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Health in HIPPY homes: Exploring women’s experiences of gender, motherhood and social support as determinants of health during refugee resettlement in Calgary, Alberta, Canada

Thousands of refugee families are resettled across Canada each year, and many must navigate parenthood while simultaneously contending with resettlement challenges. Refugee women are primarily responsible for care work yet often face disproportionate barriers to information, resources, and access to health services. We leveraged a community-engaged research approach with several project partners to: i) explore the scope, nature, and extent of literature examining the influence of gender norms, roles, and expectations on health and wellbeing during resettlement; ii) explore women’s diverse conceptualizations of health and what it means to be healthy; iii) identify barriers and resilience factors for health and wellbeing during resettlement, including in the context of the COVID-19 pandemic; iv) explore women’s experiences of gender as a determinant of health during resettlement, specifically in the context of motherhood; and v) explore the role of participation in Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY), a home visiting program, in promoting health during resettlement. We conducted a scoping review, followed by surveys, in-depth interviews, and collage-building with refugee mothers (n=28) enrolled in the HIPPY program delivered by the Calgary Immigrant Women’s Association. Data were analyzed using a participatory inductive deductive thematic analysis. Our findings establish gender roles, norms, and expectations as important determinants of health, mediating experiences of other social determinants of health during resettlement. Participation in HIPPY promoted wellbeing during resettlement and the COVID-19 pandemic by mitigating social isolation and improving women’s access to information and resources for health and parenting in Canada. Thousands of refugee families are resettled across Canada each year, and many must navigate parenthood while simultaneously contending with resettlement challenges. Refugee women are primarily responsible for care work yet often face disproportionate barriers to information, resources, and access to health services. We leveraged a community-engaged research approach with several project partners to: i) explore the scope, nature, and extent of literature examining the influence of gender norms, roles, and expectations on health and wellbeing during resettlement; ii) explore women’s diverse conceptualizations of health and what it means to be healthy; iii) identify barriers and resilience factors for health and wellbeing during resettlement, including in the context of the COVID-19 pandemic; iv) explore women’s experiences of gender as a determinant of health during resettlement, specifically in the context of motherhood; and v) explore the role of participation in Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY), a home visiting program, in promoting health during resettlement. We conducted a scoping review, followed by surveys, in-depth interviews, and collage-building with refugee mothers (n=28) enrolled in the HIPPY program delivered by the Calgary Immigrant Women’s Association. Data were analyzed using a participatory inductive deductive thematic analysis. Our findings establish gender roles, norms, and expectations as important determinants of health, mediating experiences of other social determinants of health during resettlement. Participation in HIPPY promoted wellbeing during resettlement and the COVID-19 pandemic by mitigating social isolation and improving women’s access to information and resources for health and parenting in Canada.
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