P3.122: Improving Language Concordant Care for Indigenous Mexican Language Families: A Qualitative Analysis of Healthcare Professional Perspectives

Background: Children and families who speak Indigenous Mexican languages (e.g. Mixteco, Triqui, and Zapoteco) face unique linguistic, cultural, and socioeconomic challenges that may impact their healthcare experiences. However, there is limited research on how healthcare providers navigate language-concordant care (LCC) for these families. This qualitative study aims to assess the current state of LCC at our institution for Indigenous language-speaking families by exploring 1) barriers 2) facilitators and 3) recommendations to improve LCC delivery and communication with Indigenous language-speaking families.

Methods: A qualitative approach, guided by Bronfenbrenner’s Ecological Systems Theory, was used to explore the perspectives of healthcare providers who had recently interacted with Indigenous language-speaking patients or caregivers in the past 30 days. Maximum variation purposive sampling was used to capture diverse perspectives from key stakeholders. Semi-structured interviews were conducted and transcripts were analyzed using hybrid inductive/deductive thematic analysis.

Results: 23 participants were interviewed, including interpreters (n=9), physicians (n=7), nurses (n=4), and allied health professionals (n=4) at Stanford Medicine Children’s Health with diverse socio-demographic characteristics. The majority of participants interviewed were women (78.3%), Hispanic/Latino (52.2%), bilingual or trilingual (60.9%), professionally certified in their language skills (69.6%), and had 6–20 years of work experience (65.2%) (Table 1).
Several themes emerged from the data: (1) Barriers to LCC: Challenges included identifying and consistently documenting the correct Indigenous language of patients/families, limited availability of Indigenous language interpreters, and informal assessments of Spanish language proficiency. Concerns arose about the quality of care and informed consent for families whose language needs were not fully met. 2) Facilitators of LCC: Standardized workflows for interpreter services and the use of provider strategies, such as teach-back methods, were identified as facilitators to improving comprehension and bridging cultural gaps. (3)

Recommendations: Participants emphasized the need for process improvement in requesting Indigenous language interpreters, expanding access to in-person and video-based Indigenous interpretation services, and establishing guidelines to decide when Spanish interpretation is sufficient to bridge gaps in LCC for multilingual Indigenous Mexican families.

Conclusion: This study highlights key barriers and facilitators to providing LCC for Mexican Indigenous language-speaking families in a tertiary academic hospital setting as well as opportunities to improve communication. We identified team-endorsed strategies to improve LCC not only for Mexican Indigenous families but also for other families that speak “rare” languages. Next steps will explore collaborating with Language Services to implement targeted interventions that address gaps in LCC delivery such as interpreter modality (in-person and video) and improving provider awareness of Indigenous cultural and linguistic diversity.