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Hispanic and Latino patients with diabetes face higher rates of complications and readmission after moving from hospital care back home. , recently published a study titled that uncovered overlapping themes among patients and providers that offer a framework to address the health inequities for this population.

Readmission is directly linked to poorer outcomes, so tackling reasons for readmissions is vital in improving patient health. Hispanic/Latino patients with diabetes are twice as likely to be readmitted to the hospital as their white counterparts. Study participants identified common issues that affect Hispanic/Latino patients with diabetes, including communication barriers, patients perceptions of burdening providers or a being a nuisance, lack of awareness of community resources, and lack of patient education.

“While an interpreter may be present, it is not the same as communicating with someone who is native to the language and culture,” Padilla said. “The traditional practices of being warm and personable play a part as it helps with trust and building rapport. Through a translator, that is difficult. And [patients] report feeling they are being a burden already because of language issues.”

Even if information is translated appropriately, low health literacy may impede a patient’s understanding of their condition and treatment. Cultural and language barriers may prevent patients from asking for further explanations or assistance.

“When language discordance occurs, communication is compromised, which can lead to patient feeling confused,” said Padilla. Confusion can create mistrust, and may result in the patient seeking care elsewhere, or not at all. And even if the information is understood, Hispanic/Latino patients may find it difficult to engage in self-care because of cultural systems at play.

“It is crucial to understand patients’ cultural beliefs and attitudes towards chronic conditions, particularly diabetes, which requires patients to manage their blood glucose levels through lifestyle modification, including diet and taking their medications,” Padilla said. “Latinos are very family-oriented and may prioritize their family’s needs over their own.” A family member with diabetes may not ask for help with blood glucose monitoring, for example, or continue eat regular meals that they prepared for their family rather than modify their meals.

The study used semi-structured interviews with customized questions for patients and providers at two academic health centers in the southeastern U.S. Questions focused on diabetes management, discharge processes, and actual or perceived barriers during the transition of care.

The most influential socioeconomic factors identified were income, health education, language and cultural barriers, and patient-provider language discordance, Padilla said, noting that the Hispanic/Latino population also often experiences food and housing insecurities, which also contributes to health inequity.

Study findings will inform the development of a tailored transition of care model for Hispanic/Latino adults with diabetes, Padilla said, much like , a program initiated more than 20 years ago in California that provides culturally sensitive, bilingual and bicultural peer-led support and education, including weekly web sessions to increase patient engagement. Recognized by the American Diabetes Association, Project Dulce uses a nurse-led multidisciplinary team and has documented improvements in health outcomes and cost. Padilla’s study adds to the research and understanding about how to improve health outcomes and move toward health equity for this Latino/Hispanic population. “Research has shown that cultural tailoring must go beyond linguistic translation to maximize outcomes,” Padilla said.