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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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INTEGRATING HEALTH LITERACY,
CULTURAL COMPETENCE, AND
LANGUAGE ACCESS SERVICES

WORKSHOP SUMMARY

Joe Alper, Rapporteur

Roundtable on Health Literacy

Board on Population Health and Public Health Practice

Health and Medicine Division

images

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001

This activity was supported by contracts between the National Academy of Sciences and AbbVie Inc.; the Aetna Foundation; the Agency for Healthcare Research and Quality (HHSP23337024); American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Missouri; Health Literacy Partners; Health Resources and Services Administration (HHSH25034011T); Humana; Institute for Healthcare Advancement; Merck & Co., Inc.; National Institutes of Health (HHSN26300054); National Library of Medicine; North Shore–Long Island Jewish Health System; Office of Disease Prevention and Health Promotion (HHSP23337043); and UnitedHealth Group. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-44237-4
International Standard Book Number-10: 0-309-44237-0
Digital Object Identifier: 10.17226/23498

Additional copies of this workshop summary are available for sale from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

Copyright 2016 by the National Academy of Sciences. All rights reserved.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. Integrating health literacy, cultural competence, and language access services: Workshop summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×

Image

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Ralph J. Cicerone is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. C. D. Mote, Jr., is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.national-academies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×

PLANNING COMMITTEE ON INTEGRATING HEALTH LITERACY, CULTURAL COMPETENCY, AND LANGUAGE ACCESS SERVICES1

MARIN P. ALLEN, Deputy Associate Director for Communications and Public Liason and Director of Public Information, Office of the Director, National Institutes of Health

WILMA ALVARADO-LITTLE, Principal and Founder, Alvarado-Little Consulting, LLC

DENNIS ANDRULIS, Senior Research Scientist, Texas Health Institute, and Associate Professor, University of Texas School of Public Health

IGNATIUS BAU, Independent Policy Consultant, Health Policy Consultation Services

GEM DAUS, Public Health Analyst, Office of Health Equity, Office of Special Health Affairs, Health Resources and Services Administration ALICIA FERNANDEZ, Professor of Clinical Medicine, Department of Medicine, Division of General Internal Medicine, University of California, San Francisco

SUZANNE LELAURIN, Senior Vice President, International Institute

JANET OHENE-FREMPONG, President, J O Frempong & Associates

WINSTON WONG, Medical Director, Community Benefit, Disparities Improvement, and Quality Initiatives, Kaiser Permanente

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×

ROUNDTABLE ON HEALTH LITERACY1

BERNARD ROSOF (Chair), Chief Executive Officer, Quality in Healthcare Advisory Group LLC

MARIN P. ALLEN, Deputy Associate Director for Communications and Public Liason and Director of Public Information, National Institutes of Health

WILMA ALVARADO-LITTLE, Principal and Founder, Alvarado-Little Consulting, LLC

SUZANNE BAKKEN, Alumni Professor of Nursing and Professor of Biomedical Informatics, Columbia University

CINDY BRACH, Senior Health Policy Researcher, Agency for Healthcare Research and Quality

GEM DAUS, Public Health Analyst, Office of Health Equity, Office of Special Health Affairs, Health Resources and Services Administration

TERRY DAVIS, Professor of Medicine and Pediatrics, Louisiana State University Health Sciences Center

CHRISTOPHER DEZII, Director, Healthcare Quality and Performance Measures, Bristol-Myers Squibb

JENNIFER DILLAHA, Medical Director for Immunizations, Medical Advisor, Health Literacy and Communication, Arkansas Department of Health

JAMES (JAY) DUHIG, Head, Risk Communication and Behavioral Systems, Office of Patient Safety, AbbVie Inc.

ALICIA FERNANDEZ, Professor of Clinical Medicine, Department of Medicine, Division of General Internal Medicine, University of California, San Francisco

LAURIE FRANCIS, Senior Director of Clinic Operations and Quality, Oregon Primary Care Association

LORI HALL, Advisor-Health Literacy, U.S. Medical Staff, Eli Lilly and Company

LINDA HARRIS, Director, Division of Health Communication and ehealth Team, U.S. Department of Health and Human Services

BETSY L. HUMPHREYS, Acting Director, National Library of Medicine

MARGARET LOVELAND, Senior Director, Global Medical Affairs, Merck & Co., Inc.

LAURIE MYERS, Global Health Literacy Director, Merck & Co., Inc.

CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Missouri

___________________

1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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MARYLYNN OSTROWSKI, Executive Director, Aetna Foundation

MICHAEL PAASCHE-ORLOW, Associate Professor of Medicine, Boston University School of Medicine

TERRI ANN PARNELL, Principal and Founder, Health Literacy Partners

KIM PARSON, Strategic Consultant, Proactive Care Strategies, Humana

KAVITA PATEL, Managing Director for Clinical Transformation and Delivery, The Brookings Institution

ANDREW PLEASANT, Senior Director for Health Literacy and Research, Canyon Ranch Institute

LINDSEY A. ROBINSON, Thirteenth District Trustee, American Dental Association

STACEY ROSEN, Associate Professor of Cardiology, Hofstra North Shore–Long Island Jewish School of Medicine, and Vice President, Women’s Health, The Katz Institute for Women’s Health

RIMA RUDD, Senior Lecturer on Health Literacy, Education, and Policy, Harvard School of Public Health

STEVEN RUSH, Director, Health Literacy Innovations, UnitedHealth Group

PAUL M. SCHYVE, Senior Advisor, Healthcare Improvement, The Joint Commission

MICHAEL VILLAIRE, Chief Executive Officer, Institute for Healthcare Advancement

EARNESTINE WILLIS, Kellner Professor in Pediatrics, Medical College of Wisconsin

MICHAEL WOLF, Professor, Medicine and Learning Sciences, Associate Division Chief–Research Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University

WINSTON WONG, Medical Director, Community Benefit, Disparities Improvement, and Quality Initiatives, Kaiser Permanente

Consultant

RUTH PARKER, Professor of Medicine, Pediatrics, and Public Health, Emory University School of Medicine

Roundtable Staff

LYLA HERNANDEZ, Senior Program Officer

MELISSA FRENCH, Associate Program Officer

EMILY VOLLBRECHT, Senior Program Assistant

ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×

Reviewers

This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:

SHARRON BARRETT, Health Literacy Staff Consultant

CINDY BRACH, Agency for Healthcare Research and Quality

ROBERT A. LOGAN, National Library of Medicine

YOLANDA PARTIDA, Hablamos Juntos

Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Hugh H. Tilson, University of North Carolina. He was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Acknowledgments

We are grateful to the sponsors of the Roundtable on Health Literacy who made it possible to plan and conduct the workshop on integrating health literacy, cultural competence, and language access services, which this report summarizes. Federal sponsors from the U.S. Department of Health and Human Services are the Agency for Healthcare Research and Quality, Health Resources and Services Administration, National Institutes of Health, National Library of Medicine, and the Office of Disease Prevention and Health Promotion. Nonfederal sponsorship was provided by AbbVie Inc.; the Aetna Foundation; the American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Missouri; Health Literacy Partners; Humana; Institute for Healthcare Advancement; Merck & Co., Inc.; North Shore–Long Island Jewish Health System; and UnitedHealth Group.

The workshop presentations were both interesting and stimulating, and we would like to thank each of the speakers for their time and effort. Speakers were Wilma Alvarado-Little, Dennis Andrulis, Marshall Chin, Sarah de Guia, Alicia Fernandez, Jessica Briefer French, Guadalupe Pacheco, Stacey Rosen, and Michael Wolf. Thanks also go to the excellent moderators, Ignatius Bau, Bernard Rosof, and Winston Wong, and small-group discussion facilitators, Gem Daus, Janet Ohene-Frempong, and Andrew Pleasant.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×
Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
×

Acronyms and Abbreviations

ACA

Patient Protection and Affordable Care Act

ACO

accountable care organization

AHRQ

Agency for Healthcare Research and Quality

CAHPS

Consumer Assessment of Healthcare Providers and Systems

CLAS

Culturally and Linguistically Appropriate Services

CMS

Centers for Medicare & Medicaid Services

CPEHN

California Pan-Ethnic Health Network

DMHC

California Department of Managed Health Care

DSRIP

delivery system reform incentive payment

EHR

electronic health record

HEDIS

Healthcare Effectiveness Data and Information Set

HHS

U.S. Department of Health and Human Services

HIPAA

Health Insurance Portability and Accountability Act

HITECH

Health Information Technology for Economic and Clinical Health

HRSA

Health Resources and Services Administration

IOM

Institute of Medicine

Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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NCQA

National Committee for Quality Assurance

PCORI

Patient-Centered Outcomes Research Institute

SAMHSA

Substance Abuse and Mental Health Services Administration

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2016. Integrating Health Literacy, Cultural Competence, and Language Access Services: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/23498.
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The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions.

To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop.

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