Computer-assisted Psychosocial Risk Assessment (CaPRA) for Refugee Health and Settlement

Sponsor

University of Toronto (Other)

Overall Status

Completed

CT.gov ID

NCT01427829

Collaborator

(none)

Enrollment

Arms

Duration (Months)

Study Details

Study Description

Brief Summary

The purpose of this study was to examine preliminary effect of Computer-assisted Psychosocial Risk Assessment tool (CaPRA) among Afghan refugees visiting medical professionals (family physicians or nurse practitioners) at a Community Health Center. The investigators examined the tool's acceptability among patients and its impact on patient satisfaction and patient intention to visit a psychosocial counselor as a proxy of potential to integrate medical and social care.

Condition or Disease	Intervention/Treatment	Phase
Computer Screening Decision Support System Primary Care Psychosocial Refugees	Behavioral: Computer-assisted Psychosocial Risk Assessment (CaPRA)	N/A

Detailed Description

The recent waves of refugees to Canada belong to regions of prolonged conflict and, thus arrive in compromised state of mental, physical, and social health. This complexity asks for provision of integrated medical and social care to newly arrived refugees. With this aim, a university-community initiative developed a Computer-assisted Psychosocial Risk Assessment tool (CaPRA) in Dari/Farsi for Afghan refugees. This innovative eHealth approach is first of its kind for Canadian refugees accessing primary care. In this model of care, patients complete an interactive multi-risk iPad computer survey in their own language before seeing the provider. The computer then generates individualized recommendation sheet for patients and a risk-report for providers at the point of care. The tool was developed through a collaborative process by working with Access Alliance Multicultural Health and Community Services and advisory board with community representatives.

Study Design

Study Type:

Interventional

Actual Enrollment :

50 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Health Services Research

Official Title:

Computer-assisted Psychosocial Risk Assessment (CaPRA) for Refugee Health and Settlement - Evaluation Phase

Study Start Date :

Jul 1, 2010

Actual Primary Completion Date :

Oct 1, 2010

Actual Study Completion Date :

Oct 1, 2010

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention (CaPRA)	Behavioral: Computer-assisted Psychosocial Risk Assessment (CaPRA) The study intervention was a touch-screen self-assessment survey which eligible patients completed on a touch-screen iPad in Dari/Farsi language while waiting to see their medical practitioner. The Computer-assisted Psychosocial Risk Assessment (CaPRA) survey had questions on psychosocial risks (e.g., alcohol, tobacco and street drug use, sexual health, personal violence, post-traumatic stress disorder, depression, and food insecurity), cardiovascular risks (e.g., physical activity, weight, diabetes, and hypertension), road and home safety, stress buffers (e.g., coping and social support) and sociodemographics. The tool generated two tailored print-outs at the point of care. The recommendation sheet for patients summarized their disclosed risks in simple Dari/Farsi language along with contacts of relevant services. The risk-report for medical practitioner summarized patients' risks with possible referrals. This was attached to the medical chart prior to the consult.
No Intervention: Control (usual care)	Behavioral: Computer-assisted Psychosocial Risk Assessment (CaPRA) The study intervention was a touch-screen self-assessment survey which eligible patients completed on a touch-screen iPad in Dari/Farsi language while waiting to see their medical practitioner. The Computer-assisted Psychosocial Risk Assessment (CaPRA) survey had questions on psychosocial risks (e.g., alcohol, tobacco and street drug use, sexual health, personal violence, post-traumatic stress disorder, depression, and food insecurity), cardiovascular risks (e.g., physical activity, weight, diabetes, and hypertension), road and home safety, stress buffers (e.g., coping and social support) and sociodemographics. The tool generated two tailored print-outs at the point of care. The recommendation sheet for patients summarized their disclosed risks in simple Dari/Farsi language along with contacts of relevant services. The risk-report for medical practitioner summarized patients' risks with possible referrals. This was attached to the medical chart prior to the consult.

Arm

Intervention/Treatment

Experimental: Intervention (CaPRA)

Behavioral: Computer-assisted Psychosocial Risk Assessment (CaPRA)

The study intervention was a touch-screen self-assessment survey which eligible patients completed on a touch-screen iPad in Dari/Farsi language while waiting to see their medical practitioner. The Computer-assisted Psychosocial Risk Assessment (CaPRA) survey had questions on psychosocial risks (e.g., alcohol, tobacco and street drug use, sexual health, personal violence, post-traumatic stress disorder, depression, and food insecurity), cardiovascular risks (e.g., physical activity, weight, diabetes, and hypertension), road and home safety, stress buffers (e.g., coping and social support) and sociodemographics. The tool generated two tailored print-outs at the point of care. The recommendation sheet for patients summarized their disclosed risks in simple Dari/Farsi language along with contacts of relevant services. The risk-report for medical practitioner summarized patients' risks with possible referrals. This was attached to the medical chart prior to the consult.

No Intervention: Control (usual care)

Behavioral: Computer-assisted Psychosocial Risk Assessment (CaPRA)

Outcome Measures

Primary Outcome Measures

Patient intention to visit a psychosocial counselor [July to October post-visit]
Patients completed a paper-pencil Exit Survey in the intervention (CaPRA) and control (usual care) groups

Secondary Outcome Measures

Patient satisfaction [July to October post-visit]
Patients completed a paper-pencil Exit Survey in the intervention (CaPRA) and control (usual care) groups
Patient acceptability [July to October post-visit]
Patients completed a paper-pencil Exit Survey in the intervention group (CaPRA)

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Afghan refugee patients
Over 18 years of age
Speak and read Dari /Farsi or English language
Eligible for federal or provincial health care program
Visiting a participating medical practitioner

Exclusion Criteria:

Patient visiting a provider who has not consented for the study
Patient accompanied by a family member for interpretation
New patients
Patients unable to receive study details due to logistical issue (e.g, no private room)