Assessing the Role and Integration of Community-Engaged Research (CEnR) in Addressing Health Care Access for Migrants in The United States: A Qualitative Systematic Review Öffentlichkeit

Abstract

Migrants in the United States are faced with several health care utilization and access challenges, including language barriers and a lack of sensitivity towards differences in cultural health beliefs. A qualitative systematic review was conducted to understand the current role and integration of community-engaged research (CEnR) as a key strategy in the improvement of healthcare access for migrant populations in the United States. The Cochran method for qualitative systematic reviews was carefully followed, with data extraction using the Cochrane Public Health Group method of data extraction and data eligibility. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was used to assess and organize findings throughout the data retrieval process. A total of 905 documents were identified, with only 10 records meeting the inclusion criteria for the qualitative systematic review. The level of CEnR integration into Implementation Science significantly increased within the last decade and is seen as a tool for better engagement with migrants and for improvements to their health care experiences. Yet, community engagement in all areas of the research process is not being practiced as it should. Ultimately, this review showed that the current integration of CEnR approaches to the research addressing health care experiences of migrants in the United States does not necessarily imply that community engagement is happening in all stages of research. The reviewed publications show that CEnR can positively impact the health of migrant communities through increasing awareness of intercultural dynamics and creating genuine, trustworthy relationships with stakeholders. There is also a need to further understand how CEnR strategies are being implemented and to continue researching the effectiveness of CEnR in general. The reviewed publications stated that when migrants are put in the position to spearhead the conversations surrounding their own health service utilization concerns, the ethics in research are at their best.

Table of Contents

List of Abbreviations 1

Introduction 2

Chapter 1: Literature Review 5

   Migrant Population in the United States 5

   Barriers in Access to Health Care for Migrant Populations in the United States 6

   Multicultural vs. Cross-Cultural vs. Intercultural Approaches to Engagement with Immigrants 9

   Intercultural Engagement, CEnR, and Implementation Science 11

Chapter 2: Methods 14

   Search Criteria and Strategies 14

   Table 1: Publication Types 15

   Database Types and Search Domains 16

   Table 2: Search Domains 16

   Search Terms 16

   Table 3: Search Terms 16

   Data Collection 18

   Publication Selection Process 18

   Inclusion Criteria 18

   Exclusion Criteria 19

   Document Eligibility and Data Extraction 19

   Document Eligibility Form 19

   Data Extraction 20

Chapter 3: Results 22

   Figure 4: PRISMA Flowchart, Database Searches, and Inclusion Criteria 22

   Figure 5: Eligible Documents Retrieved from Database Search 24

   Publications’ Characteristics 24

   Purpose, Role, and Effects of CEnR Approach in Health Care 25

   Community Involvement, Representation, and Gaps 27

Chapter 4: Discussion 28

   Current Level of Community-Engaged Research (CEnR) Integration 28

   Genuine and Meaningful Partnerships with Migrant Communities 29

   The Advantage of the CEnR Approach 31

   Limitations 33

Chapter 5: Conclusion and Public Health Implications 34

Appendix A: Document Eligibility Form 36

Appendix B: Data Extraction Form 37

Bibliography 38

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Stichwort	Health Care Access United States Migrant Implementation Sciences Community-Engaged Research (CEnR) Immigrant
Committee Chair / Thesis Advisor	Ordóñez, Claudia, Emory University

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