title: Tornado hazard communication disparities among Spanish-speaking individuals in an English-speaking community.
abstract: BACKGROUND
  The state of Oklahoma, known for destructive tornados, has a native Spanish-speaking (NSS) population of approximately 180,241, of which 50% report being able to speak English "very well" (US Census Bureau). With almost 50% of these native Spanish-speaking persons being limited English proficient (LEP), their reception of tornado hazard communications may be restricted. This study conducted in northeast Oklahoma (USA) evaluates the association between native language and receiving tornado hazard communications.
  
  
  METHODS
  This study was a cross-sectional survey conducted among a convenience sample of NSS and native English-speaking (NES) adults at Xavier Clinic and St. Francis Trauma Emergency Center in Tulsa, OK, USA from September 2009 through December 2009. Of the 82 surveys administered, 80 were returned, with 40 NES and 40 NSS participants. A scoring system (Severe Weather Information Reception (SWIR)) was developed to quantify reception of hazard information among the study participants (1-3 points=poor reception, 4-5=adequate reception, 6-8=excellent reception). Pearson's chi-squared test was used to calculate differences between groups with Yates' continuity correction applied where appropriate, and SWIR scores were analyzed using ANOVA. P-values<.05 were considered significant.
  
  
  RESULTS
  NSS fluency in English was 25.6%. No significant association was found between native language and those who watch television, listen to radio, have a National Oceanic and Atmospheric Administration (NOAA) All Hazards radio or telephone, or are in audible range of a tornado siren. NSS were less likely to have Internet access (P<.004), and less likely to know of local telephone warning programs (P<.03). The mean NSS SWIR score was 3.2 (95% CI, 2.8-3.7) while LEP NSS averaged 2.8 (95% CI, 2.4-3.2). The mean NES SWIR score was 4.5 (95% CI, 4.1-5.0).
  
  
  CONCLUSIONS
  Results demonstrate a disparity in tornado warning reception between NSS and NES. Poor English proficiency was noted to be 75% among NSS, which is approximately 25% more than estimated by the US Census Bureau. This study demonstrates a need for emergency managers to recognize when appropriate and overcome communication disparities among limited English proficient populations.
authors.affiliation: Utah Valley Regional Medical Center - Trauma, Provo, Utah, USA and Università degli Studi del Piemonte Orientale "Amedeo Avogadro," Novara, Italy.
authors.forename: Leslie
authors.initials: L
authors.lastname: Ahlborn
authors.forename: Jeffrey Michael
authors.initials: JM
authors.lastname: Franc
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003142:Communication; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009825:Oklahoma; D011795:Surveys and Questionnaires; D055869:Tornadoes