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Published online March 19, 2007
PEDIATRICS Vol. 119 No. 4 April 2007, pp. e920-e927 (doi:10.1542/peds.2006-1508)
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ARTICLE

Pediatricians' Use of Language Services for Families With Limited English Proficiency

Dennis Z. Kuo, MD, MHSa, Karen G. O'Connor, BSb, Glenn Flores, MDc, Cynthia S. Minkovitz, MD, MPPa,d

a Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
b Division of Health Services Research, American Academy of Pediatrics, Elk Grove Village, Illinois
c Center for the Advancement of Underserved Children, Departments of Pediatrics and Epidemiology, Health Policy Institute, Medical College of Wisconsin and Children's Research Institute, Milwaukee, Wisconsin
d Women's and Children's Health Policy Center, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

OBJECTIVES. Patients with limited English proficiency confront multiple barriers to health care access in the United States. Appropriate language services for families with limited English proficiency are essential; however, little is known about pediatricians' use of language services. The objective of this study was to examine pediatricians' provision of language services to patients with limited English proficiency and the pediatrician, practice, and state characteristics associated with use of these services.

METHODS. Data were obtained from the Periodic Survey of Fellows No. 60, a nationally representative survey of members of the American Academy of Pediatrics. A total of 1829 surveys were mailed, and responses were obtained from 58%. Use of 6 language services was assessed. Factors associated with language services use were examined after adjusting for physician, practice, and state characteristics.

RESULTS. Bilingual family members (70%) and bilingual staff (58%) were the most frequently reported language services; 40% of respondents report the use of professional interpreters, 28% use telephone interpreters, and 35% of practices report provision of translated written materials. Pediatricians in smaller and rural practices and in states with higher proportions of limited English proficiency persons report less use of professional interpreters. Pediatricians in states with third-party reimbursement for language services are more likely to report use of professional interpreters.

CONCLUSIONS. Most pediatricians report using untrained interpreters to communicate with limited English proficiency patients and their families. Pediatricians in regions with high proportions of limited English proficiency persons may be less likely to provide appropriate language services. Third-party reimbursement for professional language services may increase the use of trained interpreters and quality of care.

Key Words: child health services • multilingualism • translating

Abbreviations: LEP—limited English proficiency • AAP—American Academy of Pediatrics • SCHIP—State Children's Health Insurance Program • OR—odds ratio • CI—confidence interval

Accepted Oct 25, 2006.


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