Background

Service providers often experience difficulties in engaging refugees and migrants in health information and services. Community engagement is critical in ensuring meaningful participation of diverse groups, including those who frequently experience vulnerability. Exploring the factors that determine full engagement and uptake of proof-of-concept services by refugee and migrant communities is crucial to ensure equitable access and social justice. A systematic and genuinely participatory health literacy approach such as the Ophelia (Optimising Health Literacy and Access) process seeks to ensure the actors within health services are better equipped to address diverse and unique needs. The Ophelia process involves undertaking a community health literacy needs assessment; developing vignettes (short stories) to represent the health literacy strengths and limitations of subgroups within a community; and then engaging stakeholders including community members in co-designing realistic solutions.

Methods

Service providers were approached and briefed on the purpose and process of the project. They identified if refugee and migrant groups are experiencing disadvantage related to migration experiences and status. An advisory committee was established and consists of community members and leaders. Community leaders and members were consulted to identify the most appropriate methods and health literacy assessment process for the study.

Effects

A co-design and participatory approach during the initial engagement process enabled stakeholders, including community members, to fully participate and have a real sense of ownership from the initial planning phase. This process has led to the development of a genuine relationship between researchers, community leaders and community members. Multiple consultations with stakeholders have led to the adaptation of the Ophelia process. The Conversational Health Literacy Assessment Tool (CHAT) was identified as the most relevant health literacy assessment tool for the community of interest. The CHAT identifies health literacy needs and strengths of people in a systematic way using a series of open-ended questions.

Conclusion

The Ophelia process is adaptable and useful to co-design culturally and linguistically appropriate solutions to enhance meaningful community engagement and participation in health information and services.

1. Health literacy, immigration and migration