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Updated: Nov 23, 2025

The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
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The Use of Interpreters in Health Centers: A Mixed-Methods Analysis.

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    Language services in health centers for patients with limited English proficiency (LEP) decreased from 2009-2019. Despite challenges, bilingual staff and virtual interpretation models show promise for improving access.

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    Area of Science:

    • Health Services Research
    • Linguistic Access in Healthcare
    • Health Equity

    Background:

    • Millions of patients with limited English proficiency (LEP) rely on health centers for care.
    • Language services in these centers are highly variable, influenced by patient preferences, bilingual staff availability, and funding limitations.
    • Understanding interpreter service delivery is crucial for addressing healthcare disparities.

    Purpose of the Study:

    • To examine trends in interpreter services delivery in federally qualified health centers (FQHCs) from 2009-2019.
    • To identify characteristics of FQHCs with and without dedicated interpreter staff.
    • To explore the association between Medicaid policies and interpreter use, and to understand different interpreter service models.

    Main Methods:

    • A mixed-methods approach combining quantitative analysis of the Uniform Data System database (2009-2019) and qualitative analysis of 28 FQHCs.
    • Quantitative analysis focused on interpreter staffing ratios and associations with patient demographics and policies.
    • Qualitative analysis involved identifying and characterizing "homegrown" interpreter service models.

    Main Results:

    • The ratio of interpreter full-time equivalents per patients with LEP significantly decreased between 2009 and 2019.
    • No statistically significant relationships were found between interpreter staffing levels and the number of LEP patients served, nor with examined Medicaid policies.
    • Qualitative findings revealed diverse, "homegrown" models with inconsistent training but a notable, smooth transition to virtual interpretation during COVID-19.

    Conclusions:

    • Interpreter service utilization among patients with LEP in FQHCs has declined, despite the critical need.
    • Bilingual staff play a vital role, but inconsistent training remains a challenge.
    • The rapid adoption of virtual interpretation during the pandemic highlights adaptability and potential for future service delivery models.