Community and NYC public healthcare system partnership to promote equitable access to language services and optimal preventive health services use among individuals with limited english proficiency…

Community and NYC public healthcare system partnership to promote equitable access to language services and optimal preventive health services use among individuals with limited english proficiency - this project addresses the problem of inequitable and suboptimal language access service provision in healthcare that has contributed to disparities in preventive health services utilization, and disproportionately worse health outcomes, among individuals with limited english proficiency (LEP) living in new york city (NYC). Approximately 1.8 million people living in NYC have LEP, placing them at risk for having low health literacy (HL) and poorer health. Language access and HL-related structural barriers have been linked to disparities in health outcomes, in part due to decreased access to and use of preventive health services. The proposed project is centered within NYC health+hospitals [NYC H+H], the largest public healthcare system in the US, a safety net system which serves over 1.1 million new yorkers, where 70% of patients are insured by medicaid or have no insurance, and 30% of patients have LEP. While a significant investment has been made to standardize and elevate the quality of language access services provided within NYC H+H, there remains significant barriers to the provision of optimal language access services that have resulted in gaps in the care delivered to LEP families. This funding opportunity would serve as a catalyst to partner with community organizations to look at the existing status of language access provision across NYC H+H, beginning in 2 hospital-based sites and 2 federally qualified health centers, to create an innovative, scalable, replicable model for equitable language access service provision and promotion of preventive health services, along with a toolkit of health literacy-informed, linguistically appropriate resources, that can be implemented across this safety net healthcare system, and can provide a roadmap of lessons learned for other US health care sites. We build on the longstanding successful collaboration between NYC H+H and NYU grossman school of medicine. We partner with 3 key cbos, building on EXI sting relationships and prior collaborations: the coalition for asian american children and families, which will serve as the CBO lead / hub site for our CBO partners, and make the road new york and literacy partners. We also partner with faculty from the city university of new york-hunter (minority serving institution). Our key objectives are: 1) engage with community and health care stakeholders to partner in developing, implementing, and evaluating the NYC language access initiative, informed by an environmental scan CO-led by CBO and health system partners; 2) use a data-driven approach to inform the development of strategies to improve language access services use, and access to / use of language- and HL-sensitive preventive health-related information / services for LEP populations in neighborhoods experiencing disproportionately poor health outcomes in NYC; 3) expand community capacity through promotion of language access workforce development efforts, including via opportunities for education / training; 4) examine implementation / process outcomes, including adoption (toolkit material use (e.g. handouts, video)] and perceived appropriateness, acceptability, feasibility, and sustainability, informing joint community- and health system- development of an implementation guide to support dissemination of identified best practices. 5) examine effectiveness of the NYC language access initiative on: a) improving language access / communication-related indicators (increased use of language access services [primary outcome], knowledge of federal rights related to language access services, decreased use of untrained interpreters, use of recommended health literacy-informed counseling best practices [e.g. teachback], accuracy of health communication / decreased miscommunication, satisfaction