Lost in translation: Understanding how limited English proficiency and professional interpretive services can influence breast and cervical cancer screening among Pacific Islander and Southeast Asian women

Jessica Lee, BA¹, Jeff Dang, MPH², Mary Anne Foo, MPH³, Sora Park Tanjasiri, DrPH⁴, Marjorie Kagawa-Singer, PhD, RN, MN⁵, Tu-Uyen Nguyen, PhD, MPH³, Jacqueline Tran, MPH³, and Annalyn Valdez, MPH⁶. (1) Consulting Measurement Group, 7071 Warner Avenue #F-400, Huntington Beach, CA 92647, 866-STATS-99, hoju.lee@gmail.com, (2) Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, 11075 Santa Monica Blvd., Suite 200, Los Angeles, CA CA, (3) Orange County Asian and Pacific Islander Community Alliance, 12900 Garden Grove Blvd., Suite 214A, Garden Grove, CA 92843, (4) Department of Health Science, California State University, Fullerton, 800 N. State College Blvd., Fullerton, CA 92834, (5) UCLA School of Public Health and Asian American Studies Center, 650 Charles Young Drive South, Los Angeles, CA 90095, (6) UCLA School of Public Health, 650 Charles Young Drive South, Los Angeles, CA 90095

Background: Limited English proficiency (LEP) has been shown to be related to adverse health outcomes and can impact the patient-provider relationship. Furthermore, errors in medical interpretation are common among ad hoc interpreters. Lastly, professional interpretive services have been shown to increase the delivery of healthcare services to patients with LEP.

Methods: A large cross-sectional study was performed among Southeast Asian and Pacific Islander women. Participants were recruited from community clinics, churches, and supermarkets throughout California and consented by trained bilingual interviewers. The study yielded a 98% response rate and a total of 1512 foreign born Cambodians (n = 347), Laotians (n = 263), Thais (n = 616), and Tongans (n = 286) were included. Logistic regression analyses examined the impact of language preference and interpretation services on the receipt of a mammogram, clinical breast exam, and Pap smear after accounting for relevant sociodemographic variables.

Results: Multivariate analyses revealed that language preference was not related to previous receipt of breast and cervical screenings. However, women who typically used a professional interpreter were 1.93 times more likely to receive a mammogram and 3.99 times more likely to receive a clinical breast exam than those who did not usually use an interpreter (p's < .05). The use of a professional interpreter did not influence the receipt of Pap smears.

Conclusions: Professional medical interpreters may help increase the utilization of breast cancer screening among Pacific Islander and Southeast Asian women.