FORT WORTH, Texas - With millions of Americans speaking a language other than English at home, a limited ability to speak English can make it difficult for health care providers and their patients to communicate and may affect the overall quality of care.

Recognizing the importance of this issue, The Robert Wood Johnson Foundation has launched an $18.5 million national program to test innovative ways of providing medical interpretation to Latino patients in the hopes of achieving better health outcomes.

The foundation has selected the School of Public Health at the University of North Texas Health Science Center at Fort Worth as one of the program's 10 demonstration sites across the United States.

As a result, the health science center has received a $150,000 grant to develop strategies to address the issue of cross-cultural communications in health care. Once the planning phase is completed next year, the health science center may receive another $850,000 to implement the program.

The grant was awarded through the Hablamos Juntos Program administered by the Tomas Rivera Policy Institute located at Claremont Graduate University in Claremont, CA.

The program will be part of the new Texas Institute for Hispanic Health at the health science center. Other components of the institute are the Center for Cross-Cultural and Community Health and the Training Center for Spanish-Speaking Public Health Professionals. The institute takes advantage of a unique feature of the School of Public Health: about a third of the faculty speaks Spanish fluently.

"We recognize that better communication between patients and their health care providers can enhance health care," said Fernando Treviño, PhD, MPH, dean of the School of Public Health and executive director of the Texas Institute for Hispanic Health. "We want to develop ways to improve patient-provider communication today and lay the groundwork so that the situation in the future is even better."

Through the RWJF grant, the health science center will work with a diverse group of community partners, including Planned Parenthood of North Texas, Inc. and Tarrant County Mental Health/Mental Retardation.

Other partners are the family medicine clinics operated by the health science center's Texas College of Osteopathic Medicine, Tarrant County Public Health Department, JPS Health Center -Diamond Hill, and Osteopathic Health Systems of Texas. Alianza Comunitaria of Tarrant County and Salud para su Corazon of North Texas, two programs that focus on educating the Latino community about cardiovascular disease, will also be integrally involved.

These community and provider partners will help with collecting baseline data, developing strategies and making recommendations for the program.

Eventually, the health science center may be able expand its graduate courses to public health students, offer continuing education courses to health providers, and work with its partners to minimize cross-cultural communication barriers.

"During this first year, we'll develop and test linguistically and culturally appropriate health intervention strategies for Latino families," said Hector Balcazar, PhD, chair of social and behavioral sciences. "Our goal is to establish a self-sustainable health care translation and interpretation training program and create a model that other organizations can replicate."

The foundation received 178 letters of intent responding to its initial announcement of the program. From that, it selected 23 organizations to submit full proposals. The 10 funded recipients were chosen from this pool.

"Our activities will dovetail nicely with the mission of the Texas Health Disparities Task Force to help eliminate inequities in health care for the multicultural and disadvantaged communities of Texas," Dr. Treviño said.

Dr. Treviño, one of nine appointees to the task force, said that Latinos are Texas' fastest-growing population, but are underserved and burdened with a high occurrence of certain diseases. They are more likely to have diabetes, more likely to be obese, more likely to die from heart disease than any other cause, and less likely to control their blood pressure.

The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse - tobacco, alcohol, and illicit drugs.

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