Personnel and Training Required

None

Equipment Needs

None

Requirements

Mode of Administration

Self-administered questionnaire

Lifestage

Adult

Participants

Aged 18 years or older

Selection Rationale

The question provides a standard, accepted measure of limited English proficiency(LEP) status.

Language

Chinese, English, Spanish, Other languages available at source

Standards

Derived Variables

None

Process and Review

Not applicable

Protocol Name from Source

California Health Interview Survey (CHIS), Adult questionnaire, 2018

Source

Regents of the University of California. (2019). CHIS 2018 Adult Questionnaire, question number “QA18_G8” is represented in this protocol as question 1. Retrieved from http://healthpolicy.ucla.edu/chis/design/Pages/questionnairesEnglish.aspx

General References

U.S. Census Bureau. (2020). American Community Survey (ACS), 2020. Washington, DC: Author. Question number: Person 1, #14a and #14b.

Berdahl, T. A., & Kirby, J. B. (2018). Patient-provider communication disparities by limited English proficiency (LEP): Trends from the US Medical Expenditure Panel Survey, 2006-2015. Journal of General Internal Medicine, 1–7.

Chan, K. S., Keeler, E., Schonlau, M., Rosen, M., & Mangione-Smith, R. (2005). How do ethnicity and primary language spoken at home affect management practices and outcomes in children and adolescents with asthma? Archives of Pediatrics and Adolescent Medicine, 159(3), 283–289.

Fernandez, A., Warton, E. M., Schillinger, D., Moffet, H. H., Kruger, J., Adler, N., & Karter, A. J. (2018). Language barriers and LDL-C/SBP control among Latinos with diabetes. American Journal of Managed Care, 24(9), 405–410.

Kim, E. J., Kim, T., Paasche-Orlow, M. K., Rose, A. J., & Hanchate, A. D. (2017). Disparities in hypertension associated with limited English proficiency. Journal of General Internal Medicine, 32(6), 632–639.

Njeru, J. W., Boehm, D. H., Jacobson, D. J., Guzman-Corrales, L. M., Fan, C.,

Shimotsu, S., & Wieland, M. L. (2017). Diabetes outcome and process measures among patients who require language interpreter services in Minnesota primary care practices. Journal of Community Health, 42(4), 819–825.

Taira, B. R., Kim, K., & Mody, N. (2019). Hospital and health system-level interventions to improve care for limited English proficiency patients: A systematic review. Joint Commission Journal on Quality and Patient Safety, 45(6), 446–458.

U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. (2016). American Community Survey (ACS): Why we ask questions about… Language spoken at home. Retrieved from https://www.census.gov/acs/www/about/why-we-ask-each-question/language/

U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. (2020). Get help responding to the ACS. Retrieved from https://www.census.gov/programs-surveys/acs/respond/get-help.html

Protocol ID

270201

Variables

Measure Name

English Proficiency

Release Date

May 11, 2020

Definition

English proficiency is an individual-level measurement of spoken English language proficiency.

Purpose

Limited English proficiency (LEP) status is associated with multiple health care disparities and places patients at risk for decreased quality of care and in disaster/safety events. It is associated with lower educational attainment and limited employment opportunities. These questions help understand how well an individual speaks English and analyze and plan programs for adults and children with limited proficiency.

Keywords

ACS, American Community Survey, California Health Interview Survey, CHIS, Limited English Proficiency (LEP), Social Determinants of Health, U.S. Census, immigrant health

Measure Protocols

Publications

Nguyen, A. P., Ke, W., Mei, S., and Nguyen, T. H. (2025) Understanding Prediabetes and Diabetes Among Vietnamese Americans: Exploring Biological, Psychological, and Social Factors J Transcult Nurs. 2025 November; 36(6): 690-701. doi: 10.1177/10436596251353035

Aguilar-Palma, S. K., et al. (2025) Characteristics influencing COVID-19 testing and vaccination among Spanish-speaking Latine persons in North Carolina PLoS ONE. 2025 January; 20(1): e0317794-e0317794. doi: 10.1371/journal.pone.0317794

Hu, L., et al. (2024) The Integrating Cultural Aspects Into Diabetes Education(INCLUDE) Study to Prevent Diabetes in Chinese Immigrants: Protocol for a Randomized Controlled Trial Jmir Research Protocols. 2024 November; 13: 11. doi: 10.2196/65455

Levites Strekalova, Y. A., et al. (2024) Policy instruments for the governance of the social drivers of health data in clinical and research settings: a policy mapping brief Front Public Health. 2024 November; 12: 1369790. doi: 10.3389/fpubh.2024.1369790

Fu, S. S., et al. (2024) Evaluating chronic disease approaches to ameliorate tobacco-related health disparities: Study protocol of a hybrid type 1 implementation-effectiveness trial Contemporary Clinical Trials Communications. 2024 October; 42: 10. doi: 10.1016/j.conctc.2024.101380

Levites Strekalova, Y. A., et al. (2024) Application of the Delphi method to the development of common data elements for social drivers of health: A systematic scoping review. Translational Behavioral Medicine. 2024 June; 14(7): 426-433. doi: 10.1093/tbm/ibae020

Burnett-Bowie, S. A. M., et al. (2024) The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report. Journal of Bone and Mineral Research. 2024 May; 39(5): 517-530. doi: 10.1093/jbmr/zjae048

Bartholomew, T. S., et al. (2024) Project CHARIOT: study protocol for a hybrid type 1 effectiveness-implementation study of comprehensive tele-harm reduction for engagement of people who inject drugs in HIV prevention services Addiction Science & Clinical Practice. 2024 March; 19(1). doi: 10.1186/s13722-024-00447-9

Crusan, A., et al. (2023) Using Community-Based Participatory Research Methods to Inform the Development of Medically Tailored Food Kits for Hispanic/Latine Adults with Hypertension: A Qualitative Study. Nutrients. 2023 August; 15(16): 3600. doi: https://doi.org/10.3390/nu15163600

Markatou, M., O. Kennedy, M. Brachmann, R. Mukhopadhyay, A. Dharia, and A. H. Talal (2023) Social Determinants of Health Derived from People with Opioid Use Disorder: Improving Data Collection, Integration and Use with Cross-Domain Collaboration and Reproducible, Data-Centric, Notebook-Style Workflows Front Med . 2023 March; 10. doi: 10.3389/fmed.2023.1076794

Chan, N. W., et al. (2022) Social determinants of health data in solid organ transplantation: National data sources and future directions. Am J Transplant. 2022 October; 22(10): 2293-2301. doi: 10.1111/ajt.17096

Korn, A. R., C. Walsh-Bailey, M. Pilar, B. Sandler, P. Bhattacharjee, W. T. Moore, R. C. Brownson, K. M. Emmons, and A. Y. Oh. (2022) Social Determinants of Health and Cancer Screening Implementation and Outcomes in the USA: A Systematic Review Protocol. Syst Rev. 2022 June; 11(1). doi: 10.1186/s13643-022-01995-4

Pomeroy, A., et al. (2022) Protocol for a Longitudinal Study of the Determinants of Metabolic Syndrome Risk in Young Adults. Translational Journal of the American College of Sports Medicine. 2022 April; 7(2): 8. doi: 10.1249/tjx.0000000000000197

Brown, L. D., et al. (2022) Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing. American Journal of Health Promotion. 2022 February; 36(2): 259-268. doi: 10.1177/08901171211049679

Young Hye, K., et al. (2021) Predicting multilingual effects on executive function and individual connectomes in children: An ABCD study. Proceedings of the National Academy of Sciences of the United States of America. 2021 December; 118(49): 1-11. doi: 10.1073/pnas.2110811118

FHIR

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