Practical, skill-based training to improve HIV screening when a third person is used as an interpreter: A case study with limited English proficient (LEP) Latino patients

Disparities in behavioral screening for HIV prevention are especially challenging among limited English proficient (LEP) populations. This challenge is especially prevalent in the large and growing percentage of LEP Latinos, a population also showing increasing prevalence in HIV transmission. LEP patients and providers often rely on a third person as an interpreter which complicates communication and confidentiality factors surrounding HIV screening.

A 3-hour, skill-based training was developed for physicians to improve interpreter-facilitated HIV screening for LEP Latino patients. Three different 15-minute role plays with corrective feedback allowed physicians to practice interpreter-facilitated HIV screening in common LEP Latino patient encounters. Role plays covered fidelity, machismo, sexual orientation, religious influences, and other factors documented to be important in the published literature regarding HIV prevention with Latinos. Three-person physician teams were instructed to alternate playing the role of physician, interpreter and patient. Two groups of 15 providers were trained. A pre-post survey and video observations examined changes in knowledge and skills.

Over 90% of participants reported satisfaction with the training. Video observations of physician interactions during the role plays enabled visible evidence of improvement in skills in working with an interpreter. Skills that improved the most in both trainings included asking for clarification and asking the patient and interpreter to speak more slowly when discussion more complex terms and issues (e.g., fidelity, sexual orientation).

A skill-based training allowing providers to experience the role of patient and interpreter, and to practice communicating through an interpreter can increase performance in interpreter-facilitated HIV screening.