An Analysis of the Impact of Linguistic and Paralinguistic Variables in Mediated

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DESCRIPTION (Abstract Provided by Applicant): Of the financial, structural, and personal barriers that limit access to healthcare, language is one of the most persistent. Despite this, empirical research delving into the complexities of mediated (interpreted) human interaction in healthcare settings is scarce, and many of the studies that do exist pose serious limitations when considered in the light of current linguistic theoretical frameworks. The influx of language-minority patients into the U.S. health system has led to a flurry of interest in the healthcare interpreter by medical researchers, with a number of studies in recent years being conducted to compare the performance of ad hoc interpreters to "professional" interpreters; to analyze misunderstanding and breakdown in communication caused by interpreters; and to develop approaches to testing the language proficiency and interpreting skills of healthcare interpreters. These studies have been carried out in isolation, with little input from the science of linguistics, in which studies in interaction have been conducted for decades. They fail to tease apart important variables related to the profile of the interpreter and provider, and to the interactional goals of particular communicative events in healthcare. The purpose of this research is to improve healthcare access provided to language minority patients (speakers of Spanish and ASL, in particular) by revealing some of the underlying obstacles (linguistic contributors) to healthcare patient-provider interaction. These contributors will be identified through qualitative and quantitative data collection approaches, including video recorded provider-patient encounters at a large hospital in south Texas. Demographics will also be collected on providers, patients, and interpreters and relationships between their profiles and linguistic contributors to miscommunication will be explored. This research is grounded in concepts derived from interactional sociolinguistics and conversation analysis.