Creation of an Immigrant and Refugee Online Resource Toolkit for the State of Michigan
Background
Children who are immigrants/refugees are challenged by health disparities unique to their experiences entering and living in the US. For example, children of immigrants are more likely to live below the poverty line, be uninsured, and lack a permanent medical provider than non-immigrant children.
In meeting pediatricians and other professionals who work with immigrant/refugee children at the 2020 Acute Care Research Unit Migrant and Refugee Child Health Conference, it became apparent that there is a need for a central platform of available social services for this patient population. Our aim is to create a comprehensive Immigrant and Refugee Online Resource Toolkit (IRORT) that will direct providers to agencies addressing the social determinants of health faced by immigrant/refugee children and their families, allowing for more holistic and effective care.
Design
Creation of the IRORT required the formation of an interprofessional, cross-institutional taskforce within Michigan. A key component to the development of the toolkit was a survey disseminated to pediatric clinics intended to assess the perceived gaps in social services, identify the barriers to providing resources, and elicit preferences for the IRORT. Considering the interdisciplinary collaboration required to connect patients with social services, the survey also elicited responses from physician assistants, nurses, and social workers involved in the care of children who are immigrants. Recommendations from our respondents will be incorporated with our own research to create the IRORT hosted on the Michigan Chapter of the American Academy of Pediatrics homepage for pediatric providers and community organizations that serve immigrant families to access county-specific resources, guidelines, and best practices.
Results
Preliminary survey results (n=31) demonstrated that the most common barriers to providing adequate resources to immigrant/refugee patients were inadequate knowledge of resources or where to find them, insufficient time to provide resources, and that available resources are not reliable, have long wait times, or are over-capacity. The greatest perceived unmet resource for the immigrant/refugee patient population was by far mental health services (68% of respondents), followed by dental care, financial/housing support, and legal services. All respondents agreed that the IRORT would be a helpful resource in their practice that they would use.
Conclusion
The IRORT is a needed, central platform within the state of Michigan for primary care pediatric clinics to access information about social services for their immigrant/refugee patients. Additionally, there is a perceived unmet need for mental health services for immigrant/refugee pediatric patients in Michigan.
