Background: California has accepted more refugees and holders of special immigrant visas (SIVs) than any other US state since 2002. In fact, California welcomed over 127,000 forced migrants between 2003 and 2016. Forced migration is a known risk factor for decreasing women’s access to and utilization of sexual and reproductive health (SRH) services, yet very few studies have gone beyond this observation to explore how to address this unequal access in the resettlement context. Though further research in this area is urgently needed, refugee women are currently not active research patient partners due to assumptions about linguistic barriers or that SRH is too culturally sensitive to discuss with these populations. Consequently, previous research in this area has not benefited from the wealth of knowledge gained through engagement with refugee women themselves.
Proposed Solution: Building upon established local partnerships between community members, organizations, and academics, the project team proposes to develop a statewide Refugee Reproductive Health Network (ReproNet) engaged in regular communication, coordination, and collaboration. This interdisciplinary group of patient partners, clinicians, researchers, community leaders, and social service organizations will work together to develop a framework that prioritizes a patient-driven research agenda that reflects priorities set by refugee women in relation to SRH services.
Objectives: ReproNet will accomplish the following specific aims: strengthen regional refugee-academic-community partnerships through the formation of a network with local branches in San Diego and Sacramento/Central Valley, California; engage in dialogue with refugee communities to investigate their preferences for SRH and well-woman care; and develop a research and policy agenda (ResPA) for future collaborative PCOR with refugee women. ReproNet will consist of a governance board (GB), a patient task force (PTF), and a panel of research and service providers (PRSP).
Activities: The GB and PTF will prioritize engagement of refugee women throughout the development of the ReproNet infrastructure and continually reevaluate whether this network is making research engagement accessible, transparent, and equitable for refugee patient partners.
Outcomes and Outputs: The capacity building initiative will culminate in a statewide symposium on refugee SRH at which refugee patient partners will engage in dialogue with researchers, clinicians, policy makers, social service providers, and community stakeholders to identify best practices for PCOR and models for patient engagement with refugee populations and to inform the research and policy agenda.
Patient and Stakeholder Engagement Plan: The PFT will include patient partners who will represent diverse state regions (Southern California and Northern California) and diverse refugee groups, mainly from Afghanistan, Iraq, Iran, Syria, Democratic Republic of Congo, and Somalia. The PTF will meet quarterly. The PRSP will include stakeholders such as researchers, refugee service providers, and clinicians caring for refugee women will meet quarterly. The GB comprised of PTF leaders and PRSP researchers will meet monthly and set the norms/policies for ReproNet.
Project Collaborators: The proposed study will be led by UCSF, with subcontracts to UC San Diego and UC Davis to enhance statewide representation of researchers and refugee women.