Research Library

The human immunodeficiency virus (HIV) pandemic is a global public health and social justice issue, where HIV continues to disproportionately affect marginalized populations. This study investigated and captured the experiences of immigrants and refugees living with HIV (IRLHIV) using the social determinants of health framework. This study examined the intersecting factors affecting the health and well-being of IRLHIV in Alberta, Canada, prior to and during the COVID-19 pandemic. Concurrent mixed methods were used. Employing an online survey (n = 124) and photovoice methodology (n = 13), the findings underscored the amplification of pre-existing inequities during the COVID-19 pandemic, intensifying the discrimination and stigma faced by IRLHIV due to both their health status and immigration background. The human immunodeficiency virus (HIV) pandemic is a global public health and social justice issue, where HIV continues to disproportionately affect marginalized populations. This study investigated and captured the experiences of immigrants and refugees living with HIV (IRLHIV) using the social determinants of health framework. This study examined the intersecting factors affecting the health and well-being of IRLHIV in Alberta, Canada, prior to and during the COVID-19 pandemic. Concurrent mixed methods were used. Employing an online survey (n = 124) and photovoice methodology (n = 13), the findings underscored the amplification of pre-existing inequities during the COVID-19 pandemic, intensifying the discrimination and stigma faced by IRLHIV due to both their health status and immigration background.
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The newcomer serving sector remains pivotal in facilitating newcomers’ integration into communities, however, this sector grapples with ongoing challenges. Using a case story and immigration data from Calgary, AB, this article examines the funding and service delivery difficulties organizations encounter. It underscores a system that fosters funding competition, impedes interorganizational collaboration, complicates program outcome reporting, and entails high administrative costs. Additionally, it addresses the specific challenges faced by newcomer children, youth, and families settling in Canada. The recommendations emphasize that no single agency can resolve the settlement sector crisis alone. Urgent actions include piloting integrated networks over integrated services and adopting a new Immigration, Refugees and Citizenship Canada funding model that aligns with population and cultural needs. Moreover, eliminating silos is essential to establish a cohesive and efficient service delivery network committed to public outcomes and accountability. The newcomer serving sector remains pivotal in facilitating newcomers’ integration into communities, however, this sector grapples with ongoing challenges. Using a case story and immigration data from Calgary, AB, this article examines the funding and service delivery difficulties organizations encounter. It underscores a system that fosters funding competition, impedes interorganizational collaboration, complicates program outcome reporting, and entails high administrative costs. Additionally, it addresses the specific challenges faced by newcomer children, youth, and families settling in Canada. The recommendations emphasize that no single agency can resolve the settlement sector crisis alone. Urgent actions include piloting integrated networks over integrated services and adopting a new Immigration, Refugees and Citizenship Canada funding model that aligns with population and cultural needs. Moreover, eliminating silos is essential to establish a cohesive and efficient service delivery network committed to public outcomes and accountability.
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

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.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly

Racialized and/or ethnocultural minority older adults in supportive living settings may not have access to appropriate services and activities. Most supportive living facilities are mainstream (not specific to one group); however, culturally specific facilities are purpose-built to accommodate older adults from a particular group. Our objective was to describe the perspectives of diverse participants about access to culturally appropriate care, accessible services, and social and recreation activities in culturally specific and mainstream (non-specific) supportive living facilities. We conducted semi-structured interviews with 21 people (11 staff, 8 family members, 2 residents) from 7 supportive living homes (2 culturally specific and 5 mainstream) in Calgary or Edmonton, Alberta, Canada. We used a rapid qualitative inquiry approach to structure the data collection and analysis. Staff and family members described challenges in accessing culturally appropriate care in mainstream facilities. Family members expressed guilt and shame when their relative moved to supportive living, and they specifically described long waitlists for beds in culturally specific homes. Once in the facility, language barriers contributed to quality of care issues (e.g., delayed assessments) and challenges accessing recreation and social activities in both mainstream and culturally specific homes. Mainstream facilities often did not have appropriate food options and had limited supports for religious practices. Residents who had better English language proficiency had an easier transition to supportive living. Racialized and/or ethnoculturally diverse residents in mainstream supportive living facilities did not receive culturally appropriate care. Creating standalone facilities for every cultural group is not feasible; therefore, we must improve the care in mainstream facilities, including recruiting more diverse staff and integrating a wider range of recreation, religious services and food options. Racialized and/or ethnocultural minority older adults in supportive living settings may not have access to appropriate services and activities. Most supportive living facilities are mainstream (not specific to one group); however, culturally specific facilities are purpose-built to accommodate older adults from a particular group. Our objective was to describe the perspectives of diverse participants about access to culturally appropriate care, accessible services, and social and recreation activities in culturally specific and mainstream (non-specific) supportive living facilities. We conducted semi-structured interviews with 21 people (11 staff, 8 family members, 2 residents) from 7 supportive living homes (2 culturally specific and 5 mainstream) in Calgary or Edmonton, Alberta, Canada. We used a rapid qualitative inquiry approach to structure the data collection and analysis. Staff and family members described challenges in accessing culturally appropriate care in mainstream facilities. Family members expressed guilt and shame when their relative moved to supportive living, and they specifically described long waitlists for beds in culturally specific homes. Once in the facility, language barriers contributed to quality of care issues (e.g., delayed assessments) and challenges accessing recreation and social activities in both mainstream and culturally specific homes. Mainstream facilities often did not have appropriate food options and had limited supports for religious practices. Residents who had better English language proficiency had an easier transition to supportive living. Racialized and/or ethnoculturally diverse residents in mainstream supportive living facilities did not receive culturally appropriate care. Creating standalone facilities for every cultural group is not feasible; therefore, we must improve the care in mainstream facilities, including recruiting more diverse staff and integrating a wider range of recreation, religious services and food options.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly

In this study, we applied an intersectional framework to explore service providers’ perspectives on the mental health needs of newcomer young men. We conducted focus groups and interviews with 26 service providers in Edmonton, Calgary, and Vancouver, Canada. Findings show that service providers made sense of young men’s mental health needs and service access in the context of systems. We identified three interconnected themes: newcomer young men’s senses of self in relation to macrosystems, including racism and economic marginalization; settling well as a determinant of mental health; and systems capacities and interdependent resilience. While service providers are engaged in cross-sectoral work in support of newcomer young men’s mental health, this work is not being sufficiently supported. Further work is needed around cross-sector capacity bridging and advocacy, as well as the tailoring of services to young men without the assumption and reinforcement of gender stereotypes. In this study, we applied an intersectional framework to explore service providers’ perspectives on the mental health needs of newcomer young men. We conducted focus groups and interviews with 26 service providers in Edmonton, Calgary, and Vancouver, Canada. Findings show that service providers made sense of young men’s mental health needs and service access in the context of systems. We identified three interconnected themes: newcomer young men’s senses of self in relation to macrosystems, including racism and economic marginalization; settling well as a determinant of mental health; and systems capacities and interdependent resilience. While service providers are engaged in cross-sectoral work in support of newcomer young men’s mental health, this work is not being sufficiently supported. Further work is needed around cross-sector capacity bridging and advocacy, as well as the tailoring of services to young men without the assumption and reinforcement of gender stereotypes.
This publication has no Abstract to dispaly

Canada’s National Housing Strategy acknowledges that identity factors are closely connected to housing vulnerability. Specifically, it identifies 12 groups at heightened risk of negative housing outcomes in Canada. In this research, we focus on the intersection of two of these groups: LGBTQ people and refugees. Existing studies establish that members of both groups are vulnerable to discrimination, homelessness, and housing unaffordability. However, they have largely been examined separately, and with limited insights into the factors that produce vulnerability. To develop a more nuanced and systemic account of LGBTQ refugees’ housing vulnerability, we conducted a study in Alberta, Canada. Utilizing Crenshaw’s theory of intersectionality, and drawing on policy documents and key-informant interviews, we identified three types of barriers to housing. We conclude that an intersectional approach provides a foundation for systemic explanations of housing vulnerability that are too often absent in policy. Canada’s National Housing Strategy acknowledges that identity factors are closely connected to housing vulnerability. Specifically, it identifies 12 groups at heightened risk of negative housing outcomes in Canada. In this research, we focus on the intersection of two of these groups: LGBTQ people and refugees. Existing studies establish that members of both groups are vulnerable to discrimination, homelessness, and housing unaffordability. However, they have largely been examined separately, and with limited insights into the factors that produce vulnerability. To develop a more nuanced and systemic account of LGBTQ refugees’ housing vulnerability, we conducted a study in Alberta, Canada. Utilizing Crenshaw’s theory of intersectionality, and drawing on policy documents and key-informant interviews, we identified three types of barriers to housing. We conclude that an intersectional approach provides a foundation for systemic explanations of housing vulnerability that are too often absent in policy.
This publication has no Abstract to dispaly