Grant: Catalyst Grant: Primary and Community-Based Healthcare

Since 2002, when the Immigrant and Refugee Protection Act was revised, refugees with significant barriers to healthcare have come to Canada. In Vancouver and elsewhere in Canada, specialized refugee clinics limit the number of patients seen because of insufficient manpower and funding. As a result refugees, despite their challenges and lack of knowledge about the system, are encouraged to secure family doctors in their communities as soon as possible after arrival. No follow up of these refugees occurs so whether their needs are met and where they receive healthcare, e.g. in emergency rooms or in primary health care offices, remains unknown. This study aims to develop and validate appropriate tools necessary to conduct this research on these refugees with the intent using the tools in future cross-cultural research. A telephone survey questionnaire will shed light on how refugees acquired mainstream primary health care 2-3 years after they initially registered at Bridge Clinic, the specialized refugee clinic in Vancouver. A topic guide will be used in focus group discussions that will further explore challenges faced by refugees when acquiring primary care and highlight how they cope when faced with challenges of accessing healthcare. Questions have been adapted from the Canadian Community Health Survey and the World Bank's Living Standards Measurement Study. Proportions of refugees having a family doctor and those with particular health characteristics will be compared to the general Lower Mainland population. This preliminary mixed methods study is expected to 1) establish a research agenda in refugee health that will identify factors that promote use of primary care services by refugees and 2) develop translated and validated tools with which to accomplish this activity.