Accepted for/Published in: JMIR Research Protocols
Date Submitted: Sep 10, 2020
Date Accepted: Nov 17, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Promoting HIV, HBV and HCV screening among migrants with a language barrier: Protocol for the development and evaluation of an electronic application (Apidé)
ABSTRACT
Background:
Late diagnoses of HIV, Hepatitis B and Hepatitis C are important public health problems that affect the population at large and migrants in particular. Missed opportunities of HIV and hepatitis’ screening are numerous, with language differences being a significant barrier to testing. Several studies have shown that migrants who do not speak the language of the health provider are less likely to get tested, due to health providers’ reluctance to offer a test and to migrants’ reluctance to accept testing.
Objective:
The aim of our study is to develop a multilingual electronic tool (app) that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and to evaluate its acceptability and impact in terms of public health.
Methods:
The study will go through three stages: 1) concept development, 2) app development, and 3) app evaluation. A qualitative study has been undertaken to explore language barriers during healthcare encounters and their effect on communication, specifically when a screening test is offered. In parallel, a systematic review of the literature was conducted in order to have a comprehensive overlook of electronic tools designed to help healthcare providers communicate with migrants with a language barrier. In order to generate a list of items to be translated for inclusion in the app, we will conduct a focus group and Delphi survey. The development of the application will include translation and voice recording of items. The electronic development will also include a three steps of testing with users. The acceptability of the application will be evaluated in a survey with the System Usability Scale. The evaluation of the application’s efficacy will consist of a stepped-wedge randomized controlled trial. The study will be carried out in 16 centers that treat migrants and offer them screening tests for infectious diseases. The primary outcome measured is the percentage of screening tests realized. The secondary outcomes are rate of screening proposal by health professionals, acceptance rate by migrants, number of positive cases using this app, and frequency of use of the app.
Results:
The app evaluation study has received a 3-year grant from Agence Nationale de la Recherche contre le SIDA et les hépatites virales (ANRS) and from Office Français de l’Immigration et Intégration (OFII). At the time of publication of this protocol, the initial qualitative study and systematic literature review have been completed.
Conclusions:
This study will develop an app that assists health providers in offering and explaining HIV and hepatitis screenings to migrants with a language barrier, and measure its acceptability and effectiveness in terms of public health. When completed, this application could be distributed to numerous actors carrying out screening with migrant populations in various healthcare settings.
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