Barrier-free Communication in Maternity Care of Allophone Migrants

Communication Clinical Trial

— BRIDGE  

Official title:

Barrier-free Communication in Maternity Care of Allophone Migrants (Barrierefreie Kommunikation in Der Geburtshilflichen Versorgung Allophoner Migrantinnen)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02695316
• Other study ID #: BernUAS
• Status: Completed
• Phase: N/A
• First received: February 9, 2016
• Last updated: January 31, 2017
• Start date: September 2015
• Est. completion date: December 2016

Study information

• Verified date: January 2017
• Source: Bern University of Applied Sciences
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to describe access and communication barriers of migrant women who do not speak the local language in the Swiss maternity care service provision from the perspective of users, health care professionals and interpreters.

Description:

In Switzerland pregnant migrant women and their families are burdened in multiple ways:

pregnancy requires an adjustment process and women have to deal with foreign living conditions, limited communication or the uncertainty of their residence status. An increased maternal and child health morbidity and mortality in migrants is well documented. A poor health outcome seems also to be correlated with a limited access to obstetric and maternity care services for migrants. Nearly 10% of foreigners living in Switzerland for more than one year do not speak any of the official languages. In women native of non-EU27 and -EFTA countries and asylum seekers, these rate is considerably higher.

To improve maternity care services for migrants in Switzerland several measures have been taken in the past, e.g. Hospitals for Equity, promotion of transcultural skills, written multilingual health information and interpreter services in hospitals. The availability of comparable measures in outpatient or home care services is rather an exception. One example is the midwives network "FamilyStart", an outpatient institution that offers a helpline and home visiting services for mothers and thier newborns. It collaborates with the National Telephone Interpreter Service.

It is currently unclear how successfully midwives and other health care professionals communicate with allophone migrants, if they use and benefit from any of the currently available support measures and thus may improve the access of migrant women to maternity care in Switzerland.

The study aims

• to describe the access and communication barriers of allophone women with different migration backgrounds in maternity and obstetric health services from the perspective of users, health care professionals and Interpreters

• to make prioritized recommendations on behalf of the Swiss Midwives Association and other professional associations for improving the quality and access of maternity care Services; the transcultural understanding between professionals and users; and the coordination between the different involved services.

It is an exploratory study in three parts:

1. User perspective: Qualitative assessment of the women's experiences. The participants have different migration backgrounds: representatives of the resident foreign population of Switzerland (from Kosovo or Albania with native language Albanian) and asylum seekers (from Eritrea with native language Tigrinya) will be interviewed.

2. Perspective of professionals: Qualitative assessment of the health care professionals experiences and quantitative analysis of protocols of counseling sessions from midwives who have used the telephone interpreting service during a home visit on behalf of FamilyStart.

3. Perspective of interpreters: Qualitative assessment of experiences of professional Interpreters.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 82
• Est. completion date: December 2016
• Est. primary completion date: June 2016
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Group 1: Inclusion criteria:

• healthy women speaking Albanian or Tigrinja

• mothers of a healthy infant up to one year after birth

Exclusion criteria:

• women speaking fluent German

• women with a serious illness during pregnancy, childbirth and/or postpartum or who's infant was seriously ill or died

Group 2: Inclusion criteria:

• Minimum one year working experience

• Experience with allophone Tigrinya or Albanian speaking women

Group 3: Inclusion criteria:

• Female

• Minimum one year working experience

• having either telephone or face-to-face interpreting Expertise

Group 4: No limitation

Related Conditions & MeSH terms

• Communication
• Expectant and Nursing Mother
• Experiences

Intervention

Other:
• Focus Group Discussion in native Language
Group Interview with semi-structured key question, moderated in the native language of the participants. Interpreters translate the discussion for the Researcher analogically and adapt it culturally. The discussions are audio-recorded, summarized, translated and transcribed into German.
• Focus Group Discussion
Group Interview with semi-structured key question, audio-recorded and ad verbatim transcription
• One-to-one Interview
One-to-one Interview with semi-structured key question, audio-recorded and ad verbatim transcription.
• Retrospective Quantitative Analysis
Retrospective Quantitative Analysis of questionnaires (Telephone Interpreting Protocols)

Locations

Country	Name	City	State
Switzerland	FamilyStart	Basel
Switzerland	University Hospital Basel	Basel
Switzerland	Swiss Midwifery Association SHV	Bern
Switzerland	University Hospital Insel Bern	Bern
Switzerland	Zurich Universtiy of Applied Sciences	Winterthur	Zurcih
Switzerland	Swiss Service for Telephone Interpreter (Schweizerischer Telefondolmetschdienst )	Zürich

Sponsors (7)

Lead Sponsor	Collaborator
Bern University of Applied Sciences	FamilyStart of both Basel, Swiss Agency for Combating Racism, Swiss Federal Office of Public Health, Swiss Midwifery Association, Swiss Tropical & Public Health Institute, Zurich University of Applied Sciences

Country where clinical trial is conducted

Switzerland, 

References & Publications (6)

Bundesamt für Statistik. (2015). Integration - Indikatoren: Sprache - Personen, die 3,2,1 oder keine Landessprache beherrschen. Retrieved 23.03.2015, from Schweizerische Eidgenossenschaft www.bfs.admin.ch/bfs/portal/de/index/themen/

Hermann, M. (2013). Migrationsgerechte Angebote im Bereich reproduktive Gesundheit und frühe Kindheit in der Schweiz. In E. D. d. I. Schweizerische Eidgenossenschaft (Ed.), Eine Bestandesaufnahme von Projekten, Massnahmen und Arbeitsmethoden: Bundesamt für Gesundheit, Sektion Migration und Gesundheit.

Kurth, E. (2013). FamilyStart beider Basel - ein koordinierter Betreuungsservice für Familien nach der Geburt. hebamme.ch(7/8), 35-37.

Merten, S., & Gari, S. (2013). Die reproduktive Gesundheit der Migrationsbevölkerung in der Schweiz und anderen ausgewählten Aufnahmeländern. Eine Zusammenfassung der Literatur 2006-2012. Basel: Swiss Tropical and Public Health Institute.

Origlia Ikhilor P., van Goch S., Kurth E., Cignacco E. Stocker Kalberer B., Pehlke-Milde J. 2015 Lancierte Studie soll Kommunikation mit allophonen Migrantinnen erleichtern Hebamme.ch 10:4-8

Saladin, P. (Ed.). (2009). Diversität und Chancengleichheit. Grundlagen für erfolgreiches Handeln im Mikrokosmos der Gesundheitsinstitutionen (3. ed.). Bern: Bundesamtes für Gesundheit BAG in Zusammenarbeit mit H+ Die Spitäler der Schweiz.

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Experiences of migrant women by focus group discussions	Qualitative description of experiences made with maternity care services during pregnancy, birth, post partum up to one year after birth	after 6 weeks, up to 12 months
Secondary	Experiences of health care professionals by focus group discussions	Qualitative description of working experiences in maternity care with allohone migrants	within last five years of their professional experience
Secondary	Experiences of Interpreters by one-to-one interview	Qualitative description of working experiences when interpreting for pregnant women or mothers in maternity care services	within last five years of their professional experience
Secondary	Quality of telephone interpreting consultations with questionnairs	Descriptive analysis of protocols of telephone interpreted consultations with information on aim, content, perceived benefits and difficulties	within 24 hours after the consultation

External Links

•   Project database from the funding agency: Tripartite Agglomerationskonferenz Projekte (German)
•   Project database of the Midwifery Faculty of the Bern University of Applied Sciences (German)