Field of Work: Helping health care organizations meet the challenge of providing language services and signage to Latinos
Problem Synopsis: According to the U.S. Census Bureau's 2000 census, more than 28 million Latinos in the United States over the age of 5 spoke Spanish at home. Among those, almost 9 million said they spoke English "not well" or "not at all," according to the census. Those numbers have climbed through the decade, with Latinos becoming the largest and fastest-growing minority group in the United States.
Synopsis of the Work: Hablamos Juntos: Improving Patient-Provider Communication for Latinos (October 2001 through June 2006) focused on developing affordable models of innovative language services—including both interpretation, which refers to spoken encounters, and translation, which applies to written documents—informational materials in Spanish and easy-to-understand signage to post within health facilities. RWJF funded 10 demonstration projects located in rural and urban communities with high numbers of Latinos in 10 different states. Health care systems, health plans, including one for-profit plan, community-based organizations and educational institutions developed and ran the projects.
The Hablamos Juntos national program office created building blocks for language services programs, including a prototype health care interpreter training program and a computer-based program to assess interpreters' proficiency in Spanish and their readiness to interpret.
Five demonstration sites established interpreter training programs with local education partners. Three demonstration sites—all health care systems—adopted language services system-wide and paid for them as part of ongoing operations after the program ended. Most sites used new approaches to expand language services throughout their facilities, including hiring more interpreters and using special software and equipment.
The national program office began an initiative to develop symbols and signs to guide patients to various locations within health care facilities. The work was eventually completed under a separate RWJF grant and resulted in a best practice workbook and a set of signage symbols. RWJF also funded the further development of best practice standards for health care symbols by staff at the national program office.
The demonstration sites did not significantly change Latino patients' experiences, according to the program's evaluators at RAND. The researchers speculated that their measurements may not have been sensitive enough to detect changes during the evaluation period.