Barriers and Facilitators to Using 9-1-1 and Emergency Medical Services in a Limited English Proficiency Chinese Community

Division of General Internal Medicine, Department of Medicine, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA.
Journal of Immigrant and Minority Health (Impact Factor: 1.16). 02/2011; 14(2):307-13. DOI: 10.1007/s10903-011-9449-6
Source: PubMed


Effective communication during a medical emergency is crucial for an appropriate emergency medical services (EMS) response. This exploratory qualitative study explored intentions to use 9-1-1 in a Chinese speaking community and the barriers and facilitators to accessing EMS. Focus groups with Chinese adults who self-reported limited English proficiency were conducted. An inductive iterative approach was used to categorize and connect themes identified in the discussions. Language difficulties, negative perceptions of EMS, perceived costs of using emergency services, and no previous experience with 9-1-1 were commonly described as barriers to calling EMS during emergencies. Positive past experiences with EMS and encountering an emergency situation perceived as too great to manage alone are common facilitators for calling 9-1-1. Further exploration is necessary to assess barriers to calling 9-1-1 unique to specific communities, test findings, and tailor interventions to improve EMS communication.

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    • "In this atmosphere of distrust and uncertainty, undetected misunderstandings may delay or prevent urgently-needed help. Indeed, communication difficulties due to a language barrier between callers and emergency call operators can result in serious, possibly life-threatening outcomes for patients (Grow, Sztajnkrycer, & Moore, 2008; Higgins, Wilson, Bridge, & Cooke, 2001; Meischke, Chavez, Bradley, Rea, & Eisenberg, 2010; Ong et al., 2012). As source material, emergency telephone calls offer unique potential for listening scholarship . "
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    ABSTRACT: Persons needing urgent help who call the emergency line must explain what has happened so that the operator can help and dispatch appropriate resources. Language barriers impede the process of securing mutual understanding. Our microanalysis of 25 simulated (unscripted) emergency calls involving language barriers showed that operators responded by implicitly indicating understanding, displaying understanding, or explicitly acknowledging non-understanding. Callers followed these operator responses systematically, contributing new information, confirming (or correcting) understanding, or repeating and rephrasing. Our findings exemplify the use of microanalysis to study listening processes and have implications for practice in emergency calls and other healthcare interactions.
    Full-text · Article · Sep 2015 · International Journal of Listening
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    ABSTRACT: In the United Sates, populations with limited English proficiency (LEP) report barriers to seeking emergency care and experience significant health disparities, including being less likely to survive cardiac arrest than whites. Rapid utilization of 9-1-1 to access emergency services and early bystander cardiopulmonary resuscitation (CPR) is crucial for successful resuscitation of out-of-hospital cardiac arrest patients. Little is understood about Asian LEP communities' preparedness for emergencies. In this exploratory survey, we sought to assess intentions to call 9-1-1 in an emergency and knowledge of CPR in the Cambodian LEP community. We conducted an in-person interview with 667 Cambodian adults to assess their intentions to call 9-1-1 and their awareness of and training in bystander CPR. While the majority of participants stated that they would call 9-1-1 in an emergency, almost one-third of the sample would call a friend or family member. Awareness of CPR was very high but training in CPR was lower, especially for women. A higher level of English proficiency and greater proportion of time in the US was a strong predictor of CPR training and intention to call 9-1-1 in an emergency. This suggests that greater efforts need to be made to reach the most linguistically-isolated communities (those with little or no English) with emergency information in Khmer.
    Preview · Article · Jul 2011 · Journal of Community Health
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    ABSTRACT: Language incongruences between patients and providers are associated with delays in hospital based care, yet little is known about how they affect the prehospital setting. The out-of hospital (OOH) management of chest pain is protocol driven, however communication likely influences care provided by paramedics of Emergency Medical Services (EMS) units. This is a cross-sectional analysis of New Jersey patients who called 911 for chest pain from 2008 to 2011. Using an electronic record system, we examined the association between language congruency and total on-scene-time (OST) spent by advanced life support (ALS) paramedics. A series of linear regression models were built to examine this association. Eleven thousand two hundred forty-nine patients with chest pain were included in our study. Of these, 222 had language incongruences with paramedics (1.98%). Contrary to expectations, language incongruences were associated with less OST (β = 0 − 0.85400, p < 0.0028). After adjusting for demographic and clinical variables, language incongruences persisted as a significant independent predictor of less OST. Paramedics spent less time with Hispanics (β = − 0.3717, p < 0.0228) and Asians (β = −0.5647, p < 0.0101). The association between language incongruences and OST varied significantly among racial/ethnic groups in adjusted models. Language incongruences between patients and paramedics are associated with decreased OST suggesting that disparities may not occur in the prehospital setting.
    No preview · Article · Jun 2013 · World Medical and Health Policy
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