This report looked at the state of evidence for the use of communication apps (specifically cultural-language translation apps) with immigrant seniors in long-term care (LTC) and community settings. The study focused on understanding the acceptability, accessibility, and utility of these digital resources for older immigrant adults who have limited English proficiency, and how these tools impact health equity and care quality.
Cultural-language translation apps are digital applications designed to translate spoken or written language, often incorporating cultural context to enhance communication and understanding, particularly for individuals with limited proficiency in the dominant language of their environment
What do you need to know?
Many older adults revert to their first language as they age, increasing language barriers, creating communication challenges in care settings and potentially leading to poorer health outcomes.
Cultural-language translation apps are relevant in healthcare, where effective communication is essential for safe, person-centered care, informed consent, and daily interactions. They are seen as potential solutions to address shortages in interpretation services and to support staff and caregivers in multicultural environments. While digital translation apps (like Google Translate, Microsoft Translator, Amazon SayHi) are widely available, there is little empirical research on their use, acceptability, and impact in long-term care and community settings for immigrant seniors. There is also a lack of evidence on whether these apps improve health equity or inadvertently widen disparities.
Researchers incorporated a digital health equity framework, explicitly analyzing how these technologies address or reinforce issues like ageism, ableism, and the digital divide in geriatric care.
What did the researchers find?
Researchers highlighted several key points from the background literature and rationale:
Communication Barriers: Language barriers in LTC settings are linked to poorer health outcomes, lower sense of belonging, and increased clinical risks, especially for residents with dementia.
Potential of Apps: Translation apps could help bridge communication gaps, especially where interpretation services are lacking and staff or relatives are relied upon for ad hoc translation.
Research Gaps: There is a research gap in understanding the real-world impact of these apps in elder care, particularly regarding their ability to reduce health inequities among racialized and immigrant seniors.
What are some particularly interesting themes or outlier findings?
Equity Lens: The protocol's explicit focus on using the Digital Health Equity Framework means the review will not only map what is known but also critically assess whether digital solutions are inclusive and beneficial for marginalized populations.
Person-Centered Features: Previous work cited suggests that translation apps in LTC would benefit from more person-centered features, indicating a need for customization and cultural sensitivity.
Practice Gap: Discussions with frontline LTC practitioners reveal a gap in the routine use of these apps, despite their potential, suggesting barriers to adoption or awareness.
How can you use this research?
For Practitioners (LTC staff, community care providers):
Use the findings to inform decisions on adopting or recommending translation apps for immigrant seniors.
Identify best practices and potential pitfalls in integrating such technology into daily care routines.
For Policymakers and Administrators:
Use evidence from the review to guide resource allocation and policy development aimed at improving communication and health equity in elder care.
Support the development or procurement of more culturally and linguistically appropriate digital tools.
For Researchers and Academics:
Identify gaps in the literature and areas for further study, such as the effectiveness, usability, and impact of translation apps on health outcomes and equity.
Build on the review’s findings to design intervention studies or technology development projects.
For Technology Developers:
Use insights on user needs, equity considerations, and person-centered design to create or refine translation apps for elder care settings.
Recommendations for Future Research:
The protocol calls for more empirical studies on the real-world use and impact of translation apps in LTC and community settings, with a focus on health equity and digital inclusion. This is particularly relevant for academics, practitioners, and technology developers.
What did the researchers do?
This protocol set out to systematically map and critically analyze the evidence on the use of communication apps for immigrant seniors in care settings, with a strong focus on health equity and digital inclusion.
Methods & Activities:
This is a scoping review protocol, not a completed study.
Researchers used the five-stage Arksey and O’Malley framework, with enhancements from Levac et al. and Colquhoun et al., and integrate the Digital Health Equity Framework for analysis.
The Joanna Briggs Institute’s Population, Concept, and Context (PCC) framework was used to define the scope and formulate research questions.
Researchers searched literature from 2005 to 2024 across five multidisciplinary databases (Healthstar OVID, MEDLINE OVID, CINAHL EBSCO, Engineering Village, Web of Science), with input from librarians in health sciences, sociology, and engineering to ensure comprehensive coverage.
No primary data collection was involved; the review analyzed existing published literature.
This report looked at the state of evidence for the use of communication apps (specifically cultural-language translation apps) with immigrant seniors in long-term care (LTC) and community settings. The study focused on understanding the acceptability, accessibility, and utility of these digital resources for older immigrant adults who have limited English proficiency, and how these tools impact health equity and care quality.
