One in four children in the US grow up in immigrant families, and 55% of children in immigrant families have a parent who speaks and understands English less than \"very well\". While the number of research studies that is focused on children in immigrant families (CIF) has increased, CIF particularly those that communicate in a language other than English (LOE) are frequently excluded from research. We reviewed studies including \"children in immigrant families and the United States\" in PubMed from 2017-2023, and categorized them as qualitative, quantitative, mixed-methods or community engaged research. We review observations and offer recommendations for research to promote the health and well-being of children in immigrant families including: using strengths-based frameworks; prioritizing the inclusion of families who speak languages other than English; amending reporting standards for qualitative studies to include guidance on reporting methods for projects in which research teams and study participants speak different languages from one another; and incorporating methods to identify people who have experienced migration in large national surveys and cohort studies. We recommend research with and inclusive of CIF to consider additional areas for growth in cross-sector collaborations, interventions and clinical trials, and training and support for investigators.

BACKGROUND: The global need for palliative care (PC) is increasing, especially as the population ages. The diagnosis of a life-threatening illness triggers numerous decisions by healthcare professionals (HCPs). How these professionals understand and deal with PC influences the quantity and quality of care provided to patients. This systematic review aimed to compare perceptions of PC among HCPs around the world.
METHODS: The databases (MEDLINE/PubMed, Embase, LILACS, and EBSCO) were searched systematically. Articles reporting on the perception of HCPs, published between January 2012 and December 2022, were included. Texts that reported the perceptions of family members and patients were excluded to avoid the risk of bias. Those included were organized by country/region and continent for later analysis.
RESULTS: Of the 2,063 articles initially retrieved 32 were included and provided relevant information from four continents (America, Asia, Europe, and Oceania). Most of this was done through interviews and questionnaires. All HCPs consulted in the studies recognized the importance of PC. The perception of these professionals was influenced by cultural factors (such as religion), difficulties perceived in each country/region (such as inadequate knowledge, conceptual confusion, etc.), diseases, and the age range of patients served. The acceptance and preparation of professionals to deal with this topic in their routine also influenced their perceptions of HCPs. The limitation of this research is the lack of eligible studies from Africa and the small number of participants in some studies.
CONCLUSIONS: It can be concluded that HCPs\' perceptions of PC are similar, regardless of their country of origin.

BACKGROUND: Patients with language barriers encounter healthcare disparities, which may be alleviated by leveraging interpreter skills to reduce cultural, language, and literacy barriers through improved bidirectional communication. Evidence supports the use of in-person interpreters, especially for interactions involving patients with complex care needs. Unfortunately, due to interpreter shortages and clinician underuse of interpreters, patients with language barriers frequently do not get the language services they need or are entitled to. Health information technologies (HIT), including artificial intelligence (AI), have the potential to streamline processes, prompt clinicians to utilize in-person interpreters, and support prioritization.
METHODS: From May 1, 2023, to June 21, 2024, a single-center stepped wedge cluster randomized trial will be conducted within 35 units of Saint Marys Hospital & Methodist Hospital at Mayo Clinic in Rochester, Minnesota. The units include medical, surgical, trauma, and mixed ICUs and hospital floors that admit acute medical and surgical care patients as well as the emergency department (ED). The transitions between study phases will be initiated at 60-day intervals resulting in a 12-month study period. Units in the control group will receive standard care and rely on clinician initiative to request interpreter services. In the intervention group, the study team will generate a daily list of adult inpatients with language barriers, order the list based on their complexity scores (from highest to lowest), and share it with interpreter services, who will send a secure chat message to the bedside nurse. This engagement will be triggered by a predictive machine-learning algorithm based on a palliative care score, supplemented by other predictors of complexity including length of stay and level of care as well as procedures, events, and clinical notes.
CONCLUSIONS: This pragmatic clinical trial approach will integrate a predictive machine-learning algorithm into a workflow process and evaluate the effectiveness of the intervention. We will compare the use of in-person interpreters and time to first interpreter use between the control and intervention groups.
BACKGROUND: NCT05860777. May 16, 2023.

BACKGROUND:  Social accountability entails providing equitable and accessible services that are tailor-made for the community\'s healthcare needs and enable rehabilitation therapists to improve the efficiency and efficacy of healthcare delivery and their response. Enabling them to provide optimal care during their community service year requires understanding the gaps in their knowledge, experience and the support they provide to the communities they service.
METHODS:  Four in-depth individual interviews and four focus group discussions were conducted via Zoom. The qualitative responses to the questions related to the challenges and recommendations associated with social accountability in clinical settings were analysed using an inductive thematic approach via NVIVO.
RESULTS:  Four sub-themes emerged for each of the two areas of interest: the challenges relating to (1) budget and equipment constraints, (2) staff shortages, (3) cultural and language barriers and (4) scope of practice limitations. The recommendations related to (5) collaboration with community caregivers, (6) service inclusion in primary health care clinics, (7) improved executive management support and (8) continuing professional development.
CONCLUSIONS:  Equipping graduates with the knowledge, skills and support needed to work in an under-resourced setting is essential for community service rehabilitation therapists to ensure social accountability, given that they often work alone, specifically in rural settings.Contribution: Being aware of the challenges that face community service rehabilitation therapists, having the necessary tools and health facility management support will enable ongoing improvements in their ability to provide socially accountable services.

UNASSIGNED: This study aims to assess the intercultural competence of general hospital workers in South Korea by examining their understanding of cultural diversity in healthcare and to identify factors influencing their intercultural competence.
UNASSIGNED: A cross-institutional survey was conducted with 439 participants from four South Korean general hospitals, employing inferential statistics such as one-way Analysis of Variance, Mann-Whitney U, and Kruskal-Wallis test followed by post-hoc, and multiple linear regression analyses.
UNASSIGNED: While 85% (n = 362) of participants acknowledged the significance of multiculturalism in Korean society, only 11% (n = 49) felt competent in treating multicultural patients. Additionally, 72% (n = 315) experienced significant linguistic difficulties in medical communication. Multiple regression analysis identified advanced English competency, multicultural training experiences, and peer support with organizational awareness of multicultural importance as significant positive contributors to intercultural competence.
UNASSIGNED: Despite recognizing the importance of multiculturalism, general hospital workers face significant language barriers and low self-efficacy in providing care to multicultural patients. To address these challenges, hospitals should designate resident translators for culturally appropriate communication. Furthermore, a tri-tiered training approach is proposed to enhance the five domains of intercultural competence among general hospital workers in Korea, including overarching multicultural training, occupation-specific courses, and long-term managerial programs aimed at managing cultural diversity effectively in healthcare settings.

UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.

BACKGROUND: Following Kabul\'s fall in August 2021, there was influx of Afghan refugees in the UK. Southampton\'s Bridging Hotel provided temporary shelter to 22 families, totaling 116 individuals. The Living Well Partnership (LWP); assumed primary care provision for these vulnerable residents facing health inequalities.
OBJECTIVE: Enhancing refugee healthcare access and integration into the NHS system. Improving healthcare education, boosting confidence in appropriate healthcare use, and utilisation of electronic consultations effectively.
METHODS: Working with the local authorities, primary care services were brought to the hotel. Regular 3-hour drop-in sessions with a health and wellbeing coach were established and attended by residents. Non-identifiable data was recorded in individual patient care records and summarised quantitatively.  Qualitative data was collected via a pre-established questionnaire during the sessions.   RESULTS: Identified issues included language barriers, mental health problems, infectious diseases, contraception, and healthcare access. Language barriers were addressed with interpreters. Fifty-nine patients accessed support services, with 13 benefiting from e-consultations, and nine requiring on-site medical consultations in a 3-month period. Mental health support and infectious disease referrals were facilitated. Access challenges were mitigated by transitioning to e-consultations or face-to-face appointments. Outcomes included improved patient independence, awareness of healthcare processes, familiarity with LWP services, and confidence in navigating the NHS.
CONCLUSIONS: A multifaceted approach is vital for addressing language and access barriers for refugees. Providing educational resources through facilitated groups empowered refugees and improved healthcare access. This initiative highlights the importance of organised support for vulnerable populations during crises and can be applied more widely.

OBJECTIVE: Monolingual Spanish speakers-many of whom identify as Hispanic/Latine-often experience barriers to accessing psychology services, including language access. Integrated primary care (IPC) clinics, where individuals receive psychological services within primary care, aim to improve service accessibility. However, minoritized populations are less likely to engage with these services than non-Hispanic/Latine White individuals. Few studies examine psychology treatment engagement within pediatric integrated clinics for Spanish-speaking families. This study investigated differences in psychology treatment engagement for Spanish-speaking families and the role of patient-provider language concordance within pediatric IPC.
METHODS: A retrospective chart review examined data from a multiethnic sample of 887 patients (M age = 8.97 yrs, 55.69% male, 64.83% Hispanic/Latine, 6.99% non-Hispanic/Latine White, 41.71% Spanish-preferring) from an urban pediatric IPC clinic serving a high proportion of Hispanic/Latine, Spanish-speaking families. We examined the association between language preference and patient-provider language concordance on service engagement using hierarchical linear regression.
RESULTS: Spanish-preferring families were more likely than English-preferring families to engage in psychology services. Working with a Spanish-speaking provider during an initial psychology visit was unrelated to psychology treatment engagement for Spanish-preferring families.
CONCLUSIONS: Higher engagement for Spanish-preferring families seems to reflect the clinic\'s reputation as a center for linguistically accessible services. While linguistic accessibility remains important, our study did not detect an effect of language concordance during the initial psychology visit and subsequent treatment engagement. The findings highlight the importance of providing culturally responsive and linguistically accessible mental health services for Spanish-speaking families.

BACKGROUND: Forced displacement is a significant issue globally, and it affected 112 million people in 2022. Many of these people have found refuge in low- and middle-income countries. Migrants and refugees face complex and specialized health challenges, particularly in the area of mental health. This study aims to provide an in-depth qualitative assessment of the multi-level barriers that migrants face in accessing mental health services in Germany, Macao (Special Administrative Region of China), the Netherlands, Romania, and South Africa. The ultimate objective is to inform tailored health policy and management practices for this vulnerable population.
METHODS: Adhering to a qualitative research paradigm, the study centers on stakeholders\' perspectives spanning microsystems, mesosystems, and macrosystems of healthcare. Utilizing a purposive sampling methodology, key informants from the aforementioned geographical locations were engaged in semi-structured interviews. Data underwent thematic content analysis guided by a deductive-inductive approach.
RESULTS: The study unveiled three pivotal thematic barriers: language and communication obstacles, cultural impediments, and systemic constraints. The unavailability of professional interpreters universally exacerbated language barriers across all countries. Cultural barriers, stigmatization, and discrimination, specifically within the mental health sector, were found to limit access to healthcare further. Systemic barriers encompassed bureaucratic intricacies and a conspicuous lack of resources, including a failure to recognize the urgency of mental healthcare needs for migrants.
CONCLUSIONS: This research elucidates the multifaceted, systemic challenges hindering equitable mental healthcare provision for migrants. It posits that sweeping policy reforms are imperative, advocating for the implementation of strategies, such as increasing the availability of language services, enhancing healthcare providers\' capacity, and legal framework and policy change to be more inclusive. The findings substantially contribute to scholarly discourse by providing an interdisciplinary and international lens on the barriers to mental healthcare access for displaced populations.

While pre-exposure prophylaxis (PrEP) has demonstrated efficacy in preventing HIV transmission, disparities in access persist in the United States, especially among Hispanic/Latinx sexual minority men (SMM). Language barriers and differences in how Latinx SMM obtain information may impact access to PrEP and HIV prevention. This study used data from the 2021 American Men\'s Internet Survey (AMIS) to examine differences in communication networks and PrEP use among Latinx SMM by primary language (Spanish vs. English). We examined the associations between Latinx SMM\'s individual- and meso-level communication networks and PrEP-related outcomes using modified Poisson regression with robust variances. Spanish-speaking Latinx SMM in the study were less likely to test for HIV, be aware of PrEP, and use daily PrEP, compared to English-speaking participants. Sexuality disclosure to a healthcare provider was positively associated with PrEP uptake among all participants and predicted STI testing over the past 12 months among English-speaking Latinx SMM. Findings highlight disparities in PrEP awareness and uptake among Latinx SMM, especially among those whose primary language is Spanish. Addressing these disparities through targeted interventions, including improved communication with healthcare providers, may help facilitate PrEP access and use in this population.