@Article{info:doi/10.2196/50058,
author="Savargaonkar, Deepali
and Srivastava, Bina
and Yadav, Prakash Chander
and Singh, Pal Mrigendra
and Anvikar, Anup
and Sharma, Amit
and Singh, Himmat
and Sinha, Abhinav",
title="Contribution of Travelers to Plasmodium Vivax Malaria in South West Delhi, India: Cross-Sectional Survey",
journal="JMIR Public Health Surveill",
year="2025",
month="Jan",
day="8",
volume="11",
pages="e50058",
keywords="malaria",
keywords="Plasmodium vivax",
keywords="imported malaria",
keywords="population movement",
keywords="transmission",
keywords="elimination",
keywords="India",
abstract="Background: India is committed to malaria elimination by the year 2030. According to the classification of malaria endemicity, the National Capital Territory of Delhi falls under category 1, with an annual parasite incidence of <1, and was targeted for elimination by 2022. Among others, population movement across states is one of the key challenges for malaria control, as it can result in imported malaria, thus introducing local transmission in an area nearing elimination. Objective: This descriptive study attempts to assess the contribution of such imported Plasmodium vivax cases to the malaria burden in South West Delhi (SWD). Methods: A cross-sectional study was carried out at the fever clinic of the Indian Council of Medical Research-National Institute of Malaria Research in SWD from January 2017 to December 2019. Demographic and travel history data were recorded for all P vivax confirmed malaria cases diagnosed at the fever clinic. Vector and fever surveys along with reactive case detection were conducted in SWD and Bulandshahr district of Uttar Pradesh, 1 of the 6 geographical sources for a high number of imported malaria cases. Results: A total of 355 P vivax malaria cases were reported during the study period. The proportion of imported cases was 63\% (n=222). Of these, 96\% (n=213) of cases were from Uttar Pradesh. The distribution of malaria cases revealed that imported cases were significantly associated with travel during the transmission season compared with that in the nontransmission season. Entomological and fever surveys and reactive case detection carried out in areas visited by imported P vivax malaria cases showed the presence of adults and larvae of Anopheles species and P vivax parasitemia. Conclusions: Population movement is a key challenge for malaria elimination. Although additional P vivax infections and vector mosquitoes were detected at places visited by the imported malaria cases, the inability to detect the parasite in mosquitoes and the possibility of relapses associated with P vivax limit the significance of malaria associated with the travel. However, there remains a need to address migration malaria to prevent the introduction and re-establishment of malaria in areas with very low or 0 indigenous cases. ",
doi="10.2196/50058",
url="https://publichealth.jmir.org/2025/1/e50058"
}


@Article{info:doi/10.2196/58613,
author="Al-Hamad, Areej
and Yasin, Mohammad Yasin
and Metersky, Kateryna
and Guruge, Sepali
and Jung, Grace
and Mahsud, Khadija",
title="Homestay Hosting Dynamics and Refugee Well-Being: Scoping Review",
journal="Interact J Med Res",
year="2024",
month="Nov",
day="25",
volume="13",
pages="e58613",
keywords="homestay",
keywords="host-guest relationship",
keywords="hospitality",
keywords="hosting",
keywords="well-being",
keywords="homestay accommodation",
keywords="host-refugee relation",
keywords="refugee",
keywords="scoping review",
keywords="review",
abstract="Background: Homestay accommodations aim to support a smoother transition for refugees; yet, the intricate nature of relationships between refugees and their hosting families can make this process complex, which, in turn, can affect their health and well-being. It is crucial to grasp the experiences of both refugees and their host families in order to foster effective settlement, integration, and well-being. Objective: The purpose of this scoping review is to explore the dynamics of homestay or hosting with a focus on understanding the experiences of both refugees and their hosting families to identify gaps in the literature and propose directions for future research. Methods: We used the Joanna Briggs Institute methodology and followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist to guide this scoping review. Searches were conducted in MEDLINE via EBSCO, Scopus via OVID, CINAHL, SOCIndex, Web of Science Core Collection, ProQuest Dissertations and Theses, the SciELO Citation Index, and APA PsycInfo. Literature written in English and published from 2011 to 2024 that focused on homestay hosting contexts for refugees was included. Results: The results of this review illuminate the multifaceted and dynamic nature of homestay hosting for refugees. The findings include motivations and barriers for homestay hosting, factors influencing host-refugee relations, and psychological and social outcomes of homestay hosting. Conclusions: The results of this scoping review demonstrated the need for tailored support for refugees to improve homestay programs for the benefit of both refugees and host families and highlighted the need of more inclusive, supportive, and effective strategies for the hosting, resettlement, and integration of refugees. International Registered Report Identifier (IRRID): RR2-10.2196/56242 ",
doi="10.2196/58613",
url="https://www.i-jmr.org/2024/1/e58613"
}


@Article{info:doi/10.2196/59293,
author="Kang, Jin Soo
and Oh, Hye-Kyung
and Han, Hae-Ra",
title="Developing and Validating the Health Literacy Scale for Migrant Workers: Instrument Development and Validation Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Nov",
day="13",
volume="10",
pages="e59293",
keywords="transients and migrants",
keywords="psychometrics",
keywords="scale development",
keywords="health literacy",
keywords="validation study",
keywords="Rasch model",
abstract="Background: Research concerning health literacy among migrant workers in South Korea has been limited, especially given the lack of validated instruments and the lack of focus on the cultural diversity of migrant workers. Objective: This study aimed to develop and validate a health literacy scale for unskilled migrant workers (HLS-MW) in South Korea. Methods: We first generated a pool of potential items based on a literature review and in-depth interviews with 23 migrant workers. Subsequently, we reviewed empirical referents from the first step to select relevant medical terminologies and passages, ultimately choosing 709 words. The study team initially generated 35 items with 709 health-related terms through empirical referent reviews. After content validity testing by an expert panel, 28 items comprising 89 terms on the 2 subscales of prose and documents were selected for psychometric testing. Overall, 402 unskilled migrant workers in South Korea completed a web-based survey between August and September 2021, with 334 responses included in the final analysis. We used multiple analytic approaches, including exploratory factor analysis, Rasch analysis (item response theory), and descriptive analysis, to examine the new scale's validity and reliability. Results: The final sample primarily included young male workers from South Asian countries. The HLS-MW yielded 2 factors: prose and documents. The item difficulty scores ranged from ?1.36 to 2.56. The scale was reduced to 13 items (10 prose and 3 document items), with the final version exhibiting good internal reliability (Kuder-Richardson index=0.88; intraclass correlation coefficient=0.94, 95\% CI 0.93?0.95) and test-retest reliability (r=0.74, 95\% CI 0.57?0.92). HLS-MW scores differed significantly by Korean language proficiency (F2,331=3.54, P=.004). Conclusions: The HLS-MW is a reliable and valid measure to assess health literacy among migrant workers in South Korea. Further studies are needed to test the psychometric properties of the HLS-MW in diverse migrant groups in South Korea while also establishing cutoffs to help identify those in need of health literacy support. ",
doi="10.2196/59293",
url="https://publichealth.jmir.org/2024/1/e59293"
}


@Article{info:doi/10.2196/49253,
author="Pang, Mingli
and Wang, Jieru
and Zhao, Mingyue
and Chen, Rui
and Liu, Hui
and Xu, Xixing
and Li, Shixue
and Kong, Fanlei",
title="The Migrant-Local Difference in the Relationship Between Social Support, Sleep Disturbance, and Loneliness Among Older Adults in China: Cross-Sectional Study",
journal="JMIR Public Health Surveill",
year="2024",
month="Jan",
day="9",
volume="10",
pages="e49253",
keywords="loneliness",
keywords="social support",
keywords="sleep disturbance",
keywords="older adults",
keywords="migrant-local difference",
keywords="structural equation modeling",
abstract="Background: Driven by the accelerated aging of the population of China, the number of older adults has increased rapidly in the country. Meanwhile, following children, migrant older adults (MOA) have emerged as a vulnerable group in the process of fast urbanization. Existed studies have illustrated the association between social support and loneliness and the relationship between sleep disturbance and loneliness; however, the underlying mechanisms and the migrant-local difference in the association between social support, sleep disturbance, and loneliness have not been identified. Objective: This study aimed to clarify the migrant-local difference in the relationship between social support, sleep disturbance, and loneliness in older adults in China. Methods: Multistage cluster random sampling was used to select participants: 1205 older adults (n=613, 50.9\%, MOA and n=592, 49.1\%, local older adults [LOA]) were selected in Weifang City, China, in August 2021. Loneliness was assessed with the 6-item short-form University of California, Los Angeles Loneliness Scale, social support was evaluated with the Social Support Rating Scale, and sleep disturbance was measured with the Pittsburgh Sleep Quality Index. The chi-square test, t test, and structural equation modeling (SEM) were adopted to explore the migrant-local difference between social support, sleep disturbance, and loneliness among the MOA and LOA. Results: The mean score of loneliness was 8.58 (SD 3.03) for the MOA and 8.00 (SD 2.79) for the LOA. SEM analysis showed that social support exerts a direct negative effect on both sleep disturbance (standardized coefficient=--0.24 in the MOA and --0.20 in the LOA) and loneliness (standardized coefficient=--0.44 in the MOA and --0.40 in the LOA), while sleep disturbance generates a direct positive effect on loneliness (standardized coefficient=0.13 in the MOA and 0.22 in the LOA). Conclusions: Both MOA and LOA have a low level of loneliness, but the MOA show higher loneliness than the LOA. There is a negative correlation between social support and loneliness as well as between social support and sleep disturbance among the MOA and LOA (MOA>LOA), while loneliness is positively associated with sleep disturbance in both populations (MOA<LOA). Measures should be taken by the government, society, and families to increase social support, decrease sleep disturbance, and further reduce the loneliness among older adults, especially the MOA. ",
doi="10.2196/49253",
url="https://publichealth.jmir.org/2024/1/e49253",
url="http://www.ncbi.nlm.nih.gov/pubmed/38194253"
}


@Article{info:doi/10.2196/43511,
author="Liyanage, Ravihari Chandreen
and Mago, Vijay
and Schiff, Rebecca
and Ranta, Ken
and Park, Aaron
and Lovato-Day, Kristyn
and Agnor, Elise
and Gokani, Ravi",
title="Understanding Why Many People Experiencing Homelessness Reported Migrating to a Small Canadian City: Machine Learning Approach With Augmented Data",
journal="JMIR Form Res",
year="2023",
month="May",
day="2",
volume="7",
pages="e43511",
keywords="data augmentation",
keywords="feature selection",
keywords="homelessness",
keywords="machine learning",
keywords="migrants",
abstract="Background: Over the past years, homelessness has become a substantial issue around the globe. The largest social services organization in Thunder Bay, Ontario, Canada, has observed that a majority of the people experiencing homelessness in the city were from outside of the city or province. Thus, to improve programming and resource allocation for people experiencing homelessness in the city, including shelter use, it was important to investigate the trends associated with homelessness and migration. Objective: This study aimed to address 3 research questions related to homelessness and migration in Thunder Bay: What factors predict whether a person who migrated to the city and is experiencing homelessness stays or leaves shelters? If an individual stays, how long are they likely to stay? What factors predict stay duration? Methods: We collected the required data from 2 sources: a survey conducted with people experiencing homelessness at 3 homeless shelters in Thunder Bay and the database of a homeless information management system. The records of 110 migrants were used for the analysis. Two feature selection techniques were used to address the first and third research questions, and 8 machine learning models were used to address the second research question. In addition, data augmentation was performed to improve the size of the data set and to resolve the class imbalance problem. The area under the receiver operating characteristic curve value and cross-validation accuracy were used to measure the models' performances while avoiding possible model overfitting. Results: Factors predicting an individual's stay duration included home or previous district, highest educational qualification, recent receipt of mental health support, migrating to visit family or friends, and finding employment upon arrival. For research question 2, among the classification models developed for predicting the stay duration of migrants, the random forest and gradient boosting tree models presented better results with area under the receiver operating characteristic curve values of 0.91 and 0.93, respectively. Finally, home district, band membership, status card, previous district, and recent support for drug and/or alcohol use were recognized as the factors predicting stay duration. Conclusions: Applying machine learning enables researchers to make predictions related to migrants' homelessness and investigate how various factors become determinants of the predictions. We hope that the findings of this study will aid future policy making and resource allocation to better serve people experiencing homelessness. However, further improvements in the data set size and interpretation of the identified factors in decision-making are required. ",
doi="10.2196/43511",
url="https://formative.jmir.org/2023/1/e43511",
url="http://www.ncbi.nlm.nih.gov/pubmed/37129936"
}


@Article{info:doi/10.2196/40587,
author="Asim, Saba
and Wang, Kailu
and Nichini, Elena
and Yip, Fu Faustina
and Zhu, Liling
and Fung, Eddy Hin Chung
and Zeng, Yan
and Fang, Zhilan
and Cheung, Wai-Ling Annie
and Wong, Lai-yi Eliza
and Dong, Dong
and Yeoh, Eng-Kiong",
title="COVID-19 Vaccination Preferences Among Non-Chinese Migrants in Hong Kong: Discrete Choice Experiment",
journal="JMIR Public Health Surveill",
year="2023",
month="Mar",
day="27",
volume="9",
pages="e40587",
keywords="COVID-19 vaccination",
keywords="migrants",
keywords="discrete choice experiment",
keywords="ethnic minorities",
keywords="vaccine attributes",
keywords="Hong Kong",
keywords="COVID-19",
abstract="Background: Studies have shown increasing COVID-19 vaccination hesitancy among migrant populations in certain settings compared to the general population. Hong Kong has a growing migrant population with diverse ethnic backgrounds. Apart from individual-level factors, little is known about the migrants' preference related to COVID-19 vaccines. Objective: This study aims to investigate which COVID-19 vaccine--related attributes combined with individual factors may lead to vaccine acceptance or refusal among the migrant population in Hong Kong. Methods: An online discrete choice experiment (DCE) was conducted among adults, including Chinese people, non-Chinese Asian migrants (South, Southeast and Northeast Asians), and non-Asian migrants (Europeans, Americans, and Africans) in Hong Kong from February 26 to April 26, 2021. The participants were recruited using quota sampling and sent a link to a web survey. The vaccination attributes included in 8 choice sets in each of the 4 blocks were vaccine brand, safety and efficacy, vaccine uptake by people around, professionals' recommendation, vaccination venue, and quarantine exemption for vaccinated travelers. A nested logistic model (NLM) and a latent-class logit (LCL) model were used for statistical analysis. Results: A total of 208 (response rate 62.1\%) migrant participants were included. Among the migrants, those with longer local residential years (n=31, 27.7\%, for ?10 years, n=7, 20.6\%, for 7-9 years, n=2, 6.7\%, for 4-6 years, and n=3, 9.7\%, for ?3 years; P=.03), lower education level (n=28, 28.3\%, vs n=15, 13.9\%, P=.01), and lower income (n=33, 25.2\%, vs n=10, 13.2\%, P=.04) were more likely to refuse COVID-19 vaccination irrespective of vaccination attributes. The BioNTech vaccine compared with Sinovac (adjusted odds ratio  [AOR]=1.75, 95\% CI 1.14-2.68), vaccine with 90\% (AOR=1.44, 95\% CI 1.09-1.91) and 70\% efficacy (AOR=1.21, 95\% CI 1.03-1.44) compared with 50\% efficacy, vaccine with fewer serious adverse events (1/100,000 compared with 1/10,000; AOR=1.12, 95\% CI 1.00-1.24), and quarantine exemption for cross-border travelers (AOR=1.14, 95\% CI 1.01-1.30) were the vaccine attributes that could increase the likelihood of vaccination among migrants. For individual-level factors, full-time homemakers (AOR=0.44, 95\% CI 0.29-0.66), those with chronic conditions (AOR=0.61, 95\% CI 0.41-0.91) and more children, and those who frequently received vaccine-related information from the workplace (AOR=0.42, 95\% CI 0.31-0.57) were found to be reluctant to accept the vaccine. Those with a higher income (AOR=1.79, 95\% CI 1.26-2.52), those knowing anyone infected with COVID-19 (AOR=1.73, 95\% CI 1.25-2.38), those having greater perceived susceptibility of COVID-19 infection (AOR=3.42, 95\% CI 2.52-4.64), those who received the influenza vaccine (AOR=2.15, 95\% CI 1.45-3.19), and those who frequently received information from social media (AOR=1.52, 95\% CI 1.12-2.05) were more likely to accept the vaccine. Conclusions: This study implies that migrants have COVID-19 vaccination preference heterogeneity and that more targeted and tailored approaches are needed to promote vaccine acceptance for different subgroups of the migrant population in Hong Kong. Vaccination promotion strategies are needed for low-education and low-income migrant groups, migrants with chronic diseases, the working migrant population, homemakers, and parents. ",
doi="10.2196/40587",
url="https://publichealth.jmir.org/2023/1/e40587",
url="http://www.ncbi.nlm.nih.gov/pubmed/36848242"
}


@Article{info:doi/10.2196/29155,
author="Chae, Steve
and Lee, Yoon-Jae
and Han, Hae-Ra",
title="Sources of Health Information, Technology Access, and Use Among Non--English-Speaking Immigrant Women: Descriptive Correlational Study",
journal="J Med Internet Res",
year="2021",
month="Oct",
day="29",
volume="23",
number="10",
pages="e29155",
keywords="technology use",
keywords="internet",
keywords="text messaging",
keywords="health literacy",
keywords="English proficiency",
keywords="immigrant",
keywords="health disparities",
keywords="Korean American",
keywords="women",
keywords="mobile phone",
abstract="Background: As the world is becoming increasingly connected by the World Wide Web, the internet is becoming the main source of health information. With the novel COVID-19 pandemic, ubiquitous use of the internet has changed the daily lives of individuals, from working from home to seeking and meeting with health care providers through web-based sites. Such heavy reliance on internet-based technologies raises concerns regarding the accessibility of the internet for minority populations who are likely to already face barriers when seeking health information. Objective: This study aims to examine the level of technology access and common modes of technology used by Korean American women and to investigate how key psychosocial determinants of health such as age, education, English proficiency, and health literacy are correlated with sources of health information used by Korean American women and by their use of the internet. Methods: We used data from a subsample of Korean American women (N=157) who participated in a community-based randomized trial designed to test a health literacy--focused cancer screening intervention. In addition to descriptive statistics to summarize Korean American women's internet access and common modes of technology use, we conducted backward stepwise logistic regression analyses to substantiate the association between the psychosocial determinants of health and internet use. Results: Approximately two-thirds (103/157, 65.6\%) of the sample had access to the internet, and nearly all had access to a mobile phone. The internet was the most commonly used channel to obtain health information 63\% (99/157), and 70\% (110/157) of the sample used text messaging. Nevertheless, only approximately 38.8\% (40/103) of the sample were very confident in using the internet, and only 29.9\% (47/157) were very confident in using text messaging. Multivariate analyses revealed that older age (>50 years) was associated with 79\% lower odds of using the internet to seek health information (adjusted odds ratio [AOR] 0.21, 95\% CI 0.10-0.46). The higher health literacy group (19+ on Rapid Estimate of Adult Literacy in Medicine) had 56\% lower odds of using the internet to acquire health information (AOR 0.44, 95\% CI 1.13-11.18). Higher education (college+) was associated with both internet use (AOR 4.42, 95\% CI 1.88-9.21) and text messaging (AOR 3.42, 95\% CI 1.55-7.54). Finally, English proficiency was associated with text messaging (AOR 4.20, 95\% CI 1.44-12.24). Conclusions: The differences in modes of technology access, use, and confidence by some of the key psychosocial determinants, as observed in our study sample, have important implications when health care teams develop dissemination plans. ",
doi="10.2196/29155",
url="https://www.jmir.org/2021/10/e29155",
url="http://www.ncbi.nlm.nih.gov/pubmed/34714249"
}


@Article{info:doi/10.2196/25947,
author="Yousef, Hind
and Al-Sheyab, Nihaya
and Al Nsour, Mohannad
and Khader, Yousef
and Al Kattan, Malika
and Bardus, Marco
and Alyahya, Mohammad
and Taha, Hana
and Amiri, Mirwais",
title="Perceptions Toward the Use of Digital Technology for Enhancing Family Planning Services: Focus Group Discussion With Beneficiaries and Key Informative Interview With Midwives",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="28",
volume="23",
number="7",
pages="e25947",
keywords="family planning",
keywords="mobile apps",
keywords="social media",
keywords="digital technology",
keywords="contraceptives",
abstract="Background: Modern family planning (FP) methods allow married couples to discuss and determine the number of children and years of spacing between them. Despite many significant improvements in FP services in Jordan, there are still many issues related to the uptake of FP services for both host communities and Syrian refugees, due to limitations in the health care system based on public health facilities. Digital technologies can provide opportunities to address the challenges faced in the health system, thus offering the potential to improve both coverage and quality of FP services and practices. Objective: The aim of this study was to explore the perceptions of Jordanian women, Syrian refugees, and midwives in Jordan toward the use of digital health technology to support and enhance access to FP services. Methods: We employed a qualitative study based on semistructured, face-to face key informative interviews with 17 midwives (providers) and focus group discussions with 32 married women of reproductive age (clients). Both midwives and clients were recruited from 9 health centers in 2 major governorates in Jordan (Irbid and Mafraq), where 17 in-depth interviews were conducted with midwives and 4 focus groups were conducted with the women. Each focus group included 4 Syrian refugees and 4 Jordanian women. The transcribed narratives were analyzed using inductive thematic analysis. Results: Three major themes were derived from the narratives analysis, which covered the pros of using digital technology, concerns about digital technology use, and the ideal app or website characteristics. Ten subthemes emerged from these 3 main themes. Overall, midwives and women (Syrian refugees and host communities) agreed that digital technology can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman's awareness and knowledge regarding the FP methods and their side effect. Furthermore, digital technology can assist in enabling women's empowerment, which will allow them to make better decisions regarding FP use. No harmful risks or consequences were perceived to be associated with using digital technology. However, several concerns regarding digital technology use were related to eHealth literacy and the accuracy of the information provided. Midwives were mainly concerned about the patients who would rely mostly on the technology and choose to avoid consulting a health care professional. Conclusions: As perceived by midwives and women, incorporating digital technology in FP services can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman's awareness regarding the FP methods and their side effect. It may also empower the women to play an active role in the shared (with their husband and family) decision-making process. Therefore, digital technologies are recommended to address the challenges faced in health system and to improve both the coverage and the quality of FP services and practices. ",
doi="10.2196/25947",
url="https://www.jmir.org/2021/7/e25947",
url="http://www.ncbi.nlm.nih.gov/pubmed/34319250"
}


@Article{info:doi/10.2196/27682,
author="Shah, K. Megha
and Gibbs, Christina Ashley
and Ali, K. Mohammed
and Narayan, Venkat K. M.
and Islam, Nadia",
title="Overcoming the Digital Divide in the Post--COVID-19 ``Reset'': Enhancing Group Virtual Visits with Community Health Workers",
journal="J Med Internet Res",
year="2021",
month="Jul",
day="8",
volume="23",
number="7",
pages="e27682",
keywords="community health workers",
keywords="COVID-19",
keywords="diabetes mellitus",
keywords="eHealth",
keywords="elderly",
keywords="health equity",
keywords="telemedicine",
keywords="virtual",
keywords="vulnerable populations",
doi="10.2196/27682",
url="https://www.jmir.org/2021/7/e27682",
url="http://www.ncbi.nlm.nih.gov/pubmed/34152995"
}


@Article{info:doi/10.2196/20988,
author="Kouvonen, Anne
and Kemppainen, Laura
and Ketonen, Eeva-Leena
and Kemppainen, Teemu
and Olakivi, Antero
and Wrede, Sirpa",
title="Digital Information Technology Use, Self-Rated Health, and Depression: Population-Based Analysis of a Survey Study on Older Migrants",
journal="J Med Internet Res",
year="2021",
month="Jun",
day="14",
volume="23",
number="6",
pages="e20988",
keywords="digital information technology",
keywords="older adults",
keywords="migrants",
keywords="health",
keywords="depression",
keywords="mobile phone",
abstract="Background: Previous studies have found that in general, poor health is associated with a lower likelihood of internet use in older adults, but it is not well known how different indicators of health are associated with different types of digital information technology (DIT) use. Moreover, little is known about the relationship between health and the types of DIT use in older ethnic minority and migrant populations. Objective: The aim of this study is to examine the associations among depressive symptoms and self-rated health (SRH) with different dimensions of DIT use in older migrants. Methods: We analyzed data from the Care, Health and Ageing of Russian-speaking Minority (CHARM) study, which is based on a nationally representative sample of community-dwelling, Russian-speaking adults aged 50 years or older residing permanently in Finland (men: 616/1082, 56.93\%; age: mean 63.2 years, SD 8.4 years; response rate: 1082/3000, 36.07\%). Data were collected in 2019 using a postal survey. Health was measured using depressive symptoms (measured using the Center for Epidemiologic Studies Depression Scale) and SRH. Binary logistic regression analyses were used to investigate the associations between the two health indicators and the following six outcomes: daily internet use, smartphone ownership, the use of the internet for messages and calls, social media use, the use of the internet for personal health data, and obtaining health information from the internet. A number of sociodemographic and socioeconomic factors were controlled for in the logistic regression regression analysis. Analyses were performed with weights accounting for the survey design and nonresponse. Results: After adjusting for sociodemographic and socioeconomic factors, depressive symptoms (odds ratio [OR] 2.68, 95\% CI 1.37-5.24; P=.004) and poor SRH (OR 7.90, 95\% CI 1.88-33.11; P=.005) were associated with a higher likelihood of not using the internet daily. Depressive symptoms (OR 1.88, 95\% CI 1.06-3.35; P=.03) and poor SRH (OR 5.05, 95\% CI 1.58-16.19; P=.006) also increased the likelihood of smartphone nonuse. Depressive symptoms were additionally associated with a lower likelihood of social media use, and poor SRH was associated with a lower likelihood of using the internet for messaging and calling. Conclusions: Poor SRH and depressive symptoms are associated with a lower likelihood of DIT use in older adults. Longitudinal studies are required to determine the directions of these relationships. ",
doi="10.2196/20988",
url="https://www.jmir.org/2021/6/e20988",
url="http://www.ncbi.nlm.nih.gov/pubmed/34125069"
}


@Article{info:doi/10.2196/25131,
author="Thonon, Fr{\'e}d{\'e}rique
and Perrot, Swati
and Yergolkar, Vithal Abhijna
and Rousset-Torrente, Olivia
and Griffith, W. James
and Chassany, Olivier
and Duracinsky, Martin",
title="Electronic Tools to Bridge the Language Gap in Health Care for People Who Have Migrated: Systematic Review",
journal="J Med Internet Res",
year="2021",
month="May",
day="6",
volume="23",
number="5",
pages="e25131",
keywords="eHealth",
keywords="systematic review",
keywords="migrants",
keywords="health literacy",
keywords="access to care",
keywords="health promotion",
abstract="Background: People who have migrated or with a language barrier may face significant hurdles in accessing health care. Some apps have been specifically developed to facilitate the dialogue between health care professionals and people who have migrated who have low-level language proficiency or to promote health among people who have migrated. Objective: We conducted a systematic review to investigate  development, acceptability, and effectiveness of these types of apps. Methods: We conducted a search of PubMed, Scopus, and Embase databases. We included all study designs (qualitative, quantitative, mixed) reporting development, evaluation of efficacy, or acceptability of apps facilitating dialogue with a health professional or promoting health for people who have migrated, minorities, or tourists with a language barrier, using any outcome. Two researchers selected the studies independently. We collected general information about the app, information about health literacy and cultural adaptation, information about the development of the app, evidence on acceptability or efficacy, and information on app use. Data were collected by 2 researchers independently and results were reviewed to verify agreement and reported according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis). Results: Positive results for translation apps included better communication, but with possible limitations, and reduced consultation time. Positive results for health promotion apps included improved quality of life and better management of chronic illnesses. Conclusions: Overall, the apps had good levels of acceptability, though only half had their efficacy evaluated. In those evaluations, the endpoints were mostly related to reported behavior change and knowledge improvement, which is common for evaluations of health promotion programs. In the future, as more health apps are created, it is essential that apps that claim to have a public health objective undergo a rigorous evaluation of their acceptability, efficacy, and actual use. Indicators of outcomes beyond changes in behavior and knowledge should be reported; change in health status or access to care should also be reported. This systematic review has helped us note the characteristics associated with improved acceptability and efficacy, which can be helpful for the development of future apps. ",
doi="10.2196/25131",
url="https://www.jmir.org/2021/5/e25131",
url="http://www.ncbi.nlm.nih.gov/pubmed/33955837"
}


@Article{info:doi/10.2196/22345,
author="Lovey, Thibault
and O'Keeffe, Paul
and Petignat, Ianis",
title="Basic Medical Training for Refugees via Collaborative Blended Learning: Quasi-Experimental Design",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="24",
volume="23",
number="3",
pages="e22345",
keywords="refugees",
keywords="blended learning",
keywords="basic medical training",
keywords="higher education in emergencies",
keywords="innovation",
keywords="mobile phone",
abstract="Background: Globally, there is an excess of 68.5 million people who have been forced to leave their homes and seek sanctuary elsewhere because of poverty, persecution, conflict, violence, and human rights violations. Although international humanitarian responses usually focus on ensuring that the basic needs of these people are being met, there is growing attention on the role that development-oriented interventions can play in the longer term. Higher education in a refugee context is one such intervention that can equip refugees with the knowledge and skills they need to serve their communities and move forward. Objective: This study aims to evaluate the outcomes and effectiveness of the University of Geneva InZone-Raft Basic Medical Training Course in the Kakuma refugee camp in Kenya compared with a previous incarnation of the same course in the Dadaab refugee camp in Kenya. Methods: We used a quasi-experimental design to compare the posttest scores of both inequivalent student groups: control group (n=18) and intervention group (n=16). Factors that influenced refugee students' knowledge acquisition, the amount of knowledge they acquired, and their academic outcomes were assessed, and the pedagogical evolution of the project is presented. Results: We found that the Kakuma intervention course yielded better outcomes and was more effective in terms of learning than the Dadaab control course. Of the 16 students who took part in the intervention course, 10 (63\%) completed the program successfully and received accreditation from the University of Geneva. We observed that they received new knowledge well and scored higher on all learning modalities than those in the control course. Comparison of written and oral examinations between the courses showed statistical significance for the intervention group in written and oral exams (two-tailed: P=.006 and P=.05; one-tailed: P=.003 and P=.03, respectively). The Kakuma course was not effective in addressing electricity and internet access problems, nor in reducing the challenge of tight deadlines in the syllabus. Pedagogical adjustments to the intervention course improved student involvement, with higher participation rates in quizzes (10/11, 91\%), and overall satisfaction and learning. Conclusions: The intervention group---with an improved mode of delivery, better contextualized content, and further interaction---reached a higher level of medical knowledge acquisition and developed more complex questions on medical topics than the control group. The positive outcome of this project shows that given the right resources and support, refugees can contribute to the improvement and development of health care in their communities. Nonetheless, a more focused effort is necessary to meet the educational needs of refugee learners and better understand their living conditions. ",
doi="10.2196/22345",
url="https://www.jmir.org/2021/3/e22345",
url="http://www.ncbi.nlm.nih.gov/pubmed/33759802"
}


@Article{info:doi/10.2196/24807,
author="R{\"o}hr, Susanne
and Jung, U. Franziska
and Pabst, Alexander
and Grochtdreis, Thomas
and Dams, Judith
and Nagl, Michaela
and Renner, Anna
and Hoffmann, Rahel
and K{\"o}nig, Hans-Helmut
and Kersting, Anette
and Riedel-Heller, G. Steffi",
title="A Self-Help App for Syrian Refugees With Posttraumatic Stress (Sanadak): Randomized Controlled Trial",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Jan",
day="13",
volume="9",
number="1",
pages="e24807",
keywords="app",
keywords="cost-utility analysis",
keywords="mHealth",
keywords="posttraumatic stress",
keywords="PTSD",
keywords="quality-adjusted life years",
keywords="randomized controlled trial",
keywords="refugees",
keywords="stimga",
keywords="Syrian refugees",
keywords="usability",
abstract="Background: Syrian refugees residing in Germany often develop posttraumatic stress as a result of the Syrian civil war, their escape, and postmigration stressors. At the same time, there is a lack of adequate treatment options. The smartphone-based app Sanadak was developed to provide cognitive behavioral therapy--based self-help in the Arabic language for Syrian refugees with posttraumatic stress. Objective: The aim of this study was to evaluate the effectiveness and cost-effectiveness of the app. Methods: In a randomized controlled trial, eligible individuals were randomly allocated to the intervention group (IG; app use) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects linear regression models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis. Cost-effectiveness was evaluated based on adjusted mean total costs, quality-adjusted life years (QALYs), and cost-effectiveness acceptability curves using the net benefit approach. Results: Of 170 screened individuals (aged 18 to 65 years), 133 were eligible and randomized to the IG (n=65) and CG (n=68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between the IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff --0.90, 95\% CI --0.24 to 0.47; P=.52) and after 4 months (Diff --0.39, 95\% CI --3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma: after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS--stereotype agreement: d=0.86, 95\% CI 0.46 to 1.25; stereotype application: d=0.60, 95\% CI 0.22 to 0.99) and after 4 months (d=0.52, 95\% CI 0.12 to 0.92; d=0.50, 95\% CI 0.10 to 0.90), the IG showed significantly lower values in self-stigma than the CG. ITT showed no significant group differences in total costs and QALYs. The probability of cost-effectiveness was 81\% for a willingness-to-pay of {\texteuro}0 per additional QALY but decreased with increasing willingness-to-pay. Conclusions: Sanadak was not more effective in reducing mild to moderate posttraumatic stress in Syrian refugees than the control condition nor was it likely to be cost-effective. Therefore, Sanadak is not suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach. Trial Registration: German Clinical Trials Register DRKS00013782; https://www.drks.de/drks\_web/navigate.do?navigationId=trial.HTML\&TRIAL\_ID=DRKS00013782 International Registered Report Identifier (IRRID): RR2-10.1186/s12888-019-2110-y ",
doi="10.2196/24807",
url="http://mhealth.jmir.org/2021/1/e24807/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33439140"
}


@Article{info:doi/10.2196/21238,
author="Sungur, Hande
and Y?lmaz, Gizem Nida
and Chan, Chu Brittany Ming
and van den Muijsenbergh, C. Maria E. T.
and van Weert, M. Julia C.
and Schouten, C. Barbara",
title="Development and Evaluation of a Digital Intervention for Fulfilling the Needs of Older Migrant Patients With Cancer: User-Centered Design Approach",
journal="J Med Internet Res",
year="2020",
month="Oct",
day="26",
volume="22",
number="10",
pages="e21238",
keywords="cancer",
keywords="patient participation",
keywords="health services needs and demand",
keywords="eHealth",
keywords="migrants",
keywords="physician-patient relations",
keywords="culture",
keywords="mobile phone",
abstract="Background: Older migrant patients with cancer face many language- and culture-related barriers to patient participation during medical consultations. To bridge these barriers, an eHealth tool called Health Communicator was developed in the Netherlands. Essentially used as a digital translator that can collect medical history information from patients, the Health Communicator did not include an oncological module so far, despite the fact that the prevalence of Dutch migrant patients with cancer is rising. Objective: This study aims to systematically develop, implement, and conduct a pilot evaluation of an oncological module that can be integrated into the Health Communicator to stimulate patient participation among older Turkish-Dutch and Moroccan-Dutch patients with cancer. Methods: The Spiral Technology Action Research model, which incorporates 5 cycles that engage key stakeholders in intervention development, was used as a framework. The listen phase consisted of a needs assessment. The plan phase consisted of developing the content of the oncological module, namely the question prompt lists (QPLs) and scripts for patient education videos. On the basis of pretests in the do phase, 6 audiovisual QPLs on patient rights, treatment, psychosocial support, lifestyle and access to health care services, patient preferences, and clinical trials were created. Additionally, 5 patient education videos were created about patient rights, psychosocial support, clinical trials, and patient-professional communication. In the study phase, the oncological module was pilot-tested among 27 older Turkish-Dutch and Moroccan-Dutch patients with cancer during their consultations. In the act phase, the oncological model was disseminated to practice. Results: The patient rights QPL was chosen most often during the pilot testing in the study phase. Patients and health care professionals perceived the QPLs as easy to understand and useful. There was a negative correlation between the tool's ease of use and patient age. Patients reported that using the module impacted the consultations positively and thought they were more active compared with previous consultations. Health care professionals also found patients to be more active than usual. Health care professionals asked significantly more questions than patients during consultations. Patients requested to see the patients' rights video most often. Patients rated the videos as easy to understand, useful, and informative. Most of the patients wanted to use the tool in the future. Conclusions: Older migrant patients with cancer, survivors, and health care professionals found the oncological module to be a useful tool and have shown intentions to incorporate it into future consultation sessions. Both QPLs and videos were evaluated positively, the latter indicating that the use of narratives to inform older, low-literate migrant patients with cancer about health-related topics in their mother tongue is a viable approach to increase the effectiveness of health care communication with this target group. ",
doi="10.2196/21238",
url="http://www.jmir.org/2020/10/e21238/",
url="http://www.ncbi.nlm.nih.gov/pubmed/33104008"
}


@Article{info:doi/10.2196/17906,
author="Zehetmair, Catharina
and Nagy, Ede
and Leetz, Carla
and Cranz, Anna
and Kindermann, David
and Reddemann, Luise
and Nikendei, Christoph",
title="Self-Practice of Stabilizing and Guided Imagery Techniques for Traumatized Refugees via Digital Audio Files: Qualitative Study",
journal="J Med Internet Res",
year="2020",
month="Sep",
day="23",
volume="22",
number="9",
pages="e17906",
keywords="stabilizing techniques",
keywords="guided imagery",
keywords="refugees",
keywords="qualitative analyses",
keywords="posttraumatic stress disorder",
keywords="mental health",
keywords="PTSD",
keywords="audio",
keywords="therapy",
abstract="Background: Refugees have an increased risk of developing mental health problems. There are insufficient psychosocial care structures to meet the resulting need for support. Stabilizing and guided imagery techniques have shown promising results in increasing traumatized refugees' emotional stabilization. If delivered via audio files, the techniques can be practiced autonomously and independent of time, space, and human resources or stable treatment settings. Objective: This study aimed to evaluate the self-practice of stabilizing and guided imagery techniques via digital audio files for traumatized refugees living in a reception and registration center in Germany. Methods: From May 2018 to February 2019, 42 traumatized refugees participated in our study. At T1, patients received digital audio files in English, French, Arabic, Farsi, Turkish, or Serbian for self-practice. Nine days later, at T2, a face-to-face interview was conducted. Two months after T2, a follow-up interview took place via telephone. Results: At T2, about half of the patients reported the daily practice of stabilizing and guided imagery techniques. At follow-up, the average frequency of practice was once weekly or more for those experiencing worse symptoms. No technical difficulties were reported. According to T2 and follow-up statements, the techniques helped the patients dealing with arousal, concentration, sleep, mood, thoughts, empowerment, and tension. The guided imagery technique ``The Inner Safe Place'' was the most popular. Self-practice was impeded by postmigratory distress factors, like overcrowded accommodations. Conclusions: The results show that self-practice of stabilizing and guided imagery techniques via digital audio files was helpful to and well accepted by the assessed refugees. Even though postmigratory distress factors hampered self-practice, ``The Inner Safe Place'' technique was particularly well received. Overall, the self-practiced audio-based stabilizing and guided imagery techniques showed promising results among the highly vulnerable group of newly arrived traumatized refugees. ",
doi="10.2196/17906",
url="http://www.jmir.org/2020/9/e17906/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32965229"
}


@Article{info:doi/10.2196/19168,
author="Nwoke, Nmanma Chinenye
and Okpalauwaekwe, Udoka
and Bwala, Hauwa",
title="Mental Health Professional Consultations and the Prevalence of Mood and Anxiety Disorders Among Immigrants: Multilevel Analysis of the Canadian Community Health Survey",
journal="JMIR Ment Health",
year="2020",
month="Sep",
day="16",
volume="7",
number="9",
pages="e19168",
keywords="immigrants",
keywords="immigrant mental health",
keywords="mental health consultations",
keywords="mood disorders",
keywords="anxiety disorders",
keywords="mental health visits",
keywords="Canadian Community Health Survey",
abstract="Background: There is a significant body of evidence on the link between migration and mental health stressors. However, there has been very little research on the use of mental health services by immigrants in Canada. The prevalence of mental health professional consultations among immigrants, as well as its correlations, are not well understood and remain largely unknown. Objective: This study aims to examine how specialist mental health visits (to a psychiatrist) differ from general mental health visits (to a family doctor or general practitioner) from immigrants, when compared to visits from those born in Canada, in a nationally representative sample of Canadian adults. This study also examines which group---immigrant or Canadian-born---suffers more from depression or anxiety, 2 of the more common mental health conditions. Methods: We used data from the Canadian Community Health Survey (CCHS) between the years 2015 and 2016. The outcome variables included consultation with any mental health professional, consultation with a specialist (psychiatrist), and the prevalence of mood and anxiety disorders. The independent variable was immigrant status. Other variables of interest were adjusted for in the analyses. Multilevel regression models were developed, and all analyses were performed with Stata IC statistical software (version 13.0, StataCorp). Results: The prevalence of mood and anxiety disorders was significantly lower among immigrants compared with individuals born in Canada; the prevalence of mood disorders was 5.24\% (389,164/7,422,773) for immigrants vs. 9.15\% (2,001,829/21,885,625) for individuals born in Canada, and the prevalence of anxiety disorders was 4.47\% (330,937/7,410,437) for immigrants vs. 9.51\% (2,083,155/21,898,839) for individuals born in Canada. It is expected that individuals with a lower prevalence of mood or anxiety disorders would use mental health services less frequently. However, results show that immigrants, while less likely to consult with any mental health professional (OR=0.80, 95\% CI 0.72-0.88, P<.001), were more likely to consult with a psychiatrist (OR=1.24, 95\% CI 1.04-1.48, P=.02) for their mental health visits when compared to individuals born in Canada. Conclusions: The results of this study reveal an unusual discord between the likelihood of mental health professional consultations with any mental health professional and mental health visits with psychiatrists among immigrants compared to nonimmigrants in Canada. Mental health initiatives need to be cognizant of the differences in the associated characteristics of consultations for immigrants to better tailor mental health services to be responsive to the unique needs of immigrant populations in Canada. ",
doi="10.2196/19168",
url="http://mental.jmir.org/2020/9/e19168/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32801115"
}


@Article{info:doi/10.2196/19031,
author="Raphiphatthana, Buaphrao
and Maulana, Herdiyan
and Howarth, Timothy
and Gardner, Karen
and Nagel, Tricia",
title="Digital Mental Health Resources for Asylum Seekers, Refugees, and Immigrants: Protocol for a Scoping Review",
journal="JMIR Res Protoc",
year="2020",
month="Aug",
day="24",
volume="9",
number="8",
pages="e19031",
keywords="eHealth",
keywords="migrant",
keywords="refugee",
keywords="scoping review",
keywords="immigrant",
abstract="Background: Asylum seekers, refugees, and immigrants experience a number of risk factors for mental health problems. However, in comparison to the host population, these populations are less likely to use mental health services. Digital mental health approaches have been shown to be effective in improving well-being for the general population. Thus, they may provide an effective and culturally appropriate strategy to bridge the treatment gap for these populations vulnerable to mental health risks. Objective: This paper aims to provide the background and rationale for conducting a scoping review on digital mental health resources for asylum seekers, refugees, and immigrants. It also provides an outline of the methods and analyses, which will be used to answer the following questions. What are the available digital mental health resources for asylum seekers, refugees, and immigrants? Are they effective, feasible, appropriate, and accepted by the population? What are the knowledge gaps in the field? Methods: The scoping review methodology will follow 5 phases: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the results. Searches will be conducted in the following databases: EBSCOhost databases (CINAHL Plus with Full Text, MEDLINE with Full Text, APA PsycArticles, Psychology and Behavioral Sciences Collection, and APA PsycInfo), PubMed, and Scopus. Additionally, OpenGrey, Mednar, and Eldis will be searched for gray literature. All primary studies and gray literature in English concerning the use of information and communication technology to deliver services addressing mental health issues for asylum seekers, refugees, and immigrants will be included. Results: This scoping review will provide an overview of the available digital mental health resources for asylum seekers, refugees, and immigrants and describe the implementation outcomes of feasibility, acceptability, and appropriateness of such approaches for those populations. Potential gaps in the field will also be identified. Conclusions: As of February 2020, there were no scoping reviews, which assessed the effectiveness, feasibility, acceptability, and appropriateness of the available digital mental health resources for asylum seekers, refugees, and immigrants. This review will provide an extensive coverage on a promising and innovative intervention for such populations. It will give insight into the range of approaches, their effectiveness, and progress in their implementation. It will also provide valuable information for health practitioners, policy makers, and researchers working with the population. International Registered Report Identifier (IRRID): PRR1-10.2196/19031 ",
doi="10.2196/19031",
url="http://www.researchprotocols.org/2020/8/e19031/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32831185"
}


@Article{info:doi/10.2196/18183,
author="Saleh, Shadi
and El Arnaout, Nour
and Abdouni, Lina
and Jammoul, Zeinab
and Hachach, Noha
and Dasgupta, Amlan",
title="Sijilli: A Scalable Model of Cloud-Based Electronic Health Records for Migrating Populations in Low-Resource Settings",
journal="J Med Internet Res",
year="2020",
month="Aug",
day="13",
volume="22",
number="8",
pages="e18183",
keywords="eHealth",
keywords="digital health",
keywords="innovation",
keywords="refugees",
keywords="low- and middle-income countries",
keywords="technology",
doi="10.2196/18183",
url="http://www.jmir.org/2020/8/e18183/",
url="http://www.ncbi.nlm.nih.gov/pubmed/32788145"
}


@Article{info:doi/10.2196/14283,
author="Talhouk, Reem
and Akik, Chaza
and Araujo-Soares, Vera
and Ahmad, Balsam
and Mesmar, Sandra
and Olivier, Patrick
and Balaam, Madeline
and Montague, Kyle
and Garbett, Andrew
and Ghattas, Hala",
title="Integrating Health Technologies in Health Services for Syrian Refugees in Lebanon: Qualitative Study",
journal="J Med Internet Res",
year="2020",
month="Jul",
day="6",
volume="22",
number="7",
pages="e14283",
keywords="Syrian refugees",
keywords="Lebanon",
keywords="health technologies",
keywords="eHealth",
keywords="mHealth",
keywords="primary health care",
abstract="Background: Lebanon currently hosts around one million Syrian refugees. There has been an increasing interest in integrating eHealth and mHealth technologies into the provision of primary health care to refugees and Lebanese citizens. Objective: We aimed to gain a deeper understanding of the potential for technology integration in primary health care provision in the context of the protracted Syrian refugee crisis in Lebanon. Methods: A total of 17 face-to-face semistructured interviews were conducted with key informants (n=8) and health care providers (n=9) involved in the provision of health care to the Syrian refugee population in Lebanon. Interviews were audio recorded and directly translated and transcribed from Arabic to English. Thematic analysis was conducted. Results: Study participants indicated that varying resources, primarily time and the availability of technologies at primary health care centers, were the main challenges for integrating technologies for the provision of health care services for refugees. This challenge is compounded by refugees being viewed by participants as a mobile population thus making primary health care centers less willing to invest in refugee health technologies. Lastly, participant views regarding the health and technology literacies of refugees varied and that was considered to be a challenge that needs to be addressed for the successful integration of refugee health technologies. Conclusions: Our findings indicate that in the context of integrating technology into the provision of health care for refugees in a low or middle income country such as Lebanon, some barriers for technology integration related to the availability of resources are similar to those found elsewhere. However, we identified participant views of refugees' health and technology literacies to be a challenge specific to the context of this refugee crisis. These challenges need to be addressed when considering refugee health technologies. This could be done by increasing the visibility of refugee capabilities and configuring refugee health technologies so that they may create spaces in which refugees are empowered within the health care system and can work toward debunking the views discovered in this study. ",
doi="10.2196/14283",
url="https://www.jmir.org/2020/7/e14283",
url="http://www.ncbi.nlm.nih.gov/pubmed/32628121"
}


@Article{info:doi/10.2196/11465,
author="El-Khatib, Ziad
and Taus, Karin
and Richter, Lukas
and Allerberger, Franz
and Schmid, Daniela",
title="A Syndrome-Based Surveillance System for Infectious Diseases Among Asylum Seekers in Austrian Reception Centers, 2015-2018: Analysis of Reported Data",
journal="JMIR Public Health Surveill",
year="2019",
month="Feb",
day="27",
volume="5",
number="1",
pages="e11465",
keywords="Austria",
keywords="refugee health",
keywords="asylum seekers",
keywords="syndrome surveillance system",
keywords="mass health monitoring",
keywords="refugees",
keywords="population surveillance",
keywords="public health surveillance",
keywords="epidemiological monitoring",
abstract="Background: Austria has been among the main European countries hosting incoming asylum seekers since 2015. Consequently, there was an urgent need to predict any public health threats associated with the arriving asylum seekers. The Department of Surveillance and Infectious Disease Epidemiology at the Austrian Agency for Health and Food Safety (AGES) was mandated to implement a national syndrome-based surveillance system in the 7 reception centers by the Austrian Ministry of Interior and Ministry of Health. Objective: We aimed to analyze the occurrence and spread of infectious diseases among asylum seekers using data reported by reception centers through the syndrome-based surveillance system from September 2015 through February 2018. Methods: We deployed a daily data collection system for 13 syndromes: rash with fever; rash without fever; acute upper respiratory tract infection; acute lower respiratory tract infection; meningitis or encephalitis; fever and bleeding; nonbloody gastroenteritis or watery diarrhea; bloody diarrhea; acute jaundice; skin, soft tissue, or bone abnormalities; acute flaccid paralysis; high fever with no other signs; and unexplained death. General practitioners, the first professionals to consult for health problems at reception centers in Austria, sent the tally sheets on identified syndromes daily to the AGES. Results: We identified a total of 2914 cases, presenting 8 of the 13 syndromes. A total of 405 signals were triggered, and 6.4\% (26/405) of them generated alerts. Suspected acute upper respiratory tract infection (1470/2914, 50.45\% of cases), rash without fever (1174/2914, 40.29\% of cases), suspected acute lower respiratory tract infection (159/2914, 5.46\% of cases), watery diarrhea (73/2914, 2.51\% of cases), and skin, soft tissue, or bone abnormalities (32/2914, 1.10\% of cases) were the top 5 syndromes. Conclusions: The cooperation of the AGES with reception center health care staff, supported by the 2 involved ministries, was shown to be useful for syndromic surveillance of infectious diseases among asylum seekers. None of the identified alerts escalated to an outbreak. ",
doi="10.2196/11465",
url="http://publichealth.jmir.org/2019/1/e11465/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30810535"
}