Developing a Sexual Health Consent Strategy for Refugees: A Qualitative Approach

Authors

Amita Tuteja, Department of General Practice, University of Melbourne, Parkville, Victoria, AustraliaFollow
Elisha Riggs, Intergenerational Health, Murdoch Children’s Research Institute, 50, Flemington Road, Flemington, Victoria, Australia; Department of General Practice, University of Melbourne, Parkville, Victoria, AustraliaFollow
Lena Sanci, Department of General Practice, University of Melbourne, Parkville, Victoria, AustraliaFollow
Lester Mascarenhas, Utopia Refugee and Asylum Seekers Health, 5 Alexandra Avenue, Hoppers Crossing, Victoria, Australia ;Department of General Practice, University of Melbourne, Parkville, Victoria, AustraliaFollow
Anna Power, Department of General Practice, University of Melbourne, Parkville, Victoria, AustraliaFollow
Di VanVliet, Utopia Refugee and Asylum Seekers Health, 5 Alexandra Avenue, Hoppers Crossing, Victoria, AustraliaFollow
Katrina Sangster, Immigrant Health Service, Department of General Medicine, The Royal Children’s Hospital, Melbourne, , 50 Flemington Road, Parkville, Victoria, AustraliaFollow
Kimberley McGuinness, Isis Primary Care, 122 Harvester Road, Sunshine, Victoria, AustraliaFollow
Meredith Temple-Smith, Department of General Practice, University of Melbourne, Parkville, Victoria, AustraliaFollow

Abstract

We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, (c) usefulness of individual consent discussions with potential participants, and (d) need for verification of voluntary participation prior to research interview. Results were used to develop a three-stage process of research consent. The first stage comprises of community information sessions to introduce concepts of research including explanations of voluntary participation and informed consent. Secondly, consent discussions for interested participants are undertaken with their preferred interpreter. Finally, voluntary participation is confirmed just prior to the interview. This three-stage process of research consent will serve as a useful tool for PRS to support cross cultural SRH research interactions involving interpreters and participants.

Keywords

consent, sexual health research, reproductive health research, refugees, migrants, Burma, Myanmar, qualitative descriptive research

Author Bio(s)

Amita Tuteja (MS (Obstetrics and Gynaecology), DNB, MRCOG (UK)) is a doctoral candidate at the University of Melbourne with a passion to improve reproductive health services particularly for women from refugee backgrounds. Her research findings on reproductive health and contraceptive needs of refugee families from Burma post settlement in Australia have been presented at both international and national sexual health conferences. Dr Tuteja has published innovative research papers on breast cancer screening and delays in diagnosis. Subsequently, she has worked on diverse women’s health issues such as women with previous caesarean sections, menopausal symptoms in the Indian subcontinent, and relevance of CA125 and RMI in ovarian cancer screening in North India. https://orcid.org/0000-0003-2828-4917

Associate Professor Elisha Riggs is a Senior Research Fellow and leads the Refugee and Migrant Research Program within the Intergenerational Health research group at the Murdoch Children’s Research Institute and Honorary Senior Fellow in the Department of General Practice, The University of Melbourne. Elisha is a public health and health services researcher whose work focuses on reducing disparities in maternal and child health outcomes for socially disadvantaged communities. Collaborative and participatory approaches to research and knowledge exchange underpin her work in the co-design and evaluation of complex interventions to improve the quality and safety of healthcare and promote health equity. https://orcid.org/0000-0003-0799-7467

Professor Lena Sanci (PhD, FRACGP, MBBS, Dip. RANZCOG) is Head of Department and of the Children and Young People’s Research Stream in the Department of General Practice, The University of Melbourne. She Co-Chairs the Primary Care Committee of the Melbourne Academic Centre for Health and has expertise in the co-design of interventions, implementation, and evaluation in primary care and online settings. She chairs the Victorian Research and Education Network (VicREN) of over 600 general practices with a commitment to advance the discipline of primary care through teaching the next generation of health professionals, and through research. https://orcid.org/0000-0003-4834-4737

Dr. Lester Mascarenhas MBChB FRACGP MPH is the founder and medical director of Utopia Refugee and Asylum Seeker Health in the west of Melbourne. He is a primary care physician providing care for refugees and asylum seekers. Dr Mascarenhas has an interest in sexual health and blood borne viruses and is accredited to treat hepatitis B, hepatitis C and HIV. https://loop.frontiersin.org/people/1218097/overview

Dr Anna Power is a General Practitioner in Melbourne, Victoria, and enjoys working with culturally and linguistically diverse communities. She completed an Academic GP Registrar role at the University of Melbourne in 2020, working in a research and medical education capacity. Anna completed her Masters of Public Health in 2021, and currently works both clinically and in public health. https://www.linkedin.com/in/drapower/?originalSubdomain=au

Dianne Van Vliet is a Registered Division 1 Nurse, Naturopath and Creative Arts Therapist. She has been involved in health care since 1978 when she graduated from nursing at Prince Henry's Hospital. She then went onto study Naturopathy at the Southern School of Natural Therapies specialising in Homoeopathy. In 2000, she returned to nursing, working in both the acute and community settings. She co-ordinated the Djerriwarrh Youth Health Service for young people. Currently she works as a Refugee/Practice & Women’s Health nurse at Utopia Refugee and Asylum Seeker Health in Hoppers Crossing Victoria.

Katrina Sangster is a part-time Research Nurse in the Immigrant Health Service at the Royal Children’s Hospital (RCH), Melbourne, Australia. Katrina’s background is in paediatric nursing, and she has qualifications and experience in Neonatal and Paediatric Intensive Care at RCH and in the United Kingdom. She has worked in refugee health since graduating in Masters of Public Health and Tropical Medicine in 2006, on the Thai Burma border, as a Refugee Health Nurse in Melbourne, and currently in her research role. Her research interests include infectious diseases and improving health care outcomes and access to interpreting for language diverse patients.

Kimberley McGuinness is a Registered Nurse and Registered Midwife working in the field of Maternal and Child Health. Her commitment to women's and family-centred care has seen her advocate for women's empowerment in a wide range of clinical settings with a focus on refugee and asylum seeker health.

Professor Meredith Temple-Smith is the Director of Research Training in the Department of General Practice. Primarily a qualitative researcher, her interests centre on sexual and reproductive health, and health services research. She is currently a Chief Investigator on a substantial suite of projects examining ways to improve and sustain Chlamydia testing in the general practice setting, and a series of studies exploring the psychosocial impacts of miscarriage. https://orcid.org/0000-0003-1296-9591

Correspondence concerning this article should be addressed to Amita Tuteja, Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Victoria, 3010, Australia. Email: amita.tuteja@unimelb.edu.au; nidhikrishan2014@gmail.com

Acknowledgements

The authors profoundly thank and acknowledge the significant contribution of Melbourne Social Equity Institute, in funding the PhD student in her research initiatives. A special thanks is due to Dr Phyllis Lau and Dr Vasudha Iyengar for supporting the PhD student in her research journey. Mr. Krishan Kumar Tuteja’s vision of inclusive health is the drive behind developing a robust consent strategy before interviewing the refugee participants.

Publication Date

2-18-2022

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.

DOI

10.46743/2160-3715/2022.5158

Recommended APA Citation

Tuteja, A., Riggs, E., Sanci, L., Mascarenhas, L., Power, A., VanVliet, D., Sangster, K., McGuinness, K., & Temple-Smith, M. (2022). Developing a Sexual Health Consent Strategy for Refugees: A Qualitative Approach. The Qualitative Report, 27(2), 509-538. https://doi.org/10.46743/2160-3715/2022.5158

ORCID ID

https://orcid.org/0000-0003-2828-4917