| Theme | Sub-theme | Example |
| Communication and connections | Asking questions | “Because of their… language barrier, they want to ask you all the questions while you’re there with the interpreter, so it’s like their opportunity to get all the questions answered and even ask other questions that might not be so related. Um so they really, yeah, jump on that opportunity” (participant 7) |
| Language misunderstandings | “Understanding of the other subtleties is probably a lot more challenging for a lot of [culturally and linguistically diverse] families, because we use a lot more words, ... I certainly spend a large chunk of appointments talking, when things aren’t all fine, for them, which is likely a lot harder when we can’t easily communicate for them” (participant 11) | |
| Rapport with family | “I think sometimes it is hard to read exactly how the parents are feeling, when you’ve got that sort of, triangle if you like, you know, the interpreter, you’re not exactly sure what the parents are saying to each other” (participant 10) | |
| Cultural factors and influences | Cultural beliefs—gender | “She’s always reflexing to dad to answer all questions. And I get the sense that mum does understand, but it’s always been the case that, no no, talk to my husband” (participant 5) |
| Understanding cultural influences | “We have to have an understanding about where families have come from, what their background is, so there’s all sorts of cultural factors” (participant 8) | |
| Stigma or shame | “Sometimes there’s a mistrust of government or authority, depending on where they’ve come from… I’ve had families when I’ve diagnosed a hearing loss, say please don’t tell anybody... I don’t want the government to know” (participant 8) | |
| Differences in service provision | More support needed | “We just try to link them in with everyone that we can, without overwhelming them, that that’s the difficulty because, when that does happen, they, they’re often wanting to retreat... just try to work out what it is they need, to get them the next small step along the way” (participant 9) |
| More time needed | “Our role is providing emotional and informational support to the family so I’m trying to get through, that informational support all takes quite a bit longer” (Participant 2) | |
| Engagement in services | Practical barriers | “I’ve actually done a few [appointments] in the carpark because parents can’t have the other kids looked after so… for those parents that can’t come in on their own” (participant 6) |
| Comparison to home country | “They explain back in their country things are done a bit differently so they wonder whether we can, fix things, ..., they’re not quite understanding what the problem is” (participant 7) | |
| Disengaging, delaying, or declining services | “We will have some families who don’t engage at all, particularly some cultures, .. . they don’t want the audiologist to tell us what the diagnosis is. .. they decline our support and that’s usually [culturally and linguistically diverse] families” (participant 1) | |
| Follow-up and tracking | “The other thing we can sometimes try is maternal and child health nurses can help us out, so if we’re not able to make any contact whatsoever with families,... if the family is not attending appointments or sort of following the pathway, then the maternal and child health nurse, if she is engaged with them, can be really helpful” (participant 2) | |
| Obtaining feedback | “We honestly don’t get enough feedback,... because we often send kids off and we don’t know what happens next, it’s not just Hearing Australia, just in general we don’t necessarily hear a lot about how kids are going” (participant 9) | |
| Understanding services and service providers | “We just slow it right back, go back right to the beginning, and I’ll go through the whole process again... that just kind of alludes to the fact that they don’t quite get it... they’ll go through the process, but are they understanding each step of it? Not always entirely sure that they are” (participant 4) | |
| Interpreters and interpreting | Access to interpreters | “If that parent runs late, if the baby’s unsettled, then the booking of that interpreter goes right out the window, and often we’re making appointments for interpreters, and then the family arrive, and… the interpreters might not be available, so then we’re sort of left, kind of just hanging” (participant 4) |
| Declining interpreters, using informal interpreters | “family members at times, when they’re being the translator, sometimes you wonder how much they’re actually telling the other person, ‘cause you say a whole paragraph and they’ve just said one sentence” (participant 7) | |
| Quality of interpreting | “And there is always the challenge of using interpreters, that, they talk for a very long time and then they just tell us one sentence, and…, the amount of support we can provide. . . is limited” (participant 1) | |
| Written information | In English | “We certainly have documents that they can take home when there’s been a diagnosis, and they’re largely in English… some of them where the family’s been here for a while, there’s a little bit of English, and you’re sure there are other people in their circle who do speak quite good English, they’ll get someone to read it to them, so I’ll happily give an English version, to some non-English speakers” (participant 9) |
| In other languages | “Certainly the brochures are a huge support...when the screeners are out on the ward.... If there is no English by mum, then at least the screener can begin with, by leaving a LOTE brochure. And then following through with the interpreter service” (participant 3) |
| Theme | Sub-theme | Example |
| Communication and connections | Asking questions | “Because of their… language barrier, they want to ask you all the questions while you’re there with the interpreter, so it’s like their opportunity to get all the questions answered and even ask other questions that might not be so related. Um so they really, yeah, jump on that opportunity” (participant 7) |
| Language misunderstandings | “Understanding of the other subtleties is probably a lot more challenging for a lot of [culturally and linguistically diverse] families, because we use a lot more words, ... I certainly spend a large chunk of appointments talking, when things aren’t all fine, for them, which is likely a lot harder when we can’t easily communicate for them” (participant 11) | |
| Rapport with family | “I think sometimes it is hard to read exactly how the parents are feeling, when you’ve got that sort of, triangle if you like, you know, the interpreter, you’re not exactly sure what the parents are saying to each other” (participant 10) | |
| Cultural factors and influences | Cultural beliefs—gender | “She’s always reflexing to dad to answer all questions. And I get the sense that mum does understand, but it’s always been the case that, no no, talk to my husband” (participant 5) |
| Understanding cultural influences | “We have to have an understanding about where families have come from, what their background is, so there’s all sorts of cultural factors” (participant 8) | |
| Stigma or shame | “Sometimes there’s a mistrust of government or authority, depending on where they’ve come from… I’ve had families when I’ve diagnosed a hearing loss, say please don’t tell anybody... I don’t want the government to know” (participant 8) | |
| Differences in service provision | More support needed | “We just try to link them in with everyone that we can, without overwhelming them, that that’s the difficulty because, when that does happen, they, they’re often wanting to retreat... just try to work out what it is they need, to get them the next small step along the way” (participant 9) |
| More time needed | “Our role is providing emotional and informational support to the family so I’m trying to get through, that informational support all takes quite a bit longer” (Participant 2) | |
| Engagement in services | Practical barriers | “I’ve actually done a few [appointments] in the carpark because parents can’t have the other kids looked after so… for those parents that can’t come in on their own” (participant 6) |
| Comparison to home country | “They explain back in their country things are done a bit differently so they wonder whether we can, fix things, ..., they’re not quite understanding what the problem is” (participant 7) | |
| Disengaging, delaying, or declining services | “We will have some families who don’t engage at all, particularly some cultures, .. . they don’t want the audiologist to tell us what the diagnosis is. .. they decline our support and that’s usually [culturally and linguistically diverse] families” (participant 1) | |
| Follow-up and tracking | “The other thing we can sometimes try is maternal and child health nurses can help us out, so if we’re not able to make any contact whatsoever with families,... if the family is not attending appointments or sort of following the pathway, then the maternal and child health nurse, if she is engaged with them, can be really helpful” (participant 2) | |
| Obtaining feedback | “We honestly don’t get enough feedback,... because we often send kids off and we don’t know what happens next, it’s not just Hearing Australia, just in general we don’t necessarily hear a lot about how kids are going” (participant 9) | |
| Understanding services and service providers | “We just slow it right back, go back right to the beginning, and I’ll go through the whole process again... that just kind of alludes to the fact that they don’t quite get it... they’ll go through the process, but are they understanding each step of it? Not always entirely sure that they are” (participant 4) | |
| Interpreters and interpreting | Access to interpreters | “If that parent runs late, if the baby’s unsettled, then the booking of that interpreter goes right out the window, and often we’re making appointments for interpreters, and then the family arrive, and… the interpreters might not be available, so then we’re sort of left, kind of just hanging” (participant 4) |
| Declining interpreters, using informal interpreters | “family members at times, when they’re being the translator, sometimes you wonder how much they’re actually telling the other person, ‘cause you say a whole paragraph and they’ve just said one sentence” (participant 7) | |
| Quality of interpreting | “And there is always the challenge of using interpreters, that, they talk for a very long time and then they just tell us one sentence, and…, the amount of support we can provide. . . is limited” (participant 1) | |
| Written information | In English | “We certainly have documents that they can take home when there’s been a diagnosis, and they’re largely in English… some of them where the family’s been here for a while, there’s a little bit of English, and you’re sure there are other people in their circle who do speak quite good English, they’ll get someone to read it to them, so I’ll happily give an English version, to some non-English speakers” (participant 9) |
| In other languages | “Certainly the brochures are a huge support...when the screeners are out on the ward.... If there is no English by mum, then at least the screener can begin with, by leaving a LOTE brochure. And then following through with the interpreter service” (participant 3) |
| Theme | Sub-theme | Example |
| Communication and connections | Asking questions | “Because of their… language barrier, they want to ask you all the questions while you’re there with the interpreter, so it’s like their opportunity to get all the questions answered and even ask other questions that might not be so related. Um so they really, yeah, jump on that opportunity” (participant 7) |
| Language misunderstandings | “Understanding of the other subtleties is probably a lot more challenging for a lot of [culturally and linguistically diverse] families, because we use a lot more words, ... I certainly spend a large chunk of appointments talking, when things aren’t all fine, for them, which is likely a lot harder when we can’t easily communicate for them” (participant 11) | |
| Rapport with family | “I think sometimes it is hard to read exactly how the parents are feeling, when you’ve got that sort of, triangle if you like, you know, the interpreter, you’re not exactly sure what the parents are saying to each other” (participant 10) | |
| Cultural factors and influences | Cultural beliefs—gender | “She’s always reflexing to dad to answer all questions. And I get the sense that mum does understand, but it’s always been the case that, no no, talk to my husband” (participant 5) |
| Understanding cultural influences | “We have to have an understanding about where families have come from, what their background is, so there’s all sorts of cultural factors” (participant 8) | |
| Stigma or shame | “Sometimes there’s a mistrust of government or authority, depending on where they’ve come from… I’ve had families when I’ve diagnosed a hearing loss, say please don’t tell anybody... I don’t want the government to know” (participant 8) | |
| Differences in service provision | More support needed | “We just try to link them in with everyone that we can, without overwhelming them, that that’s the difficulty because, when that does happen, they, they’re often wanting to retreat... just try to work out what it is they need, to get them the next small step along the way” (participant 9) |
| More time needed | “Our role is providing emotional and informational support to the family so I’m trying to get through, that informational support all takes quite a bit longer” (Participant 2) | |
| Engagement in services | Practical barriers | “I’ve actually done a few [appointments] in the carpark because parents can’t have the other kids looked after so… for those parents that can’t come in on their own” (participant 6) |
| Comparison to home country | “They explain back in their country things are done a bit differently so they wonder whether we can, fix things, ..., they’re not quite understanding what the problem is” (participant 7) | |
| Disengaging, delaying, or declining services | “We will have some families who don’t engage at all, particularly some cultures, .. . they don’t want the audiologist to tell us what the diagnosis is. .. they decline our support and that’s usually [culturally and linguistically diverse] families” (participant 1) | |
| Follow-up and tracking | “The other thing we can sometimes try is maternal and child health nurses can help us out, so if we’re not able to make any contact whatsoever with families,... if the family is not attending appointments or sort of following the pathway, then the maternal and child health nurse, if she is engaged with them, can be really helpful” (participant 2) | |
| Obtaining feedback | “We honestly don’t get enough feedback,... because we often send kids off and we don’t know what happens next, it’s not just Hearing Australia, just in general we don’t necessarily hear a lot about how kids are going” (participant 9) | |
| Understanding services and service providers | “We just slow it right back, go back right to the beginning, and I’ll go through the whole process again... that just kind of alludes to the fact that they don’t quite get it... they’ll go through the process, but are they understanding each step of it? Not always entirely sure that they are” (participant 4) | |
| Interpreters and interpreting | Access to interpreters | “If that parent runs late, if the baby’s unsettled, then the booking of that interpreter goes right out the window, and often we’re making appointments for interpreters, and then the family arrive, and… the interpreters might not be available, so then we’re sort of left, kind of just hanging” (participant 4) |
| Declining interpreters, using informal interpreters | “family members at times, when they’re being the translator, sometimes you wonder how much they’re actually telling the other person, ‘cause you say a whole paragraph and they’ve just said one sentence” (participant 7) | |
| Quality of interpreting | “And there is always the challenge of using interpreters, that, they talk for a very long time and then they just tell us one sentence, and…, the amount of support we can provide. . . is limited” (participant 1) | |
| Written information | In English | “We certainly have documents that they can take home when there’s been a diagnosis, and they’re largely in English… some of them where the family’s been here for a while, there’s a little bit of English, and you’re sure there are other people in their circle who do speak quite good English, they’ll get someone to read it to them, so I’ll happily give an English version, to some non-English speakers” (participant 9) |
| In other languages | “Certainly the brochures are a huge support...when the screeners are out on the ward.... If there is no English by mum, then at least the screener can begin with, by leaving a LOTE brochure. And then following through with the interpreter service” (participant 3) |
| Theme | Sub-theme | Example |
| Communication and connections | Asking questions | “Because of their… language barrier, they want to ask you all the questions while you’re there with the interpreter, so it’s like their opportunity to get all the questions answered and even ask other questions that might not be so related. Um so they really, yeah, jump on that opportunity” (participant 7) |
| Language misunderstandings | “Understanding of the other subtleties is probably a lot more challenging for a lot of [culturally and linguistically diverse] families, because we use a lot more words, ... I certainly spend a large chunk of appointments talking, when things aren’t all fine, for them, which is likely a lot harder when we can’t easily communicate for them” (participant 11) | |
| Rapport with family | “I think sometimes it is hard to read exactly how the parents are feeling, when you’ve got that sort of, triangle if you like, you know, the interpreter, you’re not exactly sure what the parents are saying to each other” (participant 10) | |
| Cultural factors and influences | Cultural beliefs—gender | “She’s always reflexing to dad to answer all questions. And I get the sense that mum does understand, but it’s always been the case that, no no, talk to my husband” (participant 5) |
| Understanding cultural influences | “We have to have an understanding about where families have come from, what their background is, so there’s all sorts of cultural factors” (participant 8) | |
| Stigma or shame | “Sometimes there’s a mistrust of government or authority, depending on where they’ve come from… I’ve had families when I’ve diagnosed a hearing loss, say please don’t tell anybody... I don’t want the government to know” (participant 8) | |
| Differences in service provision | More support needed | “We just try to link them in with everyone that we can, without overwhelming them, that that’s the difficulty because, when that does happen, they, they’re often wanting to retreat... just try to work out what it is they need, to get them the next small step along the way” (participant 9) |
| More time needed | “Our role is providing emotional and informational support to the family so I’m trying to get through, that informational support all takes quite a bit longer” (Participant 2) | |
| Engagement in services | Practical barriers | “I’ve actually done a few [appointments] in the carpark because parents can’t have the other kids looked after so… for those parents that can’t come in on their own” (participant 6) |
| Comparison to home country | “They explain back in their country things are done a bit differently so they wonder whether we can, fix things, ..., they’re not quite understanding what the problem is” (participant 7) | |
| Disengaging, delaying, or declining services | “We will have some families who don’t engage at all, particularly some cultures, .. . they don’t want the audiologist to tell us what the diagnosis is. .. they decline our support and that’s usually [culturally and linguistically diverse] families” (participant 1) | |
| Follow-up and tracking | “The other thing we can sometimes try is maternal and child health nurses can help us out, so if we’re not able to make any contact whatsoever with families,... if the family is not attending appointments or sort of following the pathway, then the maternal and child health nurse, if she is engaged with them, can be really helpful” (participant 2) | |
| Obtaining feedback | “We honestly don’t get enough feedback,... because we often send kids off and we don’t know what happens next, it’s not just Hearing Australia, just in general we don’t necessarily hear a lot about how kids are going” (participant 9) | |
| Understanding services and service providers | “We just slow it right back, go back right to the beginning, and I’ll go through the whole process again... that just kind of alludes to the fact that they don’t quite get it... they’ll go through the process, but are they understanding each step of it? Not always entirely sure that they are” (participant 4) | |
| Interpreters and interpreting | Access to interpreters | “If that parent runs late, if the baby’s unsettled, then the booking of that interpreter goes right out the window, and often we’re making appointments for interpreters, and then the family arrive, and… the interpreters might not be available, so then we’re sort of left, kind of just hanging” (participant 4) |
| Declining interpreters, using informal interpreters | “family members at times, when they’re being the translator, sometimes you wonder how much they’re actually telling the other person, ‘cause you say a whole paragraph and they’ve just said one sentence” (participant 7) | |
| Quality of interpreting | “And there is always the challenge of using interpreters, that, they talk for a very long time and then they just tell us one sentence, and…, the amount of support we can provide. . . is limited” (participant 1) | |
| Written information | In English | “We certainly have documents that they can take home when there’s been a diagnosis, and they’re largely in English… some of them where the family’s been here for a while, there’s a little bit of English, and you’re sure there are other people in their circle who do speak quite good English, they’ll get someone to read it to them, so I’ll happily give an English version, to some non-English speakers” (participant 9) |
| In other languages | “Certainly the brochures are a huge support...when the screeners are out on the ward.... If there is no English by mum, then at least the screener can begin with, by leaving a LOTE brochure. And then following through with the interpreter service” (participant 3) |
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