Practitioner Perspectives on Linguistic Barriers in Access to Health Care for English-Speaking Minorities in Quebec

I propose to conduct a qualitative systematic review examining barriers that healthcare providers experience in providing services to linguistic minorities. In particular, the present study is designed to determine what kind of support healthcare professionals need to provide service to Anglophones in French-speaking Quebec.

Language barriers are increasingly recognized as a serious concern that creates disparities in access to health and social services (Terui, 2017). These inequalities may be reflected in access to services and healthcare delivery (Woloshin et al., 1997), as well as in low “quality of care and provider-patient relationship” (Terui, 2017, p .215). In addition, recent evidence suggests that linguistic minorities may face communication anxiety while anticipating doctor’s appointments (Zhao et al., 2021) and experience tension during appointments and low confidence in received care during (De Moissac & Bowen, 2019). 

This research project will focus on the language barriers that occur during interactions between healthcare providers and Anglophones (English speakers) in Quebec. The goal of the project is to propose feasible solutions to enhance access to health and social services in Quebec for English minority language speakers.

How Healthcare Professionals’ Communication Style Influences Black Language Minority Health Service Users’ Perceived Acceptability and Satisfaction with Healthcare Access in Quebec and Ontario

Official language minorities face language barriers when it comes to accessing health services but many of them also face racial/cultural barriers.

The healthcare system strives to ensure the health of all people equally regardless of race or language. Health-care workers communicate directly with patients and these interactions play a role in how the patients view the health care system. How the patients view the healthcare system will have implications for how they use it (Penchansky & Thomas, 1981).

The project plans to explore and highlight the importance of patient and healthcare workers communication interactions on perceptions of healthcare access from a self-determination theory perspective. The research could help protect more vulnerable groups by participating in investigations on how to reduce inequalities in healthcare access for visible and language minorities. Do health care workers’ level of language proficiency impact perceived autonomy support and perceived access to health? How do previous experiences with healthcare workers impact subsequent perceived access to health care for black linguistic minorities in Quebec and Ontario? How do race and language combine to make interactions with healthcare workers affect perceptions of autonomy support for black linguistic minorities?

The Meanings and Lived Experiences of Chronic Illness Self-Management for Culturally and Linguistically Diverse (CALD) Individuals and their Female Family Caregivers

The term culturally and linguistically diverse (CALD) refers to first-generation (foreign-born) or second-generation (having at least one immigrant parent) immigrants whose mother tongue or language spoken at home is neither English nor French. Chronic illnesses are leading causes of morbidity and mortality in Quebec, and the risk of chronic illness is increasing for CALD populations with greater time in Canada. In response to the large global burden of chronic illness, self-management has increasingly become recognized as an approach to support patients in partnering with healthcare professionals for improving their outcomes. Self-management involves the tasks (medical, behavioural and emotional), which individuals must undertake to live well with a chronic illness. However, there is limited recognition that self-management also involves family caregivers who provide most of the care to persons with a chronic illness. CALD individuals living with chronic illness face an additional burden of self-management in health care systems due to difficulties arising from culture and language. Women are more likely to be family caregivers in CALD contexts due to cultural and societal obligations, and this can result in another layer of burden for them. In view of these cumulative and intersecting burdens, there is an urgent need for meaningful definitions of chronic illness self-management that include the lived experiences of both CALD individuals and their female family caregivers.

PROJECT OBJECTIVES:

1. Explore and understand the lived experiences and meanings of chronic illness self-management for culturally and linguistically diverse individuals and their female family caregivers; and

2. Provide a critique of the assumption that self-management is not shaped by the social determinants of health, and its consequences for the study population.

Francophone Mental Health Care Practitioners’ Perceptions of Working with Anglophone Minorities: Challenges and How They Affect Practice

We are interested in investigating the perceived challenges of working with the Anglophone linguistic minorities reported by Francophone mental health practitioners in Quebec. Oftentimes, Anglophone linguistic minorities in Quebec receives mental health care services from primarily Francophone practitioners. The experiences of linguistic minority patients have been extensively documented, and it has been shown that being part of a linguistic minority decreases accessibility to health care and leads to poorer outcomes for patients (Jacobs, Chen, Karliner, Agger-Gupta, & Mutha, 2006). However, the experiences and challenges of majority linguistic mental health care providers working with linguistic minorities have rarely been explored.

We are interested in conducting a qualitative study on the experience of Francophone mental health care providers, who are part of the linguistic majority in Quebec, and are often faced with providing health care services to Anglophone linguistic minorities.

Is the Frustration of Basic Psychological Needs Interacting with Language Barriers in Worsening Health Care Access for Black Young Adults during the COVID-19 Pandemic?

The present 3-wave prospective longitudinal study will examine linguistic and motivational factors that may undermine the readiness of Black young adults to seek access to mental health care during the COVID-19 pandemic year. We will also examine whether the motivational factors interact with linguistic minority status in determining how young adults adapt to the challenges of living through the worst pandemic in a century. More precisely, the main objective is to examine whether double minorities (i.e., Black Quebec Anglophones and Black Ontarian Francophones) experiencing need frustration are less likely to seek help for mental health concerns than are Black Quebec Francophones or Black Ontarian Anglophones.

Improving Access to Fertility Care and Empowerment of Linguistic Minority Patients with Infertility Through a Mobile App

The current project involves the evaluation of a mobile app developed by a multidisciplinary team of researchers and health professionals to provide targeted bilingual informational and social support resources to patients undergoing fertility treatments in Montreal. The app content will be available in both French and English and using language that aims to be accessible to everyone with fertility concerns. The educational component will include evidence-based information on a variety of fertility-related topics and presented in a way that is easy to understand and accessible to people with differing eHealth literacy levels. Specific sections will be devoted to information about infertility diagnoses, treatment options, risks to fertility, reproductive health promotion as well as how to navigate through treatments and tips on how to cope with infertility. The social support component will consist of discussion boards and a peer support network to help connect patients with others who can understand the difficulty of their situation. The app is hypothesized to have a beneficial impact on patients’ well-being (stress, anxiety and depression), perceived empowerment, quality of life, and eHealth literacy.

The principal objective of my research project is to investigate the effectiveness of a patient-centered mobile health (mHealth) intervention that delivers informational and emotional support in improving patient empowerment in infertile patients facing language barriers in Montreal.