A pilot with computer-assisted psychosocial risk –assessment for refugees

Abstract

Background Refugees experience multiple health and social needs. This requires an integrated approach to care in the countries of resettlement, including Canada. Perhaps, interactive eHealth tools could build bridges between medical and social care in a timely manner. The authors developed and piloted a multi-risk Computer-assisted Psychosocial Risk Assessment (CaPRA) tool for Afghan refugees visiting a community health center. The iPad based CaPRA survey was completed by the patients in their own language before seeing the medical practitioner. The computer then generated individualized feedback for the patient and provider with suggestions about available services. Methods A pilot randomized trial was conducted with adult Afghan refugees who could read Dari/Farsi or English language. Consenting patients were randomly assigned to the CaPRA (intervention) or usual care (control) group. All patients completed a paper-pencil exit survey. The primary outcome was patient intention to see a psychosocial counselor. The secondary outcomes were patient acceptance of the tool and visit satisfaction. Results Out of 199 approached patients, 64 were eligible and 50 consented and one withdrew (CaPRA = 25; usual care = 24). On average, participants were 37.6 years of age and had lived 3.4 years in Canada. Seventy-two percent of participants in CaPRA group had intention to visit a psychosocial counselor, compared to 46 % in usual care group [ X 2 (1)=3.47, p = 0.06]. On a 5-point scale, CaPRA group participants agreed with the benefits of the tool (mean = 4) and were ‘unsure’ about possible barriers to interact with the clinicians (mean = 2.8) or to privacy of information (mean = 2.8) in CaPRA mediated visits. On a 5-point scale, the two groups were alike in patient satisfaction (mean = 4.3). Conclusion The studied eHealth tool offers a promising model to integrate medical and social care to address the health and settlement needs of refugees. The tool’s potential is discussed in relation to implications for healthcare practice. The study should be replicated with a larger sample to generalize the results while controlling for potential confounders.

Community-Based Healthcare for Migrants and Refugees: A Scoping Literature Review of Best Practices

“…Single interventions described for community-based mental health services pertained to the training of (future) healthcare workers and cultural brokering [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , …”

“…Complex interventions constitute school-based programs to screen (and sometimes, also to treat) children and adolescents from migrant and refugee communities for mental health problems [ 16 , 25 , 26 , 27 , 28 , 29 ], mental health promotion in community day centers [ 30 , 31 ], and by community organizations [ 32 , 33 ] and various other community-based mental health services [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Screening tools for psychosocial risk assessments were also used [ 20 , 42 , 43 ].…”

Interventions to increase migrants’ care-seeking behaviour for stigmatised conditions: a scoping review

“…All studies were conducted in North America; 15 in the USA and one in Canada. One study sought to increase care-seeking behaviour for Hepatitis B Virus (HBV) infection [28] and 15 studies for mental health problems (Table 1) [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43].…”

Computer-assisted client assessment survey for mental health: patient and health provider perspectives

“…An exception is the work by Ahmad and colleagues in developing and piloting a Computer-assisted Psychosocial Risk Assessment (CaPRA) survey for Dari/Farsi-speaking Afghan refugees visiting Access Alliance in Toronto, Ontario. This touch-screen, self-assessment tool, which generated point-of-care reports for clients and providers, was effective in promoting intentions to seek help from a psychosocial counsellor (intervention 72 % vs. usual care 46 %) [ 37 ]. More recently, Ahmad and colleagues developed a tool in English and Spanish that focused on CMDs: Interactive Computer-Assisted Client Assessment Survey (iCCAS).…”