P3B101: Effective Approaches for Collecting Place of Birth of Immigrant Children in Healthcare: Insights from Immigrants and Healthcare Providers Caring for Immigrant Patients

Background: The healthcare needs of immigrant children may differ from those of US-born children. To adequately address these needs, healthcare providers require detailed information about the child's background, including their place of birth. This information can inform clinical decision-making and help healthcare providers identify potential health risks, such as infectious diseases that are more prevalent in certain countries. Failure to do so can result in inadequate care, negatively impacting both personal and population-based healthcare needs. This project sought to explore different ways to collect place of birth data of immigrant children, with a focus on identifying best practices that promote engagement, cultural sensitivity, and accuracy.

Project Description: A purpose sampling method was used to form a diverse advisory board of 26 members, including immigrant youth, parents, clinicians, interpreters, and community leaders. They were interviewed using semi-structured interviews to gather opinions and suggestions on best practices for inquiring about an immigrant child's birthplace. The interviews were conducted following the sociotechnical framework for studying healthcare, SEIPS 2.0, and were coded per SEIPS 2.0 domains, focusing on people, tasks, tools, organization, and environment. The board had 8 meetings and gave feedback on various topics, including the appropriateness of tools for gathering information, where and when in the clinical workflow to ask about birth location, who should be asking questions, where and how to document responses, and phrasing suggestions to promote acceptability. Suggestions and themes generated from the board meetings were incorporated into an educational resource for clinicians.

Discussion: Based on the input from the advisory board, it was found that the most appropriate group to ask about an immigrant child's birthplace in primary care workflows is the clinical team, in a quiet and private space. The board identified two overarching themes, "Ask because you care" and "Be respectful," and five key principles: "Be positive," "Be welcoming," "Ask if the information can be recorded in the EHR," "Keep it straight," and "Unless you and the family speak the same language, work with an interpreter." The results of the board's feedback were incorporated into an educational resource for clinicians called "Ask Where". The resource includes sample quotes from the board and is directed towards clinicians.

Conclusion: It is crucial that healthcare providers approach the task of determining birth location with a respectful, positive, and welcoming attitude to build trust and rapport with immigrant children and their families for high-quality, culturally competent care. It is important to recognize potential challenges and sensitivities associated with collecting and utilizing place of birth data, such as concerns around privacy and confidentiality. The feedback from the advisory board has been instrumental in identifying appropriate measures to address these challenges.