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Due to the ongoing conflict in Syria, approximately 50,000 Syrian refugees arrived in Canada between 2015 and 2020. Upon arrival, Syrians needed to find housing, employment, healthcare, and language training. They also had to address psychosocial needs, such as cultivating social supports and establishing a sense of safety, which are critical for mitigating trauma and stress related to resettlement. In March 2020, the global COVID-19 pandemic was declared, and disproportionately impacted refugees by compounding pre-existing and systemic health, social, and economic inequities. Refugees are identified as particularly vulnerable during the pandemic due to the precarious working, living, economic, and health conditions they often face. Only three Canadian studies to date have explored Syrian refugee experiences during COVID-19: one used quantitative methods, the other focused on postnatal women, and one explored housing stability. Therefore, there is a dearth of qualitative information regarding how Syrian refugees in Canada have been impacted by the pandemic, especially regarding their psychosocial adaptation during this period. This study explored the impact of the COVID-19 pandemic for Syrian refugees in Canada and identified supports needed, from the perspectives of Syrian refugees themselves. This study is embedded within a broader community-based participatory research project investigating psychosocial adaptation with the Syrian refugee community and used qualitative description and thematic analysis to examine semi-structured interviews conducted with 10 Syrian refugees. Due to the ongoing conflict in Syria, approximately 50,000 Syrian refugees arrived in Canada between 2015 and 2020. Upon arrival, Syrians needed to find housing, employment, healthcare, and language training. They also had to address psychosocial needs, such as cultivating social supports and establishing a sense of safety, which are critical for mitigating trauma and stress related to resettlement. In March 2020, the global COVID-19 pandemic was declared, and disproportionately impacted refugees by compounding pre-existing and systemic health, social, and economic inequities. Refugees are identified as particularly vulnerable during the pandemic due to the precarious working, living, economic, and health conditions they often face. Only three Canadian studies to date have explored Syrian refugee experiences during COVID-19: one used quantitative methods, the other focused on postnatal women, and one explored housing stability. Therefore, there is a dearth of qualitative information regarding how Syrian refugees in Canada have been impacted by the pandemic, especially regarding their psychosocial adaptation during this period. This study explored the impact of the COVID-19 pandemic for Syrian refugees in Canada and identified supports needed, from the perspectives of Syrian refugees themselves. This study is embedded within a broader community-based participatory research project investigating psychosocial adaptation with the Syrian refugee community and used qualitative description and thematic analysis to examine semi-structured interviews conducted with 10 Syrian refugees.
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Canadian refugee healthcare has been impacted by periodic upheavals including federal funding cuts, Syrian and Yazidi resettlement programs, and COVID-19. These upheavals will have undoubtedly led to changes in clinic use, shifts in clinic demographics, or clinic policy. Refugees are a vulnerable population with specific physical health, mental health, and social needs. One model of care that can address these needs is a specialized refugee health clinic. Understanding the impacts of recent upheavals on a specialized refugee health clinic’s utilization, its staff and clinicians is critical for future planning. We studied a specialized refugee health clinic in Calgary, AB from 2011 to 2020, across five time periods: Pre-Interim Federal Health Program (IFHP) Cuts (January 2011 – June 2012), IFHP Cuts (July 2012 – October 2015), Syrian Surge (November 2015- January 2017), Yazidi Period (February 2017 – February 2020), and COVID-19 (March 2020 – December 2020). We analyzed quantitative changes as well as conducted semi-structured interviews with clinic leadership. Utilization increased greatly over different policy changes and a pandemic, at a specialized refugee clinic over ten years. These upheavals challenged clinic leadership and providers to adapt. The stress of these upheavals negatively impacted staff wellness and patient care. Understanding how health and immigration policy changes affect care, especially at specialized refugee clinics, is critical for being able to anticipate and thrive through future upheavals as turmoil globally seems to continue. Canadian refugee healthcare has been impacted by periodic upheavals including federal funding cuts, Syrian and Yazidi resettlement programs, and COVID-19. These upheavals will have undoubtedly led to changes in clinic use, shifts in clinic demographics, or clinic policy. Refugees are a vulnerable population with specific physical health, mental health, and social needs. One model of care that can address these needs is a specialized refugee health clinic. Understanding the impacts of recent upheavals on a specialized refugee health clinic’s utilization, its staff and clinicians is critical for future planning. We studied a specialized refugee health clinic in Calgary, AB from 2011 to 2020, across five time periods: Pre-Interim Federal Health Program (IFHP) Cuts (January 2011 – June 2012), IFHP Cuts (July 2012 – October 2015), Syrian Surge (November 2015- January 2017), Yazidi Period (February 2017 – February 2020), and COVID-19 (March 2020 – December 2020). We analyzed quantitative changes as well as conducted semi-structured interviews with clinic leadership. Utilization increased greatly over different policy changes and a pandemic, at a specialized refugee clinic over ten years. These upheavals challenged clinic leadership and providers to adapt. The stress of these upheavals negatively impacted staff wellness and patient care. Understanding how health and immigration policy changes affect care, especially at specialized refugee clinics, is critical for being able to anticipate and thrive through future upheavals as turmoil globally seems to continue.
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Two studies were completed as a part of this Master’s thesis. Study 1: Human papillomavirus vaccine coverage among immigrant children in Alberta: a population-based cohort study concluded that overall, immigrant children in Alberta had higher HPV vaccination coverage in comparison to non-immigrants, which is encouraging given some previous literature has suggested the opposite. This implies that efforts to increase vaccination rates among immigrant children may be having a positive impact. Among immigrants, routine immunization promotion strategies should be targeted to those living in rural residences and from North America, Oceania, and South America, in order to improve HPV vaccination coverage in this group even further. Study 2: Study 2: COVID-19 vaccine coverage among immigrants and refugees in Alberta: A population-based cross-sectional study concluded that high COVID-19 vaccination coverage among immigrant populations in Alberta is an encouraging outcome. However, continued efforts are needed to target public health interventions towards older immigrants, immigrants living in rural areas, and immigrants from specific continental backgrounds in order to improve COVID-19 vaccination coverage. Two studies were completed as a part of this Master’s thesis. Study 1: Human papillomavirus vaccine coverage among immigrant children in Alberta: a population-based cohort study concluded that overall, immigrant children in Alberta had higher HPV vaccination coverage in comparison to non-immigrants, which is encouraging given some previous literature has suggested the opposite. This implies that efforts to increase vaccination rates among immigrant children may be having a positive impact. Among immigrants, routine immunization promotion strategies should be targeted to those living in rural residences and from North America, Oceania, and South America, in order to improve HPV vaccination coverage in this group even further. Study 2: Study 2: COVID-19 vaccine coverage among immigrants and refugees in Alberta: A population-based cross-sectional study concluded that high COVID-19 vaccination coverage among immigrant populations in Alberta is an encouraging outcome. However, continued efforts are needed to target public health interventions towards older immigrants, immigrants living in rural areas, and immigrants from specific continental backgrounds in order to improve COVID-19 vaccination coverage.
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As the population of young newcomers (immigrants, refugees and international students) increases in Canada, there is a growing need to understand the social integration process of these students into Canadian schools. This thesis reports a qualitative analysis of how newcomer students in three Albertan schools perceived their experiences interacting with local students. As the population of young newcomers (immigrants, refugees and international students) increases in Canada, there is a growing need to understand the social integration process of these students into Canadian schools. This thesis reports a qualitative analysis of how newcomer students in three Albertan schools perceived their experiences interacting with local students.
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The purpose of this qualitative arts-informed and play-based case study was to explore and better understand how young newcomer children use common childhood activities of play and personal art-making as tools or vehicles of communication, for exploration of their ideas and sharing perspectives, and to demonstrate what they considered personally significant about their everyday lives and experiences. The research study was guided by the following questions: 1) What are the personally significant experiences and influences in young newcomer children’s daily lives?; 2) How do young newcomer children use play and personal art-making to understand, negotiate, and make sense of experiences, and communicate the personally significant? and; 3) How do adults support young newcomer children’s play and personal art-making and their communication of the personally significant? The purpose of this qualitative arts-informed and play-based case study was to explore and better understand how young newcomer children use common childhood activities of play and personal art-making as tools or vehicles of communication, for exploration of their ideas and sharing perspectives, and to demonstrate what they considered personally significant about their everyday lives and experiences. The research study was guided by the following questions: 1) What are the personally significant experiences and influences in young newcomer children’s daily lives?; 2) How do young newcomer children use play and personal art-making to understand, negotiate, and make sense of experiences, and communicate the personally significant? and; 3) How do adults support young newcomer children’s play and personal art-making and their communication of the personally significant?
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Children with disabilities are among the most at-risk groups for marginalization due to compounded disadvantages from the intersection of risk factors such as refugee status and disability status. Despite this high risk, there is no systematic data collected on this group and scant literature on the topic contributing to a feeling of invisibility. We conducted a narrative inquiry on the experiences of two Syrian refugee families with children living with disabilities. Narrative inquiry is a way to understand experience as a storied phenomenon. In order to understand the complexities of the experience as a refugee with a child living with disabilities, attending to the lived and told stories is essential. In hearing the narration of these experiences across time, place, and social contexts various narrative threads emerged. The narrative threads that resonated across the experiences of two families included waiting and a struggle for agency, as well as disruption and continuity. Children with disabilities are among the most at-risk groups for marginalization due to compounded disadvantages from the intersection of risk factors such as refugee status and disability status. Despite this high risk, there is no systematic data collected on this group and scant literature on the topic contributing to a feeling of invisibility. We conducted a narrative inquiry on the experiences of two Syrian refugee families with children living with disabilities. Narrative inquiry is a way to understand experience as a storied phenomenon. In order to understand the complexities of the experience as a refugee with a child living with disabilities, attending to the lived and told stories is essential. In hearing the narration of these experiences across time, place, and social contexts various narrative threads emerged. The narrative threads that resonated across the experiences of two families included waiting and a struggle for agency, as well as disruption and continuity.
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The entire healthcare system, including primary healthcare (PHC) services, has been disrupted since the onset of the COVID-19 pandemic. As the crisis threatens all citizens significantly, further barriers to accessing care exist for those who are most vulnerable, experience marginalization, and have pre-existing challenges. We aimed to explore immigrants’ lived experiences in accessing and receiving PHC services during the pandemic. A multiphase mixed-methods study using a sequential explanatory design was employed. The first study includes a systematic review that synthesizes the evidence on the experiences that immigrant patients have receiving PHC. Study two provides insights from a recently employed “COVID-19 Experiences and Impacts Survey” data and compares the experiences of Albertans that were born in and outside Canada. Descriptive statistics and multivariable logistic regression were performed, using STATA. The third study is a qualitative inquiry that aims to gain a deeper understanding of the newcomers’ (living in Canada ≤5 years) and providers’ experiences in PHC during the pandemic. A thematic analysis was applied, using NVivo software. Immigrants reported many challenges in accessing and receiving PHC, and these challenges have been increased since the COVID-19 pandemic. The results of this thesis yielded six recommendations that can inform PHC quality improvement initiatives and PHC policy. The entire healthcare system, including primary healthcare (PHC) services, has been disrupted since the onset of the COVID-19 pandemic. As the crisis threatens all citizens significantly, further barriers to accessing care exist for those who are most vulnerable, experience marginalization, and have pre-existing challenges. We aimed to explore immigrants’ lived experiences in accessing and receiving PHC services during the pandemic. A multiphase mixed-methods study using a sequential explanatory design was employed. The first study includes a systematic review that synthesizes the evidence on the experiences that immigrant patients have receiving PHC. Study two provides insights from a recently employed “COVID-19 Experiences and Impacts Survey” data and compares the experiences of Albertans that were born in and outside Canada. Descriptive statistics and multivariable logistic regression were performed, using STATA. The third study is a qualitative inquiry that aims to gain a deeper understanding of the newcomers’ (living in Canada ≤5 years) and providers’ experiences in PHC during the pandemic. A thematic analysis was applied, using NVivo software. Immigrants reported many challenges in accessing and receiving PHC, and these challenges have been increased since the COVID-19 pandemic. The results of this thesis yielded six recommendations that can inform PHC quality improvement initiatives and PHC policy.
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This study explored the support and service experiences of resettled Syrian refugee parents of autistic children in terms of their pre- and post-migration. These lived experiences were investigated with participants (n = 3) through semi-structured interviews using interpretive phenomenological analysis. This study identified the supports and services parents received, their experiences with those services, their overall experiences with resettlement having an autistic child(ren), the implications of culture in support/service provision, and their perceived areas of service need during and after their resettlement in Alberta, Canada. Parents all had unique experiences that were delineated through clustered emergent themes and subsequently organized into a superordinate conceptual structure. The results of the study are discussed in the context of theory and relevant literature to elucidate and make findings applicable. Practical implications and future directions are discussed. This study explored the support and service experiences of resettled Syrian refugee parents of autistic children in terms of their pre- and post-migration. These lived experiences were investigated with participants (n = 3) through semi-structured interviews using interpretive phenomenological analysis. This study identified the supports and services parents received, their experiences with those services, their overall experiences with resettlement having an autistic child(ren), the implications of culture in support/service provision, and their perceived areas of service need during and after their resettlement in Alberta, Canada. Parents all had unique experiences that were delineated through clustered emergent themes and subsequently organized into a superordinate conceptual structure. The results of the study are discussed in the context of theory and relevant literature to elucidate and make findings applicable. Practical implications and future directions are discussed.
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This thesis examined the narrative abilities of bilingual, English L2 newcomer and immigrant children with Autism Spectrum Disorder (ASD), Developmental Language Disorder (DLD) and Typical Development (TD). Compared to the monolingual research, there have been fewer studies examining narratives in clinical bilingual groups, especially bilinguals with ASD, and no study so far has compared bilinguals with ASD to bilinguals with DLD. This thesis asked: (1) Is macrostructure an area of weakness in DLD? (2) Do children with ASD experience difficulties with structural language, i.e., morphology and syntax? (3) Are narrative skills requiring perspective-taking abilities equally vulnerable in ASD and DLD? (4) Do bilinguals with ASD and DLD use the second language input they receive to the same as bilinguals with TD? Identified differences between newcomer children with ASD, DLD or TD can be utilized to create tailored interventions. This thesis examined the narrative abilities of bilingual, English L2 newcomer and immigrant children with Autism Spectrum Disorder (ASD), Developmental Language Disorder (DLD) and Typical Development (TD). Compared to the monolingual research, there have been fewer studies examining narratives in clinical bilingual groups, especially bilinguals with ASD, and no study so far has compared bilinguals with ASD to bilinguals with DLD. This thesis asked: (1) Is macrostructure an area of weakness in DLD? (2) Do children with ASD experience difficulties with structural language, i.e., morphology and syntax? (3) Are narrative skills requiring perspective-taking abilities equally vulnerable in ASD and DLD? (4) Do bilinguals with ASD and DLD use the second language input they receive to the same as bilinguals with TD? Identified differences between newcomer children with ASD, DLD or TD can be utilized to create tailored interventions.
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Using PhotoVoice, this research explored the settlement experiences of refugee youth who have exited high school and are in a program designed by an Albertan school board to support their language and academic needs. Newcomer youth encounter profound academic and social stresses as they attempt to create a new identity and sense of belonging in their new home. This project examined what it means for refugee youth to recuperate a place of belonging. By focusing on the notion of belonging rather than barriers to settlement, the findings revealed that at the core of the youth’s efforts, connecting to people, especially in school, in addition to connecting to the natural world, fostered feelings of well-being and belonging. Educational implications include recommendations for schools and teachers supporting newcomer youth. Using PhotoVoice, this research explored the settlement experiences of refugee youth who have exited high school and are in a program designed by an Albertan school board to support their language and academic needs. Newcomer youth encounter profound academic and social stresses as they attempt to create a new identity and sense of belonging in their new home. This project examined what it means for refugee youth to recuperate a place of belonging. By focusing on the notion of belonging rather than barriers to settlement, the findings revealed that at the core of the youth’s efforts, connecting to people, especially in school, in addition to connecting to the natural world, fostered feelings of well-being and belonging. Educational implications include recommendations for schools and teachers supporting newcomer youth.
This publication has no Abstract to dispaly