Table 5.

Summary of recommendations to support and increase PROM completion, by people from CALD backgrounds and Indigenous Peoples, based on evidence from included studies

Stage	Recommendations
During PROM development for CALD and Indigenous populations	• Consider the needs of individual populations and whether cultural and linguistic adaptations are required, rather than just language translation [34]. • PROMs should be developed free from medical jargon, suitable for patients with low health literacy [37]. • PROMs should be co-designed with communities to ensure questions align with culture and lived experiences [37]. • Increase financial resources and leadership support to embed translated PROMs in clinical workflows [34, 38].
During electronic PROM system development	• Ensure electronic systems are accessibly designed prior to release (e.g., minimal system errors, user friendly for patients, embedded in electronic medical records for healthcare staff, result outputs for translated PROMs are provided in English for healthcare staff) [36, 38].
During patient communication about PROM completion (i.e., explaining purpose, explaining importance).	• Offer patients different modes of PROM completion based on personal preference. Consider developing PROMs that can be completed verbally [37]. • Healthcare staff should explain to family and carers the importance of reading PROM questions and responses in verbatim to patients [34–36]. • The purpose and importance of PROMs and the meaning of questions should be communicated to patients prior to completion (e.g., video resources, via healthcare staff, community members, etc.) [37].
After PROM completion	• Healthcare staff should help patients understand how PROM data relates to health-related quality of life, therapeutic options, or when compared to average scores for the relevant patient cohorts.