Increasing inclusivity in patient centered research begins with language.

Autor: Curt AM; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Boston Children's Hospital, Division of Emergency Medicine, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address: acurt@hms.harvard.edu., Kanak MM; Children's Hospital Los Angeles, Division of Emergency Medicine, 4650 Sunset Blvd, Los Angeles, CA 90027, USA. Electronic address: mkanak@chla.usc.edu., Fleegler EW; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Boston Children's Hospital, Division of Emergency Medicine, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address: Eric.fleegler@childrens.harvard.edu., Stewart AM; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Boston Children's Hospital, Division of Emergency Medicine, 300 Longwood Ave, Boston, MA 02115, USA. Electronic address: Amanda.stewart@childrens.harvard.edu.
Jazyk: angličtina
Zdroj: Preventive medicine [Prev Med] 2021 Aug; Vol. 149, pp. 106621. Date of Electronic Publication: 2021 May 13.
DOI: 10.1016/j.ypmed.2021.106621
Abstrakt: Emergency departments frequently serve marginalized populations. Spanish-speaking families who come to the ED often have high rates of unmet social needs. Our study investigated how to efficiently screen families for unmet social needs in an emergency department. Participants who screened positive for needs were referred to geographically convenient, community-based resources. It became clear that barriers related to language discordance existed for recruiting Spanish-speaking participants that were not present for English-speaking participants, which we believe exacerbate existing inequities and must be addressed. We advocate for the extension of the Affordable Care Act Section 1557 to mandate expanded teams of interpreters to meet both clinical and research demands in conjunction with purposeful hiring of multilingual research assistants, along with concerted effort to standardize the certification process for multilingual staff. Prohibitive costs for the translation of written research materials need to be decreased and journals should evaluate submitted research with a language equity lens, which will help the field of clinical research prioritize inclusivity and diversity in research populations. Currently, systemic barriers complicate enrolling research participants who speak a language other than English, and we believe the proposed changes are feasible solutions to overcome these obstacles. Equitable representation in research is a critical part of addressing the legacy of oppression and exclusion within healthcare systems. Language equity is not a panacea for the distrust and systemic racism patients of color experience within our healthcare system that often prevent participation in clinical research, but it is a key first step.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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