Healthcare Navigation and Patient Activation for Recently Resettled Refugees

Refugees face many barriers to healthcare before and after resettlement in the United States (U.S.). One challenge is the complexity of the U.S. healthcare system and the difficulty refugees face attempting to access and utilize healthcare services. The purpose of this study was to improve patient activation, through healthcare navigation skill development, among recently resettled refugees. The study was implemented through the Immigrant and Refugee Resettlement Office in a small town in the Shenandoah Valley of Virginia. Study participants (N=33) were adult refugees who had been resettled in the U.S. for two years or less at the time of the study. A quasi-experimental, one group pre- and post-test design was used. The primary outcome was patient activation as measured by the Patient Activation Measure (PAM). Participants were given the PAM at the start of a single three-hour teaching session focused on basic healthcare navigation skill development and then again one month following the intervention. In-person interpreters were utilized throughout the study from recruitment to final data collection. Results showed a significant improvement in PAM scores at the one-month post-intervention visit. Data trends indicated participants who may benefit from the intervention include those with chronic conditions and those who were resettled in the U.S. for one year or less. Implications for nurses and other healthcare professionals include the potential benefits of this new approach to improve refugee engagement in their own health and health care by promoting basic skills needed to successfully access and utilize healthcare services after resettlement.