1
|
Kanengoni-Nyatara B, Watson K, Galindo C, Charania NA, Mpofu C, Holroyd E. Barriers to and Recommendations for Equitable Access to Healthcare for Migrants and Refugees in Aotearoa, New Zealand: An Integrative Review. J Immigr Minor Health 2024; 26:164-180. [PMID: 37665540 PMCID: PMC10771599 DOI: 10.1007/s10903-023-01528-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/05/2023]
Abstract
The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees. An integrative review of 13 peer-reviewed research studies from EBSCOhost research databases published between January 2016 and September 2022. Studies included: (i) related to Aotearoa; (ii) had a focus on equitable delivery of healthcare to migrants and refugees; and (iii) had a full English text available. The PRISMA framework guided the reporting of the review. The findings were thematically analysed and presented using a narrative empirical synthesis. The findings were organised into three broad themes: attitudinal barriers, structural barriers, and recommendations. Attitudinal barriers included the lack of culturally competent healthcare providers, discrimination by healthcare providers, and personal, social, and cultural attributes. Structural barriers referred to policies and frameworks that regulated the accessibility of health services such as the cost of healthcare, accessibility and acceptability of interpreter services, length of allocated appointments and long waiting times for an appointment, difficulties navigating the health system, and logistical barriers. Recommendations focused on promoting a sense of belonging, enabling a whole-of-society approach that brings together all sectors involved in providing health care for collective impact, and advocating for government policies to create a system that addresses the core health service access needs. This review provides rich context-specific findings on the barriers to equitable access to healthcare and proposed interventions to enhance equitable health outcomes for migrants and refugees in Aotearoa. The review contributes to relevant policy decisions and has practical implications to build responsive health systems which are inclusive, equitable and best address the health needs of populations from diverse cultural backgrounds.
Collapse
Affiliation(s)
- Blessing Kanengoni-Nyatara
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Katie Watson
- Hato Hone St John, 600 Great South Road, Ellerslie, Auckland, 1051, New Zealand
| | - Carolina Galindo
- Hato Hone St John, 600 Great South Road, Ellerslie, Auckland, 1051, New Zealand
| | - Nadia A Charania
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Charles Mpofu
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Eleanor Holroyd
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
- AUT Migrant and Refugee Health Research Centre, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
| |
Collapse
|
2
|
Besera G, Vu M, Dogbe A, Ta D, Escoffery C, Copeland H, Hall KS. "My culture doesn't 100% like these kinds of services, but you decide what to do": Female refugees' experiences with sexual and reproductive healthcare in the Southeastern U.S. PEC INNOVATION 2023; 2:100172. [PMID: 37384152 PMCID: PMC10294046 DOI: 10.1016/j.pecinn.2023.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/30/2023]
Abstract
Objective This study investigates female refugees' experiences accessing and utilizing sexual and reproductive (SRH) services in the state of Georgia. Methods We conducted in-person, in-depth semi-structured interviews with 26 female refugee adolescents and adults from Burma, Bhutan or Nepal, and the Democratic Republic of Congo living in Georgia. Questions inquired about perceptions and experiences while accessing and utilizing SRH services. Data were analyzed using thematic analysis. Results Participants discussed the importance but also varying influence of social and cultural norms on SRH service utilization. Challenges to accessing and utilizing SRH services included communication and cost barriers. Facilitators included accessible clinic locations, transportation, and positive interactions with clinic providers and staff. Conclusion Understanding female refugees' experiences accessing and utilizing SRH services is critical to meet their SRH needs adequately. Through community engagement, practitioners and researchers can gain insights into cultural influences on SRH, address communication and cost barriers, and enhance existing facilitators to increase female refugees' access and use of services. Innovation Our community-engaged study incorporated perspectives of diverse groups of refugee women and adolescents in the Southeastern U.S. Findings from this study highlight lived experiences with SRH services and identify barriers to and facilitators of SRH services access and utilization.
Collapse
Affiliation(s)
- Ghenet Besera
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Milkie Vu
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Aku Dogbe
- Embrace Refugee Birth Support, Clarkston, GA, USA
| | - Danny Ta
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Cam Escoffery
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Kelli S. Hall
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
3
|
Charania NA. "She vaccinated my baby and that's all…" Immunisation decision-making and experiences among refugee mothers resettled in Aotearoa New Zealand. BMC Public Health 2023; 23:1349. [PMID: 37442991 PMCID: PMC10347757 DOI: 10.1186/s12889-023-16266-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/08/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND To prevent disease outbreaks, refugee children must be age-appropriately immunised. This qualitative study gained an in-depth understanding of refugee mothers' vaccine decision-making and experiences accessing immunisation services for their children post-resettlement in Aotearoa New Zealand. METHODS An interpretive description methodology involving focus groups with refugee mothers (N = 45) was conducted in Auckland, one of the resettlement locations. Mothers were asked about their perceptions of vaccine-preventable diseases and vaccines, their experiences of attending immunisation events, and their suggestions for improvements to immunisation services. Data were analysed following the phases of reflexive thematic analysis. RESULTS Four themes were constructed. Do I have a choice? Mothers displayed pro-vaccination sentiments and parental obligation to vaccinate their children to protect their health, which underpinned their compliance with the national vaccine schedule. Transnational vaccine perceptions and behaviours It was evident that comparing their health experiences in their origin countries reinforced their positive perceptions of and trust in vaccines, health providers and their recommendations, the health system and government in New Zealand. Information sharing with their transnational networks had the potential to influence vaccine perceptions and behaviours in home and host countries. Unanswered questions and concerns Mothers discussed how many of their questions and concerns about immunisations and post-vaccine management went unanswered. Relationships and experiences matter Mothers stressed the importance of who vaccinated their child and how it was administered, highlighting that health providers' demeanour and competence influence their immunisation experiences. CONCLUSIONS Health providers are encouraged to focus on creating a positive immunisation experience for refugee background families. Qualified interpreters and provision of culturally and linguistically appropriate information are required. Transnationalism at the individual level appears to influence vaccine perceptions and behaviours among refugee-background mothers. Future research focusing on caregivers with child(ren) who are not fully vaccinated would be beneficial.
Collapse
Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand.
- Migrant and Refugee Health Research Centre, Auckland University of Technology, Auckland, New Zealand.
| |
Collapse
|
4
|
van Braam EJ, McRae DN, Portela AG, Stekelenburg J, Penn-Kekana L. Stakeholders' perspectives on the acceptability and feasibility of maternity waiting homes: a qualitative synthesis. Reprod Health 2023; 20:101. [PMID: 37407983 PMCID: PMC10324180 DOI: 10.1186/s12978-023-01615-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/25/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Maternity waiting homes (MHWs) are recommended to help bridge the geographical gap to accessing maternity services. This study aimed to provide an analysis of stakeholders' perspectives (women, families, communities and health workers) on the acceptability and feasibility of MWHs. METHODS A qualitative evidence synthesis was conducted. Studies that were published between January 1990 and July 2020, containing qualitative data on the perspectives of the stakeholder groups were included. A combination of inductive and deductive coding and thematic synthesis was used to capture the main perspectives in a thematic framework. RESULTS Out of 4,532 papers that were found in the initial search, a total of 38 studies were included for the thematic analysis. Six themes emerged: (1) individual factors, such as perceived benefits, awareness and knowledge of the MWH; (2) interpersonal factors and domestic responsibilities, such as household and childcare responsibilities, decision-making processes and social support; (3) MWH characteristics, such as basic services and food provision, state of MWH infrastructure; (4) financial and geographical accessibility, such as transport availability, costs for MWH attendance and loss of income opportunity; (5) perceived quality of care in the MWH and the adjacent health facility, including regular check-ups by health workers and respectful care; and (6) Organization and advocacy, for example funding, community engagement, governmental involvement. The decision-making process of women and their families for using an MWH involves balancing out the gains and losses, associated with all six themes. CONCLUSION This systematic synthesis of qualitative literature provides in-depth insights of interrelating factors that influence acceptability and feasibility of MWHs according to different stakeholders. The findings highlight the potential of MWHs as important links in the maternal and neonatal health (MNH) care delivery system. The complexity and scope of these determinants of utilization underlines the need for MWH implementation strategy to be guided by context. Better documentation of MWH implementation, is needed to understand which type of MWH is most effective in which setting, and to ensure that those who most need the MWH will use it and receive quality services. These results can be of interest for stakeholders, implementers of health interventions, and governmental parties that are responsible for MNH policy development to implement acceptable and feasible MWHs that provide the greatest benefits for its users. Trial registration Systematic review registration number: PROSPERO 2020, CRD42020192219.
Collapse
Affiliation(s)
| | - Daphne N McRae
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Anayda G Portela
- Department of Maternal, Newborn, Child, and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Jelle Stekelenburg
- Department of Health Sciences, Global Health Unit, University Medical Centre Groningen/University of Groningen, Groningen, The Netherlands
- Department Obstetrics and Gynaecology, Leeuwarden Medical Centre, Leeuwarden, The Netherlands
| | - Loveday Penn-Kekana
- Department of Maternal Health and Health Systems, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
5
|
Yang B, Kelly C, Shamputa IC, Barker K, Thi Kim Nguyen D. Structural Origins of Poor Health Outcomes in Documented Temporary Foreign Workers and Refugees in High-Income Countries: A Review. Healthcare (Basel) 2023; 11:healthcare11091295. [PMID: 37174837 PMCID: PMC10177793 DOI: 10.3390/healthcare11091295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/25/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Despite growing evidence of racial and institutional discrimination on minoritized communities and its negative effect on health, there are still gaps in the current literature identifying health disparities among minoritized communities. This review aims to identify health barriers faced by relatively less studied migrant subgroups including documented temporary foreign workers and refugees residing in high-income Organisation for Economic Co-operation and Development (OECD) countries focusing on the structural origins of differential health outcomes. We searched Medline, CINAHL, and Embase databases for papers describing health barriers for these groups published in English between 1 January 2011 and 30 July 2021. Two independent reviewers conducted a title, abstract, and full text screening with any discrepancies resolved by consensus or a third reviewer. Extracted data were analyzed using an inductive thematic analysis. Of the 381 articles that underwent full-text review, 27 articles were included in this review. We identified housing conditions, immigration policies, structural discrimination, and exploitative labour practices as the four major emerging themes that impacted the health and the access to healthcare services of our study populations. Our findings highlight the multidimensional nature of health inequities among migrant populations and a need to examine how the broader context of these factors influence their daily experiences.
Collapse
Affiliation(s)
- Borum Yang
- Faculty of Medicine, Dalhousie University NB, Saint John, NB E2L 4L5, Canada
| | - Clara Kelly
- Department of Nursing & Health Sciences, University of NB, Saint John, NB E2L 4L5, Canada
| | - Isdore Chola Shamputa
- Department of Nursing & Health Sciences, University of NB, Saint John, NB E2L 4L5, Canada
| | - Kimberley Barker
- Department of Public Health, Government of NB, Saint John, NB E1A E9H, Canada
| | - Duyen Thi Kim Nguyen
- Department of Public Health, Government of NB, Saint John, NB E1A E9H, Canada
- Faculty of Business, University of NB, Saint John, NB E2L 4L5, Canada
| |
Collapse
|
6
|
Mehrara L, Olaug Gjernes TK, Young S. Immigrant women’s experiences with Norwegian maternal health services: implications for policy and practice. Int J Qual Stud Health Well-being 2022; 17:2066256. [PMID: 35435143 PMCID: PMC9048944 DOI: 10.1080/17482631.2022.2066256] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Lydia Mehrara
- Faculty of Social Sciences, Nord University, Bodø, Norway
| | | | - Susan Young
- Social Work and Social Policy, The University of Western Australia, Crawley, WA, Australia
| |
Collapse
|
7
|
Cohen JH, Maleku A, Pyakurel S, Suzuki T, Raut S, Montiel Ishino FA. Exploring the Digital Divide among the Bhutanese Refugee Community during COVID-19: Engaged Research in Action. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16854. [PMID: 36554741 PMCID: PMC9779899 DOI: 10.3390/ijerph192416854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/10/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The digital divide proved a critical barrier to accessing information and healthcare during the COVID-19 pandemic and negatively impacted the Bhutanese refugee community. Moving beyond a technological model of the digital divide that highlights a lack of access to computers and the internet, we engaged the community to co-produce a dynamic approach that identifies the impact of socio-cultural and socio-environmental factors as well. Our paper reports on our community-academic research partnership and explores how the digital divide exacerbates health disparities in a midwestern Bhutanese refugee community. Combining the efforts of the community, anthropologists and social workers, this paper reports on the health disparities that confront the community as well as interventions designed to mitigate social inequities.
Collapse
Affiliation(s)
- Jeffrey H. Cohen
- Department of Anthropology, The Ohio State University, Columbus, OH 43210, USA
| | - Arati Maleku
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | | | - Taku Suzuki
- International Studies, Denison University, Granville, OH 43023, USA
| | - Shambika Raut
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | | |
Collapse
|
8
|
Debela MS, Garrett APN, Charania NA. Vaccine hesitancy and its determinants among refugee parents resettled in Aotearoa New Zealand. Hum Vaccin Immunother 2022; 18:2131336. [PMID: 36315907 PMCID: PMC9746517 DOI: 10.1080/21645515.2022.2131336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Vaccine hesitancy is an important factor underpinning suboptimal vaccine uptake and evidence on marginalized subgroups, such as refugees, is limited. This cross-sectional survey was conducted in 2020/21 with former refugee parents who resettled in Aotearoa New Zealand (NZ). The Parent Attitudes about Childhood Vaccines (PACV) was offered in Somali, Oromo, Arabic, and English languages, and the reliability of the four versions were evaluated. The prevalence of parental vaccine hesitancy was explored and the association between vaccine hesitancy and sociodemographic factors was examined using logistic regression. One hundred and seventy-eight responses were included in the analysis. The Cronbach's alpha scores for Somali, Oromo, Arabic, and English PACV were 0.89, 0.64, 0.53, and 0.77, respectively. The rate of parental vaccine hesitancy was 16.3%, 95% CI (10.7, 21.3). Most caregivers were concerned about vaccine side effects (47%), safety (43%), and efficacy (40%). Less than a quarter (21%) of parents had delayed their child receiving a vaccine and 12% had refused to vaccinate their child for reasons other than medical exemptions. After adjusting for covariate/s, parents' primary source of information and education status were significantly associated with vaccine hesitancy. Media as a primary source of vaccine information and low education status were associated with higher vaccine hesitancy. Vaccine hesitancy is relatively low among former refugees and is influenced by modifiable factors, including educational level and primary source of vaccine information. Vaccine information tailored to former refugee parents' concerns are required to reduce vaccine hesitancy and improve vaccine uptake.
Collapse
Affiliation(s)
- Mulisa Senbeta Debela
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - A. P. Nick Garrett
- Department of Biostatistics and Epidemiology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nadia A. Charania
- Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand,Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand,CONTACT Nadia A. Charania Department of Public Health, Faculty of Health and Environmental Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland 0627, New Zealand
| |
Collapse
|
9
|
Peters P, Harding C, Forde S, Heckendorf N, Seal A. Exploring barriers to domestic violence screening among culturally and linguistically diverse and migrant women in a regional midwifery setting. Midwifery 2022; 114:103454. [PMID: 35995008 DOI: 10.1016/j.midw.2022.103454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 05/24/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Women are at an increased risk of experiencing domestic violence (DV) from an intimate partner during the antenatal and post-partum period, contributing to poorer health outcomes for mother and baby. The antenatal period presents a critical window of opportunity for screening and intervention. In Australia, screening guidelines vary across state and territory health departments. NSW Health has introduced compulsory antenatal DV screening, however, screening appears to be more commonly deferred for women of CALD and non-English speaking backgrounds suggesting barriers to screening. AIM To identify barriers to undertaking DV screening of culturally and linguistically diverse (CALD) and migrant women in a regional setting METHODS: Qualitative semi-structured interviews were conducted with midwives who undertook antenatal DV assessment at a regional hospital in rural New South Wales serving a high CALD and migrant population. FINDINGS Eleven midwives participated in the interviews. Four emergent themes were apparent as barriers to DV screening: communications challenges, including literacy and use of interpreters, issues with maternity services including lack of flexibility and continuity, a woman's family issues and cultural difficulties. CONCLUSION The antenatal period presents a critical window for screening and intervention for those living with intimate partner violence from CALD and migrant groups. While it is acknowledged that there are complex language, maternity service, family and cultural barriers that impact on the ability to undertake screening in a regional setting, recognising these is the first step in addressing them and being able to intervene to break the DV cycle.
Collapse
Affiliation(s)
- Priscilla Peters
- The University of Notre Dame Australia, School of Medicine Sydney, Rural Clinical School, PO Box 5050, Wagga Wagga NSW 2650 Australia
| | - Catherine Harding
- The University of Notre Dame Australia, School of Medicine Sydney, Rural Clinical School, PO Box 5050, Wagga Wagga NSW 2650 Australia
| | - Sandra Forde
- Murrumbidgee Local Health District, Level 1, Surgical Services Block, Wagga Wagga Base Hospital, Edward St, Wagga Wagga, NSW 2650 Australia
| | - Narelle Heckendorf
- Murrumbidgee Local Health District, Level 1, Surgical Services Block, Wagga Wagga Base Hospital, Edward St, Wagga Wagga, NSW 2650 Australia
| | - Alexa Seal
- The University of Notre Dame Australia, School of Medicine Sydney, Rural Clinical School, PO Box 5050, Wagga Wagga NSW 2650 Australia.
| |
Collapse
|
10
|
Chauhan A, Walpola RL, Manias E, Seale H, Walton M, Wilson C, Smith AB, Li J, Harrison R. How do health services engage culturally and linguistically diverse consumers? An analysis of consumer engagement frameworks in Australia. Health Expect 2021; 24:1747-1762. [PMID: 34264537 PMCID: PMC8483202 DOI: 10.1111/hex.13315] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/19/2021] [Accepted: 06/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Engagement frameworks provide the conceptual structure for consumer engagement in healthcare decision making, but the level to which these frameworks support culturally and linguistically diverse (CALD) consumer engagement is not known. Objective This study aimed to investigate how consumer engagement is conceptualised and operationalized and to determine the implications of current consumer engagement frameworks for engagement with CALD consumers. Method Altheide's document analysis approach was used to guide a systematic search, selection and analytic process. Australian Government health department websites were searched for eligible publicly available engagement frameworks. A narrative synthesis was conducted. Results Eleven engagement frameworks published between 2007 and 2019 were identified and analysed. Only four frameworks discussed engagement with CALD consumers distinctly. Organisational prerequisites to enhance engagement opportunities and approaches to enable activities of engagement were highlighted to improve CALD consumers' active participation in decision making; however, these largely focused on language, with limited exploration of culturally sensitive services. Conclusion There is limited discussion of what culturally sensitive services look like and what resources are needed to enhance CALD consumer engagement in high‐level decision making. Health services and policy makers can enhance opportunities for engagement with CALD consumers by being flexible in their approach, implementing policies for reimbursement for participation and evaluating and adapting the activities of engagement in collaboration with CALD consumers. Patient/Public Contribution This study is part of a wider ‘CanEngage’ project, which includes a consumer investigator, and is supported by a consumer advisory group. The study was conceived with inputs from the consumer advisory group, which continued to meet regularly with the project team to discuss the methodology and emerging findings.
Collapse
Affiliation(s)
- Ashfaq Chauhan
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Ramesh L Walpola
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - Holly Seale
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Merrilyn Walton
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Carlene Wilson
- Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia.,School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Allan B Smith
- Centre for Oncology Education and Research Translation (CONSORT), Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, New South Wales, Australia
| | - Jiadai Li
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| | - Reema Harrison
- School of Population Health, UNSW Sydney, Kensington, New South Wales, Australia
| |
Collapse
|
11
|
Hassan H, Blackwood L. (Mis)recognition in the Therapeutic Alliance: The Experience of Mental Health Interpreters Working With Refugees in U.K. Clinical Settings. QUALITATIVE HEALTH RESEARCH 2021; 31:399-410. [PMID: 33135568 PMCID: PMC7750660 DOI: 10.1177/1049732320966586] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Mental health interpreters play a crucial role in clinical support for refugees by providing a bridge between client and clinician. Yet research on interpreters' experiences and perspectives is remarkably sparse. In this study, semi-structured interviews with mental health interpreters explored the experience of working in clinical settings with refugees. We conducted inductive analysis informed by a reflexive thematic analytic approach. Our analysis identifies interpreters' pleasure in being part of people's recovery, offset by the pain of misrecognition by clinicians that signals low self-worth and invisibility. Three sites of tension that create dilemmas for interpreters are identified: maintaining professional boundaries, managing privately shared information, and recognizing cultural norms. These findings are discussed in terms of the implications for clinicians working with interpreters, with a focus on the importance of a relationship of trust founded on recognition of the interpreters' role and the unique challenges they face.
Collapse
Affiliation(s)
| | - Leda Blackwood
- University of Bath, Bath, United
Kingdom
- Leda Blackwood, University of Bath,
10W, Bath BA2 7AY, UK.
| |
Collapse
|