Table 1 Overview of all strategies
From: Good practice in reaching and treating refugees in addiction care in Germany – a Delphi study
Strategy | Second round ratings | M | Third round ratings | Number of Experts with 4 or 5 Rating | Category | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M | SD | Min | Max | Consensus | Mdn | SD | Min | Max | Consensus | |||||
Good Practice Strategies | 1. Opening all existing addiction services to refugees | 4.5 | 0.9 | 3 | 5 | Yes | 4.6 | 5 | 1 | 3 | 5 | Yes | 17 | Care system |
4. Overcoming municipally-based support structures | 4.2 | 0.9 | 2 | 5 | Yes | 4.4 | 4.5 | 1 | 3 | 5 | Yes | 19 | ||
6. Ensuring consistency of addiction support services | 4.9 | 0.5 | 3 | 5 | Yes | 4.9 | 5 | 0 | 3 | 5 | Yes | 20 | ||
9. nationwide equal opportunities for refugees with regard to entitlement of benefits and right of use | 4.7 | 0.6 | 3 | 5 | Yes | 4.8 | 4.5 | 0 | 4 | 5 | Yes | 21 | Framework conditions | |
10. Reduction of structural factors that facilitate or maintain addiction | 4.7 | 0.6 | 3 | 5 | Yes | 4.8 | 4.5 | 0 | 4 | 5 | Yes | 21 | ||
11. Addressing people in their mother tongue as a gesture of welcome | 4.2 | 0.8 | 3 | 5 | Yes | 4.3 | 5 | 1 | 3 | 5 | Yes | 18 | Multilingualism | |
12 Nationwide implementation of language mediation in addiction support facilities | 4.5 | 0.7 | 3 | 5 | Yes | 4.6 | 4.5 | 1 | 4 | 5 | Yes | 21 | ||
13. Ensuring funding of language mediators | 4.6 | 0.6 | 3 | 5 | Yes | 4.6 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
14 Fast and low-threshold availability of language mediators | 4.5 | 0.8 | 3 | 5 | Yes | 4.7 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
15. Professionalism of the language mediators employed | 4.6 | 0.6 | 3 | 5 | Yes | 4.6 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
16 Supervision for language mediators | 4.3 | 0.7 | 3 | 5 | Yes | 4.4 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
17 Multilingualism of documents of the facility process | 4.2 | 0.8 | 3 | 5 | Yes | 4.4 | 4.5 | 1 | 3 | 5 | Yes | 19 | ||
18. Provision of centrally designed, multilingual information on substances, substance use and addiction | 4.3 | 0.9 | 2 | 5 | Yes | 4.3 | 4.5 | 1 | 2 | 5 | Yes | 18 | Information and Education | |
19. Passing on (bundled or centrally designed) multilingual information on addiction-related care services and framework conditions | 4.3 | 0.9 | 2 | 5 | Yes | 4.4 | 4.5 | 1 | 2 | 5 | Yes | 19 | ||
20. Outreach information work in the living environment of refugees. | 4.4 | 0.9 | 2 | 5 | Yes | 4.5 | 4.5 | 1 | 3 | 5 | Yes | 19 | ||
21. Raising awareness of addiction issues among those involved in refugee assistance | 4.6 | 0.7 | 3 | 5 | Yes | 4.6 | 4.5 | 1 | 3 | 5 | Yes | 20 | Access | |
22. Use of key persons as door openers | 4.3 | 0.9 | 2 | 5 | Yes | 4.4 | 4.5 | 1 | 2 | 5 | Yes | 20 | ||
24. Qualification of and work with “bridge builders | 4.1 | 0.8 | 3 | 5 | Yes | 4.3 | 4 | 1 | 3 | 5 | Yes | 19 | ||
25. Ensuring low-threshold access to addiction support services | 4.6 | 0.7 | 2 | 5 | Yes | 4.6 | 5 | 1 | 2 | 5 | Yes | 20 | Service-Level | |
26. Emphasis on discretion and anonymity | 4.7 | 0.6 | 3 | 5 | Yes | 4.7 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
27. Ensuring participation and active involvement of people affected by addiction in the process of developing services and materials | 4.2 | 0.9 | 2 | 5 | Yes | 4.3 | 4.5 | 1 | 2 | 5 | Yes | 19 | ||
28. Participation of refugees in self-help activities | 4.3 | 0.9 | 3 | 5 | Yes | 4.5 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
29. Early intervention for substance use among refugees | 4.3 | 1 | 2 | 5 | Yes | 4.4 | 4 | 1 | 2 | 5 | Yes | 17 | ||
31. Outreach counseling in the immediate surroundings of refugees | 4.3 | 0.8 | 2 | 5 | Yes | 4.4 | 4.5 | 1 | 2 | 5 | Yes | 20 | ||
32. Outreach work in places where drugs are consumed | 4.3 | 1 | 2 | 5 | Yes | 4.5 | 5 | 1 | 3 | 5 | Yes | 19 | ||
33. Outreach work to build up relationships | 4.4 | 0.9 | 2 | 5 | Yes | 4.6 | 5 | 1 | 3 | 5 | Yes | 19 | ||
34. Regularity and durability in the relational work with refugees | 4.3 | 0.9 | 2 | 5 | Yes | 4.4 | 4.5 | 1 | 2 | 5 | Yes | 19 | ||
35. Accompanying clients | 4.3 | 0.7 | 3 | 5 | Yes | 4.3 | 5 | 1 | 3 | 5 | Yes | 19 | ||
36. Trainings for addiction support professionals that addresses the living situation of refugees | 4.6 | 0.6 | 3 | 5 | Yes | 4.7 | 4.5 | 0 | 4 | 5 | Yes | 21 | Employe-Level | |
38 Promoting diversity in teams | 4.5 | 0.8 | 3 | 5 | Yes | 4.6 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
39. Understanding and acceptance of substance use as a coping strategy | 4.6 | 0.7 | 3 | 5 | Yes | 4.7 | 5 | 0 | 4 | 5 | Yes | 21 | Employe-Attitudes | |
40 Adopting an appreciative, living environment-oriented attitude | 4.6 | 0.7 | 3 | 5 | Yes | 4.7 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
41 Cross- and transcultural competences in attitude and reflection | 4.5 | 0.8 | 2 | 5 | Yes | 4.6 | 4.5 | 1 | 3 | 5 | yes | 20 | ||
42. Adopting a gender-sensitive attitude | 4.2 | 1.1 | 1 | 5 | No | 4.3 | 4.5 | 1 | 1 | 5 | No | 18 | ||
43 Coping mechanisms and setting boundaries as a competence of professionals | 4.1 | 0.9 | 3 | 5 | Yes | 4.2 | 4.5 | 1 | 0 | 5 | Yes | 17 | ||
44. Networking of all stakeholders involved in the care of drug users | 4.5 | 0.6 | 3 | 5 | Yes | 4.5 | 5 | 1 | 3 | 5 | Yes | 20 | Networking | |
45. Multidisciplinary networking beyond addiction support services | 4.3 | 0.9 | 2 | 5 | Yes | 4.3 | 4.5 | 1 | 2 | 5 | Yes | 18 | ||
47. Considering networking financially and conceptually | 4.1 | 0.9 | 2 | 5 | Yes | 4.2 | 4.5 | 1 | 2 | 5 | Yes | 18 | ||
48. Establishment of in-depth inter-institutional cooperation | 4.1 | 0.7 | 3 | 5 | Yes | 4.3 | 4.5 | 1 | 3 | 5 | Yes | 20 | ||
Strategies not considered good practice | 2. Creation of specific services for refugees | 4.2 | 1 | 2 | 5 | No | 4.3 | 5 | 1 | 3 | 5 | Yes | 16 | Strategies without consensus |
3. Establishment of services for individual subgroups of refugees | 3.9 | 0.9 | 2 | 5 | Yes | 4 | 4.5 | 1 | 3 | 5 | Yes | 15 | ||
5.Enabling flexible project development and implementation | 4 | 1.1 | 1 | 5 | No | 4.1 | 4.5 | 1 | 3 | 5 | Yes | 15 | ||
7. Management of requirements planning by policy-makers (federal government, state governments and municipalities) | 3.4 | 1 | 2 | 5 | Yes | 3.6 | 4.5 | 1 | 2 | 5 | Yes | 10 | ||
8. Integration of science and practice | 3.8 | 1 | 1 | 5 | No | 3.7 | 4 | 1 | 1 | 5 | Yes | 13 | ||
23. Working with relatives | 4 | 0.9 | 2 | 5 | Yes | 4 | 4 | 1 | 2 | 5 | Yes | 15 | ||
30. Creating and maintaining a welcoming environment across all services | 3.7 | 1.2 | 1 | 5 | No | 3.5 | 4.5 | 1 | 1 | 5 | No | 12 | ||
37. Cultural sensitivity of professionals [1] | 3.8 | 1.3 | 1 | 5 | No | 3.7 | 4 | 1 | 1 | 5 | No | 13 | ||
46. Networking with civil society stakeholders | 4 | 0.8 | 3 | 5 | Yes | 4 | 4.5 | 1 | 3 | 5 | Yes | 14 | ||