Low uptake of Aboriginal interpreters in healthcare: exploration of current use in Australia’s Northern Territory

Ralph, Anna P.; Lowell, Anne; Murphy, J; Dias, Tara; Butler, Deborah L.; Spain, Brian; Hughes, Jaquelyne T.; Campbell, Lauren; Bauert, Barbara; Salter, Claire; Tune, Kylie; Cass, Alan

doi:10.1186/s12913-017-2689-y

Cited by 33 publications

(36 citation statements)

References 22 publications

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“…While the need for culturally responsive health services for Indigenous Australians is acknowledged, the levels of cultural mediation and interpreting in practice are poor . This may be because of the restricted availability of Indigenous interpreters and the shift in the role of AHWs from providing cultural support to activities requiring greater clinical skills and responsibilities . The limited availability of personnel to fulfil the linguistic and cultural needs of patients has reportedly resulted in burnout among the declining number of AHWs who act as both family or community members and clinicians .…”

Section: Discussionmentioning

confidence: 99%

Non‐clinical eye care support for Aboriginal and Torres Strait Islander Australians: a systematic review

Yashadhana

Lee

Massie

et al. 2020

Medical Journal of Australia

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Objectives To describe research into non‐clinical support eye health care for Aboriginal and Torres Strait Islander (Indigenous) Australians, the people who provide such care, and its impact on eye health outcomes. Study design Systematic review and qualitative analysis of peer‐reviewed research publications. Data sources Peer‐reviewed research articles published between January 2000 and July 2018 and included in MEDLINE/EMBASE, Web of Science, Informit, EBSCO (CINAHL and Anthropology Plus), or ProQuest Central. Study selection We included English language, peer‐reviewed articles reporting empirical data on non‐clinical support for eye health for Indigenous Australians. Two authors independently assessed the titles and abstracts of 1678 unique articles for inclusion in a full text review; the full texts of 104 publications were reviewed, of which 77 were excluded and 27 included in our qualitative analysis. Data synthesis Qualitative analysis identified five key areas of non‐clinical support for Indigenous eye health: coordination of eye care, integrating and linking services, cultural support, health promotion, and social and emotional support. People who provide non‐clinical support include eye health coordinators, Aboriginal Health Workers, primary care clinicians, family members, carers, and community‐based liaison workers. The availability of non‐clinical support is associated with increased patient attendance at eye care services, higher visual acuity examination and cataract surgery rates, broader eye health knowledge, and greater cultural responsivity. Conclusion Non‐clinical support is critical for facilitating attendance at appointments by patients and ensuring that preventive, primary, and tertiary eye care services are accessible to Indigenous Australians. Greater financial investment is needed to support key providers of non‐clinical support, especially eye health coordinators, community‐based liaison officers, and family members and carers.

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Section: Discussionmentioning

confidence: 99%

Non‐clinical eye care support for Aboriginal and Torres Strait Islander Australians: a systematic review

Yashadhana

Lee

Massie

et al. 2020

Medical Journal of Australia

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“…Around 100 Aboriginal languages and dialects are spoken in the NT [3]. Prior estimates indicate approximately 60% of Aboriginal people at Royal Darwin Hospital [4] and in the NT [19] speak an Aboriginal language as their rst language. Community consultation indicates that the majority would bene t from an interpreter in healthcare interactions [20].…”

Section: Settingmentioning

confidence: 99%

A Complex Intervention to Improve Intercultural Communication and Aboriginal Patient Outcomes: Which Components Worked?

Ralph

Kerrigan

Castillon³

et al. 2020

Preprint

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BackgroundAboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018 - March 2019) compared with a 24-month baseline period (April 2016 – March 2018). This paper aims to explore reasons for these outcomes, and further explore the likelihood of a causal association between study activities and outcomes. MethodsWe used the ‘Template for Intervention Description and Replication’ (TIDieR) as a framework to describe intervention components and evaluate their relative importance. Information on intercurrent activities that may have contaminated study findings was reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. ResultsOne full-time Aboriginal Interpreter Coordinator was employed for the intervention period who identified language needs, promoted interpreter use and mentored interpreters. The intervention period start date corresponded with commencement of this role. Three ‘Working with Interpreter’ training sessions were held during the intervention period reaching 83 clinicians, and three medical officers volunteered as champions of interpreter use in hospital practice. Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components and timing of the changes in outcomes. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients (p=0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. ConclusionsCommunication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.

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“…Effective communication between Aboriginal language-speaking patients and healthcare providers requires cultural respect and appropriate interpreter use. Use of professional interpreters can improve patient outcomes [1,2] but in Australia's Northern Territory (NT), where dozens of languages are commonly spoken [3], uptake of interpreters is low for people who primarily speak an Aboriginal language [4 ]. Poor communication compounds existing health disparities.…”

Section: Introductionmentioning

confidence: 99%

A complex intervention to improve intercultural communication and Aboriginal patient outcomes: which components worked?

Ralph¹,

Kerrigan²,

Castillon³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background Aboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018 - March 2019) compared with a 24-month baseline period (April 2016 – March 2018). This paper aims to explore reasons for these outcomes, and further explore the likelihood of a causal association between study activities and outcomes. Methods We used the ‘Template for Intervention Description and Replication’ (TIDieR) as a framework to describe intervention components and evaluate their relative importance. Information on intercurrent activities that may have contaminated study findings was reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. Results One full-time Aboriginal Interpreter Coordinator was employed for the intervention period who identified language needs, promoted interpreter use and mentored interpreters. The intervention period start date corresponded with commencement of this role. Three ‘Working with Interpreter’ training sessions were held during the intervention period reaching 83 clinicians, and three medical officers volunteered as champions of interpreter use in hospital practice. Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components and timing of the changes in outcomes. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients (p = 0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. Conclusions Communication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.

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Low uptake of Aboriginal interpreters in healthcare: exploration of current use in Australia’s Northern Territory

Cited by 33 publications

References 22 publications

Non‐clinical eye care support for Aboriginal and Torres Strait Islander Australians: a systematic review

Non‐clinical eye care support for Aboriginal and Torres Strait Islander Australians: a systematic review

A Complex Intervention to Improve Intercultural Communication and Aboriginal Patient Outcomes: Which Components Worked?

A complex intervention to improve intercultural communication and Aboriginal patient outcomes: which components worked?

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