Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation
研究调查了317名在澳非洲难民的献血意愿，发现感知歧视和客观知识直接影响意愿，且歧视在文化适应与意愿、医疗不信任与意愿之间起中介作用，为设计包容性医疗项目提供建议。
Developed countries that accept refugees are obligated, under the UN Convention for Refugees, to integrate refugees into host communities, with inclusion in the health system being pivotal. Integration programs can be difficult though, because many refugees’ home countries have different health systems, lower health literacy, and different expectations of health services. Country health system differences require cultural adaptation of host country services when designing targeted, inclusive health care programs. Using a sample of 317 Australian-based African refugees, the authors examine how refugees’ acculturation, perceptions of discrimination, past behavior, objective knowledge, and medical mistrust affect their health inclusion, depending on their blood donation intentions. The results indicate that perceived discrimination and objective blood donation knowledge directly affect donation intentions. Perceived discrimination mediates the relationships between acculturation and intentions and between medical mistrust and donation intentions, and objective knowledge mediates the relationship between past behavior and donation intentions. The authors offer recommendations to policy makers designing social inclusion programs and health service providers designing and delivering targeted initiatives, to better facilitate refugee participation in host country health systems.