TY - JOUR
T1 - Engaging migrants and other stakeholders to improve communication in cross-cultural consultation in primary care
T2 - A theoretically informed participatory study
AU - Lionis, Christos
AU - Papadakaki, Maria
AU - Saridaki, Aristoula
AU - Dowrick, Christopher
AU - O'Donnell, Catherine A.
AU - Mair, Frances S.
AU - Van Den Muijsenbergh, Maria
AU - Burns, Nicola
AU - De Brún, Tomas
AU - O'Reilly De Brún, Mary
AU - Van Weel-Baumgarten, Evelyn
AU - Spiegel, Wolfgang
AU - MacFarlane, Anne
N1 - Publisher Copyright:
© Published by the BMJ Publishing Group Limited.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Objectives: Guidelines and training initiatives (G/TIs) are available to support communication in crosscultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. Setting: As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. Participants: A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). Primary and secondary outcome measures: We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. Results: The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. Conclusions: This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants.
AB - Objectives: Guidelines and training initiatives (G/TIs) are available to support communication in crosscultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. Setting: As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. Participants: A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). Primary and secondary outcome measures: We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. Results: The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. Conclusions: This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants.
KW - PRIMARY CARE
KW - community involvement
KW - cross-cultural consultation
KW - migrant health
UR - http://www.scopus.com/inward/record.url?scp=84979871451&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2015-010822
DO - 10.1136/bmjopen-2015-010822
M3 - Article
C2 - 27449890
AN - SCOPUS:84979871451
SN - 2044-6055
VL - 6
JO - BMJ Open
JF - BMJ Open
IS - 7
M1 - e010822
ER -