Language barriers in health care affect millions of patients within the US health delivery system each year. Under the ACA, furthermore, the number of limited English proficient (LEP) patients with access to the system has increased and will lead to a greater presence of LEP patients across the continuum of care. Language access (LA) is a key determinant of patient activation in care. While LA services have become more available in care, the mechanisms used to provide them (e.g., on-site medical interpreters, remote medical interpreters, bilingual health professionals, and caregiver mediation) are determined by the care delivery organization with little to no input from the patient.
Patient-centered comparative effectiveness research on LA mechanisms has the potential to shed new light on the variety and distribution of LA services in clinical encounters, which can lead to more efficient use of service mechanisms and enhanced patient activation in health care. This project seeks to develop capacity for research on LA mechanisms available to Spanish-speaking patients with diabetes in Ohio. We aim to engage patients, caregivers, interpreters, bilingual clinicians, language service coordinators and agencies, and language researchers throughout Ohio in a sustained, multifaceted conversation around language access mechanisms in the delivery of care.