Using a Translator in Integrated Care Settings
Failure to address limited English proficiency (LEP) is one of the main reasons leading to health disparities among Latinos. Translators in the clinical setting facilitate communication between providers and patients with LEP. In this chapter we talk about the effect of choosing to utilize a translator or not and its relationship to the quality of communication, patient/physician satisfaction, and health-related outcomes.
We describe the different types of interpreters available and compare the advantages and disadvantages of each type, patient and physician preferences, and the quality of interpretation they provide. Our hope is to provide a framework from which the provider will be able to decide the form of interpretation most appropriate for each particular circumstance.
We also explore specific themes on using a translator for mental health encounters. We will provide some information relevant to everyday interpreter use and tips to make more effective use of interpreters in integrated care settings.
We then comment on different policies and systems approaches that have been tried in order to improve communication with Hispanic patients and improve interpreter utilization. Finally, we share some insights found in the literature from the translators themselves about improving communication with Latino LEP patients.
KeywordsTranslation Latinos Integrated care Mental health care Behavioral health integration
- Fernandez, A., Schillinger, D., Grumbach, K., Rosenthal, A., Stewart, A. L., Wang, F., et al. (2004). Physician language ability and cultural competence. An exploratory study of communication with Spanish-speaking patients. Journal of General Internal Medicine, 19(2), 167–174.CrossRefPubMedPubMedCentralGoogle Scholar
- Fernandez, Y., Garcia, E., Franks, P., Jerant, A., Bell, R. A., & Kravitz, R. L. (2011). Depression treatment preferences of Hispanic individuals: Exploring the influence of ethnicity, language, and explanatory models. Journal of the American Board of Family Medicine, 24(1), 39–50.CrossRefGoogle Scholar
- Gany, F., Leng, J., Shapiro, E., Abramson, D., Motola, I., Shield, D. C., et al. (2007a). Patient satisfaction with different interpreting methods: A randomized controlled trial. Journal of General Internal Medicine, 22(Suppl 2), 312–318.Google Scholar
- Gany, F., Kapelusznik, L., Prakash, K., Gonzalez, J., Orta, L. Y., Tseng, C. H., et al. (2007b). The impact of medical interpretation method on time and errors. Journal of General Internal Medicine, 22(Suppl 2), 319–323.Google Scholar
- Gany, F., Leng, J. C., Winston, G., Tseng, C. H., Qin, A., & Changrani, J. (2011). Diabetes care and language discordance among Chinese and Latino primary care patients. Ethnicity & Disease, 21(4), 473–479.Google Scholar
- Gonzalez, R., Vasquez, V., & Mikkelson, H. (1991). Prerequisites for court interpreting. Durham, NC: Carolina Academic Press.Google Scholar
- Hewitt, W. E., & Lee, R. J. (1996). Behind the language barrier, or “You say you were eating an orange?”. State Court Journal, 20(1), 23–31.Google Scholar
- Marcos, L. R., Uruyo, L., Kesselman, M., & Alpert, M. (1973a). The language barrier in evaluating Spanish-American patients. Archives of General Psychiatry, 29(5), 655–659.Google Scholar
- Marcos, L. R., Alpert, M., Urcuyo, L., & Kesselman, M. (1973b). The effect of interview language on the evaluation of psychopathology in Spanish-American schizophrenic patients. The American Journal of Psychiatry, 130(5), 549–553.Google Scholar
- Napoles, A. M., Santoyo-Olsson, J., Karliner, L. S., O’Brien, H., Gregorich, S. E., & Pérez-Stable, E. J. (2010). Clinician ratings of interpreter mediated visits in underserved primary care settings with ad hoc, in-person professional, and video conferencing modes. Journal of Health Care for the Poor and Underserved, 21(1), 301–317.CrossRefPubMedPubMedCentralGoogle Scholar
- Norris, W. M., Wenrich, M. D., Nielsen, E. L., Treece, P. D., Jackson, J. C., & Curtis, J. R. (2005). Communication about end-of-life care between language-discordant patients and clinicians: Insights from medical interpreters. Journal of Palliative Medicine, 8(5), 1016–1024.CrossRefPubMedGoogle Scholar
- Roat, C., & CAFP. (2005). Addressing language access issues in your practice: A toolkit for physicians and their staff members Google Scholar
- VanderWielen, L. M., Enurah, A. S., Rho, H. Y., Nagarkatti-Gude, D. R., Michelsen-King, P., Crossman, S. H., et al. (2014). Medical interpreters: Improvements to address access, equity, and quality of care for limited-eEnglish-proficient patients. Academic Medicine, 89(10), 1324–1327.CrossRefPubMedGoogle Scholar
- Vasquez, C., & Javier, R. A. (1991). The problem with interpreters: Communicating with Spanish-speaking patients. Hospital & Community Psychiatry, 42(2), 163–165.Google Scholar
- Villalobos, B., Bridges, A. J., Anastasia, E. A., Ojeda, C. A., Rodriguez, J. H., Gomez D. (2015). Effects of language concordance and interpreter use on therapeutic alliance in Spanish-speaking integrated behavioral health care patients, University of Arkansas.Google Scholar