Creating community learning for empowerment groups: an innovative model for participatory research partnerships with refugee communities

Empowering communities to respond to humanitarian crises is one of the core principles of the United Nations High Commission for Refugees. In response to large numbers of refugees resettling in Canada from Syria as they fled its civil war, a community-based research partnership was initiated to examine the psychosocial needs and adaptation processes of Syrian individuals and families. In this article, we introduce Community Learning for Empowerment Groups (CLEGs) as a methodological innovation in participatory research partnerships and demonstrate how they can be used to harvest local knowledge and create critical spaces for transformative learning. We describe the process of co-creating CLEGs with seven recently resettled Syrian community leaders, examples of their implementation, and lessons learned in our community-based participatory research (CBPR). Grounded in a transformative paradigm, our CBPR project occurred over three phases of implementation. Activities undertaken by the research team in phase one aimed at empowering the leaders through a “train-the trainer” and collaborative learning approach to lead CLEGs in phase two. Focus groups were held with leaders in phase two to explore their experiences leading CLEGs. Discussions in focus groups revealed that leaders were empowered to adapt their learning from phase one according to their group dynamics and personal leadership style. Deepened insights and new facilitation approaches were evidence of leaders’ growth, as exemplified in the focus groups. Leaders were able to support their groups to generate and, in some cases, implement community-based solutions to their groups’ psychosocial challenges. Community Learning for Empowerment Groups are a promising model for supporting power sharing and knowledge co-construction in participatory research partnerships

Health of African refugee children outside Africa : a scoping review

PROBLEM : Africa is the largest source continent of refugee children. However, we found no published synthesis of the literature on the health of African refugee children outside Africa. Conducting a review of the literature on this particular population will help illuminate the particular contextual health issues faced by African child refugees who live outside Africa. The purpose of this review is to synthesize what is known from the existing literature regarding the health of sub-Saharan African refugee children who live outside Africa. METHODS : We completed a scoping review of the published literature. We included articles published in English with a focus on the health of sub-Saharan African refugee children living outside Africa. We excluded studies of refugees in Africa as the living conditions of these refugees, most of whom reside in camps, are very different from those outside Africa. Using relevant keywords, we searched 10 databases to identify and screen 6602 articles after duplicates were eliminated. SAMPLE : A total of 20 studies were included in this review. FINDINGS : Published research articles on sub-Saharan African child refugees living outside Africa focus on infectious diseases, mental health and neurodevelopmental disorders, food insecurity and psychosocial adjustment, physical health (including obesity), and health promotion strategies. This population is characterized by a high rate of infectious diseases (e.g., malaria), obesity, and mental health problems, especially post-traumatic stress disorder (PTSD). CONCLUSIONS AND IMPLICATIONS : To attend to the health needs of sub-Saharan African refugee children who live outside Africa, interventions should address pre-migration factors as well as post-migration factors (including income and community belonging) while employing a strengths-based perspective.The Worldwide Universities Network Research Development Fund.http://www.pediatricnursing.org2022-06-09Nursing Scienc

Immigrant women’s experiences of maternity services in Canada: a meta-ethnography

Objective: to synthesise data on immigrant women's experiences of maternity services in Canada. Design: a qualitative systematic literature review using a meta-ethnographic approach. Methods: a comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings. Findings: the literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings. Key conclusions and implications for practice: in order to implement woman-centred care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care

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

Background: Canada is among the top immigrant-receiving nations in the world. Immigrant populations may face structural and individual barriers in the access to and navigation of healthcare services in a new country. The aims of the study were to (1) generate new understanding of the processes that perpetuate immigrant disadvantages in maternity healthcare, and (2) devise potential interventions that might improve maternity experiences and outcomes for immigrant women in Canada. Methods: The study utilized a qualitative research approach that focused on ethnographic research design and data analysis contextualized within theories of organizational behaviour and critical realism. Data were collected over 2.5 years using focus groups and in-depth semistructured interviews with immigrant women (n = 34), healthcare providers (n = 29), and social service providers (n = 23) in a Canadian province. Purposive samples of each subgroup were generated, and recruitment and data collection – including interpretation and verification of translations – were facilitated through the hiring of community researchers and collaborations with key informants. Results: 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, such as 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. Conclusions: 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

Nurturing hope in refugee children during early years of post-war adjustment

Resettlement countries have begun to recognize the need for more services aimed at assisting children and families from known areas of conflict and with histories of trauma and loss. Despite this awareness, there is a dearth of literature that explores the experiences and practice of front-line service providers. In this qualitative case study, 12 staff of a psychosocial early intervention program for refugee children shared their observations of children's experiences during early years of adjustment in a resettlement country. The study focused on perceptions of hope, experiences that engendered and hindered hope in the children, and ways in which staff viewed their own work in nurturing hope. Thematic analysis interviews uncovered three main themes: (1) Hope is like a seed, (2) Invisible seeds: Some challenges that hinder hope, and (3) Visible seeds: Some experiences engender hope. Results highlight the range of challenges encountered by refugee children and families in post-migration contexts, the importance of hopeful orientations for service providers working with children with known histories of trauma, and how hope is nurtured in the context of caring relationships.Hope Children Trauma Refugee Case study Early intervention Cultural brokers

Applying the ADAPT Psychosocial Model to War-Affected Children and Adolescents

Multiple individual, social, and environmental factors have long been recognized as influencing a child’s response to traumatic experiences. However, there remain few socio-ecological frameworks to guide researchers and practitioners working with war-affected children. This article examines Silove’s psychosocial model of adaptation and development after trauma and persecution (ADAPT model) in relation to war-affected children. The utility of the model is explored by examining whether the systems of safety, attachment, identity, justice, and existential meaning described in the ADAPT model are represented in a narrative review of research from the last 20 years on the experiences of war-affected children and adolescents. Results suggest that research with war-affected children has covered all five psychosocial pillars in the model, but with overemphasis on the safety, followed by the attachment, domains. This review highlights that need for research and psychosocial interventions that focus on adaptation of war-affected children’s identity development, sense of justice, and meaning systems

Indigenous Canadian University Student's Experiences of Microaggressions

Racial microaggressions are defined as daily indignities directed towards disempowered racial groups that communicate hostile, derogatory, or negative racial slights (Sue et al. American Psychologist, 62, 271-286, 2007b). The purpose of the present study was to investigate Indigenous Canadian university student's experiences of racial microaggresions and provide suggestions for culturally competent educational practices. The study utilized a qualitative method and involved a focus-group and follow-up interviews. Seven domains or themes emerged. These domains were: overt discrimination; assumption of intellectual inferiority; assumption of criminality; invalidation or denial; second-class citizen; racial segregation; and myth of meritocracy. Implications for counselors and educators were discussed

Un cadre de collaboration entre le conseiller et le médiateur culturel

Cultural differences toward health and help-seeking are among the barriers that refugee youth and families experience when accessing mental health services. Cultural brokering, the act of linking or mediating between different cultural groups, is one potential solution to this service gap. Using a qualitative case study of 2 counsellors and 4 cultural brokers, we present a preliminary framework to facilitate an understanding of, and provide a guide for, collaboration between counsellors and cultural brokers when providing mental health services to refugee youth and families.Les différences culturelles à l’égard de la santé et de la recherche d’aide sont au nombre des obstacles que doivent surmonter les jeunes réfugiés et leurs familles lorsqu’ils se tournent vers les services de soins de santé mentale. La médiation culturelle, soit l’action qui consiste à server d’intermédiaire entre les différents groupes culturels, constitue l’une des solutions potentielles à cette lacune du service. Utilisant l’étude de cas qualitative de 2 conseillers et de 4 médiateurs culturels, on a élaboré le cadre préliminaire présenté, qui devrait permettre de mieux comprendre et de guider la collaboration conseiller-médiateur culturel dans le contexte de la prestation de services de santé mentale auprès de jeunes réfugiés et des membres de leur famille

Hope Lives in the Heart: Refugee and Immigrant Children’s Perceptions of Hope and Hope-Engendering Sources During Early Years of Adjustment

Children’s adjustment to resettlement countries is vitally important to future outcomes, yet little attention is given to the role of hope in this process. This research focused on expressions of hope in 10 refugee and immigrant children during early years of resettlement. Using case study methods that employed arts-based data collection, categories were constructed from participants’ visual images and associated narratives. Hope in newcomer children was conceptualized as a dynamic enduring trait that is intimately linked to each child’s life context. Further, three hope engendering sources were identified that facilitated an emotional connection to others, to self, and to the environment.L’adaptation des enfants aux pays de réinstallation est d’une importance vitale pour les résultats futurs, mais peu d’attention est accordée au rôle de l’espoir dans ce processus. La présente recherche s’est concentrée sur l’expression de l’espoir chez 10 enfants réfugiés et immigrants au début des années de réinstallation. En utilisant des méthodes d’étude de cas se servant de la collecte de données basées sur l’expression artistique, des catégories ont été construites à partir des images des participants et des récits qu’ils y associaient. Chez les enfants nouvellement arrivés, l’espoir a été conceptualisé comme un trait durable et dynamique intimement lié au contexte de vie de chaque enfant. En outre, trois sources génératrices d’espoir ont été identifiées qui facilitent une connexion émotionnelle à autrui, à soi, et à l’environnement