Research Library

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 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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This paper explores how government members of the Alberta Legislative Assembly (MLAs) “constructed” migrant work and migrant workers in legislature and media statements between 2000 and 2011. Government MLAs asserted that migrant work (1) was economically necessary and (2) posed no threat to Canadian workers. Government MLAs also asserted that international migrant workers (3) had questionable occupational, linguistic or cultural skills and (4) caused negative social and economic impacts in Canada. Taken individually, these narratives appear contradictory, casting migrant work as good but migrant workers as bad. Viewed together, these narratives comprise an effort to dehumanize temporary and permanent international migrant workers. This (sometimes racialized) “othering” of migrant workers justifies migrant workers’ partial citizenship and suppresses criticism of their poor treatment. This paper explores how government members of the Alberta Legislative Assembly (MLAs) “constructed” migrant work and migrant workers in legislature and media statements between 2000 and 2011. Government MLAs asserted that migrant work (1) was economically necessary and (2) posed no threat to Canadian workers. Government MLAs also asserted that international migrant workers (3) had questionable occupational, linguistic or cultural skills and (4) caused negative social and economic impacts in Canada. Taken individually, these narratives appear contradictory, casting migrant work as good but migrant workers as bad. Viewed together, these narratives comprise an effort to dehumanize temporary and permanent international migrant workers. This (sometimes racialized) “othering” of migrant workers justifies migrant workers’ partial citizenship and suppresses criticism of their poor treatment.
This publication has no Abstract to dispaly

Data on immigrant and refugees’ access to services in Canada does not typically focus on children. To fill this gap, this study explored immigrant and refugee mothers’ perceptions of barriers and facilitators (things that help) for mental health care for their children in Edmonton, Alberta, Canada. Barriers included financial strain, lack of information, racism/discrimination, language barriers, stigma, feeling isolated, and feeling unheard by service providers. Facilitators included schools offering services, personal levels of higher education, and free services. Nurses can improve access to mental health services by addressing issues related to racism within the health system, by creating awareness related to mental health, and by providing trained interpreters to help bridge barriers in communications. Data on immigrant and refugees’ access to services in Canada does not typically focus on children. To fill this gap, this study explored immigrant and refugee mothers’ perceptions of barriers and facilitators (things that help) for mental health care for their children in Edmonton, Alberta, Canada. Barriers included financial strain, lack of information, racism/discrimination, language barriers, stigma, feeling isolated, and feeling unheard by service providers. Facilitators included schools offering services, personal levels of higher education, and free services. Nurses can improve access to mental health services by addressing issues related to racism within the health system, by creating awareness related to mental health, and by providing trained interpreters to help bridge barriers in communications.
This publication has no Abstract to dispaly

This article examines the relationship between Pho, a type of Vietnamese soup, and Vietnamese national identity in the linguistic landscape of Edmonton, Alberta (Canada). The study suggests that Pho has not only been used by Vietnamese restaurants in Edmonton for indexical function (pointing to the specialty of a restaurant) but also for symbolic evocation associating with Vietnamese cuisine and national identity. The data comes from three Vietnamese restaurants in Edmonton. The results indicate that Pho is a very prominent word in the linguistic landscape of three restaurants. Furthermore, the symbolic relationship between Pho and Vietnamese identity is evident in the way it is used to address the feelings of nostalgia among migrant patrons. This article examines the relationship between Pho, a type of Vietnamese soup, and Vietnamese national identity in the linguistic landscape of Edmonton, Alberta (Canada). The study suggests that Pho has not only been used by Vietnamese restaurants in Edmonton for indexical function (pointing to the specialty of a restaurant) but also for symbolic evocation associating with Vietnamese cuisine and national identity. The data comes from three Vietnamese restaurants in Edmonton. The results indicate that Pho is a very prominent word in the linguistic landscape of three restaurants. Furthermore, the symbolic relationship between Pho and Vietnamese identity is evident in the way it is used to address the feelings of nostalgia among migrant patrons.
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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.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly

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.
This publication has no Abstract to dispaly