Electronic Tools to Bridge the Language Gap in Health Care for People Who Have Migrated: Systematic Review

Abstract

Background People who have migrated or with a language barrier may face significant hurdles in accessing health care. Some apps have been specifically developed to facilitate the dialogue between health care professionals and people who have migrated who have low-level language proficiency or to promote health among people who have migrated. Objective We conducted a systematic review to investigate development, acceptability, and effectiveness of these types of apps. Methods We conducted a search of PubMed, Scopus, and Embase databases. We included all study designs (qualitative, quantitative, mixed) reporting development, evaluation of efficacy, or acceptability of apps facilitating dialogue with a health professional or promoting health for people who have migrated, minorities, or tourists with a language barrier, using any outcome. Two researchers selected the studies independently. We collected general information about the app, information about health literacy and cultural adaptation, information about the development of the app, evidence on acceptability or efficacy, and information on app use. Data were collected by 2 researchers independently and results were reviewed to verify agreement and reported according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis). Results Positive results for translation apps included better communication, but with possible limitations, and reduced consultation time. Positive results for health promotion apps included improved quality of life and better management of chronic illnesses. Conclusions Overall, the apps had good levels of acceptability, though only half had their efficacy evaluated. In those evaluations, the endpoints were mostly related to reported behavior change and knowledge improvement, which is common for evaluations of health promotion programs. In the future, as more health apps are created, it is essential that apps that claim to have a public health objective undergo a rigorous evaluation of their acceptability, efficacy, and actual use. Indicators of outcomes beyond changes in behavior and knowledge should be reported; change in health status or access to care should also be reported. This systematic review has helped us note the characteristics associated with improved acceptability and efficacy, which can be helpful for the development of future apps.

Moving Towards Equity With Digital Health Innovations for Stroke Care

“…82 However, none of these integrate the culturally and linguistically tailored approaches used in in-person studies that have been shown to work in stroke prevention among communities of color and those with limited English proficiency. [83][84][85] Several studies have shown that community health care workers, care navigators, and health educators are important allies in helping patients navigate the complex health care system. A multidisciplinary team including community health care workers, 75 pharmacists, and nurses 86 in the delivery of chronic disease care and cardiovascular health has led to significant improvements in health literacy, risk factor control, self-management behaviors, lifestyle habits, clinical outcomes, and a decrease in inappropriate health care utilization.…”

“…82 However, none of these integrate the culturally and linguistically tailored approaches used in in-person studies that have been shown to work in stroke prevention among communities of color and those with limited English proficiency. 83–85…”

Strategies Used by Healthcare Systems to Communicate with Hospitalized Patients and Families with Limited English Proficiency During the COVID-19 Pandemic: A Narrative Review

“…Prior to the COVID-19 pandemic strategies beyond language interpretation to support patients with LEP have included specific clinic days with language-congruent clinicians [46], huddles between clinicians and interpreters [47], continuing education sessions on caring for patients with LEP [48], electronic apps for health promotion and communication providers [49], and chronic disease education via group video visits by community health workers [50]. Most interventions described in the literature occur in non-hospitalized patients, such those seen in outpatient clinics or through community outreach [46,49,51]. However, these strategies may not be applicable when caring for individual patients in higher-acuity settings, such as those who are hospitalized or in ICU.…”

Evaluating Clinician Expectations of mHealth Solutions to Increase Rapid-Screening for HIV and Hepatitis in Migrant Populations in France: Qualitative Study

“…A systematic review Investigating the use of electronic tools to help increase testing in migrants with LFP, conducted by our research team, found that translation apps provide better communication with HPs and have a high acceptability of use [ 10 ]. In terms of a new tool, our research found that HPs spoke most frequently of an easy to use ( Figure 1 , subtheme 3.2), accessible app with multiple features, including visual ( Figure 1 , subthemes 4.1-4.2) and audio ( Figure 1 , subtheme 4.3) components along with an accurate, reliable, and instantaneous translation ( Figure 1 , subtheme 3.1); data collection; adaptive content; and interpretation functions ( Figure 1 , subthemes 5.1, 5.2, 5.3, and 5.4).…”

“…A systematic review investigating language barriers in migrant health care found that translation apps enable better communication in the patient-provider relationship and reduce overall consultation times [ 10 ]. Another study demonstrated that a mobile translation app contributed to the use of interpretation services and resulted in a high level of satisfaction among HPs [ 11 ].…”