Prehospital treatment-seeking for acute coronary syndrome in culturally and linguistically diverse immigrant populations: a scoping review

Studies consistently report longer prehospital delays in culturally and linguistically diverse (CALD) patients experiencing acute coronary syndrome (ACS). A scoping review was conducted to describe terms and methods used to define and identify CALD populations and summarize available evidence on factors related to prehospital delays in ACS studies involving CALD populations.

We searched six electronic databases for published studies and Google Scholar for grey literature to identify studies on prehospital treatment-seeking in CALD immigrants experiencing ACS. We followed the Joanna Briggs Institute methodological framework for scoping review. Twenty-three studies met our eligibility criteria (quantitative n = 17; qualitative n = 6; mixed n = 1). Terms like ethnicity, migrant, or expatriate defined CALD populations. Most studies used a single indicator (e.g. country of birth) to identify CALD cohorts, and only two studies used a theoretical model related to treatment-seeking delays to guide data collection. Most factors affecting prehospital delays in CALD populations were similar to those reported in general populations. A unique finding was a difference in the language used to describe symptoms, which, when translated, changes their meaning and resulted in misinterpretation by healthcare providers [e.g. asfixiarse (translates as asphyxiate/suffocate) used for dyspnoea/shortness of breath in Hispanics].

Terms and methods used for defining and identifying CALD populations are inconsistent. Studies on factors affecting prehospital treatment-seeking in CALD ACS patients are limited. Future studies should use theoretical models related to treatment-seeking delays to comprehensively explore factors affecting prehospital delays. Additionally, researchers should consider self-reported or multiple indicators to determine CALD status.