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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 5 of 5 Research Studies DisplayedDiMeo A, Karlage A, Schoenherr K
Cultural brokering in pregnancy care: a critical review.
This study is a literature review of cultural brokering during pregnancy. The authors identified 33 articles in their literature search. They found that cultural brokering is not clearly defined in the current literature. Only a few articles provided information about language concordance between cultural brokers and patients or clinicians, with no articles describing the impact of cultural brokering on health outcomes. Cultural broker facilitating was described as providing information about language concordance between cultural brokers and patients or clinicians. Barriers included misunderstanding the responsibilities, difficulty maintaining personal boundaries, and limited availability and accessibility of cultural brokers. They propose cultural brokering as interactions that cover four key aims: (1) language support; (2) bridging cultural differences; (3) social support and advocacy; and (4) navigation of the healthcare system.
AHRQ-funded; HS026370.
Citation: DiMeo A, Karlage A, Schoenherr K .
Cultural brokering in pregnancy care: a critical review.
Int J Gynaecol Obstet 2023 Nov; 163(2):357-66. doi: 10.1002/ijgo.15063..
Keywords: Maternal Care, Women, Clinician-Patient Communication, Cultural Competence
Salinas KE, Bazan M, Rivera L
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
The purpose of this study was to explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers. The researchers conducted focus groups with patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center. A total of seven focus groups with 27 total participants were held. The study identified three key themes regarding preferences in patient experiences and communication when seeking pregnancy care: 1. language discordance and concordance between patients and clinicians exist on a spectrum and are not binary; 2. language-discordant care presents communication challenges, even when interpreters are present; and 3. language discordance can be effectively addressed with positive interpersonal engagements between clinicians and patients.
AHRQ-funded; HS026370.
Citation: Salinas KE, Bazan M, Rivera L .
Experiences and communication preferences in pregnancy care among patients with a Spanish language preference: a qualitative study.
Obstet Gynecol 2023 Nov 1; 142(5):1227-36. doi: 10.1097/aog.0000000000005369..
Keywords: Maternal Care, Women, Communication, Cultural Competence, Racial and Ethnic Minorities
Truong S, Foley OW, Fallah P
Transcending language barriers in obstetrics and gynecology: a critical dimension for health equity.
This article discusses the issue of language barriers in obstetrics and gynecology. The authors present two cases of language-discordant care and a framework for addressing language as a critical lens for health inequities in obstetrics and gynecology, which includes a variety of clinical settings such as labor and delivery, perioperative care, outpatient clinics, and inpatient services, as well as sensitivity around reproductive health topics. Drivers of language-related inequities at the clinician, health system, and societal level are explored in the proposed framework. They end with actionable recommendations for enhancing equitable care for patients experiencing language barriers.
AHRQ-funded; HS026370.
Citation: Truong S, Foley OW, Fallah P .
Transcending language barriers in obstetrics and gynecology: a critical dimension for health equity.
Obstet Gynecol 2023 Oct 1; 142(4):809-17. doi: 10.1097/aog.0000000000005334..
Keywords: Cultural Competence, Women, Maternal Care, Disparities
Jensen JL, Sweeney A, Gill C
Evaluation of patient access to Spanish-language-concordant care on a postpartum unit.
This study evaluated patient access to Spanish-language-concordant care on a postpartum unit and to identify facilitators and barriers to the use of interpretation services. This mixed-methods study included a chart review of 50 randomly selected birthing parent-newborn couplets and interviews with 14 inpatient health care team members, and semistructured interviews at a tertiary academic medical center in the southeastern United States. The chart review included examination of patient characteristics, health care team composition including Spanish language proficiency, length of stay, number of interpreter requests, and time between clinician interpreter requests and interpreter arrival on the unit. Access to an interpreter or clinician certified in medical Spanish was offered to 12 of 50 (24%) couplets upon admission to the unit and to 7 of 50 (14%) of couplets for daily maternal and newborn medical rounds. Clinicians reported on long and unpredictable wait times to access interpreters. Temporary solutions included relying on hand gestures, broken Spanish, and smartphone apps to "get by" when communicating with patients without certified interpretation services. These deviations from national standards may put postpartum families at risk for harm.
AHRQ-funded; HS027260.
Citation: Jensen JL, Sweeney A, Gill C .
Evaluation of patient access to Spanish-language-concordant care on a postpartum unit.
Nurs Womens Health 2022 Dec;26(6):429-38. doi: 10.1016/j.nwh.2022.09.002.
Keywords: Maternal Care, Cultural Competence, Clinician-Patient Communication, Communication
Hunte R, Klawetter S, Paul S
"Black nurses in the home is working": advocacy, naming, and processing racism to improve Black maternal and infant health.
The purpose of this qualitative study was to examine how Black women’s health, pregnancy and parenting are impacted by racism, and how the relationship between Black women’s health, pregnancy and parenting and racism-related stress are affected by a culturally-specific perinatal care program. The researchers conducted focus groups and utilized a Black Feminist approach to center the perspectives and lived experiences of Black women. Four themes surfaced in the analysis, including: 1) The widespread reach of structural racism, 2) Trust and healing facilitated through shared identities, 3) Racism directly impacts mental health, and 4) Advocacy at all levels is a vital service. The researchers concluded that structural racism has chronic and toxic effects on Black women’s physical and mental health, and Black perinatal care should include: culturally-specific approaches, advocacy, mental health support with specific attention to racism-related stress, and examination of implicit biases.
AHRQ-funded; HS026370.
Citation: Hunte R, Klawetter S, Paul S .
"Black nurses in the home is working": advocacy, naming, and processing racism to improve Black maternal and infant health.
Matern Child Health J 2022 Apr;26(4):933-40. doi: 10.1007/s10995-021-03283-4..
Keywords: Racial and Ethnic Minorities, Women, Maternal Care, Pregnancy, Newborns/Infants, Cultural Competence