Adults facing language barriers less likely to use video visits

Though adults facing language barriers had similar odds of using virtual care overall, they were far less likely to use video visits than telephone-based care, according to new research published in JAMA Network Open.        

The research also revealed that adult patients facing language barriers use virtual care less to access specialists than primary care, and when they do engage in virtual specialist care, they are more likely to use the telephone than video visits.   

Erica Wennberg, study author and PhD graduate student at the University of Toronto Dalla Lana School of Public Health, told Virtual Healthcare that the findings "highlight the importance of ensuring video visits are made more accessible for people facing language barriers."

"However, they also highlight the importance of ensuring telephone visits remain an option for people who cannot or do not wish to use video visits," she added.

The study involved a systematic review and meta-analysis of 41 studies involving more than 4.5 million participants. The researchers searched the MEDLINE, Embase, PsycINFO and Web of Science databases from inception to March 2023 to identify studies focused on virtual care use among patients with or without language barriers in high-income countries. Of the 41 studies, 38 were set in the U.S.

The researchers found that adult patients facing language barriers had no significant difference in adjusted pooled odds of virtual versus in-person care compared with adults who did not face language barriers. However, adults facing language barriers had significantly lower adjusted pooled odds of video visits compared with telephone-based care.

When researchers examined only specialist care, adult patients facing language barriers had significantly lower adjusted pooled odds of using virtual care compared to their counterparts without language barriers. They also had lower adjusted pooled odds of participating in video visits.

"A surprising aspect was that we did not see the same findings for primary care," Wennberg said. "Few studies in our review looked specifically at primary care, and those that did had conflicting findings. More research is needed in this area."

According to Wennberg, the study findings are consistent with prior studies describing virtual care experiences of people facing language barriers. Challenges they face include platforms and instructions for video visits only being available in English and a lack of access to required technology.

Despite limited research on virtual care satisfaction among adults facing language barriers, the study authors concluded that "the expanded use of virtual care must be paired with understanding its uptake among marginalized groups to ensure that any inequities are understood and mitigated."

As Wennberg had noted, the study aligns with previous research on virtual care utilization and language barriers.

A study published earlier this year showed that patients who prefer to speak languages other than English experience various barriers to accessing video visits. The qualitative study included interviews with patients who preferred Spanish or Cantonese in California.

In the interviews, the patients said that communication quality during video visits was poor and described anxiety around video visits because they did not know what to expect or how to troubleshoot. 

Further, research published in 2024 revealed that patients with limited English proficiency (LEP) not only face telehealth access challenges but also have worse video visit experiences than their peers who are proficient in English.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.