Abstract
BackgroundPeople 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.ObjectiveWe conducted a systematic review to investigate development, acceptability, and effectiveness of these types of apps.MethodsWe 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).ResultsPositive 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.ConclusionsOverall, 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.
Highlights
People who have migrated may face significant delays and barriers in accessing health care, especially those who do not fluently speak the language of the host country
Others have found that adding an interpreter to a consultation where the patient has a language barrier results in the reduction of obstetric interventions [8], better clinical outcomes in people with diabetes [7,8], a higher rate of breast cancer and colorectal cancer screening [7], and a higher rate of influenza vaccination [7]
The primary focus of this review was people who have migrated, the preliminary search yielded articles reporting apps that helped bridge the language barrier for other populations, such as tourists needing emergency care and not speaking the language of the country visited or indigenous people whose primary language is different from the official language. Since these apps help health care providers communicate with patients with a language barrier, we decided to include them because we found they were relevant
Summary
People who have migrated may face significant delays and barriers in accessing health care, especially those who do not fluently speak the language of the host country. Research has been conducted to investigate language barriers in accessing care and prevention among people who have migrated and its health consequences. Some apps have been 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. 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. 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. 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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