Please note, this is not an open access database or repository. We have focused on creating simple summaries of reports and articles that we have accessed through websites and academic journals, with a focus on key findings, so that even if a full report is not free to access you can reference it. When possible, we include a link to wherever the original document is hosted (which may or may not be open-access). If you come across a link that is no longer active, please let us know and we can update it. There are also some reports that will have been submitted directly to the project. In this case, these reports are uploaded directly with permission from the author or publisher. Any original documents found on this site are stored in Canada on our secure servers

Is Universal Screening Necessary? Incidence of Tuberculosis among Tibetan Refugees Arriving in Calgary, Alberta

Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. We found no associations between preimmigration factors and treatment completion. A case of active TB was detected and treated. Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada. Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. We found no associations between preimmigration factors and treatment completion. A case of active TB was detected and treated. Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada.
This publication has no Abstract to dispaly

Different Approaches to Cross-Lingual Focus Groups: Lessons From a Cross-Cultural Community-Based Participatory Research Project in the ENRICH Study

Focus groups are a useful strategy in qualitative health research when it is important to understand how social contexts shape participants’ health. However, when cross-lingual focus groups are conducted, and in languages in which the researcher is not fluent, it raises questions regarding the usefulness and rigor of the findings. In this article, we will discuss three different approaches to cross-lingual focus groups used in a community-based participatory research project with pregnant and postpartum, African immigrant women in Alberta, Canada. In two approaches, we moderated focus groups in women’s mother tongue with the support of real-time interpreters, but in the first approach, audio recording was used and in the second approach, audio recording was not used. In the third approach, a bilingual moderator facilitated focus groups in women’s mother tongue, with transcription and translation of audio-recorded data upon completion of data generation. We expect the lessons learned in this project may assist others in planning and implementing cross-lingual focus groups, especially in the context of community-based participatory research. Focus groups are a useful strategy in qualitative health research when it is important to understand how social contexts shape participants’ health. However, when cross-lingual focus groups are conducted, and in languages in which the researcher is not fluent, it raises questions regarding the usefulness and rigor of the findings. In this article, we will discuss three different approaches to cross-lingual focus groups used in a community-based participatory research project with pregnant and postpartum, African immigrant women in Alberta, Canada. In two approaches, we moderated focus groups in women’s mother tongue with the support of real-time interpreters, but in the first approach, audio recording was used and in the second approach, audio recording was not used. In the third approach, a bilingual moderator facilitated focus groups in women’s mother tongue, with transcription and translation of audio-recorded data upon completion of data generation. We expect the lessons learned in this project may assist others in planning and implementing cross-lingual focus groups, especially in the context of community-based participatory research.
This publication has no Abstract to dispaly

The dynamics of union responses to migrant workers in Canada

This study examines how five unions in the Canadian province of Alberta responded to a sudden influx of temporary foreign workers (TFWs) the mid-2000s. The authors find three types of response to the new TFW members: resistive, facilitative and active. (1) resistive response, which stems from unions’ unwillingness to advocate for TFWs as a part of the union membership and to acknolwedge thier economic vulnerabilities; (2) facilitative response, which is indicated by unions assisting emplyers to hire TFWs even if TFWs are viewed undesirable. This is a strategically advantageous response for unions because cooperation with the employer ‘maintains a steady labour supply to keep projects moving and members employed’; (3) and active response, which is marked by genuine efforts by unions to confront employers and advocate for TFWs’ vulnerability and unique legal status. Furthermore, these responses were dynamic and changing over time. The different responses are best explained not by the unions’ institutional context, but by internal factors shaping each union’s response. This study examines how five unions in the Canadian province of Alberta responded to a sudden influx of temporary foreign workers (TFWs) the mid-2000s. The authors find three types of response to the new TFW members: resistive, facilitative and active. (1) resistive response, which stems from unions’ unwillingness to advocate for TFWs as a part of the union membership and to acknolwedge thier economic vulnerabilities; (2) facilitative response, which is indicated by unions assisting emplyers to hire TFWs even if TFWs are viewed undesirable. This is a strategically advantageous response for unions because cooperation with the employer ‘maintains a steady labour supply to keep projects moving and members employed’; (3) and active response, which is marked by genuine efforts by unions to confront employers and advocate for TFWs’ vulnerability and unique legal status. Furthermore, these responses were dynamic and changing over time. The different responses are best explained not by the unions’ institutional context, but by internal factors shaping each union’s response.
This publication has no Abstract to dispaly

“If they tell me to get it, I’ll get it. If they don’t….”: Immunization decision-making processes of immigrant mothers

This paper aims to understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination. Our three main findings on information gathering and use in vaccination decisions were: 1) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants’ recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta. Our results highlight the limitations of Alberta’s current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children. This paper aims to understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination. Our three main findings on information gathering and use in vaccination decisions were: 1) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants’ recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta. Our results highlight the limitations of Alberta’s current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children.
This publication has no Abstract to dispaly

Exploring Sociocultural Factors During Pregnancy and Postpartum among African-immigrant Women within the Context of a Community-Based Organization

Low socioeconomic status, language difficulties and sociocultural barriers can negatively affect many aspects of a healthy pregnancy, including dietary practices. Various life adversities (e.g., poverty), in the absence of women’s family circle created a sense of isolation and increased stress, which were heightened by pregnancy and postpartum. African-immigrant women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy. This included nutritious foods, physical activity opportunities, and adequate time for rest. Once in Canada, without sufficient social support, it becomes extremely challenging to be healthy during pregnancy and postpartum. However, women described that services and supports offered through MCHB (Multicultural Health Brokers Co-operatie) (e.g., childcare, cooking classes) facilitated a healthy pregnancy and postpartum. Community-based organizations (CBOs) appear to foster a sense of kinship women often miss when they immigrate to a new country and become pregnant. Policies that support CBOs, and ensure adequate funding, will enable continuing services that can assist immigrant women in being healthier during pregnancy and postpartum in Canada. Low socioeconomic status, language difficulties and sociocultural barriers can negatively affect many aspects of a healthy pregnancy, including dietary practices. Various life adversities (e.g., poverty), in the absence of women’s family circle created a sense of isolation and increased stress, which were heightened by pregnancy and postpartum. African-immigrant women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy. This included nutritious foods, physical activity opportunities, and adequate time for rest. Once in Canada, without sufficient social support, it becomes extremely challenging to be healthy during pregnancy and postpartum. However, women described that services and supports offered through MCHB (Multicultural Health Brokers Co-operatie) (e.g., childcare, cooking classes) facilitated a healthy pregnancy and postpartum. Community-based organizations (CBOs) appear to foster a sense of kinship women often miss when they immigrate to a new country and become pregnant. Policies that support CBOs, and ensure adequate funding, will enable continuing services that can assist immigrant women in being healthier during pregnancy and postpartum in Canada.
This publication has no Abstract to dispaly

Living arrangements and loneliness of South Asian immigrant seniors in Edmonton, Canada

This paper examines the relationships between self-reported loneliness and living arrangements. A questionnaire with some open-ended questions was administered face-to-face in English, Hindi or Punjabi to a sample of 161 elderly South Asian immigrants 60 or more years of age living in Edmonton, Alberta, Canada in 2003. The majority of respondents said that they never felt lonely. More than one in three (37.3%) respondents indicated that they felt lonely occasionally, frequently or all of the time. Those living alone were significantly more likely to report feeling lonely at least occasionally than were those living with others, especially those living with their spouse in an extended family. The fact that South Asian immigrant seniors typically lived with others, often in an extended family with or without their spouse, and rarely lived alone protected them to some extent from loneliness. However, our findings showed that among those living with others, it was the amount of waking time spent alone at home and the quality of family relationships rather than living arrangement per se that significantly predicted self-reported loneliness. Nevertheless, living in a larger household was associated with spending less time alone. This paper examines the relationships between self-reported loneliness and living arrangements. A questionnaire with some open-ended questions was administered face-to-face in English, Hindi or Punjabi to a sample of 161 elderly South Asian immigrants 60 or more years of age living in Edmonton, Alberta, Canada in 2003. The majority of respondents said that they never felt lonely. More than one in three (37.3%) respondents indicated that they felt lonely occasionally, frequently or all of the time. Those living alone were significantly more likely to report feeling lonely at least occasionally than were those living with others, especially those living with their spouse in an extended family. The fact that South Asian immigrant seniors typically lived with others, often in an extended family with or without their spouse, and rarely lived alone protected them to some extent from loneliness. However, our findings showed that among those living with others, it was the amount of waking time spent alone at home and the quality of family relationships rather than living arrangement per se that significantly predicted self-reported loneliness. Nevertheless, living in a larger household was associated with spending less time alone.
This publication has no Abstract to dispaly

An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta

Many immigrant and ethno-cultural groups in Canada face substantial barriers to accessing health care including language barriers. This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada. We identified four main themes including verbal communication, unshared meaning, non-verbal communication to build relationships, and trauma, culture and open communication. Communication difficulties extended beyond matters of language competency to those encompassing non-verbal communication and its relation to shared meaning as well as the interplay of underlying pre-migration history and cultural factors which affect open communication, accessible health care and perhaps also maternal outcomes. Communication challenges may be experienced by all parties, yet those within health care management and professional bodies are responsible to ensure that providers are equipped with the skills necessary to facilitate culturally appropriate care. Many immigrant and ethno-cultural groups in Canada face substantial barriers to accessing health care including language barriers. This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada. We identified four main themes including verbal communication, unshared meaning, non-verbal communication to build relationships, and trauma, culture and open communication. Communication difficulties extended beyond matters of language competency to those encompassing non-verbal communication and its relation to shared meaning as well as the interplay of underlying pre-migration history and cultural factors which affect open communication, accessible health care and perhaps also maternal outcomes. Communication challenges may be experienced by all parties, yet those within health care management and professional bodies are responsible to ensure that providers are equipped with the skills necessary to facilitate culturally appropriate care.
This publication has no Abstract to dispaly

The power of agency: Transformation of gender roles and marital relations among Nigerian immigrant women in Lethbridge, Alberta

This research explores the shifting subjectivities of eight Nigerian immigrant women as they negotiate gender roles and marital relations in Lethbridge. Using the Gendered Geographies of Power framework, this study uncovers a reflexive relationship between the social location of participants, and the type and degree of agency that they display as immigrant women, mothers, and wives, within geographies that include, the Canadian labour market, extended family networks in Nigeria, and nuclear households in Canada. Overall, findings show that by demonstrating agency, participants were able to appropriate social-cultural realities of migration and transnational living for the transformation of marital relations in ways that promoted gendered wellbeing and positioning within their marriages. This research explores the shifting subjectivities of eight Nigerian immigrant women as they negotiate gender roles and marital relations in Lethbridge. Using the Gendered Geographies of Power framework, this study uncovers a reflexive relationship between the social location of participants, and the type and degree of agency that they display as immigrant women, mothers, and wives, within geographies that include, the Canadian labour market, extended family networks in Nigeria, and nuclear households in Canada. Overall, findings show that by demonstrating agency, participants were able to appropriate social-cultural realities of migration and transnational living for the transformation of marital relations in ways that promoted gendered wellbeing and positioning within their marriages.
This publication has no Abstract to dispaly

Navigating maternity health care: a survey of the Canadian prairie newcomer experience

Immigration to Canada has significantly increased in recent years, particularly in the Prairie Provinces. There is evidence that pregnant newcomer women often encounter challenges when attempting to navigate the health system. Our aim was to explore newcomer women’s experiences in Canada regarding pregnancy, delivery and postpartum care and to assess the degree to which Canada provides equitable access to pregnancy and delivery services. Newcomers were more likely to be university graduates, but had lower incomes than Canadian-born women. Although newcomers residing in Prairie Provinces receive adequate maternity care, improvements are needed with respect to provision of information related to postpartum depression and informed choice around the need for C-sections. Immigration to Canada has significantly increased in recent years, particularly in the Prairie Provinces. There is evidence that pregnant newcomer women often encounter challenges when attempting to navigate the health system. Our aim was to explore newcomer women’s experiences in Canada regarding pregnancy, delivery and postpartum care and to assess the degree to which Canada provides equitable access to pregnancy and delivery services. Newcomers were more likely to be university graduates, but had lower incomes than Canadian-born women. Although newcomers residing in Prairie Provinces receive adequate maternity care, improvements are needed with respect to provision of information related to postpartum depression and informed choice around the need for C-sections.
This publication has no Abstract to dispaly

“I have to do what I believe”: Sudanese women’s beliefs and resistance to hegemonic practices at home and during experiences of maternity care in Canada

Evidence suggests that immigrant women having different ethnocultural backgrounds than those dominant in the host country have difficulty during their access to and reception of maternity care services. Amongst immigrant populations in Canada, refugee women are one of the most vulnerable groups and pregnant women with immediate needs for health care services may be at higher risk of health problems. The findings of this paper revealed that there are many beliefs that impact upon behaviours and perceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe could harm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without need for special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family by males and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment for women, and the women tend to exert control in ways that may or may not be respected by their husbands. Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength. In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm, through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care. Evidence suggests that immigrant women having different ethnocultural backgrounds than those dominant in the host country have difficulty during their access to and reception of maternity care services. Amongst immigrant populations in Canada, refugee women are one of the most vulnerable groups and pregnant women with immediate needs for health care services may be at higher risk of health problems. The findings of this paper revealed that there are many beliefs that impact upon behaviours and perceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe could harm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without need for special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family by males and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment for women, and the women tend to exert control in ways that may or may not be respected by their husbands. Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength. In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm, through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.
This publication has no Abstract to dispaly