Please note, this is not an open access database or repository. We have focused on creating simple summaries of reports and articles that we have accessed through websites and academic journals, with a focus on key findings, so that even if a full report is not free to access you can reference it. When possible, we include a link to wherever the original document is hosted (which may or may not be open-access). If you come across a link that is no longer active, please let us know and we can update it. There are also some reports that will have been submitted directly to the project. In this case, these reports are uploaded directly with permission from the author or publisher. Any original documents found on this site are stored in Canada on our secure servers

An ethnographic investigation of the maternity healthcare experience of immigrants in rural and urban Alberta, Canada

Canada is among the top immigrant-receiving nations in the world. The aims of the study were to (1) create a new understanding of the processes that disadvantage immigrants in maternity healthcare, and (2) propose changes that might improve maternity experiences and outcomes for immigrant women in Canada. The findings indicate that (a) communication difficulties, (b) lack of information, (c) lack of social support (isolation), (d) cultural beliefs, e) inadequate healthcare services, and (f) cost of medicine/services represent potential barriers to the access to and navigation of maternity services by immigrant women in Canada. Having successfully accessed and navigated services, immigrant women often face additional challenges that influence their level of satisfaction and quality of care. These challenges include lack of understanding of the informed consent process, lack of regard by professionals for confidential patient information, short consultation times, short hospital stays, perceived discrimination/stereotyping, and culture shock. Although health service organizations and policies strive for universality and equality in service provision, personal and organizational barriers can limit care access, adequacy, and acceptability for immigrant women. A holistic healthcare approach must include health informational packages available in different languages/media. Health care professionals who care for diverse populations must be provided with training in cultural competence, and monitoring and evaluation programs to ameliorate personal and systemic discrimination. Canada is among the top immigrant-receiving nations in the world. The aims of the study were to (1) create a new understanding of the processes that disadvantage immigrants in maternity healthcare, and (2) propose changes that might improve maternity experiences and outcomes for immigrant women in Canada. The findings indicate that (a) communication difficulties, (b) lack of information, (c) lack of social support (isolation), (d) cultural beliefs, e) inadequate healthcare services, and (f) cost of medicine/services represent potential barriers to the access to and navigation of maternity services by immigrant women in Canada. Having successfully accessed and navigated services, immigrant women often face additional challenges that influence their level of satisfaction and quality of care. These challenges include lack of understanding of the informed consent process, lack of regard by professionals for confidential patient information, short consultation times, short hospital stays, perceived discrimination/stereotyping, and culture shock. Although health service organizations and policies strive for universality and equality in service provision, personal and organizational barriers can limit care access, adequacy, and acceptability for immigrant women. A holistic healthcare approach must include health informational packages available in different languages/media. Health care professionals who care for diverse populations must be provided with training in cultural competence, and monitoring and evaluation programs to ameliorate personal and systemic discrimination.
This publication has no Abstract to dispaly

“Cancelled Dreams”: Family Reunification and Shifting Canadian Immigration Policy

This article documents the impact of recently introduced restrictive family reunification policies on immigrants living in Canada today. Since 2008, Canadian immigration policy has changed dramatically with renewed neoliberal emphasis on economic immigrants and labor-market integration (younger, high-skilled immigrants with strong English or French language skills are prioritized over other groups of newcomers). This led to making the process of reuniting families more difficult and expensive. This article explores the impact of this policy shift on immigrant families and on immigrant women and children in particular. This article argues that there are profound human costs to limiting family reunification; these costs are disproportionately borne by immigrant women (who tend to take addition responsibilities of child care) and ultimately impact immigrant integration and belonging. This article documents the impact of recently introduced restrictive family reunification policies on immigrants living in Canada today. Since 2008, Canadian immigration policy has changed dramatically with renewed neoliberal emphasis on economic immigrants and labor-market integration (younger, high-skilled immigrants with strong English or French language skills are prioritized over other groups of newcomers). This led to making the process of reuniting families more difficult and expensive. This article explores the impact of this policy shift on immigrant families and on immigrant women and children in particular. This article argues that there are profound human costs to limiting family reunification; these costs are disproportionately borne by immigrant women (who tend to take addition responsibilities of child care) and ultimately impact immigrant integration and belonging.
This publication has no Abstract to dispaly

Policy and Management Recommendations Informed by the Health Benefits of Visitor Experiences in Alberta’s Protected Areas

Leisure in parks and other forms of protected areas are connected to an individual’s health and well-being. Findings show that anticipated human health and well-being benefits were a major factor motivating individuals decision to visit a park or protected area. However, there was a negative correlation between age and each of the perceived benefits, indicating that older visitors were less motivated to visit protected areas. Interestingly, health motivations and benefits (or outcomes) were correlated highly with nature relatedness, meaning the more connected one is to nature, the greater the motivation to visit parks and the greater the health and well-being benefits received from park experiences. Overall, this study represents the largest examination of the human health and well-being benefits associated with visitor experiences in a Canadian protected areas context. The results substantiate the need for park organizations to better understand the “service provider” “client” relationship from a human health and well-being perspective so that integrated policies and visitor experience programs can be developed or enhanced where appropriate. Leisure in parks and other forms of protected areas are connected to an individual’s health and well-being. Findings show that anticipated human health and well-being benefits were a major factor motivating individuals decision to visit a park or protected area. However, there was a negative correlation between age and each of the perceived benefits, indicating that older visitors were less motivated to visit protected areas. Interestingly, health motivations and benefits (or outcomes) were correlated highly with nature relatedness, meaning the more connected one is to nature, the greater the motivation to visit parks and the greater the health and well-being benefits received from park experiences. Overall, this study represents the largest examination of the human health and well-being benefits associated with visitor experiences in a Canadian protected areas context. The results substantiate the need for park organizations to better understand the “service provider” “client” relationship from a human health and well-being perspective so that integrated policies and visitor experience programs can be developed or enhanced where appropriate.
This publication has no Abstract to dispaly

Gauging Social Integration among Canadian Muslims: A Sense of Belonging in an Age of Anxiety

While the subject of “Muslim integration” has received extensive scholarly attention, especially in the Western European context, there has been little study of the subject in Canada. Canada has a long history of welcoming immigrants who make up 20 percent of the population. Yet, Canada has not fully escaped the debates and anxieties related to the accommodation of Muslim immigrants and the integration of those populations. In particular, these anxieties have been displayed around the proposal to use religious law in family based disputes in Ontario in 2005, controversies around the wearing of the niqab in the oath of citizenship, the admission of Syrian refugees in 2015, and concerns over homegrown violent extremism after the 11th of September 2001. This article examines social integration among Canada’s diverse Muslim communities. Using the barometer of a sense of national belonging, it examines the life experiences of Canadian Muslims and their ideas and sentiments related to belonging. It concludes that despite concerns in the community over discrimination and divisive areas of public policy (e.g., security), Canadian Muslims are well integrated socially. While the subject of “Muslim integration” has received extensive scholarly attention, especially in the Western European context, there has been little study of the subject in Canada. Canada has a long history of welcoming immigrants who make up 20 percent of the population. Yet, Canada has not fully escaped the debates and anxieties related to the accommodation of Muslim immigrants and the integration of those populations. In particular, these anxieties have been displayed around the proposal to use religious law in family based disputes in Ontario in 2005, controversies around the wearing of the niqab in the oath of citizenship, the admission of Syrian refugees in 2015, and concerns over homegrown violent extremism after the 11th of September 2001. This article examines social integration among Canada’s diverse Muslim communities. Using the barometer of a sense of national belonging, it examines the life experiences of Canadian Muslims and their ideas and sentiments related to belonging. It concludes that despite concerns in the community over discrimination and divisive areas of public policy (e.g., security), Canadian Muslims are well integrated socially.
This publication has no Abstract to dispaly

Understanding Job Status Decline among Newcomers to Canada

Problems related to the recognition of skills and education acquired by immigrants abroad and their ability to translate them into similar work and income in Canada are well-known. This paper attempts to quantify, insofar as possible the mismatch between education and skills attained abroad by comparing pre-arrival and post-arrival job statuses amongst newcomers to Canada who have been in the country for five years or less. Our results reveal that there is, in fact, a significant decline in job status for newcomers, which is influenced by province of residence, place of education attainment, and length of time in Canada. Problems related to the recognition of skills and education acquired by immigrants abroad and their ability to translate them into similar work and income in Canada are well-known. This paper attempts to quantify, insofar as possible the mismatch between education and skills attained abroad by comparing pre-arrival and post-arrival job statuses amongst newcomers to Canada who have been in the country for five years or less. Our results reveal that there is, in fact, a significant decline in job status for newcomers, which is influenced by province of residence, place of education attainment, and length of time in Canada.
This publication has no Abstract to dispaly

Is Universal Screening Necessary? Incidence of Tuberculosis among Tibetan Refugees Arriving in Calgary, Alberta

Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. We found no associations between preimmigration factors and treatment completion. A case of active TB was detected and treated. Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada. Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. We found no associations between preimmigration factors and treatment completion. A case of active TB was detected and treated. Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada.
This publication has no Abstract to dispaly

Different Approaches to Cross-Lingual Focus Groups: Lessons From a Cross-Cultural Community-Based Participatory Research Project in the ENRICH Study

Focus groups are a useful strategy in qualitative health research when it is important to understand how social contexts shape participants’ health. However, when cross-lingual focus groups are conducted, and in languages in which the researcher is not fluent, it raises questions regarding the usefulness and rigor of the findings. In this article, we will discuss three different approaches to cross-lingual focus groups used in a community-based participatory research project with pregnant and postpartum, African immigrant women in Alberta, Canada. In two approaches, we moderated focus groups in women’s mother tongue with the support of real-time interpreters, but in the first approach, audio recording was used and in the second approach, audio recording was not used. In the third approach, a bilingual moderator facilitated focus groups in women’s mother tongue, with transcription and translation of audio-recorded data upon completion of data generation. We expect the lessons learned in this project may assist others in planning and implementing cross-lingual focus groups, especially in the context of community-based participatory research. Focus groups are a useful strategy in qualitative health research when it is important to understand how social contexts shape participants’ health. However, when cross-lingual focus groups are conducted, and in languages in which the researcher is not fluent, it raises questions regarding the usefulness and rigor of the findings. In this article, we will discuss three different approaches to cross-lingual focus groups used in a community-based participatory research project with pregnant and postpartum, African immigrant women in Alberta, Canada. In two approaches, we moderated focus groups in women’s mother tongue with the support of real-time interpreters, but in the first approach, audio recording was used and in the second approach, audio recording was not used. In the third approach, a bilingual moderator facilitated focus groups in women’s mother tongue, with transcription and translation of audio-recorded data upon completion of data generation. We expect the lessons learned in this project may assist others in planning and implementing cross-lingual focus groups, especially in the context of community-based participatory research.
This publication has no Abstract to dispaly

“If they tell me to get it, I’ll get it. If they don’t….”: Immunization decision-making processes of immigrant mothers

This paper aims to understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination. Our three main findings on information gathering and use in vaccination decisions were: 1) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants’ recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta. Our results highlight the limitations of Alberta’s current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children. This paper aims to understand information-gathering and decision-making processes of immigrant mothers for scheduled childhood vaccines, vaccination during pregnancy, seasonal flu and pandemic vaccination. Our three main findings on information gathering and use in vaccination decisions were: 1) participants in all three communities passively received immunization information. Most mothers learned about vaccine practices exclusively from health care practitioners during scheduled visits. Social networks were primary sources of information in origin countries but were lost during immigration to Canada; 2) participants demonstrated universal trust in vaccines (i.e., no anti-vaccination sentiment). They were comfortable in receiving vaccines for themselves and their children, regardless of past adverse reactions; 3) participants’ recollection of the H1N1 vaccination campaign was almost nil, demonstrating the lack of reach of public health vaccination campaigns to designated priority groups (pregnant women and children) in Alberta. Our results highlight the limitations of Alberta’s current vaccination communication strategies in reaching immigrant women. When immigrant mothers receive vaccination information, our results indicate they will likely follow recommendations. However, our study shows that current communication strategies are not making this information accessible to immigrant women, which limits their ability to make informed vaccination decisions for themselves and their children.
This publication has no Abstract to dispaly

Exploring Sociocultural Factors During Pregnancy and Postpartum among African-immigrant Women within the Context of a Community-Based Organization

Low socioeconomic status, language difficulties and sociocultural barriers can negatively affect many aspects of a healthy pregnancy, including dietary practices. Various life adversities (e.g., poverty), in the absence of women’s family circle created a sense of isolation and increased stress, which were heightened by pregnancy and postpartum. African-immigrant women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy. This included nutritious foods, physical activity opportunities, and adequate time for rest. Once in Canada, without sufficient social support, it becomes extremely challenging to be healthy during pregnancy and postpartum. However, women described that services and supports offered through MCHB (Multicultural Health Brokers Co-operatie) (e.g., childcare, cooking classes) facilitated a healthy pregnancy and postpartum. Community-based organizations (CBOs) appear to foster a sense of kinship women often miss when they immigrate to a new country and become pregnant. Policies that support CBOs, and ensure adequate funding, will enable continuing services that can assist immigrant women in being healthier during pregnancy and postpartum in Canada. Low socioeconomic status, language difficulties and sociocultural barriers can negatively affect many aspects of a healthy pregnancy, including dietary practices. Various life adversities (e.g., poverty), in the absence of women’s family circle created a sense of isolation and increased stress, which were heightened by pregnancy and postpartum. African-immigrant women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy. This included nutritious foods, physical activity opportunities, and adequate time for rest. Once in Canada, without sufficient social support, it becomes extremely challenging to be healthy during pregnancy and postpartum. However, women described that services and supports offered through MCHB (Multicultural Health Brokers Co-operatie) (e.g., childcare, cooking classes) facilitated a healthy pregnancy and postpartum. Community-based organizations (CBOs) appear to foster a sense of kinship women often miss when they immigrate to a new country and become pregnant. Policies that support CBOs, and ensure adequate funding, will enable continuing services that can assist immigrant women in being healthier during pregnancy and postpartum in Canada.
This publication has no Abstract to dispaly

An ethnographic study of communication challenges in maternity care for immigrant women in rural Alberta

Many immigrant and ethno-cultural groups in Canada face substantial barriers to accessing health care including language barriers. This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada. We identified four main themes including verbal communication, unshared meaning, non-verbal communication to build relationships, and trauma, culture and open communication. Communication difficulties extended beyond matters of language competency to those encompassing non-verbal communication and its relation to shared meaning as well as the interplay of underlying pre-migration history and cultural factors which affect open communication, accessible health care and perhaps also maternal outcomes. Communication challenges may be experienced by all parties, yet those within health care management and professional bodies are responsible to ensure that providers are equipped with the skills necessary to facilitate culturally appropriate care. Many immigrant and ethno-cultural groups in Canada face substantial barriers to accessing health care including language barriers. This study identified the nature of communication difficulties in maternity services from the perspectives of immigrant women, health care providers and social service providers in a small city in southern Alberta, Canada. We identified four main themes including verbal communication, unshared meaning, non-verbal communication to build relationships, and trauma, culture and open communication. Communication difficulties extended beyond matters of language competency to those encompassing non-verbal communication and its relation to shared meaning as well as the interplay of underlying pre-migration history and cultural factors which affect open communication, accessible health care and perhaps also maternal outcomes. Communication challenges may be experienced by all parties, yet those within health care management and professional bodies are responsible to ensure that providers are equipped with the skills necessary to facilitate culturally appropriate care.
This publication has no Abstract to dispaly