Bitterfeld Leandra, Ozkaynak Mustafa, Denton Andrea H, Normeshie Cornelius A, Valdez Rupa S, Sharif Noor, Caldwell Priscilla A, Hauck Fern R
College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
Primary Children's Hospital, Salt Lake City, UT, USA.
J Community Health. 2025 Feb;50(1):130-151. doi: 10.1007/s10900-024-01400-2. Epub 2024 Sep 6.
Refugees arriving to the U.S. experience a high burden of both communicable and non-communicable diseases. There is a potential to improve health outcomes for refugees through well-developed, comprehensive interventions, but the effectiveness of such interventions is poorly understood. The purpose of this review is to identify, characterize and evaluate the effectiveness of patient-level healthcare interventions for U.S. refugee populations. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline via PubMed, Web of Science, Embase, and CINAHL were searched for articles that included a population of refugees of any age, included an intervention aimed at improving health, included an evaluation of the intervention's outcomes, and were conducted in the U.S. from 2000 to 2022. Thirty-seven studies were included, and we identified three main intervention modalities: healthcare provision/management, resource provision, and education. Interventions targeted general health, infectious disease, women's health, diet/exercise, health literacy, oral health, diabetes, family health, and substance use. The outcomes measured included knowledge, satisfaction, behavioral outcomes, and physical health markers. This review demonstrates that a few health conditions, namely tuberculosis, have been addressed with large-scale, sustained interventions. Other conditions (general health and women's health) have been addressed through piecemeal, short-term interventions. The evaluation of interventions often focuses on knowledge or satisfaction rather than health or behavior change outcomes. Future work should focus on the best strategies for developing sustainable interventions that meet the needs of the diverse population of refugees in the U.S.
抵达美国的难民面临着传染病和非传染病的沉重负担。通过完善的综合干预措施，有可能改善难民的健康状况，但此类干预措施的效果尚不清楚。本综述的目的是识别、描述和评估针对美国难民群体的患者层面医疗保健干预措施的有效性。我们根据系统评价和Meta分析的首选报告项目进行了系统评价。通过PubMed、Web of Science、Embase和CINAHL检索Medline，查找2000年至2022年在美国进行的、包含任何年龄难民群体、包含旨在改善健康的干预措施、包含对干预措施结果评估的文章。纳入了37项研究，我们确定了三种主要干预方式：医疗保健提供/管理、资源提供和教育。干预措施针对一般健康、传染病、妇女健康、饮食/运动、健康素养、口腔健康、糖尿病、家庭健康和物质使用。所测量的结果包括知识、满意度、行为结果和身体健康指标。本综述表明，少数健康状况，即结核病，已通过大规模、持续的干预措施得到解决。其他状况（一般健康和妇女健康）则通过零散的短期干预措施得到解决。对干预措施的评估通常侧重于知识或满意度，而非健康或行为改变结果。未来的工作应侧重于制定可持续干预措施的最佳策略，以满足美国不同难民群体的需求。
