{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T20:47:12Z","timestamp":1774039632325,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate whether language of choice affects compliance with speech therapy for voice disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study was performed at Kaiser Permanente Northern California to compare compliance with referrals to speech therapy for voice disorders between English\u2010 and non\u2010English\u2010speaking patients. Patients referred from January 2012 through December 2017 were included. Logistic regression models were used to calculate the adjusted odds ratios (aOR) and to determine social and demographic factors affecting compliance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 7,333 patients referred to speech therapy for a voice disorder, 7,171 were identified as English speaking and 162 as non\u2010English speaking. The two cohorts were similar in terms of gender and proportion over 65\u2009years of age, although non\u2010English\u2010speaking individuals were more likely to be Hispanic or Asian than English speakers, who were more likely to be White or African American. Overall compliance was lower among non\u2010English\u2010speaking patients than English speakers (63% vs 74%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0011). Logistic regression showed that the need for an interpreter was significantly associated with higher noncompliance (aOR 1.56, 95% CI 1.11\u20132.18), as was age less than 65 and income less than the study aggregate median income. Being multiracial or having a voice disorder of neurologic origin was associated with better compliance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates significant noncompliance with speech therapy for a variety of voice disorders. This problem is exacerbated for patients who do not speak English and who are younger, of lower income, or are referred for functional voice disorders. In\u2010person interpreters or multilingual speech therapists may help to improve compliance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>IV <jats:italic>Laryngoscope<\/jats:italic>, 131:E2298\u2013E2302, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29429","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T20:48:50Z","timestamp":1612990130000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Disparities in Speech Therapy for Voice Disorders Between English\u2010 and Non\u2010English\u2010Speaking Patients"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4119-465X","authenticated-orcid":false,"given":"Camille","family":"Huwyler","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente, Oakland Medical Center  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maqdooda","family":"Merchant","sequence":"additional","affiliation":[{"name":"Division of Research Biostatistical Consulting Unit  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Kaiser Permanente, Oakland Medical Center  Oakland California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.06.744"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28148"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940611500209"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2004.01.007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2002.00559.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24740"},{"key":"e_1_2_6_8_1","first-page":"CD006373","article-title":"Interventions for treating functional dysphonia in adults","volume":"3","author":"Ruotsalainen JH","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.10.005"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941011900706"},{"key":"e_1_2_6_11_1","first-page":"304","article-title":"Vocal improvement after voice therapy in the treatment of benign vocal fold lesions","volume":"32","author":"Schindler A","year":"2012","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.08.004"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.09.009"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816679941"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26947"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2811-1"},{"key":"e_1_2_6_17_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.7812\/TPP\/15-225","article-title":"The Kaiser Permanente Northern California adult member health survey","volume":"20","author":"Gordon N","year":"2016","journal-title":"Perm J"},{"key":"e_1_2_6_18_1","first-page":"189","article-title":"The challenge of patient adherence","volume":"1","author":"Martin LR","year":"2005","journal-title":"Ther Clin Risk Manag"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2014.892636"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2016.1161839"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2015.1092173"},{"key":"e_1_2_6_22_1","unstructured":"ColbySL OrtmanJM.Projections of the Size and Composition of the U.S. Population: 2014 to 2060 Current Population Reports P25\u20101143.https:\/\/www.census.gov\/content\/dam\/Census\/library\/publications\/2015\/demo\/p25-1143.pdf. 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