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Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study

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Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study. / Teunissen, Erik; Gravenhorst, Katja; Dowrick, Christopher et al.
In: International Journal for Equity in Health, Vol. 16, 32, 10.02.2017.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Teunissen, E, Gravenhorst, K, Dowrick, C, van Weel-Baumgarten, E, van den Driessen Mareeuw, F, de Brún, T, Burns, N, Lionis, C, Mair, FS, O'Donnell, CA, O’Reilly-de Brún , M, Papadakaki, M, Saridaki, A, Spiegel, W, Van Weel, C, van den Muijsenbergh, M & MacFarlane, A 2017, 'Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study', International Journal for Equity in Health, vol. 16, 32. https://doi.org/10.1186/s12939-017-0525-y

APA

Teunissen, E., Gravenhorst, K., Dowrick, C., van Weel-Baumgarten, E., van den Driessen Mareeuw, F., de Brún, T., Burns, N., Lionis, C., Mair, F. S., O'Donnell, C. A., O’Reilly-de Brún , M., Papadakaki, M., Saridaki, A., Spiegel, W., Van Weel, C., van den Muijsenbergh, M., & MacFarlane, A. (2017). Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study. International Journal for Equity in Health, 16, Article 32. https://doi.org/10.1186/s12939-017-0525-y

Vancouver

Teunissen E, Gravenhorst K, Dowrick C, van Weel-Baumgarten E, van den Driessen Mareeuw F, de Brún T et al. Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study. International Journal for Equity in Health. 2017 Feb 10;16:32. doi: 10.1186/s12939-017-0525-y

Author

Teunissen, Erik ; Gravenhorst, Katja ; Dowrick, Christopher et al. / Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations : a qualitative participatory European study. In: International Journal for Equity in Health. 2017 ; Vol. 16.

Bibtex

@article{5bcff061db1046cbb575afa57366b500,
title = "Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations: a qualitative participatory European study",
abstract = "BackgroundCross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice.MethodsWe undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers{\textquoteright} fieldwork reports, were coded and thematically analysed by each team using NPT.ResultsIn all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants{\textquoteright} needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP{\textquoteright}s diagnoses and GPs reported a clearer understanding of migrants{\textquoteright} symptoms.ConclusionsMigrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.",
keywords = "Primary Health Care, Transients and Migrants, General Practice, Community-Based Participatory Research, Cross-cultural communication, Equity",
author = "Erik Teunissen and Katja Gravenhorst and Christopher Dowrick and {van Weel-Baumgarten}, Evelyn and {van den Driessen Mareeuw}, Francine and {de Br{\'u}n}, Tomas and Nicola Burns and Christos Lionis and Mair, {Frances Susanne} and O'Donnell, {Catherine A.} and {O{\textquoteright}Reilly-de Br{\'u}n}, Mary and Maria Papadakaki and Aristoula Saridaki and Wolfgang Spiegel and {Van Weel}, C. and {van den Muijsenbergh}, Maria and Anne MacFarlane",
year = "2017",
month = feb,
day = "10",
doi = "10.1186/s12939-017-0525-y",
language = "English",
volume = "16",
journal = "International Journal for Equity in Health",
issn = "1475-9276",
publisher = "BIOMED CENTRAL LTD",

}

RIS

TY - JOUR

T1 - Implementing guidelines and training initiatives to improve cross-cultural communication in primary care consultations

T2 - a qualitative participatory European study

AU - Teunissen, Erik

AU - Gravenhorst, Katja

AU - Dowrick, Christopher

AU - van Weel-Baumgarten, Evelyn

AU - van den Driessen Mareeuw, Francine

AU - de Brún, Tomas

AU - Burns, Nicola

AU - Lionis, Christos

AU - Mair, Frances Susanne

AU - O'Donnell, Catherine A.

AU - O’Reilly-de Brún , Mary

AU - Papadakaki, Maria

AU - Saridaki, Aristoula

AU - Spiegel, Wolfgang

AU - Van Weel, C.

AU - van den Muijsenbergh, Maria

AU - MacFarlane, Anne

PY - 2017/2/10

Y1 - 2017/2/10

N2 - BackgroundCross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice.MethodsWe undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers’ fieldwork reports, were coded and thematically analysed by each team using NPT.ResultsIn all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants’ needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP’s diagnoses and GPs reported a clearer understanding of migrants’ symptoms.ConclusionsMigrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.

AB - BackgroundCross-cultural communication in primary care is often difficult, leading to unsatisfactory, substandard care. Supportive evidence-based guidelines and training initiatives (G/TIs) exist to enhance cross cultural communication but their use in practice is sporadic. The objective of this paper is to elucidate how migrants and other stakeholders can adapt, introduce and evaluate such G/TIs in daily clinical practice.MethodsWe undertook linked qualitative case studies to implement G/TIs focused on enhancing cross cultural communication in primary care, in five European countries. We combined Normalisation Process Theory (NPT) as an analytical framework, with Participatory Learning and Action (PLA) as the research method to engage migrants, primary healthcare providers and other stakeholders. Across all five sites, 66 stakeholders participated in 62 PLA-style focus groups over a 19 month period, and took part in activities to adapt, introduce, and evaluate the G/TIs. Data, including transcripts of group meetings and researchers’ fieldwork reports, were coded and thematically analysed by each team using NPT.ResultsIn all settings, engaging migrants and other stakeholders was challenging but feasible. Stakeholders made significant adaptations to the G/TIs to fit their local context, for example, changing the focus of a G/TI from palliative care to mental health; or altering the target audience from General Practitioners (GPs) to the wider multidisciplinary team. They also progressed plans to deliver them in routine practice, for example liaising with GP practices regarding timing and location of training sessions and to evaluate their impact. All stakeholders reported benefits of the implemented G/TIs in daily practice. Training primary care teams (clinicians and administrators) resulted in a more tolerant attitude and more effective communication, with better focus on migrants’ needs. Implementation of interpreter services was difficult mainly because of financial and other resource constraints. However, when used, migrants were more likely to trust the GP’s diagnoses and GPs reported a clearer understanding of migrants’ symptoms.ConclusionsMigrants, primary care providers and other key stakeholders can work effectively together to adapt and implement G/TIs to improve communication in cross-cultural consultations, and enhance understanding and trust between GPs and migrant patients.

KW - Primary Health Care

KW - Transients and Migrants

KW - General Practice

KW - Community-Based Participatory Research

KW - Cross-cultural communication

KW - Equity

U2 - 10.1186/s12939-017-0525-y

DO - 10.1186/s12939-017-0525-y

M3 - Journal article

VL - 16

JO - International Journal for Equity in Health

JF - International Journal for Equity in Health

SN - 1475-9276

M1 - 32

ER -