P3B282: Resident Experiences in Pathways to Health for Cleveland Refugees: A Pilot Study

Background: As defined by the United Nations High Commissioner for Refugees (UNHCR), a refugee is “someone who is unable or unwilling to return to their country of origin owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion.” The United States is one of the leading refugee resettlement countries in the world. Healthcare is one of the most important basic needs for resettled refugees rebuilding their lives. However, refugee families often report discomfort navigating the US healthcare system and medical trainees are often unfamiliar with the experiences of refugee families and have little experience caring for refugee children. This study aims to evaluate the impact of participation in a refugee health curriculum on pediatric resident physician attitudes and self-reported behaviors regarding refugee healthcare. This study was funded by a 2020 Community Access to Child Health (CATCH) grant and developed in partnership with the United States Committee for Refugees and Immigrants (USCRI), a refugee resettlement organization.

Methods: With the support of USCRI, the research team developed a health education curriculum to introduce the US healthcare system to resettled refugee families. During an outpatient advocacy rotation, Pediatrics and Internal Medicine – Pediatrics residents received a one-hour training on the background and needs of the local refugee population from the research team, as well as instruction in the refugee health curriculum content. Residents then assisted the research team in delivering one topic from the health curriculum to a refugee participant in an hour-long session. Residents completed pre- and post-intervention surveys to assess their comfort and interest in working with refugee populations.

Results: Of 32 Pediatrics and Internal Medicine-Pediatrics residents who participated in the advocacy rotation, twenty completed the pre-curriculum questionnaire (response rate = 62%). Eight residents also completed the post-intervention questionnaire (response rate = 25%, or 40% of those who completed the pre-curriculum questionnaire). Prior to the intervention, residents reported high interest in working with refugees despite little direct experience working with this population (Table 1). Comparing pre- and post-intervention responses (Table 2), there was a statistically-significant increase in the number of participants who reported having an understanding of immigrant and refugee health, from 12.5% to 62.5%. All respondents reported having a positive and enjoyable experience with the refugee health curriculum, and valued incorporating cross-cultural and refugee health training into their clinical training.

Conclusion: This study highlights the gap between pediatric trainees’ strong interest in caring for refugee families and the lack of training they have received in caring for this patient population. To bridge this gap, further studies are needed to support the development of effective cross-cultural and refugee health curricula for residency training programs.