Caregiver-Reported Quality of Pediatric Primary Care Language Services

Caregivers who use languages other than English (LOEs) experience health disparities. However, little is known about how spoken and written language services are experienced in pediatric primary care. The goal of this exploratory, cross-sectional study was to ask caregivers who use LOEs in health care about language services received during pediatric primary care visits.

We conducted the study in 3 pediatric primary care clinics in Southwestern Pennsylvania. Caregivers labeled in the electronic health record as using an LOE were called within 2 weeks after a visit and completed an interpreter-assisted structured interview. Questions included receipt of spoken and written services during their most recent visit, satisfaction with language services, and recommendations to improve care. Interviews lasted 45 minutes, and interviewers captured answers via Qualtrics. Descriptive statistics and qualitative thematic analysis were used.

One hundred twenty-four participants were interviewed; 13 who reported preferring English were excluded. The remaining 111 participants used 21 different languages for health care. Most participants reported receiving spoken language-concordant services (professional interpreter or bilingual clinicians) with the health care clinician (94/111, 85%), but fewer when scheduling (62/111, 56%), rooming (43/109, 39%), or with nursing needs (26/58, 45%). Less than one-fourth reported receiving language-concordant written materials such as questionnaires or pre-appointment reminders. Most reported "Excellent"-quality interpreters and bilingual health care clinicians.

Participants reported high-quality communication with the health care clinician; however, fewer received language-concordant written materials or spoken services during other visit touchpoints. Future work should implement processes to ensure receipt of language services before, during, and after a visit.