Document Type

Capstone Experience

Graduation Date

8-2023

Degree Name

Master of Public Health

Department

Health Promotion

First Committee Member

Dejun Su, PhD

Second Committee Member

Megan S Kelley, PhD, CHES

Third Committee Member

Michelle Howell Smith

Abstract

Background: Refugees in the US are at increased risk of poor health outcomes, spanning mental health and general well-being, compared with American-born individuals. With the rapid growth of the refugee population in Nebraska, the need to train healthcare providers to provide culturally competent care has never been greater. A common point of access to healthcare for the refugee population after resettlement is via local health departments and the primary healthcare network. Recent estimates show close to five thousand Yazidi refugees living in Nebraska, most of whom moved after 2009 based on federal legislation admitting those who served in the US Army in Iraq. Building on findings from previous work (Rashoka et al., 2022), this study examines a Yazidi-focused cultural competence training for healthcare providers in Nebraska.

Methods: A convenience sample of 45 healthcare providers were selected, with 32 completing pre- and post-survey tests and open-ended questionnaires developed based on 3 focus group meetings. Due to COVID-19, online materials were used instead of in-person sessions. A pre-intervention survey on Yazidi culture, language, dialect, and trauma experiences was administered, followed by an educational video. A post-test survey was conducted and McNemar tests and descriptive tests were used to compare the pretest and post-test scores.

Results: The intervention led to significant improvements in knowledge about the number of Yazidi refugees in Nebraska (p < 0.001) and their language and dialect (p < 0.004). The majority of healthcare providers were satisfied with the training (69% very satisfied, 23% somewhat satisfied) and found the Information helpful (68.6% very helpful, 22.9% somewhat helpful). Most participants felt they would be able to use the Information in the training (40% right away, 53.2% eventually) and found it understandable (74.3% very understandable, 17.1% somewhat). Almost all (96.9%) approved of the training's design. Conclusion: This pilot study demonstrates that the culturally informed intervention effectively improved healthcare providers' knowledge of working with Yazidi refugee patients. Implementing educational workshops on working with specific refugee groups, particularly those who have experienced trauma, may help improve health outcomes and reduce disparities.

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