Jorge A Rodriguez1, Roger B Davis2, Sanja Percac-Lima3. 1. Divisions of Clinical Informatics. 2. General Medicine and Primary Care, Beth Israel Deaconess Medical Center. 3. Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA.
Abstract
BACKGROUND: For limited English-proficient (LEP) patients, the digital divide has narrowed, creating a new population of Internet users. However, language-appropriate health information is difficult to find. Community health center (CHC) websites are health information resources and their homepages are critical access points for patients. CHCs supported by Health Resources and Services Administration (HRSA) care for many LEP patients. OBJECTIVE: We sought to determine the number of HRSA-supported CHC websites providing translated homepage content. RESEARCH DESIGN: In February 2017, we performed a cross-sectional analysis of the language availability of CHC homepages. MEASURES: The primary outcome was availability of translated content on CHC homepages. Secondary outcomes were method of translation and associations between homepage translation and CHC demographics, including percent LEP population and socioeconomic and Internet access characteristics. RESULTS: Of the 1400 CHC homepages, 480 (34.3%) provided translated information with half using Google Translate. We found higher odds of having a translated homepage as the LEP population by county increased [odds ratio (OR): 1.26, confidence interval (CI): 1.07-1.49, P=0.005], Internet subscription at the state level increased (OR: 1.19, CI: 1.02-1.38, P=0.026), and if health centers were in metropolitan areas (OR: 1.81, CI: 1.31-2.51, P<0.001). There was also higher likelihood of having a homepage translated to Spanish in counties with higher Spanish LEP populations (OR: 1.39, CI: 1.19-1.63, P<0.001), but this did not extend to non-Spanish languages (OR: 0.85, CI: 0.71-1.04, P=0.131). CONCLUSIONS: Despite increased Internet use among LEP patients and linguistic diversity of the CHC populations, there is a lack of language-appropriate content on CHC website homepages.
BACKGROUND: For limited English-proficient (LEP) patients, the digital divide has narrowed, creating a new population of Internet users. However, language-appropriate health information is difficult to find. Community health center (CHC) websites are health information resources and their homepages are critical access points for patients. CHCs supported by Health Resources and Services Administration (HRSA) care for many LEP patients. OBJECTIVE: We sought to determine the number of HRSA-supported CHC websites providing translated homepage content. RESEARCH DESIGN: In February 2017, we performed a cross-sectional analysis of the language availability of CHC homepages. MEASURES: The primary outcome was availability of translated content on CHC homepages. Secondary outcomes were method of translation and associations between homepage translation and CHC demographics, including percent LEP population and socioeconomic and Internet access characteristics. RESULTS: Of the 1400 CHC homepages, 480 (34.3%) provided translated information with half using Google Translate. We found higher odds of having a translated homepage as the LEP population by county increased [odds ratio (OR): 1.26, confidence interval (CI): 1.07-1.49, P=0.005], Internet subscription at the state level increased (OR: 1.19, CI: 1.02-1.38, P=0.026), and if health centers were in metropolitan areas (OR: 1.81, CI: 1.31-2.51, P<0.001). There was also higher likelihood of having a homepage translated to Spanish in counties with higher Spanish LEP populations (OR: 1.39, CI: 1.19-1.63, P<0.001), but this did not extend to non-Spanish languages (OR: 0.85, CI: 0.71-1.04, P=0.131). CONCLUSIONS: Despite increased Internet use among LEP patients and linguistic diversity of the CHC populations, there is a lack of language-appropriate content on CHC website homepages.