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Fam Pract. 2015 Aug;32(4):420-5. doi: 10.1093/fampra/cmv022. Epub 2015 Apr 27.

Guidelines and training initiatives that support communication in cross-cultural primary-care settings: appraising their implementability using Normalization Process Theory.

Author information

1
Discipline of General Practice, National University of Ireland, Galway, Ireland, tomas.debrun@nuigalway.ie.
2
Discipline of General Practice, National University of Ireland, Galway, Ireland.
3
Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands.
4
Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands, Australian National University, Canberra, Australia.
5
University of Liverpool, Liverpool, UK.
6
Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
7
General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
8
Department of General Practice and Family Medicine, Medical University of Vienna, Vienna, Austria and.
9
Graduate Entry Medical School, University of Limerick, Limerick, Ireland.

Abstract

BACKGROUND:

Guidelines and training initiatives (G/TIs) available to support communication in cross-cultural primary health care consultations are not routinely used. We need to understand more about levers and barriers to their implementation and identify G/TIs likely to be successfully implemented in practice.

OBJECTIVE:

To report a mapping process used to identify G/TIs and to prospectively appraise their implementability, using Normalization Process Theory (NPT).

METHODS:

RESTORE is a 4-year EU FP-7 project. We used purposeful and network sampling to identify experts in statutory and non-statutory agencies across Austria, England, Greece, Ireland, Scotland and the Netherlands who recommended G/TI data from the grey literature. In addition, a peer review of literature was conducted in each country. Resulting data were collated using a standardized Protocol Mapping Document. G/TIs were identified for inclusion by (i) initial elimination of incomplete G/TI material; (ii) application of filtering criteria; and (iii) application of NPT.

RESULTS:

20 G/TIs met selection criteria: 8 guidelines and 12 training initiatives. Most G/TIs were identified in the Netherlands (n = 7), followed by Ireland (n = 6) and England (n = 5). Fewer were identified in Scotland (n = 2), and none in Greece or Austria. The majority (n = 13) were generated without the inclusion of migrant service users. All 20 were prospectively appraised for potential implementability by applying NPT.

CONCLUSIONS:

NPT is useful as a means of prospectively testing G/TIs for implementability. Results indicate a need to initiate meaningful engagement of migrants in the development of G/TIs. A European-based professional standard for development and assessment of cross-cultural communication resources is advised.

KEYWORDS:

Community involvement; Normalization Process Theory; migrant health; primary care.

PMID:
25917169
DOI:
10.1093/fampra/cmv022
[Indexed for MEDLINE]

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