Promoting Equitable Access to Language Services in Health and Human Services
This is a community-based study that will engage community and health care stakeholders to develop, implement, and evaluate a Health Literacy (HL)-informed, culturally- and linguistically- sensitive approach to improving language access services for patients with limited English proficiency (LEP) to promote health equity and reduce disparities in preventive health services use and health outcomes in New York City (NYC). This study will have a total of 4 phases that include a preparatory work phase (Non-Human Subjects Research), a pre-implementation phase, an implementation phase, and a post-implementation phase.

Findings from the preparatory work and pre-implementation phase and discussions with key partners will inform the co-design of intervention strategies and endpoints for the later phases (implementation and post-implementation phase).
- EligibilityCriteria: Inclusion Criteria (pre- and post- implementation phase):  Post-visit survey (Patients/Caregivers):  Patient seen for ambulatory care preventive visit at one of the study locations OR caregiver of a pediatric patient seen for ambulatory preventive visit at one of the study locations. 18 years of age and older Willingness and ability to participate  H+H EHR Reports:  • Patient seen for ambulatory care preventive visit at one of the study locations  Community survey (Community members):  Individual that attends community based organizations (CBO) events or uses CBOs' services 18 years of age and older Willingness and ability to participate  Key Stakeholder interviews:  Patients/Caregivers/Community Members Inclusion Criteria: In order to be eligible to participate, an individual must meet all of the following criteria:  Prefers to speak in Bengali, French, Spanish, Mandarin, or Polish 18 years of age or older Patient seen for ambulatory care preventive visit at one of the 4 study locations, caregiver of a pediatric patient seen for ambulatory care preventive visit at one of the 4 study locations OR a community member referred by a CBO Willingness and ability to participate  NYC H+H Leadership/Providers/Staff Inclusion Criteria:  Work at one of the 4 NYC H+H study locations that does language access related work or communicates with patients that prefer to speak a language other than English regularly. Leadership (e.g., chief medical officer, Department Director, etc.), provider (Physician, Nurse, Resident), or staff (Interpreter, language access coordinator, clerical staff) at the NYC H+H location 18 years of age or older Willingness and ability to participate  CBO Leadership/Staff Inclusion Criteria:  CBO leadership (Director/Coordinator) or staff (Case manager, Patient navigator, etc.) 18 years of age or older Willingness and ability to participate  Exclusion Criteria (pre- and post- implementation phase):  CBO Leadership/Staff Exclusion Criteria:  Does not have a working phone number Uncorrected hearing impairment  Post-visit survey (Patients/Caregivers):  Enrolled to key stakeholder interviews Does not have a working phone number  H+H EHR Reports (Patients):  • No exclusion criteria  Community survey (Community members):  • Does not have a regular doctor in the US.  Key Stakeholder interviews:  Patients/Caregivers/Community Members Exclusion Criteria:  Speaks English very well (non-LEP) Does not have a working phone number Uncorrected hearing impairment  NYC H+H Leadership/Providers/Staff Exclusion Criteria:  Does not have a working phone number Uncorrected hearing impairment - HealthyVolunteers: Accepts Healthy Volunteers - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult - StudyPopulation: Post-visit survey: Patients or caregivers of pediatric patients seen for ambulatory care preventive visits. (systematic sampling) H+H EHR Reports: Patients or caregivers of pediatric patients seen for ambulatory care preventive visits. (systematic sampling) Community surveys: Individuals that use CBO services or attend their events. (convenience sampling) Key stakeholder interviews: A purposive variation sample of healthcare staff, CBO staff, patients/caregivers/community members. (purposive sampling) - SamplingMethod: Probability Sample