Language Access in Clear Communication


The NIH sponsors a Clear Communication program that encompasses cultural respect, plain language, and health literacy planning.

  • The emerging, growing field — and movement — of cultural respect is closely linked to the effort to reduce health disparities, differences between groups of people that may negatively affect individual access to quality health care. As a strategy, cultural respect​ is designed to improve quality and eliminate disparities in health care
  • Health literacy — the ability to understand and communicate health information — is dependent on culture, context, knowledge, key skills, and many other factors. Developing health information at the appropriate literacy level and targeted to the language and cultural norms of specific populations helps promote health literacy.
  • Plain language — clear, concise and well organized writing — is one strategy for developing and communicating health information. Plain language makes it easier to understand and use health information.

The NIH Clear Communication program serves to promote meaningful access to high-quality care for the broad public spectrum, taking into account patient values, beliefs, and behaviors and social, cultural, and the linguistic needs of for culturally diverse patients. One core, common thread among these concepts and strategies is patient centeredness, including communications in the language with which a patient feels most comfortable, especially when discussing or reading medical or health care information. This is called the individual's preferred language.

Language Access at NIH

Language can be a clear, profound barrier to health literacy. Language barriers and the inability to read or understand health information can pose serious health risks to individuals with limited English proficiency (LEP). Language is therefore a critical component of any effort to improve communication and access to quality healthcare for patients, their family members, caregivers, and friends.

Challenges to removing language barriers include the following:

  • Often, there is no right or wrong in translating certain concepts and words;
  • Some words and ideas, especially complex or technical ones, may defy simple translation, making comprehension difficult;
  • There is great diversity and variation in the language skills and abilities of individuals, including translators and interpreters; and
  • Context — geographic and cultural, for example — is often the most important component in health communication.

To improve access for individuals with limited English proficiency, the NIH has formulated — and is implementing — an agency-wide Language Access Plan (LAP). The goal of the plan is to improve access for eligible LEP persons to many of the agency’s public programs and activities. The focus of the LAP plan is to provide for communications in the preferred language when a patient has limited English proficiency.

Language Access is integral to the NIH’s commitment to the development of accessible and effective health, science, and medical information for broad public dissemination.

The NIH Language Access Program is coordinated by the Office of Equity, Diversity, and Inclusion. For more information, please visit

Trans-Government Language Access Planning

On August 11, 2000, the President signed Executive Order 13166, "Improving Access to Services for Persons with Limited English Proficiency." The Executive Order requires Federal agencies to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so LEP persons can have meaningful access to them.

Information about government-wide language access planning and programs, including Executive Order 13166, Title VI of the Civil Rights Act of 1964 (Title VI), and Title VI regulations regarding language access, is online at

The Language Access Plan of the U.S. Department of Health and Human Services is online at

Translation and Interpretation Contract

The National Institutes of Health offers a multiple award Translation and Interpretation Contract, designed to help the agency provide meaningful access to individuals who do not speak English as their primary language. Available task areas include translation of written materials; oral language assistance; and translation of digital information and web content. Contractors are:

  • Ad Astra HHSN263201700005I
  • CommGap HHSN263201700007I
  • Kramer Translation HHSN263201700004I
  • TransGlobal HHSN263201700006I

For more information, contact the Office of Equity, Diversity and Inclusion (EDI) or Christina Simmons, Contracting Officer Representative (COR),

This page last reviewed on December 1, 2017