Identifying barriers and facilitators to screening for depression among newcomers: a survey study
Notice bibliographique
Résumé
Background And Research Aim: Clinical depression among newcomers (immigrants, refugees, and/or asylum seekers) is a significant concern, and guidelines remain unclear on effective screening methods. There are patient-level, provider-level, and system-level factors that contribute to screening challenges, such as (but not limited to) lack of allied health supports, limited community services for positive screens, and unavailability of language translation services. This study aims to survey office-based family physicians in the Kingston, Frontenac, Lennox, and Addington (KFL&A) region of Ontario, Canada to identify potential facilitators and barriers to screening. Methods: A 10-minute online survey was developed using the Qualtrics platform, guided by the following working hypotheses: 1) Most family physicians in the region are not routinely screening newcomers for clinical depression. 2) Barriers to routine screening will include lack of time during clinical encounters, lack of personnel to complete screening, the inability to facilitate continuity of care with the correct mental health services, and potentially stigma around mental health conversations. 3) Facilitators to routine screening will include allied health teams that can screen before clinical visits, practice-type (notably team-based care models), geographical location (urban compared to rural), and access to continued mental health services. Data will be analyzed with descriptive, bivariate, and multivariable statistical methods. To enhance content validity and clarity, a structured pre-testing process was pursued. Experts in the field of newcomer medicine were consulted first for their feedback, followed by feedback from another set of physicians working in diverse practice models, ahead of finalizing the questionnaire. The survey questionnaire is now being actively circulated across the KFL&A region and data collection is ongoing. Preliminary results will be shared at the conference. Next Steps And Possible Future Research Directions: The next steps of this research include completing data collection and analysis and disseminating results to both academic audiences and regional health policy leadership. If research resources allow expansion into a mixed-methods project, we may add a qualitative component with semi-structured interviews of physicians to further understand their experiences. The survey questionnaire (and potentially interview guide, if expanded) may be eventually adapted for scale-up research to examine the perspectives of physicians from across Canada and internationally. Significance And Implications: Newcomers represent an equity-deserving group facing significant challenges in both health and social status; thus, this research is meaningful from an Equity, Diversity, and Inclusion (EDI) lens. Previous studies have evaluated the efficacy of screening, but there is limited research on the implementation of screening and on understanding the barriers family physicians face. Research results can inform improvement of local, culturally appropriate resources and screening approaches. Investigating primary and secondary prevention of newcomer mental health leads into the conversation of better implementing allied health into care teams. This research can inform expansion of culturally competent team-based care that is integrated with allied health and community services. By critically evaluating our current policies, this research may provide suggestions for new, more holistic practices that aim for collaborative efforts within communities.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».