Adolescent Healthcare Brokering: Prevalence, Experience, Impact, and Opportunities

Background: Limited health literacy disproportionately affects those with limited English proficiency (LEP). Parents with LEP might rely on their adolescent children to interpret health information. We call this "adolescent healthcare brokering." This study uncovers the prevalence of brokering, kinds of tasks, emotional and academic impact, and desired support. Methods: We invited 165 students from health classes (in a community in which 29.8% are foreign-born and 53.4% speak another language at home) to complete a survey. We used IBM SPSS to calculate descriptive statistics. Results: Of the 159 who received parental consent and assented, 54.1% (N = 86) assist with healthcare tasks. When brokering, 80.2% (N = 69) translate. Most common tasks were talking to a doctor, reading prescriptions, and searching on the Internet. Participants were most confident reading prescriptions and talking to a doctor and least confident finding healthcare services. Among brokers, 29.1% (N = 24) missed school; 33.7% did not complete homework. They most wanted to learn about filling out insurance forms and talking to doctors. Conclusions: Despite assurances that children are not permitted to interpret, adolescents are acting as healthcare brokers. The impact can be academic and emotional. Findings indicate a need for further research and support for adolescents who want to learn about healthcare tasks.