Engaging migrants and other stakeholders to improve communication in cross-cultural consultation in primary care: a theoretically informed participatory study

Lionis, C. et al. (2016) Engaging migrants and other stakeholders to improve communication in cross-cultural consultation in primary care: a theoretically informed participatory study. BMJ Open, 6(7), e010822. (doi: 10.1136/bmjopen-2015-010822) (PMID:27449890) (PMCID:PMC4964217)

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Objectives: Guidelines and training initiatives (G/TIs) are available to support communication in cross-cultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. Setting: As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. Participants: A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). Primary and secondary outcome measures: We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. Results: The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. Conclusions: This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants.

Item Type:Articles
Additional Information:The RESTORE Project has received funding from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement number 257258.
Glasgow Author(s) Enlighten ID:O'Donnell, Professor Kate and Burns, Dr Nicola and Mair, Professor Frances
Authors: Lionis, C., Papadakaki, M., Saridaki, A., Dowrick, C., O'Donnell, C. A., Mair, F. S., van den Muijsenbergh, M., Burns, N., de Brún, T., O'Reilly de Brún, M., van Weel-Baumgarten, E., Spiegel, W., and MacFarlane, A.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN (Online):2044-6055
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in BMJ Open 6(7): e010822
Publisher Policy:Reproduced under a Creative Commons License

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