A Rapid Systematic Literature Review: Barriers to Health Services in Pediatric Refugee Populations

dc.creatorAbbas, Hibahen_US
dc.creatorHudson, Meganen_US
dc.creatorSpitzer, Lillianen_US
dc.creatorAllsopp, Leslieen_US
dc.description.abstractPurpose: Pediatric refugee populations in the United States have lower rates of immunization, difficulty accessing health care, decreased access to health insurance, and lower preventative visit attendance. This systematic review seeks to analyze the existing literature on health services for refugee children in the United States and to understand the socio-demographic, cultural, and systemic factors that contribute to these challenges. Two research questions were investigated: 1) what barriers are identified in the literature to the provision of adequate healthcare among refugee children in the United States, 2) does evidence suggest there are existing services and solutions that are accessible to refugee communities? Methods: A systematic search of electronic databases, including PubMed, CINAHL, and SCOPUS, was conducted to identify relevant peer-reviewed articles published. PRISMA guidelines for rapid reviews were followed, keywords were defined, and Covidence was used to structure content. The initial search produced 547 studies, and after 34 duplicates were removed, 513 studies remained. Title and abstracts were screened based on inclusion criteria, specifically, studies published in the last 10 years that referenced health services for pediatric refugee populations. Studies were excluded based on incorrect participant age and population specifications. Editorials and non-peer-reviewed articles were also excluded. 79 articles received a full-text review, with 13 articles meeting all inclusion criteria. These articles (n=13) were analyzed, content related to the research questions was classified using a data extraction tool, and common themes and patterns were identified. Results: Nine common themes isolated among the articles were linguistic differences, trauma-related mental health issues, lack of insurance coverage, cultural differences, limited health literacy, transportation difficulties, stigma, social isolation, and insufficient housing. The most prevalent theme isolated was linguistic differences with 11 out of the 13 studies that met inclusion criteria including it as a barrier to accessing healthcare. While these are listed as distinct themes and patterns, it is important to note that many of these barriers are interrelated. Our review revealed a lack of coherent and consistent services designed to meet the complex needs of this high-risk population. Conclusion: This rapid systematic review highlights the need for targeted interventions and policies that address the complex and interrelated barriers refugee populations face in accessing health care services. There does not appear to be consistent services that target this population specifically. In prior studies, refugee children were shown to have lower rate of immunizations, emphasizing the need for improved vaccination outreach strategies and health education. The isolated nine barriers serve as a foundational starting point to build targeted interventions to better serve this vulnerable population. Since linguistic differences were the most prevalent barrier to care, targeted interventions should include translators, either in-person or virtual, to be made available at clinics to provide care to this population. Ultimately, a more comprehensive understanding of these barriers through further research and policy development can improve health equity and outcomes for pediatric refugee populations in the United States.en_US
dc.titleA Rapid Systematic Literature Review: Barriers to Health Services in Pediatric Refugee Populationsen_US