Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia.
Front Public Health. 2023 Feb 21;11:1112538. doi: 10.3389/fpubh.2023.1112538. eCollection 2023.
Refugees experience health inequities resulting from multiple barriers and difficulties in accessing and engaging with services. A health literacy development approach can be used to understand health literacy strengths, needs, and preferences to build equitable access to services and information. This protocol details an adaptation of the Ophelia (Optimizing Health Literacy and Access) process to ensure authentic engagement of all stakeholders to generate culturally appropriate, needed, wanted and implementable multisectoral solutions among a former refugee community in Melbourne, Australia. The Health Literacy Questionnaire (HLQ), widely applied around the world in different population groups, including refugees, is usually the quantitative needs assessment tool of the Ophelia process. This protocol outlines an approach tailored to the context, literacy, and health literacy needs of former refugees. This project will engage a refugee settlement agency and a former refugee community (Karen people origin from Myanmar also formerly knowns as Burma) in codesign from inception. A needs assessment will identify health literacy strengths, needs, and preferences, basic demographic data and service engagement of the Karen community. This community will be engaged and interviewed using a semi-structured interview based on the Conversational Health Literacy and Assessment Tool (CHAT) will cover supportive professional and personal relationships, health behaviors, access to health information, use of health services, and health promotion barriers and support. Using the needs assessment data, vignettes portraying typical individuals from this community will be developed. Stakeholders will be invited to participate in ideas generation and prioritization workshops for in-depth discussion on what works well and not well for the community. Contextually and culturally appropriate and meaningful action ideas will be co-designed to respond to identified health literacy strengths, needs, and preferences of the community. This protocol will develop and test new and improved methods that are likely to be useful for community-based organizations and health services to systematically understand and improve communication, services and outcomes among disadvantaged groups, particularly migrants and refugees.
难民在获取和使用服务方面面临多种障碍和困难，因此会经历健康不平等的问题。健康素养发展方法可用于了解健康素养的优势、需求和偏好，从而建立公平获取服务和信息的途径。本方案详细介绍了对奥菲莉亚（优化健康素养和获取途径）流程的改编，以确保所有利益相关者都能真实参与，从而在澳大利亚墨尔本的一个前难民社区中生成文化上适当、需要、期望和可实施的多部门解决方案。健康素养问卷（HLQ）在世界各地的不同人群中，包括难民中，广泛应用，通常是奥菲莉亚流程的定量需求评估工具。本方案概述了一种针对前难民的背景、读写能力和健康素养需求定制的方法。该项目将从一开始就与一个难民安置机构和一个前难民社区（来自缅甸的克伦族，也被称为缅甸）合作进行共同设计。需求评估将确定克伦族社区的健康素养优势、需求和偏好、基本人口统计数据和服务参与情况。将使用基于会话健康素养和评估工具（CHAT）的半结构化访谈对该社区进行访谈，以涵盖支持性的专业和个人关系、健康行为、获取健康信息、使用健康服务以及健康促进障碍和支持。使用需求评估数据，将开发描绘该社区典型个体的情景。将邀请利益相关者参加创意生成和优先级确定研讨会，以深入讨论对社区来说效果良好和不佳的内容。将共同设计符合上下文和文化且有意义的行动创意，以满足社区的健康素养优势、需求和偏好。本方案将开发和测试新的和改进的方法，这些方法可能对社区组织和卫生服务机构有用，可以系统地了解和改善弱势群体（特别是移民和难民）的沟通、服务和结果。
