Refugee Health Orientation. Minnesota Department of Health Refugee Health Program Wednesday, January 29, 2014

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2 Refugee Health Orientation Minnesota Department of Health Refugee Health Program Wednesday, January 29, 2014

3 Today s Discussion What is Refugee Health Orientation? What are we currently doing? 2013 Survey Health Orientation Work Group Where do we go from here?

4 What is Refugee Health Orientation? the process of introducing newlyarrived refugees to the American health systems and healthy ways of life in the U.S.

5 What s currently being Done? Who is doing Health Orientation? How does it work? What s involved? Teaching tools, visuals, workbooks Bilingual staff or use of interpreters Knowing the health care systems & how they work

6 2013 Health Orientation Survey Participants VOLAGs Catholic Charities International Institute Lutheran Social Services MN Council of Churches Arrive Ministries (World Relief ) LPH/Clinics Bethesda HE Roselawn HP Center for International Health Hennepin Co. Pub. Hlth. Kandiyohi Co. Pub. Hlth. Sanford Health Stearns Co. Pub. Hlth. 33 people completed the survey

7 Survey Result Highlights Health orientation is part of the VOLAGs Cooperative Agreement. When asked about their current practices: 67% of VOLAG respondents felt their health orientation practices satisfy the learning objectives for health orientation outlined in the 2013 Cooperative Agreement. When asked about their role in Health Orientation, of the LPH/Clinic survey respondents: 37% said it is a primary role 63 % said it is an important role

8 Survey Result Highlights Question/Topic VOLAG LPH/CLINIC How much time is spent teaching about U.S. Health care system? Emergency room is for life threatening conditions only You always have the right to an interpreter in a medical setting 60% < 60 minutes 100% 53% 100% 94% Importance of establishing primary care 88% 89% Importance of taking medications with you to appointments & how to access pharmacy 88% 77% Health insurance & how to choose a PMAP 89% 69% Transportation Teach how to ride bus Teach how to schedule transport via PMAP Teaching method: Conversation/discussion Lecture/slides/video/demonstrations Written materials 67% 67% 86% 57% 14% 84% < 30 minutes 25% 67% 94% 12% 47%

9 How can we improve Refugee Health Orientation? Let s start by forming a work group!

10 Work Group Members VOLAGs Sarah Rogers (MCC) Amanda Smith (IIMN) Liz Ross (IIMN) Ixia Helmueller (CC) Laura Svoboda (WR) Charlotte Pfeiffer (LSS) LPH Christine May (Hennepin) Lori Wald (Ramsey) Deb Erickson (Stearns) Joan Hooper (Stearns) Diane Lorenz (Anoka) Angela Chesshir (Washington) Clinics Kathy Lytle (CIH) Julie Weeks (Bethesda) Kelley Jewett (HE Roselawn) Community Advisory Panel Kelelaye Emiru (DSMA) Mimi Oo (AAFACD Inc.) Shukri Hassan (IIMN) Til Pokwal (BCOM) Mu Nana Loo (KOM) Abdillahi Ganey (Wellshare) MDH Laura Doggett Blain Mamo Sara Chute Marge Higgins Anna Carpenter

11 What did the Work Group talk about? Survey results Current practices Questions from refugees overseas Client s immediate concerns VOLAG Cooperative Agreement Required topics to teach new arrivals Current practices for refugee health orientation Open, honest sharing of what is being done How to improve health orientation and be more consistent Key messages Tools Best practices Evaluation

12 Health Orientation Grid: (copy in your folder) Overseas questions from refugees VOLAG Cooperative Agreement Indicators VOLAG current practices (from survey) LPH/Clinic current practices (from survey)

13 Work Group Findings Outcome: key messages 9 Health Categories from the Cooperative Agreement: 1. Immediate health care needs 2. Initial health screenings & immunizations 3. Health insurance 4. Orientation to U.S. health system 5. Preventative health care 6. Norms of U.S. health system 7. Mental health 8. Personal hygiene standards 9. Public hygiene standards

14 Steps Forward - possibilities Tools shared and new Stearns & Anoka County others? VOLAGs variety of independent and shared resources R & P Health orientation materials / training tools Evaluation what works? How do we know? Classroom or 1-1? Discussion, visuals, activities, written materials? Teach back method Asking follow-up questions Check literacy level Survey clients at end of resettlement period Best Practices Health orientation for? % all refugee arrivals/families Health orientation given in client s language Consistent, effective health orientation practices/protocols Training for those teaching Health Orientation Consistent messages - reinforced by VOLAGs, Clinics & others

15 What s Next?

16 Cultural/Health Orientation as Mental Health Practice Cultural Orientation = Road to Success Help clients be in the Present - mindfulness Rubber Band Metaphor: What causes you stress? (don t be afraid to ask) What does it feel like? What do you do about it? What do you do to manage stress? What helps? Where do you go? With who? What do you do?

17 Closing Song 1. Step by step the longest march is begun, is begun - 2. Many stones to form an arch singly done, singly done - 3. And in union what we will can be accomplished still - 4. Drops of water turn the mill singly none, singly none -

18 THANK YOU!