{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:43:06Z","timestamp":1792665786081,"version":"4.5.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001663","name":"Volkswagen Foundation","doi-asserted-by":"publisher","award":["9B368"],"award-info":[{"award-number":["9B368"]}],"id":[{"id":"10.13039\/501100001663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Equity Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Language barriers remain a major challenge to equitable healthcare delivery. While qualified interpreters are considered the preferred standard, their availability is often limited. Translation technologies are therefore increasingly used in practice. However, quantitative evidence on how healthcare providers use these tools, how they evaluate them, and which factors are associated with their acceptance remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional online survey was conducted among healthcare and psychosocial service providers across a range of clinical settings. Inferential analyses were restricted to the German sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009258), with Romanian data (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009185) used for exploratory descriptive comparison. The survey assessed experiences with language barriers, communication strategies, and acceptance of translation technologies based on the Technology Acceptance Model. Descriptive analyses characterised use patterns, and multivariable ordinary least squares regression with HC3-robust inference examined factors associated with behavioural intention to use translation technologies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 443 healthcare providers were included. Translation technologies were used by 65.0% of providers in the previous three months, often in the absence of formal organisational support, training, or guidelines. Use varied descriptively across country samples and professional groups, with higher use observed in the German sample and among medical-technical and nursing staff. Acceptance was moderately positive, with perceived usefulness showing the strongest controlled association with behavioural intention to use translation technologies (\u03b2\u2009=\u20090.44,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Organisational factors and contextual concerns were not independently associated with behavioural intention. Providers reported concerns regarding accuracy and data privacy, and more cautious use in contexts requiring nuanced, relational communication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Translation technologies appear to function as pragmatic, ad hoc solutions to communication challenges in multilingual healthcare. While these tools may facilitate basic communication, their limitations in complex interactions and the absence of governance frameworks raise important considerations for their safe and equitable implementation. Rather than replacing professional interpreting services, translation technologies may be best understood as complementary resources within a broader communication strategy. Their contribution to equitable care will depend on how they are implemented to support meaningful communication and address the needs of service users facing language barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12939-026-03085-6","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:54:49Z","timestamp":1792598089000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare providers\u2019 use and acceptance of translation technologies in multilingual healthcare settings: a cross-sectional study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3855-5559","authenticated-orcid":false,"given":"Annika","family":"Kreienbrinck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Hanft-Robert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed-Talha","family":"Top\u00e7u","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ovidiu","family":"Oltean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina-Ioana","family":"Forray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u0103zvan Mircea","family":"Chereche\u0219","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"M\u00f6sko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"1","key":"3085_CR1","doi-asserted-by":"publisher","first-page":"e12639","DOI":"10.1002\/emp2.12639","volume":"3","author":"CK Gutman","year":"2022","unstructured":"Gutman CK, Lion KC, Fisher CL, Aronson PL, Patterson M, Fernandez R. Breaking through barriers: the need for effective research to promote language-concordant communication as a facilitator of equitable emergency care. J Am Coll Emerg Physicians Open. 2022;3(1):e12639. https:\/\/doi.org\/10.1002\/emp2.12639.","journal-title":"J Am Coll Emerg Physicians Open"},{"issue":"1","key":"3085_CR2","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1353\/hpu.2024.a919823","volume":"35","author":"K Sliwinski","year":"2024","unstructured":"Sliwinski K, Kutney-Lee A, McHugh MD, Lasater KB. A review of disparities in outcomes of hospitalized patients with limited english proficiency: the importance of nursing resources. J Health Care Poor Underserved. 2024;35(1):359\u201374. doi:- PMID: 38661875.","journal-title":"J Health Care Poor Underserved"},{"key":"3085_CR3","doi-asserted-by":"publisher","first-page":"629041","DOI":"10.3389\/fpubh.2021.629041","volume":"9","author":"N Cano-Ib\u00e1\u00f1ez","year":"2021","unstructured":"Cano-Ib\u00e1\u00f1ez N, Zolfaghari Y, Amezcua-Prieto C, Khan KS. Physician-patient language discordance and poor health outcomes: A systematic scoping review. Front Public Health. 2021;9:629041. https:\/\/doi.org\/10.3389\/fpubh.2021.629041.","journal-title":"Front Public Health"},{"key":"3085_CR4","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1056\/NEJMp058316","volume":"355","author":"G Flores","year":"2006","unstructured":"Flores G. Language barriers to health care in the United States. N Engl J Med. 2006;355:229\u201331. https:\/\/doi.org\/10.1056\/NEJMp058316.","journal-title":"N Engl J Med"},{"issue":"2","key":"3085_CR5","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1111\/j.1475-6773.2006.00629.x","volume":"42","author":"LS Karliner","year":"2007","unstructured":"Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42(2):727\u201354. https:\/\/doi.org\/10.1111\/j.1475-6773.2006.00629.x.","journal-title":"Health Serv Res"},{"issue":"1","key":"3085_CR6","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1186\/s12913-024-11722-5","volume":"24","author":"S Hanft-Robert","year":"2024","unstructured":"Hanft-Robert S, Shongwe L, Cossie Q, Sithole P, Roos T, M\u00f6sko M, et al. The doctor doesn\u2019t understand Xhosa and the service user doesn\u2019t understand English\u2019 - exploring the role of security guards acting as informal interpreters in psychiatric care in South Africa. BMC Health Serv Res. 2024;24(1):1239. https:\/\/doi.org\/10.1186\/s12913-024-11722-5.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"3085_CR7","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1186\/s12939-025-02718-6","volume":"24","author":"M-T Top\u00e7u","year":"2025","unstructured":"Top\u00e7u M-T, M\u00f6sko M. Building trust and relationship across language barriers: a qualitative study of interpreter-mediated psychotherapy with therapists, interpreters and patients. Int J Equity Health. 2025;24(1):340. https:\/\/doi.org\/10.1186\/s12939-025-02718-6.","journal-title":"Int J Equity Health"},{"issue":"6","key":"3085_CR8","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1007\/s10903-015-0175-3","volume":"17","author":"MS Thomson","year":"2015","unstructured":"Thomson MS, Chaze F, George U, Guruge S. Improving immigrant populations\u2019 access to mental health services in Canada: a review of barriers and recommendations. J Immigr Minor Health. 2015;17(6):1895\u2013905. https:\/\/doi.org\/10.1007\/s10903-015-0175-3.","journal-title":"J Immigr Minor Health"},{"key":"3085_CR9","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.socscimed.2014.01.019","volume":"106","author":"S Kilian","year":"2014","unstructured":"Kilian S, Swartz L, Dowling T, Dlali M, Chiliza B. The potential consequences of informal interpreting practices for assessment of patients in a South African psychiatric hospital. Soc Sci Med. 2014;106:159\u201367. https:\/\/doi.org\/10.1016\/j.socscimed.2014.01.019.","journal-title":"Soc Sci Med"},{"issue":"1","key":"3085_CR10","doi-asserted-by":"publisher","first-page":"e13949","DOI":"10.1111\/hex.13949","volume":"27","author":"BMC Chan","year":"2024","unstructured":"Chan BMC, Suurmond J, van Weert JCM, Schouten BC. Uncovering communication strategies used in language-discordant consultations with people who are migrants: Qualitative interviews with healthcare providers. Health Expect. 2024;27(1):e13949. https:\/\/doi.org\/10.1111\/hex.13949.","journal-title":"Health Expect"},{"key":"3085_CR11","doi-asserted-by":"publisher","first-page":"108767","DOI":"10.1016\/j.pec.2025.108767","volume":"136","author":"LGG van Lent","year":"2025","unstructured":"van Lent LGG, Yilmaz NG, Goosen S, Burgers J, Giani S, Schouten BC, et al. Effectiveness of interpreters and other strategies for mitigating language barriers: a systematic review. Patient Educ Couns. 2025;136:108767. https:\/\/doi.org\/10.1016\/j.pec.2025.108767.","journal-title":"Patient Educ Couns"},{"key":"3085_CR12","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.ijnurstu.2015.03.012","volume":"54","author":"F van Rosse","year":"2016","unstructured":"van Rosse F, de Bruijne M, Suurmond J, Essink-Bot ML, Wagner C. Language barriers and patient safety risks in hospital care. A mixed methods study. Int J Nurs Stud. 2016;54:45\u201353. https:\/\/doi.org\/10.1016\/j.ijnurstu.2015.03.012.","journal-title":"Int J Nurs Stud"},{"issue":"1","key":"3085_CR13","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1186\/s12889-024-19046-z","volume":"24","author":"AI Forray","year":"2024","unstructured":"Forray AI, Oltean O, Hanft-Robert S, Madzamba R, Liem A, Schouten B, et al. Uncovering multi-level mental healthcare barriers for migrants: a qualitative analysis across China, Germany, Netherlands, Romania, and South Africa. BMC Public Health. 2024;24(1):1593. https:\/\/doi.org\/10.1186\/s12889-024-19046-z.","journal-title":"BMC Public Health"},{"issue":"1","key":"3085_CR14","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1186\/s12889-024-18988-8","volume":"24","author":"S Hanft-Robert","year":"2024","unstructured":"Hanft-Robert S, M\u00f6sko M. Community interpreting in Germany: results of a nationwide cross-sectional study among interpreters. BMC Public Health. 2024;24(1):1570. https:\/\/doi.org\/10.1186\/s12889-024-18988-8.","journal-title":"BMC Public Health"},{"issue":"2","key":"3085_CR15","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1177\/13634615241227337","volume":"61","author":"K Gartner","year":"2024","unstructured":"Gartner K, M\u00f6sko M, Becker JC, Hanft-Robert S. Barriers to use of interpreters in outpatient mental health care: exploring the attitudes of psychotherapists. Transcult Psychiatry. 2024;61(2):285\u201397. https:\/\/doi.org\/10.1177\/13634615241227337.","journal-title":"Transcult Psychiatry"},{"issue":"3","key":"3085_CR16","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1002\/jmrs.755","volume":"71","author":"B Taylor","year":"2024","unstructured":"Taylor B, McLean G. Exploring the use of mobile translation applications for culturally and linguistically diverse patients during medical imaging examinations in Australia - a systematic review. J Med Radiat Sci. 2024;71(3):432\u201344. https:\/\/doi.org\/10.1002\/jmrs.755.","journal-title":"J Med Radiat Sci"},{"issue":"1","key":"3085_CR17","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13690-025-01543-1","volume":"83","author":"A Kreienbrinck","year":"2025","unstructured":"Kreienbrinck A, Hanft-Robert S, Forray AI, Nozewu A, M\u00f6sko M. Usability of technological tools to overcome language barriers in healthcare-a scoping review. Arch Public Health. 2025;83(1):52. https:\/\/doi.org\/10.1186\/s13690-025-01543-1.","journal-title":"Arch Public Health"},{"key":"3085_CR18","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1136\/bmjqs-2024-018384","volume":"35","author":"M Kong","year":"2026","unstructured":"Kong M, Fernandez A, Bains J, Milisavljevic A, Brooks K, Shanmugam A, et al. Evaluation of the accuracy and safety of machine translation of patient-specific discharge instructions: a comparative analysis. BMJ Qual Saf. 2026;35:150\u20138. https:\/\/doi.org\/10.1136\/bmjqs-2024-018384.","journal-title":"BMJ Qual Saf"},{"issue":"1","key":"3085_CR19","doi-asserted-by":"publisher","first-page":"e2023065573","DOI":"10.1542\/peds.2023-065573","volume":"154","author":"RCL Brewster","year":"2024","unstructured":"Brewster RCL, Gonzalez P, Khazanchi R, Butler A, Selcer R, Chu D, et al. Performance of ChatGPT and Google Translate for pediatric discharge instruction translation. Pediatrics. 2024;154(1):e2023065573. https:\/\/doi.org\/10.1542\/peds.2023-065573.","journal-title":"Pediatrics"},{"key":"3085_CR20","doi-asserted-by":"publisher","first-page":"108060","DOI":"10.1016\/j.pec.2023.108060","volume":"119","author":"T Kiblinger","year":"2024","unstructured":"Kiblinger T, Daniels K, Calamaro C. Point-of-care communication for patients with limited language proficiency: a scoping review of healthcare interpretation applications. Patient Educ Couns. 2024;119:108060. https:\/\/doi.org\/10.1016\/j.pec.2023.108060.","journal-title":"Patient Educ Couns"},{"issue":"5","key":"3085_CR21","doi-asserted-by":"publisher","first-page":"e25131","DOI":"10.2196\/25131","volume":"23","author":"F Thonon","year":"2021","unstructured":"Thonon F, Perrot S, Yergolkar AV, Rousset-Torrente O, Griffith JW, Chassany O, et al. Electronic tools to bridge the language gap in health care for people who have migrated: systematic review. J Med Internet Res. 2021;23(5):e25131. https:\/\/doi.org\/10.2196\/25131.","journal-title":"J Med Internet Res"},{"key":"3085_CR22","doi-asserted-by":"publisher","first-page":"3516","DOI":"10.1111\/jocn.15390","volume":"29","author":"A Panayiotou","year":"2020","unstructured":"Panayiotou A, Hwang K, Williams S, Chong TWH, LoGiudice D, Haralambous B, et al. The perceptions of translation apps for everyday health care in healthcare workers and older people: a multi-method study. J Clin Nurs. 2020;29:3516\u201326. https:\/\/doi.org\/10.1111\/jocn.15390.","journal-title":"J Clin Nurs"},{"issue":"1","key":"3085_CR23","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12939-026-02821-2","volume":"25","author":"A Kreienbrinck","year":"2026","unstructured":"Kreienbrinck A, Hanft-Robert S, Top\u00e7u M-T, Peters L, Oltean O, Nozewu A, et al. Exploring the use of translation technologies to overcome language barriers in mental healthcare: a qualitative cross-country study. Int J Equity Health. 2026;25(1):88. https:\/\/doi.org\/10.1186\/s12939-026-02821-2.","journal-title":"Int J Equity Health"},{"issue":"1","key":"3085_CR24","doi-asserted-by":"publisher","first-page":"e102007","DOI":"10.1136\/bmjhci-2025-102007","volume":"33","author":"C Anyaegbuna","year":"2026","unstructured":"Anyaegbuna C, Steele N, Liang AS, Ma SP, Lopez I, Chilukuri N, et al. Artificial intelligence translation in healthcare: an urgent call for evidence-informed policy frameworks. BMJ Health Care Inf. 2026;33(1):e102007. https:\/\/doi.org\/10.1136\/bmjhci-2025-102007.","journal-title":"BMJ Health Care Inf"},{"issue":"3","key":"3085_CR25","doi-asserted-by":"publisher","first-page":"425","DOI":"10.2307\/30036540","volume":"27","author":"V Venkatesh","year":"2003","unstructured":"Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: Toward a unified view. MIS Q. 2003;27(3):425\u201378. https:\/\/doi.org\/10.2307\/30036540.","journal-title":"MIS Q"},{"issue":"1","key":"3085_CR26","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.jbi.2009.07.002","volume":"43","author":"RJ Holden","year":"2010","unstructured":"Holden RJ, Karsh BT. The technology acceptance model: its past and its future in health care. J Biomed Inf. 2010;43(1):159\u201372. https:\/\/doi.org\/10.1016\/j.jbi.2009.07.002.","journal-title":"J Biomed Inf"},{"key":"3085_CR27","doi-asserted-by":"publisher","unstructured":"Stengers H, L\u00e1zaro Guti\u00e9rrez R, Kerremans K. Exploring the acceptance of supporting tools in public service interpreting: a questionnaire study. Onom\u00e1zein Revista de ling\u00fc\u00edstica filolog\u00eda y traducci\u00f3n. 2024:102\u2009\u2013\u200928. https:\/\/doi.org\/10.7764\/onomazein.ne13.06.","DOI":"10.7764\/onomazein.ne13.06"},{"key":"3085_CR28","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","volume":"61","author":"E von Elm","year":"2008","unstructured":"von Elm E, Altman D, Egger M, Pocock S, G\u00f8tzsche P, Vandenbroucke J, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344\u20139. https:\/\/doi.org\/10.1016\/j.jclinepi.2007.11.008.","journal-title":"J Clin Epidemiol"},{"key":"3085_CR29","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2025","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2025. https:\/\/www.R-project.org."},{"key":"3085_CR30","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1093\/pch\/pxad054","volume":"29","author":"C Hui","year":"2024","unstructured":"Hui C. Access to appropriate interpretation is essential for the health of children. Paediatr Child Health. 2024;29:43\u20139. https:\/\/doi.org\/10.1093\/pch\/pxad054.","journal-title":"Paediatr Child Health"},{"key":"3085_CR31","doi-asserted-by":"publisher","first-page":"e43255","DOI":"10.2196\/43255","volume":"7","author":"F M\u00fcller","year":"2023","unstructured":"M\u00fcller F, Schr\u00f6der D, Noack EM. Overcoming language barriers in paramedic care with an app designed to improve communication with foreign-language patients: Nonrandomized controlled pilot study. JMIR Form Res. 2023;7:e43255. https:\/\/doi.org\/10.2196\/43255.","journal-title":"JMIR Form Res"},{"issue":"7","key":"3085_CR32","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1007\/s11606-024-08641-w","volume":"39","author":"P Hudelson","year":"2024","unstructured":"Hudelson P, Chappuis F. Using voice-to-voice machine translation to overcome language barriers in clinical communication: an exploratory study. J Gen Intern Med. 2024;39(7):1095\u2013102. https:\/\/doi.org\/10.1007\/s11606-024-08641-w.","journal-title":"J Gen Intern Med"},{"issue":"2","key":"3085_CR33","doi-asserted-by":"publisher","first-page":"e13167","DOI":"10.2196\/13167","volume":"7","author":"H Spechbach","year":"2019","unstructured":"Spechbach H, Gerlach J, Mazouri Karker S, Tsourakis N, Combescure C, Bouillon P. A speech-enabled fixed-phrase translator for emergency settings: crossover study. JMIR Med Inf. 2019;7(2):e13167. https:\/\/doi.org\/10.2196\/13167.","journal-title":"JMIR Med Inf"},{"key":"3085_CR34","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1186\/1472-6963-13-175","volume":"13","author":"D Debono","year":"2013","unstructured":"Debono D, Greenfield DT, Long JF, Black J, Johnson D, Braithwaite J. Nurses\u2019 workarounds in acute healthcare settings: a scoping review. BMC Health Serv Res. 2013;13:175. https:\/\/doi.org\/10.1186\/1472-6963-13-175.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"3085_CR35","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/27523810251409377","volume":"6","author":"K Peeters","year":"2026","unstructured":"Peeters K, Daems J, Plieseis C, Rivas Ginel M, \u015eahin M. AI for translation and interpreting. A roadmap for users and policymakers. Interpreting Society: Interdisciplinary J. 2026;6(1):3\u201333. https:\/\/doi.org\/10.1177\/27523810251409377.","journal-title":"Interpreting Society: Interdisciplinary J"},{"issue":"2","key":"3085_CR36","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1509\/jmkr.38.2.143.18840","volume":"38","author":"H Baumgartner","year":"2001","unstructured":"Baumgartner H, Steenkamp J-B. Response styles in marketing research: A cross-national investigation. J Mark Res. 2001;38(2):143\u201356. https:\/\/doi.org\/10.1509\/jmkr.38.2.143.18840.","journal-title":"J Mark Res"},{"issue":"2","key":"3085_CR37","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1177\/0022022104272905","volume":"36","author":"T Johnson","year":"2005","unstructured":"Johnson T, Kulesa P, Cho Y, Shavitt S. The Relation Between Culture and Response Styles: Evidence From 19 Countries. J Cross-Cult Psychol. 2005;36(2):264\u201377. https:\/\/doi.org\/10.1177\/0022022104272905.","journal-title":"J Cross-Cult Psychol"},{"issue":"3","key":"3085_CR38","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.pec.2008.11.015","volume":"74","author":"RLJ Street","year":"2009","unstructured":"Street RLJ, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295\u2013301. https:\/\/doi.org\/10.1016\/j.pec.2008.11.015.","journal-title":"Patient Educ Couns"},{"key":"3085_CR39","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.2110.06733","author":"D Blasi","year":"2021","unstructured":"Blasi D, Anastasopoulos A, Neubig G. Systematic Inequalities in Language Technology Performance across the World\u2019s Languages. ArXiv. 2021. https:\/\/doi.org\/10.48550\/arXiv.2110.06733.","journal-title":"ArXiv"},{"key":"3085_CR40","doi-asserted-by":"publisher","unstructured":"Delfani J, Orasan C, Saadany H, Temizoz O, Taylor-Stilgoe E, Kanojia D, et al. Google translate error analysis for mental healthcare information: evaluating accuracy, comprehensibility, and implications for multilingual healthcare communication. ArXiv. 2024:abs\/2402.04023. https:\/\/doi.org\/10.48550\/arXiv.2402.04023.","DOI":"10.48550\/arXiv.2402.04023"},{"key":"3085_CR41","doi-asserted-by":"publisher","unstructured":"European Data Protection Supervisor. AI, Act Regulation (EU). 2024\/1689 - Regulation (EU) 2024\/1689 of the European Parliament and of the Council of 13 June 2024 laying down harmonised rules on artificial intelligence and amending Regulations (EC) No 300\/2008, (EU) No 167\/2013, (EU) No 168\/2013, (EU) 2018\/858, (EU) 2018\/1139 and (EU) 2019\/2144 and Directives 2014\/90\/EU, (EU) 2016\/797 and (EU) 2020\/1828 (Artificial Intelligence Act) (Text with EEA relevance). Publications Office of the European Union; 2025. https:\/\/doi.org\/10.2804\/4225375.","DOI":"10.2804\/4225375"}],"container-title":["International Journal for Equity in Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12939-026-03085-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-026-03085-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12939-026-03085-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:14:53Z","timestamp":1792664093000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12939-026-03085-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3085"],"URL":"https:\/\/doi.org\/10.1186\/s12939-026-03085-6","relation":{},"ISSN":["1475-9276"],"issn-type":[{"value":"1475-9276","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"assertion":[{"value":"30 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All study procedures were performed according to the guidelines of the Declaration of Helsinki and ethical approval for this study was obtained from the responsible ethics committee in Germany: Local Psychological Ethics Committee, University Medical Centre Hamburg-Eppendorf (03.07.2025, ID: LPEK-0935). Informed consent was obtained from all individual participants included in the study. Consent was provided prior to participation.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"252"}}