Identifying and Addressing Language Needs in Primary Care: a Pilot Implementation Study.

Area of Science:

• Healthcare access and disparities
• Health services research
• Communication in healthcare

Background:

• Medical interpreters are crucial for patients with Limited English Proficiency (LEP) but are underutilized in primary care settings.
• There is a need for effective protocols to increase the use of medical interpreters in primary care.

Purpose of the Study:

• To evaluate a protocol for improving medical interpreter use in primary care.
• To identify barriers and facilitators to implementing interpreter services.

Main Methods:

• A protocol involving Medical Assistants (MAs) screening for language needs and arranging telephone interpreters was implemented in two pilot clinics.
• Qualitative interviews with MAs and providers were analyzed using modified grounded theory, linked to the PARiHS framework.
• Providers in pilot and comparison clinics were surveyed.

Main Results:

• Key themes included challenges with interpreter vendors, established team dynamics, and integrating time-sensitive tasks.
• Provider satisfaction with care (OR=12.7) and communication (OR=7.6) was significantly higher in pilot clinics compared to comparison clinics.
• Mixed responses to the protocol were observed, with a preference for in-person interpreters noted.

Conclusions:

• The protocol shows potential for improving patient care and communication, but implementation challenges persist.
• Language screening is complex, requiring further refinement of questions and procedures.
• Future interventions must consider health system changes, team dynamics, and staff training needs.