Computer, Decision Support System, Primary Care, Psychosocial, Refugees, Screening
Conditions
Keywords
pilot, randomized controlled trial, RCT, computer, screening, community heath center, psychosocial, immigrant
Brief summary
The purpose of this study was to examine preliminary effect of Computer-assisted Psychosocial Risk Assessment tool (CaPRA) among Afghan refugees visiting medical professionals (family physicians or nurse practitioners) at a Community Health Center. The investigators examined the tool's acceptability among patients and its impact on patient satisfaction and patient intention to visit a psychosocial counselor as a proxy of potential to integrate medical and social care.
Detailed description
The recent waves of refugees to Canada belong to regions of prolonged conflict and, thus arrive in compromised state of mental, physical, and social health. This complexity asks for provision of integrated medical and social care to newly arrived refugees. With this aim, a university-community initiative developed a Computer-assisted Psychosocial Risk Assessment tool (CaPRA) in Dari/Farsi for Afghan refugees. This innovative eHealth approach is first of its kind for Canadian refugees accessing primary care. In this model of care, patients complete an interactive multi-risk iPad computer survey in their own language before seeing the provider. The computer then generates individualized recommendation sheet for patients and a risk-report for providers at the point of care. The tool was developed through a collaborative process by working with Access Alliance Multicultural Health and Community Services and advisory board with community representatives.
Interventions
BEHAVIORALComputer-assisted Psychosocial Risk Assessment (CaPRA)
The study intervention was a touch-screen self-assessment survey which eligible patients completed on a touch-screen iPad in Dari/Farsi language while waiting to see their medical practitioner. The Computer-assisted Psychosocial Risk Assessment (CaPRA) survey had questions on psychosocial risks (e.g., alcohol, tobacco and street drug use, sexual health, personal violence, post-traumatic stress disorder, depression, and food insecurity), cardiovascular risks (e.g., physical activity, weight, diabetes, and hypertension), road and home safety, stress buffers (e.g., coping and social support) and sociodemographics. The tool generated two tailored print-outs at the point of care. The recommendation sheet for patients summarized their disclosed risks in simple Dari/Farsi language along with contacts of relevant services. The risk-report for medical practitioner summarized patients' risks with possible referrals. This was attached to the medical chart prior to the consult.
Sponsors
University of Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Afghan refugee patients * Over 18 years of age * Speak and read Dari /Farsi or English language * Eligible for federal or provincial health care program * Visiting a participating medical practitioner
Exclusion criteria
* Patient visiting a provider who has not consented for the study * Patient accompanied by a family member for interpretation * New patients * Patients unable to receive study details due to logistical issue (e.g, no private room)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient intention to visit a psychosocial counselor | July to October post-visit | Patients completed a paper-pencil Exit Survey in the intervention (CaPRA) and control (usual care) groups |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction | July to October post-visit | Patients completed a paper-pencil Exit Survey in the intervention (CaPRA) and control (usual care) groups |
| Patient acceptability | July to October post-visit | Patients completed a paper-pencil Exit Survey in the intervention group (CaPRA) |
Outcome results
None listed