Social workers can promote resiliency among refugee families by referring them to evidence-based programs to reduce the stressors of resettlement. The purpose of this study was to complete a structured adaptation process with the SafeCare® program for implementation in a refugee resettlement community. Participants included 21 members of an adaptation team made up of administrators, supervisors, and family service providers from three community agencies and community health workers. Quantitative findings suggested that content, process, and literacy-related adaptations were necessary to ensure cultural relevance of program materials. Qualitative feedback suggested the adaptation approach was a meaningful process that engaged community members and resulted in an acceptable and feasible curriculum for delivery in the refugee resettlement community, which will be further tested in a forthcoming implementation trial. The multi-pronged, community-engaged approach to SafeCare adaptation is presented as a potential framework for other programs that could benefit refugee children and their families.

Background The transmission of health information from in-person communication to web-based sources has changed over time. Patients can find, understand, and use their health information without meeting a health care provider and are able to participate more in their health care management. In recent years, the internet has emerged as the primary source of health information, although clinical providers remain the most credible source. The ease of access, anonymity, and busy schedules may be motivating factors to seek health information on the web. Social media has surfaced as a popular source of health information, as it can provide news in real time. The increase in the breadth and depth of health information available on the web has also led to a plethora of misinformation, and individuals are often unable to discern facts from fiction. Competencies in health literacy (HL) can help individuals better understand health information and enhance patient decision-making, as adequate HL is a precursor to positive health information–seeking behaviors (HISBs). Several factors such as age, sex, and socioeconomic status are known to moderate the association between HL and HISBs. Objective In this study, we aimed to examine the relationship between HL and HISBs in individuals living in a southern state in the United States by considering different demographic factors. Methods Participants aged ≥18 years were recruited using Qualtrics Research Services and stratified to match the statewide demographic characteristics of race and age. Demographics and source and frequency of health information were collected. The Health Literacy Questionnaire was used to collect self-reported HL experiences. SPSS (version 27; IBM Corp) was used for the analysis. Results A total of 520 participants met the criteria and completed the survey (mean age 36.3, SD 12.79 years). The internet was cited as the most used source of health information (mean 2.41, SD 0.93). Females are more likely to seek health information from physicians than males (r=0.121; P=.006). Older individuals are less likely to seek health information from the internet (r=−0.108; P=.02), social media (r=−0.225; P<.001), and friends (r=−0.090; P=.045) than younger individuals. Cluster analysis demonstrated that individuals with higher levels of HISBs were more likely to seek information from multiple sources than those with lower levels of HISBs (mean range 3.05-4.09, SD range 0.57-0.66; P<.001). Conclusions Age and sex are significantly associated with HISB. Older adults may benefit from web-based resources to monitor their health conditions. Higher levels of HL are significantly associated with greater HISB. Targeted strategies to improve HISB among individuals with lower levels of HL may improve their access, understanding, and use of health information.

Background Delivering evidence-based interventions to refugee and immigrant families is difficult for several reasons, including language and cultural issues, and access and trust issues that can lead to an unwillingness to engage with the typical intervention delivery systems. Adapting both the intervention and the delivery system for evidence-based interventions can make those interventions more appropriate and palatable for the targeted population, increasing uptake and effectiveness. This study focuses on the adaptation of the SafeCare© parenting model, and its delivery through either standard implementation methods via community-based organizations (CBO) and a task-shifted implementation in which members of the Afghans, Burmese, Congolese community will be trained to deliver SafeCare. Method An adaptation team consisting of community members, members of CBO, and SafeCare experts will engage a structured process to adapt the SafeCare curriculum for each targeted community. Adaptations will focus on both the model and the delivery of it. Data collection of the adaptation process will focus on documenting adaptations and team member’s engagement and satisfaction with the process. SafeCare will be implemented in each community in two ways: standard implementation and task-shifted implementation. Standard implementation will be delivered by CBOs (n = 120), and task-shifted implementation will be delivered by community members (n = 120). All interventionists will be trained in a standard format, and will receive post-training support. Both implementation metrics and family outcomes will be assessed. Implementation metrics will include ongoing adaptations, delivery of services, fidelity, skill uptake by families, engagement/completion, and satisfaction with services. Family outcomes will include assessments at three time points (pre, post, and 6 months) of positive parenting, parent-child relationship, parenting stress, and child behavioral health. Discussion The need for adapting of evidence-based programs and delivery methods for specific populations continues to be an important research question in implementation science. The goal of this study is to better understand an adaptation process and delivery method for three unique populations. We hope the study will inform other efforts to deliver health intervention to refugee communities and ultimately improve refugee health.

Background Delivering evidence-based interventions to refugee and immigrant families is difficult for several reasons, including language and cultural issues, access and trust issues that can lead to an unwillingness to engage with the typical intervention delivery systems. Adapting both the intervention and the delivery system for evidence-based interventions can make those interventions most appropriate and palatable for the targeted population, increasing uptake and effectiveness. This study focuses on the adaptation of the SafeCare© parenting model, and its delivery through either standard implementation methods via community-based organizations (CBO) and a task-shifted implementation in which members of the Afghans, Burmese, Congolese community will be trained to deliver SafeCare. MethodAn adaptation team consisting of community members, members of CBO, and SafeCare experts will engage a structured process to adapt the SafeCare curriculum for each targeted community. Adaptations will focus on both the model and the delivery of it. Data collection of the adaptation process will focus on documenting adaptations and team member’s engagement and satisfaction with the process. SafeCare will be implemented in each community in two ways: standard implementation and task-shifted implementation. Standard implementation will be delivered by CBOs (n = 120), and task-shifted implementation will be delivered by community members (n = 120). All interventionists will be trained in a standard format, and will receive post-training support. Both implementation metrics and family outcomes will be assessed. Implementation metrics will include ongoing adaptations, delivery of services, fidelity, skill uptake by families, engagement/completion, and satisfaction with services. Family outcomes will include assessments at three time points (pre, post, and six months) of positive parenting, parent-child relationship, parenting stress, and child behavioral health. Discussion The need for adapting of evidence-based programs and delivery methods for specific populations continues to be an important research question in implementation science. The goal of this study is to better understand an adaptation process and delivery method for three unique populations. We hope the study will inform other efforts to deliver health intervention to refugee communities and ultimately improve refugee health.

BACKGROUND Transmission of health information has changed over time from in-person communication to online sources. Patients are able to find, understand, and use their health information without meeting with a healthcare provider and are able to participate more in their healthcare management. In recent years, the Internet has emerged as the primary source of health information, though clinical providers remain the most credible source. Ease of access, anonymity, and busy schedules may be motivating factors to seek health information online. Social media has surfaced as a popular source of health information as it can provide news at a real-time speed. The increase in the breadth and depth of health information online has also led to a plethora of misinformation and individuals are often unable to discern fact from fiction. Competencies in health literacy can help individuals better understand health information and enhance patient decision-making as adequate health literacy is a precursor to positive health information seeking behaviors. Several factors such as age, sex, and socioeconomics are known to moderate the association between health literacy and health information seeking behaviors. OBJECTIVE This study aims to examine the relationship between health literacy and health information seeking behaviors for individuals living in a southern state in the United States considering different demographic factors. METHODS Participants 18 years of age and older were recruited using Qualtrics Research Services and were stratified to match statewide demographic characteristics of race and age. Demographics and frequency and source of health information was collected. The Health Literacy Questionnaire was used to collect self-reported health literacy experiences. SPSSV27 was used for analysis. RESULTS A total of 520 participants met the criteria and completed the survey (mean age 36.3, SD 12.79 years). The Internet was cited as the most used source of health information (mean 2.41, SD 0.93). Females are more likely to seek health information from doctors (r = 0.121, P < .01). Older individuals are less likely to seek health information from the Internet, social media, and friends (r = -.090 to -.225, P < .05) than younger individuals. Cluster analysis demonstrated that individuals with higher levels of health information seeking behaviors are more likely to seek information from multiple sources than those with lower levels of health information seeking behavior (mean range 3.05 – 4.09, P < .001). CONCLUSIONS Age and sex are significantly associated with health information seeking behaviors (HISB). Older adults may benefit from online resources to monitor their health conditions. Higher levels of health literacy are significantly associated with greater HISB. Targeted strategies to improve HISB among individuals with lower levels of health literacy may improve their access, understanding, and use of health information.