A Systematic Review of Interventions to Address Accent-Related Communication Problems in Healthcare

Abstract

Background: Linguistic diversity in terms of speech, accent, and dialect can present a barrier to communication in healthcare. This review synthesizes current evidence on the effectiveness of interventions that target accent- or dialect-related communication problems in healthcare.Methods: Eligible studies were identified through a search of literature databases in 2018 using medical subject heading (MeSH) terms and additional keywords. Articles were screened for eligibility according to predetermined inclusion criteria. Because of the heterogeneity of the studies, effect data were analyzed using narrative synthesis.Results: Twenty-six studies (n=964) were included, reporting a range of interventions that provided accent modification training, role play or simulated patient consultation training, general language and consultation skills training, web-based training, and cultural competence training. Most studies (24 of the 26) indicated some benefits of the accent elements in the interventions based on objective or subjective measures. The key benefits were improvements in speech production, communication competence, and academic/clinical performance, as well as perceptual changes.Conclusion: Notwithstanding the low research quality and lack of standardized measures in the included studies, this review establishes an evidence base for implementing accent-related communication improvement strategies in healthcare. Large randomized controlled studies would be helpful to strengthen this evidence base.

Linguistic barriers and healthcare in China: Chaoshan vs. Mandarin

“…There are well-recognized breakers of language barriers to healthcare [ 1 , 2 ], such as professional interpreting service [ 27 – 29 ], language training of healthcare providers [ 30 ], or medical translation apps [ 31 , 32 ], which are nonetheless relevant mainly to LEP (Limited English Proficiency) in recent and remote immigrants in English-speaking resource-rich countries like the United States, Australia, and United Kingdom [ 29 , 31 – 33 ]. The recommended interventions are, therefore, far to be practical in dialectically diverse countries like India [ 9 ] or China.…”

Cascade screening for beta-thalassaemia in Pakistan: relatives’ experiences of a decision support intervention in routine practice

“…Secondly, the DeSIRe was co-produced 'with' relevant stakeholders including service users (relatives) and providers (FOs), rather than 'for' them [24]. Thirdly, the FOs further improved communication by conversing in local dialects where necessary [25], and creating an empowering environment during the family meetings by encouraging questions [26]. Overall, the DeSIRe is appropriate for use by healthcare professionals in populations with low literacy rates.…”

Considering Preventative Care in a Native vs. Non-native Language: A Foreign Language Effect

“…Combined with the millions of multilinguals around the world who live their lives in a language other than their native tongue, it becomes clear that important decisions, such as those about our physical health, are routinely made while using a foreign language. How language impacts health outcomes has therefore garnered significant interest, with topics spanning the efficacy of interpreters and communication strategies ( [3][4][5], see also [6] for review) to linguistic discrimination and perceptions of foreign accented doctors and patients ( [7][8][9], see also [10] for review). One question that has received relatively less attention, however, is how evaluating health-related information in a foreign language impacts the clinical decision-making process.…”