United States encounter a variety of cultural and systemic disparities. Factors like language barriers, health care beliefs, home country health systems, cultural differences, education levels, social stigmas, entrenched gender roles, and experiences of trauma can significantly influence the ways that individuals engage with their own health and navigate health care systems. Furthermore, poor health outcomes such as physical illness or disability can also adversely affect refugees' abilities to perform immigration requirements and demonstrate asylum eligibility within the United States. This can disadvantage their cases, reduce their likelihood of receiving asylum, and negatively impact their safety, well-being, and quality of life. Studies performed both globally and within the United States have shown correlation between refugee status and health outcomes. Local needs assessments performed in Portland, Oregon within the last 10 years have also cited health care access and navigation of health care systems as key issues of concern within the refugee community. With this knowledge, our team developed a community-based approach aimed at addressing some of these disparities. We partnered with the non-profit Pacific Refugee Support Group, or PRSG, to identify both our target population and its health care needs. After performing an assessment through PRSG, we determined that the goal of our intervention would be to improve participant access to regional health care resources, empower them to make informed basic health decisions, navigate the state insurance system, and also help identify any additional perceived barriers to health care within the current Portland refugee community. We designed a three-part health workshop series, which was delivered in person at the PRSG office to four groups of recently-arrived refugees and asylum seekers from different home countries. We used on-site interpreters and education materials in the preferred language of each group. Each workshop consisted of an hour-long interactive presentation, followed by an open-question session. The first part of the session centered around general health information, such as using a first-aid kit, the differences between primary care and emergency services, and mental health. The second part focused on holistic health and prevention, including information related to diet and nutrition, exercise, vaccination, screening exams, and preventative vision and dental care. The third part was specific to health insurance and provided an overview of organ health plan coverage. Handouts were also distributed to participants in their preferred language and included pertinent contact information for organ health plans, along with a list of local resources such as free transportation, language translation services, community center access programs, and culturally-inclusive nutrition guides. Participants were recruited by PRSG from the local refugee community and included two groups of newly-arrived Venezuelan refugees, as well as two groups of newly-arrived Afghan refugees, with 21 total participants. To assess the efficacy of our intervention, we administered anonymous pre- and post-surveys to all the participants in their preferred language during each workshop. The survey data were analyzed to determine the percent change in pre- and post-responses, with positive percent change indicating an improvement in overall comprehension of material. We observed significant improvements in perceived knowledge and understanding among the nine participants who were able to successfully complete both the pre- and the post-surveys. Across all aspects and topics covered in the educational sessions, participants demonstrated a minimum 20% increase in comprehension from pre- to post. Particularly noteworthy was the increase in comfort accessing Portland Health Care Services, which rose from 33% to 78%. Prior to the presentation, only 11% of participants were aware of free transportation services for medical care. Post-presentation, this awareness reached 100%. Additionally, participants' understanding of how to appeal denial of health care coverage and utilize organ health plan assistance saw a significant increase from 0% to 67%. Due to our low sample size, we were unable to perform statistical analysis and cannot generalize the results to larger populations. The outcome of this project supports our original goals of increasing participants' ability to access health resources and make informed health decisions, despite limitations of participant numbers. It also provides insight for future initiatives within the Pacific Refugee Support Group and the greater refugee community. For example, PRSG plans to use our project results and educational materials to guide future initiatives on health care navigation and health literacy. Our research could also help direct future research evaluating the significance of health education interventions on refugee health outcomes. Additionally, and importantly, this interactive education model can be utilized by community health centers and local organizations seeking to improve their own refugee patient health outcomes. Simple guidance sessions on topics like navigating insurance or preventative health care can bridge some of these major gaps to access and provide an invaluable tool for empowerment, in spite of the significant challenges faced with relocation. These interventions would also foster partnership and build trust between refugee communities and the medical system, which supports positive long-term health outcomes for patients, as well as the overarching community-based goals of the osteopathic profession. Thank you so much for your time and consideration of our presentation.

refugees

health care access

community-based approach

educational initiatives

Portland Oregon