Language and psychosocial factors associated with post-graduate retention of anglophone health and social services students in Quebec

Language minorities often encounter language barriers when accessing health and social services. Specifically, anglophones in Quebec are a growing population but often report difficulties accessing these services and receiving personalized care due to language barriers. Many studies have explored the retention of healthcare and social service workers capable of delivering services in English. Results have shown that many anglophone students in these sectors choose to leave the province post-graduation. Thus, this study will investigate various key factors that may predict the retention of anglophone health and social service graduating students in Quebec. The results will enhance our understanding of why anglophone students choose to stay or leave the province. This knowledge will help develop programs aimed to incentivise anglophones to remain and work in the health and social services sectors in Quebec.

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Outputs:

• Loiselle, C.G., Durand, A. B., Monarque, M., Brown, T. L.. (manuscript In preparation). Predictive retention factors of English-speaking health and social service students graduating from an Anglophone Québec university.

• Brown, T. L., Durand, A., Monarque, M., & Loiselle, C. G. (2022, May). Language and psychosocial factors associated with post-graduate retention of anglophone health and social services students in Quebec [Poster Presentation]. Poster presented at the World Conference on Health Promotion, Montreal, Quebec.

• Brown, T. L., Monarque, M., Durand, A., & Loiselle, C. G. (2021, December). Key psychosocial predictors of students' retention. In C. G. Loiselle (Chair), Language matters: Dialogue McGill’s supported initiatives [Symposium]. Dialogue McGill Conference, virtual.

Innovative Practices in Service Provision with Interpreters in Times of Health Crisis: A Qualitative Study of Clinicians, Interpreters, and Service Users’ Perspectives

Language barriers hinder access and quality in health and social services. Attention to cultural and social norms is also key to the provision of good care, especially with migrants and refugees. The benefits of working through interpreters have been documented, yet not in the context of health crises nor from the perspective of service users. Our study explores how practitioners, interpreters, and service users in Quebec provide/receive health and social services during the COVID-19 crisis. Individual semi-structured interviews (n=60) will be conducted with public and community-based health and social service providers, interpreters, and non-francophone users in Montreal and Quebec. Interviews will explore (a) innovative practices in service provision with interpreters used during the COVID-19 crisis and (b) barriers and enablers to the success of these practices. Interviews will be conducted by phone, skype, or in-person following Public Health guidelines, with assistance of an interpreter when necessary. Interviews will be audio recorded with permission of participants, transcribed verbatim, and translated into English or French. Interview transcriptions and interviewers’ fieldnotes will be analyzed thematically using NVivo 12. The perspectives of clinicians, interpreters, and users will be contrasted within and across practices and socio-demographic groups. Innovative practices will be classified using the Innovative Practices Evaluation Framework. Special attention will be paid to ensuring voluntary and respectful participation and confidentiality. Ethics approval will be sought from the CIUSSS West Centre Montreal and researchers’ universities. This study will identify innovative strategies for service provision through interpreters in times of health crisis, including digital innovations.

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Outputs:

• Ruiz-Casares, M. & Bentayeb, N. (March, 2022). Intervenir avec interprètes durant la COVID-19 : le point de vue des intervenant.e.s, des interprètes et des usager.ère.s [webinar]. Sherpa University Institute.

Does language ecology in Québec modulate COVID-19 health access or outcomes?

The COVID19 pandemic suggests that language barriers impact access to health-related information and medical outcomes in Québec at societal and individual levels. The Association for Canadian Studies recently reported that English minority speakers in Québec have greater COVID19-linked anxieties and distrust of Québec Provincial pandemic governmental policies, compared to French majority speakers. Currently unclear is what gives rise to these differences, and how language barriers impact both personal attitudes and societal public health outcomes regarding the pandemic. Guided by sociolinguistic and psychological theory, reseachers will investigate several factors including people’s language experience, interpersonal networks, community contexts, and society-level constraints. We will use cutting edge social network analyses and statistical modelling approaches to analyze large-N, language-tagged, COVID19 questionnaire data from Anglophone and Francophone respondents across Quebec, particularly in Montreal. The team, comprised of language scientists, social psychologists, and big data scientists, is uniquely qualified to address these urgent questions. This work will generate important, timely knowledge and student training opportunities about language barriers faced by English minority speakers that are relevant to COVID19 health access and public health outcomes in Quebec.

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Outputs:

• Hernández-Rivera, E., Gullifer, J. W., & Titone, D. (2022). Socioecological and psycholinguistic approaches to multilingual health literacy. Translational Issues in Psychological Science. https://doi.org/10.1037/tps0000325

• Hernández-Rivera, E., Gullifer, J. W., & Titone, D. (2022). Socioecological and psycholinguistic approaches to multilingual health literacy.Translational Issues in Psychological Science, 8(2), 197–209. https://doi.org/10.1037/tps0000325

• Hernández-Rivera, E., Marco S. G., Ahia, M., Tiv, M., Knäuper, B., Johns, B. T., Doucerain, M., & Titone, D. (In prep). Does language ecology in Québec modulate COVID19 health access or outcomes?

• Ahia, M., Hernandez-Rivera, E., Titone, D. (2021). Do Language Use Affiliations Predict Health Outcomes? COVID-19 Publich Health Outcomes in Linguistic Majority and Minority Populations in Montreal. [poster presentation]. Department of Psychology, McGill University, Montreal, Quebec.

• Hernández-Rivera, E., Marco S. G., Ahia, M., Tiv, M., Knäuper, B., Johns, B. T., Doucerain, M., & Titone, D. (2021). Language-Use and COVID-19 Outcomes: Exploring Population Data Across Two Canadian Cities. Presentation at the Dialogue McGill Annual Conference of 2021. Montreal, Canada.

• Hernández-Rivera, E. (2021) Invited Speaker: Experiencias en el uso de datos censales para estudiar de la distribución de COVID-19 en Canadá. Segundo Encuentro de Egresados de la Facultad de Medicina y Psicología. Department of Medicine and Psychology, Autonomous University of Baja California, Baja California, México.

Language minorities and the risk of depression among individuals suffering from a chronic disease: a retrospective study of the Canadian Longitudinal Study on Aging

The risk of depression in individuals with diabetes has not been evaluated in relation to language. Communication barriers may lead to isolation and impaired access to health care. This may affect the mental well-being of individuals specially those also suffering from a chronic disease such as diabetes. Researchers will use baseline and 3-year follow-up data of the Canadian Longitudinal Study on Aging Comprehensive cohort (CLSA; 2012-2015 and 2015-2018; ages 45-85 years, N=21,000) to determine, among those with and those without diabetes, the effect of maternal language (French, English or Other) on the risk of depression at three years and on the rate of seeking mental health care for depression.

The cohort will include CLSA participants without baseline depression (Center for Epidemiological Studies Depression-10 score<10 and no depression treatment). These will be separated by baseline diabetes status (HbA1c ≥7% and/or self-reported diabetes). Maternal language will be the ‘language first learnt at home and still understood’ (French, English or Other). English (French) speaking minorities will be those with ‘Other’ native language and English (French) as the language most spoken at home. The associations between maternal language and language minorities and the outcomes of interests will be examined overall and by diabetes status using multivariate logistic regression models.

Findings will help health care providers and program developers tailor their services toward reducing language barriers for minorities to help curb their risk of depression and appropriately manage their diabetes and mental health disorders.

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Outputs:

• Farid, D., Li, P., Dasgupta, K., & Rahme, E. (2022). Determinants of loss to follow-up in the Canadian Longitudinal Study on Aging: a retrospective cohort study. Journal of epidemiology and community health, 76(12), 1011–1018. https://doi.org/10.1136/jech-2022-219307

• Farid, D., Li, P., Dasgupta, K., & Rahme, E. (2022). Determinants of loss to follow-up in the Canadian Longitudinal Study on Aging: a retrospective cohort study. Journal of epidemiology and community health, 76(12), 1011–1018. https://doi.org/10.1136/jech-2022-219307

• Farid, D., Li, P., Da Costa, D., Afif, W., Szabo, J., Dasgupta, K., & Rahme, E. (2020). Undiagnosed depression, persistent depressive symptoms and seeking mental health care: analysis of immigrant and non-immigrant participants of the Canadian Longitudinal Study of Aging. Epidemiology and psychiatric sciences, 29, e158. https://doi.org/10.1017/S2045796020000670

English official language minorities in Quebec who have autism: Healthcare access and developmental outcomes

This project extends research on the healthcare access of official language minorities in Canada to a new population: individuals with Autism Spectrum Disorder (ASD) and their families. Individuals with ASD face significant communication challenges (APA, 2013). There are consequential delays in the access to ASD services in Quebec, to both obtain a diagnosis (Zwaigenbaum et al., 2019), and then wait for provincial services (Rivard et al., 2014). We expect that English speakers in Quebec with ASD will face compounded challenges in access to services due to communication difficulties, delays in ASD services, and minority language status. Official language minorities in Canada (English-speaking people in Quebec, and French-speaking people in other provinces) face multiple barriers to healthcare access, and negative disparities in health outcomes (Bouchard & Desmeules, 2013; de Moissac & Bowen, 2019; Falconer & Quesnel-Vallée, 2014). In the US, language barriers had negative impacts on service access for families with a child with ASD (St. Amant et al., 2018). Researchers aim to 1) evaluate the accessibility of health and social services to English-speaking families with a child with ASD in Quebec, relative to French-speaking families and 2) obtain detailed information from a subset of families with adolescents with ASD, via focus groups, including richer quantitative survey data on the question of service access and language and cognitive measures that serve as indicators of developmental health outcomes. By identifying potential disparities in access, as well as their implications for outcomes, this project furthers the goal of optimal outcomes for English speakers in Quebec.

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Outputs:

• Amantayev, N. & Nadig, A. (2022, May). Healthcare Access of Language Minorities with Autism: The Case of English Official Language Minorities in Quebec, Canada. Poster to be presented at the annual meeting of the International Society for Autism Research, Austin, Texas, USA.

Making the switch to remote Interpreting

For the past six months, the COVID-19 pandemic has prompted the use of remote public service interpreting (R-PSI), a form of interpreting that was gradually being put into practice in Quebec’s health and social services network. R-PSI refers not only to the use of telecommunication technologies (such as videoconferencing, telephony, and web conferencing) that allow interpreters to deliver their services remotely but also to the specific communication strategies that require proper training. The goal of this study is twofold: 1) to develop two training programs (one for interpreters and one for service providers) as per recent R-PSI management and practice guidelines, and 2) to measure their impact on the satisfaction and collaboration of the professionals involved. The study will primarily ensure quality services for a clientele that is especially at risk, i.e., immigrants and refugees, during the COVID-19 crisis. It will also help ensure that Quebec’s health system makes the transition to R-PSI.

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Outputs:

• Unknown (2021). Travailler avex des interprètes à distance : les bonnes pratiques [webinar]. Québec, Québec, Canada.

• Unknown (2021). Interpréter à distance au temps de la COVID-19 [webinar]. Québec, Québec, Canada.

• Unknown (June 2022). Unknown [Oral communication]. 1er congrès international de l’EDIQ.

Examining language and social development in bilingual children with ASD and identifying the barriers to bilingualism for these children

Given Canada’s officially bilingual status and its multicultural profile, many children with autism spectrum disorder (ASD) are brought-up in minority-language or bilingual households. Although language is intimately linked to cultural identity, many families of children with ASD face barriers to raising their child bilingually, which can have important repercussions, both for the child and their family. However, there is evidence that bilingualism may not be detrimental to these children’s language development, and that bilingual children with ASD may present better social abilities when compared to their monolingual peers, which has been found in monolingual children with ASD, to predict future language development.

Thus, the current study aims to better understand bilingual language development in children with ASD by examining the trajectories of language and social development in bilingual and monolingual children with ASD from early childhood to middle school, and the relationship between these two variables. To do so, longitudinal data will be analyzed using growth curve and pathway analyses. In addition, using a thematic analysis, we aim to identify barriers to bilingualism across Canada and specifically in the province of Québec, with a focus on barriers within the healthcare system.

Results from this study will serve to better inform clinicians about the language and social development of bilingual children with ASD, and to inform the development of evidence-based recommendations and interventions geared towards these children. Additionally, by identifying barriers to bilingualism, we aim to pinpoint areas where knowledge mobilization is required, thus diminishing, and even eliminating these barriers.

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Outputs:

• Unknown. (May 2022). Examining the Influence of Bilingualism on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum [Poster presentation]. International Society for Autism Research, virtual conference.

• Unknown. (April 2022). Bilingualism, narrative, social and pragmatic skills in children on the autism spectrum [Oral presentation]. Speech-Language Pathology and Audiology Canada-Virtual Convention.

• Unknown. (August 2021). Examining the barriers and facilitators to bilingual language development in children with neurodevelopmental disorders [Symposium]. COUHR National Symposium. Virtual conference

• Unknown. (August 2021). Examining the barriers and facilitators to accessing healthcare and to receiving equitable health services: a literature review [Symposium]. COUHR National Symposium. Virtual conference

• Unknown. (April 2021). Does bilingualism influence the narrative, social and pragmatic skills of children on the autism spectrum [oral presentation]. Transforming Autism Care Consortium Pre-INSAR Blitz. Virtual presentation.

Increasing French Language Proficiency at the Ingram School of Nursing: Evaluating the Impact of a French Proficiency Requirement for Admissions

Proficiency in French is increasingly required by Ingram School of Nursing (ISoN) clinical partners. As the proportion of French speaking patients increases, students must be able to speak and write in French to ensure safe, high-quality patient care. Additionally, French proficiency is a requirement of nursing licensure and practice in Quebec. Anecdotal reports suggest that low French proficiency is a significant reason ISoN graduates leave Quebec to practice. To address training and retention issues, the ISoN implemented a French proficiency requirement for admission to entry to practice programs. This marks a significant shift in the ISoN admissions criteria for the Bachelor of Science in Nursing [BSc(N)] and Master of Science in Nursing – Direct Entry [MSc(A)–DE] programs and has potential implications for the ISoN student population, faculty, clinical partners, program graduates, and employers.

The proposed 18-month pilot project will document the implementation of the French language proficiency requirement over the 2020-2021 and 2021-2022 academic years. A utilization-focused evaluation approach will provide a framework for the project. Research methods include quantitative analysis of administrative data and qualitative data collection through in-depth interviews with key stakeholders. The primary goals of the project are to: 1) sensitize stakeholders to the change in admissions policy; 2) evaluate the initial impact of the change on key stakeholders; 3) develop and refine data collection tools and strategies for long term evaluation and research, and; 4) identify possible strategies for optimizing retention of bilingual (French and English) nurses in Quebec.

Utilizing Multilingual Medical Students and the MedComm Platform to Address Language Barriers in Healthcare

The use of professional medical interpreters is considered the highest standard in medical interpretation. However, there is currently no universal, sustainable, and feasible medical interpretation service offered across McGill-affiliated healthcare sites. Our proposal includes three projects, each addressing the need for accessible interpretation services for patients with language barriers.

First, we would like to deliver a workshop on the basics of medical interpretation to all multilingual medical trainees at the McGill School of Medicine and study the impact of this workshop on students’ knowledge and self-perceived qualification to serve as an interpreter. Second, we would like to develop and implement a series of educational workshops for a wider range of healthcare trainees at the McGill Faculty of Medicine. These workshops will cover the basics of interacting with an interpreter in a medical appointment and will teach the participants how to access interpretation services. Lastly, we want to develop an online and mobile platform for requesting the services of trained student interpreters and conduct a pilot study to test the utility and feasibility of the platform in the clinical setting. Through our work, we also aim to build cultural competency among healthcare trainees by raising awareness of the issue of language barriers, their effects on linguistic minorities, and the importance of availability of professional interpreters.

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Outputs:

1. Unknown. (2021, April). Interpretation Training for Multilingual Medical and Dental Students: A Pilot Study of a Virtual Interactive Workshop [Presentation]. Canadian Conference on Medical Education.

2. Unknown. (May, 2021). Virtual Interpretation Workshop for Multilingual Medical and Dental Students: A Pilot Study [Presentation], MASH/MJM Interprofessional Health Research Symposium.

3. Unknown. (December, 2021). MedComm Platform: A Tool for Managing Requests for Medical Interpreter [Poster presentation, virtual]. Annual 2021 Dialogue McGill Conference, virtual.

4. Unknown. (December, 2021). Working with Interpreters: Virtual Workshop for Medical and Dentistry Students [Poster presentation, virtual]. Annual 2021 Dialogue McGill Conference, virtual.

5. Unknown. (2022, April). Working with Interpreters: Virtual Workshop for Medical and Dentistry Students [Poster presentation]. Ontario Student Medical Education Research Conference.

Are language and motivational barriers limiting healthcare access for Black young adults during the Covid-19 Pandemic?

Health care access during the second wave of the Covid-19 pandemic in Canada may be especially problematic for Black young adults who are a linguistic minority in their province. Studies have found marked disparities in access to health care among official language minorities in Quebec (Falconer & Quesnel-Valee, 2014). Intersectionality theory suggests that the combination of marginalized identities could make it uniquely difficult for Black anglophone Quebecers (and Black francophone Ontarians) to feel empowered to seek access health care. A 3-wave prospective longitudinal study will examine linguistic and motivational factors that may undermine the readiness of Black young adults to seek access to health care during the coming fall and winter. The study will assess the extent to which participants have experienced autonomy-support in their interactions with health-care providers and how this relates to their motivation to adhere to public health guidelines regarding the pandemic (e.g., hand-hygiene, social-distancing, wearing masks) and influence the pursuit of health care information and health care access. Researchers will also examine whether the motivational factors interact with linguistic minority status in determining how young adults adapt to the challenge of living through the worst pandemic in a century.

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Outputs:

1. Audet, É. C., Thai, H., Holding, A. C., Davids, J., Fang, X., & Koestner, R. (2023). The depth of stories: How Black young adults' disclosure of high arousal negative affect in narratives about the COVID-19 pandemic and the BLM protests improved adjustment over the year 2020. Journal of Community Psychology, 51(4), 1504–1517. https://doi.org/10.1002/jcop.22929

2. Audet, É.C., Leboeuf, J., Holding, A.C. et al. (2022). Better together: Family and peer support for black young adults during the COVID-19 pandemic and the Black Lives Matter movement. Trends in Psychology. 30, 688–705. https://doi.org/10.1007/s43076-022-00157-8