Project Grant CPIMP221355

PROMOTING EQUITY ACCESS TO LANGUAGE SERVICE IN HEALTH AND HUMAN SERVICES - CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS (CYSHCN) WITH LIMITED ENGLISH PROFICIENCY (LEP) OR WITH PARENTS WITH LEP ARE MORE LIKELY TO HAVE POOR HEALTH OUTCOMES THAN THEIR ENGLISH-SPEAKING COUNTERPARTS. OF THOSE IDENTIFIED AS CYSHCN, 8.2%, OR APPROXIMATELY 1 MILLION LIVE IN A HOME WHERE ENGLISH IS NOT THEIR PRIMARY LANGUAGE (GHANDOUR ET AL., 2022). CYSHCN CURRENTLY ACCOUNT FOR THE MAJORITY OF ALL PEDIATRIC MORBIDITY AND COST, AND THUS IT IS CRITICAL TO ADDRESS THE DISPARATE NEEDS OF THIS POPULATION (COHEN ET AL., 2011). BECAUSE THE VOLUME, COMPLEXITY, AND POTENTIAL CONSEQUENCES OF WRITTEN AND SPOKEN HEALTH INFORMATION ARE HIGHER FOR CYSHCN, PARENTAL LEP MAY BE STRONGLY LINKED TO SERIOUSDISPARITIESIN HEALTH OUTCOMES FOR CYSHCN (ENERIZ-WIEMER ET AL., 2014). THESE MULTIPLE FACTORS CREATE AN EXPONENTIAL RISK FOR HEALTH DISPARITIES AND ADVERSE HEALTH OUTCOMES FOR THOSE WITH THE INTERSECTIONAL IDENTITIES OF CYSHCN AND LEP. THIS PROJECT'S GOAL IS TO IMPROVE EFFECTIVENESS AND USE OF LANGUAGE ACCESS SERVICES FOR FAMILIES AND HEALTH CARE PROVIDERS (HCPS) SERVING CYSHCN, FOCUSING ON FAMILIES WITH LEP. TO ACHIEVE THIS GOAL, FAMILY VOICES AND AMERICAN ACADEMY OF PEDIATRICS WILL TAKE A COLLABORATIVE APPROACH ROOTED IN THE EXPERTISE OF FAMILIES WITH LIVED EXPERIENCE, TO DEVELOP AND DISSEMINATE EDUCATIONAL TOOLS AND STRATEGIES TO FAMILIES OF CYSHCN, COMMUNITY HEALTH WORKERS (CHWS) AND HCPS. TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 OUTLAWS DISCRIMINATION BASED ON RACE, COLOR, RELIGION, SEX, OR NATIONAL ORIGIN. THIS ANTIDISCRIMINATION LAW REGARDING NATIONAL ORIGIN INCLUDES ACCESS TO LANGUAGE SERVICES. WHILE HCPS AND HEALTH SYSTEMS STRIVE TO ADHERE TO THESE FEDERAL PROTECTIONS, THEY OFTEN LACK THE NECESSARY KNOWLEDGE AND SUPPORT TO ADEQUATELY IMPLEMENT THE POLICIES SET FORTH BY GOVERNMENT AGENCIES, AND GROWING DOCUMENTATION SHOWS THE ENTRENCHED RACIAL, ETHNIC, LANGUAGE AND DISABILITY DISPARITIES IN HEALTH CARE RELATED TO LOW AVAILABILITY OF HIGH-QUALITY LANGUAGE ACCESS SERVICES. WE WILL EMPLOY THE DISPARITIES IMPACT STATEMENT FRAMEWORK TO CONDUCT AN INTERNAL AND EXTERNAL ENVIRONMENTAL SCAN AND KEY INFORMANT INTERVIEWS TO IDENTIFY APPROACHES, CRITICAL GAPS AND DISPARITIES AFFECTING ACCESS TO HIGH QUALITY LANGUAGE ACCESS SERVICES FOR CYSHCN AND THEIR FAMILIES WITH LEP. MULTIMODAL TRAININGS FOR FAMILIES, CHWS, AND HCPS ON TOPICS IDENTIFIED IN THE LITERATURE AND THE ENVIRONMENTAL SCAN WILL BE CO-DESIGNED BY FV, THE PROJECT'S ADVISORY COMMITTEE, AND AAP. FV WILL DEVELOP THESE INNOVATIVE TRAINING PROGRAMS TO INCREASE AWARENESS, UNDERSTANDING AND USE OF LANGUAGE ACCESS SERVICES FOR FAMILIES OF CYSHCN WITH LEP. THE PROJECT TEAM, INCLUDING AAP, WILL DEVELOP AND CONDUCT AN ECHO TRAINING PROGRAM FOCUSED ON INCREASING PROVIDERS' CAPACITY TO ENGAGE APPROPRIATE LANGUAGE ACCESS SERVICES WITH FAMILIES OF CYSHCN WITH LEP, WITH EMPHASIS ON HEALTH LITERACY, HEALTH EQUITY, AND POLICY IMPLICATIONS FOR THIS POPULATION. THE ECHO WILL CONSIST OF A MULTIDISCIPLINARY HUB TEAM OF HEALTH CARE, COMMUNITY HEALTH, AND PRIMARY CARE PROVIDERS, ALONG WITH CYSHCN AND THEIR FAMILIES. THE EVALUATION OF OUTCOMES WILL EXAMINE THE EXTENT TO WHICH PROJECT ACTIVITIES RESULTED IN THE INTENDED OUTCOMES OF INCREASED ACCESS TO SERVICES, UNDERSTANDING OF RIGHTS AND RESPONSIBILITIES FOR INTERPRETATION SERVICES, UNDERSTANDING OF PROVIDER RECOMMENDATIONS, AND SAFETY AND HEALTH OUTCOMES OF FAMILIES OF CYSHCN WITH LEP.