Project Summary

Background: Patients with limited English proficiency (LEP) have worse health care quality than those who speak English. A shared language (language concordance) between patients and clinicians and use of professional interpreters in clinical settings are two important ways to provide language access and eliminate disparities. All U.S. health systems must, by federal law, provide language access. However, many of the existing services are not robust and there are no agreed upon approaches to help them improve.

Proposed Solution to the Problem: The PCORI-funded Language Access System Improvement (LASI) study evaluated the impact of combining clinicians’ non-English language skills certification with easy access to professional interpreters through videoconferencing in one health system. Findings from this study can help guide other health systems, physicians and patients in their own efforts to improve language access. Achieving this will require widespread sharing of this knowledge. This project aims to build capacity for that spread.

Objectives: Bring together patients, patient advocacy organizations, interpreter/language organizations, national medical professional organizations and health care systems to: 1) share LASI study findings and 2) garner input and collaborate on the content and dissemination planning for messages stemming from LASI that ultimately will benefit language access and health of patients with LEP.

Activities: The project team will conduct three virtual stakeholder convenings over one and a half years. At the first convening, the team will share what the LASI study findings add to the understanding of language access, promote discussion about the implications and elicit input on the content of messaging that would be most useful for the stakeholders’ constituencies to increase language access. At the second convening, project team members will elicit input and feedback to improve sample messages and images. Each stakeholder will identify at least two constituents with which to pretest the content. At the third convening the project team will review what was learned from the pretests and plan for broader dissemination.

Projected Outcomes and Outputs:

Short-term outcomes during the project period include: Create a stakeholder group with the capacity to spread the lessons and implications of the LASI study Develop tailored messages and toolkits to help others improve language access in health care Understand the needs of stakeholders and their constituents and contextual factors that will inform a larger dissemination plan.

Medium-term outcomes (zero to two years post project period) include: disseminating the tailored messages and toolkits to a broad audience, including patients, physicians, interpreters and health systems.

Long-term outcomes (three and more years post project period) include improving language access and health equity for patients with LEP across the United States.

Patient and Stakeholder Engagement Plan: This capacity-building project is a collaboration between the diverse stakeholders and the project team. The project team has engaged four individual patients as stakeholders—two bilingual Spanish-English speakers and two bilingual Chinese-English speakers—all with personal and/or family experience bridging language barriers in U.S. health care settings. The team has additionally engaged stakeholders from four other groups: patient advocacy, national interpreter/language access organizations, national medical professional groups and health systems.

Project Collaborators: The project team is from University of California San Francisco and Memorial Sloan Kettering and includes investigators and stakeholders from the LASI study.

Project Information

Leah Karliner, MD, MAS
Lisa Diamond, MD, MPH
University of California San Francisco

Key Dates

February 2025


Project Status
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Last updated: April 3, 2024