Department of Pediatrics, University of Washington, Seattle, WA, United States.
Independent Consultant, Seattle, WA, United States.
Front Public Health. 2023 Mar 30;11:1078980. doi: 10.3389/fpubh.2023.1078980. eCollection 2023.
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'.
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.
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.
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 and in working with communities. On the patient-facing side, health systems played a role in and . On the organizational side, health systems collaborated with public health and community-based organizations, in and to evolving needs throughout the pandemic.
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.
本文是“COVID-19 和长期冲突背景下的卫生系统恢复”研究专题的一部分。
难民、移民和移民（以下简称“移民”）社区受到 COVID-19 大流行的不平等影响。几乎没有数据可以帮助我们了解卫生系统对其作用的看法，即在与公共卫生和社区组织合作方面，在解决移民人口的不平等方面发挥作用。本研究将解决这一知识差距。
本定性研究使用半结构式视频访谈了 20 名在大流行期间照顾移民社区的卫生系统领导人和提供者。受访者来自美国各地，访谈于 2020 年 11 月至 2021 年 3 月进行。使用主题分析方法对数据进行分析。
代表卫生系统的 20 人参加了研究，其中 14 人（70%）来自社区卫生中心，3 人（15%）来自县医院，3 人（15%）来自学术系统。大多数（16 个卫生系统（80%））专门照顾移民社区，14 个（70%）与难民社区合作，2 个（10%）与移民农场工人合作。我们确定了六个主题（带有子主题），这些主题代表了卫生系统在具有临床和公共卫生意义的角色。两个基础主题是卫生系统在与社区合作方面的角色和作用。在面向患者的方面，卫生系统在和方面发挥了作用。在组织方面，卫生系统与公共卫生和社区组织合作，以满足整个大流行期间不断变化的需求，和。
卫生系统应注重建立信任关系，有针对性地开展工作，并与社区组织和公共卫生部门合作，以有效和有影响力的方式处理 COVID-19 和未来的大流行，将受影响最大的社区放在中心位置。这些发现对减轻当前和未来传染病暴发对移民社区的不平等影响具有重要意义，移民社区在美国仍然是一个重要且不断增长的群体。
