Co-Design Workshops to Develop a Psychosocial Support Service Model for Refugees in Sweden Affected by Gender-Based Violence.

BACKGROUND: Experiencing gender-based violence (GBV) is common among refugees. Intersecting systems of oppression can increase the risk of GBV and of suffering detrimental consequences, while concurrently creating barriers to meaningful support. Despite this, refugees with lived experience of GBV are rarely involved in the development, planning and adaptation of services and policies. METHODS: This article reports on a formative research process that aimed to involve public contributors (refugee victim-survivors of GBV) and relevant stakeholders in co-designing a service model aimed at improving psychosocial support in Sweden. Led by a partnership of public contributors and academic researchers, the research process consisted of iterative cycles of co-design workshops, complemented by scoping of existing literature. RESULTS: The co-design process resulted in a characterisation of the psychosocial service system needs, as perceived by the survivor co-researchers and stakeholders, and a two-level empowerment and support service model. The model included (i) a community-based intervention to promote help-seeking and (ii) psychosocial group support delivered in specialist clinics. Outcomes of the project included perceived benefits for those involved, service-led direct changes and acquisition of funding for continued research on the co-designed model. CONCLUSION: Improving psychosocial support for refugees in Sweden affected by GBV requires safe spaces to connect with peers and familiarise with available services, laws and rights in the society. Further, strengthened collaborations across sectors are necessary to meet the variety of needs. Co-design workshops were an effective way to initiate changes in the service delivery model for psychosocial support for refugees in Sweden affected by GBV. PATIENT OR PUBLIC CONTRIBUTIONS: This is a participatory reflection on a participatory process. The survivor co-researchers contributed to designing and carrying out the PPI process and have co-authored this manuscript.

Ameliorating epistemic injustice in practice: Communication strategies in a research project with refugee youth coresearchers.

INTRODUCTION: Many researchers want to include seldom involved groups, such as refugees and youth, in patient and public involvement (PPI), but experience a number of barriers. The PPI research community calls for critical evaluations that are prospective, data-based and conducted by researchers and public contributors together. In this study, we conducted a longitudinal evaluation of a core activity in all collaborations: communication strategies. The aim was to evaluate the communication strategies adopted throughout a research project with refugee youth coresearchers. METHODS: This article is based on the evaluation of a project where refugee youth were involved in the online adaptation of a group-based programme for youth with posttraumatic stress. Behavioural observations and field notes collected during the project were analysed with qualitative content analysis and a readability index, and discussed through the lens of epistemic injustice. The article was cowritten by researchers and refugee youth. FINDINGS: Four manifest categories were identified: Facilitating engagement through coplanning and circumstantial flexibility; Different needs require different channels; It's not just about the channel-facilitation skills matter; Finding a common language opens a communicative flow. In addition, a latent underlying theme reflecting the role of trust was identified: Interactive moments facilitate trust-trust facilitates richer involvement. CONCLUSION: At the core of the identified communication strategies were strengthening relationship-building and actively facilitating involvement. Establishing trusting relationships enabled refugee youth to share input. The communication strategies increased hermeneutical justice by contributing to a common understanding; thus, taking a step towards ameliorating epistemic injustice. PATIENT OR PUBLIC CONTRIBUTION: This article is a participatory analysis of a PPI process; it was written in collaboration between researchers and refugee youth coauthors, who were all previously involved in the evaluated project.