A Role for Health Literacy in Protecting People with Limited English Proficiency against Falling: A Retrospective, Cohort Study.

ABSTRACT

OBJECTIVE: To identify risk factors related to falls within the scope of speech-language pathology (SLP) using assessments from the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) over a 4-month period in four Inpatient Rehabilitation Facilities (IRFs). DESIGN: Observational Retrospective Cohort Study SETTING: Four inpatient rehabilitation facilities (IRFs) as part of a larger learning health system PARTICIPANTS: Adults 18 years or older admitted to the IRFs from 10/01/2022 and 02/28/2023 were included. INTERVENTION N/A MAIN OUTCOME MEASURES: Occurrence of falls RESULTS: Analyses of 631 patient records revealed that the odds of falling were almost 3 times greater in people with limited English proficiency compared to English speakers (OR = 2.92, 95% CI [1.09, 6.85]). People with limited English proficiency who reported poorer health literacy had a 4 times higher odds of falling, (OR = 3.90, 95% CI [1.13, 13.44]) when compared to English speakers who reported adequate health literacy. People with limited English proficiency who reported adequate health literacy had the same risk of falling as English speakers, (OR = .98, 95% CI [.16, 6.12]) suggesting the protective role of health literacy for people with limited English proficiency. CONCLUSIONS: Language barriers have a significant impact on falls among patients in IRFs. SLPs improving health literacy and providing language support may play a crucial role in mitigating fall risk, thereby enhancing patient safety and outcomes.