Interventions Between Providers and Patients with Limited English Proficiency to Improve Health-Related Outcomes

<h3>Context</h3> Substantial ethnic and linguistic diversity of the population in the United States may contribute to significant communication barriers between patients and their healthcare providers, and result in negative healthcare outcomes <h3>Objective</h3> To conduct a systematic review of published communication interventions which improved patient care or health outcomes for patients with limited English proficiency. <h3>Study Design</h3> This study was a systematic review of randomized controlled trials to identify RCTs demonstrating successful interventions that used communication interventions to impact patient outcomes. <h3>Setting or Dataset</h3> We retrieved studies from Embase, Wiley, Cochrane, and MEDLINE published until February 2022. Additional relevant studies were used from references listed in systematic reviews found in our search. <h3>Population Studied</h3> Included studies were required to be an RCT, had published results that reported intervention effects in a distinct-language discordant population, or in which ≥ 80% of the study population reported limited English proficiency. <h3>Intervention/Instrument</h3> Multiple interventions utilized, as specified in each study. <h3>Outcome Measures</h3> We constructed a framework to organize interventions used by outcome. (e.g., diagnosis of a condition; biological markers; knowledge; attitude; quality of life and change in symptoms; individual or group behavior, skills; healthcare process and system outcomes). <h3>Results</h3> Eighty-four studies fit inclusion criteria. Almost all included studies utilized interventions were efficacious compared to usual care. Studies utilizing interventions with one-on-one interaction tended to have significant outcomes. Additionally, studies with more than one intervention tended to use a mix of counseling and education. Overwhelmingly, however, the studies did not measure either changes in healthcare system processes nor implemented outcomes of effective interventions at the clinical setting’s point-of-care. <h3>Conclusions</h3> Utilized interventions need to address healthcare system processes and/or implement effective interventions at the clinical settings’ point-of-care. There remains a gap in extant research on “clinician-facing” or “supply-side” outcomes. There is a need to focus on implementation into practice and study the results of putting effective communication interventions into systematic practice at the point of care, for both patient and process outcomes.