Effect of Interventions to Facilitate Communication Between Families or Single Young People with Minority Language Background and Public Services: A Systematic Review

This systematic review examines whether aids for communication are effective between public services and children and youth, or families with an immigrant background. The researchers analyse relevant studies, and the team included four comparative studies, three for health services and one for education. There is no clear indication that any particular approach to interpretation works better than others. None of in‐person, telephone, bilingual staff or ad hoc interpreting could demonstrate a clear advantage over other approaches. There is uncertainty about the reliability of this finding because the studies had limitations, including small scale. One study of the effect of two different training programmes of English as a Second Language (‘ESL’) suggests that an enhanced ESL class (where the course was tailored to immigrant parents) improved parents' involvement in students' schoolwork and parents' English skills more than a regular ESL course. There is uncertainty about the reliability of this finding because the study had important limitations, including small scale. Similar studies of more robust design are needed in order to draw firm conclusions. Key messages Over recent decades, the number of immigrants with minority language background has increased. This has occurred in many countries, including those with a tradition of relatively low immigration. In consequence, a higher share of children, young people and families with minority‐language and immigrant backgrounds may need to communicate with public service providers. In this report, we examine whether interventions to facilitate communication between public services, on the one hand, and minority language children and youth or families with an immigrant background, on the other, are effective. Examples of such interventions are types of interpretation services and foreign language training programs. We included in this review four studies that addressed families with children or parents with minority language backgrounds; we found no studies exclusively addressing youth with minority language backgrounds. Three studies conducted within the health services compared the effect of different types of interpretation service (in‐person interpreter, telephone interpreter, ad hoc‐interpreter) or bilingual personnel on different outcomes observed for families. None of these interventions appeared to stand out in favor of another. We were therefore unable to draw any conclusion on the effectiveness one of any particular type of interpretation service. We identified one study that compared the effect of two different training programs of English as a second language (ESL) on Spanish‐speaking parents' English skills and on parents' involvement in their children's school work. The findings indicate that an enhanced ESL class (i.e., an intervention guided by the theoretical frame on immigrant parent involvement) had a stronger impact on parents' involvement in students' schoolwork and parents' English skills than did an ESL‐course focusing solely on language skills. Although this is a promising finding, it was obtained from a small‐scale study, which had methodological limitations, and further studies with a more robust design are needed to allow firm conclusions on effectiveness to be drawn. We did not find any studies measuring the effect of interventions on the degree of trust between the respective parties. Executive Summary/Abstract BACKGROUND Over recent decades, the number of immigrants with a minority language background has increased. This has occurred in many countries, including those with relatively low levels of immigration. This increase is especially pronounced in the larger cities. As a result, a higher proportion of children, young people and families with minority‐language and immigrant backgrounds might need to communicate with public service providers. Public services are required by law to offer equal services to all client groups. This can mean an obligation to adjust services to cater to individual needs, e.g. with respect to language proficiency. Statistics show that immigrant children and their parents receive assistance from child welfare services proportionately more often than those who do not have such a background. Well‐functioning communication is a prerequisite to make such interventions work. The Norwegian Directorate for Children, Youth and Family Affairs commissioned the Social Research Unit at the Norwegian Knowledge Center for the Health Services to systematically review studies of the effect of interventions to facilitate communication between immigrant children, youth or families with minority language background and the public services. Examples of such interventions are the use of professional interpretation services, cultural interpreters and bilingual case workers. OBJECTIVES To systematically review studies on the effect of interventions intended to facilitate the communication between immigrant children, youth or families with minority language background, and public services such as child welfare services or health services. SEARCH STRATEGY We conducted a systematic literature search of twelve different databases in March 2013. Additionally, we searched for grey literature on relevant websites and hand‐searched reference lists of included publications. SELECTION CRITERIA Two review authors independently assessed the retrieved references (titles and abstracts) for inclusion/exclusion, based on the following inclusion criteria: 1)Population: Immigrant children, youth or families (with children under 18 years of age) with minority language backgrounds. 2)Intervention: a) Interventions to facilitate verbal or direct communication such as different types of interpretation services, b) interventions to facilitate written communication, such as translation of case documents or information materials, or c) broader interventions where improvement of communication between service providers and service recipients was addressed, such as second language training for parents to improve communication between school and parents. 3)Comparison: other active intervention or no intervention. 4)Outcomes addressing change in communication, user satisfaction, reported trust, use of services or similar indirect outcomes. 5)Study design: studies with control conditions. DATA COLLECTION AND ANALYSIS We extracted data from each study and summarized the results in a narrative format by means of tables for each comparison. We did not conduct meta‐analyses because the included studies were too different in terms of comparisons, outcomes and in the way results were reported. In consequence, we synthesized the results of the included studies narratively and in tables, categorized according to comparators and outcomes. We assessed the risk of bias of the included studies by using the Risk of Bias Tool of the Cochrane Collaboration. The quality of the evidence across all studies was assessed by using the Grading of Recommendation Assessment, Development and Evaluation tool (GRADE). RESULTS AND DISCUSSION Of a total of 9 896 references that emerged from the systematic literature search we included four studies, either randomized or quasi‐randomized controlled studies. One study addressed cooperation between schools and parents; three studies were conducted in the context of the healthcare services. We found no studies addressing children or youth only. Three studies conducted within the health services compared the effect of different interpretation services (in‐person interpreter, telephone interpreter, ad hoc‐interpreter) or bilingual personnel on different outcomes observed for families. They addressed both subjective (e.g., user satisfaction, self‐reported ability to communicate) and objective outcomes (e.g. words understood). The results indicate that interpretation services have a positive effect on communication. However, it makes little difference whether one chooses bilingual personnel, in‐person interpreter or telephone interpreter to facilitate communication; none of these interventions seems to outperform any of the others. We are unable to conclude on the relative effectiveness of any one type of interpretation service. One study compared the effect of two different training programs of English as a second language (ESL) on Spanish‐speaking parents' English skills and parents' involvement in children's school work. The findings indicate that an extended ESL Class had a higher impact on parents' involvement in students' schoolwork and parents' English skills than an ESL course focusing solely on isolated language skills. As this was a small‐scale study with methodological limitations, similar studies of more robust design are needed to allow any conclusions to be drawn. We did not find any studies measuring the effect of interventions on the degree of trust between the respective parties. There is a need for more randomized studies on a larger scale to address the effect of different interventions aimed at facilitating communication for this population, and particularly in domains beyond the health services. In addition, further studies are needed with control conditions that address the effect of similar interventions on outcomes related to children and youth. AUTHORS' CONCLUSIONS In a health service setting, the use of an interpretation service appears to help to increase communication quality, irrespective of the kind of interpretation service chosen. There is a need for additional studies of interventions intended to facilitate communication between the population and public services, particularly for services outside health care, such as child welfare, school and early childcare, work and welfare services, and prison and probation services.