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APHA Scientific Session and Event Listing

Recorded presentation

Tilly A. Gurman, MPH, Department of Population and Family Health Science, The Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, 410-547-3381, tgurman@jhsph.edu and Allisyn Moran, MHS, Department of Health, Behavior and Society, The Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway Street, Baltimore, MD 21205.

Background: Latinas are less likely than Whites to access prenatal health care. Barriers to accessing services during labor and delivery (L&D) are not well understood. The ability of clinical staff, with assistance from interpreters, to communicate with limited-English-proficient patients is an essential component of ensuring access to services.

Methods: Qualitative interviews and focus groups with 13 Latina immigrants documented patient experiences with L&D. Quantitative surveys of 200 clinical staff at five hospitals measured knowledge, attitudes, and behaviors related to L&D services for Latinas. Factor analysis informed the creation of an index measuring working with interpreters—later used as the outcome for multiple linear regression. Qualitative and quantitative results identified professional development needs which guided the structure of customized interventions.

Results: Patients experienced suboptimal quality of care due to poor communication with clinical staff, resulting in failure to understand analgesia, laboratory tests, and discharge instructions. Among clinical respondents, 47.5% felt confident in their ability to meet Latinas' needs. From factor analysis, the new index combined three behaviors representing inappropriate use of interpreters (alpha=0.774). The strongest predictors for inappropriate interpreter use were: 1) belief that a patient's country of origin can predict health behaviors (p=0.001), and 2) belief that family members can serve as appropriate interpreters (p=0.001). Evidence-based professional development strategies for clinical staff incorporated these patient experiences and provider misconceptions.

Conclusion: Similar needs assessments, combining both patient and provider perspectives, can assist tailoring relevant intervention strategies and advance the goal of providing more culturally and linguistically appropriate services for Latino populations.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

1.Explain barriers to accessing services during labor and delivery (L&D) as experienced by Latina immigrants.
• Identify factors that predict inappropriate use of interpreters by clinical staff in L&D. 3.Describe how qualitative and quantitative methods can identify cultural competency training needs for clinical staff in L&D.

Keywords: Cultural Competency, Immigrant Women

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation