The (un)caring experienced by racialized and/or ethnoculturally diverse residents in supportive living: a qualitative study.

BACKGROUND: Racialized and/or ethnocultural minority older adults in supportive living settings may not have access to appropriate services and activities. Most supportive living facilities are mainstream (not specific to one group); however, culturally specific facilities are purpose-built to accommodate older adults from a particular group. Our objective was to describe the perspectives of diverse participants about access to culturally appropriate care, accessible services, and social and recreation activities in culturally specific and mainstream (non-specific) supportive living facilities. METHODS: We conducted semi-structured interviews with 21 people (11 staff, 8 family members, 2 residents) from 7 supportive living homes (2 culturally specific and 5 mainstream) in Alberta, Canada. We used a rapid qualitative inquiry approach to structure the data collection and analysis. RESULTS: Staff and family members described challenges in accessing culturally appropriate care in mainstream facilities. Family members expressed guilt and shame when their relative moved to supportive living, and they specifically described long waitlists for beds in culturally specific homes. Once in the facility, language barriers contributed to quality of care issues (e.g., delayed assessments) and challenges accessing recreation and social activities in both mainstream and culturally specific homes. Mainstream facilities often did not have appropriate food options and had limited supports for religious practices. Residents who had better English language proficiency had an easier transition to supportive living. CONCLUSIONS: Racialized and/or ethnoculturally diverse residents in mainstream supportive living facilities did not receive culturally appropriate care. Creating standalone facilities for every cultural group is not feasible; therefore, we must improve the care in mainstream facilities, including recruiting more diverse staff and integrating a wider range of recreation and religious services and food options.

Counting what counts: assessing quality of life and its social determinants among nursing home residents with dementia.

BACKGROUND: Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants. Therefore, we lack robust, quantitative studies evaluating the association of multiple intersecting social determinants with NH residents' QoL. The goal of this study is to address this critical knowledge gap. METHODS: We will recruit a random sample of 80 NHs from 5 Canadian provinces (Alberta, British Columbia, Manitoba, Nova Scotia, Ontario). We will stratify facilities by urban/rural location, for-profit/not-for-profit ownership, and size (above/below median number of beds among urban versus rural facilities in each province). In video-based structured interviews with care staff, we will complete QoL assessments for each of ~ 4,320 residents, using the DEMQOL-CH, a validated, feasible tool for this purpose. We will also assess resident's social determinants of QoL, using items from validated Canadian population surveys. Health and quality of care data will come from routinely collected Resident Assessment Instrument - Minimum Data Set 2.0 records. Knowledge users (health system decision makers, Alzheimer Societies, NH managers, care staff, people with dementia and their family/friend caregivers) have been involved in the design of this study, and we will partner with them throughout the study. We will share and discuss study findings with knowledge users in web-based summits with embedded focus groups. This will provide much needed data on knowledge users' interpretations, usefulness and intended use of data on NH residents' QoL and its health and social determinants. DISCUSSION: This large-scale, robust, quantitative study will address a major knowledge gap by assessing QoL and multiple intersecting social determinants of QoL among NH residents with dementia. We will also generate evidence on clusters of intersecting social determinants of QoL. This study will be a prerequisite for future studies to investigate in depth the mechanisms leading to QoL inequities in LTC, longitudinal studies to identify trajectories in QoL, and robust intervention studies aiming to reduce these inequities.

Community Group-Based Physical Activity Programs for Immigrant Older Adults: A Systematic Realist Review.

Physical activity program interventions often lack sensitivity to the needs of older immigrant adults. The objective of this systematic realist review is to explain how, why, for whom, and under which circumstances community group-based physical activity programs work for immigrant older adults. The initial program theory was developed using prior research, team expertise, social cognitive theory, and knowledge user consultations. The program theory was tested and refined via a systematic review of the literature. Database searches were conducted in MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Library, Sports Medicine and Education Index, and SPORTDiscus. A total of 22 sources of evidence met inclusion criteria and included intervention studies, systematic reviews, and a discussion paper. Intervention studies were appraised using the Mixed Methods Appraisal Tool. The final program theory constituted eight context-mechanism-outcome configurations that highlight the importance of facilitator characteristics, access to safe spaces, group dynamics, and social support. A limitation was the small number and variable quality of included evidence. Physical activity programs that target immigrant older adults must strengthen physical and psychological safety and maximize opportunities for role modeling and socialization. This research was supported by the Alberta Health Services Seniors Health Strategic Clinical Network and is registered in PROSPERO (ID#258179).

A Scoping Review on Community-Based Programs to Promote Physical Activity in Older Immigrants.

Older immigrants are at higher risks for inactivity due to cultural, environmental, and social barriers in the postmigration context. Community-based physical activity (PA) programs increase PA in older adults, yet little is known about approaches that specifically target older immigrants. This scoping review explores the literature on community-based programs that increase PA and physical fitness in immigrant older adults and identifies barriers and facilitators to PA program participation in this population. A systematic search of electronic databases and gray literature was conducted, and a total of 11 articles met the inclusion criteria after full-text screening. A range of populations and PA program characteristics are described, yet there is a lack of studies on older immigrant men, Black older immigrants, and immigrants from Arab and African countries. There is a need for further research to develop evidence-informed PA programs for this diverse population.

Health Information Seeking Among Immigrant Families in Western Canada.

PURPOSE: Studies on immigrant populations' access to healthcare in Canada tend to focus on adults and usually concentrate on specific ethnic groups, particularly South Asians and Chinese. This study sought to present the experiences of immigrant parents when they access health services for their children focusing specifically on the various sources of information that they used to improve their children's health. DESIGN AND METHOD: This qualitative study was carried out in Edmonton, Alberta between April to October 2018. Fifty parents, chosen using purposive sampling participated in one-on-one semi-structured interviews. Interviews were recorded digitally, transcribed verbatim, and analyzed thematically. RESULTS: We developed three main themes from the data: Accessing social networks for informational support, the role of professionals in accessing health care information, and navigating and evaluating information sources. The study demonstrates that immigrant families consulted various sources of information in order to meet their children's healthcare needs. The most common source was the Internet followed by friends and family members, and health care professionals. DISCUSSION: Findings suggest that health information that is disseminated using the Internet needs to be made available in multiple languages to facilitate communication to persons who are not fluent in English nor French. Also, policy makers and health care professionals must increase focus on informal sources of health care information.

A Qualitative Exploration of Immigrant Muslim Older Adults' Experiences and Perceptions of Physical Activity.

Physical activity is essential for healthy aging; however, there has been little exploration of physical activity in Muslim older immigrants in Canada. Over one million Canadians identify as Muslim, the majority is first-generation immigrants, with increasing cohorts entering older age. A community-based participatory research project on healthy aging was conducted with 68 older adults and community members from South Asian, Arab, and African Muslim ethnocultural communities in a Canadian urban center. A combination of individual interviews and focus groups discussions were completed, followed by thematic analysis of data. Participating community groups emphasized the importance of physical activity in older age and prioritized the need for physical activity programs. The four themes highlight Muslim older immigrants' perspectives on physical activity in Canada: (a) values and approaches to staying active; (b) health factors: pain and health limitations; (c) social factors: culture, religion, and belonging; and (d) environmental factors: safety and accessibility.

An Intersectional Exploration: Experiences of Stroke Prevention in Middle-Aged and Older Arab Muslim Immigrant Women in Canada.

Background Arab immigrants have increasing rates of stroke and uncontrolled stroke risk factors coupled with minimal resources for stroke prevention. Purpose This article describes the results of an interpretive descriptive study about Arab immigrant women's experiences of practicing stroke prevention. We use an intersectionality approach to discuss some of the factors that influenced women's ability to manage their health. Methods Sixteen middle-aged and older Arab Muslim immigrant women were recruited between 2015 and 2016 from two religious centers in an urban Canadian center. Women were between the ages of 45 and 75 years, were living in the community, and had a combination of stroke risk factors. Semi-structured interviews lasting 2-3 h were conducted in Arabic by the primary bilingual researcher. Data analysis was completed in Arabic, with final themes and exemplars translated to English with the support of a certified translator. Results Study themes include relating life stressors to physical health, pursuing knowledge in the dark, negotiating medication and treatment options, making an effort to eat healthy and be active, and identifying triple ingredients for empowerment. Conclusion Economic status, access to transportation, language fluency, life stressors, and personal coping strategies influenced Arab women's ability to manage personal health.

Social dimensions of health across the life course: Narratives of Arab immigrant women ageing in Canada.

The increase in ethnically and linguistically diverse older adults in Canada necessitates attention to their experiences and needs for healthy ageing. Arab immigrant women often report challenges in maintaining health, but little is known about their ageing experiences. This interpretive descriptive study uses a transnational life course framework to understand Arab Muslim immigrant women's experiences of engaging in health-promoting practices as they age in Canada. Women's stories highlight social dimensions of health such social connectedness, social roles and social support that are constructed and maintained within different migration contexts across the life course. Barriers and facilitators to healthy ageing in this population centred around five themes: (i) the necessity of staying strong, (ii) caring for self while caring for others, (iii) double jeopardy of chronic illnesses and loneliness, (iv) inadequate support within large social networks and (v) navigating access to health-supporting resources. The findings point to transnational connections and post-migration social support as major influencers in creating facilitators and barriers to healthy ageing for Arab Muslim immigrant women.

Arts-based research with immigrant and racialized older adults: A scoping review.

This scoping review aims to describe the range of research studies using arts-based data collection methods with immigrant and racialized older adults. A secondary aim is to identify challenges and strengths of using these approaches with this population. This review uses Arksey and O'Malley's five-stage scoping review framework with a final number of 16 references included for the study. Enhanced social connectedness, increased transparency and quality of findings, and self-empowerment were key strengths of using arts-based approaches for data collection. Challenges identified included resource limitations, cultural and language barriers, and barriers to meaningful engagement. Only a small number of studies have utilized arts-based methods with immigrant and racialized older adults. Arts-based approaches require unique methodological adaptations with this population but have the potential to increase engagement in research activities, authenticity of research findings and empowerment of older adults.

"If I Stay Quiet, the Only Person That Gets Hurt Is Me": Anti-Asian Racism and the Mental Health of Chinese-Canadian Youth During the COVID-19 Pandemic.

BACKGROUND AND PURPOSE: Despite documented accounts of racial discrimination against Chinese communities during the COVID-19 pandemic, few studies have examined experiences of racism among Canadian youth. This qualitative study explored the experiences of Chinese-Canadian youth during the COVID-19 pandemic and their mental health. METHODS: A qualitative descriptive research design, informed by Critical Race Theory (CRT), was used for this study. Data was collected using focus groups and image-based elicitation methods. Youth who self-identified as Chinese-Canadian, aged 18-24, and who experienced some account of self-defined racism were included. We analyzed the data using a coding system developed for this study and formulated key themes. RESULTS: Our analysis identified three themes: (I) Becoming racialized; (II) Learning the rules of racism; and (III) Effects of racism on mental health. We discuss findings in relation to the model minority stereotype, intersectionality of race and gender, and factors leading to a lack of support. CONCLUSIONS: This study provides evidence that racism had immediate and prolonged effects on the mental health of Chinese-Canadian youth and their relationships with peers, family, and even strangers. Our research suggests the need for enhanced services for Chinese-Canadian youth and other groups experiencing racism.

Service-policy gaps in the settlement journey of Arabic-speaking immigrant newcomer and refugee older adults in Edmonton, Canada.

Immigrant newcomers and refugees (INRs) are two migrant categories that experience consistent systemic barriers to settlement and integration in Canada as older adults. This paper explores the challenges experienced by Arabic-speaking INR older adults in Edmonton, Canada, during settlement and discusses policy and service implications. A qualitative description study using community-based participatory research principles was implemented to evaluate and support digital literacy in Arabic-speaking INR older adults. We included men and women aged 55 and older who identified as immigrants or refugees and spoke Arabic. Experiences of settlement challenges were consistently identified during data collection and engagement of INR older adult participants. A thematic sub-analysis of interviews with (10 individuals and one couple) of participants' narratives was completed in 2022 and was used to identify themes related to settlement barriers for this population. Two main themes were identified: (1) Limited English skills and digital literacy gaps create service barriers for INR older adults, and (2) Gaps in services and policies as basic needs remain unmet. We describe key challenges experienced by INR older adults, such as language barriers, precarious finances, poor access to health care services and lack of transportation and employment opportunities, which hinder successful integration into the new society. This study showcases the ongoing challenges with early settlement and integration that continue despite Canada's well-developed immigration settlement landscape. INR older adults often remain invisible in policy, and understanding their experiences is a first step to addressing their needs for resources that support healthy aging in the post-migration context.

Immigrant Older Adults' Experiences of Aging in Place and Their Neighborhoods: A Qualitative Systematic Review.

Engaging in one's neighborhood fosters independence, promotes social connectedness, improves quality of life, and increases life expectancy in older adults. There is a lack of evidence synthesis on immigrant older adults' neighborhood perceptions and experiences, essential for addressing neighborhood-level influences on aging in place. This study systematically synthesizes qualitative evidence on immigrant older adults' perceptions and experiences of their neighborhoods. A comprehensive search was conducted from inception to 5 April 2023, in multiple databases. This review considered studies including immigrant older adults aged ≥60 years, included studies from any country where the neighborhood was the focus, and only considered qualitative data while excluding review studies, theoretical publications, and protocols. Eligible studies were appraised using the JBI critical appraisal checklist for qualitative research. The Joanna Briggs Institute meta-aggregation approach was used to synthesize findings, and the ConQual approach established confidence in the synthesis. A total of 30 studies were included. Most studies were conducted in North America and explored phenomena such as aging in place, social capital, social cohesion, sense of community, and life satisfaction. Key contextual factors were walkable safe access to social spaces, accessible transportation to amenities, social cohesion with neighbors, and pre-migration neighborhood experiences. Immigrant older adults have varied experiences related to their sense of belonging and social cohesion. Factors such as racial discrimination, feeling unsafe, and social isolation contributed to negative perceptions. This review highlights the need for inclusive neighborhoods that align with the needs and values of immigrant older adults aging in place.

Sexual Health Implications of Return Migration for Women and Their Partners in Rural Mexico: A Critical Ethnography.

ABSTRACT: The return of a migrant partner can negatively impact the sexual health of women who stayed in their communities. Understanding their sexual health needs is crucial for developing targeted interventions and support systems. Our study used a critical ethnographic approach in Agua Dulce, a rural community in Mexico, involving 50 key informants: women who stayed behind (n = 20), returnees (n = 12), community leaders (n = 12), and health care professionals (n = 6). We used participant observation, policy analysis, and interviews, using purposeful and snowball sampling methods. A gender-based thematic analysis revealed economic hardships and early separations affect the sexual well-being of women who stay behind. Infidelity, discovered through social media or calls, causes emotional distress and family disruptions. Male migrants spend an average of 8.85 years abroad, leading to fears of risky sexual behaviors. Our study highlights the urgent need for specialized support centers and comprehensive health interventions.

Advancing nursing education through wearable electronic devices: A scoping review.

AIM: To examine the incorporation of wearable electronic devices in the education of undergraduate nursing students. BACKGROUND: The advancement of technology has influenced nursing education and will continue to do so in the future. Wearable technologies are electronic devices that can be worn as an accessory and expand the possibilities in nursing education with increased engagement in the learning process. DESIGN: A scoping review was conducted following JBI and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. METHODS: The search was performed on August 25th, 2023, in the databases: MEDLINE via PubMed, ISI Web of Science, ERIC, EBSCOhost CINAHL, EBSCOhost Academic Search Premier, EBSCOhost Health Source Nursing, EMBASE, Scopus, BVShost LILACS and ProQuest. Literature that examined the application of wearable electronic devices in the education of undergraduate nursing students was included. RESULTS: This scoping review study included a total of 21 records published between 2014 and 2023. The analysis showed that smart glasses are the most common wearable electronic device used in nursing education, followed by smartwatches. The devices provide an opportunity for competencies development, especially when applied in the simulation environment, such as physical examination and medication administration. Wearable technologies are potentially useful and feasible as learning tools in nursing education, increasing nursing students' motivation, confidence and satisfaction. CONCLUSIONS: In the technological revolution, educators must consider the potential of innovative teaching strategies, such as wearable electronic devices, to advance nursing education. Wearables can contribute to developing competencies required for the professionalism of undergraduate nursing students.

Workforce resilience supporting staff in managing stress: A coherent breathing intervention for the long-term care workforce.

BACKGROUND: Staff in long-term care (LTC) homes have long-standing stressors, such as short staffing and high workloads. These stressors increased during the COVID-19 pandemic; better resources are needed to help staff manage stress and well-being. The purpose of this study was to evaluate the effect of a simple stress management strategy (coherent breathing). METHODS: We conducted a pre-post intervention study to evaluate a self-managed coherent breathing intervention from February to September 2022. The intervention included basic (breathing only) and comprehensive (breathing plus a biofeedback device) groups. Six hundred eighty-six participants were initially recruited (359 and 327 in the comprehensive and basic groups respectively) from 31 LTC homes in Alberta, Canada. Two hundred fifty-four participants completed pre-and post-intervention questionnaires (142 [55.9%] in comprehensive and 112 [44.1%] in basic). Participants were asked to use coherent breathing based on a schedule increasing from 2 to 10 min daily, 5-7 times a week over 8 weeks. Participants completed self-administered online questionnaires pre- and post-intervention to assess outcomes-stress, psychological distress, anxiety, depression, resilience, insomnia, compassion satisfaction, compassion fatigue, and burnout. We used a mixed-effects regression model to test the main effect of time (pre- and post-intervention) and group while testing the interaction between time and group and controlling for covariates. RESULTS: We found statistically significant changes from pre- to post-intervention in stress (b = -2.5, p < 0.001, 95% CI = -3.1, -1.9), anxiety (b = -0.5, p < 0.001, 95% CI = -0.7, -0.3), depression (b = -0.4, p < 0.001, 95% CI = -0.6, -0.2), insomnia (b = -1.5, p < 0.001, 95% CI = -2.1, -0.9), and resilience (b = 0.2, p < 0.001, 95% CI = 0.1, 0.2). We observed no statistically significant differences between the two intervention groups on any outcome. CONCLUSIONS: Our findings suggest that coherent breathing is a promising strategy for improving stress-related outcomes and resilience. This intervention warrants further, more rigorous testing.

Impact of the COVID-19 pandemic on Muslim older immigrants in Edmonton, Alberta: A community-based participatory research project with a local mosque.

OBJECTIVE: Older Muslim immigrants experience multiple vulnerabilities living in Canada. This study explores the experiences of Muslim older adults during the COVID-19 pandemic to identify ways to build community resilience as part of a community-based participatory research partnership with a mosque in Edmonton, Alberta. METHODS: Using a mixed-methods approach, check-in surveys (n = 88) followed by semi-structured interviews (n = 16) were conducted to assess the impact of COVID-19 on older adults from the mosque congregation. Quantitative findings were reported through descriptive statistics, and thematic analysis guided the identification of key findings from the interviews using the socio-ecological model. RESULTS: Three major themes were identified in consultation with a Muslim community advisory committee: (a) triple jeopardy leading to loneliness, (b) decreased access to resources for connectivity, and (c) organizational struggles to provide support during the pandemic. The findings from the survey and interviews highlight various supports that were missing during the pandemic for this population. CONCLUSION: The COVID-19 pandemic exacerbated the challenges associated with aging in the Muslim population and contributed to further marginalization, with mosques being sites of support during times of crises. Policymakers and service providers must explore ways of engaging mosque-based support systems in meeting the needs of older Muslim adults during pandemics.

RéSUMé: OBJECTIF: Les immigrants musulmans âgés vivant au Canada sont confrontés à des vulnérabilités multiples. Cette étude explore les expériences des personnes âgées musulmanes durant la pandémie de COVID-19 afin d'identifier des moyens pour renforcer la résilience communautaire dans le cadre d'un partenariat de recherche participative communautaire (CBPR) avec une mosquée à Edmonton, en Alberta. MéTHODES: À l'aide d'une approche à méthodes mixtes, des enquêtes de contrôle (n = 88) suivies d'entretiens semi-dirigés (n = 16) ont été menés pour évaluer l'impact du COVID-19 sur les personnes âgées de la congrégation de la mosquée. Les résultats quantitatifs ont été rapportés au moyen de statistiques descriptives, tandis que l'analyse thématique a guidé l'identification des principaux résultats des entretiens à l'aide du modèle socio-écologique. RéSULTATS: Trois thèmes majeurs ont été identifiés en concertation avec un comité consultatif de la communauté musulmane : a) triple péril menant à la solitude, b) accès réduit aux ressources pour la connectivité, et c) luttes organisationnelles pour fournir un soutien pendant la pandémie. Les résultats de l'enquête et des entretiens mettent en évidence le manque d'aides diverses à cette population durant la pandémie. CONCLUSION: La pandémie de COVID-19 a exacerbé les défis associés au vieillissement de cette population et a contribué à une marginalisation supplémentaire, les mosquées étant des sites de soutien en temps de crise. Les décideurs politiques et les prestataires de services doivent explorer les moyens d'engager les systèmes d'aide basés dans les mosquées pour répondre aux besoins des adultes musulmans âgés pendant les pandémies.

Access to mental health for Black youths in Alberta. / L'accès des jeunes Noirs de l'Alberta aux services en santé mentale.

INTRODUCTION: The objective of this study was to examine the barriers that influence access to and use of mental health services by Black youths in Alberta. METHODS: We used a youth-led participatory action research (PAR) methodology within a youth empowerment model situated within intersectionality theory to understand access to health care for both Canadian-born and immigrant Black youth in Alberta. The research project was co-led by an advisory committee consisting of 10 youths who provided advice and tangible support to the research. Seven members of the advisory committee also collected data, co-facilitated conversation cafés, analyzed data and helped in the dissemination activities. We conducted in-depth individual interviews and held four conversation café-style focus groups with a total of 129 youth. During the conversation cafés, the youths took the lead in identifying issues of concern and in explaining the impact of these issues on their lives. Through rigorous data coding and thematic analysis as well as reflexivity and member checking we ensured our empirical findings were trustworthy. RESULTS: Our findings highlight key barriers that can limit access to and utilization of mental health services by Black youth, including a lack of cultural inclusion and safety, a lack of knowledge/information on mental health services, the cost of mental health services, geographical barriers, stigma and judgmentalism, and limits of resilience. CONCLUSION: Findings confirm diverse/intersecting barriers that collectively perpetuate disproportional access to and uptake of mental health services by Black youths. The results of this study suggest health policy and practice stakeholders should consider the following recommendations to break down barriers: diversify the mental health service workforce; increase the availability and quality of mental health services in Black-dominated neighbourhoods; and embed anti-racist practices and intercultural competencies in mental health service delivery.

Risk and Resilience: How Is the Health of Older Adults and Immigrant People Living in Canada Impacted by Climate- and Air Pollution-Related Exposures?

BACKGROUND: In the rapidly shifting Canadian climate, an ageing population, and increased migration, a greater understanding of how local climate and air pollution hazards impact older adults and immigrant populations will be necessary for mitigating and adapting to adverse health impacts. OBJECTIVES: To explore the reported health impacts of climate change and air pollution exposures in older adults and immigrant people living in Canada, identify known factors influencing risk and resilience in these populations and gaps in the literature. METHODS: We searched for research focused on older adults and immigrants living in Canada, published from 2010 onward, where the primary exposures were related to climate or air pollution. We extracted data on setting, exposures, health outcomes, and other relevant contextual factors. RESULTS AND DISCUSSION: We identified 52 eligible studies, most focused in Ontario and Quebec. Older people in Canada experience health risks due to climate and air pollution exposures. The extent of the risk depends on multiple factors. We found little information about the climate- and air pollution-related health impacts experienced by immigrant communities. CONCLUSIONS: Further research about climate- and air pollution-related exposures, health, and which factors promote or reduce resiliency in Canada's older adults and immigrant communities is necessary.

"Growing Old is not for the Weak of Heart": Social isolation and loneliness in Muslim immigrant older adults in Canada.

The increase in global migration means more immigrants are ageing in host countries with unique experiences and needs. Muslim immigrants in Canada are from diverse ethnocultural communities and experience unmet health and social needs in older age. A community-based participatory research project was conducted in Alberta, Canada, in 2017-2018 to understand the experiences and needs of healthy ageing in this population. A community advisory committee participated in all phases of the research project including initial framing of the research focus, recruitment, data collection and data analysis. In total, 67 older adults and stakeholders from South Asian, Arab and African Muslim communities participated in one of 23 individual interviews or seven focus group discussions over a 1-year period. Participants were asked about their experiences of growing old in Canada, unmet health and social needs, and community perspectives on healthy ageing. All data were audio-taped and transcribed verbatim. Interpreters were used for non-English speaking participants. Data were thematically analysed with a focus on social isolation and loneliness. Using an exclusion lens two major themes were identified: (a) intersections of exclusion: ageism, sexism, racism, and; (b) strategies for inclusion: local, national, transnational. Findings highlight both the vulnerability of Muslim immigrant older adults and their capacity for agency. The study findings point to the intersecting influences of exclusionary practices on social isolation and loneliness in immigrant older adults and the need to incorporate an exclusion lens in developing social policies and programs for healthy ageing.

"We Are Like Any Other People, but We Don't Cry Much Because Nobody Listens": The Need to Strengthen Aging Policies and Service Provision for Minorities in Canada.

BACKGROUND AND OBJECTIVES: This study explores the aging experiences and needs of immigrant Muslim communities in an urban center in Alberta, Canada. Over one million Muslims live in Canada, with the majority being immigrants and visible minorities. Aging-focused policies and services have yet to address the needs of this population as larger cohorts begin to enter older age. RESEARCH DESIGN AND METHODS: A community-based participatory research approach was adopted with a community advisory committee co-leading all aspects of the research process. Sixty-seven older adults and stakeholders from diverse ethnocultural immigrant Muslim communities participated in either individual interviews or one of the seven focus groups (2017-2018). Data were transcribed verbatim and thematically analyzed with a focus on factors that support or hinder positive aging experiences in this population. RESULTS: Participants not only described the benefits of growing old in Canada but also identified unique challenges stemming from their social positioning as religious minorities, immigrants, and older adults. We highlight these experiences in three themes: (a) aging while living across places, (b) negotiating access to aging-supportive resources in a time of scarcity, and (c) re-envisioning Islamic approaches to eldercare. DISCUSSION AND IMPLICATIONS: Immigrant Muslim communities report inequities experienced by older community members. There is a need for an in-depth analysis of the ways aging and migration policies intersect to influence the resources that immigrant minorities have access to as they grow old in Canada.