies. Retrieved from The California Endowment website: http://www.calendow.org/uploadedFiles/how_to_choose_use_language_agency.pdf

This relatively short guide includes a great deal of information on the effective selection and use of language agencies, the questions to ask beforehand, and the monitoring of performance once an agency is in place. An extensive list of language agencies in California is provided.

Keywords:    Engagement, Continuous Improvement, and Accountability | Tools | Communication and Language Assistance |

The collaboration primer: Proven strategies, considerations, and tools to get you started External Web Site Policy

Torres, G. W., & Margolin, F. S. (2003). The collaboration primer: Proven strategies, considerations, and tools to get you started. Retrieved from Health Research and Educational Trust website: http://www.hret.org/upload/resources/collaboration-primer.pdf

Collaboration can offer a better alignment of resources with needs, reduce competition for resources, increase organizational effectiveness, and lead to sustainable results. The authors draw on the Health Research and Educational Trust's 10 years' experience in collaborative efforts. They encourage those contemplating collaboration to think about the degree to which they are willing to collaborate. They provide a checklist of issues to consider before embarking on collaboration. They offer examples of model collaboratives, nuts and bolts and organizational principles for successful collaboration, and an assessment tool to discover strengths and weaknesses.

Keywords:    Engagement, Continuous Improvement, and Accountability | Tools | Communication and Language Assistance |

Creating a culturally and politically appropriate dispute resolution model: Working in Indian country External Web Site Policy

Townsend, J. R. (2011, March). Creating a culturally and politically appropriate dispute resolution model: Working in Indian country. RCAC's Rural Review, 28(3), 1-7. Retrieved from http://www.rcac.org/assets/white-papers/CreatingACulturally.pdf

Many of the principles and practices employed in dispute resolution abroad may be adapted to work in Indian country, but other factors influencing the resolution of disputes are unique. The author, a member of the Muscogee Indian Nation, offers "several core concepts helpful to anyone working in Indian Country who wishes to create meaningful and culturally appropriate processes that result in culturally relevant and politically durable outcomes."

Keywords:    Engagement, Continuous Improvement, and Accountability | Population-Based | Communication and Language Assistance |

University of Colorado Conflict Information Consortium External Web Site Policy

University of Colorado Conflict Information Consortium. (n.d.). Retrieved from http://conflict.colorado.edu/

This website, promoting constructive approaches to conflict, offers links to information on and training in conflict resolution, including resources for difficult and intractable conflicts. The stated aim is to offer information that is trustworthy, affordable (preferably free), understandable, and comprehensive. Consortium Web pages are integrated into United Nations websites.

Keywords:    Engagement, Continuous Improvement, and Accountability | Communication and Language Assistance | Education & Training |

Collecting and using race, ethnicity and language data in ambulatory settings: A white paper with recommendations from the Commission to End Health Care Disparities External Web Site Policy

Wynia, M., Hasnain-Wynia, R., Hotze, T., & Ivey, S. (2011). Collecting and using race, ethnicity and language data in ambulatory settings: A white paper with recommendations from the Commission to End Health Care Disparities. Retrieved from American Medical Association website: http://www.ama-assn.org/resources/doc/public-health/cehcd-redata.pdf

The authors make the point that, to eliminate disparities in care, it is necessary to collect valid and reliable demographic data. They discuss the potential barriers to the collection and use of such data and make recommendations as to when to collect demographic data, the type of data to collect, how to ask for race, ethnicity, and primary language data. The authors also discuss patient demographic data in relation to electronic health records systems.

Keywords:    Engagement, Continuous Improvement, and Accountability | Disparities | Communication and Language Assistance |

LGBT-TRISTAR External Web Site Policy

LGBT-TRISTAR is a government-funded technical assistance (TA) and training services division targeting providers of alcohol and other drug (AOD) prevention, treatment and recovery support services. We provide on-site and online technical assistance and training designed to equip administrators and staff to provide services that are more accessible and culturally responsive to Lesbian, Gay, Bisexual and Transgender (LGBT) individuals and families.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Clinical & Mental Health | Governance, Leadership, and Workforce | Disparities | Communication and Language Assistance | Engagement, Continuous Improvement, and Accountability | Policy | Quality Improvement | Tools | Provide effective, equitable, understandable, and respectful quality care and services |

Implementing Cultural and Linguistic Requirements in Health Insurance Exchanges External Web Site Policy

This timely report offers an update on implementation progress, guidance, best practices, and tools for states, health plans, and organizations hastening to implement ACA’s cultural and linguistic requirements by October 1, 2013, when open enrollment begins. Also featured are seven in-depth case studies on State-Based Exchanges in California, Colorado, Connecticut, Maryland, New York, Oregon, and Washington, with information on best practices on integrating race, culture, and language in planning and operation.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance & Leadership | Disparities | Health Literacy | Communication and Language Assistance | Policy | Research | Tools |

Supporting and Transitioning the Health Care Safety Net External Web Site Policy

The Texas Health Institute recently released its second report, “Supporting and Transitioning the Health Care Safety Net,” in its five-part series known as The ACA & Racial and Ethnic Health Equity Series. This new report provides a snapshot on status and progress of nine key provisions in the ACA critical for advancing racial and ethnic health equity within the health care safety net. Through a close review of latest data, research, and federal guidance on safety net provisions, this report describes how the safety net stands at a crossroads in an era of reform. Complemented by perspectives from the field—including hospitals and health centers—the report discusses important priorities, challenges, and next steps for addressing and advancing racial and ethnic health equity through the safety net.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Governance, Leadership, and Workforce | Disparities | Health Literacy | Communication and Language Assistance | Patients & Consumers | Policy | Research | Tools | Provide effective, equitable, understandable, and respectful quality care and services |

Race, Ethnicity, Language Collection - Self Reference Guide for Providers External Web Site Policy

Quick reference guide for providers to assist them in collecting race, ethnicity, and language data.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Clinical & Mental Health | Communication and Language Assistance | Profession-Based | Tools |

Race, Language, and Ethnicity Self-Check Form External Web Site Policy

This form allows for standardized race, ethnicity, and language data collection.

*This resource was submitted by a Think Cultural Health visitor using our "Submit a Resource" feature.

Keywords:    Clinical & Mental Health | Communication and Language Assistance | Profession-Based | Tools |