Introduction to the U.S. Healthcare System for Afghan Refugees: An Educational Intervention

Abstract

Purpose: The purpose of this quality improvement (QI) project is to facilitate client education on accessing care in the United States (U.S.) healthcare system through the provision of a handout to volunteers at Northern Virginia Resettling Afghan Families Together (NoVA RAFT), a local refugee organization. Background: There is a general lack of understanding among people newly arriving to the United States regarding how to navigate the U.S. healthcare system, including confusion over the various levels of care (i.e., ER vs. urgent care vs. primary care) and health insurance coverage and eligibility. NoVA RAFT volunteers have confirmed this knowledge deficit and have expressed a desire for educational tools to provide to clients so that they may successfully navigate the U.S. healthcare system. Methods: A handout was created to provide an overview of healthcare in the U.S., including a review of the levels of care (primary vs. urgent care vs. ER) and options for payment and insurance methods, as well as information on resources available in Northern Virginia to help displaced persons from Afghanistan access and pay for care. A quantitative survey was used to assess volunteers' knowledge, confidence, satisfaction, and practice intent in their ability to use these tools in working with their Afghan clients. Findings were used to improve the educational tools and recommendations made for implementation. Results: Overall, the survey participants confirmed that their clients would benefit from the education included in the handout and provided useful critiques and suggestions for further improvements to the handout prior to dissemination. Of the 15 participants who completed the survey, the majority indicated that their confidence and intent to share the intervention increased after reviewing the handout. The participants were also generally satisfied with the intervention. Conclusion: The educational handout given to volunteers at NoVA RAFT to facilitate client education on navigation of the U.S. healthcare system and connection to local health resources was successful in improving the volunteers’ confidence in assisting their clients and intent to share the included resources and information. Once suggestions for improvement are implemented and translation of the handout is complete, physical and virtual copies of the handout should be made available to the clients at NoVA RAFT at all classes and events.