Research In Practice Blog
Intro
A team of researchers from Children’s Hospital of Philadelphia and Clinical Futures is behind a new study that uncovered trends in methods for research preparation, data collection, and analysis of language data collected during qualitative child health studies with families who speak languages other than English. Experts believe that this analysis can inform best practices for handling language data for these families and promote equitable inclusion of participants who speak different languages in qualitative research.
Cross-language qualitative research, in which there is a language barrier between participants and researchers, has become more prevalent in recent years with increasing numbers of U.S. children in families that prefer a language other than English (LOE). Among pediatric populations, one in four U.S. children has at least one immigrant parent or caregiver, and approximately one in ten U.S. children has parents who do not speak English “very well”. However, the study authors highlight a lack of guidelines or protocols for researchers to conduct cross-language qualitative research in child health settings. For instance, cross-language practices are not yet included in the Consolidated Criteria for Reporting Qualitative research (COREQ).
“Including families that speak languages other than English is essential for advancing health equity in these populations. Qualitative research is unique in that it can empower people to describe their lived experience, to shed light on challenges they face and their sources of resilience. To successfully promote language-based equity, it is critical that child health qualitative research include the perspectives of families who prefer languages other than English,” said Dr. Kate Wallis, who led the study.
Study Design and Methods
U.S. based cross-language research studies published between January 2010 and July 2025 that met the following criteria were included: they were conducted in the U.S., utilized cross-language qualitative research methods (meaning that studies used a translator, interpreter, or bilingual staff at any point during the research process), involved adult (aged 18+ years) parents or caregivers who use a language other than English (LOE), and featured informants discussing topics related to the physical, mental, or social health of their child(ren).
A total of 52 studies met these criteria and were analyzed to describe processes involved in design preparation, data collection and analysis for data gathered from participants who spoke languages other than English. These articles covered a wide range of child health research and used a range of qualitative study designs including mixed methods, interviews only, focus group only, both interview and focus group, and a community advisory board.
For each manuscript, the following was documented:
- Identifying information
- Study design (interview, focus group, other qualitative design)
- Participant characteristics, including languages represented
- Data collection (including collaboration with interpreters or bilingual staff)
- Data analysis (including preparation for analysis, e.g., transcription of data in language(s) other than English and coding
- Study dissemination strategies
Findings
Participant language use and proficiency were documented in various ways, and often without clear definitions in the study methods. For example, descriptions included “limited English proficiency,” “None of the participants were fluent in English,” “Speaks English Yes/No," or “Language spoken at home.” Most studies indicated that study procedures, such as interviews and focus group moderation, were completed by a bilingual or native language-speaking research assistant or team member. Some studies utilized language interpretation services or collaboration with community-partnered organizations. The language proficiency of individuals conducting interviews or moderating focus groups was noted in most studies. However, some did not specify how language competence or qualifications were determined.
A critical analysis of the included studies revealed diverse approaches to including participants who use LOE steps of the research process, highlighting the need for clarity around best practices for conducting qualitative research with these families.
Clinical Implications
When working with families who speak a language other than English in qualitative research, it is important to consider both translation of written materials and the interpretation of spoken communication to promote inclusive practices. Similarly, whether interviews and focus groups are conducted using an interpreter or a bilingual research team, the language proficiency and qualifications of research team members are crucial factors to consider, as well as their cultural familiarity with the study population. Wherever possible, analyzing data and providing quotes in the original source language is preferred to using translated materials only, to remain true to honor the experience of study participants. Lastly, identifying relevant strategies to disseminate study findings back to participants and their communities in their preferred languages and acceptable modalities is important to consider at study outset.