The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews (34), to assess and synthesize the evidence in published and unpublished literature on individuals with disability from CALD backgrounds. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) checklist (see Additional file 1) has been followed to confirm the content of this protocol . The review will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist to ensure transparency and completeness of the review (35).
This scoping review will consider all published and unpublished studies relevant to individuals with disability from CALD backgrounds and their health and support services needs. Individuals from CALD backgrounds are defined mainly by their “country of birth, language spoken at home (36)” or characteristics including year of arrival in the adopted country and parents’ country of birth (36).
Studies involving individuals with disability from CALD backgrounds will be considered. Disability is defined as the interaction between an individual’s impairment in their body structure or function and their personal and environmental factors (37). It leads to activity limitations and participation restrictions, which may prevent meaningful engagement in occupations (37).
The review will consider all studies that describe the health service and health service needs related to individuals with disability from CALD backgrounds. These services are practices that assess, document, maintain or improve an individual’s health, treat and diagnose illness or disability, or prescribe medication (38).
Studies that describe support service and support service needs related to disability will be considered. These services are government services that provide income support to individuals with disability, provision of services and provision of funds to organizations to carry out services (39).
Studies that describe meaningful engagement in occupations at a healthcare level will be considered. Meaningful engagement in occupations is the degree to which an individual finds their occupations to be worthwhile, important, and in line with their values and sense of self (1). Occupation refers to a wide range of activities that individuals “need to, want to, are expected to do” (1), that are worthwhile, important and compatible with their values and sense of self, ultimately bringing meaning to their life (1).
Research conducted in primary and secondary health and support care setting will be considered. Primary care is usually the first contact an individual has with the health system and covers majority of an individual’s health needs, and delivering community-based care by various health professionals (16). Secondary care requires more specific knowledge, skills and equipment and is provided by a specialist or hospital upon referral by a primary care professional (16).
This scoping review will consider experimental and quasi-experimental studies, analytical observational studies, descriptive observational studies, qualitative studies, systematic reviews, text and opinion papers that meet the inclusion criteria. Studies published in English language will be included. Studies published since 1974 will be included in order to be comprehensive and attempt to ‘cover the field’.
A three-step search strategy will be undertaken (34). An initial search strategy was devised in consultation with a librarian (KC) and employed on CINAHL (EBSCOhost) to identify relevant articles, the text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles to develop a full search strategy (see Additional file 2). Initial keywords include disability, culturally and linguistically diverse, multicultural, culturally diverse, linguistically diverse, ethnic minority, minority group, immigrant, migrant, health service, support service, and disability service. A second search will be undertaken including all identified keywords and index terms, which will be adapted for each database. The databases to be searched include PubMed, Embase (Ovid), Scopus, PsychInfo (EBSCOhost) and Cochrane Library, as well as searching for grey literature in Trove, Mednar, OpenGrey and Google Scholar. As the scoping review aims to search for a diverse range of literature in a topic area , meaningful engagement in occupations and meaningful occupations was not applied to the search strategy. Boolean operators and wildcards were applied to search terms to ensure a comprehensive search. Thirdly, the reference list of identified reports and articles will be searched for additional sources.
A range of data will be considered in this scoping review, including peer-reviewed journal articles, publications, practice guidelines, policy, reports and statements. This review will include studies relevant to individuals with disability from CALD backgrounds and their health and support service needs. Following the search, all identified citations will be collated and uploaded into Endnote X9 (Clarivate Analytics, PA, USA) and duplicates will be removed. Titles and abstracts will be screened for eligibility against the inclusion criteria. The full text of selected citations will be assessed in detail against the inclusion criteria. Reasons for exclusion of full text studies that do not meet the inclusion criteria will be recorded and reported in the scoping review. The results of the search will be reported in full in the final report and presented in a PRISMA flow diagram  (see Additional file 3).
Data will be extracted from papers included in the scoping review using a modified JBI data extraction instrument (40) (see Additional file 4) by author (JP) as supervised by co-authors. The data extracted will include citation and study information (author, year of publication, aim, study population, study design, setting and methodology), as well as results relevant to the scoping review (type of CALD groups, type of disability, micro-meso-macro system factors and relevant key findings and themes). Where required, authors of papers will be contacted to request missing or additional data.
Risk of bias assessment or quality appraisal
As the scoping review aims to identify gaps in existing evidence and map all available evidence, a risk of bias assessment will not be undertaken. Quality appraisal will be undertaken independently by two reviewers for all included studies using the JBI appraisal tools (41) to assess the methodological quality of the studies as well as to determine the extent to which the articles had addressed the possibility of biases. Following an independent review, any discrepancy in interpretation of the data will be discussed between authors to obtain consensus. A kappa coefficient will be obtained.
Data presentation and synthesis of results
As the studies considered will include a mix of qualitative, quantitative and mixed research methodologies, meta-aggregation will be used for the synthesis of qualitative results. Meta-aggregation is a process that summarises common findings that are then synthesized and may be from different methodologies (42). They produce generalisations that lead to recommendations for action, hence statements can be useful for evidence-based practice (43). Individual studies will be summarised, then categorized into common themes among all qualitative studies before synthesis. The extracted data will be presented in a tabular form in a manner that aligns with the objective of this scoping review. A narrative summary will accompany the tabulated results and will describe how the results relate to the review objective and questions.