Abstract
Background/Aims To investigate communication problems and preferences of Limited English Proficiency Spanish speakers in a predominantly English-oriented medical care system.
Methods Waiting room survey (self-administered questionnaire) conducted January-October 2011 at 5 Kaiser Permanente Northern California facilities (incl. 4 Latino Health Modules). Study Sample: Patients classified based on self-report as having Very Limited English Proficiency (VLEP, n=1527, doesn’t speak English at all or not well) or Limited English Proficiency (LEP, n=431, speaks English well, but not very well). The sample included 380 women and 169 men aged 18–39, 681 women and 294 men aged 40–59, and 290 women and 108 men aged = 60. By age group, 74.1%, 79.2%, and 80.2%, respectively, were classified as VLEP, with women comprising approximately 71% of VLEP and 60% of LEP in each age group. Over 85% came from Mexico or Central America.
Results
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Educational attainment very low in both LEP and VLEP groups, but across all age groups, significantly lower for VLEP vs. LEP.
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Approximately 75% of LEP (“speak English well”) patients have trouble at least sometimes understanding people speaking to them in English.
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Over half of LEP patients have difficulty understanding letters and information in English.
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Nearly half of LEP and 15% of VLEP patients want to receive letters and instructions in both English and Spanish.
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Home Internet access is approximately 80% for LEP and 55% for VLEP aged 20–59; 46% and 28%, respectively, for ages =60.
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Ability to use email and the Internet significantly declines with age; lower among VLEP than LEP across age groups.
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Significant VLEP-LEP and age group differences exist for communication modality preferences. Preference for modalities involving computer/Internet decrease with age and language proficiency within age group; while age differences persist, VLEP-LEP differences within age group are smaller for text messages, DVDs, and phone-based messages.
Discussion Limited English Proficient Latinos face many difficulties in ability to communicate with and to receive and understand health-related communications in a predominantly English-language setting, and ability to understand and act on health-related communications is compounded by the very low levels of education.
