Track 1-5
Research

The Exclusion of Non-English-Speaking Persons from Research

OBJECTIVE: We sought to determine how often non-English-speaking (NES) persons are excluded from medical research.

DESIGN: Self-administered survey.

PARTICIPANTS: A Medline search identified all original investigations on provider-patient relations published in major U.S. journals from 1989 through 1991, whose methodologies involved direct interaction between researcher and subject (N=216). Each study’s corresponding author was surveyed; 81% responded.

MEASUREMENTS AND MAIN RESULTS: Of the 172 respondents, 22% included NES persons; among these includers, 16% had not considered the issue during the study design process, and 32% thought including the NES had affected their study results. Among the 40% who excluded the NES (excluders), the most common reason was not having thought of the issue (51%), followed by translation issues and recruitment of bilingual staff. The remaining 35% (others) indicated that there were no NES persons in their study areas.

CONCLUSIONS: NES persons are commonly excluded from provider-patient communication studies appearing in influential journals, potentially limiting the generalizability of study findings. Because they are often excluded through oversight, heightened awareness among researchers and granting institutions, along with the development of valid instruments in varied languages, may increase representation of non-English-speaking subjects in research.

Eric J. Hardt, MD
Firm Chief, Geriatrics Medical Consultant
Interpreter Services
Boston Medical Center
88 E. Newton Street, F4
Boston, MA 02118-2393
Phone: (617) 638-6100
Fax: (617)638-6179
eric.hardt@bmc.org

Dr. Eric Hardt has distinguished himself as a clinician teacher in general medicine and geriatrics for nearly twenty years. His clinical practice remains active with a large number of home care patients focused mainly in the neighborhoods of Roxbury and a weekly clinic session at Roxbury Comp. NHC. He maintains a weekly clinic session at Boston Medical Center, which includes a large panel of patients ethnically, racially and linguistically diverse. Dr. Hardt’s activities in the area of non-English-speaking patients and medical interpretation are well known around the country. He has been the prime mover behind the production of videotape educational materials for medical interpreters and for health care workers working across language barriers. He is regularly invited to speak on issues related to non-English-speaking patients and regularly consults on educational and program development related to interpreter services. His network includes active participation with The National Work Group on Medical Interpretation. He is a founding member of the Massachusetts Medical Interpreters Association and currently on their Advisory Board. He has worked with the Babel III Coalition and the Massachusetts Office for Refugees and Immigrants advocating for legislation related to interpreter services for the State of Massachusetts. For nearly ten years he has served as a Medical Consultant to Interpreter Services and for a period of time as Acting Director. Most recently he has published on the issue of exclusion non-English-speaking patients from research projects and has become a regular consultant in the area of translation and interpretation methodology appropriate to include non-English speaking patients in research efforts.  NEXT >

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