story by Claire Miller
ATLANTA – Georgia State University’s Adult Literacy Research Center (ALRC) has awarded two-year, $25,000 grants to two projects aimed at improving health literacy for adults.
The ALRC Research/Community Service Grant Program, which is open to university faculty affiliated with the center, provides funding for projects that are “innovative, creative and will make an impactful contribution to the broad field of adult and/or health literacy,” according to the ALRC.
This year’s awardees include:
- “Incorporating Principles of Health and Legal Literacy into Medical Legal Partnerships,” led by Stacie Kershner and Amanda Cole. Kershner is the deputy director of the Center for Law, Health and Society, and Cole is the co-director of the Health Law Partnership (HeLP) Legal Services Clinic in the College of Law.
- “Lost in Translation: Quantifying the Risk of Figurative Language Mistranslation in Clinical Encounters with Limited English Proficiency Patients,” led by Iris Feinberg and Sara Cushing. Feinberg is a research associate professor in the College of Education & Human Development, and Cushing is professor and chair of the Department of Applied Linguistics and ESL in the College of Arts and Sciences.
Incorporating Principles of Health and Legal Literacy into Medical Legal Partnerships
Medical-legal partnerships (MLPs) bring lawyers into health care settings to help clients address legal issues that affect their health.
But many families face barriers to understanding their legal options and improving their health, including poverty, language differences, stress and limited literacy skills.
That’s where Kershner and Cole’s work comes in.
Lawyers will communicate with the family through oral communication, like the initial intake and subsequent client calls, and written communication, through emails and letters.
Their ALRC-funded project is designed to make the health and legal information MLPs provide easier to understand so families can better navigate challenges and advocate for themselves.
To do this, they’ll work with colleagues at Atlanta Legal Aid Society, Children’s Healthcare of Atlanta and the College of Law to develop several resources that MLPs can use.
These resources include in-person and asynchronous trainings for attorneys, faculty, students and health care professionals; plain-language communication strategies; revised client materials and conversation guides; a dictionary explaining common legal and health terms in everyday language; and a public website where MLPs across the country can access everything.
Susan McLaren, assistant project director for the Center of Excellence for Behavioral Health and Wellbeing with the Georgia Health Policy Center, will evaluate the project.
“We recognized the need to learn more about health and legal literacy and to incorporate it into our clinic class and other trainings, and this grant allows us to work with the experts at the ALRC as we develop the training and other resources,” Kershner said. “The funding also provides us the opportunity to involve clients, seeking their feedback on HeLP and clinic communications and the changes that would help meet their needs.”
By creating tools, training and resources that can be shared nationally, the project has the potential to improve communication and access to services for families far beyond Atlanta.
Lost in Translation: Quantifying the Risk of Figurative Language Mistranslation in Clinical Encounters with Limited English Proficiency Patients,
Picture this: A patient goes to visit their doctor to ask about the pain they’re feeling, and the doctor asks them to describe the pain using words like “sharp,” “stabbing” and “burning.”
While these descriptions make sense to many English speakers, they can be difficult to translate accurately into another language. This can lead to miscommunications between patients and doctors and make it more difficult to identify symptoms and determine possible treatments.
Feinberg and Cushing’s grant project explores how figurative language – metaphors, euphemisms and everyday phrases, among others – affects communication between health care providers and patients with limited English proficiency, and whether mistranslations could create risks for patient care.
“Clinicians elicit symptoms ('Is there a burning sensation?'), deliver prognoses ('You're not out of the woods yet') and frame risk ('a small chance') using figurative constructs whose meaning is culturally contingent and frequently fails to transfer equivalently across languages,” Feinberg explained. “We’re thrilled to get funding from the ALRC to study how routine figurative language like metaphors and idioms can create risk due to misunderstanding in encounters between physicians and patients, especially for patients whose native language is not English.”
To do this work, they’ll analyze 160 audio-recorded and transcribed clinical encounters with patients from a recent study to answer a few key questions:
- What is the relative risk of clinically significant mistranslation when figurative language is present in clinical encounters with limited English proficiency patients, and how does that risk vary by language type, clinical domain, interpreter type and figurative language category?
- What is the difference between how the high-risk speech segments are interpreted by an AI voice-assisted tool and a human interpreter?
Their findings could help doctors avoid communication-related errors, improve patient safety and make health care experiences more productive for patients with limited English proficiency and their health care providers.
“By framing mistranslation as a measurable, quantifiable risk rather than an anecdotal concern, this research positions figurative language as a patient safety issue amenable to systematic study and intervention,” Feinberg and Cushing wrote.