RESEARCH REPORT PLATFORM PRESENTATION

A STUDY OF LIMITED ENGLISH PROFICIENCY (LEP) IN PATIENTS SERVED BY PHYSICAL THERAPY PRACTICES IN NORTHERN CALIFORNIA. McGinty S, Avalos L, Bhim M, Lopez T, Osborne R; California State University Sacramento, Sacramento, California, USA

PURPOSE: This study was conducted to determine the extent of multiple languages being encountered in patients seeking services in Physical Therapy practices in Northern California and to determine the means of communication being utilized to serve patients with Limited English Proficiency (LEP). RELEVANCE: Language barriers can interfere with all processes involved with the provision of health care. Effective cross cultural communication and cultural competency is impossible without understanding and addressing the importance of language in culture. PARTICIPANTS: Participating clinics were randomly selected from a list of 493 clinics compiled from online phone directories in 28 counties in Northern California. METHODS: A survey instrument was developed to determine whether or not clinicians were encountering patients with LEP and if so, which languages were most often heard. The survey sought information about whether or not clinicians, or their staff, were bilingual, and what methods were utilized to communicate with patients with LEP. The top 25 languages from the 137 languages spoken in California were selected from the 2000 United States of America census data. A stratified, random sample of 216 clinics was selected from the 493 clinics identified. A minimum of 1 clinic was selected from each of the 28 counties in Northern California with the exception of Colusa, Sierra, Alpine, and Trinity for which no clinics were listed. ANALYSIS: SPSS version 13.0 was utilized for analysis of quantitative data. Qualitative analysis of written responses was completed to identify common themes. RESULTS: 33 of 216 surveys were returned to sender. 111 of the remaining 183 were returned and usable for a 60.7% return rate. 85% of all Northern California counties were represented. 85% of clinics reported encountering patients with LEP. 89.9% of those patients speak Spanish, followed by Vietnamese, Hindi, Chinese, Russian and Tagalog. 40% of clinicians report they are bilingual; 34% speak Spanish. 45% of non-licensed staff are bilingual; 37% speak Spanish. 46% of clinics state they provide patient education in another language and 49% state they provide written information. Many clinics report they commonly use patients’ family members (including children) to serve as interpreters, some utilize contracted interpreter services, and some rely on English/other language dictionaries, pictures, and demonstration to instruct patients. CONCLUSIONS: Although 85% of participating clinics report treating patients with LEP, less than half provide instruction in another language (written or oral). Only 46% of clinics offer instruction in Spanish despite the fact that almost 90% of patients with LEP speak Spanish. Bilingual clinicians and staff skills often do not match the languages encountered in the clinics. IMPLICATIONS: Clinicians may not be aware of ethical and legal requirements to provide instruction to patients in their primary languages. Education about patients’ rights to be provided services in their primary language should be included in entry-level education. In addition, the possible negative consequences of using patients’ family members as interpreters should be discussed. KEYWORDS: Limited English Proficiency. FUNDING ACKNOWLEDGEMENTS: This work was unfunded. CONTACT: mcgintys@csus.edu

ETHICS COMMITTEE: California State University, Sacramento Committee for the Protection of Human Subjects