Limited English Proficiency Research Articles

Pain Management Among Older Farsi and Azeri Speaking Immigrant Adults With Limited English Proficiency (LEP): Interpretive Approach.

Pain is a major public health issue in the United States. The ability to communicate the severity of pain with healthcare providers is crucial to receiving appropriate pain management. Many factors can limit this ability, including limited proficiency in the language spoken by providers. This body of research suggests gaps in the multidimensional approach to pain management for older adults with limited English proficiency (LEP). In this study, we describe the lived experiences of pain management of older adults with LEP living with chronic pain in the United States. We used a qualitative interpretive approach with semi-structured interviews from nineteen Farsi and Azeri-speaking older adults with LEP and chronic pain to describe the lived experiences of older adults with LEP. Participants relied on alternative medicine to manage their pain and reported fears of becoming dependent on prescription pain medications. Some reported poor physician-patient rapport and felt unseen by healthcare providers, and all reported language barriers even with the use of translators. Farsi and Azeri-speaking older adults with LEP and chronic pain felt the US healthcare system ignored their social, cultural, and linguistic needs. Pain management training for healthcare providers should address language barriers and include cultural competency.

Descriptive analysis of interpreter service mode costs & usage in Northwestern Wisconsin pre and peri COVID-19

BackgroundInterpreter service mode (in person, audio, or video) can impact patient experiences and engagement in the healthcare system, but clinics must balance quality with costs and volume to deliver services. Videoconferencing and telephone services provide lower cost options, effective where on site interpreters are scarce, or patients with limited English proficiency (LEP) and/or interpreters are unable to visit healthcare centers. The COVID 19 pandemic generated these conditions in Northwest Wisconsin (NWWI). The objectives of our study were to describe visit characteristics for interpreter services pre and peri COVID-19 and how interpreter visits and costs differed by modality and language pre and peri COVID-19 at Mayo Clinic Health System (MCHS) Eau Claire and Menomonie, Wisconsin (WI).MethodsWe analyzed medical records and billing data from MCHS Eau Claire and Menomonie that included interpretation visit characteristics and aggregate costs. We performed descriptive analysis of visit characteristics and aggregate costs (dependent variables: cost, duration, language, modality, payer type, department, patient age, and patient biological sex) from June-December 2019, 2020 (independent variables). We used Pearson’s chi-square and t tests to test for significant differences in visit characteristics between time periods.ResultsSignificant differences were found in distribution of all visit characteristics (language, p-value < .001; biological sex, p-value .011; mode, p-value < .001; payer type, p-value < .001; department, p-value < .001; age, p-value .016; visit duration in hours, p-value < .001) between 2019 and 2020 windows. Total costs of all interpretation modes increased between 2019 (in person, $188,109; audio, $15,734; video $15,881) and 2020 (in person, $388,500; audio, $44,376; video, $34,245) despite similar visit counts for both years (2019, 3750 visits; 2020, 3425 visits). Differences between years are consistent with COVID-19 protocols, department usage by language, and patient age.ConclusionsOur results show similar counts in the number of overall visits and increase in interpreter service costs in all modes, positively reflecting upon the availability of multimodal language resources.

Investigating the impact of screen-sharing visual aids during genomic results disclosure via telehealth in diverse families in the TeleKidSeq pilot study.

Telehealth genetic counseling is comparable to in-person visits in terms of satisfaction, knowledge, and psychological outcomes, but using visual aids can be challenging on telehealth platforms. This pilot study assessed if the "screen-sharing" feature via Zoom to display visual aids during results disclosure session positively impacted parental experience and comprehension of their child's genomic results especially in underrepresented groups and those with limited English proficiency. In the TeleKidSeq pilot study, 409 children with suspected genetic conditions underwent genome sequencing. Families were randomized to receive genomic results via televisits with (ScrS) or without (NScrS) screen-sharing of visual aids. Spanish- or English-speaking parents/legal guardians completed surveys at three timepoints to assess perceived and objective understanding, perceived confidence, and telehealth experience. Regression models evaluated the effect of screen-sharing over time. Overall, understanding and telehealth experience ratings were high, with no significant differences between the ScrS (N = 192) and NScrS (N = 200) arms with regard to perceived (p = 0.32) or objective (0.94) understanding, confidence (p = 0.14) over time, or telehealth experience (p = 0.10). When stratifying by sociodemographic characteristics and type of device used during results disclosure, we observed subtle differences in the effect of screen-sharing within some sub-groups. While screen-sharing had no significant impact on overall outcomes, we identified modest effects of screen-sharing within population groups that highlight the need for tailored communication strategies to ensure diverse, multilingual communities derive equitable benefit from telehealth-based genomic results disclosure. Future research is needed to determine whether certain types of visual aids best enhance genomic results disclosure in larger, more robust studies designed to detect smaller effects and subgroup differences.

Association Between Social Determinants of Health and Concussion Among High School Students in the United States.

We examined the association between social determinants of health and the likelihood of sustaining a concussion among adolescents. Participants in this cross-sectional study were 7164 high school students who completed the 2021 Adolescent Behaviors and Experiences Survey (52.7% girls; mean age = 16.0 years, SD = 1.2; age range 12-18 years). Logistic regression was used to determine which social determinants of health variables were associated with a self-reported history of concussion from playing a sport or being physically active over the past year. One in 10 adolescents (n = 716; 10.0% total; 11.8% of boys, 8.3% of girls) reported sustaining a concussion during the past year. Seven of 10 adolescents (70.3%) reported experiencing at least 1 of 8 negative social determinants of health. A multivariable logistic regression was statistically significant (P < .001), indicating that the negative social determinants of health were associated with having sustained a concussion during the past year; the model explained 12.5% (Nagelkerke R2) of the variance in concussion. Controlling for all other predictors, sports participation (odds ratio [OR] = 3.72, medium effect), housing instability (OR = 3.25, small-medium effect) and limited English language proficiency (OR = 3.05, small-medium effect) were the strongest independent predictors of sustaining concussion within the past year. Adolescents who lived in a neighborhood where there is violence (OR = 1.78, small effect), who were bullied (OR = 1.57, very small effect), and who experienced food insecurity (OR = 1.36, very small effect) were more likely to have sustained a concussion. Research is needed to understand the nature of these determinant-injury associations. Whether social determinants of health are associated with specific treatment and rehabilitation needs, and time to recover following concussion, should be examined with prospective studies.

Bilingual Perspectives of Functional Dyspepsia Management in People from Underserved Areas.

Disorders of gut-brain interaction (DGBIs), like functional dyspepsia (FD), are prevalent and challenging conditions. In other gastrointestinal (GI) disorders, individuals from underserved areas (UAs) have difficulty accessing care. Little is known about UA FD patient perspectives of their care, especially in those with limited English proficiency (LEP). We aimed to characterize patients' experiences with FD management with the goal of informing future studies targeting DGBI management in potentially vulnerable communities residing in UAs. Participants meeting FD criteria were identified in two community health centers affiliated with a large academic medical center in the northeastern United States. Semi-structured interviews were conducted in English and Spanish. Transcripts were reviewed by a bilingual panel of investigators using the constant comparative method of iterative data acquisition. Psychosocial stressors and GI symptom severity were assessed. A total of 26 participants were interviewed (12 English-speaking, 14 Spanish-speaking). Broadly, GI symptoms were mild and there was mild-to-moderate psychological distress present. Adverse social determinants of health were highly prevalent. Despite mild symptom severity on objective scales, FD severely impacted quality-of-life and interfered with physical, psychological, and social wellbeing, including avoidance of certain foods and professional/social situations. Study subjects (particularly those of LEP status) reported difficulty in receiving care. Thematic saturation was achieved. Even when symptoms were mild, interviewees from UAs reported significant FD-related impairment, along with psychological distress. Education interventions targeting FD-related care in UAs should be designed to improve shared decision-making in FD, sensitive to the burden of social determinants of health.

A Review on English-Medium Instruction (EMI) in Teaching and Its Effects on University Students’ English Proficiency and Content Learning

English-Medium Instruction (EMI) has gained prominence globally as higher education institutions (HEIs) adopt English to teach academic subjects, particularly in non-Anglophone regions. This review explores the implementation and impacts of EMI on students' English proficiency and content learning in various contexts, including Taiwan, the UAE, Malaysia, and Thailand. EMI has been driven by globalization, institutional internationalization, and the perceived advantages of enhancing students’ career prospects and mobility. While EMI has successfully improved English language skills, its effects on content learning remain inconclusive, with studies showing varied outcomes. Key challenges include linguistic barriers, cultural mismatches, insufficient institutional support, and concerns over linguistic and cultural identity erosion. Notable issues such as limited English proficiency often hinder students' ability to fully engage with course material, leading to disparities in academic outcomes. The review also highlights the diversity of EMI implementation across educational levels and regions, ranging from partial integration in Chinese universities to fully English-medium programs in European HEIs. The findings underscore the importance of policy support, bilingual teaching strategies, and adequate teacher training to address the challenges associated with EMI. Ultimately, while EMI enhances international competitiveness and student employability, its broader implications for equity, cultural preservation, and effective content delivery warrant further investigation. This review calls for more rigorous research to explore the intersection of language proficiency, academic ability, and content mastery in EMI settings.

From Marginalized to Strength: Socio-Ecological Coping Strategies of Older Korean Americans with Language Barriers and Healthcare Needs

This study, with research questions guided by the socio-ecological model, examined how ethnic minority older adults with limited English proficiency navigate cultural and language barriers in their daily lives, relationships, and healthcare interactions, and what challenges and strategies emerge in their efforts while living in the U.S. Individual in-depth interviews with Korean American older adults with limited English proficiency and chronic medical conditions (N = 12) were conducted over a 90-day period between November 2023 and January 2024. Using the thematic analysis technique of constant comparative method, data analysis identified 9 coping strategies, which were organized into four levels: (1) individual-level strategies (resilience in self-management); (2) family-level strategies (prioritizing family in health decisions, mitigating acculturative hurdles, and avoiding burdening family); (3) co-ethnic peer-level strategies (reciprocal information sharing and expectations of cohesion); and (4) community-level strategies (reliance on Korean-speaking healthcare providers, community services, and religious groups). The findings highlight the importance of culturally tailored services and balanced support from family, peers, and community organizations to ensure equitable healthcare access among older ethnic immigrants. Future research should explore in what ways these findings may apply to other ethnic immigrant groups in the U.S. in efforts to develop interventions toward improving health and social outcomes.

Replicating the Expected and the Unexpected: Neuropsychological and Symptom Profiles in a Neurotypical Romanian-English Bilingual Sample.

Establishing the effect of limited English proficiency (LEP) on cognitive performance within linguistically diverse populations is central to cross-cultural neuropsychological assessments. The present study was designed to replicate previous research on cognitive profiles in Romanian-English bilinguals. Seventy-six participants (54 women, MAge = 23.16, SDAge = 5.91; MEducation = 14.49, SDEducation = 1.57) completed a neuropsychological battery in English. The Digit Span, Animal and Emotion Fluency, and several symptom-report scales were also administered in Romanian. Performance patterns were similar to previous findings: verbal fluency, auditory verbal learning, and picture and speeded color naming were highly sensitive to LEP. In contrast, visuomotor processing speed and mental flexibility were robust to LEP. Participants performed better when ability tests were administered in their native language; there was no difference on symptom inventories. Test performance was related to the degree of LEP, operationalized as performance on the Boston Naming Test-Short Form. Level of verbal mediation and LEP are independent predictors of cognitive performance. Administering tests in the native language may provide a more accurate measure of cognitive functioning in examinees with LEP (especially at the low end of English proficiency). Developing population-specific norms is a necessary safeguard against the multiple confounding factors in the neuropsychological assessment of individuals with LEP.

Examining Intersectionality and Barriers to the Uptake of Video Consultations Among Older Adults From Disadvantaged Backgrounds With Limited English Proficiency: Qualitative Narrative Interview Study.

The rapid shift to video consultation services during the COVID-19 pandemic has raised concerns about exacerbating existing health inequities, particularly for disadvantaged populations. Intersectionality theory provides a valuable framework for understanding how multiple dimensions of disadvantage interact to shape health experiences and outcomes. This study aims to explore how multiple dimensions of disadvantage-specifically older age, limited English proficiency, and low socioeconomic status-intersect to shape experiences with digital health services, focusing on video consultations. Following familiarization visits and interviews with service providers, 17 older people with multiple markers of disadvantage (older age, low socioeconomic status, and limited English proficiency) were recruited in the Redbridge borough of London. Data collection included narrative interviews and ethnographic observations during home visits. Field notes captured participants' living conditions, family dynamics, and technological arrangements. Guided by intersectionality theory and digital capital concepts, interviews explored participants' experiences accessing health care remotely. Intersectional narrative analysis was used to identify key themes and examine how different forms of disadvantage interact. We developed theoretically informed narrative portraits and user personas to synthesize findings. Analysis revealed that the digitalization of health care can exacerbate existing inequities, erode trust, compound oppression, and reduce patient agency for multiply disadvantaged patient populations. Examining intersectionality illuminated how age, language proficiency, and socioeconomic status interact to create unique barriers and experiences. Key themes included the following: weakened presence in digital interactions, erosion of therapeutic relationships, shift from relational to distributed continuity, increased complexity leading to disorientation, engagement shaped by previous experiences of discrimination, and reduced patient agency. This study provides critical insights into how the digitalization of health care can deepen disparities for older patients with low income and limited English proficiency. By applying intersectionality theory to digital health disparities, our findings underscore the need for multifaceted approaches to digital health equity that address the complex interplay of disadvantage. Recommendations include co-designing inclusive digital services, strengthening relational continuity, and developing targeted support to preserve agency and trust for marginalized groups in an increasingly digital health care landscape.

Reducing disparities in emergency department outcomes for individuals with limited English proficiency: The nurse work environment

BackgroundPatients with limited English proficiency (LEP) experience worse emergency department (ED) outcomes. PurposeTo evaluate the association between nurses’ work environments and ED outcomes among individuals with and without LEP. MethodCross-sectional study of 1,358,802 patients seen in 64 New Jersey hospital EDs.Nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index. Outcomes included 72-hour ED revisits and departures against medical advice (AMA). FindingsIndividuals with LEP experienced higher odds of a 72-hour ED revisit (aOR 1.12, 95% CI 1.04-1.21 p<.001) and lower odds of AMA departure (aOR 0.67 95% CI, 0.61-0.74, p<.001). An interaction was found between LEP status and the nurse work environment: individuals with LEP experienced lower odds of a 72-hour ED revisit in better versus poor nurse work environments, compared to those without LEP. DiscussionDisparities in LEP outcomes might be ameliorated by targeted improvements to nurses’ work environments.

Barriers to Timely Dementia Diagnosis in Older Latinos With Limited English Proficiency: An Integrative Review.

Timely diagnosis is critical for persons with Alzheimer's disease and related dementias (ADRD) to ensure they receive adequate services; however, timely diagnosis may be prevented by a person's English language skills. The purpose of this integrative review was to understand how limited English proficiency (LEP) impacts older Latino's ability to access a timely ADRD diagnosis. Whittemore and Knafl's methodological approach guided the review. Searches in five databases yielded 12 articles for inclusion. Lack of culturally congruent health care systems, health care providers, and knowledge of ADRD resulted in delays in obtaining a timely ADRD diagnosis among older Latinos with LEP. Latinos with LEP and risk for ADRD benefit from language assistance and support in navigating the health care system. Nurses must be advocates, even when a language barrier is present, and recognize that interpreters are not a single source solution.

Interpreter Modalities and Unplanned Emergency Department Revisits in Limited English Proficiency Patients.

Emergency department encounters include an increasing number of patients with limited English proficiency, yet little is known about the impact of interpreter services on unplanned revisits to the emergency department. This study aims to assess interpreters'utilization and unplanned ED revisits, serving as an indicator of care quality. This was a single-center, retrospective chart review of ED visits at an urban academic center between January and April 2019. Inclusion criteria involved patients aged >18, discharged after evaluation, and with at least 1 ED revisit in the study period. Demographic data, interpreter modality, and revisit incidences within 72 hours and 30days were analyzed using Chi-squared and Wilcoxon rank-sum tests. Of 786 reviewed charts, 401 limited English proficiency patients and 294 controls matched by gender, race, and ethnicity were included. Among limited English proficiency patients, the majority identified as Hispanic (84.8% vs 36%, P<.01) and showed higher 72-hour unplanned revisit rates (2.8% vs 0.7%, P= .05). Interpreter documentation for limited English proficiency patients was only 49.6%, with in-person modality prevailing (45.8%). Trained interpreters were underutilized (13% in-person vs 7.7% video, P<.0001). Only 78% (P<.01) of patients with limited English proficiency received discharge instructions in their preferred language. This study reveals a higher unplanned ED revisit rate among limited English proficiency patients, potentially linked to varying interpreter modality effectiveness and underutilization of trained interpreters. Emphasizing the critical role of trained interpreters, these findings offer an opportunity to enhance care quality for limited English proficiency patients in the emergency department.

MINDFULNESS-BASED COGNITIVE THERAPY STUDY FOR DEPRESSION AMONG KOREAN SPEAKING OLDER ADULTS

Abstract Korean American (KA) older adults experience higher risk for depression compared to Non-Hispanic whites. Healthy Mind Healthy Living (HMHL) is a single arm, pre/post pilot intervention study to test and evaluate the effect of an abbreviated telephone-based mindfulness-based cognitive therapy (MBCT-brief) protocol to reduce depression and improve sleep quality and stress. MBCT-brief was adapted culturally and linguistically for older KA adults; participants attended one of three MBCT-brief groups (8-10 participants, N=24), delivered virtually over the span of 8 weeks by a licensed bilingual/bicultural (English/Korean) clinical therapist. Survey data were collected at baseline and 9 weeks post intervention and measured depressive symptoms (QIDS-SR16), sleep quality (PROMIS Sleep Disturbance 4a), and stress (Perceived Stress Scale). The differences in the three outcome measures from pre and post were calculated using paired T-tests. We observed significant differences for changes in mean±SD for depressive symptoms and sleep quality. Post MBCT-brief, participants had a significant reduction in depressive symptoms (8.04±4.70) compared to baseline (10.29±4.22, t(23)=2.87, p=0.004). Similarly, participants had a significant improvement in sleep quality post MBCT-brief (51.03±2.82) compared to baseline (53.23±4.14, t(23)=2.53, p=0.009). Participants also had reduction in stress (17.54±4.56) compared to the baseline (17.21±3.99, t(23)=0.28, p=0.39), but it was not statistically significant. These findings indicate that culturally and linguistically adapted MBCT-brief has potential to improve symptoms of depression, sleep quality, and stress among older KA adults with limited English proficiency. Future larger trials may want to explore the efficacy and effectiveness of MBCT-brief on depression, sleep quality, and stress with a control group.

Clinician Perspectives on the Management of Hearing Loss in Patients With Limited English Proficiency.

Clinicians face challenges in managing the growing population of patients with limited English proficiency (LEP) and hearing loss (HL) in the United States. This study seeks to investigate provider perspectives on evaluating, counseling, and treating HL in LEP patients. Prospective descriptive study. Tertiary care center. Researchers employed a mixed methods design: (1) structured clinician interviews, (2) cross-sectional, national electronic survey, both regarding perspectives on managing hearing loss in LEP patients. Structured interviews were analyzed using modified grounded theory. Twenty-nine providers participated in interviews (16 otologists, 13 audiologists). The most reported non-English language was Spanish, followed by Chinese languages. Four thematic domains were derived: barriers to care, cochlear implant (CI) candidacy evaluation, counseling, and ideal resources. Major barriers were patient desire (97%; n = 28), and lack of validated tests (72%; n = 21). Methods of CI evaluation included improvising on validated speech perception testing (59%; n = 17) and use of non-speech evaluation (52%; n = 15). One-quarter forgoes speech testing in non-Spanish-speaking patients (24%; n = 7). Suggestions to improve management include in-person interpreters (62%; n = 18) and testing battery in all languages (31%; n = 9). National survey results (n = 87 providers) demonstrated that respondents were significantly less confident in the methods of speech perception testing and in counseling on surgical hearing rehabilitation in LEP. Clinicians encounter challenges in managing LEP patients with HL, including limitations in audiometric and CI candidacy assessment, communication barriers, information accessibility, and cultural competency. Opportunities for improving care include developing language-specific test batteries, linguistically and culturally appropriate education materials, and cultural competency training.

Integrating Critical Thinking Skills in English Language Speaking Activities: A Study at the Banking Academy of Vietnam

This study explores the integration of critical thinking skills into English language speaking activities at the Banking Academy of Vietnam, aiming to assess both the current practices and the challenges faced by teachers and students. A mixed-methods research design was employed, involving quantitative surveys of 132 students and 8 teachers, as well as qualitative interviews and classroom observations. The findings reveal that teachers frequently incorporate critical thinking tasks, such as debates, problem-solving activities, and group discussions, into their lessons, which are seen as beneficial for improving students’ speaking skills and preparing them for careers in banking and finance. However, challenges such as students' limited English proficiency, time constraints, and insufficient institutional support hinder the full integration of critical thinking into the curriculum. Teachers expressed a need for more training and resources to better implement these tasks. Despite these challenges, both students and teachers reported positive outcomes from critical thinking activities, particularly in terms of improved communication and problem-solving abilities. The study concludes that addressing these challenges and enhancing institutional support can further strengthen the role of critical thinking in English language education, helping to prepare students for the demands of the banking and finance industry.

A Study of UNIMEN Students' Perspectives on Cross-Cultural Adaptation in Thailand

This study explores the perspectives of Universitas Muhammadiyah Enrekang (UNIMEN) students on cross-cultural adaptation during their international internship in Thailand. Community service programs, which are mandatory for Indonesian tertiary students, offer practical experiences that bridge the gap between academic learning and real-world application. This research focuses on the challenges and adaptation strategies employed by students participating in teaching practices at private Thai schools. Using a qualitative methodology and thematic analysis, data were collected through interviews with eight fifth-semester students majoring in English Language Education. The findings identify eight key challenges: administrative issues, health problems, psychological stress, social integration difficulties, teaching challenges, culture shock, language barriers, and inadequate facilities. Cultural barriers, such as differences in the education system and social norms, led to experiences of homesickness and stress. Language difficulties were particularly pronounced due to limited Thai and English proficiency among locals. To address these challenges, students adopted several strategies, including seeking social support, engaging in cultural learning, using sign language, and fostering communication with locals. These strategies helped alleviate culture shock, improve cross-cultural understanding, and enhance teaching effectiveness. The study underscores the importance of adequate preparation, including cultural learning modules, and provides valuable insights for universities to better support future participants in international community service programs.

Digital health literacy and use of patient portals among Spanish-preferred patients in the United States: a cross-sectional assessment.

Individuals with Limited English Proficiency (LEP), including Spanish-preferred patients, face healthcare challenges due to language barriers. Despite the potential of digital health technologies to improve access and outcomes, there is a "digital divide" with underutilization among vulnerable populations, including Spanish-speaking LEP individuals, highlighting a need for increased understanding and equitable digital health solutions. A multi-mode, multi-language cross-sectional survey was built based on the Technology Acceptance Model and deployed from a multi-state healthcare practice. Measures included patient-reported comfort level with reading and speaking English, internet and computer access and satisfaction, ability to perform healthcare-related online tasks, and the eHEALS scale of digital health literacy. A total of 212 Spanish-preferred patients completed the survey (response rate, 212/2,726 = 7.8%), of which 73.6% indicated lack of comfort in reading or writing in English (LEP n = 156). Spanish-speaking individuals with LEP reported higher rates of needing help when learning how to use new technology or devices, reporting difficulty in the evaluation of health information on the internet and being able to differentiate high-quality information from low-quality online health resources, feeling confident in using health information found online to make health decisions, and having lower access to health-related online services than Spanish-speaking individuals without LEP. Improving equitable accessibility to digital tools for individuals with LEP seeking healthcare can help to improve their engagement with their providers and promote self-efficacy in their care. Opportunities exist with emerging technologies to develop language-concordant healthcare resources that will improve outcomes for Spanish-preferred patients.

Navigating Academic Language in English Medium Instruction (EMI) Science Classrooms in Hong Kong

The use of English to teach content subjects is a growing phenomenon in schools around the world. However, many content teachers in English medium instruction (EMI) classrooms are unsure of the extent to which they should focus on academic language while teaching their subjects. Should they focus on content and not be overly concerned about language, or should they put more emphasis on fostering students’ academic language skills? This study explored the role of academic language in EMI science classrooms from the perspective of secondary teachers and students in Hong Kong through the lens of Systematic Functional Linguistics (SFL) and a sociocultural approach to academic language. Interviews and focus group discussions were conducted with 10 teachers and 50 students, respectively. The results reveal the participants’ attitudes towards academic language in science learning, report relevant practices, and highlight the challenges and coping strategies for teaching and learning academic language in science classrooms. The data shows that the participating teachers and students all had a preference for teaching and learning science content over language. The teachers expressed concerns regarding their students’ limited academic English proficiency for effective communication during science lessons. However, the students focused overwhelmingly on their lack of vocabulary knowledge. Both groups also demonstrated a lack of effective strategies to improve academic English abilities necessary for authentic communication during science learning. The implications of the value of using different registers of English to facilitate EMI science learning are discussed.

Información es poder (information is power): menopause knowledge, attitudes, and experiences in midlife Hispanic women and Latinas

BackgroundLatinas constitute nearly 20% of midlife women in the United States (U.S.), but remain underrepresented in menopause research. Many midlife Latinas are disadvantaged by limited English proficiency, less formal education, living below the federal poverty level, lack of health insurance, and social isolation and discrimination — factors that negatively affect menopause-related symptoms and health outcomes. This study aimed to understand knowledge, attitudes, and experiences of the menopause transition among midlife Latinas.MethodsWe conducted a qualitative descriptive study using five focus groups with 29 Hispanic/Latina midlife women. An emergent content analysis was performed by four bilingual coders. Data on socio-demographics, menopausal symptoms, menopause knowledge, and attitudes toward menopause and hormone therapy were collected over the phone. Descriptive statistics were performed to characterize study participants.ResultsParticipants were aged 50.3 ± 6.3 years, 45% postmenopausal, 79% viewed menopause positively, and 55% reported having “little knowledge” about menopause. Seven themes emerged: 1) menopause is a stage of life (una etapa de vida); 2) not wanting to become an old lady (no quererme hacer viejita); 3) in our culture, we do not ask [about menopause]; 4) family dynamics; 5) each body is different (todo cuerpo es diferente); 6) menopause self-management and treatment options; 7) information is power (información es poder).ConclusionsAlthough Latinas reported having a positive view of menopause, we found a need for culturally-tailored comprehensive menopause education. The importance of involving family members in menopause education was also revealed. Our next steps are to determine the best menopause messaging strategies and educational formats for midlife Latinas.

Association Between Limited English Proficiency and Hearing Healthcare Use in the United States.

To determine whether limited English proficiency (LEP) is associated with likelihood of prior audiogram and hearing aid use among US adults with hearing loss. This cross-sectional study of four merged National Health and Nutrition Examination Survey (NHANES) cycles included 12,636 adults with subjective (self-reported) or objective (audiometric) hearing loss. Subjects were classified as LEP if they completed the NHANES survey in a language other than English, or with the help of an interpreter. Likelihood of audiogram among participants with subjective and objective hearing loss, and likelihood of hearing aid use among participants with objective hearing loss were assessed using unadjusted and adjusted logistic regression. Individuals with LEP were less likely to have undergone audiogram among subjects with subjective (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.67-0.77), and objective (OR 0.70, 95% CI 0.65-0.74) hearing loss. The association persisted for those with subjective hearing loss (OR 0.79, 95% CI 0.72-0.86), and objective hearing loss (OR 0.81, 95% CI 0.73-0.89) after adjusting for relevant covariates. Individuals with LEP were less likely to use hearing aids (OR 0.88, 95% CI 0.84-0.93). This association disappeared (OR 0.99, 95% CI 0.95-1.04) after adjustment. LEP is associated with lower utilization of hearing healthcare services. This may be due to the complex interplay of socioeconomic and language disparities, which may act as barriers to hearing healthcare utilization. Individuals with LEP should be prioritized when designing interventions to improve accessibility to hearing healthcare. 3 Laryngoscope, 134:5122-5130, 2024.