# Designing Beyond Language: Sociotechnical Barriers in AI Health Technologies for Limited English Proficiency

arXiv: https://arxiv.org/abs/2511.07277 · HTML: https://mlsanity.com/paper/2511.07277/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 39 of its 176 references that are in the map.
- First posted on arXiv 10 Nov 2025.

## Builds on (most cited first, 30 of 39)

- [QLoRA: Efficient Finetuning of Quantized LLMs](https://mlsanity.com/paper/2305.14314/) (2023)
- [gpt-oss-120b & gpt-oss-20b Model Card](https://mlsanity.com/paper/2508.10925/) (2025)
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- [A Roadmap to Pluralistic Alignment](https://mlsanity.com/paper/2402.05070/) (2024)
- [AI Transparency in the Age of LLMs: A Human-Centered Research Roadmap](https://mlsanity.com/paper/2306.01941/) (2023)
- [A Recipe For Arbitrary Text Style Transfer with Large Language Models](https://mlsanity.com/paper/2109.03910/) (2021)
- [A Computational Approach to Politeness with Application to Social Factors](https://mlsanity.com/paper/1306.6078/) (2013)
- [Aligning Language Models to User Opinions](https://mlsanity.com/paper/2305.14929/) (2023)
- [NLPositionality: Characterizing Design Biases of Datasets and Models](https://mlsanity.com/paper/2306.01943/) (2023)
- [Better to Ask in English: Cross-Lingual Evaluation of Large Language Models for Healthcare Queries](https://mlsanity.com/paper/2310.13132/) (2023)
- [Aligning LLMs with Individual Preferences via Interaction](https://mlsanity.com/paper/2410.03642/) (2024)
- [Automated Lay Language Summarization of Biomedical Scientific Reviews](https://mlsanity.com/paper/2012.12573/) (2020)
- [Creating General User Models from Computer Use](https://mlsanity.com/paper/2505.10831/) (2025)
- [Magentic-UI: Towards Human-in-the-loop Agentic Systems](https://mlsanity.com/paper/2507.22358/) (2025)
- [CowPilot: A Framework for Autonomous and Human-Agent Collaborative Web Navigation](https://mlsanity.com/paper/2501.16609/) (2025)
- [Few-shot Personalization of LLMs with Mis-aligned Responses](https://mlsanity.com/paper/2406.18678/) (2024)
- [Paper Plain: Making Medical Research Papers Approachable to Healthcare Consumers with Natural Language Processing](https://mlsanity.com/paper/2203.00130/) (2022)
- [BenchMAX: A Comprehensive Multilingual Evaluation Suite for Large Language Models](https://mlsanity.com/paper/2502.07346/) (2025)
- [Physician Detection of Clinical Harm in Machine Translation: Quality Estimation Aids in Reliance and Backtranslation Identifies Critical Errors](https://mlsanity.com/paper/2310.16924/) (2023)
- [Modeling Cross-Cultural Pragmatic Inference with Codenames Duet](https://mlsanity.com/paper/2306.02475/) (2023)
- [The impact of generative artificial intelligence on socioeconomic inequalities and policy making](https://mlsanity.com/paper/2401.05377/) (2023)
- [ValueCompass: A Framework for Measuring Contextual Value Alignment Between Human and LLMs](https://mlsanity.com/paper/2409.09586/) (2024)
- [NLP for Maternal Healthcare: Perspectives and Guiding Principles in the Age of LLMs](https://mlsanity.com/paper/2312.11803/) (2023)
- [User-Driven Value Alignment: Understanding Users' Perceptions and Strategies for Addressing Biased and Discriminatory Statements in AI Companions](https://mlsanity.com/paper/2409.00862/) (2024)
- [Sensing Wellbeing in the Workplace, Why and For Whom? Envisioning Impacts with Organizational Stakeholders](https://mlsanity.com/paper/2303.06794/) (2023)
- [AI Chatbots for Mental Health: Values and Harms from Lived Experiences of Depression](https://mlsanity.com/paper/2504.18932/) (2025)
- [Mapping Caregiver Needs to AI Chatbot Design: Strengths and Gaps in Mental Health Support for Alzheimer's and Dementia Caregivers](https://mlsanity.com/paper/2506.15047/) (2025)
- [Human-Centered Privacy Research in the Age of Large Language Models](https://mlsanity.com/paper/2402.01994/) (2024)
- [Targeted Multilingual Adaptation for Low-resource Language Families](https://mlsanity.com/paper/2405.12413/) (2024)
- [Not Like Us, Hunty: Measuring Perceptions and Behavioral Effects of Minoritized Anthropomorphic Cues in LLMs](https://mlsanity.com/paper/2505.05660/) (2025)

## Built on by (most cited first, 1 of 1)

- [Personalizing Personal Health Interfaces: Co-Design with Generative AI](https://mlsanity.com/paper/2609.15046/) (2026)

## Abstract (arXiv)

Limited English proficiency (LEP) patients in the U.S. face systemic barriers to healthcare beyond language and interpreter access, encompassing procedural and institutional constraints. AI advances may support communication and care through on-demand translation and visit preparation, but also risk exacerbating existing inequalities. We conducted storyboard-driven interviews with 14 patient navigators to explore how AI could shape care experiences for Spanish-speaking LEP individuals. We identified tensions around linguistic and cultural misunderstandings, privacy concerns, and opportunities and risks for AI to augment care workflows. Participants highlighted structural factors that can undermine trust in AI systems, including sensitive information disclosure, unstable technology access, and low literacy. While AI tools can potentially alleviate social barriers and institutional constraints, there are risks of misinformation and reducing human-to-human interactions. Our findings contribute AI design considerations that support LEP patients and care teams via rapport-building, educational and language support, and minimizing disruptions to existing practices.