Interventions to improve patient participation in the treatment process for culturally and linguistically diverse people with cancer: A systematic review

Authors

  • Aisha Harun,

    1. Surgical Outcomes Research Centre, Sydney Local Health Sydney Local Health District and Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
    2. The Johns Hopkins University School of Medicine, Baltimore, MD
    Search for more papers by this author
  • James D. Harrison,

    Corresponding author
    1. Surgical Outcomes Research Centre, Sydney Local Health Sydney Local Health District and Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
      Dr James D Harrison PhD, Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, PO Box M157, Missenden Road, Sydney, NSW 2050, Australia. Email: james.harrison@sswahs.nsw.gov.au
    Search for more papers by this author
  • Jane M. Young

    1. Surgical Outcomes Research Centre, Sydney Local Health Sydney Local Health District and Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
    2. Cancer Epidemiology and Services Research, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
    Search for more papers by this author

  • Conflict of interest statement: There are no conflicts of interest to declare by any authors of this article.

  • Funding: Ms Harun was supported by a Fulbright scholarship grant from the Institute of International Education. The authors have no other financial disclosures to declare

Dr James D Harrison PhD, Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, PO Box M157, Missenden Road, Sydney, NSW 2050, Australia. Email: james.harrison@sswahs.nsw.gov.au

Abstract

Disparities in cancer outcomes for people from culturally and linguistically diverse (CALD) groups are well known. Improving CALD patients' active participation in treatment processes holds potential to improve outcomes, but little is known of effective strategies to facilitate this. This systematic review investigated interventions to improve three aspects of participation in cancer care among CALD groups, namely involvement in decision-making, communication with health providers and treatment adherence. A comprehensive search of electronic bibliographic databases was conducted to identify intervention studies that reported outcomes relevant to patient participation for CALD groups. Two reviewers independently critically appraised the studies and abstracted data. Of 10 278 potential articles, seven met the inclusion criteria, including three randomized controlled, three non-randomized and one mixed-method experimental studies. Interventions included the use of patient navigators, videos and decision aids. The impact on patient participation was varied. The effect of a decision aid and patient navigator interventions on communication with health providers was positive. While the use of a decisions aid successfully facilitated shared decision-making and patients' perception of treatment adherence, the use of patient navigators was ineffective. A computer support system was found to improve general patient participation; however little clarification of what this involved was provided. This systematic review identified few rigorous evaluations of interventions to improve treatment participation for CALD people with cancer, highlighting the lack of a robust evidence base to improve this crucial aspect of care. The development and evaluation of interventions for diverse populations remains a priority.

Ancillary