Skip to main content

Advertisement

Log in

The Adolescent Health Care Broker—Adolescents Interpreting for Family Members and Themselves in Health Care

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Parents with limited English proficiency might rely on their adolescent children to interpret health information. We call this adolescent healthcare brokering. Using a mixed-methods, transformative research approach rooted in grounded theory, we sought to answer these questions: (a) “What is happening? What are people doing?” and (b) “What do these stories indicate? What might they suggest about social justice?” High school students from a community in which 53.4% speak another language at home were invited to participate in a survey and focus groups. Of 238 survey participants, 57.5% (n = 137) indicated they assisted with healthcare tasks. When doing so, 81.7% (n = 112) translated. Common tasks were reading prescriptions and talking to doctors. While some participants cited negative emotions associated with brokering, the net emotion was positive. Focus groups (n = 11) revealed that tasks varied broadly in complexity and type, emotional experiences were dichotomous, and access to interpreting services and other supports was inconsistent. This research adopts an advocacy lens and uses a mixed-methods, transformative research approach rooted in grounded theory to describe and call attention to a social justice phenomenon we call adolescent healthcare brokering. We define adolescent healthcare brokering as young people acting as linguistic interpreters in healthcare situations for themselves and for family members with limited English proficiency (LEP). In such situations, language acts as a barrier to health literacy and access to healthcare [17]. Despite this known barrier, there is a gap in the research regarding how to successfully address this situation (McKee, Paasche-Orlow, Journal of health communication 17(3):7–12, 2012).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Baker, D. W., Parker, R. M., Williams, M. V., & Clark, W. S. (1998). Health literacy and the risk of hospital admission. Journal of General Internal Medicine, 13(12), 791–798.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Charmaz, K. (2006). Constructing grounded theory. London; Thousand Oaks, Calif.: Sage Publications.

    Google Scholar 

  3. Chen, A. H., Youdelman, M. K., & Brooks, J. (2007). The legal framework for language access in healthcare settings: Title VI and beyond. Journal of General Internal Medicine, 22 Suppl 2, 362–367. doi:10.1007/s11606-007-0366-2.

    Article  Google Scholar 

  4. Civil Rights Act of 1964, 88–352 C.F.R. § 601 (1964).

  5. Cresswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed-methods research (2nd edn.). Thousand Oaks, CA: Sage.

    Google Scholar 

  6. Exec. Order No. 13166, 65 C.F.R. 50121, (2000).

  7. Faulstich Orellana, M. (2010). From here to there: On the process of an ethnography of language brokering. MediAzioni 10(4), 47–67.

    Google Scholar 

  8. Faulstich Orellana, M., Dorner, L., & Pulido, L. (2003). Accessing assets: immigrant youth’s work as family translators or “para-phrasers”. Social Problems, 50(4), 505–524.

    Article  Google Scholar 

  9. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine Pub. Co.

    Google Scholar 

  10. Green, J., Free, C., Bhavnani, V., & Newman, T. (2005). Translators and mediators: Bilingual young people’s accounts of their interpreting work in health care. Social science & medicine (1982), 60(9), 2097–2110. doi:10.1016/j.socscimed.2004.08.067.

    Article  Google Scholar 

  11. Health education: Theoretical concepts, effective strategies and core competencies. (ISBN: 978-92-9021-829-6 (online)). (2012). Cairo, Egypt.: World Health Organization.

  12. Health literacy interventions and outcomes. (2014). Retrieved from Rockville, MD: http://www.ahrq.gov/research/findings/evidence-based-reports/er199-abstract.html.

  13. Hua, J. M., & Costigan, C. L. (2012). The familial context of adolescent language brokering within immigrant Chinese families in Canada. Journal of Youth and Adolescence, 41(7), 894–906. doi:10.1007/s10964-011-9682-2.

    Article  PubMed  Google Scholar 

  14. Illinois Report Card 2014–2015. (2015). Illinois Report Card. Retrieved from http://public-schools.startclass.com/l/30869/Waukegan-High-School.

  15. Kam, J. A., & Lazarevic, V. (2014). The stressful (and not so stressful) nature of language brokering: identifying when brokering functions as a cultural stressor for Latino immigrant children in early adolescence. Journal of Youth and Adolescence, 43(12), 1994–2011. doi:10.1007/s10964-013-0061-z.

    Article  PubMed  Google Scholar 

  16. Katz, V. (2014). Children as Brokers of Their Immigrant Families’ Health-Care Connections. Social Problems, 61(2), 194–215.

    Article  Google Scholar 

  17. Kutner, M. A. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. Retrieved from Washington, DC.: Table of contents only http://www.loc.gov/catdir/toc/fy0709/2006475219.html.

  18. http://nces.ed.gov/pubs2006/2006483.pdf Full Report Online.

  19. Language use in the United States: 2007, American Community Survey reports. (2010). Retrieved from http://www.census.gov/prod/2010pubs/acs-12.pdf.

  20. McKee, M. M., & Paasche-Orlow, M. K. (2012). Health literacy and the disenfranchised: The importance of collaboration between limited English proficiency and health literacy researchers. Journal of health communication, 17 Suppl (3), 7–12. doi:10.1080/10810730.2012.712627.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Merriam, S. B., & Tisdell, E. J. (2016). Qualitative research : A guide to design and implementation (4th ed.). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  22. Mertens, D. M. (2003). Mixed methods and the politics of human research: The transformative-emancipatory perspective. In A. Tashakkori & C. Teddlie (Eds.), Handbook of mixed methods in social and behavioral research (pp. 135–164). Thousand Oaks, CA: Sage.

    Google Scholar 

  23. Mertens, D. M. (2009). Transformative research and evaluation. New York: Guilford Press.

    Google Scholar 

  24. Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed. ed.). Thousand Oaks: SAGE Publications, Inc.

    Google Scholar 

  25. Purposive Sampling. (2012). Laerd Dissertation. Retrieved from http://dissertation.laerd.com/purposive-sampling.php.

  26. QuickFacts, U. S. C. B. S. a. C. (2015, December 2, 2015). State & County QuickFacts—Waukegan (city), Illinois. Retrieved from http://quickfacts.census.gov/qfd/states/17/1779293.html.

  27. Schillinger, D., Grumbach, K., Piette, J., Wang, F., Osmond, D., Daher, C., Bindman, A. B., (2002). Association of health literacy with diabetes outcomes. JAMA, 288(4), 475–482.

    Article  PubMed  Google Scholar 

  28. Singleton, K., & Krause, E. M. (2010). Understanding cultural and linguistic barriers to health literacy. Ky Nurse, 58(4), 6–9.

    Google Scholar 

  29. Sweetman, D., Badiee, M., & Creswell, J. W. (2010). Use of the transformative framework in mixed methods studies. Qualitative Inquiry, 16(6), 441–454.

    Article  Google Scholar 

  30. Tolerance, T. (n.d.). Strategies for Reducing Racial and Ethnic Prejudice: Essential Principles for Program Design. Retrieved from http://www.tolerance.org/supplement/strategies-reducing-racial-and-ethnic-prejudice-essential-pr.

  31. Tse, L. (1995). Language brokering among Latino adolescents: Prevalence, attitudes, and school performance. Hispanic Journal of Behavioral Sciences, 17, 180–193. doi:10.1177/07399863950172003.

    Article  Google Scholar 

  32. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.

    Article  CAS  PubMed  Google Scholar 

  33. Weiss, B. (1999). 20 common problems in primary care. New York, NY: McGraw Hill.

    Google Scholar 

  34. Weiss, B. (2007). Health literacy and patient safety: Help patients understand. Manual for clinicians. (2nd. ed.). Chicago, IL: American Medical Association Foundation and American Medical Association.

    Google Scholar 

  35. Wolf, M. S., Gazmararian, J. A., & Baker, D. W. (2005). Health literacy and functional health status among older adults. Archives of internal medicine, 165(17), 1946–1952. doi:10.1001/archinte.165.17.1946.

    Article  PubMed  Google Scholar 

Download references

Funding

Qualitative work funded by a Northeastern Illinois University faculty research summer stipend

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jennifer R. Banas.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Banas, J.R., Ball, J.W., Wallis, L.C. et al. The Adolescent Health Care Broker—Adolescents Interpreting for Family Members and Themselves in Health Care. J Community Health 42, 739–747 (2017). https://doi.org/10.1007/s10900-016-0312-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-016-0312-5

Keywords

Navigation