Thonon Frédérique, Fahmi Saleh, Rousset-Torrente Olivia, Bessonneau Pascal, Griffith James W, Brown Carter, Chassany Olivier, Duracinsky Martin
Patient-Reported Outcomes Unit (PROQOL), UMR 1123, Université de Paris, INSERM, F-75004, Paris, France.
Unité de Recherche Clinique en Economie de la Santé (URC-ECO), AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France.
JMIR Res Protoc. 2021 May 5;10(5):e22239. doi: 10.2196/22239.
Late diagnoses of HIV, hepatitis B, and hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers' reluctance to offer a test and to migrants' reluctance to accept testing.
The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier and to evaluate its acceptability and impact in terms of public health.
The study will go through 3 stages: (1) concept development, (2) app development, and (3) app evaluation. A qualitative study has been undertaken to explore language barriers during health care encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted to have a comprehensive overlook of electronic tools designed to help health care providers communicate with migrants with a language barrier. To generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the app will include translation and voice recording of items. The electronic development will also include 3 steps of user testing. The acceptability of the app will be evaluated using the System Usability Scale. Evaluation of the app's efficacy will consist of a stepped wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome is the percentage of screening tests realized. The secondary outcomes are the rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app.
The app evaluation study received a 3-year grant from the Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from the Office Français de l'Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review were completed.
This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier and measure its acceptability and effectiveness in terms of public health. When completed, this app could be distributed to numerous professionals carrying out screening with migrant populations in various health care settings.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/22239.
艾滋病毒、乙型肝炎和丙型肝炎的晚期诊断是重要的公共卫生问题，影响着广大人群，尤其是移民。艾滋病毒和肝炎筛查存在众多错失的机会，语言差异是检测的重大障碍。多项研究表明，不会讲医疗服务提供者所用语言的移民接受检测的可能性较小，原因在于医疗服务提供者不愿提供检测以及移民不愿接受检测。
我们研究的目的是开发一种多语言电子工具（应用程序），帮助医疗服务提供者向有语言障碍的移民提供并解释艾滋病毒和肝炎筛查，并从公共卫生角度评估其可接受性和影响。
该研究将经历三个阶段：（1）概念开发，（2）应用程序开发，（3）应用程序评估。已开展一项定性研究，以探索医疗保健过程中的语言障碍及其对沟通的影响，特别是在提供筛查检测时。与此同时，对文献进行了系统综述，以全面了解旨在帮助医疗服务提供者与有语言障碍的移民进行沟通的电子工具。为生成要翻译并纳入应用程序的项目列表，我们将进行焦点小组讨论和德尔菲调查。应用程序的开发将包括项目的翻译和语音录制。电子开发还将包括三个用户测试步骤。将使用系统可用性量表评估应用程序的可接受性。对应用程序效果的评估将包括一项阶梯楔形随机对照试验。该研究将在16个为移民提供治疗并为他们提供传染病筛查检测的中心进行。主要结果是实际进行的筛查检测的百分比。次要结果是卫生专业人员的筛查建议率、移民的接受率、使用此应用程序的阳性病例数以及应用程序的使用频率。
该应用程序评估研究获得了法国国家艾滋病和病毒性肝炎研究机构（ANRS）以及法国移民与融合办公室（OFII）提供的为期三年的资助。在本方案发表时，初步定性研究和系统文献综述已完成。
本研究将开发一种应用程序，帮助医疗服务提供者向有语言障碍的移民提供并解释艾滋病毒和肝炎筛查，并衡量其在公共卫生方面的可接受性和有效性。完成后，此应用程序可分发给在各种医疗保健环境中对移民人群进行筛查的众多专业人员。
国际注册报告识别码（IRRID）：PRR1-10.2196/22239。
