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Testing a novel theoretical framework to study language services implementation in health care.

Allison Squires1, Lauren Gerchow1, Chenjuan Ma1

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|September 15, 2025
PubMed
Summary

Language Planning Theory helps understand healthcare language access services. This study adapted the three-level view model (3LVM) to identify factors influencing language service implementation in healthcare settings.

Keywords:
Home health careHospitalsInterpreter servicesLanguage barrierLimited English proficiencyMedical interpretersNursesTheory

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Area of Science:

  • Health Services Research
  • Sociolinguistics
  • Health Equity

Background:

  • Language services are crucial for equitable healthcare but their implementation remains understudied.
  • Language Planning Theory offers a framework to analyze implementation challenges and successes.
  • Existing research lacks a robust theoretical model for studying language access services in healthcare.

Purpose of the Study:

  • To adapt and test the three-level view model (3LVM) of Language Planning Theory for analyzing language access services implementation in healthcare.
  • To identify factors influencing the need for, and implementation of, language services in healthcare settings.
  • To develop a healthcare-specific version of the 3LVM.

Main Methods:

  • Qualitative secondary analysis of data from a study involving patients with limited English proficiency and home healthcare clinicians.
  • Directed content analysis guided by the 3LVM framework.
  • Adaptation of the 3LVM to incorporate healthcare-specific functions for clinicians/staff and patients.

Main Results:

  • The 3LVM effectively identified factors creating the need for language services.
  • The model distinguished between facilitators and barriers to language service implementation.
  • An adapted, healthcare-specific 3LVM was developed, proving useful for research structuring.

Conclusions:

  • The adapted 3LVM provides a valuable theoretical framework for studying language access services implementation in healthcare.
  • Understanding clinician/staff and patient functions is key to successful language service integration.
  • This research contributes to reducing health outcome inequities by improving language access in healthcare.