PsA IMPACT Toolkit
Collaboration

Language and communication1

How we communicate and how we interpret others’ communication styles is influenced by various factors.

Key principles

Instructions

Be aware of the verbal, nonverbal, and written aspects of communication

Chat

Understand the relationship between communication and individual identity

Patients

Focus on relationships with patients

Mentor

Engage with patients in a way that respects their background and personal experiences

Processes

Adapt your communication to each patient, making an effort to understand communication preferences and cues from the patient’s perspective

Language barriers can hinder effective communication between HCPs and patients. It is crucial to have access to interpreters or translation services to ensure clear and accurate communication. Nuances and idiomatic expressions should also be considered for better understanding.

Culturally and linguistically appropriate services (CLAS)2

Understand that improving cultural and linguistic appropriateness is an ongoing journey.
Understand the role that your culture plays in your interactions and delivery of care.
Understand the role culture plays in health beliefs and behaviors.
Become knowledgeable about the backgrounds of the individuals you serve.
Be aware of language differences and offer language assistance services.
Build trust and rapport with the individuals you serve to facilitate learning about their needs, values, and preferences.
Be aware that some individuals may use various terms to describe medical issues (eg, “sugar” for diabetes).
Be aware of barriers that can arise when expressions, idioms, acronyms, or multi-meaning words are used (even if you and your patient both speak the same language).
Ask about stressors and support structure.
Ask open-ended questions.

Examples:

  • How are you feeling between your medication doses?
  • How are you feeling after being on this medication?
  • What are some of your personal goals?
  • What are you most concerned about?
  • How can I help?
  • What are you hoping to get out of your clinic visit?
Adopted from Effective cross-cultural communication skills – Think Cultural Health with input from people living with PsA and an expert steering committee.

Working effectively with an interpreter3

Working with an interpreter during clinic visits can help bridge communication gaps, but can also present challenges. These challenges include time constraints, reduced translation accuracy, and limited observation of nonverbal communication. Careful planning, well-trained interpreters, and fostering trust between the patient, clinician, and interpreter can minimize these issues.

Types of interpreters

FAQs

Live interpreters

  • Adapt more easily into a conversation
  • Recognize nonverbal communication cues
  • May have limited availability and higher cost
Tablet

Phone/app-based interpreters

  • More accessible and convenient
  • May face technical issues and the potential for miscommunication

Choosing the best option for your patients and clinic requires consideration of these factors.

Some individuals who require an interpreter may understand English well. Comments you make to others might be understood by the patient.
If your patient declines language assistance services, ask them to sign a form that says they understand that language assistance is available and choose to decline these services.
  • This form must be available and signed in their primary language, or completed orally if they are unable to read in their primary language.
  • Document that the individual has been notified of these rights, as well as the patient’s preferences in utilizing language access services.
  • These are precautions in case of issues regarding whether certain information was provided to and understood by the patient.
Adopted from Working effectively with an interpreter – Think Cultural Health with input from people living with PsA and an expert steering committee.

RESPECT model of engaging with patients4

What is most important when you engage with patients is that you remain open and maintain a sense of respect for your patients. The RESPECT model can help you remember what factors to consider engaging patients in an inclusive and linguistically competent manner. These factors are important throughout assessment, diagnosis, and treatment.

R

Respect

Understand how respect is shown within different backgrounds. HCPs demonstrate this attitude through verbal and nonverbal communications.

E

Explanatory model

Devote time in treatment to understanding how patients perceive their presenting problems. What are their views about their own symptoms? How do they explain the origin of current problems? How similar or different is the HCP’s perspective?

S

Sociocultural context

Recognize how class, race, ethnicity, gender, education, socioeconomic status, sexual and gender orientation, immigrant status, community, family, gender roles, and so forth affect care.

P

Power

Acknowledge the power differential between patients and HCPs.

E

Empathy

Express, verbally, and nonverbally, the significance of each patient’s concerns so that they feel understood by the HCP.

C

Concerns and fears

Elicit patients’ concerns and apprehensions regarding help-seeking behavior and initiation of treatment.

T

Therapeutic alliance, trust

Commit to behaviors that enhance the therapeutic relationship; recognize that trust is not inherent but must be earned by HCPs. Recognize that self-disclosure may be difficult for some patients; consciously work to establish trust.

Adopted from RESPECT Model – Think Cultural Health with input from people living with PsA and an expert steering committee.
  1. Office of Minority Health, U.S. Department of Health & Human Services. Think cultural health. Providing CLAS. Accessed May 22, 2026. https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/providing-clas.pdf
  2. Office of Minority Health, U.S. Department of Health & Human Services. Think cultural health. Effective cross-cultural communication skills. Accessed May 22, 2026. https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/effective-cross-cultural-communication-skills.pdf
  3. Office of Minority Health, U.S. Department of Health & Human Services. Think cultural health. Working effectively with an interpreter. Accessed May 22, 2026. https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/working-effectively-with-interpreter.pdf
  4. Office of Minority Health, U.S. Department of Health & Human Services. Think cultural health. RESPECT model. Accessed May 22, 2026. https://thinkculturalhealth.hhs.gov/assets/pdfs/resource-library/respect-model.pdf