Involvement in Routine Healthcare Screening Services for Refugees Resettled in the U.S.: Applying Andersen’s Behavioral Model

Abstract Refugees often experience poor health complications due to traumatic experiences before, during, and after resettlement, necessitating timely access to healthcare screening services. Guided by the Andersen Behavioral Model(ABM), this cross-sectional study examined several factors associated with refugees’ involvement in routine healthcare screening services in the United States (U.S). Data were drawn from the 2020 Annual Survey of Refugees (ASR), which involved refugees resettled between 2015 and 2019 in the U.S (N = 1527). Multivariate logistic regression was conducted to determine significant associations between ABM’s predisposing, enabling, and need-of-care factors and refugees’ involvement in routine healthcare screening services. Approximately 72.6% of refugees reported being involved in routine healthcare screening services. Refugees identifying as Hispanics/Latinos (OR = 2.36, 95% CI [1.03, 5.40], p = .042), refugees with depressive symptoms during the past 30 days (OR = 1.76, 95% CI [1.11, 2.78], p = .016), and refugees with self-reported good physical health conditions (OR = 1.98, 95% CI [1.17, 3.34], p = .010) were associated with higher odds of being involved in routine healthcare screening services. However, refugees who were employed (OR = 0.52, 95% CI [0.33, 0.83], p = .007) and had Medicaid or other forms of health insurance (OR = 0.41, 95% CI [0.25, 0.68], p < .001) were associated with lower odds of being involved in routine healthcare screening services. This study underscores the importance of providing culturally and linguistically tailored healthcare support systems, enhancing health insurance literacy, and implementing policy initiatives to mitigate structural and economic barriers to healthcare access for vulnerable refugees resettled in the U.S.