Accessibility and Acceptability of Infectious Disease Interventions Among Migrants in the EU/EEA: A CERQual Systematic Review

Abstract

In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants’ acceptability, value placed on outcomes, and accessibility of infectious disease interventions. We conducted a systematic review of qualitative reviews adhering to the PRISMA reporting guidelines. We searched MEDLINE, EMBASE, CINAHL, DARE, and CDSR, and assessed review quality using AMSTAR. We conducted a framework analysis based on the Health Beliefs Model, which was used to organize our preliminary findings with respect to the beliefs that underlie preventive health behavior, including knowledge of risk factors, perceived susceptibility, severity and barriers, and cues to action. We assessed confidence in findings using an adapted GRADE CERQual tool. We included 11 qualitative systematic reviews from 2111 articles. In these studies, migrants report several facilitators to public health interventions. Acceptability depended on migrants’ relationship with healthcare practitioners, knowledge of the disease, and degree of disease-related stigma. Facilitators to public health interventions relevant for migrant populations may provide clues for implementation. Trust, cultural sensitivity, and communication skills also have implications for linkage to care and public health practitioner education. Recommendations from practitioners continue to play a key role in the acceptance of infectious disease interventions.

A systematic review of barriers and facilitators for hepatitis B and C screening among migrants in the EU/EEA region

“…This systematic review identified barriers and facilitating factors for HBV and HCV screening in migrants in the EU/EEA region. Many of the here identified factors were in line with previous review-studies examining infectious disease screening initiatives among migrants ( 13 , 16 , 92 , 93 ). By discussing concepts according to seven domains inspired by Flottorp, Oxman ( 19 ), Grol and Wensing ( 20 ), and Fleuren, Paulussen ( 21 ), we allowed the inclusion of less frequently featured domains, such as healthcare innovations, since in recent years more innovations are being applied in screening, such as rapid POCT ( 84 , 86 , 88 ).…”

Access to Refugee and Migrant Mental Health Care Services during the First Six Months of the COVID-19 Pandemic: A Canadian Refugee Clinician Survey

“…Social determinants of health and health systems play a critical factor in determining refugee and migrant patient access to primary health care [ 16 ]. Indeed, prior to COVID-19, refugee access to care was limited due to income, unemployment, literacy, housing, social exclusion, race and official language skills [ 17 ].…”

Health of Refugees and Migrants—Where Do We Stand and What Directions Should We Take?

“…These reviews discuss the effectiveness and cost effectiveness of screening for HIV, hepatitis B and C, schistosomiasis, and strongyloidiasis. The articles also discuss the effectiveness of interventions (including vaccinations) and their cost effectiveness in migrants in the EU/EEA (Table 1) [9,10,11,12,15,16]. These have led to a recent publication of the European Center for Disease Prevention and Control (ECDC) entitled “Public health guidance on screening and vaccination for infectious diseases in newly arrived migrants within the EU/European Economic Area (EEA)” [46].…”

“…Factors associated with accessibility and acceptability of interventions to prevent infectious disease included knowledge of the disease and the related stigma, as well as migrants’ interaction with HC providers [16].…”

“…HC providers must possess culture-sensitive communication skills when planning interventions [16]. They must focus on social mobilization and community outreach when planning vaccination programs and educational campaigns [15].…”