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Thonon F, Perrot S, Yergolkar AV, Rousset-Torrente O, Griffith JW, Chassany O, Duracinsky M. Electronic Tools to Bridge the Language Gap in Health Care for People Who Have Migrated: Systematic Review. J Med Internet Res 2021; 23:e25131. [PMID: 33955837 PMCID: PMC8138704 DOI: 10.2196/25131] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022] Open
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.
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Affiliation(s)
- Frédérique Thonon
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Swati Perrot
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | | | - Olivia Rousset-Torrente
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - James W Griffith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
- Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, F94270, Le Kremlin Bicêtre, France
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Thonon F, Fahmi S, Rousset-Torrente O, Bessonneau P, Griffith JW, Brown C, Chassany O, Duracinsky M. Promoting HIV, Hepatitis B Virus, and Hepatitis C Virus Screening Among Migrants With a Language Barrier: Protocol for the Development and Evaluation of an Electronic App (Apidé). JMIR Res Protoc 2021; 10:e22239. [PMID: 33949963 PMCID: PMC8135028 DOI: 10.2196/22239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 11/28/2022] Open
Abstract
Background Late diagnoses of HIV, hepatitis B, and hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers’ reluctance to offer a test and to migrants’ reluctance to accept testing. Objective The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier and to evaluate its acceptability and impact in terms of public health. Methods The study will go through 3 stages: (1) concept development, (2) app development, and (3) app evaluation. A qualitative study has been undertaken to explore language barriers during health care encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted to have a comprehensive overlook of electronic tools designed to help health care providers communicate with migrants with a language barrier. To generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the app will include translation and voice recording of items. The electronic development will also include 3 steps of user testing. The acceptability of the app will be evaluated using the System Usability Scale. Evaluation of the app’s efficacy will consist of a stepped wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome is the percentage of screening tests realized. The secondary outcomes are the rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app. Results The app evaluation study received a 3-year grant from the Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from the Office Français de l’Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review were completed. Conclusions This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier and measure its acceptability and effectiveness in terms of public health. When completed, this app could be distributed to numerous professionals carrying out screening with migrant populations in various health care settings. International Registered Report Identifier (IRRID) PRR1-10.2196/22239
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Affiliation(s)
- Frédérique Thonon
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Saleh Fahmi
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | - Olivia Rousset-Torrente
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Pascal Bessonneau
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - James W Griffith
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carter Brown
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France
| | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.,Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.,Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, F94270, Le Kremlin-Bicêtre, France
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Spechbach H, Gerlach J, Mazouri Karker S, Tsourakis N, Combescure C, Bouillon P. A Speech-Enabled Fixed-Phrase Translator for Emergency Settings: Crossover Study. JMIR Med Inform 2019; 7:e13167. [PMID: 31066702 PMCID: PMC6528434 DOI: 10.2196/13167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/29/2019] [Accepted: 04/15/2019] [Indexed: 11/13/2022] Open
Abstract
Background In the context of the current refugee crisis, emergency services often have to deal with patients who have no language in common with the staff. As interpreters are not always available, especially in emergency settings, medical personnel rely on alternative solutions such as machine translation, which raises reliability and data confidentiality issues, or medical fixed-phrase translators, which sometimes lack usability. A collaboration between Geneva University Hospitals and Geneva University led to the development of BabelDr, a new type of speech-enabled fixed-phrase translator. Similar to other fixed-phrase translators (such as Medibabble or UniversalDoctor), it relies on a predefined list of pretranslated sentences, but instead of searching for sentences in this list, doctors can freely ask questions. Objective This study aimed to assess if a translation tool, such as BabelDr, can be used by doctors to perform diagnostic interviews under emergency conditions and to reach a correct diagnosis. In addition, we aimed to observe how doctors interact with the system using text and speech and to investigate if speech is a useful modality in this context. Methods We conducted a crossover study in December 2017 at Geneva University Hospitals with 12 French-speaking doctors (6 doctors working at the outpatient emergency service and 6 general practitioners who also regularly work in this service). They were asked to use the BabelDr tool to diagnose two standardized Arabic-speaking patients (one male and one female). The patients received a priori list of symptoms for the condition they presented with and were instructed to provide a negative or noncommittal answer for all other symptoms during the diagnostic interview. The male patient was standardized for nephritic colic and the female, for cystitis. Doctors used BabelDr as the only means of communication with the patient and were asked to make their diagnosis at the end of the dialogue. The doctors also completed a satisfaction questionnaire. Results All doctors were able to reach the correct diagnosis based on the information collected using BabelDr. They all agreed that the system helped them reach a conclusion, even if one-half felt constrained by the tool and some considered that they could not ask enough questions to reach a diagnosis. Overall, participants used more speech than text, thus confirming that speech is an important functionality in this type of tool. There was a negative association (P=.02) between the percentage of successful speech interactions (spoken sentences sent for translation) and the number of translated text items, showing that the doctors used more text when they had no success with speech. Conclusions In emergency settings, when no interpreter is available, speech-enabled fixed-phrase translators can be a good alternative to reliably collect information from the patient.
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Affiliation(s)
| | - Johanna Gerlach
- Faculté de traduction et d'interprétation, Université de Genève, Genève, Switzerland
| | | | - Nikos Tsourakis
- Faculté de traduction et d'interprétation, Université de Genève, Genève, Switzerland
| | | | - Pierrette Bouillon
- Faculté de traduction et d'interprétation, Université de Genève, Genève, Switzerland
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Simpao AF, Lingappan AM, Ahumada LM, Rehman MA, Gálvez JA. Perioperative Smartphone Apps and Devices for Patient-Centered Care. J Med Syst 2015; 39:102. [PMID: 26265239 DOI: 10.1007/s10916-015-0310-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/04/2015] [Indexed: 12/19/2022]
Abstract
Smartphones have grown in ubiquity and computing power, and they play an ever-increasing role in patient-centered health care. The "medicalized smartphone" not only enables web-based access to patient health resources, but also can run patient-oriented software applications and be connected to health-related peripheral devices. A variety of patient-oriented smartphone apps and devices are available for use to facilitate patient-centered care throughout the continuum of perioperative care. Ongoing advances in smartphone technology and health care apps and devices should expand their utility for enhancing patient-centered care in the future.
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Affiliation(s)
- Allan F Simpao
- Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Suite 9329, Philadelphia, PA, 19104-4399, USA,
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Abstract
The enormous diversity of physician practices, including specialists, and patient requirements and comorbidities make integration of appropriate perioperative information difficult. Lack of communicating computer systems adds to the difficulty of assembling data. Meta analysis and evidence-based studies indicate that far too many tests are performed perioperatively. Guidelines for appropriate perioperative management have been formulated by several specialties. Education as to current findings and requirements should be better communicated to surgeons, consultants, and patients to improve healthcare needs and at the same time decrease costs. Means to better communication by interpersonal collaboration are outlined.
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Kraidin J, Ginsberg SH, Solina A. Anesthesia Apps: Overview of Current Technology and Intelligent Search Techniques. J Cardiothorac Vasc Anesth 2012; 26:322-6. [DOI: 10.1053/j.jvca.2011.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Indexed: 11/11/2022]
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