Improving delivery of primary care for vulnerable migrants: Delphi consensus to prioritize innovative practice strategies.
OBJECTIVE
To identify and prioritize innovative strategies to address the health concerns of vulnerable migrant populations.


METHODS
Modified Delphi consensus process.


METHODS
Canada.


METHODS
Forty-one primary care practitioners, including family physicians and nurse practitioners, who provided care for migrant populations.


METHODS
We used a modified Delphi consensus process to identify and prioritize innovative strategies that could potentially improve the delivery of primary health care for vulnerable migrants. Forty-one primary care practitioners from various centres across Canada who cared for migrant populations proposed strategies and participated in the consensus process.


RESULTS
The response rate was 93% for the first round. The 3 most highly ranked practice strategies to address delivery challenges for migrants were language interpretation, comprehensive interdisciplinary care, and evidence-based guidelines. Training and mentorship for practitioners, intersectoral collaboration, and immigrant community engagement ranked fourth, fifth, and sixth, respectively, as strategies to address delivery challenges. These strategies aligned with strategies coming out of the United States, Europe, and Australia, with the exception of the proposed evidence-based guidelines.


CONCLUSIONS
Primary health care practices across Canada now need to evolve to address the challenges inherent in caring for vulnerable migrants. The selected strategies provide guidance for practices and health systems interested in improving health care delivery for migrant populations.
University of Ottawa, Family Medicine, 75 Bruyère St, Ottawa, ON K1S 0P6. kpottie@uottawa.ca.
Kevin
K
Pottie
Ricardo
R
Batista
Maureen
M
Mayhew
Lorena
L
Mota
Karen
K
Grant
D000328:Adult; D002170:Canada; D032921:Consensus; D003695:Delivery of Health Care / Q000379:methods*; D003697:Delphi Technique; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D058996:Quality Improvement; D012036:Refugees; D035862:Vulnerable Populations