TY - JOUR
T1 - Participatory implementation research in the field of migrant health
T2 - Sustainable changes and ripple effects over time
AU - van den Muijsenbergh, Maria E.T.C.
AU - LeMaster, Joseph W.
AU - Shahiri, Parmida
AU - Brouwer, Michelle
AU - Hussain, Mohammed
AU - Dowrick, Chris
AU - Papadakaki, Maria
AU - Lionis, Christos
AU - MacFarlane, Anne
N1 - Publisher Copyright:
© 2020 The Authors Health Expectations published by John Wiley & Sons Ltd
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objective: This study aimed to explore whether positive impacts were sustained and unanticipated ripple effects had occurred four years after the implementation of interventions to improve cross-cultural communication in primary care. Background: Sustaining the implementation of change using complex interventions is challenging. The EU-funded “RESTORE” study implemented guidelines and training on cross-cultural communication in five Primary Care sites in Europe, combining implementation theory (Normalisation Process Theory) with participatory methodology (participatory learning and action—PLA). There were positive impacts on knowledge, skills and clinical routines. Design, setting and participants: Four of the five original sites (England, Ireland, Greece, The Netherlands) were available for this qualitative follow-up study. The study population (N = 44) was primary healthcare staff and migrants, most of whom had participated in RESTORE. Intervention; main outcome measures: PLA-style focus groups and interviews explored routine practice during consultations with migrants. Etic cards based on the effects of RESTORE stimulated the discussion. Deductive framework analysis was performed in each country followed by comparative data analysis and synthesis. Results: Changes in knowledge, attitudes and behaviour with regard to consultations with migrants were sustained and migrants felt empowered by their participation in RESTORE. There were ongoing concerns about macro level factors, like the political climate and financial policies, negatively affecting migrant healthcare. Conclusion: There were sustained effects in clinical settings, and additional unanticipated positive ripple effects, due in part, from the participatory approach employed.
AB - Objective: This study aimed to explore whether positive impacts were sustained and unanticipated ripple effects had occurred four years after the implementation of interventions to improve cross-cultural communication in primary care. Background: Sustaining the implementation of change using complex interventions is challenging. The EU-funded “RESTORE” study implemented guidelines and training on cross-cultural communication in five Primary Care sites in Europe, combining implementation theory (Normalisation Process Theory) with participatory methodology (participatory learning and action—PLA). There were positive impacts on knowledge, skills and clinical routines. Design, setting and participants: Four of the five original sites (England, Ireland, Greece, The Netherlands) were available for this qualitative follow-up study. The study population (N = 44) was primary healthcare staff and migrants, most of whom had participated in RESTORE. Intervention; main outcome measures: PLA-style focus groups and interviews explored routine practice during consultations with migrants. Etic cards based on the effects of RESTORE stimulated the discussion. Deductive framework analysis was performed in each country followed by comparative data analysis and synthesis. Results: Changes in knowledge, attitudes and behaviour with regard to consultations with migrants were sustained and migrants felt empowered by their participation in RESTORE. There were ongoing concerns about macro level factors, like the political climate and financial policies, negatively affecting migrant healthcare. Conclusion: There were sustained effects in clinical settings, and additional unanticipated positive ripple effects, due in part, from the participatory approach employed.
KW - implementation
KW - migrant health
KW - normalisation process theory
KW - participatory learning and action methods
KW - patient and public involvement
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85079122681&partnerID=8YFLogxK
U2 - 10.1111/hex.13034
DO - 10.1111/hex.13034
M3 - Article
C2 - 32035009
AN - SCOPUS:85079122681
SN - 1369-6513
VL - 23
SP - 306
EP - 317
JO - Health Expectations
JF - Health Expectations
IS - 2
ER -