Residents of the United States speak at least 329 languages. In some U.S. cities, less than 60 percent of the population speaks English. Also, the Census Bureau estimates that by 2030, the Hispanic population will increase by 113 percent, and the number of Asian Americans will grow 132 percent. Health plans need to develop culturally and linguistically appropriate materials (CLAMs) to help diverse populations overcome language barriers to effective treatment.
CLAMs help health plan managers and providers inform and educate members and patients and, at the same time, comply with accreditation standards, explain Sandra Smith, M.P.H., C.H.E.S., and Virginia Gonzales, Ed.D., M.S.W., M.P.H., of the University of Washington Center for Health Education and Research. They point out in a recent commentary that Federal and State civil rights laws and Medicaid regulations require that patients have access to medical information in their own languages. These laws form the basis for accreditation standards that require plans and providers to position themselves for a multicultural future. For example, the Joint Commission on Accreditation of Healthcare Organizations requires hospitals to document that patients and families received and demonstrated understanding of linguistically appropriate explanations and instructions.
One cost-effective way to develop CLAMs is to translate printed materials already in use by plans to convey information to English speakers, explain the researchers. They describe a process they developed for producing foreign language CLAMs on prenatal health information from materials written in English. With support from the Agency for Healthcare Research and Quality (HS09836), the researchers used the written pamphlet, "Beginnings: A Practical Guide Through Your Pregnancy," to develop a guide suitable for both college-educated women and those with less than a 9th-grade education. By forming a partnership with a team of perinatal outreach workers from five Spanish-speaking cultures, they produced translated materials acceptable and persuasive to Spanish speakers from various Hispanic cultures in the United States.
For details, see "All health plans need CLAMs," by Ms. Smith and Dr. Gonzales, in the September 2000 Healthplan 41(5), pp. 45-48.