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Development of guidelines for recently arrived immigrants and refugees to Canada: Delphi consensus on selecting
Helena Swinkels1, Kevin Pottie, Peter Tugwell
1Department of Family Practice, University of British Columbia, Vancouver, BC. helena.swinkels@fraserhealth.ca
Background:
Setting priorities is critical to ensure guidelines are relevant and acceptable to users, and that time, resources and expertise are used cost-effectively in their development. Stakeholder engagement and the use of an explicit procedure for developing recommendations are critical components in this process.
Methods:
We used a modified Delphi consensus process to select 20 high-priority conditions for guideline development. Canadian primary care practitioners who care for immigrants and refugees used criteria that emphasize inequities in health to identify clinical care gaps.
Results:
Nine infectious diseases were selected, as well as four mental health conditions, three maternal and child health issues, caries and periodontal disease, iron-deficiency anemia, diabetes and vision screening.
Interpretation:
Immigrant and refugee medicine covers the full spectrum of primary care, and although infectious disease continues to be an important area of concern, we are now seeing mental health and chronic diseases as key considerations for recently arriving immigrants and refugees.
Insights
Canadian primary care practitioners identified 20 high-priority conditions for immigrant and refugee health guidelines. Key areas include infectious diseases, mental health, and chronic conditions, reflecting evolving health needs.
Area of Science:
- Primary Care Medicine
- Public Health
- Health Equity
Background:
- Guideline development requires strategic prioritization for relevance, user acceptance, and cost-effectiveness.
- Stakeholder engagement and explicit procedures are crucial for effective guideline creation.
Purpose of the Study:
- To identify high-priority health conditions for guideline development among immigrants and refugees.
- To inform Canadian primary care practice regarding the health needs of diverse patient populations.
Main Methods:
- A modified Delphi consensus process was employed to select priority conditions.
- Canadian primary care practitioners evaluated clinical care gaps using criteria focused on health inequities.
Main Results:
- Twenty high-priority conditions were selected for guideline development.
- Selected conditions include nine infectious diseases, four mental health issues, and three maternal/child health concerns.
- Other key areas identified were caries, periodontal disease, iron-deficiency anemia, diabetes, and vision screening.
Conclusions:
- Immigrant and refugee medicine encompasses comprehensive primary care needs.
- While infectious diseases remain important, mental health and chronic diseases are increasingly significant for new immigrants and refugees.
- These findings highlight the need for updated guidelines addressing the evolving health landscape in immigrant and refugee populations.
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