Leandra Bitterfeld, Mustafa Ozkaynak, Andrea H Denton, Cornelius A Normeshie, Rupa S Valdez, Noor Sharif, Priscilla A Caldwell, Fern R Hauck
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引用次数: 0
摘要
来到美国的难民面临着传染性和非传染性疾病的沉重负担。通过制定完善的综合干预措施,有可能改善难民的健康状况,但人们对此类干预措施的有效性知之甚少。本综述旨在确定、描述和评估针对美国难民人口的患者层面医疗保健干预措施的有效性。我们根据《系统综述和元分析首选报告项目》进行了系统综述。我们通过PubMed Medline、Web of Science、Embase和CINAHL检索了2000年至2022年期间在美国进行的、包含任何年龄的难民人群、包含旨在改善健康状况的干预措施、包含对干预措施结果的评估的文章。我们共纳入了 37 项研究,并确定了三种主要干预方式:医疗保健提供/管理、资源提供和教育。干预措施主要针对一般健康、传染病、妇女健康、饮食/运动、健康知识普及、口腔健康、糖尿病、家庭健康和药物使用。衡量的结果包括知识、满意度、行为结果和身体健康指标。本次审查表明,少数健康状况,即结核病,已经通过大规模、持续的干预措施得到了解决。其他疾病(一般健康和妇女健康)则是通过零散的短期干预措施来解决的。对干预措施的评估往往侧重于知识或满意度,而不是健康或行为改变的结果。今后的工作应侧重于制定可持续干预措施的最佳战略,以满足在美难民的不同需求。
Interventions to Improve Health Among Refugees in the United States: A Systematic Review.
Refugees arriving to the U.S. experience a high burden of both communicable and non-communicable diseases. There is a potential to improve health outcomes for refugees through well-developed, comprehensive interventions, but the effectiveness of such interventions is poorly understood. The purpose of this review is to identify, characterize and evaluate the effectiveness of patient-level healthcare interventions for U.S. refugee populations. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medline via PubMed, Web of Science, Embase, and CINAHL were searched for articles that included a population of refugees of any age, included an intervention aimed at improving health, included an evaluation of the intervention's outcomes, and were conducted in the U.S. from 2000 to 2022. Thirty-seven studies were included, and we identified three main intervention modalities: healthcare provision/management, resource provision, and education. Interventions targeted general health, infectious disease, women's health, diet/exercise, health literacy, oral health, diabetes, family health, and substance use. The outcomes measured included knowledge, satisfaction, behavioral outcomes, and physical health markers. This review demonstrates that a few health conditions, namely tuberculosis, have been addressed with large-scale, sustained interventions. Other conditions (general health and women's health) have been addressed through piecemeal, short-term interventions. The evaluation of interventions often focuses on knowledge or satisfaction rather than health or behavior change outcomes. Future work should focus on the best strategies for developing sustainable interventions that meet the needs of the diverse population of refugees in the U.S.
期刊介绍:
The Journal of Community Health is a peer-reviewed publication that offers original articles on research, teaching, and the practice of community health and public health. Coverage includes public health, epidemiology, preventive medicine, health promotion, disease prevention, environmental and occupational health, health policy and management, and health disparities. The Journal does not publish articles on clinical medicine. Serving as a forum for the exchange of ideas, the Journal features articles on research that serve the educational needs of public and community health personnel.