P3.P303: Investigating accessibility of language interpretation services in healthcare settings for underserved and minoritized refugee and immigrant families

Purpose/Objectives: According to the Virginia Department of Social Services’ Virginia Refugee Statistics, fiscal years 2022 - 2023 saw 4,037 newcomers to the state of Virginia under the age of 18. Refugee families face numerous health inequalities, barriers, and disparities to accessing healthcare services, stemming from their migration experiences and sociocultural backgrounds. Refugee pediatric patients oftentimes present with complex and diverse medical and social needs unfamiliar to healthcare providers, and it is important to analyze documented health issues and healthcare requirements. This study aims to examine language interpretation barriers to healthcare during medical visits amongst refugee and underserved families with children in Roanoke, Virginia. This study aims to enhance pediatric refugee healthcare models in Roanoke and similar resettlement areas.

Design/Methods: A 10-item questionnaire in 2023 and an 18-item questionnaire in 2024 were administered to attendees at community events for refugee and immigrant children in Roanoke City. The survey included questions about healthcare barriers including language interpretation needs and difficulty scheduling medical appointments as well as acculturation topics, including perceived familial safety and usage of resettlement resource aid. The questionnaires were adapted from screening tools, including the Accountable Health Communities Screening Tool and the Hispanic Community Health Study Acculturation Questionnaire.

Results: 149 families completed the questionnaires across both years. 62.9% (2023) and 79.5% (2024) identified Spanish as their preferred language. Of parents with children that resettled in Roanoke and queried in these questionnaires, 43.6% resettled in the past six months. Though many had engaged in health care since arriving, 45.9% reported difficulties making an appointment. Upon arriving at an appointment, there was reportedly access to an interpreter >97% of the time if needed and a strong preference for an in person human interpreter with >90% of respondents expressing this preference over a virtual interpreter. Despite this reported access to interpreters, 28.7% of parents reported a problem with understanding medical conversations because it was not explained in their preferred language.

Conclusion/Discussion: As the refugee, asylee, and new arrival populations in communities across Virginia and the United States grow, it is critical that health care providers rise to meet the needs of these pediatric communities. This survey highlights the persistent language barriers for parents and children that prevent equitable access to health care services and the medical team. This disparity in language services is likely a contributing factor to the noted difficulty in making appointments for those English limited and English emerging speakers, though further exploration is necessary to delineate those barriers specifically. While interpreter services have been available, there is a clear need for increased access to in-person interpreters and for interpreters to be available to provide language support to children and their families through all parts of the encounter.