Hablamos Juntos: Improving Patient-Provider Communication for Latinos, a national program of the Robert Wood Johnson Foundation (RWJF), was the first national effort to help health care organizations meet the challenge of providing language services and signage. It ran from October 2001 through June 2006.

The program was targeted toward communities or service areas with new and fast-growing Latino populations. It focused on developing:

• Affordable models of innovative language services (including both interpretation, which refers to spoken encounters, and translation, which applies to written documents).
• Interpreter services, informational materials in Spanish and easy-to-understand signage to post within health facilities.

Key Results

• The Hablamos Juntos national program office — originally located at Tomas Rivera Policy Institute at the University of Southern California in Los Angeles and then moved to the Fresno Center for Medical Education and Research, part of the University of California, San Francisco — created building blocks for language services programs, including:
  • A prototype health care interpreter training program.
  • A computer-based program to assess interpreters' proficiency in Spanish and their readiness to interpret.
• RWJF also funded 10 demonstration projects. The projects were 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.
  • See Appendix 1 for contact information. See Project List for links to profiles of four projects and Grant Results on two others.
• Five demonstration sites established interpreter training programs with local education partners. See Site Results for examples of training programs developed by the sites.
• Three demonstration sites — all health care systems — adopted language services systemwide and paid for them as part of ongoing operations after the program ended. See Temple Grant Results, Memphis Grant Results and Inova Profile for more details.
• 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 (ID# 049836) 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 (ID# 056777) by staff at the national program office.
• The demonstration sites did not significantly change Latino patients' experiences, according to the evaluators. The researchers speculated that their measurements may not have been sensitive enough to detect changes during the evaluation period.

Administration and Evaluation
The national program office managed the projects and provided technical assistance to their staffs. A national advisory committee assisted in project selection.

A team from the RAND Corporation in Santa Monica, Calif., a nonprofit institution that conducts research and analysis in order to improve policy and decision-making, evaluated the program.

Funding
The RWJF Board of Trustees authorized Hablamos Juntos in April 2001 for up to $18.5 million. In October 2005, they authorized up to $5.4 million for a three-year renewal. The second phase was to increase the use of effective language services by health care systems.