(Poster 28) Language Concordant Care Among Urogynecology Clinicians and Spanish-Speakers

Objectives: Hispanic patients with pelvic floor disorders (PFD) experience many barriers to seeking care, and challenges of language discordance lead to poorer healthcare and education. Understanding Urogynecology clinicians’ practices with Spanish-speaking patients can inform targeted efforts to improve care for this patient group. This study assessed Urogynecology clinicians' Spanish proficiency and patient communication methods.

Methods: This was a cross-sectional survey study of members of the American Urogynecologic Society. Survey respondents were asked about Spanish language proficiency and clinical practice features. Characteristics were compared between respondents based on proficiency, practice variables and use of interpreters and educational PFD materials, and Characteristics were compared between respondents based on proficiency, use of interpreters and educational PFD materials, and practice variables.

Results: The response rate was 10% (n=138). Most respondents were female (70.6%), 40 years or older (55.9%), identified as non-Latino/Hispanic (84.6%), were White/Caucasian (79.7%), and were predominantly English speakers (86.0%). Spanish language proficiency of respondents varied, with 7.4% being native Spanish speakers, 33.3% reporting a professional working-level of Spanish proficiency or higher, and 63.1% reporting limited to no Spanish proficiency. On average, 73.1% of respondents spent less time, 45 minutes or less, on a new visit for an English-speaking patient compared to 56.5%, who spent greater than 45 minutes with a new Spanish-speaking patient. 74% of respondents reported visit time constraints as a challenge when utilizing an interpreter. When assessing interpreter use (excluding native speakers and those with full professional fluency), the odds of utilizing an interpreter was two and half times higher for clinicians who treat Spanish-speaking patients less frequently (less than daily) compared to daily (p=0.03). The odds of utilizing an interpreter was twelve and half times higher among those with lower Spanish proficiency compared to a professional working-level of proficiency (p < 0.01) (Table 1). The odds of utilizing Spanish PFD educational materials was four times higher for clinicians treating Spanish-speaking patients daily compared to those treating Spanish-speaking patients less than daily (p=0.01) (Table 1). Among all respondents, 32% reported difficulty in finding appropriate educational materials in Spanish, with 30% noting difficulty with patient literacy with the available written materials (Figure 1). 26% of respondents believe recruitment/retention of Spanish-proficient clinicians should be prioritized in improving communication.

Conclusions: Clinicians face many challenges in utilizing interpreters appropriately and providing adequate Spanish-language PFD education materials when caring for Spanish-speaking patients. Improving access to and quality of PFD educational materials, addressing time constraints in interpreter use, and prioritizing the recruitment of Spanish-proficient clinicians could enhance communication and care for Spanish-speaking patients.

Figure legend:
PFD, pelvic floor disorder