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      Framework for refugee and migrant health research in the WHO European Region

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          Abstract

          Migration is a longstanding, growing global phenomenon. As a social determinant of health, migration can lead to health inequities between people on the move and host populations. Thus, it is imperative that there is a coordinated effort to advance migration‐ and health‐related goals. WHO has a specific remit to support evidence‐based decision‐making in its Member States. As part of that remit, WHO Europe presents this Framework for Refugee and Migrant Health Research in the WHO European Region. It is designed as a starting point for debating and analysing a broad range of options and approaches to help inform a WHO global research agenda on health and migration. This is important because refugee and migrant health research is a complex interdisciplinary field that is expanding in a fast‐changing socio‐political environment. The Framework is intended for all stakeholders involved: academic, civil society organisations, refugees, migrants, policy‐makers, healthcare providers, educators and funders. It is developed by academics in consultation with these stakeholder groups. It reflects on three specific interrelated dynamics in research practice. These are (i) research prioritisation; (ii) study samples and (iii) research design. The Framework offers recommendations to consider for each one of these. It elucidates the value of involving refugees and migrants in research and research agendas and the need to develop an ecosystem that will support and sustain participatory, interdisciplinary, transdisciplinary and inter‐sectoral projects.

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          Most cited references39

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          The UCL–Lancet Commission on Migration and Health: the health of a world on the move

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            Uncovering the Benefits of Participatory Research: Implications of a Realist Review for Health Research and Practice

            Context Participatory research (PR) is the co-construction of research through partnerships between researchers and people affected by and/or responsible for action on the issues under study. Evaluating the benefits of PR is challenging for a number of reasons: the research topics, methods, and study designs are heterogeneous; the extent of collaborative involvement may vary over the duration of a project and from one project to the next; and partnership activities may generate a complex array of both short- and long-term outcomes. Methods Our review team consisted of a collaboration among researchers and decision makers in public health, research funding, ethics review, and community-engaged scholarship. We identified, selected, and appraised a large-variety sample of primary studies describing PR partnerships, and in each stage, two team members independently reviewed and coded the literature. We used key realist review concepts (middle-range theory, demi-regularity, and context-mechanism-outcome configurations [CMO]) to analyze and synthesize the data, using the PR partnership as the main unit of analysis. Findings From 7,167 abstracts and 591 full-text papers, we distilled for synthesis a final sample of twenty-three PR partnerships described in 276 publications. The link between process and outcome in these partnerships was best explained using the middle-range theory of partnership synergy, which demonstrates how PR can (1) ensure culturally and logistically appropriate research, (2) enhance recruitment capacity, (3) generate professional capacity and competence in stakeholder groups, (4) result in productive conflicts followed by useful negotiation, (5) increase the quality of outputs and outcomes over time, (6) increase the sustainability of project goals beyond funded time frames and during gaps in external funding, and (7) create system changes and new unanticipated projects and activities. Negative examples illustrated why these outcomes were not a guaranteed product of PR partnerships but were contingent on key aspects of context. Conclusions We used a realist approach to embrace the heterogeneity and complexity of the PR literature. This theory-driven synthesis identified mechanisms by which PR may add value to the research process. Using the middle-range theory of partnership synergy, our review confirmed findings from previous PR reviews, documented and explained some negative outcomes, and generated new insights into the benefits of PR regarding conflicts and negotiation between stakeholders, program sustainability and advancement, unanticipated project activity, and the generation of systemic change.
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              The role of conceptual frameworks in epidemiological analysis: a hierarchical approach.

              This paper discusses appropriate strategies for multivariate data analysis in epidemiological studies.
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                Author and article information

                Contributors
                anne.macfarlane@ul.ie
                Journal
                Trop Med Int Health
                Trop Med Int Health
                10.1111/(ISSN)1365-3156
                TMI
                Tropical Medicine & International Health
                John Wiley and Sons Inc. (Hoboken )
                1360-2276
                1365-3156
                23 January 2023
                February 2023
                : 28
                : 2 ( doiID: 10.1111/tmi.v28.2 )
                : 90-97
                Affiliations
                [ 1 ] Public and Patient Involvement Research Unit, School of Medicine and Health Research Institute University of Limerick Limerick Ireland
                [ 2 ] Department of Women's and Children's Health Uppsala University Uppsala Sweden
                [ 3 ] Division of Country Support, Emergency Preparedness and Response WHO Regional Office for Europe Copenhagen Denmark
                [ 4 ] Health Directorate National Institute for Health, Migration and Poverty Rome Italy
                [ 5 ] Department of Public Health Koç University School of Medicine Istanbul Turkey
                [ 6 ] Migration Research Center, Koç University Istanbul Turkey
                [ 7 ] Health and Migration Program WHO Geneva Switzerland
                Author notes
                [*] [* ] Correspondence

                Anne MacFarlane, University of Limerick, Limerick, Ireland.

                Email: anne.macfarlane@ 123456ul.ie

                Author information
                https://orcid.org/0000-0002-9708-5025
                Article
                TMI13845
                10.1111/tmi.13845
                10107437
                36576432
                b7c244b7-6a91-4f59-8a1e-58a58fac3d7f
                © 2022 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                Page count
                Figures: 0, Tables: 2, Pages: 8, Words: 6363
                Categories
                Opinion
                Editors' Choice
                Custom metadata
                2.0
                February 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:17.04.2023

                Medicine
                health equity,migrant research,participatory research,refugee
                Medicine
                health equity, migrant research, participatory research, refugee

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