Cross-cultural communication in a women's health service: A mixed-methods evaluation

BackgroundEffective communication is critical to safety and quality in healthcare. Women with limited English proficiency face cultural and linguistic barriers to quality communication in anglophone settings, perpetuating poor health outcomes and health inequity. Womens perspectives are essential to inform future evidence-based strategies. This study aimed to evaluate and explore womens experiences of cross-cultural communication within a womens health service. MethodsWomen receiving maternity or gynaecology care at a womens health service in Western Australia were eligible to participate if they had accessed interpretation support in Arabic, Burmese, Farsi, Mandarin or Vietnamese. A total 68 women completed a cross-sectional survey; 15 women participated in a semi-structured telephone interview. Quantitative and qualitative data underwent descriptive statistical and multilingual reflexive thematic analyses respectively. ResultsParticipants reported diverse language preferences and skills, most frequently identifying Mandarin, Arabic and Vietnamese as their preferred language. At their most recent visit, most recalled having an in-person interpreter present speaking their preferred language. However, less than half of participants were provided with written health information resources in their preferred language. Three themes, the role of interpretation, navigating the health service with uncertainty, and a foundation of trust, explore facets of womens experiences, linked by an overarching theme, Health is too important not to understand. ConclusionsThis study highlights the need for proactive service-wide approaches to cross-cultural communication encompassing but not exclusive to, clinical encounters, offering insight into key systemic gaps. Improved integration of interpretation services, language-concordant information resources and language-concordant support for service navigation are recommended. Plain language abstractEffective communication is critical for safety and quality in healthcare. Barriers to cross-cultural communication perpetuate health inequities. This study found that participants experienced inconsistent access to and quality of professional interpretation, provision of language-concordant health information resources was inadequate, and language support was limited to clinical interactions, impeding service navigation. Proactive strategies are recommended to improve service-wide cross-cultural communication not only in clinical encounters, but in womens broader interactions with health services.