Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
BMC Health Serv Res. 2023 May 11;23(1):476. doi: 10.1186/s12913-023-09514-4.
Patients from culturally and linguistically diverse (CALD) backgrounds often face difficulties in accessing health and social care services. This study explored the feasibility and acceptability of involving community health workers (CHWs) as bilingual community navigators (BCNs) in general practice setting, to help patients from CALD backgrounds access health and social care services in Australia.
This research was conducted in two general practices in Sydney where most patients are from specific CALD backgrounds (Chinese in one practice and Samoan in other). Three CHWs trained as BCNs were placed in these practices to help patients access health and social care service. A mixed-method design was followed to explore the feasibility and acceptability of this intervention including analysis of a record of services provided by BCNs and post-intervention qualitative interviews with patients, practice staff and BCNs exploring the feasibility and acceptability of the BCNs' role. The record was analyzed using descriptive statistics and interviews were audio-recorded, transcribed, and thematically analyzed.
BCNs served a total of 95 patients, providing help with referral to other services (52.6%), information about appointments (46.3%), local resources (12.6%) or available social benefits (23.2%). Most patients received one service from BCNs with the average duration of appointments being half an hour. Overall, BCNs fitted in well within the practices and patients as well as staff of participating practices accepted them well. Their role was facilitated by patients' felt need for and acceptance of BCNs' services, recruitment of BCNs from the patient community, as well as BCNs' training and motivation for their role. Major barriers for patients to access BCNs' services included lack of awareness of the BCNs' roles among some patients and practice staff, unavailability of information about local culture specific services, and inadequate time and health system knowledge by BCNs. Limited funding support and the short timeframe of the project were major limitations of the project.
BCNs' placement in general practice was feasible and acceptable to patients and staff in these practices. This first step needs to be followed by accredited training, development of the workforce and establishing systems for supervision in order to sustain the program. Future research is needed on the extension of the intrevention to other practices and culture groups.
来自文化和语言背景多样化(CALD)的患者在获得卫生和社会保健服务方面往往面临困难。本研究探讨了在全科医疗环境中引入双语社区导航员(BCN)作为社区卫生工作者(CHW)的可行性和可接受性,以帮助来自澳大利亚 CALD 背景的患者获得卫生和社会保健服务。
本研究在悉尼的两家全科诊所进行,这两家诊所的大多数患者都来自特定的 CALD 背景(一家是中国人,另一家是萨摩亚人)。培训了三名 CHW 作为 BCN,将他们安置在这些诊所,以帮助患者获得卫生和社会保健服务。采用混合方法设计,通过分析 BCN 提供的服务记录以及对患者、实践工作人员和 BCN 的事后定性访谈,探讨该干预措施的可行性和可接受性,探讨 BCN 角色的可行性和可接受性。记录采用描述性统计进行分析,访谈进行录音、转录和主题分析。
BCN 共为 95 名患者提供服务,提供转诊至其他服务(52.6%)、预约信息(46.3%)、当地资源(12.6%)或可用社会福利(23.2%)方面的帮助。大多数患者从 BCN 获得一项服务,预约平均持续半小时。总体而言,BCN 在实践中非常适应,患者以及参与实践的工作人员也非常接受他们。他们的角色得益于患者对 BCN 服务的需求和接受程度、从患者社区招聘 BCN 以及 BCN 对其角色的培训和激励。患者获得 BCN 服务的主要障碍包括一些患者和实践工作人员对 BCN 角色缺乏认识、缺乏关于当地文化特定服务的信息,以及 BCN 对时间和卫生系统知识的掌握不足。项目资金支持有限和项目时间框架短是项目的主要限制。
BCN 在全科医疗中的安置对这些实践中的患者和工作人员是可行和可接受的。这是第一步,需要后续进行认可培训、发展劳动力队伍并建立监督系统,以维持该计划。需要进一步研究将干预措施扩展到其他实践和文化群体。