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Profile of Refugee Primary Care Access and Delivery Needs in Pima County

Refugees are resettled into the Tucson metropolitan area of Pima County at a
rate of between 600-800 persons annually. They come from every continent and
diverse backgrounds, speak a range of languages, including Arabic, Kirundi,
Somali, Mai Mai, Nepali, Burmese and Swahili, and all of them hold in common
the need to learn to navigate an unfamiliar and complex primary health care
delivery system. The challenges they face in this process, and the challenges
encountered by health and human service agencies in providing optimal
services to them have been documented anecdotally in Pima County, but as yet,
have not been closely examined qualitatively. This project included a primary
care service needs assessment focusing on the population of refugees in
Tucson, as well as a service delivery and training needs assessment of
primary care providers in Pima County. Using a model of community-based,
participatory research, I formed a Refugee Primary Care Work Group who guided
the development and implementaion of a survey among a multidisciplinary
universe of service providers to identify the range of refugees’ priority
and unmet needs, and the challenges they currently face in serving new
refugees (cultural, linguistic, economic, among others). Once the provider
survey was complete, we employed the same participatory model to develop and
conduct group and individual interviews with refugees from at least six
different language groups, to elicit health concerns, barriers to accessing
services, and recommendations for improvement of outreach and services. An
interdisciplinary team of graduate students from the disciplines of public
health, nursing, and information resources and library science were involved,
under my supervision and guidance, in development, implementation, data
collection and management, analysis and community reporting of the findings.
Diverse agencies including Arizona Health Sciences Library, refugee
resettlement agencies, urgent care facilities, primary health care providers,
Pima County Health Department Public Health Nurses and Pima County Public
Library assisted in this process in an advisory capacity. Findings and
recommendations have been utilized by RISP-Net and PCCHTF to take steps to
respond to identified needs and recommendations, to include fundraising and
program modification wherever indicated and possible, and will assist in
dissemination of findings through local, state and national networks. The
work group has continued with my leadership, unfunded, beyond March 2010, and
I presented findings at the APHA Annual Meeting in Denver in November 2010.
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D Jean McClelland

The University of Arizona