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Updated: May 11, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Progression in understanding and implementing the cultural and linguistic appropriate services standards: five-year
Genny Carrillo Zuniga1, Yoon-Ho Seol, Bonnie Dadig
1School of Rural Public Health, Texas A&M University, College Station, TX, USA. gcarrillo@srph.tamhsc.edu
Abstract:
In 2001, 14 national standards on Culturally and Linguistically Appropriate Services (CLAS) in health care were issued by the US Department of Health and Human Services Office of Minority Health to guide outcomes specific to disparities affecting patients with limited English proficiency. Additionally, demographic changes are rapidly occurring throughout the United States leading to more culturally and racially diverse communities, which have increased language barriers in the health care environment. This nonrandomized, cross-sectional study assessed changes and attitudes and applications of CLAS in an academic health care setting over a 5-year period (2006 to 2011). Results indicated that, in 2006, 72.6% participants reported they were "not at all familiar with CLAS" in comparison with 28.8% in 2011. In 2006, 16.5% participants strongly agreed to the question, "I know how to work with medical interpreters" compared with 24.9% in 2011. The same trend is seen with the question, "I use medical interpreters when I have a Spanish-speaking patient," in 2006, 25.5% strongly agreed in comparison with 35.4% in 2011. This study suggests that significant improvements occurred in the use of medical interpreters and understanding of CLAS as a result of educational activities implemented from 2006 to 2011.
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