Guidelines and training initiatives that support communication in cross-cultural primary-care settings:appraising their implementability using Normalization Process Theory

Brun, T. de and de-Brun, M. O'reilly and Weel-Baumgarten, E. van and Weel, C. van and Dowrick, C. and Lionis, C. and O'Donnell, C.A. and Burns, N. and Mair, F. S. and Saridaki, A. and Papadakaki, M. and Princz, C. and Muijsenbergh, M. van den and MacFarlane, A. (2015) Guidelines and training initiatives that support communication in cross-cultural primary-care settings:appraising their implementability using Normalization Process Theory. Family Practice, 32 (4). pp. 420-425. ISSN 0263-2136

Abstract

Background Guidelines and training initiatives (G/TIs) available to support communication in cross-cultural primary health care consultations are not routinely used. We need to understand more about levers and barriers to their implementation and identify G/TIs likely to be successfully implemented in practice. Objective To report a mapping process used to identify G/TIs and to prospectively appraise their implementability, using Normalization Process Theory (NPT). Methods RESTORE is a 4-year EU FP-7 project. We used purposeful and network sampling to identify experts in statutory and non-statutory agencies across Austria, England, Greece, Ireland, Scotland and the Netherlands who recommended G/TI data from the grey literature. In addition, a peer review of literature was conducted in each country. Resulting data were collated using a standardized Protocol Mapping Document. G/TIs were identified for inclusion by (i) initial elimination of incomplete G/TI material; (ii) application of filtering criteria; and (iii) application of NPT. Results 20 G/TIs met selection criteria: 8 guidelines and 12 training initiatives. Most G/TIs were identified in the Netherlands (n = 7), followed by Ireland (n = 6) and England (n = 5). Fewer were identified in Scotland (n = 2), and none in Greece or Austria. The majority (n = 13) were generated without the inclusion of migrant service users. All 20 were prospectively appraised for potential implementability by applying NPT. Conclusions NPT is useful as a means of prospectively testing G/TIs for implementability. Results indicate a need to initiate meaningful engagement of migrants in the development of G/TIs. A European-based professional standard for development and assessment of cross-cultural communication resources is advised.