Strategies to improve telehealth access for culturally and linguistically diverse communities: a systematic review.

Victor M Gallegos-Rejas, Keshia R De Guzman, Jaimon T Kelly, Anthony C Smith, Emma E Thomas
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Abstract

Aims: CaLD populations face considerable digital health inequities; strategies are needed to ensure telehealth models of care are available to all. We aimed to identify and describe interventions that enhance telehealth access for CaLD communities.

Methods: We systematically searched four databases (PubMed, Scopus, Embase, and CINAHL). Included studies were published between 2011 and 2024 and reported on at least one of the outcomes described in the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework. Two authors independently screened articles, solutions were synthesized qualitatively.

Results: Twenty-seven articles were included in the review and primarily used videoconferencing as the predominant telehealth modality (n = 14, 52%). Five strategies were identified to promote telehealth use across CaLD communities including: (i) Provide bilingual options; (ii) Enhance staff cultural competence; (iii) Provide flexible adaptions to align with consumer needs; (iv) Supply technology and technological support; and (v) Involve digital health navigators and/or health educators.

Conclusions: Culturally competent professionals supported by language services and technological support are strategies which can help improve equity of access to telehealth services for people from CaLD communities. Such strategies can support the implementation of practical solutions to overcome health inequities and prevent access gaps.

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改善文化和语言多样化社区远程保健服务的战略:系统审查。
目标:非发达国家人口面临相当大的数字卫生不平等;需要制定战略,确保所有人都能获得远程保健模式。我们的目的是确定和描述增强CaLD社区远程医疗访问的干预措施。方法:系统检索PubMed、Scopus、Embase、CINAHL四个数据库。纳入的研究发表于2011年至2024年之间,并报告了Reach、有效性、采用、实施和维护(RE-AIM)框架中描述的至少一项结果。两位作者独立筛选文章,定性合成溶液。结果:27篇文章被纳入综述,主要使用视频会议作为主要的远程医疗方式(n = 14, 52%)。确定了五项战略,以促进土著居民社区的远程保健使用,包括:(i)提供双语选择;提高工作人员的文化能力;提供灵活的调整,以配合消费者的需要;提供技术和技术支助;㈤让数字健康导航员和/或健康教育工作者参与进来。结论:在语言服务和技术支持的支持下,具有文化能力的专业人员是有助于提高CaLD社区人民获得远程保健服务的公平性的战略。这种战略可支持实施切实可行的解决办法,以克服卫生不公平现象和防止获取差距。
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