As we’ve seen with the COVID-19 pandemic, mainstream messaging doesn’t always resonate with every community. “Avoid the Rona” hits home with Black Americans, but misses the mark with white and Asian communities. Oregon leaders found that their initial campaign of “Stay Home. Save Lives.” wasn’t connecting with non-English-speaking communities. Not only was there confusion from essential workers who couldn’t stay home, but there was also no clear guidance on social distancing within multi-generational households.
Messaging can be more effective if it’s relatable to the intended audience. City officials warned residents of Leon County, Florida, to “keep at least 1 large alligator between you and everyone else at all times.” This ask is very much in line with the Floridian lifestyle, but might confuse those unaccustomed to living amongst reptiles.
These examples underscore the importance of cultural response and context in messaging. While providing qualified medical interpreters is a huge piece of the puzzle, for minority communities especially, it’s also important for messengers to understand how their communications will be construed culturally. If this step gets missed, and “Western constructs of health and health care are assumed,” the messaging will not resonate as intended.
To really understand how to connect with your non-English-speaking patients, you will need to look beyond the walls of the hospital and involve the community in the ideation, creation, and distribution of healthcare-related communications.
Involving the community in your communication efforts can help you identify unmet needs, more efficiently allocate language resources, and better understand the cultural, religious, and social complexities that influence how a population communicates. Here are some strategies to get you started.
First, know your patient population
Before adopting a formal data collecting process, the University of Mississippi Medical Center thought they had a pretty good handle on the needs of their patient population. After their data collection efforts, however, officials were surprised to learn that more of their patients wanted communications in Spanish than they realized. Now the medical center is rethinking how they’re providing their language services. They’re also reanalyzing their materials to make sure they’re culturally appropriate.
This is a good example of how data collection can help make health communication more equitable. The medical center identified that their communications weren’t as targeted as they thought they were, nor were their current programs meeting the needs of their patient population linguistically. Officials could re-direct their efforts to better support their patients while saving a few bucks by ceasing the misapplication of resources.
If your hospital isn’t collecting data on your patient population, now is the time to start. While the University of Mississippi Medical Center used more quantitative forms of data collection, starting with baseline demographic or qualitative data like race, ethnicity, and primary language is a good way to understand who your patients are. After all, you can’t reach out to them if you don’t know who you’re trying to connect with!
In addition, language data can inform who you hire (bilingual staff, language-concordant providers, etc.), target what materials you need to translate and into what language, and help determine if your language assistance program is impacting quality of care.
Understand common barriers that hinder effective communication
In addition to different demographic, cultural, behavioral, and socioeconomic characteristics, there are other factors that influence minority engagement with healthcare. Distrust, fear, language, and health literacy are among some of the most common, but by no means an exhaustive list. These factors, in many instances, are long-standing barriers; they stem from economic and structural inequities that date back centuries.
It’s important to understand what the main barriers are for your patient population in accessing care, and how they intersect with and influence communication. For example, a higher percentage of Black and Latinx adults have below basic health literacy compared to white, Asian/Pacific Islander, or multiracial adults.
Knowing this information will help you build stronger relationships within the community, better relate to their struggles, and help you understand any biases or misperceptions you have about minority populations.
Get community buy-in
Community buy-in will rest on first forming partnerships with community leaders. Not only should you connect with “anchor institutions,” like local religious organizations, nonprofits, schools, and public libraries, you also need to establish relationships with community leaders.
Community leaders are service-oriented individuals who have established trust within the community. Sometimes they’re obvious (elected officials), but oftentimes they’re not (faith leaders or block captains), so make sure to talk to a lot of different people to find the right anchor or educator for your program.
Once you make a connection with a community leader, they can be one of your most invaluable advocates. They can work with you to help deliver culturally appropriate messaging that people will be receptive to, and help you develop a deeper understanding of the culture. They’ll also lend credibility (and ultimately trust) to your campaign or program within the targeted community.
Give them the microphone
Community engagement begins with a partnership on equal footing. The community and/or community leaders are the experts in what they need, so make it clear that you’re not there to make decisions for them. Jointly define and agree upon goals, objectives, roles, and responsibilities. Allow them to lead the conversation and fully participate in the planning and execution of effective communication solutions.
Check and re-check your efforts
We’re in a health crisis, so community involvement is a hot topic in healthcare, but this work should continue beyond the immediate communication needs of the pandemic. In essence, it’s recursive.
It will be important to evaluate your approach often. Test your communication campaigns with community members to ensure they’re working. Ask for feedback. Optimize your message. And keep the dialogue to the community open, honest, and inclusive. It’s not a one-and-done solution, nor will it happen overnight. It will take long-term involvement and a commitment to make true progress. But one thing’s for sure: Building relationships based on clear and trusted communication will serve all communities today and in the future.
If you need help setting up your language access plan, we can help!