Titre : Application électronique d'aide au dépistage chez les personnes migrantes (ApiDé) PARTIE I : Evaluation Scientifique Le projet relève-t-il des missions scientifiques de l'ANRS ? oui Qualité du projet (scientifique et technique) Pertinence pour la recherche sur l'infection à VIH, les hépatites virales et/ou co-infections Excellent Progrès par rapport à l'état actuel des connaissances Bon Définition des hypothèses et des objectifs Bon Pertinence de l'approche méthodologique, statistique et/ou technologique Excellent Impact potentiel du projet Bon Faisabilité du projet La durée du projet est-elle raisonnable pour sa réalisation ? Bon Environnement scientifique et ressources du laboratoire (collaboration, missions/déplcaements, conditions de sécurité) Bon PARTIE II : Adéquation budget / projet Coûts Fonctionnement Raisonnable Equipement (< 16 000 euros HT) Raisonnable Personnel Raisonnable Participation demandée à l'ANRS Raisonnable Coût total estimé du projet Raisonnable PARTIE III : Dimension éthiqueLes problèmes éthiques ont-ils été pris en considération (homme, animal) ? OuiSi le projet relève de la règlementation applicable à la recherche sur la personne, les demandes nécessaires ont-elles été prises en considération? Oui
Background Migrants underuse screening opportunities for HIV, hepatitis B, and hepatitis C despite elevated risk factors for contracting these infections. Language barriers are an often given as reasons for limiting access to services. Translation and communication apps increase communication and overall patient satisfaction in the patient-provider relationship. In the development and adoption of new technology, expectations play an important role. Objective This study aimed to explore health care professionals’ opinions and attitudes regarding their screening practices with migrants and their expectations for a new communication tool that could improve migrants’ screening use. Methods In this qualitative study, a purposive (diverse) sampling method was used to invite doctors and nurses who conduct rapid screening tests with migrants from 4 centers of the French Office of Immigration and Integration in 3 geographic regions of France. Semistructured interviews were conducted to survey their opinions on the rapid testing of migrants, the use of telephone interpreters, the concept of health literacy, and their expectations of a new communication tool that could overcome language barriers and promote rapid screening in the new migrant population. Results In all, 20 interviews were conducted with 11 doctors and 9 nurses with a median age of 58 (range 25-67) years. Participants favored the integration of an innovative communication tool in the context of rapid screening of migrants. However, there were concerns related to the implementation and added value of the tool while migrants were already reluctant to be screened. Expectations were for a tool that would present information in simplified French or a chosen language but also supports a positive attitude toward screening. Health professionals also expressed the wish that the technology could help with the collection of health data. Conclusions Feedback from health professionals provides a better understanding of potential formats, characteristics, functions, content, and use of an innovative, digital method to communicate with migrants with limited French proficiency. Findings contribute to the conceptual development of an electronic app and its implementation within the ApiDé study, which aims to validate a digital app to address language barriers to increase the use of screening among migrants with limited French proficiency in France.
BACKGROUND Migrants underutilize screening opportunities for HIV, Hepatitis B, and Hepatitis C despite elevated risk factors for contracting these infections. Language barriers are an often given as reasons for limiting access to services. Translation and communication apps increase communication and overall patient-satisfaction in the patient-provider relationship. In the development and adoption of new technology, expectations play an important role. OBJECTIVE To explore the expectations of healthcare professionals (HPs), at the French Office of Immigration and Integration (OFII), for a new communication tool that could improve migrant’ screening utilization. METHODS In this qualitative study, a purposive (diverse) sampling method was used to recruit doctors and nurses who conduct rapid screening tests with migrants in four centers in France. Semi-structured interviews explored HP’s experience with migrants at the OFII. Opinions on the rapid testing of migrants, the use of telephone interpreters, the concept of health literacy, and the creation of a new tool to promote rapid screening in the MLPF population were explored. RESULTS Twenty interviews were conducted with eleven doctors and nine nurses with a median age of 58 years (25-67 years). Participants favored the integration of an innovative communication tool in the context of rapid screening of migrants. However, there were concerns the implementation of the tool, the value of the tool when migrants had a pre-existing reluctance to screening, and the need for wider practice improvements. Expectations were for a tool that would present information but also support a positive attitude towards screening. HPs also expressed the wish that the technology could help with the collection of health data. CONCLUSIONS This research provides a better understand of potential formats, characteristics, functions, content, and use of an innovative, digital method to communicate with MLPF. We found support from HPs for a digital tool. The findings contribute to the conceptual development of an electronic application and its implementation within the ApiDé study, which aims to validate a digital application to address language barriers to increase utilisation of screening among MLPF in France.
BACKGROUND Late diagnoses of HIV, Hepatitis B and Hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis’ screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers’ reluctance to offer a test and to migrants’ reluctance to accept testing. OBJECTIVE The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and to evaluate its acceptability and impact in terms of public health. METHODS The study will go through three stages: 1) concept development, 2) app development, and 3) app evaluation. A qualitative study has been undertaken to explore language barriers during healthcare encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted in order to have a comprehensive overlook of electronic tools designed to help healthcare providers communicate with migrants with a language barrier. In order to generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the application will include translation and voice recording of items. The electronic development will also include a three steps of testing with users. The acceptability of the application will be evaluated in a survey with the System Usability Scale. The evaluation of the application’s efficacy will consist of a stepped-wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome measured is the percentage of screening tests realized. The secondary outcomes are rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app. RESULTS The app evaluation study has received a 3-year grant from Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from Office Français de l’Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review have been completed. CONCLUSIONS This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and measure its acceptability and effectiveness in terms of public health. When completed, this application could be distributed to numerous actors carrying out screening with migrant populations in various healthcare settings.
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