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Peprah P, Lloyd J, Harris M. Health literacy and cultural responsiveness of primary health care systems and services in Australia: reflections from service providers, stakeholders, and people from refugee backgrounds. BMC Public Health 2023; 23:2557. [PMID: 38129802 PMCID: PMC10734201 DOI: 10.1186/s12889-023-17448-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Primary health care [PHC] services with general practitioners (GPs) as the first point of access to health care services for people from refugee backgrounds in Australia can play a crucial role in building health literacy and promoting access to culturally appropriate services. To achieve equitable access and engagement, services and systems must be responsive to diverse health literacy and cultural needs. This study aims to explore how primary health services respond as a system and organisation to the health literacy and cultural needs of people from refugee backgrounds in Australia. METHODS This exploratory qualitative study involved 52 semi-structured interviews among 19 Africans from refugee backgrounds, 14 service providers, including GPs and nurses, and 19 other stakeholders, such as service managers/directors. Participants resided in New South Wales, Victoria, and Queensland. Interviews were audio-recorded, transcribed, and coded into QSR NVivo 12. Data analysis was guided by reflexive thematic analysis. FINDINGS Three interrelated themes were identified from the data relating to the health literacy and cultural responsiveness of PHC systems and services. The first theme, 'variable and ad hoc organisational response to health literacy and culturally responsive care,' demonstrated that some organisations did not systematically address the inherent complexity of navigating the health system nor the capacity of services and providers to respond to the cultural needs of people from refugee backgrounds. The second theme, 'individual provider responsibility,' captured the individual providers' interpersonal and relational efforts in supporting the health literacy and cultural needs of people from refugee backgrounds based on their motivation and adaptation. The third theme, 'refugee patient responsibility,' encapsulated people from refugee backgrounds' adaptations to and learning of the health system to navigate and access services. CONCLUSION Health literacy and culturally responsive practices need to be systematised by PHC organisations to be implemented and sustained over time. There is a need for diversity in the organisational leadership and health care workforce, organisational commitment, health literacy and culturally responsive care policies, provider training, and auditing practice as essential components of the change process. Engaging with refugee communities would allow services to focus on people from refugee backgrounds' needs by design.
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Affiliation(s)
- Prince Peprah
- Social Policy Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia.
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Jane Lloyd
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
- Australia's National Research Organisation for Women's Safety, Sydney, NSW, 2000, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia
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2
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Sawalha R, Hosseinzadeh H, Bajorek B. Culturally and linguistically diverse patients' perspectives and experiences on medicines management in Australia: a systematic review. Int J Clin Pharm 2023:10.1007/s11096-023-01560-6. [PMID: 37020057 DOI: 10.1007/s11096-023-01560-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 02/15/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Within the quality use of medicines (QUM)-which entails timely access to, and the rational use of, medicines-medicine safety is a global health priority. In multicultural countries, such as Australia, national medicines policies are focused on achieving QUM, although this is more challenging among their Culturally and Linguistically Diverse (CALD) patients (i.e., those from ethnic minority groups). AIM This review aimed to identify and explore the specific challenges to achieving QUM, as experienced by CALD patients living in Australia. METHOD A systematic literature search was conducted using Web of Science, Scopus, Academic search complete, CINHAL, PubMed and Medline. Qualitative studies describing any aspects of QUM among CALD patients in Australia were included. RESULTS Major challenges in facilitating QUM among CALD patients in Australia were identified, particularly in relation to the following medicines management pathway steps: difficulties around participation in treatment decision-making alongside deficiencies in information provision about medicines. Furthermore, medication non-adherence was commonly observed and reported. When mapped against the bio-psycho-socio-systems model, the main contributors to the medicine management challenges identified related to "social" and "system" factors, reflecting the current health-system's lack of capacity and resourcing to respond to patients' low health literacy levels, communication and language barriers, and cultural and religious perceptions about medicines. CONCLUSION QUM challenges were different among different ethnic groups. This review suggests a need to engage with CALD patients in co-designing culturally appropriate resources and/or interventions to enable the health-system to address the identified barriers to QUM.
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Affiliation(s)
- Rawan Sawalha
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia.
| | - Hassan Hosseinzadeh
- School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Beata Bajorek
- Heart and Stroke Program, Hunter Medical Research Institute, NSW, Australia
- Hunter New England Local Health District, New Lambton, NSW, Australia
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3
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Filmer T, Ray R, Glass BD. Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review. Res Social Adm Pharm 2023; 19:977-988. [PMID: 36868911 DOI: 10.1016/j.sapharm.2023.02.016] [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: 03/24/2022] [Revised: 02/03/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction. OBJECTIVE The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries. METHODS A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria. RESULTS A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building. CONCLUSIONS While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..
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Affiliation(s)
- Tamara Filmer
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
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Robinson A, O'Brien N, Sile L, Guraya HK, Govind T, Harris V, Pilkington G, Todd A, Husband A. Recommendations for community pharmacy to improve access to medication advice for people from ethnic minority communities: A qualitative person-centred codesign study. Health Expect 2022; 25:3040-3052. [PMID: 36161966 DOI: 10.1111/hex.13611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/11/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Medicines-centred consultations are vital to support medicine effectiveness and optimize health outcomes for patients. However, inequalities negatively impact ethnic minority populations when accessing medicines advice. It is important to identify opportunities to improve access for these communities however, knowledge of how best to achieve this is lacking; this study will generate recommendations to improve access to medicines advice from community pharmacies for people from ethnic minority communities. METHODS A series of codesign workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call (adhering to COVID-19 restrictions). Existing evidence-based perceptions affecting access to medicines advice were critiqued and recommendations were generated, by use of reflexive thematic analysis, to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim. QSR NVivo (Version 12) facilitated data analysis. RESULTS Twelve participants were recruited using purposive sampling; including eight UK citizens, two asylum seekers and two participants in receipt of residency visas. In total, four different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and cocreate recommendations to improve access to medicines advice in community pharmacies. Three recommendations were developed and centred on: (i) delivering and providing culturally competent medicines advice; (ii) building awareness of accessing medicines advice from community pharmacies; and (iii) enabling better discussions with patients from ethnic minority communities. CONCLUSIONS These recommendations have the potential to support community pharmacy services to overcome ethnic inequalities affecting medicines advice; service commissioners should consider these findings to best meet the needs of ethnic minority patients. Cultural competence training for community pharmacy staff could support the creation of pharmacies as inclusive healthcare settings. Collaborative working with ethnic minority communities could enable specific tailoring of medicines-centred services to best meet their needs. PATIENT OR PUBLIC CONTRIBUTION The National Institute for Health Research (NIHR) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualization. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and findings were reported, with cultural competence. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Laura Sile
- Alumni, School of Pharmacy, Liverpool John Moores University, Liverpool, UK
| | | | - Thorrun Govind
- Chair of the English Pharmacy Board, Royal Pharmaceutical Society, London, UK
| | - Vicki Harris
- Connected Voice Haref, Higham House, Newcastle upon Tyne, UK
| | - Guy Pilkington
- West End Family Health Primary Care Network, Cruddas Park Surgery, Newcastle upon Tyne, UK
| | - Adam Todd
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Andy Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, UK.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Suzuki S, Kato ET, Sato K, Konda M, Kuwabara Y, Yasuno S, Liu J, Masuda I, Ueshima K. The effect of the Original MethOd at pharmacy To ENhAnce Support for Health Improvement in the limited Japanese proficiency patients visiting local community pharmacy: A randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2022; 105:366-374. [PMID: 34059363 DOI: 10.1016/j.pec.2021.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 05/09/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES With an increase in globalization, the number of non-native-speaking citizens and tourists visiting local pharmacies is rapidly growing worldwide, creating linguistic and sociological problems. The aim of this study is to compare the effect of adding our original method, Original MethOd at pharmacy To ENhAnce Support for Health Improvement (OMOTENASHI), to the conventional medication counselling method (CMC) when counselling non-Japanese patients at the pharmacy. METHODS The OMOTENASHI consists of tools written in multiple languages and illustrations to clarify the effects and side effects, and to confirm patients' understanding. 71 non-Japanese patients were recruited and randomly assigned to the OMOTENASHI or to the CMC in a 1:1 ratio. Comprehension and satisfaction level were evaluated. RESULTS The overall comprehension level was significantly higher in the OMOTENASHI than in the CMC (75% vs 38%, p = 0.002), with a prominent difference in the recognition of the name, effects, side effects, precautions, and how to deal with side effects of the prescribed medication. CONCLUSION The OMOTENASHI to be a helpful tool in providing essential information to non-native-speaking patients. PRACTICE IMPLICATION The study highlighted the need to ensure every patient's safety and interests, and to avoid disadvantages caused by limited language proficiency in the globalization era.
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Affiliation(s)
- Shota Suzuki
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan; Institute for Clinical and Translational Science, Nara Medical University Hospital, Nara, Japan.
| | - Eri Toda Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keiko Sato
- Department of Health Informatics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Manako Konda
- Department of Preventive Services, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yoshihiro Kuwabara
- Center for Accessing Early Promising Treatment, Kyoto University Hospital, Kyoto, Japan
| | - Shinji Yasuno
- Clinical Research Support Center, The Jikei University School of Medicine, Tokyo, Japan
| | - Jinliang Liu
- Department of Infectious Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Izuru Masuda
- Medical Examination Center, Takeda Hospital, Kyoto, Japan
| | - Kenji Ueshima
- Center for Accessing Early Promising Treatment, Kyoto University Hospital, Kyoto, Japan
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Hawkes C, Norris K, Joyce J, Paton D. Professional mental health support seeking in Women of Refugee Background resettled in Australia: An exploratory study of facilitators and barriers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e440-e456. [PMID: 33797138 DOI: 10.1111/hsc.13370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/30/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
The present study is the first to investigate factors influencing professional mental health support seeking in Women of Refugee Background (WoRB) in Australia. WoRB are a vulnerable population with a range of complex mental health needs. Despite this, research has indicated that WoRB are an underrepresented population in the utilisation of mental health support services. This is a particular concern in Australia, due to an increasing number of WoRB being resettled. A multivariate logistical regression was conducted on a sample of 450 WoRB resettled in Australia from the Building a New Life in Australia (BNLA) data set to investigate factors associated with seeking professional mental health support. Several factors were identified as being significantly associated with professional mental health support seeking in WoRB resettled in Australia, including age, resettlement location, marital status, prearrival trauma involving violence against women, language barriers and health-related variables, including mental distress and long-term disability. The current study provides a unique insight into professional mental health support seeking from a gendered perspective in WoRB resettled in Australia. Insights into factors that influence seeking professional mental health support in this highly vulnerable population must inform mental health practice, service delivery and policies.
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Affiliation(s)
- Clare Hawkes
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kimberley Norris
- School of Medicine (Psychology), University of Tasmania, Hobart, Tasmania, Australia
| | - Janine Joyce
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Douglas Paton
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
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7
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Aref HAT, Witry M, Olufemi-Yusuf D, Guirguis LM. Ensuring quality qualitative research reporting in community pharmacy: a systematic literature review. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:416-427. [PMID: 34390342 DOI: 10.1093/ijpp/riab027] [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: 07/16/2020] [Accepted: 04/30/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To evaluate the reporting quality for a sample of community pharmacy qualitative research articles based on the Standards for Reporting Qualitative Research (SRQR) guidelines, data interpretation and use of theory. METHODS A systematic literature search was conducted using Ovid MEDLINE to identify qualitative research related to community pharmacy. Data were extracted and evaluated based on the SRQR standards, data interpretation level and use of theory. Adherence to standards was analysed using descriptive statistics. KEY FINDINGS Eighty-one studies were retrieved through the database search (n = 81). Then, 31 studies met the inclusion criteria after screening abstracts and full texts. Twelve out of 21 SRQR were present in more than 80% of the studies. However, essential standards, such as research approach, reflexivity and trustworthiness techniques, were absent or partially present in 30 (97%) studies, 30 (97%) studies and 21 (68%) studies, respectively. Data interpretation level was descriptive in 27 (87%) studies and interpretive or partially interpretive in 4 (13%) studies. Theory was absent in 19 (60%) and implied, partially integrated or retrospectively applied in 12 (40%) of the studies. CONCLUSION Trustworthiness and quality of qualitative inferences within community pharmacy research could be enhanced with increasing awareness about reporting; the approach and paradigm, reflexivity, trustworthiness techniques, data interpretation level and theoretical use.
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Affiliation(s)
- Heba A T Aref
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Matthew Witry
- Department of Pharmacy Practice and Science, Division of Health Services Research, College of Pharmacy, The University of Iowa, Iowa City, IA, USA
| | - Damilola Olufemi-Yusuf
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
| | - Lisa M Guirguis
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, Canada
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Parajuli J, Horey D, Avgoulas MI. Perceived barriers to cervical cancer screening among refugee women after resettlement: A qualitative study. Contemp Nurse 2020; 56:363-375. [DOI: 10.1080/10376178.2020.1806089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jamuna Parajuli
- Public Health, La Trobe University, Health Sciences Building 1, Bundoora, VIC, 3086, Australia
| | - Dell Horey
- Public Health, La Trobe University, College of Science, Health & Engineering, Office PW 228, Bundoora, VIC, 3086, Australia
| | - Maria-Irini Avgoulas
- School of Psychology and Public Health, La Trobe University, College of Science, Health & Engineering, Office HS2, 525, Bundoora, 3086, Australia
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9
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Bellamy K, Dowse R, Ostini R, Martini N, Kairuz T. Preferences of Resettled Refugees on Pictograms Describing Common Symptoms of Illness. J Immigr Minor Health 2020; 22:216-219. [DOI: 10.1007/s10903-019-00908-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bellamy K, Ostini R, Martini N, Kairuz T. Insights from the coalface: barriers to accessing medicines and pharmacy services for resettled refugees from Africa. Aust J Prim Health 2019; 25:118-124. [PMID: 30721646 DOI: 10.1071/py18092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 12/03/2018] [Indexed: 11/23/2022]
Abstract
Resettled refugees in Australia have been shown to exhibit a high prevalence of limited health literacy and are at greater risk of mismanaging their medication and not being able to access the healthcare services they need. The aim of the current study is to explore the barriers to accessing medicines and pharmacy services in Queensland, Australia, among resettled refugees from Africa; this research was conducted from the perspectives of healthcare professionals and people who help the refugees to resettle in their adopted country (resettlement workers). A 'generic qualitative' approach was used in this study. In-depth interviews were conducted among healthcare professionals (two GPs, nine pharmacists and three nurse practitioners) and resettlement workers. Participants were recruited via a purposive snowball sampling method in the cities of Brisbane and Townsville, Queensland, Australia. Twenty-four in-depth interviews were conducted; 14 with healthcare professionals. Three key themes emerged from the data: (1) Communication Barriers; (2) Navigating the Health System; and (3) Belief Systems and Culture. Perceptions of those 'at the coalface' - healthcare professionals and people who are responsible for assisting refugees to resettle in Australia - provide insight into the language and cultural challenges experienced by resettled refugees from Africa regarding access to the Australian health system, including medicines and pharmacy services.
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Affiliation(s)
- Kim Bellamy
- School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Qld 4102, Australia; and Corresponding author.
| | - Remo Ostini
- Rural Clinical School, The University of Queensland, Toowoomba, Qld 4350, Australia
| | - Nataly Martini
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Therese Kairuz
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia
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11
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Au M, Anandakumar AD, Preston R, Ray RA, Davis M. A model explaining refugee experiences of the Australian healthcare system: a systematic review of refugee perceptions. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2019; 19:22. [PMID: 31319819 PMCID: PMC6637597 DOI: 10.1186/s12914-019-0206-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 06/06/2019] [Indexed: 12/03/2022]
Abstract
Background Refugees have significant unmet health needs. Delivering services to refugees continues to be problematic in the Australian healthcare system. A systematic review and thematic synthesis of the literature exploring refugee perceptions of the Australian healthcare system was performed. Methods Titles and abstracts of 1610 articles published between 2006 and 2019 were screened, and 147 articles were read in full text. Depending on the type of study, articles were appraised using the Modified Critical Appraisal Tool (developed by authors), the Mixed Methods Appraisal Tool, or the JBI Appraisal Checklist for Systematic Reviews. Using QSR NVivo 11, articles were coded into descriptive themes and synthesised into analytical themes. An explanatory model was used to synthesise these findings. Confidence in the review findings were assessed with GRADE-CERQual approach. Results The final synthesis included 35 articles consisting of one systematic review, 7 mixed methods studies, and 27 qualitative studies. Only one study was from a regional or rural area. A model incorporating aspects of engagement, access, trust, and privacy can be used to explain the experiences of refugees in using the Australian healthcare system. Refugees struggled to engage with health services due to their unfamiliarity with the health system. Information sharing is needed but this is not always delivered effectively, resulting in disempowerment and loss of autonomy. In response, refugees resorted to familiar means, such as family members and their pre-existing cultural knowledge. At times, this perpetuated their unfamiliarity with the broader health system. Access barriers were also encountered. Trust and privacy are pervasive issues that influenced access and engagement. Conclusions Refugees face significant barriers in accessing and engaging with healthcare services and often resorted to familiar means to overcome what is unfamiliar. This has implications across all areas of service provision. Health administrators and educators need to consider improving the cultural competency of staff and students. Policymakers need to consider engaging communities and upscale the availability and accessibility of professional language and cultural supports. Research is needed on how these measures can be effectively delivered. There is limited research in remote areas and further evidence is needed in these settings. Electronic supplementary material The online version of this article (10.1186/s12914-019-0206-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael Au
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
| | | | - Robyn Preston
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.,School of Health, Medical and Applied Sciences, CQUniversity, Townsville, Queensland, Australia
| | - Robin A Ray
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Meg Davis
- Townsville Multicultural Support Group Incorporated, Townsville, Queensland, Australia
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12
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Parajuli J, Horey D. How can healthcare professionals address poor health service utilisation among refugees after resettlement in Australia? A narrative systematic review of recent evidence. Aust J Prim Health 2019; 25:205-213. [PMID: 31239028 DOI: 10.1071/py18120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 05/08/2019] [Indexed: 01/08/2023]
Abstract
This systematic narrative review of qualitative studies examined health service barriers and facilitators in Australia for refugees after resettlement. Twelve qualitative studies published between 2006 and 2017 involving more than 500 participants were included in the review. Approximately half of all participants were healthcare professionals. A meta-synthesis approach was used to compare and combine findings from across studies. Few facilitators were identified. Barriers to accessing health services were commonly attributed to refugees, but several barriers were associated with healthcare professionals and health services. Barriers attributed to healthcare professionals included gaps in knowledge and skills; poor cultural competency; poor communication skills; and time constraints. Understanding such barriers is the first step in developing strategies to overcome them. The skills and knowledge of healthcare professionals are important to facilitating access to healthcare among this vulnerable population.
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Affiliation(s)
- Jamuna Parajuli
- Public Health, La Trobe University, Health Sciences Building 1, Bundoora, Vic. 3086, Australia; and Corresponding author
| | - Dell Horey
- Public Health, La Trobe University, College of Science, Health & Engineering, Office PW 228, Bundoora, Vic. 3086, Australia
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13
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Kairuz T. Meet Our Editorial Board Member. Curr Drug Saf 2019. [DOI: 10.2174/157488631401190117163131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Therése Kairuz
- School of Biomedical Sciences & Pharmacy Faculty of Health and Medicine University Drive, Callaghan, NSW 2308, Australia
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14
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Gray C, Crawford G, Reid A, Lobo R. HIV knowledge and use of health services among people from South-East Asia and sub-Saharan Africa living in Western Australia. Health Promot J Austr 2018; 29:274-281. [PMID: 29687507 DOI: 10.1002/hpja.168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/16/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND HIV notifications among people born in sub-Saharan Africa and South-East Asia have increased in Australia in the last decade. People born in these regions have the highest rates of HIV diagnosis by region of birth and are overrepresented in late or advanced presentation of HIV infection. METHODS This study developed and tested a questionnaire for reliability through test-retest. A cross-sectional survey using intercept and online recruitment of HIV knowledge and use of health services was then undertaken among people born in sub-Saharan Africa and South-East Asia, who had arrived in Australia less than 10 years ago and were living in Western Australia (n = 209). Results were reported on by gender and length of time in Australia. RESULTS Participants had a reasonable knowledge of HIV transmission, but held a number of incorrect beliefs. Two-thirds (65%) of participants reported a barrier to accessing health services in Australia. Just over a third (34%) of participants had ever tested for HIV, despite indicating that they believed HIV testing was important. CONCLUSIONS This project indicates a very low rate of HIV testing among this priority population. Further action is required to improve early diagnosis of HIV and reduce onward transmission of HIV infection within these communities. SO WHAT?: We need targeted interventions that extend beyond knowledge to increase HIV testing rates among this population.
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Affiliation(s)
- Corie Gray
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, WA, Australia
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, WA, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Bentley, WA, Australia
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