Under what circumstances can immigrant patients and healthcare professionals co-produce health? - an interpretive scoping review

Figures & data

Figure 1. Conceptual model of healthcare service co-production (Batalden et al., 2015)

Figure 2. PRISMA flowchart showing the study selection process

Table I. Characteristics of included studies

Authors Year	Country	Aim of the article	Patient group	Healthcare professionals	Setting	Co-production element
Intervention studies
(Balán et al., 2013)	USA	Describe experiences with a motivational pharmacotherapy intervention	Spanish-speaking immigrant patients	Psychiatrists	Psychiatric clinic	Co-productive counselling to improve treatment adherence
(DeCamp et al., 2015)	USA	Describe experiences with family advisory groups for clinics and hospitals	Latina mothers	Healthcare professionals	Primary healthcare setting	Identify and address areas for healthcare improvement in a co-productive process
(Lee et al., 2009)	Australia	Describing experiences of a consumer reference group to understand barriers for migrant patients	Ethnic women	Healthcare professionals	Primary healthcare setting	Patient participation in primary health care programme planning and services
(Kaltman et al., 2016)	USA	Measuring the effectiveness of an integrated self-management intervention	Latino patients	Healthcare professionals	Primary healthcare setting	Co-production of an intervention for diabetes and depression self-management
(Polo et al., 2012)	USA	Describing benefits and challenges of strategies aiming at increasing patient participation	Latino patients	Bilingual care managers, healthcare professionals	Mental healthcare setting	Individuals’ contribution to co-production of healthcare service
Interview studies
(King et al., 2015)	Canada	Examining strategies to enhance culturally sensitive care in paediatric rehabilitation	Immigrant parents of children with disabilities	Social workers, occupational and speech therapist	Hospital setting	Tools for and approaches to co-productive culturally sensitive care
(Brassart et al., 2017)	Canada	Describing barriers to and strategies for treatment engagement	Immigrant parents raising a child with a disability	Healthcare professional	Hospital setting	Engagement in and understanding of the therapeutic process of immigrant parents raising a child with a disability
(Naldemirci et al., 2018)	Sweden	Describing the risks of person-centred care in three research projects	Migrant patients	Healthcare professionals	Healthcare setting (used for community setting)	Co-production in person-centred care routines (patient narrative, partnership, and documentation)
Case studies
(Mendenhall et al., 2008)	USA	Describing the clinical journey of a refugee patient	Refugee patient	Healthcare professionals, outreach coordinator	Primary healthcare setting	A co-productive partnership between patient and healthcare professionals
(Balachandra et al., 2009)	USA	Describing the clinical journey of a refugee patient	Refugee patient	Healthcare professionals, Interpreters	Primary healthcare setting	Co-production between patient and health care professionals
(Cochran et al., 2017)	USA	Describing the tragic medical case of a Pakistani immigrant family	Immigrant parents to a terminally ill child	Healthcare professionals	Hospital setting	Cultural humility in shared decision-making
Systematic review
(Mead et al., 2013)	USA	Review of literature on shared-decision making	Minority patients	Healthcare professionals	Hospital setting	Factors influencing co-production with minority patients
Other publications
(Borkan et al., 2008)	USA	Perspective paper describing a framework for quality care that relates to ethnicity-based on case examples	Migrant patients	Healthcare professionals	Hospital setting	Approaches and tools to achieve co-productive cultural competency and humility
(Benson et al., 2010)	Australia	Editorial describing a refugee’s experiences of mental health services	Refugee patient	Healthcare professionals	Hospital setting	The role of narrative competence in co-producing a patient’s diagnosis and treatment
(Alegria et al., 2020)	USA	Editorial describing lessons learnt about how to engage ethnic minorities	Minority patients	Healthcare professionals	Mental healthcare setting	The role of egalitarian collaboration in the clinical encounter

Table II. Factors towards co-production with immigrant patients

Nr.	Factor	Underlying strategy	How to exactly?
1	Prioritizing co-production in the organization	Create consensus on co-production across all organization levels Allow creativity amongst people working on the frontline	No “tokenistic gesture” Allocating time and other resources Having organizational practices and habits for co-production
2	Providing a safe environment that promotes trust and patience	Signalizing “I see you, I hear you and I try to understand you”	Allowing trust to be built little by little Exercising patience
3	Using a language the patient understands	“Tune in” on how to communicate with the patient	Taking time for friendly, simplified communication Using a medical competent interpreter
4	Respecting the patient’s knowledge and priorities	Create a shared starting point by listening to the patient’s story and worries	Learning about the underlying cultural background for patient’s priorities Considering family situation Acknowledging the patient’s resources and other priorities Including family/society context
5	Improvising with knowledge and courage	Be creative in meeting the patient’s needs	Tailoring interventions to the patient’s reality Including approaches outside the biomedical paradigm Accepting the open-ended process
6	Engaging in self-reflection	Take a step back and do not let harmful stereotypes affect your judgement	Being aware of stereotypic views, own norms, and values Asking questions Learning about other cultures

Appendix A. PubMed search strategy and results

9 December 2019		Title/abstract
Block 1
1	Coproduction OR co-production OR coproduce OR co-produce OR coproducing OR co-producing	2.269
2	Cocreation OR co-creation OR cocreate OR co-create OR cocreating OR co-creating	616
3	Codesign OR co-design OR codesigning OR co-designing	678
4	Cooperation OR co-operation OR cooperate OR co-operate OR cooperating OR co-operating	70.116
5	Collaboration OR collaborate OR collaborating	79.684
6	Co-care	18
9	“patient participation” OR “patient involvement” OR “patient empowerment” OR “patient activation”	6.620
10	“Relationship-centered care” OR “relationship-centred care”	174
11	“patient-centered care” OR “patient-centred care” OR “patient-focused care”	6.912
12	“patient-centered nursing” OR “patient-centred nursing”	85
13	“patient-centered communication” OR “patient-centred communication”	639
14	Patient-centeredness OR patient-centredness	1.394
15	“shared decision-making”	7.495
16	“cross-cultural communication” OR “culturally competent care”	803
17	“patient-provider relation” OR “patient-provider relations” OR “patient-provider relationship” OR “patient-provider relationships” OR “patient-provider communication” OR “patient-provider communications” OR “patient-provider interaction” OR “patient-provider interactions”	2.243
18	“patient-physician relation” OR “patient-physician relations” OR “patient-physician relationship” OR “patient-physician relationships” OR “patient-physician communication” OR “patient-physician communications” OR “patient-physician interaction” OR “patient-physician interactions”	2.392
19	“patient-doctor relation” OR “patient-doctor relations” OR “patient-doctor relationship” OR “patient-doctor relationships” OR “patient-doctor communication” OR “patient-doctor communications” OR “patient-doctor interaction” OR “patient-doctor interactions”	883
20	“patient-nurse relation” OR “patient-nurse relations” OR “patient-nurse relationship” OR “patient-nurse relationships” OR “patient-nurse communication” OR “patient-nurse communications” OR “patient-nurse interaction” OR “patient-nurse interactions”	171
21	“patient-hospital relation” OR “patient-hospital relations” OR “patient-hospital relationship” OR “patient-hospital relationships” OR “patient-hospital communication” OR “patient-hospital communications” OR “patient-hospital interaction” OR “patient-hospital interactions”	10
22	(((((“Patient Participation”[Mesh]) OR “Community Participation”[Mesh]) OR “Patient-Centered Care”[Mesh]) OR “Decision Making”[Mesh]) OR “Hospital-Patient Relations”[Mesh]) OR “Physician-Patient Relations”[Mesh] OR “Culturally competent care”[Mesh]	307.973
23	Or/1-22	465.523
Block 2
24	Migrant OR migrants	18.751
25	Immigrant OR immigrants	24.342
26	“ethnic minority” OR “ethnic minorities” OR “ethnic minority group” OR “ethnic minority groups”	10.547
27	Refugee OR refugees	10.136
28	“asylum seeker” OR “asylum seekers”	1.506
29	Descendant OR descendants	5.445
30	“undocumented immigrant” OR “undocumented immigrants” OR “illegal immigrant” OR “illegal immigrants”	585
31	(((“Emigrants and Immigrants”[Mesh]) OR “Transients and Migrants”[Mesh]) OR “Refugees”[Mesh]) OR “Undocumented Immigrants”[Mesh]	30.643
32	OR/24-31	71.957
Block 3
33	“healthcare service” OR “healthcare services” OR “health care service” OR “health care services”	23.170
	“delivery of healthcare” OR “delivery of health care”	11.650
	“Integrated delivery of healthcare” OR “Integrated delivery of health care”	27
37	((“Health Services”[Mesh]) OR (“Delivery of Health Care”[Mesh] OR “Delivery of Health Care, Integrated”[Mesh]))	2.681.002
38	OR/33-37	2.691.281
39	23 AND 32 AND 38	2.300
	23 AND 32 AND 38 only: English, Swedish, Norwegian, Danish, German	2.197
	From 2007 onwards	1.604

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