Guidelines and training initiatives that support communication in cross-cultural primary-care settings: appraising their implementability using Normalization Process Theory

• Published in: Family practice Vol. 32; no. 4; pp. 420 - 425
• Main Authors: de Brún, Tomas, de-Brún, Mary O'Reilly, van Weel-Baumgarten, Evelyn, van Weel, Chris, Dowrick, Christopher, Lionis, Christos, O'Donnell, Catherine A, Burns, Nicola, Mair, Frances S, Saridaki, Aristoula, Papadakaki, Maria, Princz, Christine, van den Muijsenbergh, Maria, MacFarlane, Anne
• Format: Journal Article
• Language: English
• Published: England 01.08.2015
• Subjects: Austria; Communication; Cross-Cultural Comparison; Culturally Competent Care - methods; England; Greece; Humans; Ireland; Netherlands; Practice Guidelines as Topic - standards; Primary Health Care - standards; Qualitative Research; Referral and Consultation; Scotland; Transients and Migrants; Greece; England; Scotland; Austria; Netherlands; Ireland; migrant health; primary care; Community involvement; Normalization Process Theory
• ISSN: 0263-2136; 1460-2229
• DOI: 10.1093/fampra/cmv022

Guidelines and training initiatives (G/TIs) available to support communication in cross-cultural primary health care consultations are not routinely used. We need to understand more about levers and barriers to their implementation and identify G/TIs likely to be successfully implemented in practice. To report a mapping process used to identify G/TIs and to prospectively appraise their implementability, using Normalization Process Theory (NPT). RESTORE is a 4-year EU FP-7 project. We used purposeful and network sampling to identify experts in statutory and non-statutory agencies across Austria, England, Greece, Ireland, Scotland and the Netherlands who recommended G/TI data from the grey literature. In addition, a peer review of literature was conducted in each country. Resulting data were collated using a standardized Protocol Mapping Document. G/TIs were identified for inclusion by (i) initial elimination of incomplete G/TI material; (ii) application of filtering criteria; and (iii) application of NPT. 20 G/TIs met selection criteria: 8 guidelines and 12 training initiatives. Most G/TIs were identified in the Netherlands (n = 7), followed by Ireland (n = 6) and England (n = 5). Fewer were identified in Scotland (n = 2), and none in Greece or Austria. The majority (n = 13) were generated without the inclusion of migrant service users. All 20 were prospectively appraised for potential implementability by applying NPT. NPT is useful as a means of prospectively testing G/TIs for implementability. Results indicate a need to initiate meaningful engagement of migrants in the development of G/TIs. A European-based professional standard for development and assessment of cross-cultural communication resources is advised.