Physicians need global health competencies to provide effective care to culturally and linguistically diverse patients. Medical schools are seeking innovative approaches to support global health learning. This pilot study evaluated e-learning versus peer-reviewed articles to improve conceptual knowledge of global health. A mixed methods study using a randomized-controlled trial (RCT) and qualitative inquiry consisting of four post-intervention focus groups. Outcomes included pre/post knowledge quiz and self-assessment measures based on validated tools from a Global Health CanMEDS Competency Model. RCT results were analyzed using SPSS-21 and focus group transcripts coded using NVivo-9 and recoded using thematic analysis. One hundred and sixty-one pre-clerkship medical students from three Canadian medical schools participated in 2012–2013: 59 completed all elements of the RCT, 24 participated in the focus groups. Overall, comparing pre to post results, both groups showed a significant increase in the mean knowledge (quiz) scores and for 5/7 self-assessed competencies (p < 0.05). These quantitative data were triangulated with the focus groups findings that revealed knowledge acquisition with both approaches. There was no statistically significant difference between the two approaches. Participants highlighted their preference for e-learning to introduce new global health knowledge and as a repository of resources. They also mentioned personal interest in global health, online convenience and integration into the curriculum as incentives to complete the e-learning. Beta version e-learning barriers included content overload and technical difficulties. Both the e-learning and the peer reviewed PDF articles improved global health conceptual knowledge. Many students however, preferred e-learning given its interactive, multi-media approach, access to links and reference materials and its capacity to engage and re-engage over long periods of time.

In the EU/EEA, subgroups of international migrants have an increased prevalence of certain infectious diseases. The objective of this study was to examine migrants’ acceptability, value placed on outcomes, and accessibility of infectious disease interventions. We conducted a systematic review of qualitative reviews adhering to the PRISMA reporting guidelines. We searched MEDLINE, EMBASE, CINAHL, DARE, and CDSR, and assessed review quality using AMSTAR. We conducted a framework analysis based on the Health Beliefs Model, which was used to organize our preliminary findings with respect to the beliefs that underlie preventive health behavior, including knowledge of risk factors, perceived susceptibility, severity and barriers, and cues to action. We assessed confidence in findings using an adapted GRADE CERQual tool. We included 11 qualitative systematic reviews from 2111 articles. In these studies, migrants report several facilitators to public health interventions. Acceptability depended on migrants’ relationship with healthcare practitioners, knowledge of the disease, and degree of disease-related stigma. Facilitators to public health interventions relevant for migrant populations may provide clues for implementation. Trust, cultural sensitivity, and communication skills also have implications for linkage to care and public health practitioner education. Recommendations from practitioners continue to play a key role in the acceptance of infectious disease interventions.

Objective To study the prevalence of chronic conditions (ie, anemia, glucose-6-phosphate dehydrogenase [G6PD] deficiency, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, and tobacco use) in Syrian refugees. Design Cross-sectional study. Four primary care health clinics received Syrian refugees from December 2015 to April 2016, and each followed a standard protocol for refugee health assessments. Setting Ottawa, Ont. Participants Arabic-speaking Syrian refugees were invited for early primary care health assessment. Most participants arrived in Ottawa from temporary refugee encampments in Lebanon and Jordan between December 2015 and April 2016. Main outcome measures Following a protocol, family physicians and nurse practitioners systematically documented age, sex, education, hemoglobin level, G6PD status, HBV and HCV infection, and tobacco use. Results The study included 669 of the 916 government-assisted refugees, which represents most of the 1087 Syrian refugees to Ottawa: 373 male and 296 female participants. Overall, 28.5% of women and adolescent girls had anemia, and 2.0% of men had G6PD deficiency. The seroprevalence of HBV and HCV infection in the overall population was 0.9% and 0.7%, respectively. Tobacco use was reported in 60.3% of men and 11.7% of women. Overall, alcohol use (3.7%) and other substance use (0.5%) were uncommon. Conclusion Anemia was a common health problem in women of reproductive age, while the prevalence of chronic HBV and HCV infection was lower than the prevalence in the general Canadian population. Results showed substantial sex differences in tobacco use, with Syrian men using it at a rate much higher than Canadian men and Syrian women. The health assessment did not document chronic conditions affecting dental or mental health. Résumé Objectif Étudier la prévalence de problèmes chroniques (p. ex. anémie, carence en glucose-6-phosphate déshydrogénase [G6PD], infection au virus de l’hépatite B (VHB) ou de l’hépatite C (VHC), et tabagisme) chez des réfugiés syriens. Type d’étude Une étude transversale. Quatre cliniques de soins de santé primaires ont reçu des réfugiés syriens entre décembre 2015 et avril 2016, et chacune a suivi un protocole standard pour l’évaluation de la santé des réfugiés. Contexte Ottawa (Ontario). Participants Des réfugiés syriens arabophones ont été invités à un examen d’évaluation initiale en soins de santé primaires. La plupart des participants étaient arrivés à Ottawa en provenance de campements temporaires de réfugiés au Liban et en Jordanie, entre décembre 2015 et avril 2016. Principaux paramètres à l’étude Conformément à un protocole, des médecins de famille et des infirmières praticiennes ont systématiquement documenté leur âge, leur sexe, leur scolarité, leur taux d’hémoglobine, leur taux de G6PD, la présence d’une infection au virus de l’hépatite B (VHB) ou de l’hépatite C (VHC), et leur utilisation du tabac. Résultats L’étude portait sur 669 des 918 réfugiés pris en charge par le gouvernement, ce qui représente la majorité des 1087 réfugiés syriens à Ottawa : les participants comptaient 373 hommes et 296 femmes. Dans l’ensemble, 28,5 % des femmes et des adolescentes souffraient d’anémie, et 2,0 % des hommes avaient une carence en G6PD. La séroprévalence d’une infection au VHB et au VHC se situait respectivement à 0,9 et à 0,7 % dans l’ensemble de cette population. Le tabagisme a été signalé chez 60,3 % des hommes et 11,7 % des femmes. Dans l’ensemble, la consommation d’alcool (3,7 %) et d’autres substances (0,5 %) était peu fréquente. Conclusion L’anémie était un problème de santé courant chez les femmes en âge de procréer, tandis que la prévalence des infections chroniques au VHB et au VHC était plus faible que celle de la population canadienne en général. Les résultats ont fait valoir une différence considérable entre les sexes sur le plan du tabagisme, les hommes syriens faisant usage du tabac à des taux bien plus élevés que les hommes canadiens et les femmes syriennes. Dans cette évaluation de la santé, les problèmes chroniques liés à la santé dentaire ou mentale n’étaient pas documentés.