Patient Navigator Acceptance by Language

Patient navigation is an effective strategy to reduce barriers to care, improve care coordination, and address disparities in health outcomes. Emergency Department (ED)-based navigation is emerging as an important intervention, yet its effectiveness may vary by participant language preference. Our objective was to examine whether phone-based patient navigator acceptance differed by language.

This is a secondary analysis of an ongoing randomized controlled trial. Patients were eligible if they spoke English or Spanish, had unmet oral health needs and presented to one of three urban EDs. Study team patient navigators provided patient resources including oral health, food, housing, transportation, and utilities by phone following an index ED visit. The primary outcome was patient navigator acceptance; sample tests of proportions were performed to test differences by language preference.

In this cohort, 570 (English; n=462; Spanish; n=108) participants were randomized to receive patient navigation. Among Spanish-speakers, 92 (85%) accepted patient navigation compared to 313 (68%) English-speakers for a 17.4-percentage-point difference (95% CI: –25.4 to –9.5; p<0.001). ED site-level analyses showed a consistent pattern; Spanish-speaking participants demonstrated higher proportion of patient navigator acceptance across all EDs.

Findings indicate English-speaking participants were less likely to accept patient navigation compared to Spanish-speaking participants. Higher acceptance among Spanish-speaking patients across EDs demonstrates feasibility of multi-lingual navigation. Future interventions should focus on enhanced implementation of navigation and examining social and clinical outcomes of navigation.