Language Concordance and Interpreter Use in Primary Care: Perspectives from Spanish-preferring Patients

Area of Science:

• Health Services Research
• Linguistic Health Equity
• Patient-Provider Communication

Background:

• Federal laws mandate language assistance for non-English proficient patients.
• Many Spanish-preferring patients lack access to Spanish-fluent providers or formal interpreters.
• Existing communication strategies often fall short in primary care settings.

Purpose of the Study:

• To compare the experiences of Spanish-preferring primary care patients with different provider communication approaches.
• To identify barriers and facilitators to effective healthcare communication in multilingual settings.
• To inform policy and practice for optimizing language services in healthcare.

Main Methods:

• Focus groups conducted in Spanish with 62 adult Spanish-preferring primary care patients in Southern California.
• Patients were grouped based on provider type: Spanish-qualified, formal interpreter, or informal interpreter/other strategies.
• Transcripts were coded to identify themes and compare patient experiences.

Main Results:

• Patients preferred continuity with established English-speaking providers despite language barriers due to rapport.
• Spanish-qualified providers fostered greater trust and more comprehensive care, though interactions could be rushed.
• Formal interpreters improved understanding but could depersonalize interactions; informal interpreters yielded mixed results.

Conclusions:

• Healthcare systems need to support direct communication, ensure interpreter quality, and maintain patient-provider relationships.
• Robust language and interpretation services are crucial for high-quality health outcomes and patient experiences.
• Policy and practice improvements are necessary to optimize healthcare communication for Spanish-preferring patients.