Hunter Kelly, Knettel Brandon, Reisinger Deborah, Ganapathy Pranav, Lian Tyler, Wong Jake, Mayorga-Young Danielle, Zhou Ailing, Elnagheeb Maram, McGovern Melissa, Thielman Nathan, Whetten Kathryn, Esmaili Emily
graduate student, Sanford School of Public Policy and Department of Political Science, Duke University, Durham, North Carolina.
assistant professor, Duke University School of Nursing and Duke Global Health Institute, Duke University, Durham, North Carolina.
N C Med J. 2020 Nov-Dec;81(6):348-354. doi: 10.18043/ncm.81.6.348.
Resettled refugees are at increased risk of poor health outcomes due to acculturation challenges, logistical barriers, experiences of trauma, and other barriers to care that are poorly understood. Refugee children may be particularly vulnerable due to disruptions in health, well-being, education, and nutrition during the resettlement process. To describe the health care barriers facing refugees in the North Carolina Triangle area (comprised of Durham, Chapel Hill, Raleigh, and their surrounding areas), we conducted three focus group interviews (in Arabic, French, and Swahili) with 25 refugee parents from Syria, Iraq, Central African Republic, the Democratic Republic of the Congo, and Chad. We also administered a survey to nine organizations that provide services for refugees. Focus group responses highlighted the multidimensional nature of health care barriers for refugee families and children, encompassing challenges with acculturation, communication, transportation, finances, and health literacy. Organizations emphasized similar challenges and described their efforts to improve access to services through increased communication, coordination, and seeking new financial support for programs. Given the geographic focus of the study, results may not be generalizable to other populations and settings. Men spoke more than women in some focus groups, and participants may have been influenced by more vocal contributors. Furthermore, this study is limited by a lack of health outcomes data. This study suggests that the health care needs of refugees living in the North Carolina Triangle area can be better met by providing comprehensive, coordinated, and culturally relevant care. This could include minimizing the number of visits by integrating multiple services under one roof, providing trauma-informed interpreters, and offering accessible transportation services.
由于文化适应挑战、后勤障碍、创伤经历以及其他难以理解的医疗保健障碍,重新安置的难民健康状况不佳的风险增加。在重新安置过程中,难民儿童的健康、福祉、教育和营养受到干扰,可能特别脆弱。为了描述北卡罗来纳三角地区(由达勒姆、教堂山、罗利及其周边地区组成)难民面临的医疗保健障碍,我们对来自叙利亚、伊拉克、中非共和国、刚果民主共和国和乍得的25名难民父母进行了三次焦点小组访谈(分别用阿拉伯语、法语和斯瓦希里语)。我们还对九个为难民提供服务的组织进行了调查。焦点小组的反馈突出了难民家庭和儿童医疗保健障碍的多维度性质,包括文化适应、沟通、交通、财务和健康素养方面的挑战。各组织强调了类似的挑战,并描述了他们通过加强沟通、协调以及为项目寻求新的财政支持来改善服务获取的努力。鉴于该研究的地理重点,结果可能不适用于其他人群和环境。在一些焦点小组中男性发言多于女性,参与者可能受到了更积极发言者的影响。此外,这项研究因缺乏健康结果数据而受到限制。这项研究表明,通过提供全面、协调且具有文化相关性的护理,可以更好地满足居住在北卡罗来纳三角地区难民的医疗保健需求。这可能包括通过在一个屋檐下整合多种服务来减少就诊次数、提供具备创伤知情知识的口译员以及提供便捷的交通服务。