Addressing language barriers in client-centered health promotion: lessons learned and promising practices from Texas WIC.

The growing population of nonnative English speakers in the United States challenges program planners to offer services that will effectively reach limited English proficiency (LEP) audiences. This article presents findings from evaluation research conducted with the Special Supplemental Program for Women, Infants, and Children (WIC) to identify best practices and areas of concern for working with LEP clients. Data were collected through online surveys of 338 WIC teaching staff in 2010 and 65 WIC local agency directors in 2011 as part of an implementation evaluation of client-centered nutrition education. Data identified current practices, facilitating factors, and challenges in working with LEP clients. Facilitating factors included cultural competency, material and translation resources, linguistic competency, professional development opportunities, and rapport with clients. Challenges cited included linguistic challenges, lack of cultural competencies, issues related to the client-staff interaction, and insufficient time, materials, and staffing. Best practices inferred from the data relate to developing linguistic standards for bilingual staff, considerations for translating written materials, interpretation services, cultural competency, and staff training. Findings may help inform the development of this and other linguistically and culturally appropriate health promotion programs.