THE EXCLUSION OF NON-ENGLISH-SPEAKING PERSONS FROM RESEARCH

OBJECTIVE: We sought to determine how often non-English-speaking (NES) persons are excluded from medical research. DESIGN: Self-administered survey. PARTICIPANTS: A Medline search identified all original invest igations on provider-patient relations published in major U.S. journal s from 1989 through 1991, whose methodologies involved direct interact ion between researcher and subject (N = 216). Each study's correspondi ng author was surveyed; 81% responded. MEASUREMENTS AND MAIN RESULTS: Of the 172 respondents, 22% included NES persons; among these includer s, 16% had not considered the issue during the study design process, a nd 32% thought including the NES had affected their study results. Amo ng the 40% who excluded the NES (excluders), the most common reason wa s not having thought of the issue (51%), followed by translation issue s and recruitment of bilingual staff. The remaining 35% (others) indic ated that there were no NES persons in their study areas. CONCLUSIONS: NES persons are commonly excluded from provider-patient communication studies appearing in influential journals, potentially limiting the g eneralizability of study findings. Because they are often excluded thr ough oversight, heightened awareness among researchers and granting in stitutions, along with the development of valid instruments in varied languages, may increase representation of non-English-speaking subject s in research.