Improving Communication: How Pediatricians Can Support Non-English-Speaking Parents
By Abigail Preston
Many individuals experience feelings of fear or anxiety when going to the doctor. They may find healthcare settings scary due to not understanding what is happening, or not knowing what providers will do.
Imagine going to see a healthcare provider who does not speak your own language. Having someone speak to you quickly about unfamiliar topics can lead to no understanding at all and make you more confused than when you came in.
More than 25 million individuals in the United States do not speak English, leading to a huge communication barrier in multiple settings (Steinberg et al., 2016). The problem of communication barriers in healthcare is even more concerning when pediatricians and parents don’t share a common language, as these barriers can affect children’s health.
By using health literate strategies with parents, pediatricians can overcome communication barriers. As a result, they can provide better care for their patients.
What Is Organizational Health Literacy?
Organizational health literacy refers to strategies implemented by healthcare organizations to help patients better understand, navigate, and manage their health (Brega et al., 2019). Pediatricians can promote organizational health literacy by communicating well with the parents of their patients.
The Link Between Health Literacy and Health Equity
Research has revealed a link between health literacy and health equity. According to Braveman et al. (2018), “health equity means that everyone has a fair and just opportunity to be as healthy as possible.”
Non-English-speaking families are more likely to experience health disparities, which makes it more challenging for them to access adequate care and close the gap of health inequity. People with low English proficiency experience lower quality of care and suffer worse health outcomes (Espinoza & Derrington, 2021). In a survey on racism, discrimination, and health, 34% of families with low English literacy stated that they had fair or poor health, whereas only 19% of proficient English-speaking families said the same (Gonzalez-Barrera et al., 2024).
By using health literate strategies with non-English-speaking parents, pediatricians can improve care for their children. This shrinks health disparities and increases health equity.
Communication Barriers
In interactions between pediatricians and non-English-speaking parents, some of the greatest communication barriers are insufficient access to interpreters, limited multicultural resources, and physician bias. In addition, parents who don’t speak English as their first language are much less likely to ask questions and speak up (Khan et al., 2022). This may lead providers to believe (incorrectly) that the parents fully understand their children’s treatment plan.
Pediatricians’ Duty To Improve Communication
Pediatricians are responsible for reducing communication barriers with non-English-speaking parents so that children can receive equitable care. Indeed, providing language access is required by both federal law and the Joint Commission (Daniels, 2024). The Affordable Care Act states that patients are allowed to receive language access services free of charge (U.S. Department of Health and Human Services, 2024). Many parents are not aware of this, making it even more crucial that pediatricians practice these skills.
Health Literate Approaches To Improve Communication
Here are some health literate strategies that can help pediatricians improve communication with non-English-speaking parents.
Cultural Awareness. Learn about the health cultures of your patient population. Be aware of each family’s cultural needs. This includes not only using the family’s language, but also being culturally appropriate (Andrulis & Brach, 2007). Cultural awareness helps build understanding and trust.
Cultural Humility. Likewise, consider taking a cultural humility training. When healthcare professionals exhibit cultural humility towards families, it helps to build trust and create collaboration between the two parties (Centers for Disease Control and Prevention, 2024). This reduces stigma and creates a comfortable environment.
Qualified Healthcare Interpreters. Providing qualified healthcare interpreters in healthcare settings can ensure that parents correctly understand their children’s health and wellness. This reduces barriers when communicating with non-English-speaking parents (Heath et al., 2023).
Artificial Intelligence (AI). AI services can be a beneficial tool when it comes to interpreting during healthcare appointments. When AI translation services are used during medical appointments, there are fewer misunderstandings, preventable errors, and harms (Genovese et al., 2024).
Appropriate Written Materials. Similarly, using health education materials in multiple languages can improve families’ awareness and knowledge, which leads to better health outcomes (Seidel et al., 2023).
Getting Support
Pediatricians don’t need to address communication barriers singlehandedly. Local organizations can provide resources. Together, they can look at the challenges and improve health outcomes in the community.
References
Andrulis, D. P., & Brach, C. (2007). Integrating literacy, culture, and language to improve health care quality for diverse populations. American journal of health behavior, 31 Suppl 1(Suppl 1), S122–S133. https://doi.org/10.5555/ajhb.2007.31.supp.S122
Braveman, P., Arkin, E., Orleans, T., Proctor, D., Acker, J., & Plough, A. (2018). What is Health Equity? Behavioral Science & Policy, 4(1), 1-14. https://doi.org/10.1177/237946151800400102
Brega, A. G., Hamer, M. K., Albright, K., Brach, C., Saliba, D., Abbey, D., & Gritz, R. M. (2019). Organizational Health Literacy: Quality Improvement Measures with Expert Consensus. Health literacy research and practice, 3(2), e127–e146. https://doi.org/10.3928/24748307-20190503-01
Centers for Disease Control and Prevention. (2024). Embracing Cultural Humility and Community Engagement. https://www.cdc.gov/global-health-equity/php/publications/cultural-humility.html
Daniels, B. (2024). Caring for patients with non-English language preferences. American Association of Critical-care Nurses. https://www.aacn.org/blog/caring-for-patients-with-non-english-language-preferences#:~:text=When%20patients%20with%20non%2DEnglish,inconvenience%20of%20using%20interpreter%20services.
Espinoza, J., & Derrington, S. (2021). How should clinicians respond to language barriers that exacerbate health inequity? AMA Journal of Ethics, 23(2):E109-116. doi: 10.1001/amajethics.2021.109.
Genovese, A., Borna, S., Gomez-Cabello, C. A., Haider, S. A., Prabha, S., Forte, A. J., & Veenstra, B. R. (2024). Artificial intelligence in clinical settings: a systematic review of its role in language translation and interpretation. Annals of translational medicine, 12(6), 117. https://doi.org/10.21037/atm-24-162
Gonzalez-Barrera, A., Hamel, L., Artiga, S., & Presiado, M. (2024). Language barriers in health care: Findings from the KFF survey on racism, discrimination, and health. KFF. https://www.kff.org/racial-equity-and-health-policy/poll-finding/language-barriers-in-health-care-findings-from-the-kff-survey-on-racism-discrimination-and-health/
Heath, M., Hvass, A. M. F., & Wejse, C. M. (2023). Interpreter services and effect on healthcare - a systematic review of the impact of different types of interpreters on patient outcome. Journal of migration and health, 7, 100162. https://doi.org/10.1016/j.jmh.2023.100162
Khan, A., Parente, V., Baird, JD., et al. (2022). Association of Patient and Family Reports of Hospital Safety Climate With Language Proficiency in the US. JAMA Pediatr. 176(8):776–786. doi:10.1001/jamapediatrics.2022.1831
Liu, C., Wang, D., Liu, C., Jiang, J., Wang, X., Chen, H., Ju, X., & Zhang, X. (2020). What is the meaning of health literacy? A systematic review and qualitative synthesis. Family medicine and community health, 8(2), e000351. https://doi.org/10.1136/fmch-2020-000351
Seidel, E., Cortes, T., & Chong, C. (2023). Strategies to Improve Organizational Health Literacy. Strategies to Improve Organizational Health Literacy. https://psnet.ahrq.gov/primer/strategies-improve-organizational-health-literacy
Steinberg, E. M., Valenzuela-Araujo, D., Zickafoose, J. S., Kieffer, E., & DeCamp, L. R. (2016). The "Battle" of Managing Language Barriers in Health Care. Clinical pediatrics, 55(14), 1318–1327. https://doi.org/10.1177/0009922816629760
U.S. Department of Health and Human Services. (2024). Limited English proficiency.
https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/index.html#:~:text=There%20are%20two%20federal%20laws,Section%201557)%20and%20implementing%20regulations
About the Author
Abigail Preston is currently pursuing a Master of Public Health degree with an emphasis on health promotion at Grand Valley State University, where she is expected to graduate in April 2025. Her public health interests include women’s health, addressing health barriers, and enhancing health education, particularly in the areas of preventative care and advocacy. Abigail recently completed a practicum at Cherry Health, where she gained hands-on experience advocating for women’s health within the Women’s Health Network.
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