A Helping Hand Out of the River: Refugee Perspectives for Provider Engagement

Brian L Isakson; Elizabeth R Stein; Alexandra Olson; Destiny Waggoner; Jill Holtz; Sara Ali; Suha Amer; Martin Ndayisenga

doi:10.17294/2330-0698.2042

A Helping Hand Out of the River: Refugee Perspectives for Provider Engagement

J Patient Cent Res Rev. 2023 Nov 27;10(4):231-238. doi: 10.17294/2330-0698.2042. eCollection 2023 Fall.

Authors

Brian L Isakson¹, Elizabeth R Stein², Alexandra Olson³, Destiny Waggoner⁴, Jill Holtz⁵, Sara Ali⁶, Suha Amer⁷, Martin Ndayisenga⁷

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM.
² Salem Veterans Affairs Medical Center, Salem, VA.
³ Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA.
⁴ Young Children's Health Center, University of New Mexico Hospitals, Albuquerque, NM.
⁵ Primary Care Behavioral Health, Presbyterian Healthcare Services, Albuquerque, NM.
⁶ Bay Area Clinical Associates, San Jose, CA.
⁷ United Voices for Newcomer Rights, Albuquerque, NM.

Abstract

Purpose: A growing number of refugee groups are seeking care within the U.S. health care system for medical, psychological, and social needs. Research is limited in understanding refugee-specific conceptualizations of helping relationships and provider characteristics that improve interactions in health systems. This study aimed to identify provider characteristics that facilitate engagement and helpfulness in a refugee-specific population from refugee participant voices to inform future practices of health care clinics.

Methods: Semi-structured interviews with refugee participants were conducted to assess 1) experiences moving on from difficult experiences, 2) engagement with the health system, and 3) provider characteristics that facilitated engagement and healing. Qualitative data were analyzed using a grounded theory approach.

Results: An emergent theory was revealed on refugee-defined provider characteristics that facilitated healing and engagement in the health system. Providers who support an individual's story to be told, show awareness of barriers to accessing resources and prioritization of addressing barriers, maintain cultural humility, and demonstrate compassion, empathy, warmth, and openness toward patient engagement were the primary characteristics that facilitated engagement and healing.

Conclusions: Utilization of engagement strategies by providers at the onset of treatment is critical to providing culturally sensitive health care. Nonspecific but essential provider characteristics are thought to improve relational dynamics, trust-building, and overall engagement in the U.S. health care system from the perspective of refugee participants.

Keywords: engagement; health care utilization; integrated care; mental health; refugee.