title: Pharmacists' provision of information to Spanish-speaking patients: a social cognitive approach.
abstract: BACKGROUND
  Hispanics with limited English proficiency face communication challenges that affect medication use and outcomes. Pharmacists are poised to help patients' use medications safely and effectively; however, scant research has explored factors that may impact pharmacists' communication with Spanish-speaking patients (SSPs).
  
  
  OBJECTIVE
  Guided by social cognitive theory (SCT), the purpose of this study was to examine the relationships between pharmacy environmental factors, pharmacists' cognition, and pharmacists' communication with SSPs.
  
  
  METHODS
  A cross-sectional survey used a vignette to quantify the amount of information pharmacists would provide to an SSP. Pharmacy environmental factors (language-assistance resources, Spanish-speaking staff, and number of SSPs) and pharmacists' cognition (self-efficacy beliefs and cultural sensitivity) that may influence communication also were assessed. The relationships between environmental factors, cognition, and pharmacists' communication with SSPs, including indirect relationships, were examined using composite indicator structural equation (CISE) modeling.
  
  
  RESULTS
  Of the 183 respondents, most were white (91%) and male (63%) with a mean age of 47 years (SD = 12.77). The CISE modeling revealed that the number of SSPs served by the pharmacy and the pharmacist's self-efficacy in communicating with SSPs were significantly directly associated with pharmacist's provision of information to SSPs. Two environmental factors (presence of interpreter services and Spanish-speaking staff) operated indirectly through self-efficacy to significantly impact the provision of information.
  
  
  CONCLUSIONS
  Study findings identify both environmental factors and cognition that could contribute to pharmacists' communication behavior with SSPs. Thus, future interventions to improve pharmacists' communication with SSPs may include training pharmacists to integrate interpretative services and Spanish-speaking staff into service delivery and strengthening pharmacists' self-efficacy beliefs.
authors.affiliation: Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin School of Pharmacy, 777 Highland Ave, Madison, WI 53705, USA. hnyoung@pharmacy.wisc.edu
authors.forename: Henry N
authors.initials: HN
authors.lastname: Young
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Dilworth
authors.forename: David A
authors.initials: DA
authors.lastname: Mott
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Cox
authors.forename: Megan A
authors.initials: MA
authors.lastname: Moreno
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
mesh_terms: D000328:Adult; D003071:Cognition; D003142:Communication; D003144:Communication Barriers; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D019538:Health Care Surveys; D006630:Hispanic or Latino; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010353:Patient Education as Topic / Q000379:methods*; D010595:Pharmacists / Q000706:statistics & numerical data*; D020377:Self Efficacy; D012931:Social Environment; D014481:United States