Improving Health Literacy among Latinos: Language Precedes Patient-Centered Communication

BACKGROUND

Being Latino has been associated with limited health literacy, and poorer health. There is a pressing need for healthcare systems to address this problem, and yet minimal evidence on where to target such efforts. We examined the extent to which improving patient-centered communication (PCC) and addressing language needs might promote health literacy among Latino patients.

METHOD

Latino patients at 11 healthcare centers in multiple states completed items on PCC, language, and health literacy that were embedded in a larger, organizational assessment of PCC. A series of multiple linear regression models examined the incremental impact of PCC and language items on health literacy.

RESULTS

The sample included 822 patients: 75% female, 30% = 55+. PCC and language needs accounted for a significant amount of the variability in how often patients had problems learning about their medical condition, R2=.18, p<.001; how confident they were in filling out medical forms, R2=.14, p<.001; how confident they were in following medication label instruction, R2=.16, p<.001; and how often someone helped them read hospital materials, R2=.10, p<.001. Patients who spoke Spanish (63%), wanted to talk to their doctors in Spanish (66%), and needed an interpreter (40%) had significantly lower literacy. PCC was a positive predictor of literacy, but less predictive than language needs.

CONCLUSION

PCC and language needs both accounted for a substantial amount of variability in health literacy, but language was a much better predictor. Language barriers have negatively affected patient-provider communication. This triangulation should be incorporated into future studies, and considered in clinical encounters.