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Introduction: Globalization has increased the importance of multicultural research to address health disparities and improve healthcare outcomes for underrepresented communities. The International Nursing Network for HIV Research (The Network) serves as a platform for researchers to collaborate on cross-cultural and cross-national HIV studies. This article discusses the Network's approach to overcoming barriers in multicultural and multinational research in a qualitative context. Methods: The network created a protocol to guide decision-making throughout the translation process of qualitative data collected from participants in their native languages. The protocol includes aspects of why, when, what, who, how, where, and by what means the translation is completed. Results: The protocol has allowed researchers to enhance the validity, reliability, and cultural sensitivity of translation process, ensuring the clarity and impact of their research findings. Discussion: Rigorous translation practices promote cross-cultural understanding and respect for participants' perspectives, fostering global collaborations and knowledge exchange. [ABSTRACT FROM AUTHOR]

Purpose: Large language models continue to dramatically change the medical landscape. We aimed to explore the utility of ChatGPT in providing accurate, actionable, and understandable generative medical translations in English, Spanish, and Mandarin pertaining to Otolaryngology. Methods: Responses of GPT-4 to commonly asked patient questions listed on official otolaryngology clinical practice guidelines (CPG) were evaluated with the Patient Education materials Assessment Tool-printable (PEMAT-P.) Additional critical elements were identified a priori to evaluate ChatGPT's accuracy and thoroughness in its responses. Multiple fluent speakers of English, Mandarin, and Spanish evaluated each response generated by ChatGPT. Results: Total PEMAT-P scores differed between English, Mandarin, and Spanish GPT-4 generated responses depicting a moderate effect size of language, Eta-Square 0.07 with scores ranging from 73 to 77 (P-value = 0.03). Overall understandability scores did not differ between English, Mandarin, and Spanish depicting a small effect size of language, Eta-Square 0.02 scores ranging from 76 to 79 (P-value = 0.17), nor did overall actionability scores Eta-Square 0 score ranging 66–73 (P-value = 0.44). Overall a priori procedure-specific responses similarly did not differ between English, Spanish, and Mandarin Eta-Square 0.02 scores ranging 61–78 (P-value = 0.22). Conclusion: GPT-4 produces accurate, understandable, and actionable outputs in English, Spanish, and Mandarin. Responses generated by GPT-4 in Spanish and Mandarin are comparable to English counterparts indicating a novel use for these models within Otolaryngology, and implications for bridging healthcare access and literacy gaps. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Background: This study investigated the perceived barriers and potential facilitators for culturally sensitive care among general practitioners in Flanders. Understanding these dynamics is crucial for improving healthcare quality and equity. Methodology: Twenty-one in-depth interviews were conducted with Flemish GPs. Braun and Clarke's reflexive thematic analysis was employed to develop and interpret themes that elucidate shared underlying meanings and capture the nuanced challenges and strategies related to cultural sensitivity in healthcare. Results: Two core themes were generated: GPs' uncertainty and opposition. These themes manifest in emotional responses such as frustration, miscomprehension, and feelings of helplessness, influencing relational outcomes marked by patient disconnect and reduced motivation for cultural sensitivity. The barriers identified are exacerbated by resource scarcity and limited intercultural contact. Conversely, facilitators include structural elements like interpreters and individual strategies such as engagement, aimed at enhancing GPs' confidence in culturally diverse encounters. A meta-theme of perceived lack of control underscores the challenges, particularly regarding language barriers and resource constraints, highlighting the critical role of GPs' empowerment through enhanced intercultural communication skills. Conclusion: Addressing GPs' uncertainties and oppositions can mitigate related issues, thereby promoting comprehensive culturally sensitive care. Essential strategies include continuous education and policy reforms to dismantle structural barriers. Moreover, incentivizing culturally sensitive care through quality care financial incentives could bolster GP motivation. These insights are pivotal for stakeholders—practitioners, policymakers, and educators—committed to advancing culturally sensitive healthcare practices and, ultimately, for fostering more equitable care provision. [ABSTRACT FROM AUTHOR]

Background: Depression and anxiety are significant health burdens that greatly impact the quality of life of refugees and migrants. In this study, we have translated and culturally adapted the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Screener (GAD-7) into Kinyarwanda and performed a validation study in a United States (US) primary care setting. Methods: A committee of seven experts including psychiatric and family medicine providers, health researchers, and trained medical interpreters translated and culturally adapted the PHQ-9 and GAD-7, and incorporated feedback from cognitive interviews with bilingual participants. The translated instruments were then tested in a cross-sectional validation study. Analyses include internal consistency, discriminant validity, principal component analyses, and confirmatory factor analyses. Results: Analyses of 119 responses indicated overall good internal consistency with Cronbach's α of 0.85 (PHQ-9) and 0.92 (GAD-7). Both scales showed acceptable factor loadings between 0.44 and 0.90 in the principal component analyses and showed strong correlations with health-related quality of life and depression/anxiety symptoms measured with visual analog scales. Significantly higher scores for PHQ-9 and GAD-7 were shown among participants with known psychiatric conditions. Discussion: PHQ-9 and GAD-7 demonstrated commendable applicability for Kinyarwanda-speaking patients in primary healthcare settings in the US. Our instruments can already be used in primary care settings and thus help to mitigate health disparities. Future research should further validate our tool against gold-standard diagnostics in larger, geographically diverse samples. [ABSTRACT FROM AUTHOR]

Background/Objectives: Medical interpreters support communication between medical professionals and foreign patients. However, the communication skills required of medical interpreters in the field are currently unclear. The purpose of this study was to investigate what medical professionals and medical interpreters consider to be most important communication skills of medical interpreters, and whether there are differences in perceptions between medical professionals and medical interpreters. Methods: From December 2023 to February 2024, we interviewed 10 medical professionals and medical interpreters (five medical professionals and five medical interpreters) working throughout Japan and in the United States. The narratives collected in the interviews were analyzed and evaluated in a conceptual framework. Results: Healthcare professionals and medical interpreters exhibited differences in perceptions regarding the most important communication skills for medical interpreters. The narratives of medical professionals and medical interpreters regarding medical interpreters' communication skills were divided into a 2 × 2 grid consisting of four quadrants with two axes (intervention and perspective). Regarding the communication skills of medical interpreters, medical professionals were primarily concerned with the transmission of medical information and felt that it was necessary for interpreters to understand medical professionals' perspectives and what they wanted to say in order to convey it accurately. In contrast, medical interpreters emphasized the importance of empathy and communication skills for respecting the other person and understanding the other person's opinion and perspective. Additionally, to understand the patient's perspective, medical interpreters reported that it was important to understand the cultural background of the patient and to maintain good relationships with all of the people around the patient. Conclusions: We explored the communication skills of medical interpreters and the characteristics of the perceptions and narratives of medical professionals and medical interpreters. Concepts regarding the communication skills of medical interpreters were divided into two axes (intervention and perspective) and presented as a 2 × 2 grid with four quadrants. The results of our study suggested that medical interpreters should actively intervene in interpretation situations involving foreign patients. [ABSTRACT FROM AUTHOR]

Issue Addressed: Patients with low English proficiency (LEP) often require interpreter services in health care, however, their usage remains low. This study aimed to explore the barriers to accessing interpreter services and suggests ways services can be improved in hospitals. Methods: We conducted focus groups with clinicians and a retrospective audit of patient records. The clinicians were recruited from the inpatient wards and Emergency Department in a Sydney hospital, August 2022. The focus group discussion explored clinicians' experiences using an interpreter, and ways to improve access to the service. It was recorded, transcribed and coded thematically using Braun and Clarke's (2006) 6‐step framework. The patient record data were linked with the interpreter service booking data to determine whether patients flagged as requiring an interpreter on admission were provided with the service. Results: Two focus groups were conducted with clinicians (N = 9 in total). Long wait times for telephone interpreters, an inflexible booking system, and low availability of in‐person interpreters were identified as the barriers. The COVID‐19 pandemic also impacted in‐person service provision. Conclusion: Some systemic barriers including an inflexible booking process and long wait times for immediate interpreter services were identified. The low use of interpreter services is attributed to the difficulties accessing the service and poor documentation in patient records. So What?: Greater availability of in‐person interpreter services, an upgraded booking system, and effective implementation the NSW Health Standard Procedures for Working with Health Care Interpreters will address some of these barriers. [ABSTRACT FROM AUTHOR]

Background: The study explores the language barriers between two language minority populations and healthcare professionals in the Volta Region of Ghana. Methods: An interpretive description with a qualitative approach to data collection and analysis was used. This study was carried out in the Tafi-Atome and Avatime-Vane communities, the Hohoe Municipal Hospital and the Margaret Marquart Catholic Hospital in the Kpando Municipality. In all, 46 respondents comprising 19 purposively sampled community members (patients) from the two selected communities and 27 conveniently sampled healthcare professionals from the two health facilities were interviewed. The face-to-face in-depth interviews were audio-recorded, transcribed and thematically analysed. Results: The study revealed a barrier in language use between healthcare professionals and patients from the two language minority communities. While healthcare professionals preferred to use English, Akan and Ewe, the patients, on the other hand, preferred their native languages, which are Sideme and Tegbor. The services of unqualified interpreters were utilised by both healthcare professionals and patients. Study participants were aware of these challenges, which prevented the patients from receiving optimum healthcare services, and the healthcare workers from delivering client-centred healthcare services. Conclusions: The presence of communication challenges emanating from language barriers between healthcare professionals and patients should be considered as a key hindrance to the attainment of the Sustainable Development Goal Three (SDG3), which aims to promote health and well-being at all ages. Therefore, stakeholders in the healthcare delivery system in Ghana need to prioritize stronger communication and translation practices and policies. [ABSTRACT FROM AUTHOR]

This study aimed to conduct a cross-sectional questionnaire survey of foreign patients to analyze the impact of patients' illness perceptions on their need for professional medical interpreters. From February 2022 to May 2023, an online questionnaire was distributed to 4,962 individuals aged 18 years or older who were non-native speakers of Japanese. These individuals were enrolled in organizations such as international exchange associations and Japanese language support classes and had utilized medical institutions in Japan due to their own illness or injury or that of their children. Among the 312 valid responses, international patients with a high score for illness perception were more likely to want to utilize professional medical interpreters than those with a low score for illness perception (odds ratio, 1.968; 95% confidence interval, 1.044–3.709; P = 0.036). Our findings suggest that hospitals should be better prepared to meet the potential language needs of international patients with a higher illness perception. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify the challenges encountered by bilingual service providers working with survivors of intimate partner violence (IPV). Latinx experience IPV at a high rate, and their ability to seek services is affected by multiple factors, including their immigration status, English language proficiency, and lack of familiarity with the U.S. healthcare system. Bilingual service providers working in shelters often treat Latinx in Spanish. While some research exists on the stressors associated with providing IPV services in shelters, nothing is known about how being bilingual affects service providers. This qualitative study was designed to fill this gap. The findings yielded two themes: difficult workload and service provider exhaustion. The disproportionate rate of IPV services requiring services in Spanish and the available staff equipped to serve them often results in high caseloads and additional responsibilities for bilingual service providers. The lack of training in both service provision in Spanish and serving monolingual Spanish-speaking IPV survivors increases the strain of providing quality client care. Emotional and mental exhaustion is a common experience when serving trauma clients; however, it can be compounded for bilingual service providers, who must also use a second language. Agencies must consider the work demands of bilingual service providers to ensure that the expectations are balanced and reasonable. More Spanish-speaking providers are needed to meet the need, and evidence-based training must be developed and widely disseminated. [ABSTRACT FROM AUTHOR]

Background: Patients with limited English proficiency that are hospitalized without regular access to professional medical interpreters have a longer length of stay (LO S).1 The authors studied the difference in LO S between English-speaking patients and patients with limited English proficiency in New Hampshire's only academic trauma medical center. The authors also examined race, ethnicity, and distance of residence from hospital. Methods: Retrospective data were queried from EPIC, the electronic medical record system used by the authors. Queried data focused on inpatient hospitalizations between January 1, 2019, and December 31, 2021. Patient primary language was grouped into English, Spanish, and other non-E nglish language. Results: Spanish-speaking patients live on average 39.6 miles farther from a hospital than English-speaking patients and have a 0.34 lower case mix index. After English, Spanish is the second-most frequently spoken language. Regression analyses found language to be a significant factor in LO S, LO S variance, and case mix index. Discussion: A 2.34-day longer LO S for Spanish-speaking patients demonstrates an important health care disparity warranting further attention. [ABSTRACT FROM AUTHOR]

Introduction: Language barriers are prevalent across growing societies and are likely to become a larger issue with further population growth. Language barriers impair communication between patients and physical therapists. This systematic review addresses how language barriers between patients and physical therapists impact clinicians' perceived quality of care. Methods: A stepwise search of databases based on key terms was conducted, followed by abstract and full-text screenings with inclusion and exclusion criteria. Eight articles were included in the final review. Results: Screening processes resulted in the inclusion of eight articles from which abstracted information was sorted into six different categories. In total, six articles addressed overall clinical perception, four articles spoke of interpretive services, seven articles detailed methods of communication in practice, five articles on tests and measures, four articles on establishing rapport, and two articles factored cultural components. Discussion: Collected information was analyzed within topics of patient interactions, interpretive services, visit mechanics, and clinician's perception of self. These themes demonstrated that language barriers can negatively impact clinician-perceived care quality. Examples include limiting the collection of patient history, usage of standardized tests, and other aspects of best practice, ultimately hindering clinician autonomy. Conclusion: There are benefits and disadvantages to communication methods used within clinical settings for therapists when negotiating language barriers. Legislation often states that interpretive services must be provided to patients but does not delineate specific guidelines. Governing bodies in physical therapy could provide more formalized guidelines and education to address language barriers in practice. [ABSTRACT FROM AUTHOR]

This article explores the extent to which healthcare interpreting can be considered "relational practice." It describes an interactional sociolinguistic study conducted in Australia, based on video recordings of two naturally occurring interpreted general practice consultations. Participants were hearing Australian Sign Language (Auslan)/English interpreters, deaf patients, and hearing doctors. Analysis of these recordings was supplemented by reflective interviews with participants. The study examines the ways in which interpreters facilitate good working relationships between participants, and to explore the extent to which their decision-making is driven by relational considerations. The analyses presented in this article provide evidence that relational work is an important aspect of the healthcare interpreter's role. Some of the ways in which it is achieved, however, may challenge our ideas about "appropriate" interpreter behaviour. Thus, the skilled and experienced interpreters in the study were seen to modify face threats, directly influence the flow of interaction, and actively facilitate social talk and humour, occasionally even engaging in it themselves. It is argued that interpreters' decisions can only be understood within the discursive context in which they occur, and such behaviour can highlight interpreters' attentiveness to the maintenance of good rapport. [ABSTRACT FROM AUTHOR]

The article discusses the importance of language in psychiatry and the challenges posed by linguistic diversity in medical education, particularly in India. It highlights the need for language training programs to ensure effective communication and quality care for patients. The article introduces the Clinical Linguistic Proficiency Program (CLPP), a novel approach implemented in a tertiary care institute in Karnataka, India, to train psychiatric residents in Kannada and Hindi. The CLPP follows an adult learning model, emphasizes peer learning, and focuses on speaking skills first. It includes classroom training, role-playing exercises, and simulated practice to enhance residents' communication skills and cultural competence. The article concludes by discussing the strengths and limitations of the CLPP and suggesting future directions for its improvement and expansion. [Extracted from the article]

The book "Figures of Interpretation" explores the role of interpreters in various contexts and the ethical dilemmas they face. Through 31 narrative vignettes, the book introduces different individuals who work as interpreters, such as a journalist in the Middle East, an immigrant in the United States, a child in Spain, and a philosophy student in Switzerland. The book highlights the intersection of language work with factors like ethnicity, class, gender, and social and geopolitical conditions. It challenges traditional academic writing norms and prompts reflection on the politics of writing, knowledge production, and collaborative work. The book offers a unique perspective on structural inequalities and the potential for change. [Extracted from the article]

Background: Despite their essential role in language concordant patient care, medical interpreters do not routinely receive training focused on difficult conversations and may not feel comfortable interpreting these encounters. Previous studies, while acknowledging the need for increased support, have provided limited strategies targeted at enhancing interpreter training and improving interpreter comfort levels in difficult conversations. Methods: Fifty-seven in-person medical interpreters providing services at our quaternary and community hospitals completed a 21-question mixed-methods survey regarding their comfort levels and experiences surrounding serious illness conversations. Results: Most medical interpreters reported being uncomfortable interpreting conversations surrounding difficult diagnosis, poor prognosis, and/or end-of-life. Nearly all respondents (98%) indicated that pre-meetings and/or debriefings with the medical team are helpful, yet only 25% reported frequent participation in these meetings. Conclusions: Our study highlighted the significant variability in medical interpreter training as well as ranging comfort levels in interpreting difficult conversations. Medical providers should not presume that interpreters are instantly prepared for these encounters. Current findings call for novel training opportunities specific to medical interpreters and difficult dialogues, as well as improved adherence of interprofessional pre-meeting/debriefings when serious news is discussed. [ABSTRACT FROM AUTHOR]

This study describes medical interpreters' experiences with behavioral health (BH) services in a primary care clinic. Focus group data with medical interpreters representing multiple languages was analyzed using hybrid inductive-deductive thematic analysis. Themes related to interpreter roles were: (1) case management, (2) patient-interpreter relationship, and (3) patient-provider liaison. Themes related to barriers and facilitators to interpreter-mediated BH care were: (1) cultural factors, (2) patient-provider interactions, (3) BH-specific considerations, and (4) clinic factors. Results illustrate ways that interpreters directly (e.g. interpreter-mediated services) and indirectly (e.g. relationship building) support care. The interpreter-patient relationship reportedly helped improve patient attitudes and buy-in for BH. [ABSTRACT FROM AUTHOR]

• Australian Pelvic Floor Questionnaire (APFQ) as a comprehensive female pelvic floor questionnaire. Moreover, the APFQ was recently acknowledged as an attractive tool for patients, clinicians, and researchers. • There has been no study validating APFQ in Indonesia. • The translation and cross-cultural adaptation were conducted by forward translation to Bahasa Indonesia by two medical translators along with consultants of urogynecology, backward translation to English by another medical translator, comparison between the original and the translated version of the questionnaire, and debriefing of the new translation to the physicians and patients. • The Indonesian version of APFQ was administered consecutively to women aged ≥ 18 years old in two study groups. The urogynecology patient group consisted of urogynecology clinic patients with pelvic floor disorders and, the community (control) group consisted of similarly aged women without any pelvic floor disorders within the last 6 months prior to the recruitment. • The questionnaire can significantly discriminate between pelvic floor dysfunction patients and those without dysfunctions. The results of each domain of the questionnaire correlated with clinical examinations and another questionnaire. • The Indonesian version of the Australian Pelvic Floor Questionnaire (APFQ) is a valid and reliable questionnaire for assessing pelvic floor symptoms among women in Indonesia. To adapt and determine the validity and reliability of the Indonesian version of the Australian Pelvic Floor Questionnaire (APFQ). The original APFQ was translated and validated to obtain an Indonesian, physician-administered version on 41 urogynecology patients and 41 age-matched women without pelvic floor dysfunction. Missing answers never exceeded 2%. The questionnaire can significantly discriminate between pelvic floor dysfunction patients and those without dysfunctions. The results of each domain of the questionnaire correlated with clinical examinations and another questionnaire. Cronbach's alpha scores of all domains were 0.859 for bladder function, 0.829 for bowel function, 0.892 for prolapse symptoms, and 0.766 for sexual function. The Indonesian version of the Australian Pelvic Floor Questionnaire (APFQ) is a valid and reliable questionnaire for assessing pelvic floor symptoms among women in Indonesia. [ABSTRACT FROM AUTHOR]

Background Deaf and hard of hearing people persistently experience barriers accessing health services, largely due to ineffective communication systems, a lack of flexible booking arrangements, and a lack of Deaf awareness training for health professional staff. Methods Face to face focus groups were conducted with 66 Deaf and hard of hearing people in Deaf clubs across Wales, UK. Thematic analysis was undertaken. Results Responses identified from focus groups are reported as barriers faced using health services, improvements that would make a difference, impact of accessibility of health services, and a potential Sign language badge for healthcare staff. Conclusions Deaf people report that health professionals lack training on Deaf awareness and do not know how to communicate effectively with Deaf and hard of hearing people. Further research into Deaf awareness and training resources for health professionals are needed to establish what improves Deaf cultural competencies, and ultimately makes healthcare experiences more positive for people who are Deaf. [ABSTRACT FROM AUTHOR]

Objective: Despite the decrease in the number of foreign visitors and residents in Japan due to the coronavirus disease 2019, a resurgence is remarkable from 2022. However, Japan's medical support system for foreign patients, especially residents, is inadequate, with language barriers potentially causing health disparities. Comprehensive interpretation and translation services are challenging, but "plain Japanese" may be a viable alternative for foreign patients with basic Japanese language skills. This study explores the application and obstacles of plain Japanese in the medical sector. Methods: A literature review was performed across these databases: Web of Science, PubMed, Google Scholar, Scopus, CINAHL Plus, Springer Link and Ichushi-Web (Japanese medical literature). The search covered themes related to healthcare, care for foreign patients, and scholarly articles, and was conducted in July 2023. Results: The study incorporated five papers. Each paper emphasized the language barriers foreign residents in Japan face when accessing healthcare, highlighting the critical role and necessity of plain Japanese in medical environments. Most of the reports focused on the challenges of delivering medical care to foreign patients and the training of healthcare professionals in using plain Japanese for communication. Conclusion: The knowledge and application of plain Japanese among healthcare professionals are inadequate, and literature also remains scarce. With the increasing number of foreign residents in Japan, the establishment of a healthcare system that effectively uses plain Japanese is essential. However, plain Japanese may not be the optimal linguistic assistance in certain situations, thus it is imperative to encourage more research and reports on healthcare services using plain Japanese. [ABSTRACT FROM AUTHOR]

In 2020 it is estimated that 281 million people were international migrants. Migrants constitute a potentially vulnerable population in terms of facing discrimination, poor living and housing conditions, and insufficient access to healthcare services. Due to the armed conflict in Ukraine in 2022, almost 10 million people crossed the Polish border within a year of the outbreak of the conflict. The objective of this paper is to present the use of primary healthcare services by people migrating from Ukraine to Poland and identify the barriers in access to healthcare by this group of persons. This study used a qualitative research technique in the form of an expert interview using individual in-depth interviews (IDI). The study group consisted of professionally active primary healthcare providers (doctors, nurses, and facility managers) in Poland. Research was carried out in the areas regarding the availability of healthcare, the potential threats and challenges, and possible system solutions. The results showed that the most common cause for doctor's appointments among migrants are respiratory infections, including COVID-19. Many cases were related to back pain, mainly resulting from the physical work of the patients. Additionally, some barriers to access and the provision of healthcare services for patients from Ukraine were identified. The majority (75%) of respondents indicated language as a significant barrier when providing services. Based on the study results, we recommend creating a dedicated website and telephone hotline for this group of persons as well as the use of traditional media to distribute information about access to healthcare services. It is also essential to focus on assistance for older people, since they may experience more difficulties with language and navigating the healthcare system. [ABSTRACT FROM AUTHOR]

Introduction: A growing body of research is examining how healthcare systems are responding to the increasing numbers of migrants and the resulting superdiversity of patients. The aim of this article is to identify and explain communication barriers in the provision of healthcare to Ukrainian war refugees in the Czech Republic from the perspectives of healthcare professionals and intercultural mediators. Methods: The exploratory case study is based on a qualitative analysis of semi‐structured interviews with frontline health professionals: 20 with doctors and 10 with nurses. The second source of data is two focus groups aimed at capturing communication problems from the perspective of intercultural mediators who accompany refugees to health facilities. The interview transcripts and FGs were analysed using six‐stage thematic coding. Results: The survey identified five main themes related to barriers to communication: (1) language barriers and interpreting, (2) cultural barriers, (3) differing expectations of health and the healthcare systems in the Czech Republic and Ukraine, (4) prejudices and negative attitudes and unethical behaviour towards refugees and migrants and (5) lack of awareness of patient rights. Conclusions: The arrival of large numbers of migrants has highlighted deficiencies in the system that may affect other vulnerable groups and the general population. These include the lack of general communication skills and legal awareness among many health professionals, which are barriers to the development of patient‐centred care. The involvement of intercultural mediators fundamentally improves communication between health professionals and (not only) migrant patients. Nevertheless, it is necessary to legally anchor and define the position of intercultural mediators within the healthcare system. Patient or Public Contribution: Collaboration with intercultural mediators who interpreted the extensive experiences of Ukrainian refugee patients and also have personal experience as migrant or migrant‐origin patients contributed to shaping research questions, facilitating study participation and enriching evidence interpretation. Researchers with multicultural backgrounds and experience with working with people from refugee backgrounds were involved in the study design and analysis. [ABSTRACT FROM AUTHOR]

Introduction: The adoption of remote healthcare methods has been accelerated by the COVID‐19 pandemic, but evidence suggests that some patients need additional support to engage remotely, potentially increasing health disparities if needs are not met. This study of COVID‐19 remote home monitoring services across England explores experiences of and engagement with the service across different patient groups. Methods: This was a mixed‐methods study with survey and interview data collected from 28 services across England between February and June 2021. Surveys were conducted with staff and patients and carers receiving the service. Interviews with staff service leads, patients and carers were conducted in 17 sites. Quantitative data were analysed using univariate and multivariate methods, and qualitative data were analysed using thematic analysis. Findings: Survey responses were received from 292 staff and 1069 patients and carers. Twenty‐three staff service leads, 59 patients and 3 carers were interviewed. Many service leads reported that they had considered inclusivity when adapting the service for their local population; strategies included widening the eligibility criteria, prioritising vulnerable groups and creating referral pathways. However, disparities were reported across patient groups in their experiences and engagement. Older patients reported the service to be less helpful (p = 0.004), were more likely to report a problem (p < 0.001) and had more difficulty in understanding information (p = 0.005). Health status (p = 0.004), ethnicity (p < 0.001), gender (p < 0.001) and employment (p = 0.007) were associated with differential engagement with monitoring, and minority ethnic groups reported more difficulty understanding service information (p = 0.001). Qualitative data found illness severity to be an important factor in the support required, and patients' living situation and social network affected whether they found the service reassuring. Conclusion: Addressing health disparities must be a key focus in the design and delivery of remote care. Services should be tailored to match the needs of their local population, encourage access through collaboration and referral pathways with other services and monitor their inclusiveness. Involving patients and staff in service design can illuminate the diversity of patients' needs and experiences of care. Patient or Public Contribution: The study team met with service user and public members of the BRACE PPI group and patient representatives from RSET in a series of workshops. Workshops informed study design, data collection tools, data interpretation and dissemination activities. Study documents (such as consent forms, topic guides, surveys and information sheets) were reviewed by PPI members; patient surveys and interview guides were piloted, and members also commented on the manuscript. [ABSTRACT FROM AUTHOR]

Limited English proficient patients are prone to adverse health care effects compared to English proficient patients, including decreased access to care, lower health literacy, and worse clinical outcomes. This report describes a multi-modal medical interpreter program at a safety-net health system designed for the emerging Afghan population in San Antonio, Texas. [ABSTRACT FROM AUTHOR]

Background. Asian Americans (AA) face cultural and linguistic barriers to health care access, resulting in poor health outcomes. This study investigates the experiences of AAs using language interpretation services (LIS) in health care settings. Methods. Using a mixed-methods approach, we conducted a community survey (N=401) and seven focus groups between April and September 2023. We use the Andersen model to understand the experience around LIS for AAs and calculated descriptive statistics for predisposing (i.e. sociodemographic factors and attitudes toward LIS), enabling (i.e. perceived barriers), and need factors (i.e. perceived need for LIS). Focus groups were analyzed using a modified template approach to text analysis. Results. Quantitative and qualitative analyses found that although AAs recognize the benefits and need for LIS, various barriers (e.g. lack of interpreters when booking an appointment) preclude these communities from accessing these services. Conclusions. Results from this study will help inform interventions that seek to improve LIS within health care systems. [ABSTRACT FROM AUTHOR]

Translating medical terminologies from English into Arabic poses a challenge that usually directly impacts precision and efficiency in medical communication and, hence, the treatment of patients. This paper aims to explore terminology inconsistencies in medical translation and propose methods to enhance accuracy and consistency, thereby addressing a research gap that ultimately impacts healthcare delivery. It addresses research questions regarding common medical inconsistencies in English-to-Arabic translation, their impact on patients as perceived by healthcare professionals, and the tools and strategies employed by medical translators to ensure accuracy. The study is both quantitative and qualitative in nature. In the qualitative part, 100 medical terms were given to 10 medical translators. Out of 100 terms, the study qualitatively analyses 10 translated terms with high inconsistency. The data were classified according to subjects such as ambiguity in the source terminology, variability in translator proficiency, and cultural factors impacting translation. The thematic categorisation of the responses provides an analysis of the main factors contributing to terminological inconsistencies and the challenges faced when translating medical terminology across various specialties. Additionally, two open-ended surveys were disseminated, one involving 50 medical translators and 50 medical specialists in the quantitative part. The respondents' feedback was analysed to determine the types of errors, their impact on patient clinical outcomes, and the effectiveness of translation processes and tools. The study found that an overwhelming majority of doctors (80%) and nurses (75%) constantly come across examples of translation errors. Medical translators pointed out the complexity of medical vocabulary and professional development in developing continuous improvement. The impact on patient care was significant. Examples given in the findings included poorly understood terms such as 'hypertension', 'myocardial infarction', and 'cerebrovascular accident'. Other strategies identified to review and eliminate errors were translation tools, quality control by peer and cadre support, and continuing education. Cultural differences and localisation were cited as influential in delivering accurate translations. The implications of this research are significant for medical translators, healthcare professionals, and patients. Since there will be an improvement in the quality of translation practices, the accuracy of the communication is more likely to improve. Hence, there will be health-related outcomes for patients and seekers of health information. [ABSTRACT FROM AUTHOR]

This article explores the consequences of the loss of indigenous languages on native health, healing, and cultural wellbeing. It emphasizes the connection between indigenous languages and native medicine, noting that as these languages decline, so do the medicinal benefits of native medicine. The article discusses how colonization has intentionally eroded native medicinal knowledge, leading to negative health outcomes for indigenous communities. It argues that reconnecting young natives to their cultural practices, including language, can improve health outcomes, and suggests incorporating native language and cultural views into healthcare appointments for more inclusive and effective care. The text also highlights the impact of language loss on Native American communities and their traditional medicine practices, emphasizing the need to preserve indigenous languages and cultural practices to improve the health outcomes of Native Americans. [Extracted from the article]

The article discusses research which analyzed the perceptions of teachers of deaf and hard of hearing (D/HH) students on inclusive and interpreted education. It explored the challenges associated with the application of inclusive models in teaching D/HH students, the perspectives offered by research participants on the roles of educational interpreters assigned in individualized education programs (IEP) for concerned students, and the concerns about the lack of oversight for these interpreters.

Medical interpreters aid in providing culturally sensitive palliative care to patients with limited-English proficiency. However, navigating their complex, and sometimes contradictory, roles and the sensitive nature of the content in palliative care encounters can negatively impact medical interpreters. Compassion fatigue (CF) and secondary traumatic stress (STS) are concepts that have been explored in many healthcare professionals but have not been fully explored in medical interpreters in palliative care. This review examines the psychometric properties of three measures of CF and STS that have been utilized in various populations of healthcare providers. There are no measures of CF or STS that have been shown to be valid and reliable in medical interpreters participating palliative care encounters. Further research is needed to investigate the validity of the reviewed measures in medical interpreters, and it may be beneficial to modify existing tools to measure CF and STS more accurately in this population. [ABSTRACT FROM AUTHOR]

The role of healthcare interpreters has attracted much interest over the years, with particular emphasis on the distance between an invisible, uninvolved prescribed behaviour that contrasts with the interpreters' behaviour in practice as active participants. However, much of the existing literature focuses on unfolding medical consultations where providers, patients and interpreters are simultaneously present, often overlooking situations when interpreters are left alone with patients. This involves areas of special role complexity in which interpreters must choose whether or not to become visible to the patient in what has been defined as the in-between (Shaffer, 2020). This contribution aims to observe the healthcare interpreter's role beyond the very act of the medical interview. Inspired by Shaffer (2020), we examine 66 moments "in-between" involving a sample of six interpreters (including four student interns) that took place prior, mid and end of consultations in a Spanish hospital. Rather than staying invisible, our analysis reveals that interpreters of the sample often participate in moments in-between (89.39%) to enact different roles (i.e., companion/confidant, advocate for the profession, mediator, institutional navigator, and healthcare ambassador). Among other aspects, triggers for role adoption in the in-between space include preventing conflict and deploying empathy. In this study, the behaviour of interpreters has demonstrated to influence the subsequent development of medical consultations (e.g., saving time or facilitating history taking). In light of preliminary findings that must be interpreted considering our research context, the next step is to examine how the healthcare interpreter's behaviour in the in-between zone can facilitate interprofessional collaboration to provide patients with quality-care. [ABSTRACT FROM AUTHOR]

People with communication differences are known to have poorer hospital outcomes than their peers. However, the combined impact of aphasia and cultural/linguistic differences on care and outcomes after stroke remains unknown. To investigate the association between cultural/linguistic differences, defined as those requiring an interpreter, and the provision of acute evidence-based stroke care and in-hospital outcomes for people with aphasia. Cross-sectional, observational data collected in the Stroke Foundation National Audit of Acute Services (2017, 2019, 2021) were used. Multivariable regression models compared evidence-based care and in-hospital outcomes (e.g., length of stay) by interpreter status. Models were adjusted for sex, hospital location, stroke type and severity, with clustering by hospital. Among 3122 people with aphasia (median age 78, 49% female) from 126 hospitals, 193 (6%) required an interpreter (median age 78, 55% female). Compared to people with aphasia not requiring an interpreter, those requiring an interpreter had similar care access but less often had their mood assessed (OR 0.50, 95% CI 0.32, 0.76), were more likely to have physiotherapy assessments (96% vs 90% p = 0.011) and carer training (OR 4.83, 95% CI 1.70, 13.70), had a 2 day longer median length of stay (8 days vs 6 days, p = 0.003), and were less likely to be independent on discharge (OR 0.54, 95% CI 0.33, 0.89). Some differences exist in the management and outcomes for people with post-stroke aphasia who require an interpreter. Further research to explore their needs and the practical issues underpinning their clinical care pathways is required. [ABSTRACT FROM AUTHOR]

This article presents a comprehensive analysis of the advancements and impact of medical translation during the Golden Age of Translation. It focuses on the fundamental role that translators and scholars played in disseminating medical knowledge, shaping medical practices, and fostering intellectual and cultural exchange. It also discusses the significance of the House of Wisdom in Baghdad, key translators and their contributions, as well as the influence of translated medical texts such as Avicenna's Canon of Medicine, Al-Razi's Book of Healing, and Al-Zahrawi's Comprehensive Book on Medicine. Also examined is the impact of translation on the standardization of medical terminology and the transmission of medical knowledge across cultures and regions. The article concludes by highlighting the lasting legacy of translations in terms of their impact on global medical knowledge and suggests possible areas in which to conduct further research on medical translation history, as well as the role of modern technology in understanding and interpreting historical medical texts. [ABSTRACT FROM AUTHOR]

Background Lack of communication in a family's preferred language is inequitable and results in inferior care. Pediatric residents provide care to many families with non-English or French language preferences (NEFLP). There is no data available about how Canadian pediatric residents use interpreters, making it difficult to develop targeted interventions to improve patient experience. Objectives Our purpose was to assess translation services in pediatric training centers and evaluate resident perception of their clinical skills when working with NEFLP patients and families. This survey represents the first collection of data from Canadian pediatric residents about interpreter services. Methods Eligible participants included all pediatric residents enrolled in an accredited Canadian pediatric training program. An anonymous survey was developed in REDCap© and distributed via email to all pediatric residents across Canada. Descriptive statistics were performed in STATA v15.1. Results 122 residents responded. Interpreter services were widely available but underused in a variety of clinical situations. Most (85%) residents felt they provided better care to patients who shared their primary language (English or French), compared with families who preferred other languages—even when an interpreter was present. This finding was consistent across four self-assessed clinical skills. Conclusions Residents are more confident in their clinical and communication skills when working with families who share their primary language. Our findings suggest that residents lack the training and confidence to provide equal care to families with varying language preferences. Pediatric training programs should develop curriculum content that targets safe and effective interpreter use while reviewing non-spoken aspects of cultural awareness and safety. Key Messages: What is already known on this topic. Healthcare interactions between providers and non-English speaking patients can result in decreased understanding of medical information, fewer opportunities to build a relationship with their provider, and risk of medical error. The use of professional interpreter services, whether in person or by telephone or video, can help to alleviate some of these risks. Patients and their families feel that their care is improved when practitioners speak to them in their preferred language. What this study adds. This study is the first to examine interpreter services available in Canadian pediatric training centers and assess residents' perception of their use. Interestingly, residents identify that the use of an interpreter only somewhat improves their abilities to perform clinical duties and build rapport with families who speak other languages. This finding illuminates that residency training programs must do more to educate trainees about safe and equitable care, and provides opportunity for future study of what families may feel is missing from their care. How this study might affect research, practice, or policy. Our results indicate the need for pediatric centers to implement easily accessible forms of translation services that can be used in the moment by care providers in all areas of the hospital. Training programs should investigate practitioner- and system-specific factors that prevent residents from performing at their best when working with patients who prefer a non-English language. [ABSTRACT FROM AUTHOR]

This article explores the interpreter's role and approaches to working with deaf students as seen from deaf individuals' and interpreters' perspectives. A group of 41 formerly mainstreamed deaf individuals and interpreters offered insights into how the interpreter's role in mainstream classrooms influences deaf student autonomy and participation. This research illustrates the significance of autonomy for mainstreamed deaf students and suggests a correlation between the interpreter's role and deaf students' perceived autonomy in the classroom. In addition, the findings suggest that deaf students do not always know what an interpreter is supposed to do in K-12 classrooms. This study also finds that educational team members do not always explicitly communicate their roles and responsibilities to deaf students, leading to confusion that impacts their autonomy and overall experience. Finally, this research finds that deaf students are not trained with the ability to negotiate and renegotiate the interpreter's role. This article concludes with considerations and recommendations for deaf education and interpreter education communities. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: More time spent with interpreters may support clinician-patient communication for patients with limited English proficiency (LEP), especially when interpreter support before and after clinical encounters is considered. We assessed whether more time spent with interpreters is associated with better patient-reported experiences of clinician-patient communication and interpreter support among patients with LEP. Methods: Patients with LEP (n = 338) were surveyed about their experiences with both the clinician and interpreter. Duration of interpreter support during the encounter (in min) and auxiliary time spent before and after encounters supporting patients (in min) were documented by interpreters. Multivariable linear regression models were estimated to assess the association of the time duration of interpreter support and patient experiences of (1) clinician-patient communication, and (2) interpreter support, controlling for patient and encounter characteristics. Results: The average encounter duration was 47.7 min (standard deviation, SD = 25.1), the average auxiliary time was 43.8 min (SD = 16.4), and the average total interpreter time was 91.1 min (SD = 28.6). LEP patients reported better experiences of interpreter support with a mean score of 97.4 out of 100 (SD = 6.99) compared to clinician-patient communication, with a mean score of 93.7 out of 100 (SD = 14.1). In adjusted analyses, total patient time spent with an interpreter was associated with better patient experiences of clinician-patient communication (β = 7.23, P <.01) when auxiliary time spent by interpreters supporting patients before and after the encounter was considered, but not when only the encounter time was considered. Conclusions: Longer duration of time spent with an interpreter was associated with better clinician-patient communication for patients with LEP when time spent with an interpreter before and after the clinician encounter is considered. Policymakers should consider reimbursing health care organizations for time interpreters spend providing patient navigation and other support beyond clinical encounters. [ABSTRACT FROM AUTHOR]

Introduction: Medical interpreters are crucial to ensure fair and high-quality healthcare for patients with limited English proficiency (LEP). Despite the need to use high-quality medical interpreters to communicate with LEP patients, medical schools often do not adequately educate their students on how to work with interpreters. Aims: This study seeks to investigate the efficacy of using peer-assisted learning to teach medical students how to properly use medical interpreters. Moreover, the study strives to elucidate if an interactive peer-led model can be an effective teaching modality to train medical students about the basics of using medical interpreters. Methods: A pre- and post-training design was utilized to investigate the efficacy of peer-assisted learning in teaching medical students how to use interpreters. Second year medical students led a two-part workshop consisting of the following: (1) a didactic training session and (2) a practical session where learners interacted with Spanish-speaking standardized patients through an interpreter. Pre-training and post-training responses to survey questions were analyzed to determine changes in student comfort, confidence, and knowledge of best practices when using a medical interpreter. Results: There was a statistically significant increase in comfort and confidence with using interpreters after receiving peer-assisted training. Conclusions: A peer-led didactic training followed by an interactive training session can increase student comfort and confidence with using medical interpreters in clinical settings. Peer-assisted-learning may be an effective way to teach some of the best practices of using medical interpreters. [ABSTRACT FROM AUTHOR]

The article discusses nurses' ethical responsibilities in caring for patients with Limited English Proficiency (LEP), emphasizing the importance of routine assessment of language preferences and access to professional interpreters to optimize healthcare outcomes and prevent errors.

This pilot study assessed the feasibility of implementing a pain assessment information visualization (InfoViz) tool to address cultural and language barriers among limited English proficiency (LEP) Hmong patients in primary care. We used a static group comparison design to collect data from 20 patient, interpreter, and provider triads under usual care (i.e., interpreter using verbal pain descriptions), followed by another 20 triads under the intervention (i.e., interpreter using verbal pain descriptions and the InfoViz tool). Feasibility outcomes included recruitment and retention rates, InfoViz tool completion, acceptability, and fidelity. We also assessed mutual understanding (MU) and pain electronic health record (EHR) documentation. Descriptive data were calculated and thematic analysis was conducted. Thirty‐six LEP Hmong patients (n = 29 female, mean age = 59.03), 27 providers (n = 15 female), and four interpreters participated in this study. The patient recruitment rate was 18% while the retention rate was 81%. Interpreter recruitment rate was 80%, and 75% for retention rate. The intervention fidelity mean score was 83%. In the intervention condition, patient–provider MU of pain severity improved by 30%, coupled with a 28% increase in pain severity EHR documentation compared to usual care. While communication of pain quality did not improve, there was a higher mean number of pain descriptors (3.31 in the intervention vs. 1.79 in usual care) in EHR documentation. All participants had a positive experience with the tool, reporting it as valuable with 100% completeness of all tools. Findings revealed the tool was acceptable and feasible to use among LEP patients–interpreters–providers, providing support for an efficacy study. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify interpretation challenges specific to exome sequencing and errors of potential clinical significance in the context of genetic counseling for adults at risk for a hereditary cancer syndrome. Thirty transcripts of interpreter-mediated telephone results disclosure genetic counseling appointments were coded for errors by bilingual researchers, and the coders applied an overall rating to denote the degree to which the errors interfered with communication overall. Genetic counselors reviewed a subset of errors flagged for potential clinical significance to identify those likely to have clinical impact. Qualitative interviews with 19 interpreters were analyzed to elucidate the challenges they face in interpreting for genetic counseling appointments. Our analysis identified common interpretation errors such as raising the register, omissions, and additions. Further, we found errors specific to genetic counseling concepts and content that appeared to impact the ability of the genetic counselor to accurately assess risk. These errors also may have impacted the patients ability to understand their results, access appropriate follow-up care, and communicate with family members. Among interpreters strengths was the use of requests for clarification; in fact, even more use of clarification would have been beneficial in these encounters. Qualitative interviews surfaced challenges stemming from the structure of interpreter work, such as switching from medical and nonmedical interpretations without substantial breaks. Importantly, while errors were frequent, most did not impede communication overall, and most were not likely to impact clinical care. Nevertheless, potentially clinically impactful errors in communication of genetics concepts may contribute to inequitable care for limited English proficient patients and suggest that additional training in genetics and specialization in healthcare may be warranted. In addition, training for genetic counselors and guidance for patients in working effectively with interpreters could enhance interpreters transmission of complex genetic concepts.

The article addresses the challenges faced by Limited English Proficiency (LEP) communities in accessing medical interpretation services, focusing on Michigan's policy on these services. Topics discussed include the limitations of current policies in considering patient preferences for interpreters, the challenges posed by the shortage and underutilization of medical interpreters, and the need for cultural sensitivity in interpretation practices.

In 2015, my father was diagnosed with primary progressive aphasia (PPA), a type of frontotemporal dementia that my family and I knew nothing about. Medical professionals told us that there was no research on the disease, and I believed this until very recently. I took a class in neurobiology, leading me to attempt to document this lack of research and create a call to action for the research and treatment of rare disorders. However, I was met with an overwhelming amount of information regarding PPA that I was not expecting to find. I was frustrated that I was not given this information; moreover, I did not understand why it was all being 'hidden' from me. After discussion with my mother, I realized that my science education allowed me to find and interpret this information, but more importantly, that not everyone has this same privilege. My call to action pivoted into a call for better communication and for open access to biomedical information. Regardless of the existence and quality of literature about rare diseases, most of the information is out of reach of the public.The public often does not have the scientific literacy to understand the complexities of the genre that is required for comprehension. I recognize that not every patient and family may wish to access the information generated by biomedical research. I argue that they have a right to examine these findings because they are the ones that are being the most deeply affected by these disorders. While the translation of information may seem cumbersome , the impact it could have on patients, caregivers, and providers is worth the effort. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to analyze an automated voice to text translation device by reporting the translation accuracy for recorded pediatric neurosurgery clinic conversations, classifying errors in translation according to their impact on overall understanding, and comparing the incidence of these errors in English to Spanish vs. Spanish to English conversations. Methods: English and Spanish speaking patients at a single academic health system's outpatient pediatric neurosurgery clinic had their conversations recorded. These recordings were played back to a Google Pixel handheld smartphone with Live Translate voice to text translation software. A certified medical interpreter evaluated recordings for incidence of minor errors, errors impacting understanding, and catastrophic errors affecting patient-provider relationship or care. Two proportion t-testing was used to compare these outcomes. Results: 50 patient visits were recorded: 40 English recordings translated to Spanish and 10 Spanish recordings translated to English. The mean transcript length was 4244 ± 992 words. The overall accuracy was 98.2% ± 0.5%. On average, 46 words were missed in translation (1.09% error rate), 31 understanding-altering translation errors (0.73% error rate), and 0 catastrophic errors were made. There was no significant difference in English to Spanish or vice versa. Conclusion: Voice to text translation devices using automatic speech recognition accurately translate recorded clinic conversations between Spanish and English with high accuracy and low incidence of errors impacting medical care or understanding. Further study should investigate additional languages, assess patient preferences and potential concerns with respect to device use, and compare these devices directly to medical interpreters in live clinic settings. [ABSTRACT FROM AUTHOR]

The article discusses how reimbursement for language interpretation services can help promote equity in pediatric health care in the U.S. Topics discussed include challenges in the care of patients with limited English proficiency (LEP), the benefits of using professional medical interpreters for LEP families, and the call on state and federal policies to extend reimbursement to translation services for patient-facing written materials.

Many Alabamian Latinos/as/x experience limited English proficiency (LEP), creating a barrier to health care. Providers regularly work with medical interpreters to aid patients with LEP. This article brings the Alabama providers' perceptions of working with medical interpreters to light and examines strategies to improve care for patients with LEP. Objectives: Sixty-three percent of Latinos/as/x in Alabama, speak English "not well" or "not at all." Effective provider–patient communication is the foundation of successful clinical interactions. Medical interpretation is important to the healthcare provision for patients with limited English proficiency (LEP). We examined Alabama providers' perceptions of working with medical interpreters to identify strategies to improve healthcare provision for LEP patients. Methods: We conducted nine semistructured qualitative interviews with primary healthcare providers in western Alabama. We used NVivo to conduct thematic coding and content analysis. Results: Of the nine providers, one self-identified as Latina and the others identified as White. Four participants worked in community clinics and five worked at university-based clinics. Four themes emerged: preference for in-person interpreters over technology-based interpretation; providers' perceptions and expectations of the roles of professional interpreters; challenges in the communication process; and use of family members or other ad hoc interpreters. Conclusions: To meet the needs of Latino/a/x communities, clinical settings should invest in adequate staffing of in-person interpreters, infrastructure and workflow improvements, and the hiring and training of polylingual providers. Capacity-building opportunities to establish team building between interpreters and providers could be useful tools in improving healthcare provision for LEP patients. [ABSTRACT FROM AUTHOR]

Objective: The objective of this pilot study was to explore the impact of interpreter format (virtual vs in person) on clinical outcomes in patients with non-English language preference (NELP) and type 2 diabetes mellitus (T2DM) in a primary care setting. We hypothesized that NELP patients utilizing in person interpreters would have improved HbA1c values, better follow-up rate, and more complex care plans compared to patients utilizing virtual interpreters. Methods: We completed a retrospective chart review of 137 NELP patients with T2DM who required a medical interpreter (February to June 2021). We calculated univariate and bivariate statistics to characterize the sample and assess the extent to which measures of continuity (follow-up visit rate and time to follow-up visit), quality (change in HbA1c), and complexity (medication intervention complexity) were associated with interpreter type. Results: There was no statistically significant difference in follow-up rate or average days to follow-up visit for NELP patients with in person as opposed to virtual interpreters. Patients with virtual interpreters demonstrated a non-statistically significant decrease in HbA1c compared to those with in person interpreters. Finally, there was no statistically significant association between interpreter format and intervention complexity. Conclusions: Quality medical interpretation contributes to optimal health outcomes in NELP patients with diabetes. Our study suggests that both in person and virtual interpreters can be effective in providing care for NELP patients, especially for chronic disease management in the context of a primary care relationship. It also highlights the importance of pursuing additional qualitative and mixed method studies to better understand the benefits of various interpreter formats across different visit types. [ABSTRACT FROM AUTHOR]

More than 25 million Americans have limited English-language proficiency (LEP) according to the U.S. Census Bureau. This population experiences challenges accessing health care and is least likely to receive preventive health care, including screening mammogram. In a setting where the breast radiologist does not speak the language of their patient, using certified medical interpreter services is fundamental. Medical interpreter use is associated with improved clinical care and patient satisfaction and can potentially increase adherence to screening mammograms and follow-up in patients with LEP. Title VI of the Civil Rights Act requires interpreter services for patients with LEP who are receiving federal financial assistance. Failure to provide interpretative services when necessary is considered discriminatory and illegal. The use of untrained medical interpreters, including ad hoc interpreters (eg, family, friends, or untrained staff), is associated with more medical errors, violation of confidentiality, and poor health outcomes. Types of medical interpretation services available to address language barriers include in-person interpretation, telephone and video remote interpretation, and qualified bilingual staff. Proper training and certification of medical interpreters is essential to prevent misinterpretations and ensure patient safety. When using an interpreter service, speak to and maintain eye contact with the patient, address the patient directly and seat the interpreter next to or slightly behind the patient, use visual aids whenever possible, and have the patient repeat the information to verify comprehension. Breast radiologists can address disparities in breast cancer screening and treatment by promoting effective communication. [ABSTRACT FROM AUTHOR]

Background: When patients do not speak the same language as their doctors, they face poorer medical outcomes, decreased doctor-patient trust, and a diminished desire to seek medical care. It has been well established that interpretation is an essential part of an accessible healthcare system, but effective use of such language services relies on both the interpreters themselves and the healthcare teams working with them. This study presents an interdisciplinary examination of the motivations of undergraduate student medical interpreters, a group which serves as a bridge between these roles. While not full-time interpreters, they receive official training and spend time serving patients in local clinics. Further, for those who aspire to careers in medicine, interpreting provides invaluable exposure to the medical field and early professional know-how. Methods: Semi-structured individual interviews with undergraduate student interpreters were conducted to describe this multifaceted educational experience. A thematic analysis framework was employed to understand how and why they volunteer their time to interpret. Results: Motivations of student interpreters were found to fall under three general categories: (1) personal identity, or connection to family, language, and their career aspirations; (2) community engagement, or the opportunity to make a direct impact on patients at an early stage; and (3) pre-professional experience, both in general and specifically in healthcare. Each of these contributes to the view of a student medical interpreter as a unique contributor to language equity in medicine, as they provide language services in the short-term as well as set themselves up to be linguistically and culturally competent providers in the long-term. Conclusions: A greater understanding of student motivations adds to knowledge about language mediation and validates the utility of students in this role, encouraging the development of more student interpreter programs. Particularly in communities with high proportions of non-English speakers, these students can contribute to making medical care as inclusive and accessible as possible. [ABSTRACT FROM AUTHOR]

Background: Latent tuberculosis infection (LTBI) screening and treatment interventions that are tailored to optimize acceptance among the non-U.S.–born population are essential for U.S. tuberculosis elimination. We investigated the impact of medical interpreter use on LTBI treatment acceptance and completion among non-U.S.–born persons in a multisite study. Methods: The Tuberculosis Epidemiologic Studies Consortium was a prospective cohort study that enrolled participants at high risk for LTBI at ten U.S. sites with 18 affiliated clinics from 2012 to 2017. Non-U.S.–born participants with at least one positive tuberculosis infection test result were included in analyses. Characteristics associated with LTBI treatment offer, acceptance, and completion were evaluated using multivariable logistic regression with random intercepts to account for clustering by enrollment site. Our primary outcomes were whether use of an interpreter was associated with LTBI treatment acceptance and completion. We also evaluated whether interpreter usage was associated treatment offer and whether interpreter type was associated with treatment offer, acceptance, or completion. Results: Among 8,761 non-U.S.–born participants, those who used an interpreter during the initial interview had a significantly greater odds of accepting LTBI treatment than those who did not use an interpreter. There was no association between use of an interpreter and a clinician's decision to offer treatment or treatment completion once accepted. Characteristics associated with lower odds of treatment being offered included experiencing homelessness and identifying as Pacific Islander persons. Lower treatment acceptance was observed in Black and Latino persons and lower treatment completion by participants experiencing homelessness. Successful treatment completion was associated with use of shorter rifamycin-based regimens. Interpreter type was not associated with LTBI treatment offer, acceptance, or completion. Conclusions: We found greater LTBI treatment acceptance was associated with interpreter use among non-U.S.–born individuals. [ABSTRACT FROM AUTHOR]

Issue: The way educators think about the nature of competence, the approaches one selects for the assessment of competence, what generated data implies, and what counts as good assessment now involve broader and more diverse interpretive processes. Broadening philosophical positions in assessment has educators applying different interpretations to similar assessment concepts. As a result, what is claimed through assessment, including what counts as quality, can be different for each of us despite using similar activities and language. This is leading to some uncertainty on how to proceed or worse, provides opportunities for questioning the legitimacy of any assessment activity or outcome. While some debate in assessment is inevitable, most have been within philosophical positions (e.g., how best to minimize error), whereas newer debates are happening across philosophical positions (e.g., whether error is a useful concept). As new ways of approaching assessment have emerged, the interpretive nature of underlying philosophical positions has not been sufficiently attended to. Evidence: We illustrate interpretive processes of assessment in action by: (a) summarizing the current health professions assessment context from a philosophical perspective as a way of describing its evolution; (b) demonstrating implications in practice using two examples (i.e., analysis of assessment work and validity claims); and (c) examining pragmatism to demonstrate how even within specific philosophical positions opportunities for variable interpretations still exist. Implications: Our concern is not that assessment designers and users have different assumptions, but that practically, educators may unknowingly (or insidiously) apply different assumptions, and methodological and interpretive norms, and subsequently settle on different views on what serves as quality assessment even for the same assessment program or event. With the state of assessment in health professions in flux, we conclude by calling for a philosophically explicit approach to assessment, and underscore assessment as, fundamentally, an interpretive process – one which demands the careful elucidation of philosophical assumptions to promote understanding and ultimately defensibility of assessment processes and outcomes. [ABSTRACT FROM AUTHOR]

The support of professional interpreters is an essential component of adequate mental health care for migrants with limited language proficiency. Nevertheless, for varied reasons, only a small proportion of outpatient psychotherapists provide interpreter-mediated psychotherapy for migrants. This study explored the perspectives of psychotherapists who have not worked with professional interpreters in outpatient mental health care to identify factors that may prevent the use of interpreters in outpatient care and explore possible incentives to provide interpreter-mediated psychotherapy for migrants with limited language proficiency. Semi-structured interviews were conducted with 13 outpatient psychotherapists in Northern Germany who had not yet worked with professional interpreters in outpatient care. The interviews were audio recorded, transcribed and analysed using a structured content analysis approach. The psychotherapists named structural as well as subjective barriers and concerns. Findings suggest that improving structural factors, such as secure funding, minimal additional work, better preparation and training could facilitate the integration of professional interpreters into everyday treatment. Psychotherapists also mentioned concerns about their own confidence (e.g., insecurities regarding the triadic situation), the patient (e.g., reduced openness), the interpreter (e.g., doubts about suitability, motivation and empathy), as well as the therapeutic process (e.g., unclear allocation of roles). However, positive aspects and opportunities of interpreter-mediated psychotherapy were also described. These could be enhanced by the presence of conducive factors, such as existing trust between all parties and professional cooperation between interpreter and psychotherapist. [ABSTRACT FROM AUTHOR]

This paper develops and applies a methodology of qualitative inquiry that equips researchers to capture how social actors produce and contest accepted forms of knowledge at the margins of mainstream globalizing discourses in times of crisis. Standing at the intersection between conceptual and empirical research, our methodology builds on the common epistemological premises of 'narrative', as stories constructed and enacted in social life, and 'practice', as tasks and projects composed by 'doings' and 'sayings'. Overcoming the dualism between 'action' and 'discourse' in traditional social theory, this methodology integrates narrative theory and practice theory into a joint framework for fieldwork and interviews. The use of the narrative-practice methodology in ethnographic case studies – such as interpreters' experience of the COVID-19 pandemic in Qatar – allows researchers to gain analytical granularity on participants' storied practice and practiced stories of the crisis, to harness 'peripheral' knowledge and refashion public discourse. [ABSTRACT FROM AUTHOR]