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Background: Patients with limited English proficiency (LEP) in the United States face significant barriers to safe and equitable healthcare despite federal protections guaranteeing access to qualified interpreter services at no cost. Many patients with LEP remain unaware of these rights, relying instead on informal learning through clinical encounters and community networks which are unreliable pathways that may perpetuate language access disparities. Point-of-care educational interventions grounded in just-in-time and situated learning theory represent a promising but understudied approach to bridging this gap. Objective: The aim was to examine Spanish-speaking emergency department patients’ interpreter access patterns, baseline knowledge of federal language rights, and immediate responses to a brief multilingual point-of-care educational video intervention. Methods: A pre–post survey design was used with a convenience sample of 40 Spanish-speaking adult patients presenting to a large, level 1 trauma center ED in the Southeastern United States between February and April 2025. Participants completed a 22-item iPad-administered Spanish-language survey that included baseline knowledge questions, an embedded 2 min educational video about federal language access rights, and post-video response questions. Descriptive statistics were calculated for quantitative data and thematic analysis was conducted for open-ended responses, with two independent coders achieving substantial inter-rater agreement (κ = 0.75, p < 0.001). Fisher’s exact tests examined associations between interpreter access mode and patient demographic characteristics. Results: Most participants (70%) accessed interpreters passively rather than by self-request, a pattern that did not vary significantly by patient status, age, or length of time in the United States. At baseline, 57.5% knew that federal laws prohibit language discrimination in healthcare and 77.5% knew they were entitled to a free qualified interpreter. Most participants (80%) reported learning something new from the video, with responses centering on rights awareness and anti-discrimination protections. Most participants (70%) reported that knowing their federal rights was helpful, describing increased confidence and reduced anxiety. All participants (100%) reported difficulty communicating without an interpreter and nearly all (97.5%) felt more confident asking questions when one was present. Conclusions: Significant knowledge gaps persist even among patients with some baseline rights awareness; a brief culturally appropriate point-of-care video may meaningfully increase awareness and confidence. The consistently passive pattern of interpreter access across all demographic subgroups underscores the need for proactive institutional practices and patient-facing education that empowers LEP patients to advocate for themselves in healthcare settings.
Feinberg et al. (Tue,) studied this question.