Research Library

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.
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A conceptual model was designed and tested to predict immigrant children’s oral health in Canada by examining parental acculturation and perceived social support (PSS) using structural equation modelling. A convenience sample of first-generation immigrant parents and their children aged 2–12 years were recruited by multilingual community workers in Edmonton, AB, Canada. Parents completed a validated questionnaire on demographics, child’s oral health (OH) behaviours, parental acculturation and PSS. Dental examinations determined children’s dental caries rate using DMFT/dmft index. Structural equation modelling (SEM) was used to analyse the data. A total of 336 families participated in this study. The findings emphasize the important role of parental acculturation and PSS levels in predicting immigrant children’s oral health behaviours and dental caries. A conceptual model was designed and tested to predict immigrant children’s oral health in Canada by examining parental acculturation and perceived social support (PSS) using structural equation modelling. A convenience sample of first-generation immigrant parents and their children aged 2–12 years were recruited by multilingual community workers in Edmonton, AB, Canada. Parents completed a validated questionnaire on demographics, child’s oral health (OH) behaviours, parental acculturation and PSS. Dental examinations determined children’s dental caries rate using DMFT/dmft index. Structural equation modelling (SEM) was used to analyse the data. A total of 336 families participated in this study. The findings emphasize the important role of parental acculturation and PSS levels in predicting immigrant children’s oral health behaviours and dental caries.
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Research on immigrant and refugee vaccination uptake in Canada shows that immunization decisions vary by vaccine type, location, age and migration status. Despite their diversity, these studies often treat immigrant and refugee populations as a single group relative to other Canadians. In this comparative study, we explored how previous risk communication and immunization experiences influence immunization decisions by immigrant and refugee women from three communities across Canada. Participants included women from the Punjabi immigrant community located in Surrey and Abbotsford, British Columbia (n = 36), the Nigerian immigrant community located in Winnipeg, Manitoba (n = 43), and the Congolese refugee community in Edmonton, Alberta (n = 18). Using focus groups, we sought to understand immunization experiences in Canada and before arrival, and what information sources influenced the immunization decision-making process by the women in the three communities. Given our participants’ different communication preferences and needs, we argue that a one-size-fits-all communication approach is inappropriate for immigrant and refugee populations. Research on immigrant and refugee vaccination uptake in Canada shows that immunization decisions vary by vaccine type, location, age and migration status. Despite their diversity, these studies often treat immigrant and refugee populations as a single group relative to other Canadians. In this comparative study, we explored how previous risk communication and immunization experiences influence immunization decisions by immigrant and refugee women from three communities across Canada. Participants included women from the Punjabi immigrant community located in Surrey and Abbotsford, British Columbia (n = 36), the Nigerian immigrant community located in Winnipeg, Manitoba (n = 43), and the Congolese refugee community in Edmonton, Alberta (n = 18). Using focus groups, we sought to understand immunization experiences in Canada and before arrival, and what information sources influenced the immunization decision-making process by the women in the three communities. Given our participants’ different communication preferences and needs, we argue that a one-size-fits-all communication approach is inappropriate for immigrant and refugee populations.
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Forced migration is one of the most pressing crises of our lifetime. Of the millions forced to migrate, many come to know the brutality of state-managed migration that habitually denies asylum seekers and places substantive restrictions on refugees who have been resettled. Sociologists of sport and leisure have examined the sporting experiences of refugees through an intersectional lens, foregrounding how displacement and resettlement are differently lived and negotiated across overlapping power structures and markers of gender, sexuality, ethnicity, religion, and legal status. Through a participatory and collective photovoice project, this article explores the experiences of an all-Afghan soccer team that played in a social, co-ed soccer league in the spring of 2022, just after they arrived in Edmonton, Alberta, Canada. In photovoice narratives and subsequent interviews, team members underlined many of the barriers they faced as they navigated the formal and informal rules and dominant norms of this seemingly inclusive sports landscape. In doing so, they revealed some of the limits of official discourses of Canadian multiculturism, which rarely accommodate more significant forms of difference, and which reproduce racial and ethnic hierarchies that powerfully discipline newcomers who are encouraged to embrace their precarious status as model minorities. Forced migration is one of the most pressing crises of our lifetime. Of the millions forced to migrate, many come to know the brutality of state-managed migration that habitually denies asylum seekers and places substantive restrictions on refugees who have been resettled. Sociologists of sport and leisure have examined the sporting experiences of refugees through an intersectional lens, foregrounding how displacement and resettlement are differently lived and negotiated across overlapping power structures and markers of gender, sexuality, ethnicity, religion, and legal status. Through a participatory and collective photovoice project, this article explores the experiences of an all-Afghan soccer team that played in a social, co-ed soccer league in the spring of 2022, just after they arrived in Edmonton, Alberta, Canada. In photovoice narratives and subsequent interviews, team members underlined many of the barriers they faced as they navigated the formal and informal rules and dominant norms of this seemingly inclusive sports landscape. In doing so, they revealed some of the limits of official discourses of Canadian multiculturism, which rarely accommodate more significant forms of difference, and which reproduce racial and ethnic hierarchies that powerfully discipline newcomers who are encouraged to embrace their precarious status as model minorities.
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Resettlement for refugee youth in Canada presents multifaceted challenges, notably in integrating into existing social structures, including sports and physical activity (PA) programs. Sports and PA programs can play a crucial role in promoting physical and mental well-being, yet refugee youth often face lower participation rates compared to their Canadian-born counterparts. To address this gap, this study investigated the impact of a community-developed multi-sport program, the Calgary Catholic Immigration Society (CCIS) multi-sport program, on the physical literacy (PL) development and psychosocial well-being of young refugees in Calgary, AB, Canada. The program aimed to equip refugee youth with the tools to embrace sports and PA opportunities in their new environment, fostering physical well-being and a sense of belonging. A total of 16 refugee youth participants between the ages of 13-19 years old (Mean age = 16.00±1.75, n =14 males) were recruited for this study and were living in temporary housing (M = 1.19 months on arrival) while being assisted by CCIS during their resettlement period. The study employed mixed methods, including the PLAY-basic tool and a modified PLAY-self questionnaire, to assess program effects on various PL domains. Qualitative data from focus group interviews and an ethnographic approach provided further insights into the program’s broader impact on well-being and social health. Resettlement for refugee youth in Canada presents multifaceted challenges, notably in integrating into existing social structures, including sports and physical activity (PA) programs. Sports and PA programs can play a crucial role in promoting physical and mental well-being, yet refugee youth often face lower participation rates compared to their Canadian-born counterparts. To address this gap, this study investigated the impact of a community-developed multi-sport program, the Calgary Catholic Immigration Society (CCIS) multi-sport program, on the physical literacy (PL) development and psychosocial well-being of young refugees in Calgary, AB, Canada. The program aimed to equip refugee youth with the tools to embrace sports and PA opportunities in their new environment, fostering physical well-being and a sense of belonging. A total of 16 refugee youth participants between the ages of 13-19 years old (Mean age = 16.00±1.75, n =14 males) were recruited for this study and were living in temporary housing (M = 1.19 months on arrival) while being assisted by CCIS during their resettlement period. The study employed mixed methods, including the PLAY-basic tool and a modified PLAY-self questionnaire, to assess program effects on various PL domains. Qualitative data from focus group interviews and an ethnographic approach provided further insights into the program’s broader impact on well-being and social health.
This publication has no Abstract to dispaly

The immigrant population in Canada is rapidly increasing and projected to rise exponentially in the coming years. The immigrant population faces complex and diverse challenges when transitioning into a new country, and this occurrence may be uniquely experienced by youth, who are also navigating transitions in child development, most notably into adolescence. Embedded in a broader mixed methods pilot project, the aim of this thesis was to qualitatively investigate the impact of the Immigrant-based Physical Literacy for Youth (IPLAY) program on mental health and well-being. 21 Afghan refugee youth in Calgary, AB who participated in IPLAY were interviewed. Results indicated that youth held a holistic conceptualization of mental health, contrasting what is common practice in the field and literature. Such findings provide a rich tapestry of understanding into how newcomer youth define, understand, and experience mental health, and implications for stress management. The immigrant population in Canada is rapidly increasing and projected to rise exponentially in the coming years. The immigrant population faces complex and diverse challenges when transitioning into a new country, and this occurrence may be uniquely experienced by youth, who are also navigating transitions in child development, most notably into adolescence. Embedded in a broader mixed methods pilot project, the aim of this thesis was to qualitatively investigate the impact of the Immigrant-based Physical Literacy for Youth (IPLAY) program on mental health and well-being. 21 Afghan refugee youth in Calgary, AB who participated in IPLAY were interviewed. Results indicated that youth held a holistic conceptualization of mental health, contrasting what is common practice in the field and literature. Such findings provide a rich tapestry of understanding into how newcomer youth define, understand, and experience mental health, and implications for stress management.
This publication has no Abstract to dispaly

The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. For immigrant female adolescents of Pakistani descent, who are also racialized youth in Canada, the silence around issues of sexuality needs can affect their physical, emotional, and sexual health and well-being, and ability to reach their full potential. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than do non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with sociocultural and religious practices. The overarching purpose of this dissertation is to contribute towards improving sexual health of female immigrant adolescents living in Canada. The purpose of this study was to qualitatively explore the experience of developing sexuality and its relationship to developing identity and well-being in middle- to late- female adolescents of Pakistani-descent, living in a large urban area in Alberta, Canada. This study sought to create space for dialogue and to explore the perceived cultural influence on issues of sexuality that often arise among individuals from different cultural backgrounds using the postmodern feminist lens. An art-based strategy was used to conduct research with 21 female adolescents who were of first- or second-generation Pakistani-descent. Data was collected using semi-structured interviews and having participants create a relevant timeline. The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. For immigrant female adolescents of Pakistani descent, who are also racialized youth in Canada, the silence around issues of sexuality needs can affect their physical, emotional, and sexual health and well-being, and ability to reach their full potential. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than do non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with sociocultural and religious practices. The overarching purpose of this dissertation is to contribute towards improving sexual health of female immigrant adolescents living in Canada. The purpose of this study was to qualitatively explore the experience of developing sexuality and its relationship to developing identity and well-being in middle- to late- female adolescents of Pakistani-descent, living in a large urban area in Alberta, Canada. This study sought to create space for dialogue and to explore the perceived cultural influence on issues of sexuality that often arise among individuals from different cultural backgrounds using the postmodern feminist lens. An art-based strategy was used to conduct research with 21 female adolescents who were of first- or second-generation Pakistani-descent. Data was collected using semi-structured interviews and having participants create a relevant timeline.
This publication has no Abstract to dispaly

We investigated health risks associated with climate and air pollution hazards and community covariates to generate insights into the resilience of older adults and immigrants at the community level in a northern urban center in the Canadian prairies (i.e. Edmonton, AB). Communities with higher proportions of older adults were associated with increased cardiovascular, injury, mental, and respiratory health event rates. Notably, heat effects on injury rates impacted communities with higher percentages of older adults (Prevalence Rate Ratio (PRR) [95%CI] 1.110 [1.011, 1.219] at 25% ≥65 years). Ozone effects on cardiovascular event rates exhibited similar trends. Areas with higher percentages of immigrants generally had lower rates of health events. However, increasing diurnal temperature range became a risk factor for respiratory health rates where there were higher percentages of refugees (PRR 1.205 [1.004, 1.447] at 20%). Industrial emission effects on injury and respiratory health rates also amplified in areas with higher percentages of refugees (PRR 1.127 [1.058, 1.200]; 1.130 [1.050, 1.216] at 20%). Similar effects were observed for mental health event rates and total immigrants. Greater neighborhood material and social deprivation were significant risk factors for increased health event rates across outcomes. Future work should focus on disproportionately affected vulnerable populations to address community-level resilience. We investigated health risks associated with climate and air pollution hazards and community covariates to generate insights into the resilience of older adults and immigrants at the community level in a northern urban center in the Canadian prairies (i.e. Edmonton, AB). Communities with higher proportions of older adults were associated with increased cardiovascular, injury, mental, and respiratory health event rates. Notably, heat effects on injury rates impacted communities with higher percentages of older adults (Prevalence Rate Ratio (PRR) [95%CI] 1.110 [1.011, 1.219] at 25% ≥65 years). Ozone effects on cardiovascular event rates exhibited similar trends. Areas with higher percentages of immigrants generally had lower rates of health events. However, increasing diurnal temperature range became a risk factor for respiratory health rates where there were higher percentages of refugees (PRR 1.205 [1.004, 1.447] at 20%). Industrial emission effects on injury and respiratory health rates also amplified in areas with higher percentages of refugees (PRR 1.127 [1.058, 1.200]; 1.130 [1.050, 1.216] at 20%). Similar effects were observed for mental health event rates and total immigrants. Greater neighborhood material and social deprivation were significant risk factors for increased health event rates across outcomes. Future work should focus on disproportionately affected vulnerable populations to address community-level resilience.
This publication has no Abstract to dispaly

Miscarriage is the most common pregnancy complication affecting 1 in 4 pregnancies. The loss of a baby can seriously impact women’s physical and mental health, leading to traumatic disorders such as anxiety, depression, anger, self-blame, and self-harm. Women who receive support after their miscarriage are more likely to manage their mental health well. Despite this, research shows many women do not have access to the support they need after a miscarriage. Immigrant women have more difficulties accessing support due to communication barriers, cultural barriers, differences in their religion compared to their host country, and living far from family and support networks. The objective of this thesis project is to investigate the areas where immigrant women lack support and determine how the design of a digital platform can provide this support helping to improve women’s well-being after a miscarriage. Semi-structured interviews were conducted with experts in the fields of obstetrics/gynecology, psychology, grief counselling, and user experience design to better understand 1) The challenges women experience after having a miscarriage, 2) How immigrants’ experience with miscarriage is different from the Canadian experience, and 3) How the design of an application could help women better manage their health physically and mentally after having a miscarriage. In addition, a co-design session with experts was held to find the design solutions and recommendations for creating a digital platform. Lastly, the data analysis from the interviews, analysis of existing miscarriage applications, co-design session with experts and literature review were employed to develop a mobile application called Miscarriage Corner. The application aims to support immigrant women through their healing journey after a miscarriage. This thesis project explores the potential benefits of employing technology to improve the accessibility and usability of a mobile application to provide a support system for immigrant women who have had a miscarriage. Miscarriage is the most common pregnancy complication affecting 1 in 4 pregnancies. The loss of a baby can seriously impact women’s physical and mental health, leading to traumatic disorders such as anxiety, depression, anger, self-blame, and self-harm. Women who receive support after their miscarriage are more likely to manage their mental health well. Despite this, research shows many women do not have access to the support they need after a miscarriage. Immigrant women have more difficulties accessing support due to communication barriers, cultural barriers, differences in their religion compared to their host country, and living far from family and support networks. The objective of this thesis project is to investigate the areas where immigrant women lack support and determine how the design of a digital platform can provide this support helping to improve women’s well-being after a miscarriage. Semi-structured interviews were conducted with experts in the fields of obstetrics/gynecology, psychology, grief counselling, and user experience design to better understand 1) The challenges women experience after having a miscarriage, 2) How immigrants’ experience with miscarriage is different from the Canadian experience, and 3) How the design of an application could help women better manage their health physically and mentally after having a miscarriage. In addition, a co-design session with experts was held to find the design solutions and recommendations for creating a digital platform. Lastly, the data analysis from the interviews, analysis of existing miscarriage applications, co-design session with experts and literature review were employed to develop a mobile application called Miscarriage Corner. The application aims to support immigrant women through their healing journey after a miscarriage. This thesis project explores the potential benefits of employing technology to improve the accessibility and usability of a mobile application to provide a support system for immigrant women who have had a miscarriage.
This publication has no Abstract to dispaly

The entire healthcare system, including primary healthcare (PHC) services, has been disrupted since the onset of the COVID-19 pandemic. As the crisis threatens all citizens significantly, further barriers to accessing care exist for those who are most vulnerable, experience marginalization, and have pre-existing challenges. We aimed to explore immigrants’ lived experiences in accessing and receiving PHC services during the pandemic. A multiphase mixed-methods study using a sequential explanatory design was employed. The first study includes a systematic review that synthesizes the evidence on the experiences that immigrant patients have receiving PHC. Study two provides insights from a recently employed “COVID-19 Experiences and Impacts Survey” data and compares the experiences of Albertans that were born in and outside Canada. Descriptive statistics and multivariable logistic regression were performed, using STATA. The third study is a qualitative inquiry that aims to gain a deeper understanding of the newcomers’ (living in Canada ≤5 years) and providers’ experiences in PHC during the pandemic. A thematic analysis was applied, using NVivo software. Immigrants reported many challenges in accessing and receiving PHC, and these challenges have been increased since the COVID-19 pandemic. The results of this thesis yielded six recommendations that can inform PHC quality improvement initiatives and PHC policy. The entire healthcare system, including primary healthcare (PHC) services, has been disrupted since the onset of the COVID-19 pandemic. As the crisis threatens all citizens significantly, further barriers to accessing care exist for those who are most vulnerable, experience marginalization, and have pre-existing challenges. We aimed to explore immigrants’ lived experiences in accessing and receiving PHC services during the pandemic. A multiphase mixed-methods study using a sequential explanatory design was employed. The first study includes a systematic review that synthesizes the evidence on the experiences that immigrant patients have receiving PHC. Study two provides insights from a recently employed “COVID-19 Experiences and Impacts Survey” data and compares the experiences of Albertans that were born in and outside Canada. Descriptive statistics and multivariable logistic regression were performed, using STATA. The third study is a qualitative inquiry that aims to gain a deeper understanding of the newcomers’ (living in Canada ≤5 years) and providers’ experiences in PHC during the pandemic. A thematic analysis was applied, using NVivo software. Immigrants reported many challenges in accessing and receiving PHC, and these challenges have been increased since the COVID-19 pandemic. The results of this thesis yielded six recommendations that can inform PHC quality improvement initiatives and PHC policy.
This publication has no Abstract to dispaly