(Poster 113) Impact of Language Barriers on Patient Understanding of Pelvic Floor Disorders

Objectives: Pelvic floor disorders (PFDs) are common among women, yet substantial gaps in patient knowledge persist. Language barriers have been identified as a potential contributor to these disparities, potentially limiting access to information and effective care. This study aims to evaluate the impact of primary language, English versus Spanish, on patient knowledge of PFDs. Using data from a multi-site urinary incontinence (UI) educational intervention, we compared levels of understanding amongst English- and Spanish-speaking patients over time to assess how language influences understanding of pelvic floor conditions.

Methods: A total of 89 female patients from three healthcare institutions in Southern California were screened for UI and invited to participate in a quality improvement initiative within a primary care setting. Participants completed the Pelvic Floor Awareness and Knowledge Survey (PFAKS), a validated instrument with scores ranging from 0 to 100, where higher scores reflect greater knowledge of pelvic floor disorders. The PFAKS was administered at baseline and again at three-month follow-up, following receipt of usual care. Demographic data, including primary language and educational attainment, were collected and analyzed to evaluate their association with PFAKS scores.

Results: Of the 89 participants, 16 identified Spanish as their primary language, while 73 identified English. Mean PFAKS scores increased at the three-month follow-up in both language groups. However, Spanish-speaking patients demonstrated significantly lower knowledge scores at both baseline (25.9 vs. 33.7, p = 0.013) and three months (27.2 vs. 40.8, p = 0.009). Educational attainment was not significantly associated with PFAKS scores at baseline (p = 0.102) or at the three-month follow-up (p = 0.110). The mean change in PFAKS scores over time did not differ significantly between English- and Spanish-speaking participants.

Conclusions: Pelvic floor knowledge scores were significantly lower among Spanish-speaking patients compared to their English-speaking counterparts at baseline and follow up. Given that educational attainment was not associated with pelvic floor disorder knowledge, these findings suggest a language-specific disparity in health literacy. Also, the magnitude of change in knowledge scores over time did not differ between groups, indicating equitable educational intervention. However, the persistently lower absolute scores among Spanish speakers highlight the need for targeted strategies to bridge this gap. Given the profound impact of UI on quality of life, addressing language barriers is essential to improving patient understanding, engagement, and health outcomes.

Table 1: Primary language and PFAKS (Pelvic Floor Awareness and Knowledge Survey) scores.
p < 0.05 indicates statistical significance