title: Serving limited English proficient callers: a survey of 9-1-1 police telecommunicators.
abstract: BACKGROUND
  The emergency telephone number 9-1-1 serves as a lifeline to the public during emergencies, and first responders rely on information gathered by 9-1-1 telecommunicators who speak with callers. Timely, accurate information from the telecommunicators is essential for providing appropriate care on scene. Language barriers can hamper these efforts and result in less efficient information exchange. Although 9-1-1 telecommunicators may access over-the-phone interpreter (OPI) services to facilitate communication, managing three-way communication during an emergency is challenging. Problem There is little published on the relationship between limited English proficient (LEP) callers and 9-1-1 police telecommunicators, and the role of OPI services during these calls. Further, little is known about effective strategies to manage such calls.
  
  
  METHODS
  In King County, Washington, 9-1-1 police telecommunicators were surveyed about their experiences handling LEP calls and managing three-way communication with OPI services. The survey contained 13 multiple-choice and three open-response questions addressing communication strategies, challenges with LEP callers, and three-way communication with OPI services. Goodman-Kruskal Gamma and chi-square tests were conducted with OPI use as the dependent variable. Additional analyses were conducted using stress levels as the dependent variable.
  
  
  RESULTS
  Of 123 respondents, 69 (56.5%) 9-1-1 telecommunicators reported utilizing OPI services at least 75% of the time when receiving a call from an LEP caller. Further, 35 (28.7%) of these telecommunicators reported calls with LEP individuals as more stressful than calls with fluent English speakers. Dispatcher stress level during LEP calls compared with stress during calls with fluent English speakers was positively associated with use of OPI services (P < .01). Further, stress level was also positively associated with telecommunicator difficulties in assessing the situation with respect to officer safety (P < .01). Sixty-three (58.3%) of the telecommunicators described difficulties assessing the situation to determine the appropriate response as the biggest challenge with LEP callers. Additionally, 62 (53%) identified knowing their location in English as information LEP callers need to know prior to calling 9-1-1.
  
  
  CONCLUSIONS
  These results highlight intervention opportunities for both 9-1-1 telecommunicators and LEP communities. Together, interventions such as working with LEP communities to educate them on best communication practices during 9-1-1 calls, and with 9-1-1 telecommunicators to help them manage three-way communication and reduce stress associated with concern for officer safety may improve emergency communication during 9-1-1 calls.
authors.affiliation: Department of Health Services, University of Washington, Seattle, WA, USA. lncarr@uw.edu
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Carroll
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Calhoun
authors.forename: Cleo C
authors.initials: CC
authors.lastname: Subido
authors.forename: Ian S
authors.initials: IS
authors.lastname: Painter
authors.forename: Hendrika W
authors.initials: HW
authors.lastname: Meischke
mesh_terms: D000328:Adult; D004631:Emergency Medical Service Communication Systems; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D016495:Police; D013685:Telecommunications; D014175:Translating; D055815:Young Adult