Online Program

Perceptions of patient-provider communication by language concordance status: A qualitative study of spanish-speaking women receiving breast and cervical cancer-related care in safety net clinics

Tuesday, November 5, 2013

Daiva Ragas, BA, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
Narissa Nonzee, MA, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL
Ava Phisuthikul, BA, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL
Melissa Simon, MD, MPH, Departments of Obstetrics and Gynecology, Preventive Medicine and Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL
Underutilization of breast and cervical cancer screening among low-income ethnic minority women has been tied to language barriers, which present further challenges to follow-up care and treatment. Language concordance and quality interpretation have been shown to enhance patient-provider communication among patients with limited English proficiency. To explore patient perceptions of patient-provider communication among Spanish-speakers receiving breast or cervical cancer-related care at safety net clinics, we qualitatively examined communication barriers and facilitators according to patient-provider language concordance status. Participants were interviewed after receiving an abnormal breast or cervical cancer screening test or cancer diagnosis. Interviews were coded and analyzed by language concordance status. Of 37 participants, 27% (n = 10) were Spanish-concordant; 38% (n = 14) were Spanish-discordant, requiring an interpreter; and 35% (n = 13) were Spanish mixed-concordant, experiencing both types of communication throughout the care continuum. Appreciation for language support resources was a common theme among all groups. Spanish-concordant and Spanish-discordant participants perceived patient-provider communication positively, emphasizing facilitators. Mixed-concordant participants' perceptions depended on whether communication was language-concordant or –discordant; barriers were reported only in the context of language-discordant communication. Mixed concordant participants reported the majority of communication barriers among all participants and strongly preferred Spanish-speaking providers. Efforts should be directed toward exploring the prevalence of mixed language concordance and its impact on real and perceived patient-provider communication. Our findings posit that providing consistent language concordance or interpretation, respectively, may be associated with improved health communication experiences in breast and cervical cancer-related care for low-income Spanish-speaking women.

Learning Areas:

Communication and informatics
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Define the concept of mixed language concordance. Identify the implications of mixed language concordance for patients in the breast and cervical cancer-related care continuum. Discuss possible factors for differing perceptions of provider-patient communication quality among mixed-concordant patients.

Keyword(s): Latinas, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Vice Chair of Clinical and Policy Research in the Department of Obstetrics and Gynecology and Associate Professor at Northwestern University, my research integrates social epidemiology principles with health services and health behavior intervention studies to reduce health disparities through community-based participatory research approaches in culturally and linguistically isolated communities. I have 7 years of continuous CBPR, patient navigation research, and health disparities research experience with my primary clinical care experience.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.