May is Asian Pacific American Heritage Month! It is an important reminder to celebrate the diversity and strength of Asian, Asian American (A/AA), Native Hawaiian, and Pacific Islander (NH/PI) communities. A/AA and NH/PI communities are the fastest-growing racial groups in the United States. Within these communities, there are a wide variety of cultures, experiences, rich histories, and languages. The A/AA community includes people from more than 20 countries in East and Southeast Asian and the Indian subcontinent. The NH/PI community has origins throughout the Pacific region, also referred to as Oceania, which is a geographically widespread region populated by people of diverse cultures and ethnicities (e.g., 14 countries and a sea of islands grouped into four geopolitical sub-regions: Australia and New Zealand; Melanesia; Micronesia; and Polynesia). Despite their heterogeneity, these populations are often aggregated into one racial category, masking meaningful differences in health and social barriers to care between these subgroups.

Community health centers have been an integral part of providing culturally and linguistically appropriate care to A/AA and NH/PI as well as other communities of color. According to the Health Center Program Uniform Data System (UDS) 2020 data, nearly 1 in 4 health center patients are best served in a language other than English.  

In response to the need for linguistically responsive care, the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) team translated the assessment tool. The PRAPARE assessment tool supports health centers and other providers to collect and apply the data they need to better understand their patients’ social drivers of health, transform care to meet the needs of their patients, and ultimately improve health outcomes and reduce the total cost of care. The assessment tool is translated into 25+ languages. There are translations available in AA and PI languages, including Arabic, Bengali, Burmese, Chinese (Simplified), Chinese (Traditional), Chuukese, Dari, Hindi, Karen, Karenni, Khmer, Korean, Lao, Marshallese, Nepali, Pashto, Tagalog, Tongan, Uzbek, and Vietnamese. Additional translation requests have been made by health centers and future AA languages will include Hakha, Hmong, and Urdu.

To use the tool, providers ask a set of questions centered on personal characteristics, family and home, money and resources, and social and emotional health. As these are sensitive questions that patients may hesitate in responding to, developing a workflow and working with a team that is culturally and linguistically responsive are essential for whole-person care. 

The PRAPARE tool ensures that the patient is at the center of care. This is especially important when considering the health disparities and barriers to care that communities of color face. During the COVID-19 pandemic, AAPCHO found that 45% of A/AA patients surveyed put off getting health care because they couldn’t take time off work. For the NH/PI population, particularly in Arkansas, NH/PI communities had their salaries dramatically reduced during the pandemic and had low health insurance rates. The PRAPARE assessment tool captures data that provides a deeper understanding of the patient experience and highlights the social needs of communities of color. As more providers adopt PRAPARE and use the assessment tool, there will be more disaggregated data and progress towards health equity. 

If you have any concerns and/or questions about the PRAPARE assessment tool, please contact the PRAPARE team. You can also join us every third Monday at the Tiger Team workgroup to ask questions live and provide feedback. 

If you would like to request any accommodations, please email prapare@nachc.org and the PRAPARE team will do its best to provide reasonable accommodations. 

For more information on the PRAPARE assessment tool, visit our website: 

• PRAPARE Implementation and Action Toolkit
• Methodology for Translation of PRAPARE into Non-English Languages (April 2019)

For more information on cultural and linguistic competency, check out these resources: 

• National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care 
• Practicing Cultural Humility
• Language Access at Community Health Centers

Authors: Kristine Alarcon, Albert Ayson, Jr., Beverly Quintana, and Rosy Chang Weir | Association for Asian Pacific Community Health Organizations (AAPCHO)

Questions? Email the PRAPARE team