Assuntos
Menores de Idade , Atenção Primária à Saúde , Refugiados , Humanos , Adolescente , Criança , Masculino , Feminino , Exame Físico , Pré-EscolarRESUMO
In the early months of the COVID-19 pandemic The National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) was established. NRC-RIM initially sought to rapidly identify promising case investigation and contact tracing (CICT) practices within refugee, immigrant, and migrant communities. Between September 2020 and April 2021, the team conducted 60 interviews with individuals from cross-sector organizations (i.e., public health, health systems, community experts/organizations) working with refugee, immigrant and migrant communities in health and public health capacities related to COVID-19. The overarching aim was to identify and amplify innovative promising and best practices for CICT with refugee, immigrant, and migrant communities, including an exploration of barriers and facilitators. We utilized layered methods to rapidly assess, summarize and disseminate promising practices while simultaneously completing four thematic analyses including: (1) public health organizations; (2) health system organizations; (3) community leaders and organizations; and (4) vaccine planning and access across the three sectors. The primary objective of this article is to describe the project design, applied methods, and team science approach we utilized. We found that rapid identification and dissemination of promising practices, and barriers and facilitators for CICT with refugee, immigrant and migrant communities was feasible during a public health emergency. This approach was essential for identifying and widely sharing culturally and linguistically concordant public health practices.
Assuntos
COVID-19 , Busca de Comunicante , Emigrantes e Imigrantes , Refugiados , Migrantes , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Busca de Comunicante/métodos , Migrantes/estatística & dados numéricos , Pesquisa Qualitativa , SARS-CoV-2 , Saúde PúblicaRESUMO
One in four children in the US grow up in immigrant families, and 55% of children in immigrant families have a parent who speaks and understands English less than "very well". While the number of research studies that is focused on children in immigrant families (CIF) has increased, CIF particularly those that communicate in a language other than English (LOE) are frequently excluded from research. We reviewed studies including "children in immigrant families and the United States" in PubMed from 2017-2023, and categorized them as qualitative, quantitative, mixed-methods or community engaged research. We review observations and offer recommendations for research to promote the health and well-being of children in immigrant families including: using strengths-based frameworks; prioritizing the inclusion of families who speak languages other than English; amending reporting standards for qualitative studies to include guidance on reporting methods for projects in which research teams and study participants speak different languages from one another; and incorporating methods to identify people who have experienced migration in large national surveys and cohort studies. We recommend research with and inclusive of CIF to consider additional areas for growth in cross-sector collaborations, interventions and clinical trials, and training and support for investigators.
Assuntos
Emigrantes e Imigrantes , Humanos , Criança , Estados Unidos , Projetos de Pesquisa , Idioma , Pesquisa Qualitativa , Barreiras de ComunicaçãoRESUMO
Objectives: To understand public health organizations' experiences providing comprehensive COVID-19 case investigation and contact tracing, and related promising practices with refugee, immigrant and migrant communities. Methods: We interviewed public health professionals (September 2020 to February 2021) from local and state health departments using a geographically stratified, purposive sampling approach. A multidisciplinary team at the National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) conducted a thematic analysis of the data. Results: Six themes were identified: understanding community and public health context, cultivating relationships, ensuring linguistic and cultural concordance, communicating intentionally, evolving response, and implementing equity. The interconnection of themes and promising practices is explored. Conclusion: As public health continues to learn from and build upon COVID-19 response experiences, the thematic findings and potential promising practices identified in this project may foster proactive, community-engaged solutions for public health, and other organizations working and partnering with refugee, immigrant, and migrant communities. Implementing these findings with COVID-19 into current and future public health crisis responses may improve public health, collaborations with refugee, immigrant, and migrant communities, and staff wellbeing.
Assuntos
COVID-19 , Emigrantes e Imigrantes , Refugiados , Migrantes , Humanos , Busca de Comunicante , COVID-19/epidemiologia , Saúde PúblicaRESUMO
Effective provision of COVID-19 vaccines could mitigate the disproportionate impact of the COVID-19 pandemic experienced by many immigrant communities. To describe organizational experiences in using COVID-19 vaccination programs, qualitative interviews were conducted from September 2020 to April 2021 with representatives from public health, health system, and community organizations responding to the COVID-19 pandemic among immigrant communities across the United States. Interviews followed a semistructured interview guide and were audio recorded, transcribed, and coded. A latent thematic analysis was facilitated by Dedoose software. Interviews representative of 18 public health departments, 20 healthcare systems, and 18 community organizations were included in the analysis. Five identified themes referenced the importance of 1) appreciating community and individual heterogeneity in health priorities and attitudes; 2) addressing vaccine fears with trustworthy messages; 3) ensuring equitable access to vaccine opportunities; 4) making substantive investments in community partnerships and outreach; and 5) adapting to meet new needs. It is essential that vaccine efforts consider community heterogeneity, communicate in a trustworthy and culturally and linguistically appropriate manner, strive for equitable provision of care, build partnerships, and learn from prior experiences.
Assuntos
COVID-19 , Emigrantes e Imigrantes , Refugiados , Migrantes , Humanos , Vacinas contra COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controleRESUMO
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Introduction: Refugee, immigrant and migrant (hereafter referred to as "immigrant") communities have been inequitably affected by the COVID-19 pandemic. There is little data to help us understand the perspectives of health systems on their role, in collaboration with public health and community-based organizations, in addressing inequities for immigrant populations. This study will address that knowledge gap. Methods: This qualitative study used semi-structured video interviews of 20 leaders and providers from health systems who cared for immigrant communities during the pandemic. Interviewees were from across the US with interviews conducted between November 2020-March 2021. Data was analyzed using thematic analysis methods. Results: Twenty individuals representing health systems participated with 14 (70%) community health centers, three (15%) county hospitals and three (15%) academic systems represented. The majority [16 health systems (80%)] cared specifically for immigrant communities while 14 (70%) partnered with refugee communities, and two (10%) partnered with migrant farm workers. We identified six themes (with subthemes) that represent roles health systems performed with clinical and public health implications. Two foundational themes were the roles health systems had building and maintaining trust and establishing intentionality in working with communities. On the patient-facing side, health systems played a role in developing communication strategies and reducing barriers to care and support. On the organizational side, health systems collaborated with public health and community-based organizations, in optimizing pre-existing systems and adapting roles to evolving needs throughout the pandemic. Conclusion: Health systems should focus on building trusting relationships, acting intentionally, and partnering with community-based organizations and public health to handle COVID-19 and future pandemics in effective and impactful ways that center disparately affected communities. These findings have implications to mitigate disparities in current and future infectious disease outbreaks for immigrant communities who remain an essential and growing population in the US.
Assuntos
COVID-19 , Refugiados , Migrantes , Humanos , Estados Unidos , Pandemias , COVID-19/epidemiologia , Pesquisa QualitativaRESUMO
Formal and informal bilingual/bicultural organizations and networks form the backbone of support for refugee, immigrant, and migrant (RIM) communities in the United States. They are pivotal in mitigating barriers and inequities in social and structural determinants of health. These organizations and networks are situated within the communities they serve, and often are established and run by members of a community, to serve the community. In the United States, the COVID-19 pandemic surfaced and widened existing health inequities for some racial and ethnic communities. Our primary objectives were to: (1) describe the processes that underpinned the pivotal role of immigrant-serving community structures in developing and implementing culturally sustaining programming in the context of pandemic response, and (2) amplify the voices of community experts, as they shared experiences and perspectives around these humanistic and community-centered approaches. We applied a community case study approach to a national sample of RIM-serving community structures representing broad country/region-of-origin, cultural, and linguistic identities. Community engagement strategies utilized in the project period included engaging community partners to identify and facilitate connections, and consult on analysis and dissemination. The project team conducted 20 in-depth, semi-structured interviews with a purposive sample of community experts/community organizations. Sampling strategy was further informed by immigrant identity (i.e., characterization of status) and geography (i.e., United States Department of Health & Human Services, Office of Intergovernmental and External Affairs Regions). Through thematic analysis, results identified key contextual, process-, and impact-oriented themes inherent to community-led COVID-19 responses, that were situated within and around the public and health system response to the pandemic. As public health and health systems scrambled to address acute and unprecedented barriers to access, distribution of COVID-19-related health resources and services, and disparate health outcomes, community structures diligently and intentionally reimagined and reconceptualized their response to COVID-19, frequently in the setting of scarce resources. The grassroots response evolved as a counter-narrative to top-down equity processes, historically defined by systems and applied to the community.