Testing a novel theoretical framework to study language services implementation in health care.

Language services are used to bridge language barriers during healthcare encounters, with the goal of reducing health outcome inequities; however, the implementation of language services in healthcare is understudied. Language Planning Theory has the potential to offer a theoretical framework for studying language services implementation challenges and successes in healthcare. The purpose of this study was to test the three-level view model (3LVM) of Language Planning Theory for studying the implementation of language access services in healthcare. A qualitative secondary analysis of data generated from a study of patients with limited English proficiency receiving home healthcare services and clinicians working for the agency structured this study. Data were analyzed according to the 3LVM using directed content analysis. Results from the analysis provided insights into the factors that generate the need for language services and those that facilitate or hinder their implementation, with the theoretical framework offering clear distinctions. Analyses generated an adapted, healthcare-specific version of the model that includes clinician/staff and patient functions, which proved useful for structuring research about language access services implementation in health care.