Research Library

The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across diferent COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. Structured interviews with Government Assisted Refugees (n=39), and semistructured interviews with Privately Sponsored Refugees (n=6), private refugee sponsors (n=3), and stakeholders involved in vaccination systems (n=13) were conducted in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn. The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across diferent COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. Structured interviews with Government Assisted Refugees (n=39), and semistructured interviews with Privately Sponsored Refugees (n=6), private refugee sponsors (n=3), and stakeholders involved in vaccination systems (n=13) were conducted in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn.
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Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders. Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders.
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The purpose of this chapter is to discuss continuing professional development (CPD) for Teaching English to Speakers of Other Languages (TESOL) instructors in the Language Instruction for Newcomers to Canada (LINC) programme in the province of Alberta, Canada. LINC is a federally funded, tuition-free, basic English language training programme for beginner to intermediate adult learners that is designed to facilitate immigrants’ integration into Canadian society. The Teachers of English as a Second Language (TESL) Canada Federation and provincial professional associations such as the Alberta Teachers of English as a Second Language (ATESL) also organize professional development (PD) activities (e.g., conferences, workshops, webinars). However, these PD activities are typically one-shot events where the learning facilitator determines the learning objectives, but these objectives may not necessarily align with individual instructors’ CPD needs. Over the past decade, groups of LINC instructors with diverse teaching experiences have been participating in researcher-supported professional reading groups as an additional form of informal, situated CPD in Alberta. The group members regularly select and read peer-reviewed articles and meet to discuss articles during unpaid time as a way to address their shared, current CPD needs and goals. They also complete researcher-designed questionnaires and participate in focus group interviews that ask them to reflect on and document the impact that the information in the articles and group discussions had on their professional practices. In these groups, the members reflect on their own practices, and combine one another’s knowledge and experience with the information in the articles to co-create innovative, research-informed solutions to their classroom issues. The purpose of this chapter is to discuss continuing professional development (CPD) for Teaching English to Speakers of Other Languages (TESOL) instructors in the Language Instruction for Newcomers to Canada (LINC) programme in the province of Alberta, Canada. LINC is a federally funded, tuition-free, basic English language training programme for beginner to intermediate adult learners that is designed to facilitate immigrants’ integration into Canadian society. The Teachers of English as a Second Language (TESL) Canada Federation and provincial professional associations such as the Alberta Teachers of English as a Second Language (ATESL) also organize professional development (PD) activities (e.g., conferences, workshops, webinars). However, these PD activities are typically one-shot events where the learning facilitator determines the learning objectives, but these objectives may not necessarily align with individual instructors’ CPD needs. Over the past decade, groups of LINC instructors with diverse teaching experiences have been participating in researcher-supported professional reading groups as an additional form of informal, situated CPD in Alberta. The group members regularly select and read peer-reviewed articles and meet to discuss articles during unpaid time as a way to address their shared, current CPD needs and goals. They also complete researcher-designed questionnaires and participate in focus group interviews that ask them to reflect on and document the impact that the information in the articles and group discussions had on their professional practices. In these groups, the members reflect on their own practices, and combine one another’s knowledge and experience with the information in the articles to co-create innovative, research-informed solutions to their classroom issues.
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What can be learned about the healthcare access of undocumented workers? How can health equity be advanced through sensitivity to the process of precaritization and the precarities informing their lives? Thailand and Spain are the only countries in the world that offer the same healthcare access to undocumented migrants as citizens. Most European countries only offer emergency services: France, the Netherlands, Portugal, Spain, and Switzerland allow undocumented migrants to access similar services to citizens if they meet conditions (proof of identity; length of residence in the country). European cities such as Ghent, Frankfurt, and Dusseldorf, offer barrier-free healthcare. Throughout the USA, Federally Qualified Health Centers support care to the uninsured regardless of immigration status. In Canada, Ontario and Quebec, provide a base level of healthcare access to undocumented migrants, and a small number of stand-alone community-based clinics offer additional care and specialized services. To promote healthcare for undocumented migrants in Alberta, barrier-free access to vaccination, COVID-19 treatment, and proof of vaccinations are essential, but an equity lens to healthcare service— informed by analytic understanding and robust approach to precaritization as a social determinant, is most needed. What can be learned about the healthcare access of undocumented workers? How can health equity be advanced through sensitivity to the process of precaritization and the precarities informing their lives? Thailand and Spain are the only countries in the world that offer the same healthcare access to undocumented migrants as citizens. Most European countries only offer emergency services: France, the Netherlands, Portugal, Spain, and Switzerland allow undocumented migrants to access similar services to citizens if they meet conditions (proof of identity; length of residence in the country). European cities such as Ghent, Frankfurt, and Dusseldorf, offer barrier-free healthcare. Throughout the USA, Federally Qualified Health Centers support care to the uninsured regardless of immigration status. In Canada, Ontario and Quebec, provide a base level of healthcare access to undocumented migrants, and a small number of stand-alone community-based clinics offer additional care and specialized services. To promote healthcare for undocumented migrants in Alberta, barrier-free access to vaccination, COVID-19 treatment, and proof of vaccinations are essential, but an equity lens to healthcare service— informed by analytic understanding and robust approach to precaritization as a social determinant, is most needed.
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Racialized, low-income, and migrant communities in East and Northeast Calgary were disproportionately impacted by COVID-19, yet faced vaccine access barriers. This article is a formative evaluation of a low-barrier, community-engaged vaccine outreach clinic in Calgary, Alberta, Canada, on June 5–6, 2021. Stakeholder respondents felt the clinic was effective (99.2%), efficient (96.9%), patient-centered (92.3%), and safe (90.8%), and that the outreach model was scalable 94.6% (123/130). Suggested improvements include increased time for clinic planning and promotion, more multilingual staff, and further efforts to reduce accessibility barriers, such as priority check-in for people with disabilities. These findings support the value of community-engaged outreach to improve vaccine equity among other marginalized newcomer communities. Racialized, low-income, and migrant communities in East and Northeast Calgary were disproportionately impacted by COVID-19, yet faced vaccine access barriers. This article is a formative evaluation of a low-barrier, community-engaged vaccine outreach clinic in Calgary, Alberta, Canada, on June 5–6, 2021. Stakeholder respondents felt the clinic was effective (99.2%), efficient (96.9%), patient-centered (92.3%), and safe (90.8%), and that the outreach model was scalable 94.6% (123/130). Suggested improvements include increased time for clinic planning and promotion, more multilingual staff, and further efforts to reduce accessibility barriers, such as priority check-in for people with disabilities. These findings support the value of community-engaged outreach to improve vaccine equity among other marginalized newcomer communities.
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Administrative data was used to study COVID-19 vaccine coverage in immigrants and refugees compared to the Canadian-born population. Broadly, immigrants and refugees (78.2%) had comparable vaccine coverage to Canadian-born individuals (76%). However, initiatives to improve vaccine coverage is needed for older immigrants, immigrants in rural areas, and immigrants from certain ethnicities. Administrative data was used to study COVID-19 vaccine coverage in immigrants and refugees compared to the Canadian-born population. Broadly, immigrants and refugees (78.2%) had comparable vaccine coverage to Canadian-born individuals (76%). However, initiatives to improve vaccine coverage is needed for older immigrants, immigrants in rural areas, and immigrants from certain ethnicities.
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This community-based research study provides new data collected from 25 in-depth individual interviews with immigrant women HCAs who were working in LTC in Calgary, Alberta between January 1 and March 30, 2021. The data, analysed through the lens of intersectional exclusion, highlight how the pandemic has impacted the working lives of immigrant women employed in LTC facilities on a daily basis, as well as their suggestions for enhancing their safety and employment conditions. Two key themes emerged during the process of data analysis: (a) HCA experiences of economic exclusion and workplace precarity—many of which pre-dated the pandemic but have been exacerbated by current policies and practices that prioritize profits over quality of community care, and (b) experiences of broader social exclusion, many of which are tied to being considered “just HCAs” who are doing “immigrant’s work”, rather than including HCAs in broader conversations about how to reform and improve the LTC sector for future. Concluding thoughts discuss how to improve policy to support low wage workers within LTC in order to address intersectional inequalities and to better support front-line care workers during current and future health pandemic recovery efforts. This community-based research study provides new data collected from 25 in-depth individual interviews with immigrant women HCAs who were working in LTC in Calgary, Alberta between January 1 and March 30, 2021. The data, analysed through the lens of intersectional exclusion, highlight how the pandemic has impacted the working lives of immigrant women employed in LTC facilities on a daily basis, as well as their suggestions for enhancing their safety and employment conditions. Two key themes emerged during the process of data analysis: (a) HCA experiences of economic exclusion and workplace precarity—many of which pre-dated the pandemic but have been exacerbated by current policies and practices that prioritize profits over quality of community care, and (b) experiences of broader social exclusion, many of which are tied to being considered “just HCAs” who are doing “immigrant’s work”, rather than including HCAs in broader conversations about how to reform and improve the LTC sector for future. Concluding thoughts discuss how to improve policy to support low wage workers within LTC in order to address intersectional inequalities and to better support front-line care workers during current and future health pandemic recovery efforts.
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In this qualitative study, researchers conducted interviews with 11 participants who had entered Canada through the Temporary Foreign Worker Program and who had since loss status. Findings show policy changes, abuse and exploitation by employers, language barriers, and misinformation and language gaps drive workers out of status. Once without status, people often remain in Canada because they are motivated by issues related to family. These can include the continued desire to bring family members to Canada, financial responsibilities for family members in countries of origin, the desire to stay with Canadian partners or children, or the breakdown of family ties which dissuades the desire to return. Challenges of living without status include mental health struggles, financial strain, and barriers to service access. Interplays between factors driving status loss and experiences of those who live without status in Canada show that the state plays an important role in creating precarity through restrictive immigration and residency policies. Understandings the state’s role in the production of precarity may inform effective policy changes moving forward. In this qualitative study, researchers conducted interviews with 11 participants who had entered Canada through the Temporary Foreign Worker Program and who had since loss status. Findings show policy changes, abuse and exploitation by employers, language barriers, and misinformation and language gaps drive workers out of status. Once without status, people often remain in Canada because they are motivated by issues related to family. These can include the continued desire to bring family members to Canada, financial responsibilities for family members in countries of origin, the desire to stay with Canadian partners or children, or the breakdown of family ties which dissuades the desire to return. Challenges of living without status include mental health struggles, financial strain, and barriers to service access. Interplays between factors driving status loss and experiences of those who live without status in Canada show that the state plays an important role in creating precarity through restrictive immigration and residency policies. Understandings the state’s role in the production of precarity may inform effective policy changes moving forward.
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This cross-sectional study examines the healthcare experiences of Albertans during the COVID-19 pandemic, with a focus on comparing experiences between those born in and outside Canada. The study collected 10,175 surveys in October 2020, with nearly 10% of respondents reporting their status as born outside Canada. The study found that foreign-born Albertans experienced more delays in care and had less access to healthcare services than Canadian-born Albertans. The study highlights the need for policy and practice changes to address the healthcare disparities faced by immigrant populations during the pandemic. This cross-sectional study examines the healthcare experiences of Albertans during the COVID-19 pandemic, with a focus on comparing experiences between those born in and outside Canada. The study collected 10,175 surveys in October 2020, with nearly 10% of respondents reporting their status as born outside Canada. The study found that foreign-born Albertans experienced more delays in care and had less access to healthcare services than Canadian-born Albertans. The study highlights the need for policy and practice changes to address the healthcare disparities faced by immigrant populations during the pandemic.
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There remains an ongoing need to address not only the post-migration experiences of newcomers settling in Calgary but also to understand how systems that serve them perceive, make sense of, and contribute to these experiences. By hearing from those who work with newcomers within the institutional settings that support newcomers, we can begin to understand some complexities of newcomer integration. The purpose of this qualitative pilot study was to explore the perceptions that front-line workers hold regarding needs and experiences of newcomers. This study involved a series of eleven semi-structured interviews with workers at an immigrant-serving language-learning agency which were analyzed using thematic coding. The findings highlighted: front-line workers perception of their newcomer cli-ents’ identity in connection to language; the clients’ emotional burden and sense of belonging; and the challenges clients faced balancing everyday commitments. Moreover, this study explored the front-line worker’s role in cultural brokerage and promoting wellness. This study provided reason to value the practices and interpretations that front-line workers have of the newcomer experience due to the role they play in creating a sense of integration for newcom-ers. The interpretations that surfaced in this study sheds light on the complexity that both front-line workers and newcomers face and implies that further research and interventions are needed to ensure successful integration There remains an ongoing need to address not only the post-migration experiences of newcomers settling in Calgary but also to understand how systems that serve them perceive, make sense of, and contribute to these experiences. By hearing from those who work with newcomers within the institutional settings that support newcomers, we can begin to understand some complexities of newcomer integration. The purpose of this qualitative pilot study was to explore the perceptions that front-line workers hold regarding needs and experiences of newcomers. This study involved a series of eleven semi-structured interviews with workers at an immigrant-serving language-learning agency which were analyzed using thematic coding. The findings highlighted: front-line workers perception of their newcomer cli-ents’ identity in connection to language; the clients’ emotional burden and sense of belonging; and the challenges clients faced balancing everyday commitments. Moreover, this study explored the front-line worker’s role in cultural brokerage and promoting wellness. This study provided reason to value the practices and interpretations that front-line workers have of the newcomer experience due to the role they play in creating a sense of integration for newcom-ers. The interpretations that surfaced in this study sheds light on the complexity that both front-line workers and newcomers face and implies that further research and interventions are needed to ensure successful integration
This publication has no Abstract to dispaly