Introduction
Culturally and linguistically competent health and human services are essential for America’s diverse populations. Cultural competence describes the ability of service delivery systems to provide quality assistance to clients with diverse values, beliefs, or traditions, including tailoring delivery to meet their social, cultural, and linguistic needs. It is a set of behaviors, attitudes, and policies that come together in an agency or among professionals enabling them to work effectively in cross–cultural situations.
Limited English proficiency (LEP) refers to the restricted ability to read, speak, write, or understand English by individuals who do not speak English as their primary language. These individuals may be entitled language assistance with respect to a particular type or service, benefit, or encounter. Collectively, cultural competence and LEP address the necessity to understand and respond effectively to the cultural and linguistic needs among people of different nationalities, ethnicities, and cultures.
Frequently Asked Questions
Tools
Ask Me 3
Web site
Provides information about health literacy for health care providers, patients, employers, and the media. Includes brochures in English and Spanish, lists questions to ask a doctor, nurse, or pharmacist, and offers tips to help better understand personal health.
Civil Rights Division's Coordination and Review Section
Web site
A comprehensive, government-wide program of technical and legal assistance, training, interagency coordination, and regulatory, policy, and program review, to assure that federal agencies consistently and effectively enforce various landmark civil rights statutes and related Executive Orders that prohibit discrimination in federally assisted programs and in the federal government's own programs and activities.
Complaint Form for the USDOJ, Civil Rights Div., Coordination and Review Section
Web site
Contains several formats of the complaint form used by the Department of Justice, Civil Rights Division and their contact information. The USDOJ will review discrimination against persons with limited English proficiency complaints and refer those complaints to the appropriate agency.
Consumer Health Brochures in Multiple Languages
Web site
Electronic access to over 200 health education brochures in 24 different languages.
Contextual Health Profile for Rural Racial and Ethnic Minority Populations
Web site
Tool for health planners on culturally competent health programming. The profile is a comprehensive description of the health status of a specific community. Includes community health status information typically in a community health needs assessment, as well as cultural and environmental information.
Cross Cultural Health Care Program
Web site
Serves as a bridge between communities and health care institutions to ensure full access to quality health care that is culturally and linguistically appropriate. Provides a combination of cultural competency trainings, interpreter trainings, research projects, and community coalition building.
Cultural and Linguistic Competence (CLC) Toolkit
Web site
Provides information and benchmark tools for the implementation of cultural and linguistic competence to support the positive development of children and families through the implementation of services, activities, and interventions based on a model of community collaboration.
Cultural and Linguistic Competence Policy Assessment (CLCPA)
Web site
A self-assessment instrument designed to examine cultural and linguistic competence in four dimensions: values, policy, structure, and practice.
Cultural Brokering Web Portal
Web site
Encourages the use of cultural brokering in health and mental health care by providing information and resources.
Cultural Competence Resources for Health Care Providers
Web site
Highlights projects on cross-cultural health care. Helps health care providers enhance their clinical and organizational skills in cultural competence
Cultural Competency Curriculum for Disaster Preparedness and Crisis Response
Web site
A free online educational program designed for first responders of disaster preparedness and crisis response including emergency medical technicians, psychologists, psychiatrists and social workers.
Cultural Competency Toolkit: Ten Grant Sites Share Lessons Learned
Web site
Provides an overview of 10 model cultural competency programs. Includes their project goals, implementation plans, and program materials. This information will assist other consumer supporter organizations to launch similar cultural competency outreach programs.
Culturally Competent Nursing Modules (CCNMs)
Web site
A case-based curriculum designed to help nurses better meet the cultural and linguistic needs of an increasingly diverse patient population.
Culturally Specific Patient Health Information for non-English speakers
Web site
Librarian recommended reference sites for culturally specific patient health information.
Culture and Health Literacy Modules
Web site
An online course that discusses how inequalities in health information contribute to health disparities and what communities can do to close the gap and improve health literacy.
Dictionary of Health Related Terms, 3rd Edition (English - Spanish)
Print publication
An instrument for health care personnel and other
professionals working with the Latino population in the United States. Purpose is to strengthen communication between Spanish-speaking populations and the health workers serving them, and facilitate dialogue by reducing cultural and linguistic barriers.
English Language Learner Resources
Web site
A variety of Limited-English Proficient (LEP) resources that include assessment tools, documents, brochures, case decisions, and FAQs.
EthnoMed
Web site
Provides information about cultural beliefs, medical and other related issues pertinent to the health care of recent immigrants to the United States. Includes these culture-specific pages: Amharic, Cambodian, Chinese, Eritrean, Ethiopian, Hispanic, Hmong, Oromo, Somali, Tigrean, & Vietnamese and covers a wide variety of health topics. Some information is available in languages other than English.
Evaluation Tools for Racial Equity
Web site
Provides tools, resources and success stories to help evaluate racial equity within a group, a community, or an organization.
Guide to Choosing and Adapting Culturally and Linguistically Competent Health Promotion Materials
Web site
Provides guidance on how to assure that health promotion materials reflect the principles and practices of cultural and linguistic competence.
Guidelines for Accessing Interpreter Services
Web site
Provides a list of procedures for accessing interpreters in a timely and cost-effective manner.
Harborview Project: Accessing Online Information for Immigrant and Refugee Health
Web site
Helps users find Internet-based health information for specific immigrant populations to better understand their health and diagnosed disorders.
Health & Literacy Special Collection
Web site
Contains health curricula for literacy classes, resources that provide basic health information in simple terms, resources in languages other than English, information about the link between literacy & health status, and links to organizations dedicated to health and literacy education.
Health Information in Multiple Languages
Web site
Provides access to consumer health information in languages other than English.
Health Information Translations
Web site
Provides culturally appropriate materials to promote health education and wellness among Limited English Proficiency (LEP) populations.
Health Literacy and Cultural Competency: Research Findings
Web site
Lists links to research activities regarding health literacy and cultural competency from the years 2005-2010.
HRET Disparities Toolkit
Web site
Provides hospitals, health systems, clinics, and health plans information and resources for systematically collecting race, ethnicity, and primary language data from patients.
HUD Limited English Proficiency (LEP)
Web site
Provides documents from the U.S. Department of Housing and Urban Development (HUD) that are translated into various languages including, but not limited to: Arabic, Cambodian, Chinese, Creole, Hmong, Korean, Russian, Spanish, and Vietnamese.
Interpreter Associations
Web site
A list of local and regional interpreting associations with a special focus on healthcare interpreting.
Knowledge Path: Spanish-Language Health Resources
Web site
A guide of high-quality Spanish-language health resources for health professionals and consumers. The collection covers a wide range of health topics, each with a section that focuses on topics of interest to families and professionals in the maternal and child health (MCH) community.
Language Access Resource Guide
Web site
Contains materials related to interpreter training and resources, such as publications, organizations, listservs, and agencies.
Language and Cultural Access Program
Web site
Established by Asian Health Services to help reduce language and cultural barriers that immigrants face in accessing health care.
Language Assistance Self-Assessment and Planning Tool for Recipients of Federal Financial Assistance
Web site
Assists organizations that receive Federal financial assistance in their efforts to ensure that program goals and objectives address meaningful access for all of the people they serve, including those who are limited-English proficient.
Language Services Action Kit: Interpreter Services in Health Care Settings for People with Limited English Proficiency
Print publication
Toolkit for advocates and others working to ensure that people with limited English proficiency in their state get appropriate language assistance services in medical settings. Available for $25 in English or Spanish.
Learning Services
Web site
A list of documents and reports on language services in health care settings and people with limited English proficiency.
Limited English Proficiency (LEP) and Hispanic Worker Initiative
Web site
Provides a variety of resources regarding multilingual and multicultural strategies for serving job seekers and workers with limited English proficiency.
Limited English Proficiency: A Federal Interagency Website
Web site
Promotes a positive and cooperative understanding of the importance of language access to federal programs and federally assisted programs. Acts as a clearinghouse, providing information, tools, and technical assistance regarding Limited English Proficiency (LEP) and language services for federal agencies, recipients of federal funds, users of federal programs and federally assisted programs.
Maternal and Child Health Library: Non-English Materials and Resources
Web site
An online catalog of maternal and child health materials and resources for consumers and professionals in numerous languages other than English.
Multicultural Council
Web site
Advocates on behalf of the cultural diversity and cultural competence mandates of the Developmental Disabilities Act. Serves as a conduit for technical assistance, providing input into policy, and engaging in other support activities necessary to advance cultural competency.
Multilingual Glossary of Technical and Popular Medical Terms in Nine European Languages
Web site
A multilingual glossary of technical and popular medical terms in nine European Languages: Danish, Dutch, English, French, German, Italian, Portuguese and Spanish.
National Association of State Offices of Minority Health Directors
Web site
Lists contact information for directors of state offices of minority health.
National Prevention Information Network - Cultural Competence
Web site
Provides information and resources about cultural competence and how it applies to HIV/AIDS, STD, and TB prevention.
National Resource Center on Advancing Emergency Preparedness for Culturally Diverse Communities
Web site
An information exchange portal designed to facilitate communication, networking and collaboration to improve preparedness and eliminate disparities for racially and ethnically diverse communities in public health emergencies.
New Americans Health Information Portal (NAHIP)
Web site
Serves as an Internet portal to identified quality multi-lingual health education documents and as a receptacle for health documents created by Heartland's Refugee Health Programs.
Office for Civil Rights, Headquarters and Regional Addresses
Web site
Lists the contact information for the main Office of Civil Rights and the regional Offices of Civil Rights. Accepts complaints regarding Federal civil rights laws that protect the rights of all persons in the United States to receive health and human services without discrimination based on race, color, national origin, disability, age, and in some cases, sex and religion. This includes LEP persons who are not provided language access in an appropriate manner.
Office for Civil Rights: Limited English Proficiency (LEP) - Resources
Web site
Includes documents pertaining to persons with Limited English Proficiency (LEP).
Office of Minority Health
Web site
A resource center that provides publications, articles, statistics, data, funding sources as well as database searches on minority health topics. Can be contacted by phone at 1.800.444.6472, or by e-mail at info@omhrc.gov.
Office of Minority Health Regional Minority Health Consultants (RMHCs)
Web site
A locator map of the Office of Minority Health Regional Minority Health Consultants (RMHCs) who work to build partnerships with consumers and professionals working on minority health issues at the regional, state and community level.
Other Language Resources
Web site
Provides links to multilingual materials on health related topics.
Patient Education Resources All Languages
Web site
List of links to patient education materials and brochures available in a variety of different languages.
Physician Toolkit and Curriculum: Resources to Implement Cross-Cultural Clinical Practice Guidelines for Medicaid Practitioners
Print publication
This toolkit aids healthcare providers in the practical application of the Cross-Cultural Clinical Practice Guidelines. It introduces the basic fundamentals of cross-cultural practice and offers steps and processes essential to delivering quality care to culturally diverse populations.
Physician's Practical Guide to Culturally Competent Care
Web site
A website that offers CME, CNE, and CEU credit and equips health care professionals with awareness, knowledge, and skills to treat the increasingly diverse U.S. population they serve. Includes a self-directed training course for family physicians and other health care professionals with an interest in cultural competency.
Provider's Guide to Quality and Culture
Web site
Designed to assist healthcare organizations throughout the United States in providing high quality, culturally competent services to multi-ethnic populations.
Rural Health Research: Cultural competency
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of cultural competency, produced by the Office of Rural Health Policy's funded rural health research centers.
Rural Minority and Multicultural Health Information Warehouse
Web site
Central source for finding information about rural minority and multicultural health. Lists research studies, reports, journal articles, and rural minority population data. Prepared by the South Carolina Rural Health Research Center with funding from the Office of Rural Health Policy.
SNAP Informational Materials in Other Languages
Web site
Offers links to materials in languages other than English. Materials are designed for partners, advocates, and the public to distribute to consumers who may be eligible to participate in the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program.
Speaking Together
Web site
A national program aimed at improving the quality and availability of health care language services for patients with limited English proficiency (LEP). Hospitals pilot new performance measures and test techniques for reducing health care disparities associated with language barriers.
Speaking Together for Better Care: How Effective Medical Interpretation Can Improve Quality of Care
Web site
This video takes you to Cambridge Hospital in Massachusetts and to Phoenix Children's Hospital, where medically trained interpreter services are making a critical contribution to improving safety and clinical outcomes for patients who speak or understand little English.
Study On Measuring Cultural Competence in Health Care Delivery Settings: A Review of the Literature
Web site
A literature assessment, sponsored by HRSA, that synthesizes and examines the measurement of cultural competence, as related to health care. This review will serve as a basis for decisions about the scope, content, and value of the cultural competence measurement profile to be developed.
Think Cultural Health
Web site
Works to improve the health of racial and ethnic minority populations through the development of effective health policies and programs that help to eliminate disparities in health. Develops and tests curriculum modules that effectively equip family physicians with cultural and linguistic competencies.
Tool for Assessing Cultural Competence Training (TACCT)
Web site
An instrument for measuring cultural competence in the undergraduate medical school curriculum. Website provides guidelines and a resource guide to assist with TACCT implementation.
TrainingFinder Real-time Affiliate Integrated Network (TRAIN)
Database
Information on learning opportunities, particularly online learning, for health care professionals who work for the public's health. Searchable by subject, keyword, target audience, core competencies, etc.
Unified Health Communication 101: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency
Tutorial
Serves as free online training. Course can be taken for credit (CEU/CE, CHES, CME, CNE) or not for credit. Course addresses health literacy, cultural competency and patient communication skills.
USA-Mexico Border Health
Web site
Assists individuals with locating and competing for funding opportunities in order to address health care needs in the U.S.-Mexico Border region. Lists funding opportunities and information resources on topics relevant to border health.
Why The Difference Initiative
Web site
Designed to increase provider awareness about disparities in health care. The website also provides a Speaker's Kit to help physicians talk to patients about cardiovascular care.
Regulations, Forms & Other Useful Documents
Addressing Language Access Issues in Your Practice: A Toolkit for Physicians and Their Staff Members
Author(s): Cynthia E. Roat
Discusses the importance of addressing the language access needs of a changing patient population. Provides tools and resources for developing skills to facilitate language access.
Date: 2005
And the Journey Continues: Achieving Cultural and Linguistic Competence in Systems Serving Children and Youth with Special Health Care Needs and their Families
Author(s): Tawara D. Goode, Wendy Jones, Suzanne Bronheim, Clare Dunne
Sponsoring organization: National Center for Cultural Competence
Offers insights and lessons learned by the National Center for Cultural Competence and provides success stories from State Title V Children with Special Health Care Needs programs.
Date: 2007
Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It
Author(s): Arthur Kleinman, Peter Benson
Discusses the idea of cultural competency and associated problems with definition, lack of research, and the constant changing cultural process.
Journal citation: PLoS Medicine Volume 3 Issue 10
Date: 09 / 2006
Bridging the Cultural Divide in Health Care Settings: The Essential Role of Cultural Broker Programs
Sponsoring organization: National Center for Cultural Competence
A guide for implementing cultural broker programs in health care settings, particularly those that employ or serve as placement sites for National Health Service Corps scholars and clinicians in service.
Date: 2004
Building Culturally and Linguistically Competent Services to Support Young Children, Their Families, and School Readiness
Author(s): Kathy Seitzinger Hepburn
Sponsoring organization: Annie E. Casey Foundation
Provides guidance, tools, and resources that will assist communities in building culturally and linguistically competent services, supports, programs, and practices related to young
children, their families.
Date: 05 / 2004
Certification of Health Care Interpreters: A Primer, a Status Report and Considerations for National Certification
Author(s): Cynthia Roat
Sponsoring organization: California Endowment
Provides an overview of certification issues for health care interpreters in the United States.
Date: 09 / 2006
Closing the Health Disparity Gap in New Mexico: A Roadmap for Grantmaking (Executive Summary)
Author(s): Lisa Cacari Stone, Deborah Boldt
Provides information and recommendations necessary to be aware of, and respond to the health rights and needs of culturally and demographically diverse peoples and communities
of New Mexico.
Date: 05 / 2006
Cultural Competence Education
Sponsoring organization: American Medical Association
Discusses the need for cultural competence curriculum for medical students and identifies ways in which to develop a curriculum.
Date: 2005
Cultural Competence in Serving Children and Adolescents With Mental Health Problems
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Discusses the need for culturally competent systems of mental health care and describes what such systems should include.
Cultural Competence in the Prevention and Treatment of Obesity: Latino Americans
Author(s): John P. Foreyt
Sponsoring organization: Kaiser Permanente
Discusses weight management among Latino Americans.
Journal citation: Permanente Journal Volume 7 Issue 2
Date: 2003
Cultural Competence Training Survey - Results 2008
Author(s): Anne Turner
Sponsoring organization: Cross Cultural Health Care Program
Results from a cultural competence training survey developed to learn more about the needs of the professionals who purchase or deliver cultural competence training within hospitals, health care organizations, and other institutions.
Date: 2008
Cultural Competency and Quality of Care: Obtaining the Patient's Perspective
Author(s): Quyen Ngo-Metzger, Joseph Telfair, Dara H. Sorkin, Beverly Weidmer, Robert Weech-Maldonado, Margarita Hurtado, Ron D. Hays
Sponsoring organization: Commonwealth Fund
This report identifies five domains of culturally competent care that can best be assessed through patients' perspectives: 1) patient - provider communication; 2) respect for patient preferences and shared decision-making;
3) experiences leading to trust or distrust; 4) experiences of discrimination; and 5) linguistic
competency.
Date: 10 / 2006
Cultural Heritage Organizations: Nonprofits That Support Traditional, Ethnic, Folk, and Noncommercial Popular Culture
Author(s): Carole Rosenstein
Sponsoring organization: Urban Institute
Provides an overview of nonprofit cultural heritage organizations in the United States and a snapshot of their structure, finances and programs.
Date: 03 / 2006
Definition of Linguistic Competence
Author(s): Tawara D. Goode, Wendy Jones
Sponsoring organization: National Center for Cultural Competence
A definition of Linguistic Competence, developed by the National Center for Cultural Competence, that provides a foundation for determining linguistic competence in health care, mental health and other human service delivery systems.
Date: 06 / 2006
Developing Cultural Competence in Disaster Mental Health Programs: Guiding Principles and Recommendations
Author(s): Jean Athey, Jean Moody-Williams
Sponsoring organization: Substance Abuse and Mental Health Services Administration
Assists States and communities in planning, designing, and implementing culturally competent disaster mental health services for survivors of natural and human-caused disasters of all scales.
Date: 2003
Diversity of Cultural Participation: Findings from a National Survey
Author(s): Francie Ostrower
Sponsoring organization: Urban Institute
The central conclusion from a national
survey of cultural participation. This project revealed important differences in participation among different ethnic groups, as well as by type of cultural event.
Date: 10 / 2005
Don't Get Disconnected: 10 Steps to Bridge the Language Divide
Author(s): Jeanette Anders
Ten steps for working with limited English-speaking patients and medical interpreters for more effective communication over the phone.
Date: 09 / 2006
Executive Order 13166, Limited English Proficiency Resource Document: Tips and Tools from the Field
Sponsoring organization: U.S. Department of Justice
Lists many of the tips, tools, and practices identified in the DOJ surveys of court personnel, social service providers, police departments, 911 call centers, and several DOJ components, to determine how these organizations have responded to the call for meaningful access for LEP individuals.
Date: 09 / 2004
Executive Order 13166: Improving Access to Services for Persons with Limited English Proficiency
Sponsoring organization: U.S. Department of Justice
The Executive Order that requires Federal agencies to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so LEP persons can have meaningful access to them.
Date: 08 / 2000
Guide for Advancing Family-Centered and Culturally and Linguistically Competent Care
Sponsoring organization: National Center for Cultural Competence
Discusses ways in which family-centered care and cultural and linguistic competence can be integrated to support and sustain a community-based system of services that provide high quality of care to families who have children and youth with special health care needs.
Guidelines on Bureau of Substance Abuse Services Interpreter Services
A uniform set of guidelines and recommendations for interpreting in substance abuse practice settings.
Date: 2005
Health Care Language Services Implementation Guide
Sponsoring organization: Health Resources and Services Administration
A guide to help healthcare organizations implement effective language access services (LAS) to meet the needs of their patients with limited English proficiency (LEP), thereby increasing their access to health care. Requires registration.
Date: 2007
Health Literacy Practices in Primary Care Settings: Examples from the Field
Author(s): Sharon E. Barrett, Jennifer Sheen Puryear, Kathie Westpheling
Sponsoring organization: Commonwealth Fund
Reports on the findings from a 2005 study in which the Association of Clinicians for the Underserved administered an online survey of health care facilities across the country, then followed up with visits to five selected sites, including rural, for staff and patient interviews.
Date: 01 / 2008
Hospital Language Services for Patients With Limited English Proficiency: Results From a National Survey
Author(s): Romana Hasnain-Wynia, Julie Yonek, Debra Pierce, Ray Kang, Cynthia Hedges Greising
This report describes current practices, common
barriers, and the specific resources and tools
needed to provide language services to patients
with LEP. The results of the survey will inform
federal policymakers, practitioners, providers, and others of the issues and potential solutions facing hospitals as they work to improve language
services for all patients with LEP.
Date: 10 / 2006
Hospitals, Language, and Culture: A Snapshot of the Nation
Author(s): Amy Wilson-Stronks, Erica Galvez
Sponsoring organization: Joint Commission
A qualitative cross-sectional study designed to provide a snapshot of how 60 hospitals across the country are providing health care to culturally and linguistically diverse patient populations.
Date: 2007
How Race/Ethnicity, Immigration Status, and Language Affect Health Insurance Coverage, Access to and Quality of Care Among the Low-Income Population (Full Report)
Author(s): Leighton Ku, Timothy Waidmann
Sponsoring organization: Kaiser Commission on Medicaid and the Uninsured
Discusses the roles that race, language and citizenship status play in insurance coverage, access to health care and quality of health care, particularly for the low-income
Latino population.
Date: 08 / 2003
Improving Access to Care Among Medicare Beneficiaries With Limited English Proficiency: Can Medicare Do More?
Sponsoring organization: AARP Public Policy Institute
Examines problems associated with language barriers in health care setting, describes federal efforts to address the barriers, and makes policy recommendations.
Date: 2008
Improving Access to Language Services in Health Care: A Look at National and State Efforts
Author(s): Melanie Au, Erin Fries Taylor, Marsha Gold
Sponsoring organization: Mathematica Policy Research, Inc.
Assesses emerging national efforts to address language barriers and profiles work in three states—California, Minnesota, and New York—to highlight challenges, successes, and implications for future policy and activities related to providing language services.
Date: 04 / 2009
Improving Homeownership Opportunities for Hispanic Families: Language, Agglomeration, and Hispanic Homeownership
Author(s): Donald R. Haurin, Stuart S. Rosenthal
Sponsoring organization: U.S. Department of Housing and Urban Development
Investigates the degree to which language barriers contribute to well-known Hispanic-white gaps in homeownership that have been documented in numerous previous studies: as of the fourth quarter of 2005, data from the Current Population Survey indicate that 76 percent of white non-Hispanic families owned homes, but only 50 percent of Hispanic families.
Date: 03 / 2006
Improving Quality and Achieving Equity: The Role of Cultural Competence in Reducing Racial and Ethnic Disparities in Health Care
Author(s): Joseph R. Betancourt
Sponsoring organization: Commonwealth Fund
Reviews key principles of quality (as it relates to the overall quality of the health care system and individual approaches to quality improvement); reviews evidence of the existence and root causes of racial and ethnic health disparities and recommendations to address them; and discusses strategies by which the quality and cultural competence movements could be linked.
Date: 10 / 2006
Improving Quality of Health Care Relies on Effective Language Services
Sponsoring organization: Robert Wood Johnson Foundation
Highlights how data are helping hospitals improve the way they provide language services to America's increasingly diverse patient populations.
Date: 09 / 2007
Interpreter Services for Patients in Medical and Dental Settings
Sponsoring organization: Interpreter Services Work Group
Outcome of a study involving a work group in Minnesota, who examined ensuring access to interpreter services; complying with requirements of federal law and guidance; developing a quality assurance program to ensure the quality of health care interpreting services; and identifying broad-based funding mechanisms for interpreter services.
Date: 02 / 2008
Joint Commission 2006 Requirements Related to the Provision of Culturally and Linguistically Appropriate Health Care
Sponsoring organization: Joint Commission
Identifies and lists the Joint Commission standards and elements of performance (EPs) that
are related to the provision of culturally and linguistically appropriate services in the various accreditation settings - hospital, ambulatory, long term care, behavioral health, and home care.
Date: 01 / 2006
Language Access Services in Critical Access Hospitals for Patients with Limited English Proficiency in Rural Minnesota
Sponsoring organization: Minnesota Department of Health
Examines how well Critical Assess Hospitals (CAHs) were meeting the needs of patients with limited English proficiency in rural Minnesota.
Date: 03 / 2008
Language Access Solutions for OBGYN Medical Practices
Provides policy and practice recommendations to promote the use of language access practices that ensure interpretation, confidentiality, adherence to medical ethics standards, while discouraging the use of inappropriate methods.
Date: 2007
Language Proficiency and Adverse Events in U.S. Hospitals: A Pilot Study (Summary)
Author(s): Chandrika Divi, Richard G. Koss, Stephen P. Schmaltz, Jerod M. Loeb
Sponsoring organization: Commonwealth Fund
Reports on the type and frequency of adverse events experienced by LEP (limited English proficiency) and English-speaking patients in six U.S. hospitals.
Date: 04 / 2007
Language Services for Patients with Limited English Proficiency: Results of a National Survey of Internal Medicine Physicians
Sponsoring organization: American College of Physicians
Presents the findings of a national survey of American College of Physicians members to determine whether internal medicine practices provide language services for LEP patients.
Date: 2007
Language Services Resource Guide for Health Care Providers
Author(s): Alyssa Sampson
Sponsoring organization: Cross Cultural Health Care Program
A guide to aid health care providers, administrators, interpreters, translators, and others in improving language access and improving health care for their clients and patients.
Date: 10 / 2006
Limited English Proficiency, Primary Language at Home, and Disparities in Children's Health Care: How Language Barriers Are Measured Matters
Author(s): Glenn Flores, Milagros Abreu, Sandra C. Tomany-Korman
Sponsoring organization: Commonwealth Fund
Summarizes the Commonwealth Fund study of the same title and concludes that LEP is more useful than language spoken at home in gauging the impact of language barriers in children's health care.
Date: 2005
MedlinePlus and the Challenge of Low Health Literacy: Findings From the Colonias Project
Author(s): Cynthia A. Olney, Debra G. Warner, Greysi Reyna, Fred B. Wood, Elliot R. Siegel
Sponsoring organization: Medical Library Association
Discusses the Colonias Project, an 18-month outreach project with the goal of increasing the usage of MedlinePlus and MedlinePlus en español and overcoming associated problems with health literacy in low-income, medically underserved Hispanic communities (colonias) along the Texas-Mexico border, where residents primarily speak Spanish.
Journal citation: Journal of the Medical Library Association Volume 95 Issue 1 Pages: 31-39
Date: 01 / 2007
Multicultural Health Care: A Quality Improvement Guide
Sponsoring organization: National Committee for Quality Assurance
Provides a quality improvement framework for health care organizations seeking to promote culturally appropriate care, provide equitable access for individuals with limited English proficiency and reduce health care disparities.
Date: 2008
National Standards for Culturally and Linguistically Appropriate Services in Health Care: Executive Summary
Sponsoring organization: Health Resources and Services Administration
A summary with list of the National Standards for Culturally and Linguistically Appropriate Services in Health Care as issued by the U.S. Department of Health and Human Services' Office of Minority Health (OMH) to ensure that all people entering the health care system receive equitable and effective treatment in a culturally and linguistically appropriate manner. These standards are proposed as a means to correct inequities that currently exist in the provision of health services and to make these services more responsive to the individual needs of all patients/consumers.
Date: 03 / 2001
National Standards for Culturally and Linguistically Appropriate Services in Health Care: Final Report
Sponsoring organization: Health Resources and Services Administration
Provides a list and discussion of the National Standards for Culturally and Linguistically Appropriate Services in Health Care as issued by the U.S. Department of Health and Human Services' Office of Minority Health (OMH) to ensure that all people entering the health care system receive equitable and effective treatment in a culturally and linguistically appropriate manner. These standards are proposed as a means to correct inequities that currently exist
in the provision of health services and to make these services more responsive to the
individual needs of all patients/consumers.
Date: 03 / 2001
National Standards on Culturally and Linguistically Appropriate Services (CLAS)
Sponsoring organization: HHS Office of Minority Health
A list of the Culturally and Linguistically Appropriate Services (CLAS) standards as developed by the National Project Advisory Committee, in conjunction with the U.S. Department of Health and Human Services, and the Office of Minority Health. These standards are directed at health care organizations; however, individual providers are also encouraged to use the standards to make their practices more culturally and linguistically accessible.
Date: 2000
Outcomes of Community Health Worker Interventions
Sponsoring organization: Agency for Healthcare Research and Quality
Results of a systematic review on the characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. Includes references to rural.
Date: 06 / 2009
Overcoming Language as a Barrier to Quality Health Care
Sponsoring organization: Robert Wood Johnson Foundation
Discusses a program sponsored by RWJ to break down language barriers to help physicians who treat non-English proficient patients.
Journal citation: Advances Issue 1 Pages: 7
Date: 04 / 2005
Patient Centeredness, Cultural Competence and Healthcare Quality
Author(s): Somnath Saha, Mary Catherine Beach, Lisa A. Cooper
Sponsoring organization: Commonwealth Fund
Explores and compares the historical evolution of both cultural competence and patient centeredness - interpersonal and healthcare systems levels.
Journal citation: Journal of the National Medical Association
Date: 11 / 2008
Patient-Centered Guide to Implementing Language Access Services (LAS) in Healthcare Organizations (Executive Summary)
A summary of full document of same title intended to help healthcare organizations implement effective language access services to meet the needs of their limited English proficient patients (LEP), and increase their access to health care.
Date: 09 / 2005
Patient-Centered Guide to Implementing Language Access Services in Healthcare Organizations
Sponsoring organization: U.S. Department of Health and Human Services
Helps healthcare organizations implement effective language access services to meet the needs of their limited English proficient patients (LEP), and increase their access to health care.
Date: 09 / 2005
Paying for Language Services in Medicare: Preliminary Options and Recommendations
Author(s): Leighton Ku
This report discusses how the federal
government could design payment systems for
language services in Medicare. It reviews
information about current approaches to pay
for language services and offers recommendations as a starting point for change in payment systems.
Date: 10 / 2006
Physicians are Becoming Engaged in Addressing Disparities
Sponsoring organization: American Medical Association
Reports on a study consisting of a sample of national primary care physicians with an emphasis on those practicing in communities with a high proportion of racial and ethnic minorities.
Date: 04 / 2005
Priority Populations Initiative: Breaking New Ground and Building Capacity in Cultural Tailoring
Author(s): Helen Lettlow, Guillermo Brito,
Sponsoring organization: American Legacy Foundation
Highlights the importance of cultural tailoring to the successful servicing of traditionally underserved populations.
Date: 03 / 2007
Providing Language Services in State and Local Health-Related Benefits Offices: Examples from the Field
Author(s): Mara Youdelman, Jane Perkins, Jamie D. Brooks, Deborah Reid
Sponsoring organization: Commonwealth Fund
The National Health Law Program visited and conducted telephone interviews and surveys with Medicaid and other public programs offices to assess effective models of providing language services to people who are LEP.
Date: 01 / 2007
Race, Ethnicity, and Language of Patients: Hospital Practices Regarding Collection of Information to Address Disparities in Health Care
Author(s): Marsha Regenstein, Donna Sickler
Sponsoring organization: Robert Wood Johnson Foundation
Addresses the ability of health care organizations to describe their populations and assess the size and
scope of health care disparities in-house. Provides information on the state of data collection in the U.S. hospital industry and also describes data collection practices at more than 60 safety net hospital systems across the country.
Date: 01 / 2006
Resident Physicians' Preparedness to Provide Cross-Cultural Care: Implications for Clinical Care and Medical Education Policy
Author(s): Joseph R. Betancourt, Joel S. Weissman, Minah K. Kim, Elyse R. Park, Angela W. Maina
Sponsoring organization: Commonwealth Fund
Reports on a national study of resident physicians in their final year of training regarding the preparedness to care for patients from racial and ethnic minorities and from diverse cultures.
Date: 05 / 2007
Role and Relationship of Cultural Competence and Patient-Centeredness in Health Care Quality
Author(s): Mary Catherine Beach, Somnath Saha, Lisa A. Cooper
Sponsoring organization: Commonwealth Fund
Explores the historical evolution of patient-centeredness and cultural competence in health care quality, and how each approach holds promise for improving the quality of health care for individual patients, communities, and populations.
Date: 10 / 2006
Rural Hospitals and Spanish Speaking Patients with Limited English Proficiency
Author(s): Myriam E. Torres, Deborah Parra-Medina, Amy Brock Martin, Andrew O. Johnson, Jessica D. Bellinger, Janice C. Probst
Sponsoring organization: South Carolina Rural Health Research Center
This is the executive summary. Reports that 40 million Latinos in the United States, 14.2% of the population, have limited English proficiency (LEP), which can lead to poor health outcomes in the absence of effective medical interpretation or translation services.
Date: 10 / 2005
Services for African American Children and Families
Author(s): Beth Stroul
Sponsoring organization: National Technical Assistance Center for Children's Mental Health
Summarize issues and challenges related to services for African American children and families, identifies effective service delivery strategies for local systems of care, and develop recommendations for policy and technical assistance.
Date: 05 / 2006
Serving Patients with Limited English Proficiency: Results of a Community Health Center Survey
Sponsoring organization: National Association of Community Health Centers
Discusses the challenges of serving people with limited English proficiency (LEP) at health care safety net organizations.
Date: 06 / 2008
Sound of Success: Efficient And Effective Language Services Becoming A Reality In Some Hospitals
Sponsoring organization: Robert Wood Johnson Foundation
Reports on a national initiative aimed at identifying, testing and assessing strategies for hospitals to provide effective language services to LEP patients.
Date: 09 / 2008
State Approaches to Covering Medical Interpreter Services in Medicaid and SCHIP Programs
Sponsoring organization: Connecticut Health Foundation
Summarizes the existing programs and what states have done to address the issues regarding medical interpreter services.
Date: 04 / 2007
Taking Cultural Competency from Theory to Action
Author(s): Ellen Wu, Martin Martinez
Sponsoring organization: Commonwealth Fund
Provides principles and recommendations for implementing cultural competency in the field. Based on interviews with leaders in the field of cultural competency, the authors discuss best practices and important lessons in the implementation of cultural competency initiatives.
Date: 10 / 2006
Training Community Health Workers: Using Technology and Distance Education
Sponsoring organization: Office of Rural Health Policy
Overview of programs and issues related to the use of technology and distance education to train community health workers (CHWs) in frontier areas. Includes examples of successful programs.
Date: 04 / 2006
Transforming the Face of Health Professions Through Cultural & Linguistic Competence Education: The Role of the HRSA Centers of Excellence
A compendium providing practical guidance in the form of strategies, tools, and resources for HRSA Centers of Excellence implementing and integrating cultural and linguistic competency content and methods into existing academic programs. It also provides guidance for evaluating cultural and linguistic competency efforts.
Date: 03 / 2005
Using Professionally Trained Interpreters to Increase Patient/Provider Satisfaction: Does It Work?
Author(s): Ann D. Bagchi, Stacy Dale, Natalya Verbitsky-Savitz, Sky Andrecheck
Sponsoring organization: Mathematica Policy Research, Inc.
A study addressing the research suggesting a link between the use of a professional interpreter during ED visits and higher levels of patient and provider satisfaction.
Date: 02 / 2010
What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety
Sponsoring organization: Joint Commission
Discusses health literacy issues which place patients at greater risk of preventable adverse events. Discusses how cultural, language, and communication barriers can potentially lead to misunderstandings between patients and their health care providers.
Date: 2007
Organizations
Access Project
Nonprofit/Foundation
Part of the Center for Community Health Research and Action. Works to strengthen community action, promote social change, and improve health, especially for those who are most vulnerable.
Association of Clinicians for the Underserved (ACU)
National organization
A nonprofit, transdisciplinary organization of clinicians, advocates, and health care organizations working to improve the health of America's underserved populations and to enhance the development and support of the medical and dental clinicians serving these populations.
CDC's Office of Minority Health & Health Disparities (OMHH)
Federal government
Aims to accelerate CDC’s health impact in the U.S population and to eliminate health disparities for vulnerable populations as defined by race/ethnicity, socio-economic status, geography, gender, age, disability status, risk status related to sex and gender, and among other populations identified to be at-risk for health disparities.
Center for Cross Cultural Health (CCCH)
State/regional organization
Integrates the role of culture in improving health through the education and training of health and human service providers and organizations in the State of Minnesota and beyond.
Commonwealth Fund
Nonprofit/Foundation
Supports independent research on health and social issues and makes grants to improve health care practice and policy. Dedicated to helping people become more informed about their health care and improving care for vulnerable populations such as children, elderly people, low-income families, minority Americans, and the uninsured.
Cross Cultural Health Care Program (CCHCP)
National organization
Serves as a bridge between communities and health care institutions to ensure full access to quality health care that is culturally and linguistically appropriate.
DiversityRx
National organization
Promotes language and cultural competence to improve the quality of health care for minority, immigrant, and ethnically diverse communities.
Healthy Roads Media
Nonprofit/Foundation
Contains free health education materials in a number of languages and a variety of formats.
Institute for Diversity in Health Management
National organization
Committed to expanding health care leadership opportunities for ethnically, culturally, and racially diverse individuals, and increasing the number of these individuals entering and advancing in the field.
Minnesota International Health Volunteers (MIHV)
International organization
Works to improve the health of underserved women of reproductive age and children under five years of age around the world. Somali language publications available.
National Center for Cultural Competence (NCCC)
National organization
Mission is to increase the capacity of health and mental health programs to design, implement, and evaluate culturally and linguistically competent service delivery systems. Provides a variety of tools, publications and other resources online. Information available in Spanish.
National Center on Minority Health and Health Disparities (NCMHD)
Federal government
The mission is to promote minority health and to lead, coordinate, support, and assess the NIH effort to reduce and eliminate health disparities. NCMHD will conduct and support basic, clinical, social, and behavioral research, promote research infrastructure and training, foster emerging programs, disseminate information, and reach out to minority and other health disparity communities.
National Council on Interpreting in Health Care (NCIHC)
National organization
A multidisciplinary organization based in the United States whose mission is to promote culturally competent professional health care interpreting as a means to support equal access to health care for individuals with limited English proficiency.
National Health Service Corps (NHSC)
Federal government
Works to improve the health of the underserved by recruiting and retaining the health professionals to deliver health care in underserved communities. Provides technical assistance to federally designated Health Professional Shortage Areas (HPSAs) on projects that enhance the NHSC's site development mission. Part of the Bureau of Health Professionals, Health Resources and Services Administration.
National Medical Association (NMA)
National organization
Represents African American physicians and health professionals in the United States. Promotes the collective interests of physicians and patients of African descent.
National MultiCultural Institute (NMCI)
National organization
Works with individuals, organizations, and communities to facilitate change in order to build an inclusive society that is strengthened and empowered by its diversity. Provides seminars and online training regarding effective teamwork, developing a diverse workforce, conflict resolution, cultural competence and leadership skills.
ProLiteracy
Nonprofit/Foundation
ProLiteracy champions the power of literacy to improve the lives of adults and their families, communities, and societies.
Refugee Health Information Network (RHIN)
National organization
A national collaborative partnership, managed by refugee health professionals, whose objective is to provide quality multilingual, health information resources for those providing care to resettled refugees and asylees.
Refugee Health Information Network (RHIN)
National organization
A national collaborative partnership, managed by refugee health professionals, whose objective is to provide quality multilingual, health information resources for those providing care to resettled refugees and asylees.
Robert Wood Johnson Foundation
Nonprofit/Foundation
The largest philanthropy devoted exclusively to health and health care in the United States.
Think Cultural Health
Federal government
Provides culturally competency continuing education programs and other resources for physicians, pharmacists, and nurses to better meet the cultural and linguistic needs of an increasingly diverse patient population. Offers a free online accredited educational program for health care providers.
W.K. Kellogg Foundation
Nonprofit/Foundation
Works to help people help themselves through the practical application of knowledge and resources to improve their quality of life and that of future generations.
Terms & Acronyms
Acculturation Cultural modification of an individual or a group by adapting to, or borrowing traits from another culture often a result of long term contact.
Capacity building Efforts to develop human skills or society infrastructures with a community or organization.
Community Interpreter Service Pool A pool of trained and qualified interpreters providing interpreter services in several languages, including American Sign Language (ASL) to a number of hospitals, private practices, and other local health and social services agencies.
Cultural Brokering The act of bridging, linking or mediating between groups or persons of different cultural backgrounds to effect change.
Cultural Competency A competency based on the premise of respect for individuals and cultural differences, and an implementation of a trust-promoting method of inquiry.
Culturally and Linguistically Appropriate Services (CLAS) Services that reflect a set of behaviors, attitudes, and policies that enable effective work in cross-cultural situations.
Culture A specific set of social, educational, religious and professional behaviors, practices and values that individuals learn and adhere to while participating in or out of groups they usually interact with.
Encounter A communication event in which the services of an interpreter are required.
Ethnic Of or relating to large groups of people classed according to a common racial, national, tribal, linguistic, or cultural origin or background.
Interpretation The act of receiving a message in one language and sending exactly the same message in another language through a verbal exchange. Interpretation also includes body language messages.
Language Access Services (LAS) Services designed to ensure effective communication between limited English proficient individuals and English speakers. May include oral interpretation and written translation services and other provisions that enhance communication such as signage and symbols.
Linguistic Competence The ability of an organization and its personnel to effectively communicate and convey information in a manner that is understood by a diverse audience.
Office for Civil Rights (OCR) Agency of the Department of Health and Human Services charged with enforcing HIPAA civil penalties and handling complaints. The agency to contact regarding discrimination complaints associated with federal health care and social service programs, and LEP services.
Promotoras A person who, with or without compensation, provides a bilingual liaison between health care providers and patients through activities that include assisting in case conferences, providing
patient education, making referrals to health and social services, conducting needs assessments, distributing surveys to identify
barriers to health care delivery, making home visits, and providing language services.
Referral List Includes specific services and providers (in-house or outside) who may be selected to provide care or other services, e.g. pastoral care, patient representation, interpretation, social services, nutrition, shelter, etc.
Transcription Accurate written rendition of oral or recorded information such as medication dosages, diet, wound care, etc.
Translation The rendering, in writing, of a written text from one language to another.
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