Researchers at the Harvard Opinion Research Program, with funding from the Centers for Disease Control and Prevention (CDC), have completed two multi-year projects to enhance outreach and communications to Spanish and Chinese-speaking persons with limited English proficiency (LEP). People with LEP comprise nearly a tenth of the US population over age 5, and they are especially vulnerable to poor health outcomes during infectious disease outbreaks. Effective communications are critical tools in addressing inequities during outbreaks, but there is little evidence about the experiences of communities with LEP during outbreaks or how to best develop and disseminate communications. Researchers sought to expand this evidence base and develop recommendations that would be utilized by public health agencies in order to respond to challenges in accessing and understanding relevant information during outbreaks among Spanish and Chinese-speaking persons with LEP.
The first project was designed to support federal public health agency communicators, and it included a series of inter-connected studies looked at the perspectives of people with LEP alongside views of people who likely communicate with them during emergencies including: their English-speaking family members, staff at public health agencies responsible for outreach to these communities, and staff at community-based organizations (CBOs) in these communities. This largescale, mixed-methods project was conducted over the course of COVID-19 pandemic, which allowed researchers to document and learn from respondents’ experiences in near real-time. It included both surveys and in-depth interviews with Spanish and Chinese-speaking people with LEP, along with in-depth interviews with family members, public health agency staff, and CBO staff. It also included exploratory in-depth interviews with physicians working at federally qualified health centers serving communities with LEP.
Key resources from this project include:
- Recommendations to Support Federal Public Health Communication Efforts (pdf)
- SteelFisher GK, Caporello HL, Stein RI, et al. Developing Infectious Disease Outbreak Emergency Communications for Populations With Limited English Proficiency: Insights to Sustain Collaborations Between Local Health Departments and Community-Based Organizations. Am J Health Promot. Published online August 19, 2024. doi:10.1177/08901171241273349
- Findling MG, Caporello HL, Stein RI, et al. Communications for US Populations With Limited English Proficiency During Infectious Disease Outbreaks: A Scoping Review. Health Secur. 2023;21(6):489-499. doi:10.1089/hs.2023.0050
- SteelFisher GK, Caporello HL, Lubell KM, et al. Getting Critical Information During the COVID-19 Pandemic: Experiences of Spanish and Chinese Speakers With Limited English Proficiency. Health Secur. 2022;20(4):273-285. doi:10.1089/hs.2021.0218
Recognizing the strong need to address communication challenges and opportunities from a local perspective, researchers were awarded funding for a second project designed to support local and state public health agency (LHD) communicators. Building off of the robust data from the first project, researchers sought to develop targeted, practical recommendations for LHD communicators to better meet the health information needs and preferences of people with LEP during large-scale infectious disease outbreaks. In addition to supplemental analysis of in-depth interviews with staff at public health agencies and CBOs working with communities with LEP, researchers worked with a cohort of communication staff from LHDs across the country to apply and evaluate these recommendations in the context of their work through a pilot test, ensuring the recommendations are relevant, usable, and adaptable.
Key resources from this project include:
