Hilder Jo, Gray Ben, Stubbe Maria
Department of Primary Health Care & General Practice, University of Otago Wellington, PO Box 7343, Newtown, Wellington, New Zealand; and Corresponding author. Email:
Department of Primary Health Care & General Practice, University of Otago Wellington, PO Box 7343, Newtown, Wellington, New Zealand.
J Prim Health Care. 2019 Sep;11(3):217-226. doi: 10.1071/HC18067.
INTRODUCTION Culturally and linguistically diverse populations (CALD) have significant health outcome disparities compared to dominant groups in high-income countries. The use of both navigators and interpreters are strategies used to address these disparities, but the intersections between these two roles can be poorly understood. AIM To gain an overview of the literature on health navigation and similar roles, with particular reference to the New Zealand context, and to explore the interface between these roles and that of interpreters for CALD populations with limited English proficiency. METHODS A narrative review of the literature was conducted using a range of search strategies and a thematic analysis was conducted. RESULTS There are several barriers to health-care access relating to health systems and CALD populations. For over 50 years, health workers who are members of these communities have been used to address these barriers, but there are many terms describing workers with wide-ranging roles. There is some evidence of efficacy in economic, psychosocial and functional terms. For health navigation services to work, they need to have staff who are well selected, trained and supported; are integrated into health-care teams; and have clearly defined roles. There may be a place for integrating interpreting more formally into the navigator role for members of communities who have limited English proficiency. CONCLUSION To achieve better access to health care for CALD populations, there is an argument for adding another member to the health team who combines clearly defined aspects of the roles of interpreter, community health worker and navigator. Organisations considering setting up such a position should have a clear target population, carefully consider the barriers they are trying to address and define a role, scope of practice and training requirements best suited to addressing those barriers.
引言 在高收入国家，与主流群体相比，文化和语言多样化人群（CALD）在健康结果方面存在显著差异。使用导航员和口译员都是解决这些差异的策略，但这两个角色之间的交叉点可能未得到充分理解。目的 概述有关健康导航及类似角色的文献，特别参考新西兰的情况，并探讨这些角色与英语水平有限的CALD人群的口译员角色之间的界面。方法 使用一系列搜索策略对文献进行叙述性综述，并进行主题分析。结果 与卫生系统和CALD人群相关的医疗保健获取存在若干障碍。五十多年来，这些社区的成员作为卫生工作者被用来解决这些障碍，但有许多术语描述了具有广泛角色的工作者。在经济、心理社会和功能方面有一些疗效证据。为使健康导航服务发挥作用，它们需要有经过精心挑选、培训和支持的工作人员；融入医疗保健团队；并具有明确界定的角色。对于英语水平有限的社区成员，可能有必要将口译更正式地纳入导航员角色。结论 为了使CALD人群更好地获得医疗保健，有理由在医疗团队中增加另一名成员，该成员结合口译员、社区卫生工作者和导航员角色中明确界定的方面。考虑设立这样一个职位的组织应该有明确的目标人群，仔细考虑他们试图解决的障碍，并界定最适合解决这些障碍的角色、实践范围和培训要求。
