{
  "abstract": "Why did you do this work? Children and young people seeking asylum and refugees (CYPSAR) in the UK face significant challenges accessing healthcare, 1 including for screening and treatment for infections such as latent tuberculosis, HIV, and hepatitis B. Language barriers, cultural differences, financial challenges, and poor understanding and mistrust of the healthcare system may contribute to missed clinic appointments.2 These missed appointments can lead to delayed diagnosis and treatment, widening health inequalities.1 3 We aimed to improve clinic attendance among CYPSAR by introducing a peer support worker (PSW) to our infection screening service.What did you do? We developed a peer support role in our clinic, held as a Hospital Volunteer by a person who had previously successfully sought asylum in the UK. The role included confirming attendance via phone calls, assisting with navigation around the hospital (eg pharmacy, radiology), and providing support during consultations. Clinic attendance data were collected for 8 weeks prior to and after the appointment of the PSW. Feedback regarding experiences of the PSW role and its effect on patient engagement was sought from staff members, the PSW, and service users with semi-structured interviews.What did you find? 97 patients were booked to attend the clinic in the period prior to PSW involvement, and 63 after. Of these booked appointments, attendance rates were 63/97 (65.0%) for the pre-intervention period, and 47/63 (74.6) for the period post-intervention. Language-specific trends showed increased attendance across most language groups. Feedback themes (from 2 staff members, the PSW and 2 service users) highlighted the value of trust and rapport between service users and PSW, with patients reporting a positive impact on their experience and understanding when interacting with the PSW. Staff also reported improvements in clinic efficiency, as involvement of the PSW reduced non-clinical tasks, allowing medical staff to focus on clinical duties. Thus, preliminary findings suggest that a PSW role may be of value in improving clinic attendance in a vulnerable inclusion health population, and may additionally enhance patient and staff experience.What does it mean? This pilot work precedes a detailed follow-up study that will assess attendance, satisfaction, and the role of the PSW in promoting engagement, including development of appropriate training in trauma informed care. Ultimately, increased attendance could improve patient engagement, diagnosis and treatment of infections, potentially benefiting public health and reducing NHS costs, 4 by addressing healthcare disparities through logistical and relational support from PSWs.References Bradby H, Humphris R, Newall D, Phillimore J. Public health aspects of migrant health: a review of the evidence on health status for refugees and asylum seekers in the European Region. 2015.Armitage AJ, Cohen J, Heys M, et al. Description and evaluation of a pathway for unaccompanied asylum-seeking children. Archives of Disease in Childhood 2022;107:456–460.Hacker K, Anies M, Folb BL, Zallman L. Barriers to health care for undocumented immigrants: a literature review. Risk management and healthcare policy. 2015;175–83.Pareek M, Watson JP, Ormerod LP, Kon OM, Woltmann G, White PJ. Screening immigrants in the UK for imported latent tuberculosis: cost-effectiveness analysis. The Lancet infectious diseases 2011;11(6):435–44.",
  "authors": [
    {
      "affiliations": [
        "University College London Medical School"
      ],
      "name": "Kirshun Suvendiran"
    },
    {
      "affiliations": [
        "University College London Medical School"
      ],
      "name": "Zuva Dengu"
    },
    {
      "affiliations": [
        "Children and Young People’s Division and Hospital for Tropical Diseases, UCLH"
      ],
      "name": "Sarah Eisen"
    },
    {
      "affiliations": [
        "Paediatrics, University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Camilla Sen"
    },
    {
      "affiliations": [
        "Paediatrics, University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Joanna Martin"
    }
  ],
  "title": "7885 Improving clinic attendance among asylum-seeking and refugee children and young people through a peer support worker: a pilot study",
  "uid": "ffecfb86-bb0f-5d3b-877f-dce6f1176f7b"
}