Research Library

Despite rising forced displacement globally, refugees’ health and research priorities are largely unknown. We investigated whether a diverse refugee committee could utilize participatory methods to identify health priorities and a research agenda to address them. We conducted a qualitative study with focus groups of current and former refugees, asylum claimants and evacuees from a specialized refugee clinic over a year. We collected sociodemographic data using standardized instruments, then utilized a four-step nominal group technique process (idea generation, recording, discussion, and voting) to identify and rank participants’ health and research priorities. Participants ranked their top five priorities across three time periods: Pre-migration/early arrival (0–3 months), post-migration (3 months–2 years), and long-term health (>2 years). Participants created overarching priorities and corroborated findings via a member checking step. Twenty-three participants (median age 35 years) attended one or more of five focus groups. Twenty-one completed sociodemographic surveys: 16/21 (76%) were women, representing 8 countries of origin. Twelve participants completed the member checking process, affirming the results with minor clarifications. This proof-of-concept study illustrates how refugees can use a rigorous consensus process without external influence to prioritize their healthcare needs, direct a health research agenda to address those needs, and co-produce research. These low-cost participatory methods should be replicated elsewhere. Despite rising forced displacement globally, refugees’ health and research priorities are largely unknown. We investigated whether a diverse refugee committee could utilize participatory methods to identify health priorities and a research agenda to address them. We conducted a qualitative study with focus groups of current and former refugees, asylum claimants and evacuees from a specialized refugee clinic over a year. We collected sociodemographic data using standardized instruments, then utilized a four-step nominal group technique process (idea generation, recording, discussion, and voting) to identify and rank participants’ health and research priorities. Participants ranked their top five priorities across three time periods: Pre-migration/early arrival (0–3 months), post-migration (3 months–2 years), and long-term health (>2 years). Participants created overarching priorities and corroborated findings via a member checking step. Twenty-three participants (median age 35 years) attended one or more of five focus groups. Twenty-one completed sociodemographic surveys: 16/21 (76%) were women, representing 8 countries of origin. Twelve participants completed the member checking process, affirming the results with minor clarifications. This proof-of-concept study illustrates how refugees can use a rigorous consensus process without external influence to prioritize their healthcare needs, direct a health research agenda to address those needs, and co-produce research. These low-cost participatory methods should be replicated elsewhere.
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Older adults who lack a secure sense of social belonging may report loneliness, isolation, and ostracization in their communities. Little attention has been paid to the perceptions of social belonging among immigrant Muslim older (IMO) women. This study aimed to address this gap by exploring IMO women’s experiences of social belonging. This qualitative descriptive study used photo elicitation and narrative interviewing to draw on the experiences of 14 IMO women living in Edmonton, AB, Canada. An integrative framework of social belonging was used to guide theoretical conceptualizations of what comprises belonging, and a thematic analysis approach was used to highlight factors and influences that shape how participants have constructed their experiences of belonging. The findings suggest that a sense of belonging is influenced by feelings of loneliness and loss, opportunities for community engagement, and social competencies related to maintaining family relationships. Additionally, the findings indicate the importance of IMO women’s perceptions and reflections on aging as these shape their sense of belonging. These findings not only provide insight into the intricate and shifting nature of belonging but also emphasize the need for structural support to benefit both IMO women and the communities they reside in. Cultivating belonging is a collective responsibility involving older women, their social networks, and society at large, including government and public services. A sense of belonging is crucial to counter ageism and promote positive self-perceptions of aging, particularly within ethnocultural communities. Older adults who lack a secure sense of social belonging may report loneliness, isolation, and ostracization in their communities. Little attention has been paid to the perceptions of social belonging among immigrant Muslim older (IMO) women. This study aimed to address this gap by exploring IMO women’s experiences of social belonging. This qualitative descriptive study used photo elicitation and narrative interviewing to draw on the experiences of 14 IMO women living in Edmonton, AB, Canada. An integrative framework of social belonging was used to guide theoretical conceptualizations of what comprises belonging, and a thematic analysis approach was used to highlight factors and influences that shape how participants have constructed their experiences of belonging. The findings suggest that a sense of belonging is influenced by feelings of loneliness and loss, opportunities for community engagement, and social competencies related to maintaining family relationships. Additionally, the findings indicate the importance of IMO women’s perceptions and reflections on aging as these shape their sense of belonging. These findings not only provide insight into the intricate and shifting nature of belonging but also emphasize the need for structural support to benefit both IMO women and the communities they reside in. Cultivating belonging is a collective responsibility involving older women, their social networks, and society at large, including government and public services. A sense of belonging is crucial to counter ageism and promote positive self-perceptions of aging, particularly within ethnocultural communities.
This publication has no Abstract to dispaly

This publication has no Abstract to dispaly

The objective of this study was to examine how women who have immigrated from the Middle East and North Africa (MENA) region perceive breast cancer risk and screening in Canada and how they approach breast health, and to explore barriers to breast cancer screening in this population. Participants were women who were born in MENA countries (e.g., Egypt, Iraq, Lebanon, Libya, Saudi Arabia, Somalia, Sudan, and Syria) and had immigrated to Canada less than 5 years prior to study recruitment and lived in Edmonton, Alta. Six focus groups were conducted over a 6-week period in July and August 2018 with 6 participants in each group (N=36); results were analyzed thematically. Findings indicated participants have limited knowledge about breast cancer screening practices in Alberta and that multiple barriers to screening remain. This study can help inform the development of culturally appropriate interventions to overcome barriers and to motivate women from MENA countries to use breast cancer screening. The objective of this study was to examine how women who have immigrated from the Middle East and North Africa (MENA) region perceive breast cancer risk and screening in Canada and how they approach breast health, and to explore barriers to breast cancer screening in this population. Participants were women who were born in MENA countries (e.g., Egypt, Iraq, Lebanon, Libya, Saudi Arabia, Somalia, Sudan, and Syria) and had immigrated to Canada less than 5 years prior to study recruitment and lived in Edmonton, Alta. Six focus groups were conducted over a 6-week period in July and August 2018 with 6 participants in each group (N=36); results were analyzed thematically. Findings indicated participants have limited knowledge about breast cancer screening practices in Alberta and that multiple barriers to screening remain. This study can help inform the development of culturally appropriate interventions to overcome barriers and to motivate women from MENA countries to use breast cancer screening.
This publication has no Abstract to dispaly

The United States and Canada have resettled over 120,000 Afghan refugees since August 2021, but sociodemographic and health status data remains sparse with investigations often limited to refugee entrance exams, standardized health screenings, or acute health settings. This retrospective community-engaged cohort study investigated Afghan patients who received care between January 1, 2011 and December 31, 2020 at an interdisciplinary specialized refugee clinic in Calgary, AB, Canada that provides care to newly arrived refugees. 2 reviewers independently extracted and manually verified sociodemographic factors, medical diagnoses, and clinic utilization variables from patients’ electronic medical records, then coded patient diagnoses into ICD-10 codes and chapter groups. Diagnosis frequencies were calculated and stratified by age group and sex. We corroborated these findings with Afghan refugee co-investigators. Among 402 Afghan refugee patients, they were relatively young, experienced diverse health characteristics, and had multi-specialty care engagement in their first two years after arrival. These findings may guide specialized healthcare provision to this inadequately characterized but growing population of refugee arrivals in North America and elsewhere. The United States and Canada have resettled over 120,000 Afghan refugees since August 2021, but sociodemographic and health status data remains sparse with investigations often limited to refugee entrance exams, standardized health screenings, or acute health settings. This retrospective community-engaged cohort study investigated Afghan patients who received care between January 1, 2011 and December 31, 2020 at an interdisciplinary specialized refugee clinic in Calgary, AB, Canada that provides care to newly arrived refugees. 2 reviewers independently extracted and manually verified sociodemographic factors, medical diagnoses, and clinic utilization variables from patients’ electronic medical records, then coded patient diagnoses into ICD-10 codes and chapter groups. Diagnosis frequencies were calculated and stratified by age group and sex. We corroborated these findings with Afghan refugee co-investigators. Among 402 Afghan refugee patients, they were relatively young, experienced diverse health characteristics, and had multi-specialty care engagement in their first two years after arrival. These findings may guide specialized healthcare provision to this inadequately characterized but growing population of refugee arrivals in North America and elsewhere.
This publication has no Abstract to dispaly

Recent events, such as the COVID-19 pandemic, have drawn nationwide attention to systemic racism as a serious threat to public health in Canada. One promising approach to address such racism is through developing and implementing standardized procedures for collecting and using disaggregated, race-based data. In this commentary, we summarize why this approach is necessary to address systemic racism in Canada, and highlight municipal actions being taken in Edmonton, Alberta, to move this approach forward. This article describes Edmonton’s Race-based Data Table created in 2021. In documenting the beginning stages of the Table, and in evaluating its ongoing progress, we contribute to national conversations regarding the need for government institutions and other organizations to consistently collect and use race-based data as a means of increasing transparency and accountability in their actions. Recent events, such as the COVID-19 pandemic, have drawn nationwide attention to systemic racism as a serious threat to public health in Canada. One promising approach to address such racism is through developing and implementing standardized procedures for collecting and using disaggregated, race-based data. In this commentary, we summarize why this approach is necessary to address systemic racism in Canada, and highlight municipal actions being taken in Edmonton, Alberta, to move this approach forward. This article describes Edmonton’s Race-based Data Table created in 2021. In documenting the beginning stages of the Table, and in evaluating its ongoing progress, we contribute to national conversations regarding the need for government institutions and other organizations to consistently collect and use race-based data as a means of increasing transparency and accountability in their actions.
This publication has no Abstract to dispaly

Following spring 2020’s deadly COVID-19 outbreaks in the Alberta meatpacking industry, we conducted research with meatpackers who were formerly resettled refugees and now Canadian permanent residents (PRs) or Canadian citizens. Research with temporary foreign workers often promotes permanent legal status as a solution to poor conditions of precarious work in Canada, but even with permanent immigration status, former refugees experienced a large gap between their rights as “guaranteed” by the state through their PR status and their daily work in meatpacking plants in rural Alberta. Work in the plants is dangerous, dirty, and difficult, and employees found it difficult to enact their rights as workers. Access to adequate breaks, sick days, and other mandated requirements was reported to be contested and contingent. Former refugees working in this sector experience unexpected “unfreedom.” Following spring 2020’s deadly COVID-19 outbreaks in the Alberta meatpacking industry, we conducted research with meatpackers who were formerly resettled refugees and now Canadian permanent residents (PRs) or Canadian citizens. Research with temporary foreign workers often promotes permanent legal status as a solution to poor conditions of precarious work in Canada, but even with permanent immigration status, former refugees experienced a large gap between their rights as “guaranteed” by the state through their PR status and their daily work in meatpacking plants in rural Alberta. Work in the plants is dangerous, dirty, and difficult, and employees found it difficult to enact their rights as workers. Access to adequate breaks, sick days, and other mandated requirements was reported to be contested and contingent. Former refugees working in this sector experience unexpected “unfreedom.”
This publication has no Abstract to dispaly

The Calgary-based Foundation for Black Communities’ (FFBC) Black Ideas Grant (BIG) Bridge and Build Program has provided funding for RaricaNow, an organization in Edmonton aiding 2SLGBTQ+ refugees. The numbers of 2SLGBTQ+ refugees continue to climb, and this grant will allow RaricaNow to provide housing and more settlement supports. The Calgary-based Foundation for Black Communities’ (FFBC) Black Ideas Grant (BIG) Bridge and Build Program has provided funding for RaricaNow, an organization in Edmonton aiding 2SLGBTQ+ refugees. The numbers of 2SLGBTQ+ refugees continue to climb, and this grant will allow RaricaNow to provide housing and more settlement supports.
This publication has no Abstract to dispaly

Little is known about human papillomavirus (HPV) vaccination among immigrant children in Canada. We conducted a study in Alberta, Canada to assess HPV vaccine coverage among school-aged immigrant children compared with non-immigrant children. This cohort study analyzed population-based linked administrative health data to measure HPV vaccine coverage for 346749 school-aged children, including 31656 immigrants. Coverage was examined at 12 years of age from 2008 to 2018 for females, and from 2014 to 2018 for males and both sexes combined. Vaccine series completion was considered receipt of three doses, with initiation (one or more dose) as a supplementary analysis. Multivariable logistic regression examined the association of vaccine coverage with migration status, adjusting for sociodemographic variables. Overall, immigrant children had significantly higher rates of HPV vaccination than nonimmigrant children. When controlled for location, income, biological sex and year, immigrant children still had greater odds of vaccine series completion than nonimmigrant children. Little is known about human papillomavirus (HPV) vaccination among immigrant children in Canada. We conducted a study in Alberta, Canada to assess HPV vaccine coverage among school-aged immigrant children compared with non-immigrant children. This cohort study analyzed population-based linked administrative health data to measure HPV vaccine coverage for 346749 school-aged children, including 31656 immigrants. Coverage was examined at 12 years of age from 2008 to 2018 for females, and from 2014 to 2018 for males and both sexes combined. Vaccine series completion was considered receipt of three doses, with initiation (one or more dose) as a supplementary analysis. Multivariable logistic regression examined the association of vaccine coverage with migration status, adjusting for sociodemographic variables. Overall, immigrant children had significantly higher rates of HPV vaccination than nonimmigrant children. When controlled for location, income, biological sex and year, immigrant children still had greater odds of vaccine series completion than nonimmigrant children.
This publication has no Abstract to dispaly

Thousands of refugee families are resettled across Canada each year, and many must navigate parenthood while simultaneously contending with resettlement challenges. Refugee women are primarily responsible for care work yet often face disproportionate barriers to information, resources, and access to health services. We leveraged a community-engaged research approach with several project partners to: i) explore the scope, nature, and extent of literature examining the influence of gender norms, roles, and expectations on health and wellbeing during resettlement; ii) explore women’s diverse conceptualizations of health and what it means to be healthy; iii) identify barriers and resilience factors for health and wellbeing during resettlement, including in the context of the COVID-19 pandemic; iv) explore women’s experiences of gender as a determinant of health during resettlement, specifically in the context of motherhood; and v) explore the role of participation in Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY), a home visiting program, in promoting health during resettlement. We conducted a scoping review, followed by surveys, in-depth interviews, and collage-building with refugee mothers (n=28) enrolled in the HIPPY program delivered by the Calgary Immigrant Women’s Association. Data were analyzed using a participatory inductive deductive thematic analysis. Our findings establish gender roles, norms, and expectations as important determinants of health, mediating experiences of other social determinants of health during resettlement. Participation in HIPPY promoted wellbeing during resettlement and the COVID-19 pandemic by mitigating social isolation and improving women’s access to information and resources for health and parenting in Canada. Thousands of refugee families are resettled across Canada each year, and many must navigate parenthood while simultaneously contending with resettlement challenges. Refugee women are primarily responsible for care work yet often face disproportionate barriers to information, resources, and access to health services. We leveraged a community-engaged research approach with several project partners to: i) explore the scope, nature, and extent of literature examining the influence of gender norms, roles, and expectations on health and wellbeing during resettlement; ii) explore women’s diverse conceptualizations of health and what it means to be healthy; iii) identify barriers and resilience factors for health and wellbeing during resettlement, including in the context of the COVID-19 pandemic; iv) explore women’s experiences of gender as a determinant of health during resettlement, specifically in the context of motherhood; and v) explore the role of participation in Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY), a home visiting program, in promoting health during resettlement. We conducted a scoping review, followed by surveys, in-depth interviews, and collage-building with refugee mothers (n=28) enrolled in the HIPPY program delivered by the Calgary Immigrant Women’s Association. Data were analyzed using a participatory inductive deductive thematic analysis. Our findings establish gender roles, norms, and expectations as important determinants of health, mediating experiences of other social determinants of health during resettlement. Participation in HIPPY promoted wellbeing during resettlement and the COVID-19 pandemic by mitigating social isolation and improving women’s access to information and resources for health and parenting in Canada.
This publication has no Abstract to dispaly