The impact of intensive health promotion to a targeted refugee population on utilisation of a new refugee paediatric clinic at the children's hospital at Westmead

Abstract

Objective: To evaluate the impact of intensive promotion of a new health service to a targeted refugee population, recently resettled in Sydney, and the role of early social connection and membership of social group in promoting health service utilisation of refugees.

Design: Descriptive epidemiological study and survey.

Settings: A paediatric refugee clinic at a children's hospital in Sydney.

Participants: Newly resettled refugee parents of children seen at the clinic.

Interventions: An intensive health promotion and education campaign using ethnic media and social networks to increase awareness of and encourage utilisation of a new clinical service for refugee children (above and beyond the standard promotion that accompanied the start of the new refugee clinic) to a targeted group of refugees from Sub-Saharan Africa.

Main outcome measure(s): Rates of attendance and utilisation of the new service in targeted versus non-targeted refugee parents; changes in health beliefs, health-seeking behaviour and utilisation of services following clinic attendance.

Results: We interviewed 34 Sub-Saharan African refugee parents (intervention) and 12 non-African refugee parents (non-intervention) attending a paediatric refugee clinic, between June 2005 and May 2006, with a total number of 112 children. The mean ages of the children were 12 and 10 years for the Africans and non-Africans, respectively. Our targeted health promotion campaign appeared to be effective in increasing attendance for target communities compared to the non-targeted communities (OR for African families attending clinic 3.0, 95% CI=1.5-6.2, p<0.001). We observed a significant change in parental knowledge, attitudes and beliefs about infectious diseases after attending the clinic, including decreased stigma around tuberculosis, more awareness of the seriousness of some infections, and increased awareness of the role of immunisation in prevention of infectious diseases.

Conclusion: Our study shows that targeted promotion of service to refugee parents is effective. Such efforts may improve access to care for refugees and may constructively change knowledge, attitudes and beliefs about infectious diseases.