Advertisement

Patient-Physician Language Concordance and Lifestyle Counseling Among Spanish-Speaking Patients

  • Pracha P. EamranondEmail author
  • Roger B. Davis
  • Russell S. Phillips
  • Christina C. Wee
Original Paper

Abstract

Objective Patient-physician language discordance is associated with worse quality of healthcare for patients with limited English proficiency. Patients with language-discordant physicians have more problems understanding medical situations. The impact of patient-physician language concordance on lifestyle counseling among Spanish-speaking patients is not known. Methods We performed a retrospective medical record review and identified 306 Spanish-speaking patients who used interpreter services between June 2001 and June 2006 in two Boston-based primary care practices. Our primary outcome was counseling on exercise, diet, and smoking. Our main predictor of interest was patient-physician language concordance. Results Patients with language-concordant physicians were more likely to be counseled on diet and physical activity compared to patients with language-discordant physicians. After adjustment for age, sex, insurance status, number of primary care visits, and comorbidity score, these differences in counseling persisted for diet [odds ratio (OR) = 2.2, CI 1.3–3.7] and physical activity (OR = 2.3, CI 1.4–3.8). There was no significant difference with regard to discussion of smoking (OR = 1.3, CI 0.8–2.1). Conclusions Spanish-speaking patients are more likely to discuss diet and exercise modification if they have a Spanish-speaking physician compared to those having a non-Spanish-speaking physician. Further research is needed to explore whether matching Spanish-speaking patients with Spanish-speaking providers may improve lifestyle counseling.

Keywords

Diet Exercise Counseling Hispanic Language concordance 

Notes

Acknowledgements

This research was supported by an individual and institutional Ruth L. Kirschstein National Research Service Award (5 T32 HP11001-18) from the Health Resources and Services Administration. There are no conflicts of interest to report for the authors of this manuscript.

References

  1. 1.
    United States Census Bureau. Available at http://www.census.gov?jpc/www/usinterimproj.
  2. 2.
    United States Census Bureau. 2006 American Community Survey. Available at http://factfinder.census.gov/.
  3. 3.
    U.S. Department of Health and Human Services. Data 2010: the healthy people 2010 database. Hyattsvile MUDoHaHS, CDC, National Center for Health Statistics; 2004. Available at http://wonder.cdc.gov/data2010/focus.htm.
  4. 4.
    AHRQ Releases 2005 National Healthcare Quality And Disparities Reports. Press Release, January 9, 2006. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/press/pr2006/nhqrdrpr.htm.
  5. 5.
    Solis JM, Marks G, Garcia M, Shelton D. Acculturation, access to care, and use of preventive services by Hispanics: findings from HHANES 1982-84. Am J Public Health. 1990;80(Suppl):11–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Pippins JR, Alegria M, Haas JS. Association between language proficiency and the quality of primary care among a national sample of insured Latinos. Med Care. 2007;45:1020–5.CrossRefPubMedGoogle Scholar
  7. 7.
    Ngo-Metzger Q, Sorkin DH, Phillips RS. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. J Gen Intern Med. 2007;22(Suppl 2):324–30.CrossRefPubMedGoogle Scholar
  8. 8.
    Wilson E, Chen AH, Grumbach K, Wang F, Fernandez A. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005;20:800–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Perez-Stable EJ, Napoles-Springer A, Miramontes JM. The effects of ethnicity and language on medical outcomes of patients with hypertension or diabetes. Med Care. 1997;35:1212–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42:727–54.CrossRefPubMedGoogle Scholar
  11. 11.
    Baker DW, Hayes R, Fortier JP. Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998;36:1461–70.CrossRefPubMedGoogle Scholar
  12. 12.
    Sarver J, Baker DW. Effect of language barriers on follow-up appointments after an emergency department visit. J Gen Intern Med. 2000;15:256–64.CrossRefPubMedGoogle Scholar
  13. 13.
    United States Preventive Services Task Force. Available at http://www.ahrq.gov/clinic/USpstfix.htm.
  14. 14.
    Krauss RM, Eckel RH, Howard B, et al. AHA Dietary Guidelines: revision 2000: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation. 2000;102:2284–99.PubMedGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. Prevalence of fruit and vegetable consumption and physical activity by race/ethnicity—United States, 2005. MMWR Morb Mortal Wkly Rep. 2007;56:301–4.Google Scholar
  16. 16.
    Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DE. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26:367–97.CrossRefPubMedGoogle Scholar
  17. 17.
    Gregory-Mercado KY, Staten LK, Ranger-Moore J, et al. Fruit and vegetable consumption of older Mexican-American women is associated with their acculturation level. Ethn Dis. 2006;16:89–95.PubMedGoogle Scholar
  18. 18.
    Murtaugh MA, Herrick JS, Sweeney C, et al. Diet composition and risk of overweight and obesity in women living in the southwestern United States. J Am Diet Assoc. 2007;107:1311–21.CrossRefPubMedGoogle Scholar
  19. 19.
    Slattery ML, Sweeney C, Edwards S, et al. Physical activity patterns and obesity in Hispanic and non-Hispanic white women. Med Sci Sports Exerc. 2006;38:33–41.CrossRefPubMedGoogle Scholar
  20. 20.
    Missed opportunities in preventive counseling for cardiovascular disease—United States, 1995. MMWR Morb Mortal Wkly Rep. 1998;47:91–5.Google Scholar
  21. 21.
    Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRefPubMedGoogle Scholar
  22. 22.
    Ory MG, Yuma PJ, Hurwicz ML, et al. Prevalence and correlates of doctor-geriatric patient lifestyle discussions: analysis of ADEPT videotapes. Prev Med. 2006;43:494–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Ma J, Urizar GG Jr, Alehegn T, Stafford RS. Diet and physical activity counseling during ambulatory care visits in the United States. Prev Med. 2004;39:815–22.CrossRefPubMedGoogle Scholar
  24. 24.
    Wee CC, McCarthy EP, Davis RB, Phillips RS. Physician counseling about exercise. Jama. 1999;282:1583–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Karliner LS, Perez-Stable EJ, Gildengorin G. The language divide. The importance of training in the use of interpreters for outpatient practice. J Gen Intern Med. 2004;19:175–83.CrossRefPubMedGoogle Scholar
  26. 26.
    Anderson LM, Scrimshaw SC, Fullilove MT, Fielding JE, Normand J. Culturally competent healthcare systems. A systematic review. Am J Prev Med. 2003;24:68–79.CrossRefPubMedGoogle Scholar
  27. 27.
    Vandervort EB, Melkus GD. Linguistic services in ambulatory clinics. J Transcult Nurs. 2003;14:358–66.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Pracha P. Eamranond
    • 1
    Email author
  • Roger B. Davis
    • 1
  • Russell S. Phillips
    • 1
  • Christina C. Wee
    • 1
  1. 1.Division of General Medicine and Primary CareBeth Israel Deaconess Medical CenterBrookline, BostonUSA

Personalised recommendations