Defining terminology for patients and families who speak languages other than English: a scoping review

Many people across the globe speak a language other than English in English-dominant countries. This large, heterogeneous patient group is known to experience worse health outcomes, such as increased hospital admission and misdiagnosis. Despite this, there is no current standard way to refer to patients or families with preferred language other than English – a critical step in being able to consistently identify and support these patients in healthcare settings. This study aims to better understand the breadth of different terms used in the current literature to describe patients and families with preferred language other than English and how these terms are defined. This scoping review searched seven databases from 2014-January 2024. Articles meeting the following criteria were included: (1) English-language full-text original articles; (2) any study focused on healthcare; and (3) uses an explicitly defined term to describe patients or families who speak languages other than English. Screening and data extraction occurred independently and in duplicate. Data extracted included study and demographic information, and details of terminology used. A total of 167 studies were included, with the majority coming from the United States and Australia. Twenty-nine unique terms were identified, including Culturally and Linguistically Diverse (CALD), Limited English Proficiency (LEP), language concordance, linguistically diverse, non-English preferring, and linguistic isolation. There was substantial variability both in the terms themselves and in how the terms were defined. The heterogeneity of terms and definitions used in current literature demonstrates a lack of understanding of what terms to use and when. There is an urgent need for medical and research communities to be more intentional and precise in how they describe patients and families who speak languages other than English. Establishing common terminology for patients and families who speak languages other than English is critical to standardizing ways to measure and report data to guide health services interventions that address health equity.