Table 1 Summary of included studies: quantitative N = 27
Author | Year | Country | Setting | Aspect measured in the Patient Reported Experience measure: topics and relevant questions | Sample and population | Description of qualitative and quantitative data collection (i.e. survey) | Specific strategies employed to improve participation of CALD population | How were recruitment sites identified and examples of places | Evidence of effectiveness of strategy to increase CALD patient participation | |
|---|---|---|---|---|---|---|---|---|---|---|
1. | Bockey | 2020 | Germany | Primary care | Integrated health care facility (ICF) | N = 102 patients | Cross sectional study Quantitative study: Questionnaire with open and closed ended questions Questions derived from the validated German ZUF-8 client satisfaction | • Questionnaire was translated into five key languages spoken including English, German, Arabic, French and Chinese • English and German language questionnaires were offered verbally as face-to-face interviews • peers were permitted to assist with the completion of questionnaires in other languages • The questions were pilot tested with the Integrated care facility staff members • Intra-method mixing, a technique that uses both open and closed ended items to achieve more comprehensive data | Participants (asylum seekers and refugees) living in the Integrated care facility were recruited | Response rate -60% |
2. | Boutziona | 2020 | Greece | Hospital | Emergency department experience Specific questions: Do you visit Albania looking for medical care? Do you think it is better to address a health problem in Greece than in Albania? | Snowballing sampling- N = 167 adult patients of Albanian origin completed the questionnaire | Cross sectional study Quantitative: Survey | • A pilot questionnaire was initially developed and tested on a sample of 15 patients (Albanian immigrants), to determine its applicability and validity to the specific population • The questionnaire was cross translated from Greek into Albanian, and vice-versa, in order to ensure coherence between the Greek and Albanian versions • Eligible patients were asked if they would like to participate in the study while waiting for their test results | adult patients of Albanian origin who visited the ED of a tertiary general hospital was invited to participate | Response rate 83.5% (167/200 surveys completed) Although 75% of participants reported they had good knowledge of the Greek language and could use it to function in their daily lives, only 27.5% of them chose to complete the questionnaire in Greek |
3. | Cook | 2015 | USA | Primary care | Integrated care: health centre medical home care | N = 488 patients surveys | Patient experience Quantitative Study: Clinician and Group Surveys Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) and the CG-CAHPS PCMH item set | • As many surveyors were multi or bilingual, patients were surveyed in their chosen language of English, Spanish or Haitian Creole • Patients were advised that they would receive a $5 Wal-Mart gift card for completing the survey • The project team developed an initial question set. The final tool was pilot tested with four patients, which resulted in minor revisions to wording | All surveys were conducted face-to-face at the Health Centres by faculty and students from a Master of Public Health program | Response rate: 96.6% (488/505 surveys completed) |
4. | Cook | 2016 | USA | Primary Care | Integrated care: Patient-Centered Medical Home (PCMH) | N = 351 patients | cross-sectional study design Quantitative: 36 item questionnaire designed from previously validated questionnaires | • The questionnaire was translated into Spanish and Haitian Creole by native language speakers to improve the cultural appropriateness of survey questions • Administered questionnaire online and face to face in different languages • Patients, if they asked, had access to a printout of the questions to follow along with the surveyor • Patients received a $5 gift card for completing the questionnaire | At each of the four sites, surveyors had full access to screen and recruit patients from waiting rooms, using a convenience sampling approach. Surveyors approached adult patients who were not otherwise engaged (eg, talking on cell phone; sleeping) | Estimated 90% |
5. | Detollenaere | 2018 | Europe | Primary care | Patient satisfaction with general practice | Patients completed the questionnaire Europe wide | Cross-sectional study Quantitative questionnaire | • Social groups were identified according to four patient characteristics: education, household income, ethnicity and gender (male/female) | Patients sitting in the waiting room of the GP were asked to participate | Response rate was 74.1% |
6. | Eskes | 2013 | USA | Primary care | Spanish Patient satisfaction with primary care | Consecutive sampling | Quantitative questionnaire | • Spanish version of the survey used • Survey shortened in order to be completed in clinical setting • Participants were provided with a cover letter in Spanish explaining that their participation in the survey was voluntary | Patients recruited from community care clinics | Not reported |
7. | Gurbuz | 2019 | Germany | Hospital | Patient satisfaction: Maternity care | N = 410 patients | Quantitative questionnaire. A modified version of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) | • Questionnaire translated in in German, English, French, Spanish, Arabic and Turkish was used • Offering to complete the questionnaire in an interview | Patient invited from sites where they had given birth | The overall response rate of evaluable questionnaires was 58.4% (410 out of 701 women) |
8. | Henderson | 2018 | UK | Hospital | Patient satisfaction with Maternity Care | Random sample N = 5332 patients | Cross sectional study Quantitative questionnaire | • Patients were mailed the questionnaire • Invitation to participate included a sentence in 18 different languages which encouraged them to call a Freephone number to enable them to complete the questionnaire by interview or through an interpreter if preferred | none | 5332 women responded to the survey (a usable response rate of 54%) |
9. | LaGrandeur | 2018 | USA | Community setting | Patient experience with student directed free clinic for pediatric patients | N = 63 patients | Quantitative questionnaire Parents of patients were surveyed using an instrument created by Commitment to Underserved People (CUP) students through small group discussion in 2017 for use in the TotShots program | • Offered in English and Spanish | Patients recruited using social media, and email communication with school district social workers, coaches, and nurses | Response rate 95.4% |
10. | Lim | 2019 | Australia | Hospital | Care coordination and health literacy | N = 68 patients and n = 8 carers | Cross sectional study Quantitative questionnaire Health Literacy and Cancer Care Coordination questionnaires | • Chinese versions of both HLQ and CCCQ, which were translated using the forward‐backward procedure were used • Questionnaire pilot tested with leaders of Chinese community cancer support organisations in Sydney, Australia to ensure clarity and cultural appropriateness | Participants recruited if they attended Chinese community cancer support organisations or cancer treatment centres across the wider Sydney region | None reported |
11. | Lindberg | 2019 | Denmark | Hospital | Mental health treatment | n = 686 | Cross sectional study Quantitative questionnaire- patient satisfaction questionnaire | • Questionnaire developed after clinical experience with a multicultural patient population • The questionnaire was forward–backward translated from Danish to five additional languages: Arabic, Bosnian, English, Persian and Russian | Participants received the questionnaire after the last treatment session and could complete it immediately or at home and return it by mail. If participants missed their last session, the questionnaire and a stamped return envelope were mailed to them | Response rate 76.6% |
12. | Mander | 2016 | Australia | Hospital | Maternity care | N = 655 women with CALD background | Cross sectional study Quantitative questionnaire- Having a Baby in Queensland Survey 2012 | • Multiple formats of the survey: The survey could be completed on paper (Returned via mail with provided reply-paid envelope) or online • Survey could also be completed over the telephone with a trained female interviewer and translator if required • Multiple language instructions: Instructions for survey participation and completion were provided in English and 19 other languages • Special questions to identify CALD population: (“Where were you born?” “Do you identify with any cultural group(s) or ethnicity?”; “What language(s) do you speak at home?”) | None | None |
13. | Martino | 2022 | USA | Community setting | Integrated care: Healthcare experience | Hispanic patients living in rural residence experience with healthcare | Quantitative questionnaire- Healthcare Providers and Systems (CAHPS) survey | • Multiple languages and multiple formats: The surveys were administered in English and Spanish by mail, with bilingual telephone follow-up of nonrespondents • Specific questions to identify race /ethnicity: Are you of Hispanic or Latino origin or descent? | none | Response rate: 42–43% |
14. | Moroz | 2003 | USA | Community setting | Healthcare experience: convalescence care | N = 70 patients | Quantitative questionnaires | • The survey available in Chinese language • Patients could be assisted in completing the survey | Via patient brochures Outreach specialist visited 12 community sites Relevant doctors were provided with information about the program | none |
15. | Nayfeh | 2021 | Canada | Hospital | End of life care for patients with diverse backgrounds | N = 1543 | Quantitative questionnaires: End-of-Life Satisfaction Survey was used to measure satisfaction with the quality of inpatient end of-life care from the perspective of next-of-kin of recently deceased patients at Sunnybrook Health Sciences Centre in Toronto, Ontario | • The items included: patient race/ethnicity (Caucasian, Caucasian, Mediterranean, Black, East Asian, South Asian, Southeast Asian, Middle Eastern, Hispanic, First Nations, and other); patient religion [Atheist, Buddhist, Christian (all denominations), Hindu, Jehovah’s Witness, Jewish, Mormon, Muslim, Sikh, no religion, other]; level of religiosity/spirituality; and preferred spoken language • Invitation letter accompanying the survey explained the confidential and voluntary nature of the request. One reminder survey was sent three weeks after the initial mail-out to those who did not respond | none | Response rate was 37.7% |
16. | Olausson | 2016 | Sweden | Public dental services | Dental services | Quantitative questionnaires: Dental Visit Satisfaction Scale (DVSS) | • Multiple languages: The questionnaires were available in English, Swedish, Arabic and Farsi • At the clinics all patients aged 18 or older were asked to participate. Most completed the questionnaires in the waiting room prior to treatment, but five people answered the questionnaires at home and mailed them back • The participants were asked about the following background factors: Gender; Age; Education; Dental habits; Country of origin; Skills in Swedish language | Two of the clinics were located in multicultural areas with a high proportion of foreign-born patients | response rate was 74% | |
17. | Parast | 2022 | USA | Hospital | Emergency department—racial/ethnic differences in the experience of care received during an ED visit | N = 16,006 eligible patients discharged from the 50 hospitals were randomly sampled survey modes | Quantitative questionnaires: Emergency Department Patient Experience of Care (EDPEC) DTC Survey | • Different modes of survey administration: mail only, telephone only, or mixed mode (mail with telephone follow-up); the survey was conducted in English • Linear regression used to measure the differences in patient experiences based on racial /ethnic group | None reported | response rate: 20.25% |
18. | Pinder | 2016 | UK | Hospital | Patients experiences of receiving care for cancer | N = 138 878 responses from 155 hospital trusts across the National Health Service in England | Quantitative questionnaires: National Cancer Patient Experience Survey (NCPES) | • Survey included questions related to: Sex, employment status and ethnicity | The Index of Multiple Deprivation (IMD), the official composite measure of deprivation in England, was derived on the basis of patient postcode ascertained from the health record. This was done to ascertain whether the patient was categorised as deprived | Response rate of 63.9% |
19. | Platonova | 2016 | USA | Community Setting | Integrated care: Patient-centered medical home (PCMH) | N = 548 patients | Cross sectional study Quantitative questionnaires: multi-item Consumer Assessment of Healthcare Providers and Systems scales developed by the Agency for Healthcare Research and Quality | • Patients were approached by research staff while waiting for their appointments • Multiple languages: The survey was available in English and Spanish. Survey • items were translated from English into Spanish by professional translators and reviewed by Spanish-speaking healthcare professionals • Some screening questions were removed or rephrased to shorten the survey, reduce the complexity and to reduce the reading level | Study conducted in 2 independent free clinics in a large metropolitan area in the Southeastern United States | Response rate 66% |
20. | Redshaw | 2018 | UK | Hospital | Maternity care: Care associated with stillbirth | N = 473 participated in the survey | Quantitative survey | • An information sheet in 18 non-English languages gave information regarding a contact number for the team | Response rate 30% | |
21. | Ryan | 2018 | USA | Community setting | Mental health: Promotion of mental health (Mindfulness) among Latina immigrant women | N = 24 women | Quantitative: pre and post test survey | • Spanish version of the surveys used and demographic information was collected • Trained bilingual interviewers administered the surveys to participants in separate sessions before and after the intervention’s five sessions • Participants received a gift card in the amount of 20 dollars for each survey completed | None | None reported |
22. | Schinkel | 2016 | Netherlands | Community Setting | Integrated care: Exploration of patients’ preferred and perceived participation and doctor–patient concordance in preferred doctor–patient relationship on patient satisfaction | N = 236 patients | Quantitative questionnaires: Pre and post test design After signing the informed consent form in the waiting room, participants were given preconsultation questionnaire. Following the consultation with the GP, they were given a post consultation questionnaire | • Recruitment in waiting rooms • Recruited both Dutch and bilingual Turkish-Dutch assistants for data collection • Multiple languages: questionnaires available in Dutch and Turkish • The patient questionnaires were pilot-tested twice among low-educated and low-literate Dutch and Turkish-Dutch people to ensure that all items were comprehensible to the targeted populations | none | none |
23. | Schutt | 2020 | USA | Hospital | patient navigators and services for chronic illness | N = 157 patients before and N = 378 patients after | Quantitative questionnaires: Pre and post test design Health care satisfaction surveys both before and after the program design | • surveyed by phone both before and after the program design • Multiple languages: Questionnaires were translated into Spanish and Portuguese | none | none |
24. | Sharif | 2019 | USA | Community care | Integrated care: healthcare experiences of Cambodian American refugees and immigrants | N = 308 patients | Quantitative questionnaires: questionnaires and medical records from two community clinics in Southern California | • A bilingual Khmer research assistant described the study to each patient, obtained informed consent from any interested patients and administered the baseline questionnaire • Data were collected on the respondents’ sociodemographic information, including gender current age, age at US entry, year of immigration to the US educational attainment, religious affiliation, employment status, participation in Food Stamps program, total annual household income and household size | patients recruited from two community clinics (one which has 11 different locations and the other with one location) in Long Beach, California | none |
25. | Shin | 2020 | USA | Hospital | Patient experience with clinical pharmacist services | N = 99 Patients | Cross sectional study design Quantitative questionnaire: Oxford Patient Involvement and Experience Scale | • Multiple languages: survey offered in English and Spanish • Clinical pharmacists read out loud a script which described the survey purpose (i.e., to get feedback about and improve pharmacist services), directions, and privacy procedures | The patients completed surveys in a designated area in the clinic, but away from their clinical pharmacist, and surveys were inserted into a sealed box | none |
26. | Soo | 2013 | Canada | Hospital | Radiation therapy | N = 128 | Quantitative questionnaire: patient satisfaction survey | • Multiple languages: Chinese version of the questionnaire • The survey was pre-tested on volunteers and staff members for construct validity | No information | none |
27. | Yelland | 2015 | Australia | Hospital | Maternity care—views and experiences of immigrant women of non-English speaking background (NESB) giving birth in Victoria, Australia | N = 4516 | Quantitative questionnaire: | • Multiple languages: survey available in Arabic, Vietnamese, Cantonese, Mandarin, Somali, Turkish • Women were posted a questionnaire six months following the birth, together with a covering letter, and a reply paid envelope for returning the completed questionnaire | None | None |