SIIReN - System Integration & Innovation Research Network

Primary Health Care System


Improving health care for immigrants and refugees in Canada: a Delphi consensus study to prioritize emerging innovations and best practices
Researchers: Dr. Kevin Pottie CoIs: Meb Rasid, Lavanya Narasiah

Canada receives more than 500,000 international migrants each year. While immigration is most noticeable in major urban centres, the greatest challenges are often in small to midsize cities where primary health systems have yet to develop innovative practices to accommodate culturally and linguistically diverse patients. The identification of innovative delivery strategies for further effectiveness study and implementation could improve primary health care practices.

We conducted a consensus process using a modified Delphi technique to identify the top five high-priority practices/strategies to improve primary health care of immigrants and refugees.

The top three strategies to improve primary care for immigrants were:

  1. Language interpretative services
  2. Comprehensive health care: interdisciplinary care, collaborative or team-based health care delivery and continuity of care, and
  3. Evidence-based guidelines for clinical practice. The final two strategies were
  4. Training and mentorship for health care providers,
  5. Intersectoral collaboration with community engagement and support.

Language and collaborative care supports emerged as priorities as they did in Australia and the European Union. Introducing evidence based clinical guidelines and intersectoral collaboration emerged as new innovations to strengthen primary health care in Canada, as well as the efforts and progress to achieve better health conditions of vulnerable populations. The research team recognized provincial telehealth programs offer an opportunity to deliver just-in-time communication support, evidence based decision support, and primary health care navigation support and have thus selected this resource as a priority area for further research.

Key Messages:

  • This Canadian primary health care expert consensus study identified a set of innovative and promising primary health care practices to improve health care of immigrants and refugees.
  • The top three priority practices were: Language interpretative services (just-in-time communication support), Comprehensive health care: interdisciplinary care and Evidence-based guidelines and decision support for clinical practice.
  • These results have guided our CIHR Community Based PHC team grant, which aims to develop improved infrastructure support (ie Telehealth) to improve communication, decision and collaborative supports to relevant for vulnerable immigrants in Canada.
  • We anticipate integration of these promising practices within the primary health care system can help reduce existing health inequities in immigrant populations


For further information, please contact the Principal Investigator:
Dr. Kevin Pottie MD, CCFP, MCISc, FCFP
Associate Professor in the Departments of Family Medicine and Epidemiology & Community Medicine
University of Ottawa

Back to Seed Funding Projects