Immigrants’ healthcare-seeking behaviour Not Applicable
Conditions
Interventions
Immigrants are assigned to one of three groups who receive: a course of 12 hours on access to and optimal use of the Danish healthcare system
written information on the Danish healthcare system in their mother tongues
or no information (current situation). The intervention took place at Vestegnens Language and Competence School (VSK) which has two divisions, while the control group was formed by students at CBSI la
Sponsors
Innovation Fund Denmark
Helsefonden
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: The study population consisted of adult immigrants attending two language schools, CBSI and Vestegnens Language and Competence School, in the greater catchment area of Copenhagen in 2012 and 2013. To be eligible for the study, the immigrants had to have basic understanding of Danish (for this reason we omitted students from module 1) which also implies that the immigrants have lived in Denmark for some time and have had some experience with the Danish healthcare system. The trialists used Statistics Denmark’s definition of an immigrant as a person who is born in a foreign country of parents who both are foreign citizens or born in a foreign country. The participants represent the mixture of migrants in Denmark: labour migrants, family reunified and refugees with different educational backgrounds and countries of birth.
Exclusion criteria
Exclusion criteria: Immigrants at module 1 at Danish language school (not sufficient Danish skills) and at module 6 (preparing for final Danish exam)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Immigrants’ healthcare-seeking behavior. To assess healthcare-seeking behaviour, three case vignettes with descriptions of persons with different healthcare needs at different times of the day were used: i) flu-like symptoms with a fever of 39.5°C (including sore throat and coughing); ii) chest pain; iii) major depression. The participants were asked to report on what they would do in the three cases by only choosing one of the following answer categories: a) talk to family and friends; b) go to pharmacy; c) call 112 (the Emergency Operations Centre); d) consult an out-of-hours-doctor; e) go to ER; f) contact GP; g) pray to God; h) nothing. To assess the “appropriateness” of service use, we applied an understanding of accessing healthcare services according to health need by the principle of using the lowest effective care level from the lens of a Western medicine oriented healthcare system. In the case of flu-like symptoms with relative high fever, where consulting a doctor may be appropriate but in most cases does not require emergency healthcare, the following actions were categorised as appropriate healthcare-seeking behaviour: consult out-of-hours-doctor and go to GP. Inappropriate healthcare-seeking behaviour was considered as: talk to family and friends, go to pharmacy, call 112, go to ER, pray to God and no actions. In the case of chest pain, where fast healthcare might be life-saving, the following actions were considered as appropriate healthcare-seeking behaviour: call 112, go to ER and go to GP. Inappropriate healthcare-seeking behaviour was considered as: talk to family and friends, go to pharmacy, consult out-of-hours-doctor, pray to God and no actions. In the case of major depression that requires healthcare or help to seek healthcare, the following actions were considered as appropriate healthcare-seeking behaviour: talk to family and friends, consult out-of-hours-doctor, go to ER and go to GP. Inappropriate healthcare-seeking behaviour was consid | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Immigrants’ knowledge. To assess whether the intervention affected self-perceived knowledge of the Danish healthcare systems, immigrants were asked: “In case of illness, do you know who to contact?” and “In case of an accident, do you know who to contact?”. Potential responses included ‘Yes, always,’ ‘Sometimes,’ ‘No, ’Don’t know’. We dichotomized the responses as “Yes, always” versus other. To assess whether the intervention affected actual knowledge of access to the Danish healthcare systems, immigrants were asked a number of positively and negatively formulated true and false questions e.g. “All children can receive several free vaccines at their doctor” and “You are welcome to contact an out-of-office-hours doctor from 8 am until 4 pm. Also when your general practitioner (GP) is open”. Potential responses included ‘True,’ and ‘False’. The responses were assessed based on pre-determined right or wrong answers. Timepoints: Measured at baseline and at follow-up (app. 3 months after). 2. Patient satisfaction. To assess whether the intervention affected satisfaction with the Danish healthcare system, immigrants were asked questions on satisfaction with their GP, specialist doctors in private practice and hospital doctors as well as whether Danish doctors are good at helping you when you are ill. E.g. “Are doctors at hospitals good in Denmark?”. Potential responses included ‘Yes, very good,’ ‘They are okay,’ ‘No, they are poor,’ ’I have never been at the hospital,’ ’Don’t know’. The trialists dichotomized the responses as “Yes, very good” versus other. Missing categories included ’I have never been at the hospital,’ ’Don’t know’. Timepoints: Measured at baseline and at follow-up (app. 3 months after). | — |
Countries
Denmark
Outcome results
None listed