The Linguist

@CIOL_Linguists AUTUMN 2024 The Linguist 17 FEATURES 2021 and 2023, only 40 were provided with professional interpretation services. This confirms that employing telephone interpreters is not a widely used practice for recruitment despite its availability and accessibility in our centre. Women's health research is far from being the only medical field affected by these challenges; no discipline has proved to be immune. As a result, there has been a growing interest within the NHS, research agencies and higher education institutions to address these barriers and ensure diverse communities are more engaged with research. 5 Key recommendations As part of these ongoing initiatives, a comprehensive guidance document, 'NHS Increasing Diversity in Research Participation: A good practice guide for engaging with underrepresented communities (2023)', was created to provide practical suggestions to improve the situation. This work offers a theoretical framework for barriers to and enablers of research recruitment in underrepresented groups in the UK, further supported by outreach work within six vulnerable communities across the country. Limited English proficiency with poor and/or no access to good translation services, as well as the use of jargon, excessive acronyms and culturally inappropriate explanations, have been highlighted as leading reasons behind the low participation in research. The authors recommend using participants' "language of trust" via professional interpreters, and tailoring information to look and feel like it is from the community to minimise distrust. Key take-home messages include the importance of planning to be inclusive before the outset of the study by researching the target population and their needs, and engaging with community organisations, link workers and trusted advocates to support engagement and build on their expertise. The need to make research accessible at convenient times and locations, and conveyed in appropriate language with 'easy read', straightforward information, is also noted. There are clear examples in which such strategies have been implemented successfully. The local Book Before Ten campaign, led by Dr Rosselyn Ngadze, for instance, encourages women from all ethnic backgrounds to access antenatal care before 10 weeks of pregnancy through succinct and powerful infographics opportunistically placed near pregnancy tests at supermarkets and chemists. The multidisciplinary effort the Deep End Research Alliance addresses health inequalities within minorities, for example in the provision and uptake of contraception, facilitated by language and cultural link workers. We have seen that improving research participation is key to ensure equity and reduce the burden of disease, which disproportionately affects ethnic minorities. Multiple barriers to research recruitment have been identified, with cultural and language challenges often topping the list. While there is a clear need to increase the use of professional translators and interpreters in the context of research recruitment, we have noticed that this alone is unlikely to resolve the issue. For it to be effective, language must be clear, culturally acceptable and succinct; and those with bilingual knowledge (whether link workers, interpreters or translators) must operate in partnership with local communities to build and maintain an effective two-way channel of communication. Notes 1 Ransing, R et al (2021) 'Language as Multi- Level Barrier in Health Research and the Way Forward'. In Indian Journal of Psychological Medicine, 45,1, 65-68 2 Murray, S and Buller, AM (2007) 'Exclusion on Grounds of Language Ability – A reporting gap in health services research?' In Journal of Health Services Research & Policy, 12,4, 205-208 3 Brown, G et al (2014) 'Barriers to Recruiting Ethnic Minorities to Mental Health Research: A systematic review'. In International Journal of Methods in Psychiatric Research, 23,1, 36-48 4 Sackett, DL et al (1996) 'Evidence Based Medicine: What it is and what it isn't'. In British Medical Journal, 312,7023, 71 5 DHSC (2022) 'The Future of UK Clinical Research Delivery: 2022 to 2025 implementation plan'; https://cutt.ly/pezcGJYd 6 MBRRACE-UK: Mothers and Babies: Reducing risk through audits and confidential enquiries across the UK; www.npeu.ox.ac.uk/mbrrace-uk In 2021, 29% of births in the largest maternity unit in South Yorkshire were to people from Black, Asian or ethnic minority backgrounds. In keeping with national statistics , 6 these women had higher than average adverse perinatal outcomes, such as preterm babies, stillbirths, neonatal death, maternal death and poor mental health. They were also more likely to reside in the most deprived areas, have lower income and have poorer healthcare access, partly due to language barriers. For those with limited English proficiency, the most required interpreters were for Arabic, Slovakian, Urdu, Kurdish Sorani and Tigrinya. In our unit, 24/7 telephone interpretation is provided through DA Languages and face-to-face link workers for Urdu, Punjabi and Arabic. Despite this, Black, Asian and ethnic minorities service users were less likely to report that they were offered choice and information, and enough support in decision making, compared to their self-reported British counterparts, as revealed by the National Maternity Survey (2022). A local audit in 2022 assessing compliance with interpreting policy in maternity services highlighted potential reasons why people with limited English might struggle to navigate pregnancy- related care. A professional interpreter was offered in only 46% of the situations in which the need for such a service was identified. Even when it was offered, in a quarter of cases it was declined by the woman in favour of a relative and/or friend. Frontline care © PEXELS

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