Clinical trial NCT02695316: Barrier-free Communication in Maternity Care of Allophone Migrants
Official title: Barrier-free Communication in Maternity Care of Allophone Migrants (Barrierefreie Kommunikation in Der Geburtshilflichen Versorgung Allophoner Migrantinnen)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Expectant and Nursing Mother
Communication
Experiences
Keywords: Migrants
Communication Barriers
Maternal Health Services
Health Services Needs and Demand
Access to Health Care
Professional-Patient Relations
Eritrea
Kosovo
Switzerland
Lead sponsor: Bern University of Applied Sciences
Sponsor class: OTHER
Collaborators: name: Zurich University of Applied Sciences
name: Swiss Tropical & Public Health Institute
name: FamilyStart of both Basel
name: Swiss Midwifery Association
name: Federal Office of Public Health, Switzerland
name: Swiss Agency for Combating Racism
First posted: 2016-03-01
Enrollment: 82
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The aim of this study is to describe access and communication barriers of migrant women who do not speak the local language in the Swiss maternity care service provision from the perspective of users, health care professionals and interpreters.

Detailed description: In Switzerland pregnant migrant women and their families are burdened in multiple ways: pregnancy requires an adjustment process and women have to deal with foreign living conditions, limited communication or the uncertainty of their residence status. An increased maternal and child health morbidity and mortality in migrants is well documented. A poor health outcome seems also to be correlated with a limited access to obstetric and maternity care services for migrants. Nearly 10% of foreigners living in Switzerland for more than one year do not speak any of the official languages. In women native of non-EU27 and -EFTA countries and asylum seekers, these rate is considerably higher.

To improve maternity care services for migrants in Switzerland several measures have been taken in the past, e.g. Hospitals for Equity, promotion of transcultural skills, written multilingual health information and interpreter services in hospitals. The availability of comparable measures in outpatient or home care services is rather an exception. One example is the midwives network "FamilyStart", an outpatient institution that offers a helpline and home visiting services for mothers and thier newborns. It collaborates with the National Telephone Interpreter Service.

It is currently unclear how successfully midwives and other health care professionals communicate with allophone migrants, if they use and benefit from any of the currently available support measures and thus may improve the access of migrant women to maternity care in Switzerland.

The study aims

* to describe the access and communication barriers of allophone women with different migration backgrounds in maternity and obstetric health services from the perspective of users, health care professionals and Interpreters
* to make prioritized recommendations on behalf of the Swiss Midwives Association and other professional associations for improving the quality and access of maternity care Services; the transcultural understanding between professionals and users; and the coordination between the different involved services.

It is an exploratory study in three parts:

1. User perspective: Qualitative assessment of the women's experiences. The participants have different migration backgrounds: representatives of the resident foreign population of Switzerland (from Kosovo or Albania with native language Albanian) and asylum seekers (from Eritrea with native language Tigrinya) will be interviewed.
2. Perspective of professionals: Qualitative assessment of the health care professionals experiences and quantitative analysis of protocols of counseling sessions from midwives who have used the telephone interpreting service during a home visit on behalf of FamilyStart.
3. Perspective of interpreters: Qualitative assessment of experiences of professional Interpreters.

Eligibility criteria: Group 1: Inclusion criteria:

* healthy women speaking Albanian or Tigrinja
* mothers of a healthy infant up to one year after birth

Exclusion criteria:

* women speaking fluent German
* women with a serious illness during pregnancy, childbirth and/or postpartum or who's infant was seriously ill or died

Group 2: Inclusion criteria:

* Minimum one year working experience
* Experience with allophone Tigrinya or Albanian speaking women

Group 3: Inclusion criteria:

* Female
* Minimum one year working experience
* having either telephone or face-to-face interpreting Expertise

Group 4: No limitation

Primary outcomes:
measure: Experiences of migrant women by focus group discussions
timeFrame: after 6 weeks, up to 12 months
Secondary outcomes:
measure: Experiences of health care professionals by focus group discussions
timeFrame: within last five years of their professional experience
measure: Experiences of Interpreters by one-to-one interview
timeFrame: within last five years of their professional experience
measure: Quality of telephone interpreting consultations with questionnairs
timeFrame: within 24 hours after the consultation
Other outcomes:
Locations:
city: Winterthur
country: Switzerland
facility: Zurich Universtiy of Applied Sciences
state: Zurcih
city: Basel
country: Switzerland
facility: FamilyStart
city: Basel
country: Switzerland
facility: University Hospital Basel
city: Bern
country: Switzerland
facility: Swiss Midwifery Association SHV
city: Bern
country: Switzerland
facility: University Hospital Insel Bern
city: Zürich
country: Switzerland
facility: Swiss Service for Telephone Interpreter (Schweizerischer Telefondolmetschdienst )
Study officials:
affiliation: Bern University of Applied Sciences
name: Paola Origlia Ikhilor, MSc
role: PRINCIPAL_INVESTIGATOR
References:
citation: Merten, S., & Gari, S. (2013). Die reproduktive Gesundheit der Migrationsbevölkerung in der Schweiz und anderen ausgewählten Aufnahmeländern. Eine Zusammenfassung der Literatur 2006-2012. Basel: Swiss Tropical and Public Health Institute.
citation: Kurth, E. (2013). FamilyStart beider Basel - ein koordinierter Betreuungsservice für Familien nach der Geburt. hebamme.ch(7/8), 35-37.
citation: Saladin, P. (Ed.). (2009). Diversität und Chancengleichheit. Grundlagen für erfolgreiches Handeln im Mikrokosmos der Gesundheitsinstitutionen (3. ed.). Bern: Bundesamtes für Gesundheit BAG in Zusammenarbeit mit H+ Die Spitäler der Schweiz.
citation: Hermann, M. (2013). Migrationsgerechte Angebote im Bereich reproduktive Gesundheit und frühe Kindheit in der Schweiz. In E. D. d. I. Schweizerische Eidgenossenschaft (Ed.), Eine Bestandesaufnahme von Projekten, Massnahmen und Arbeitsmethoden: Bundesamt für Gesundheit, Sektion Migration und Gesundheit.
citation: Bundesamt für Statistik. (2015). Integration - Indikatoren: Sprache - Personen, die 3,2,1 oder keine Landessprache beherrschen. Retrieved 23.03.2015, from Schweizerische Eidgenossenschaft www.bfs.admin.ch/bfs/portal/de/index/themen/
citation: Origlia Ikhilor P., van Goch S., Kurth E., Cignacco E. Stocker Kalberer B., Pehlke-Milde J. 2015 Lancierte Studie soll Kommunikation mit allophonen Migrantinnen erleichtern Hebamme.ch 10:4-8
citation: Origlia Ikhilor P, Hasenberg G, Kurth E, Stocker Kalberer B, Cignacco E, Pehlke-Milde J. Barrier-free communication in maternity care of allophone migrants: BRIDGE study protocol. J Adv Nurs. 2018 Feb;74(2):472-481. doi: 10.1111/jan.13441. Epub 2017 Oct 5.