Communication Problems and Preferences of Limited English Proficiency Chinese Patients Anne Tang, MD, FACP Chief, Bilingual Chinese Module Chief, Pharmacy & Therapeutics San Francisco Kaiser Permanente Center of Excellence Nancy P. Gordon, DSc Kaiser Permanente Division of Research 3/12/2013 © 2013 Institute for Culturally Competent Care, National Diversity. All Rights Reserved.

KPSF Chinese LEP Patient Survey 2012 Assess the prevalence and frequency of communication issues Identify barriers to communication Access IT readiness Identify preferred methods for receiving health information

KPSF Chinese LEP Patient Survey 2012 Participants: Chinese patients who received primary care in the KPSF Bilingual Chinese Module Number completed survey: 2093 Focus: VLEP (1,242) LEP (430) Age >35 VLEP=Very Limited English Proficiency ( speaks no English or not well) LEP=Limited English Proficiency ( speaks English well but not very well) 12/1/2018 © 2013 Institute for Culturally Competent Care, National Diversity. All Rights Reserved.

Educational Level by Age and English Proficiency 35-59 yr ≥ 60 yr In comparison, over 88% of those who said they spoke English very well had attended at least some college (62% were 4-year college graduates)

BY ENGLISH PROFICIENCY AND AGE GROUP COMMUNICATION ISSUES BY ENGLISH PROFICIENCY AND AGE GROUP

How often VLEP and LEP have difficulty understanding when someone speaks to them in English % 35-59 yr ≥ 60 yr

Percentage of VLEP and LEP with difficulty reading English/Chinese At least one language % 35-59 yr ≥60 yr 35-59 yr ≥ 60 yr 35-59 yr ≥ 60 yr

Percentages of those who reads neither Chinese nor English (VLEP + LEP) %

How often VLEP and LEP have difficulty understanding letters in English/Chinese Letters in Chinese % 35-59 yr ≥60 yr 35-59 yr ≥ 60 yr * Includes people who always get help reading letters

How often VLEP and LEP have trouble understanding test results/instructions for medicines/procedures and Procedures % 35-59 yr ≥60 yr 35-59 yr ≥ 60 yr

How often VLEP & LEP asks for help to understand the test results % 35-59 yr ≥ 60 yr 82% of VLEP and 66% of LEP would like someone to call them to explain test results

Percentages who ask for help to understand test results and instructions by level of education (VLEP + LEP) Usually has trouble understanding test results Usually asks for help % 70% of those at all levels of education thought it would be helpful to get a call to discuss test results in addition to getting results in print

ABILITY TO ACCESS AND USE THE INTERNET AND EMAIL

How many has computer and Internet access at home % ≥ 60 yr 35-59 yr

Those able to get information from the Internet Those able to send and receive email Get information from Internet Use email % 35-59 yr ≥ 60 35-59 yr ≥ 60 yr

Able to use the Internet to get information by self, by level of education and age group (VLEP +LEP) Ages 35-59 Ages ≥ 60 %

Preferred Languages and Methods for Getting Reminders and Health Information

Preferred language for lab results letters, instructions for medicines and health information Test Results/Instructions Health Education Materials Audio Materials % 35-59 yr ≥60 yr 35-59 yr ≥ 60 yr ≥ 35 yr

CONCLUSIONS Chinese speaking patients with limited English proficiency have difficulties in their ability to understand health-related information even those who say they speak English well. The ability of Chinese patients with limited English proficiency to understand and act on health-related communications may be related to their lower level of formal education. Significant percentage of LEP patients prefer emails with link to websites for their health information Significant percentage of VLEP patients prefer Chinese media for their health information Both VLEP and LEP prefer all information in their preferred language.

Bilingual Lab Letter 12/1/2018 © 2013 Institute for Culturally Competent Care, National Diversity. All Rights Reserved.

KPSF Bilingual Chinese Module 12/1/2018 © 2013 Institute for Culturally Competent Care, National Diversity. All Rights Reserved.