Facilitating Health Communication
with Immigrant, Refugee, and
Migrant Populations Through
the Use of Health Literacy and
Community Engagement Strategies
PROCEEDINGS OF A WORKSHOP
Joe Alper, Rapporteur
Roundtable on Health Literacy
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was partially supported by AbbVie Inc.; Aetna Foundation; 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 Media; Health Literacy Partners; Health Resources and Services Administration (HHSH25034011T); Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; National Institutes of Health (HHSN26300054); National Library of Medicine; Northwell Health; 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: 978-0-309-46340-9
International Standard Book Number-10: 0-309-46340-8
Digital Object Identifier: https://doi.org/10.17226/24845
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Facilitating health communication with immigrant, refugee, and migrant populations through the use of health literacy and community engagement strategies: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/24845.
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PLANNING COMMITTEE ON FACILITATING HEALTH COMMUNICATION WITH IMMIGRANT, REFUGEE, AND MIGRANT POPULATIONS THROUGH HEALTH LITERATE APPROACHES1
BERNARD ROSOF (Chair), Chief Executive Officer, Quality in Healthcare Advisory Group, LLC
GEM DAUS, Public Health Analyst, Office of Health Equity, Health Resources and Services Administration
JENNIFER DILLAHA, Medical Director for Immunizations, Medical Advisor, Health Literacy and Communication, Arkansas Department of Health
ALICIA FERNANDEZ, Professor of Clinical Medicine, Department of Medicine, Division of General Internal Medicine, University of California, San Francisco
MEGAN ROONEY, Director of Program Development, Health Literacy Media
UMAIR SHAH, Executive Director, Harris County Public Health
ALINA SHAW, Health Communication Specialist, Centers for Disease Control and Prevention
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 Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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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 Liaison 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, 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, Director of 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
LAURIE MYERS, Global Health Literacy Director, Merck Sharp & Dohme Corp.
CATINA O’LEARY, President and Chief Executive Officer, Health Literacy Media
MARYLYNN OSTROWSKI, Executive Director, Aetna Foundation
___________________
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 Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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, Director of Canyon Ranch Institute and Global Health Literacy Research, Health Literacy Media
LINDSEY A. ROBINSON, Thirteenth District Trustee, American Dental Association
STACEY ROSEN, Associate Professor of Cardiology, Hofstra Northwell Health 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
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
Health and Medicine Division Staff
LYLA M. HERNANDEZ, Senior Program Officer
MELISSA FRENCH, Program Officer
ALEXIS WOJTOWICZ, Senior Program Assistant
ROSE MARIE MARTINEZ, Senior Board Director, Board on Population Health and Public Health Practice
Reviewers
This Proceedings of a Workshop was 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 National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
JULIA ACKLEY, Sutter Center for Integrated Care, Sutter Health
SUSAN J. CURRY, The University of Iowa College of Public Health
GRACE M. LEE, Harvard Medical School and Boston Children’s Hospital
ANDREW PLEASANT, Canyon Ranch Institute, Health Literacy Media
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by Georges Benjamin, American Public Health Association. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Acknowledgments
The sponsors of the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Health Literacy made it possible to plan and conduct the workshop on health communication with immigrants, refugees, and migrant workers, which this publication summarizes. Federal sponsors include the Agency for Healthcare Research and Quality, Health Resources and Services Administration, National Institutes of Health, National Library of Medicine, and Office of Disease Prevention and Health Promotion at the U.S. Department of Health and Human Services. Nonfederal sponsorship was provided by AbbVie Inc., Aetna Foundation; American Dental Association; Bristol-Myers Squibb; East Bay Community Foundation (Kaiser Permanente); Eli Lilly and Company; Health Literacy Media; Health Literacy Partners; Humana; Institute for Healthcare Advancement; Merck Sharp & Dohme Corp.; Northwell Health; and UnitedHealth Group.
The roundtable would like to thank each of the speakers, panelists, and panel moderators for their time and effort. Speakers, panelists, and moderators were, in alphabetical order, Suzanne Bakken, Jeffrey B. Caballero, Clifford Coleman, Alicia Fernandez, Paul Geltman, Anthony Iton, Iyanrick John, Mimi Kiser, Justine Kozo, Kari LaScala, Julia Liou, Hugo Morales, Nick Nelson, Liliana Osario, Henry R. Perea, Jesús E. Quiñones, Megan Rooney, Maricel G. Santos, and Rishi Sood.
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Contents
Organization of the Proceedings
Challenges Dealing with the Health Care System
Building Trusted Relationships
3 ACCESSING AND USING HEALTH CARE SERVICES
Delivering Trauma-Informed Care to Immigrants, Refugees, and Migrants
Innovative Access Points Customized for Newly Arrived Populations
Establishing Trust to Bring Individuals into Primary Care
Let’s Talk About Medicines: Workshops for Refugees and Immigrants
4 HEALTH LITERACY CONSIDERATIONS FOR OUTREACH
Teaching English Using Health Concepts and Health Literacy
Messaging for Disasters and Emergency Preparedness
Outreach to Uninsured Foreign-Born Populations
Partnerships in Building Trusted Community Networks
5 APPLICATION OF HEALTH LITERACY TO COMMUNICATION WITH IMMIGRANTS, REFUGEES, AND MIGRANTS
What Systematic Changes Are Needed?
B Biographical Sketches of Moderators, Speakers, and Panelists
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Acronyms and Abbreviations
| AAPCHO |
Association of Asian Pacific Community Health Organizations |
| ACA |
Patient Protection and Affordable Care Act |
| CDC |
Centers for Disease Control and Prevention |
| EHR |
electronic health record |
| ESL |
English as a second language |
| GUIA |
Guides for Understanding Information and Access |
| IDNYC |
New York City identification card program |
| PRAPARE |
Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences |
| PTSD |
posttraumatic stress disorder |
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