Development of a novel clinic for refugee claimant children with medical or psycho-emotional complexity through community based participatory research
Innovative Approaches to Care Delivery, Public Health, and Equity, Diversity & Inclusion
We identified six key components of a clinical program to support immigrant and refugee children with special healthcare needs, which has been implemented with good success in our Compass Clinic. We have also identified that immigrant and refugee children have high rates of food and income insecurity, requiring care coordination and additional support. This has led to another CIHR-funded study co-designing a navigation program specifically for newcomer families with children with special health needs.
Globally, there are unprecedented numbers of displaced peoples. Canada, and especially Toronto, have seen growing numbers of refugees and asylum seekers, many of whom are children. As refugee children face higher risks of poor health outcomes, it is important that they can access healthcare that is able to meet their needs. This study used community-engaged research methods to understand existing gaps in care and identify needs to develop and evaluate a pilot clinical model of care.
We conducted an environmental scan and needs assessment with families, care providers and refugee service providers and identified six key elements of a successful program: a) access to interpretation; b) knowledge of insurance coverage; c) sufficient time for appointments d) family centred care e) culturally-safe care from trained providers and e) access to care coordination and service navigation. Our work led to the development of the Compass Clinic at St. Michael’s Hospital, which provides trauma-informed, low-barrier and culturally-safe care to newcomer families and their children. The clinic saw 86 referrals in its first 18 months. The majority of these families (94%) were racialized. 1/3 required interpretation and 40% did not have provincial health insurance. 73% required access to care coordination, as nearly 2/3 families had income insecurity and 1/3 had food insecurity. Families and providers were extremely appreciative of the clinic’s model, and many wished knowledge of the program was more widely known.
Since then, the Compass Clinic has grown to have multiple providers and been shared as a model of care at national and international conferences.
While we currently have one paper in preparation to the Journal of Immigrant and Minority Health that summarizes this study, we have a number of published abstracts and two media stories:
Angarso L*, Filler T*, Mohammed U,,* Suleman S. Feasibility study of a pilot clinical program for newcomer children with special health care needs. American Academy of Pediatrics National Conference and Exhibition 2022. October 7 – 11, 2022, Anaheim, USA. Board #026.
Filler T*, Kaur P*, Mohammed U*, Suleman S. Evaluation of a Novel Clinical Prototype for Newcomer Children with Special Health Care Needs. 2021 National Conference & Exhibition’s Council on Immigrant Child and Family Health. Oct 8-12, 2021, Philadelphia, USA. Accepted as poster presentation (*Research students)
Stranges J. ‘Kids can be the canary in the coal mine: Two St. Michael’s pediatricians reflect on their past and seeing themselves in their patients. Dec 8, 2021. Interview with Dr. Shazeen Suleman: https://unityhealth.to/2021/12/compass-clinic/
N4 Newcomer to Canada Clinic, St. Michael’s Hospital: