From 'multicultural health' to 'knowledge translation'—rethinking strategies to promote language access within a risk management framework

Abstract

Introduction. There is compelling international evidence on the negative impacts of language barriers and reliance on untrained interpreters on health and healthcare. However, response to this evidence has been slow and uneven, and gains made over the years risk being eroded. This 'knowledge to action' gap is, however, not unique to the issue of language access. Methods. In one large Canadian health authority, a four stage knowledge translation (KT) strategy (getting the issue on the agenda; informing the response; guiding implementation; and changing provider practice) was developed to promote evidence-informed action to address language barriers. This multi-faceted strategy incorporated the principles of partnership with knowledge users, maintaining a focus on the evidence, phased introduction of evidence, synthesising evidence in context, and working within the conceptual framework of decision-makers. This approach reflected a shift from a 'multicultural health' to a 'risk management' approach in communicating with decision-makers, and integration of the issue of language access with already identified organisational priorities. Results. This collaborative strategy resulted in health system adoption of a unique evidence-informed model of trained health interpreter services, even though initiated during difficult economic times. Conclusion. Focused use of 'knowledge to action' strategies has the potential to promote evidence-informed action in provision of interpreter services.