Dataset Information

Perspectives on health examination for asylum seekers in relation to health literacy - focus group discussions with Arabic and Somali speaking participants.

ABSTRACT:

Background

Asylum seekers coming to most countries are offered a specific health examination. A previous study concluded that a considerable proportion of those taking part of it in Sweden had poor experiences of the communication in and the usefulness of this examination and had poor health literacy. The aim of this study was to explore in greater depth the experiences of the health examination for asylum seekers among Arabic- and Somali-speaking participants in Sweden. A secondary aim was to examine experiences and discuss findings using a health literacy framework.

Methods

Seven focus group discussions were conducted with 28 Arabic and Somali speaking men and women that participated in a health examination for asylum seekers. Data were analyzed by latent content analysis.

Results

One overarching theme - beneficial and detrimental - was found to represent the participants' experiences of the health examination for asylum seekers. Three categories were identified that deal with those experiences. The category of "gives some good" describes the examination as something that "gives support and relief" and "cares on a personal level." The category of "causes feelings of insecurity" describes the examination as something that "lacks clarity" and that "does not give protection." The category "causes feelings of disappointment" views the examination as something that "does not fulfil the image of a health examination" and "does not focus on the individual level."

Conclusion

The health examination for asylum seekers was experienced as beneficial and detrimental at the same time. The feelings were influenced by the experiences of information and communication before, during and after the examination and on how health literate the organizations providing the HEA are. To achieve more satisfied participants, it is crucial that all organizations providing the HEA become health literate and person-centered.

SUBMITTER: Wangdahl J

PROVIDER: S-EPMC6751618 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Perspectives on health examination for asylum seekers in relation to health literacy - focus group discussions with Arabic and Somali speaking participants.

Wångdahl Josefin J Westerling Ragnar R Lytsy Per P Mårtensson Lena L

BMC health services research 20190918 1

<h4>Background</h4>Asylum seekers coming to most countries are offered a specific health examination. A previous study concluded that a considerable proportion of those taking part of it in Sweden had poor experiences of the communication in and the usefulness of this examination and had poor health literacy. The aim of this study was to explore in greater depth the experiences of the health examination for asylum seekers among Arabic- and Somali-speaking participants in Sweden. A secondary aim ...[more]

PMID: 31533817

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Project description:BackgroundHealth inequities arise when the public cannot access and understand health information in an easy, accessible, and understandable way. Evidence supports that health literacy (HL) is a determinant for health outcomes, and when HL is limited this may have a major impact on morbidity as well as mortality. Migrants are known to have limited HL. Therefore, this study aimed to explore comprehensive health literacy (CHL) and electronic health literacy (eHL) among Arabic-speaking migrants in Sweden.MethodsThis was a cross-sectional observational study conducted in Sweden. A total of 703 persons were invited to participate between February and September 2019. Two questionnaires - the Health Literacy Survey European Questionnaire (HLS-EU-Q16) and the eHealth Literacy Scale (eHEALS) - and questions about self-perceived health and Internet use were distributed in Swedish and Arabic. Various statistical analyses were performed to determine the associations for limited CHL and eHL.ResultsA total of 681 respondents were included in the analysis. Of these, 334 (49%) were native Arabic-speaking migrants and 347 (51%) were native Swedish-speaking residents. CHL and eHL differed between the groups. The Arabic speakers had significantly lower mean sum scores in eHL 28.1 (SD 6.1) vs 29.3 (6.2), p = 0.012 and lower proportion of sufficient CHL 125 (38.9%) vs 239 (71.3%), p < 0.001 compared to Swedish speakers. Multiple regression analysis showed on associations between limited CHL and eHL and being Arabic speaking, less Internet use, and not finding the Internet to be important or useful. Furthermore, longer time spent in Sweden was associated with higher levels of CHL among the Arabic speakers, (OR 0.94, 95% CI 0.91-0.98, p < 0.01).ConclusionsCHL and eHL differ between Arabic-speaking migrants and native Swedish speakers, but also between Arabic speakers who have lived different lengths of time in Sweden. Though it seems that the eHealth literacy is less affected by language spoken, the Internet is suggested to be an appropriate channel for disseminating health information to Arabic-speaking migrants.

Project description:BackgroundHealth information is often communicated through the internet. It is vital for the end user to have a range of digital skills as well as understand the information to promote their health. There is a valid and reliable 8-item instrument, the Electronic Health Literacy Scale (eHEALS), that evaluates these skills. The number of Arabic-speaking people migrating to Sweden and to other parts of the world is increasing due to unstable military and political situations in their countries of origin. Poor health and limited health literacy have been described in this population in Sweden. Still, to our knowledge, an Arabic version of eHEALS has not been tested for validity or reliability. Thus, Arabic-speaking populations in Sweden cannot be included in studies measuring eHealth literacy, which does not support equal treatment in health care.ObjectiveThe aim of this study was to translate and adapt the original English eHEALS version into Arabic and to evaluate its psychometric properties.MethodsThe eHEALS was rigorously translated, adapted, and evaluated for content validity. We conducted prospective psychometric evaluation with natively Arabic-speaking participants living in Sweden. Construct validity, factor structure, internal consistency, and test-retest reliability were evaluated using Spearman correlation, principal component analysis, Cronbach α, and weighted quadratic Cohen κ, respectively.ResultsThe study population consisted of Arabic-speaking participants (n=298; age: mean 41.8 years, SD 10.5). Construct validity was supported with weak and moderate correlations. Principal component factor analysis revealed a one-factor structure. Internal consistency was high (Cronbach α=0.92); test-retest reliability was acceptable (weighted quadratic Cohen κ=0.76). Evaluation indicated that eHealth literacy threshold values should be dichotomized (limited and sufficient) rather than trichotomized (inadequate, problematic, and sufficient).ConclusionsThe Arabic version of eHEALS, a unidimensional scale that is valid and reliable for measuring eHealth literacy among natively Arabic-speaking people in Sweden, was found to be acceptable and feasible in a general population.

Project description:BackgroundThere are many African asylum seekers and refugees (AAR) in Asia. However, little research has been conducted on their well-being within the sociocultural milieu. This systematic review explores the characteristics of AAR's psychological and mental well-being and how their acculturation practices, social networks and support (i.e. social capital), health-related knowledge and skills (i.e., health literacy) influence their psychological and mental well-being.MethodsThe study included relevant peer-reviewed articles from any Asian country/region, published in English. No date restriction was applied. Five databases (i.e. Scopus, PubMed, Web of Science, PsycINFO, and CINAHL) were searched for studies conducted about AAR from any of the 54 African countries and residing in any of the 51 Asian countries. Following a predefined inclusion criteria and quality assessment, nine articles were included in this study. Narrative synthesis approach was used to analyse the articles.ResultsIt was found that AARs face significant challenges that culminate in poor psychological and mental well-being, including conditions such as depression and discontent with their lives. Notwithstanding, being in a safe place made some of them optimistic about their future. However, many AARs had difficulties adjusting to the host culture. They had limited awareness of the prevailing health system and services and faced restrictions on their rights to social services, partly because of difficulty obtaining appropriate information. The few social bonds and bridges they possessed enabled them to develop a sense of belonging and protected them from psychological distress. However, problematic social relationships increased the chances of poor health-related outcomes.ConclusionThe psychological and mental well-being of AAR in Asia is concerning. Hence, more research on how critical health determinants (i.e. social capital, health literacy and acculturation processes from this study) directly and interactively influence their well-being across age cohorts. Given their roles in promoting AAR's well-being, appropriate interventions to improve those critical health determinants are also sorely needed.

Project description:BackgroundSwedish law entitles asylum seekers to a voluntary health assessment and to "health care that cannot be postponed". The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective.MethodsThe study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health.FindingsForty-eight (12.4%) respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such.ConclusionsAlthough being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the information, procedures and services that it includes.

Project description:BACKGROUND:Norway, like other European countries, has a growing refugee population. Upon arrival to Norway, refugees and asylum seekers need to learn about Norwegian society and social services such as healthcare. Despite various programs and assistance, they face numerous challenges using the healthcare system. Understanding the healthcare experiences of Ethiopian refugees and asylum seekers may improve how services such as informational sessions and delivery of medical care are provided. This qualitative study seeks to describe the health-related experiences of Ethiopians who have sought asylum in Norway and shed light on potential barriers to care. METHODS:Individual interviews were conducted with ten Ethiopian refugees and asylum seekers in Norway. Thematic analysis was used to understand the broader context of refugee resettlement and how this experience influences participants' health experiences and health seeking behaviors. RESULTS:We identified three main themes that played a role in participants' health and healthcare experiences. Participants described how 'living in limbo' during their application for residency took a mental toll, the difficulties they had 'using the healthcare system', and the role 'interpersonal factors' had on their experiences. While applying for asylum, participants felt consumed by the process and were affected by the lack of structure in their lives, the conditions in the reception center, and perceived inadequate healthcare. Participants perceived a change in access to services before and after they had been granted residency. Participants learned about the healthcare system both through official information sessions and social networks. Doctor-patient communication and interpersonal factors such as a sense of feeling valued, language, and discrimination had a large impact on perceived quality of care. CONCLUSIONS:Ethiopian refugees and asylum seekers face numerous challenges accessing, using, and interacting with Norway's healthcare system. Contextualizing these challenges within the asylum seeking process may help policy makers better understand, and therefore address, these challenges. Interventions offered at reception centers and in health worker trainings may improve healthcare experiences for this and similar populations.

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Dataset Information

Perspectives on health examination for asylum seekers in relation to health literacy - focus group discussions with Arabic and Somali speaking participants.

Background

Methods

Results

Conclusion

Publications

Perspectives on health examination for asylum seekers in relation to health literacy - focus group discussions with Arabic and Somali speaking participants.

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