Improving access to refugee-focused health services for people from refugee-like backgrounds in south-eastern Melbourne through the education sector
Katrina M. Long
A D , Shiva Vasi B , Susannah Westbury C , Sandy Shergill C , Chloé Guilbert-Savary C , Ashley Whitelaw C , I-Hao Cheng C and Grant Russell C
+ Author Affiliations
- Author Affiliations
A School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 3, Building G, Monash University Peninsula Campus, 47–49 Mooroduc Highway, Frankston, Vic. 3199, Australia.
B Department of Psychiatry, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Level 3, P Block, Monash Medical Centre, 246 Clayton Road, Clayton, Vic. 3168, Australia.
C Department of General Practice, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
D Corresponding author. Email: Katrina.Long@monash.edu
Australian Journal of Primary Health 27(2) 93-101 https://doi.org/10.1071/PY20233
Submitted: 6 October 2020 Accepted: 18 January 2021 Published: 15 March 2021
Abstract
People from refugee-like backgrounds living in Australia face substantial health challenges that benefit from access to health and social services. Many people from refugee-like backgrounds have frequent contact with education sector staff, who have the potential to act as conduits to health and social services. The aim of this project was to improve access to refugee-focused health services for people from refugee-like backgrounds in south-eastern Melbourne by codesigning and delivering a 1-day education forum to education sector staff. Evaluation of the forum used mixed-methods analysis of data from pre-post and follow-up surveys (n = 11; administered before, immediately after and 1 month after the forum respectively), post-forum interviews (n = 4) and one school’s referral records. The forum improved attendees’ refugee-focused health service referral knowledge, confidence and behaviour. This was supported by the qualitative findings of high staff motivation, high forum satisfaction and evidence of outcome sustainability. Education staff are an important complement to an integrated model of health care for recently resettled people from refugee-like backgrounds. These results show that a straightforward local intervention can improve the ability of education staff to act as conduits to health services, increasing access to health services for people from refugee-like backgrounds.
Keywords: primary health care, health services accessibility, health services needs and demands, minority health, community health networks.
References
Asgary R, Segar N (2011) Barriers to health care access among refugee asylum seekers. Journal of Health Care for the Poor and Underserved 22, 506–522.| Barriers to health care access among refugee asylum seekers.Crossref | GoogleScholarGoogle Scholar | 21551930PubMed |
Baak M, Miller E, Ziersch A, Due C, Masocha S, Ziaian T (2020) The role of schools in identifying and referring refugee background young people who are experiencing mental health issues. The Journal of School Health 90, 172–181.
| The role of schools in identifying and referring refugee background young people who are experiencing mental health issues.Crossref | GoogleScholarGoogle Scholar | 31859380PubMed |
Baker D, Anderson L, Johnson J (2017) Building student and family-centered care coordination through ongoing delivery system design. NASN School Nurse 32, 42–49.
| Building student and family-centered care coordination through ongoing delivery system design.Crossref | GoogleScholarGoogle Scholar | 27481478PubMed |
Blackmore R, Gray KM, Boyle JA, Fazel M, Ranasinha S, Fitzgerald G, Misso M, Gibson-Helm M (2020) Systematic review and meta-analysis: the prevalence of mental illness in child and adolescent refugees and asylum seekers. Journal of the American Academy of Child and Adolescent Psychiatry 59, 705–714.
| Systematic review and meta-analysis: the prevalence of mental illness in child and adolescent refugees and asylum seekers.Crossref | GoogleScholarGoogle Scholar | 31778780PubMed |
Block K, Cross S, Riggs E, Gibbs L (2014) Supporting schools to create an inclusive environment for refugee students. International Journal of Inclusive Education 18, 1337–1355.
| Supporting schools to create an inclusive environment for refugee students.Crossref | GoogleScholarGoogle Scholar |
Brown J, Isaacs D, The World Café Community (2005) ‘The World Café: shaping our futures through conversations that matter.’ (Berrett-Koehler Publishers: San Francisco, CA, USA)
Cheng IH, Drillich A, Schattner P (2015) Refugee experiences of general practice in countries of resettlement: a literature review. The British Journal of General Practice 65, e171–e176.
| Refugee experiences of general practice in countries of resettlement: a literature review.Crossref | GoogleScholarGoogle Scholar | 25733438PubMed |
Correa-Velez I, Gifford SM, Barnett AG (2010) Longing to belong: social inclusion and wellbeing among youth with refugee backgrounds in the first three years in Melbourne, Australia. Social Science & Medicine 71, 1399–1408.
| Longing to belong: social inclusion and wellbeing among youth with refugee backgrounds in the first three years in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar |
Department of Education and Training (2017) Higher Education Institutions by State and Type – Public Universities (Table A), Private Universities (Table B and C) and Other Approved Higher Education Institutions(a). (Department of Education and Training: Canberra, ACT, Australia) Available at https://docs.education.gov.au/documents/2016-list-higher-education-institutions [Verified 4 February 2021]
Department of Education and Training (2020) Victorian Schools: Summary Statistics July 2020. (Department of Education and Training: Melbourne, Vic., Australia) Available at https://www.education.vic.gov.au/Documents/about/department/summarystatssnapshot.pdf [Verified 4 February 2021]
Department of Education, Skills and Employment (2020) Australian Government Department of Education, Skills and Employment. Available at https://www.education.gov.au/ [Verified 4 September 2020]
Department of Health and Human Services (2014) The Victorian refugee and asylum seeker health action plan 2014–2018. (Department of Health & Human Services: Melbourne, Vic., Australia) Available at https://www2.health.vic.gov.au/about/publications/policiesandguidelines/Victorian-refugee-and-asylum-seeker-health-action-plan-2014-2018 [Verified 4 February 2021]
Department of Home Affairs (2019a) Australian Migration Statistics, 2018–19. Australian Migration Statistics dataset. (Australian Government, Canberra, ACT, Australia) Available at https://data.gov.au/data/dataset/australian-migration-statistics/resource/afbf44d6-080b-48d1-bffb-093887ce9a65 [Verified 28 June 2020]
Department of Home Affairs (2019b) Permanent Settlers (All Streams) in Victoria with a Date of Settlement between 01 July 2018 and 30 June 2019. Settlement data reports. (Australian Government, Canberra, ACT, Australia) Available at https://www.data.gov.au/dataset/ds-dga-8d1b90a9-a4d7-4b10-ad6a-8273722c8628/details [Verified 17 September 2020]
Doyle J (2014) Access to services for migrants, refugees and asylum seekers. (Victorian Auditor-General’s Office, Melbourne, Vic., Australia) Available at https://www.audit.vic.gov.au/report/access-services-refugees-migrants-and-asylum-seekers?section= [Verified 4 February 2021]
Finney Lamb C, Smith M (2002) Problems refugees face when accessing health services. NSW Public Health Bulletin 13, 161–163.
| Problems refugees face when accessing health services.Crossref | GoogleScholarGoogle Scholar |
Foundation House (2016) School’s in for refugees: a whole-school approach to supporting students and families of refugee background. (Foundation House, Melbourne, Vic., Australia) Available at http://www.foundationhouse.org.au/wp-content/uploads/2016/11/Schools_In_for_Refugees_2nd_Edn_Update_Chap1-11_2016.pdf [Verified 4 February 2021]
Graneheim UH, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24, 105–112.
| Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.Crossref | GoogleScholarGoogle Scholar | 14769454PubMed |
Hilder J, Gray B, Stubbe M (2019) Health navigation and interpreting services for patients with limited English proficiency: a narrative literature review. Journal of Primary Health Care 11, 217–226.
| Health navigation and interpreting services for patients with limited English proficiency: a narrative literature review.Crossref | GoogleScholarGoogle Scholar | 32171374PubMed |
Kirkpatrick D, Kirkpatrick J (2006) ‘Evaluating training programs: The four levels.’ (Berrett-Koehler Publishers: San Francisco, CA, USA)
Levesque JF, Harris MF, Russell G (2013) Patient-centred access to health care: conceptualising access at the interface of health systems and populations. International Journal for Equity in Health 12, 18
| Patient-centred access to health care: conceptualising access at the interface of health systems and populations.Crossref | GoogleScholarGoogle Scholar | 23496984PubMed |
Loue S (2009) Migration and mental health. In ‘Determinants of Minority Mental Health and Wellness’. (Eds S Loue, M Sajatovic.) pp. 1–16. (Springer New York: New York, NY, USA)
McNeely CA, Morland L, Doty SB, Meschke LL, Awad S, Husain A, Nashwan A (2017) How schools can promote healthy development for newly arrived immigrant and refugee adolescents: research priorities. The Journal of School Health 87, 121–132.
| How schools can promote healthy development for newly arrived immigrant and refugee adolescents: research priorities.Crossref | GoogleScholarGoogle Scholar | 28076923PubMed |
Murray SB, Skull SA (2005) Hurdles to health: immigrant and refugee health care in Australia. Australian Health Review 29, 25–29.
| Hurdles to health: immigrant and refugee health care in Australia.Crossref | GoogleScholarGoogle Scholar | 15683352PubMed |
Musliu E, Vasic S, Clausson EK, Garmy P (2019) School nurses’ experiences working with unaccompanied refugee children and adolescents: a qualitative study. SAGE Open Nursing 5, 2377960819843713
| School nurses’ experiences working with unaccompanied refugee children and adolescents: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 33415234PubMed |
Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D (2016) SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. BMJ Quality & Safety 25, 986
| SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process.Crossref | GoogleScholarGoogle Scholar |
Public Health Information Development Unit (2020) Social Health Atlas of Australia. (Public Health Information Development Unit: Adelaide, SA, Australia) Available at https://phidu.torrens.edu.au/social-health-atlases [Verified 4 February 2021]
Ranmuthugala G, Plumb JJ, Cunningham FC, Georgiou A, Westbrook JI, Braithwaite J (2011) How and why are communities of practice established in the healthcare sector? A systematic review of the literature. BMC Health Services Research 11, 273
| How and why are communities of practice established in the healthcare sector? A systematic review of the literature.Crossref | GoogleScholarGoogle Scholar | 21999305PubMed |
Richard L, Richardson G, Jaye C, Stokes T (2019) Providing care to refugees through mainstream general practice in the southern health region of New Zealand: a qualitative study of primary healthcare professionals’ perspectives. BMJ Open 9, e034323
| Providing care to refugees through mainstream general practice in the southern health region of New Zealand: a qualitative study of primary healthcare professionals’ perspectives.Crossref | GoogleScholarGoogle Scholar | 31892670PubMed |
Robertshaw L, Dhesi S, Jones LL (2017) Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research. BMJ Open 7, e015981
| Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research.Crossref | GoogleScholarGoogle Scholar | 28780549PubMed |
Russell, G, Harris, M, Cheng, I-H, Kay, M, Vasi, S, Joshi, C, Chan, B, Lo, W, Wahidi, S, Advocat, J (2013) Coordinated primary health care for refugees: a best practice framework for Australia. (Southern Academic Primary Care Research Unit: Melbourne, Vic., Australia) Available at http://www.refugeehealthnetworkqld.org.au/wp-content/uploads/2019/07/Coordinated-PHC-for-Refugees_FULL-REPORT-1.pdf [Verified 4 February 2021]
Russell G, Gunatillaka N, Lewis V, Cheng IH, Enticott J, Marsh G, Vasi S, Advocat J, Song H, Saito S, Casey S, Smith M, Harris M (2019) The OPTIMISE project: protocol for a mixed methods, pragmatic, quasi-experimental trial to improve primary care delivery to refugees in Australia. BMC Health Services Research 19, 396
| The OPTIMISE project: protocol for a mixed methods, pragmatic, quasi-experimental trial to improve primary care delivery to refugees in Australia.Crossref | GoogleScholarGoogle Scholar | 31217004PubMed |
The Forum of Australian Services for Survivors of Torture and Trauma (FASSTT) (2018) Never turning away: Australia’s world-leading Program of Assistance to Survivors of Torture and Trauma (PASTT). Brisbane, Qld, Australia. Available at https://fasstt.org.au/wordpress/wp-content/uploads/2018/12/FASSTT_BOOKLET_2017_A4_FA_web.pdf [Verified 4 February 2021]
