P3B212: Exploring Cleveland Refugees’ Experience in Obtaining Healthcare

Background: The United States is one of the largest resettlement countries in the world. Healthcare is one of the most important basic needs that can help refugees rebuild their lives as many of them arrive with medical problems, given their complicated background. This study explored the healthcare needs and barriers of the refugees in Cleveland by interviewing refugee families and resettlement staff to help healthcare providers have a better understanding of the specific needs of this population with the intent to utilize the information provided to create a healthcare curriculum tailored to this population. This study is a part of a project funded by The Community Access to Child Health (CATCH) grant in 2020 and partnered with the local resettlement agency in Cleveland, The U.S. Committee for Refugees and Immigrants (USCRI).

Methods: The refugees who were clients of the Cleveland USCRI and the USCRI staff were recruited for the interviews. Due to the COVID-19 pandemic, the focus interview was conducted virtually and individually. An interpreter was available if needed for each session. The interview consisted of open-ended and multiple choices questions. The interviews were recorded, transcribed, and coded. Themes were identified.

Results: Seven refugees and four USCRI staff working with refugees were recruited and interviewed. Among the 7 refugees, 3 were from the Republic of the Congo, 2 were from Afghanistan, 1 was from Ukraine, and 1 from Burandi. Nine themes were identified as shown in the figure 1. The participants described that to access healthcare it is important to understand the healthcare needs which can be affected by the refugees’ experience in different healthcare system and culture and the knowledge gap. Their past experiences can also affect their decision in seeking healthcare. To seek healthcare, the refugees need to know how to navigate the system. They may use the resettlement agency to help them or use their own skills to learn to navigate the system. However, unmet needs or systemic/individual barriers can affect their decision and success in seeking healthcare. Interpersonal healthcare relationships between the refugees and healthcare providers can affect how the refugee and provider understand each other and impacts their feelings about and trust in the healthcare system and/or their provider. The important factor of communication across culture and language plays a significant role in how the refugees understand, seek, and receive healthcare. The participants also report that their support from the resettlement program and government funded insurance ends in their second year, but they continue to need longitudinal/extended support in seeking healthcare.

Conclusion: Healthcare in the refugee population is complicated and there are many factors that can affect their practice. The information from this interview could be used to develop an intervention to help support the refugee engagement in healthcare.