8.4 Blackbelt

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Scholar Methods

An old painting of a scholar reading from ancient-looking books.
The Scholar and His Books
Painting by Gerbrand Van Den Eechout

The scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge.

Step 1 – What Are The Potential Health Problems?

  • Why does it occur (risk factors)?
  • How do immigrants and refugees differ from the Canadian population?
  • Is it useful for practitioners?
  • Is it important?
  • What actions might be most feasible for primary care practitioners?
  • Does doing this cost more than that?
  • If I do this here what happens over there?
  • Will immigrants accept it?
  • Will practitioner use it?

What Accounts for the Health Inequities for Migrant Populations?

A graph of the components of Migration Health Determinants. The four components are as follows: 1. Disease Exposures, 2. Disease Susceptibility, 3. Barriers to Health Services, 4. Social Stratification.

Step 2 – What Criteria Could Help Select the Conditions Most in Need of Guidelines?4

A group of women sitting in a circle, talking.
Photo Credit: L. Narasiah
  • Importance (burden of Illness)
  • Usefulness (intervention works)
  • Disparity (unjust outcomes)

Step 3 – What Screening and Interventions Are Most Effective: Developing a Logic Model

A complex graph representing a logic model. The person at risk goes through screening, which either causes adverse effects or helps with early detection of the target condition. They then try prevention/treatment strategies, which may or may not cause adverse effects. They continue with an intermediate outcome, which is followed by association and, finally, reduced morbidity and/or mortality.

Step 4 – What Criteria Could Help you to Develop Recommendations: The Grade Approach

  • Balancing Desirable and Undesirable Effects
  • Quality of the Evidence
  • Values and Patient Preferences
  • Cost (Resource Allocation)

[Reference] GRADE Working Group: The Grades of Recommendation, Assessment, Development, and Evaluation

Step 5 – What Supports Improve the Implementation of Interventions for Disadvantaged Populations?6

A graph showing the components of a multifaceted intervention. There are 5 components: 1. Community Educators, 2. Cultural Tailoring, 3. Incorporating Care Algorithms, 4. high Intensity Intervention, 5. Individualized Assessment.

Video Discussion7

Transcript

High quality care is of utmost importance for vulnerable populations. Evidence-based guidelines can improve the qaulity of patient care, reduce costs and other patient harms, and significantly impact health policies. When such recommendations do not exist it will be important to call on the skills and commitment of teams of medical scholars.

The CCIRH project is one example of scholarly work; work that has led to more appropriate effective clinical practices, and more evidence-based health policies for immigrants and refugees.

Duration: 59 seconds

Examples of the Impact of the CCIRH Evidence Reviews

Intestinal Parasites

CCIRH guidelines focus attention on serology tests for potentially life threatening parasites (strongyloides and schistosoma) and reassure clinicians that other worms and parasites will be self limiting once the refugee has left the endemic region, thus reducing the burden and cost of routine stool testing.

Post Traumatic Stress Disorder (PTSD)

CCIRH Guidelines focus clinician attention on importance of empathy, reassurance and advocacy as key elements of the PTSD recovery process. And highlight how routine trauma screening and pushing for disclosure of traumatic events for well-functioning individuals could be harmful.