Participatory implementation research in the field of migrant health: Sustainable changes and ripple effects over time

Autor: Anne MacFarlane, Michelle A. E. Brouwer, Christos Lionis, Maria van den Muijsenbergh, Christopher Dowrick, Joseph W. LeMaster, Mohammed Hussain, Parmida Shahiri, M Papadakaki
Rok vydání: 2020
Předmět:
participatory learning and action methods
lnfectious Diseases and Global Health Radboud Institute for Molecular Life Sciences [Radboudumc 4]
Psychological intervention
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
primary care
03 medical and health sciences
normalisation process theory
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
migrant health
Process theory
Health care
Humans
Political climate
030212 general & internal medicine
implementation
Qualitative Research
Implementation theory
Transients and Migrants
lcsh:R5-920
Medical education
Primary Health Care
business.industry
lcsh:Public aspects of medicine
Communication
030503 health policy & services
Public Health
Environmental and Occupational Health
lcsh:RA1-1270
patient and public involvement
Focus group
Original Research Paper
Emic and etic
Implementation research
lcsh:Medicine (General)
0305 other medical science
Psychology
business
Original Research Papers
Follow-Up Studies
Zdroj: Health Expectations, 23, 306-317
Health Expectations, 23, 2, pp. 306-317
Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
Health Expectations, Vol 23, Iss 2, Pp 306-317 (2020)
ISSN: 1369-7625
1369-6513
Popis: Objective: This study aimed to explore whether positive impacts were sustained and unanticipated ripple effects had occurred four years after the implementation of interventions to improve cross-cultural communication in primary care. Background: Sustaining the implementation of change using complex interventions is challenging. The EU-funded "RESTORE" study implemented guidelines and training on cross-cultural communication in five Primary Care sites in Europe, combining implementation theory (Normalisation Process Theory) with participatory methodology (participatory learning and action-PLA). There were positive impacts on knowledge, skills and clinical routines. Design, setting and participants: Four of the five original sites (England, Ireland, Greece, The Netherlands) were available for this qualitative follow-up study. The study population (N = 44) was primary healthcare staff and migrants, most of whom had participated in RESTORE. INTERVENTION; MAIN OUTCOME MEASURES: PLA-style focus groups and interviews explored routine practice during consultations with migrants. Etic cards based on the effects of RESTORE stimulated the discussion. Deductive framework analysis was performed in each country followed by comparative data analysis and synthesis. Results: Changes in knowledge, attitudes and behaviour with regard to consultations with migrants were sustained and migrants felt empowered by their participation in RESTORE. There were ongoing concerns about macro level factors, like the political climate and financial policies, negatively affecting migrant healthcare. Conclusion: There were sustained effects in clinical settings, and additional unanticipated positive ripple effects, due in part, from the participatory approach employed.
Databáze: OpenAIRE
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