Effect of interventions to facilitating communication between families with children or single young people with minority language background and public services
Systematic review
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The question we address in this report is whether interventions to facilitate communication between minority language children, young or families with immigrant background and public services are effective.
Key message
The number of immigrants with minority language background has increased over the last decades in Norway, in particularly in larger cities.In consequence, a higher share of children, young people and families with minority-language and immigrant background might need to communicate with public service providers. The question we address in this report is whether interventions to facilitate communication between minority language children, young or families with immigrant background and public services are effective. Examples of such kind of interventions are different types of interpretation services or foreign language training programs.
We included four studies in total, addressing families with children or parents with minority language backgrounds; we found no studies exclusively addressing youth with minority language backgrounds. We identified one single study that compared the effect of two different training programs of English as a second language on Spanish speaking parents’ English skills and parents’ involvement in their children’s school work. The findings indicate that an extended English as a Second Language Class (ESL) had a higher impact on parents’ involvement in students’ schoolwork and parents’ English skills than an ESL-course focussing solely on isolated language skills. This is a promising finding. As this was a small-scale study with methodological limitations, we need similar studies with a more robust design, to draw any conclusions.
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. None of these interventions appeared to stand out in favour of another. Thus, we cannot draw any conclusion on the effect in favour of one particular interpretation service.
We did not find any studies on interventions measuring the effect on the degree of trust.
Summary
Background
The number of immigrants with minority language background has increased during the last decades in Norway, in particularly in the larger cities. In consequence, a higher share of children, young people and families with minority-language and immigrant backgrounds might need to communicate with public service providers. Public services are decreed by law to offer equal services to all client groups. Thus, one needs to adjust services to the individuals’ needs, e.g., with respect to language proficiency.
Statistics show that immigrant children and their parents more often receive assistance form child welfare services compared to those who do not have this background. However, well-functioning communication is a prerequisite to make such interventions work.
The Norwegian Directorate for Children, Youth and Family Affairs has commissioned the Social Research Unit at the Norwegian Knowledge Center for the Health Services to systematically review studies on the effect on interventions to facilitate communication between immigrant children, youth or families with minority language background and the public services. Examples of such interventions are professional interpretation services, cultural interpreters and bilingual case workers.
Objective
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.
Method
We conducted a systematic literature search in twelve different databases in March 2013. Additionally, we searched for grey literature on relevant web-sites and hand-searched reference lists of included publications. Two review authors independently assessed the retrieved references (titles and abstracts) for inclusion/exclusion, based on the following criteria:
- Population: Immigrant children, youth or families (with children under 18 years of age) with minority language backgrounds.
- Intervention: a) Interventions to facilitate verbal or direct communication such as different types of interpretation services, b) interventions to facilitate written communication, e.g., translation of case documents, information materials or c) broader interventions where improvement of communication between service providers and –service receivers was addressed, e.g., second language training.
- Comparison: other active intervention or no intervention.
- Outcomes addressing change in communication, user satisfaction or reported trust, use of services or similar indirect outcomes.
- Study design: studies with control conditions. 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
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.
One single study compared the effect of two different training programs of English as a second language on Spanish speaking parents’ English skills and parents’ involvement in children’s school work. The findings indicate that an extended English as a Second Language Class (ESL) 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, we need similar studies with a more robust design, to draw any conclusions.
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. None of these interventions appeared to stand out in favour of another. Thus, we cannot draw any conclusion on the effect in favour of one particular interpretation service.
We did not find any studies on interventions measuring the effect on the degree of trust.
Discussion
We did not conduct meta-analyses because the included studies were too different in terms of comparisons, outcomes and not least in the way results were reported. In consequence, the results were summarized in a narrative format by means of tables for each comparison. Three among four of the included studies compared the effect of different interpretation services on both subjective (e.g., user satisfaction, self-reported ability to communicate) and objective outcomes (e.g. words understood). In sum, the results from the three studies within health services indicate that interpretation services have an effect on communication, no matter which kind of service is chosen. With other words, it makes little difference, whether one chooses bilingual personnel, in-person interpreter or telephone interpreter to facilitate communication between families with children with minority language background and health services. However, we know little how these interventions work in other contexts, e.g. child welfare.
One single study with few participants, conducted in a school-setting, found that an extended English as a Second Language Class (ESL) had a higher impact on parents’ involvement in students’ schoolwork and parents’ English skills than an ESL-course focusing solely on isolated language skills. This is a promising result, even though we cannot draw any conclusions to the Norwegian context from one US American, single study with few participants.
Thus, we do need more randomized controlled studies of a larger scale that address the effect of different interventions to facilitate communication, specifically in other domains than the health services. In addition, we need studies with control conditions what address the effect of similar interventions on outcomes related to children and youth.
Conclusion
For the health service setting, interpretation service matters to increase communication quality, no matter what kind of interpretation service is chosen. There is a need for additional studies of interventions intended to facilitate communication between the population and public services, in particular within other services than health care, e.g., child welfare, school and early childcare, work and welfare services and prison and probation services.