Above chaos, quest, and restitution: narrative experiences of African immigrant youth's settlement in Canada.

BACKGROUND: African Immigrant and refugee youth represent an increasing group of newcomers in Canada. Upon their immigration, youth experience challenges that have the potential to lead to poor health, yet little is known about their settlement journey. Accordingly, this qualitative study examines the settlement journey of African immigrant and refugee youth with a focus on how their experiences were shaped by the social determinants of health. METHODS: We conducted a total of 70 interviews with 52 immigrant and refugee youth (ages 13-29 years) who had arrived in Canada in the preceding six years. Qualitative data was analyzed using Frank's dialogical narrative analysis approach (Frank AW, Practicing Dialogical Narrative Analysis. In: Varieties of Narrative Analysis, 2016). RESULTS: Youth experienced different settlement journeys that are described in the three narrative typologies of chaos, quest, and restitution. The chaos narrative of a long road ahead revealed the themes of 'facing challenges' and 'still the outsider.' The quest narrative of not there yet was represented by the themes of 'stepping out of your comfort zone' and 'being relentless.' The theme of 'supportive environments' depicted the restitution narrative of dreams become a reality. Youth highlighted the impact of social determinants of health in their settlement. CONCLUSION: Youth experienced different settlement journeys that were mired in chaos and challenges. However, youth were more likely to experience restitution when they received social support and found a sense of belonging. In future, policies and programs that seek to improve immigrant and refugee youth's settlement experiences need to be multifaceted, offer more support and promote a sense of belonging.

A qualitative study on African immigrant and refugee families' experiences of accessing primary health care services in Manitoba, Canada: it's not easy!

BACKGROUND: Immigrant and refugee families form a growing proportion of the Canadian population and experience barriers in accessing primary health care services. The aim of this study was to examine the experiences of access to primary health care by African immigrant and refugee families. METHODS: Eighty-three families originating from 15 African countries took part in multiple open ended interviews in western Canada. Qualitative data was collected in six different languages between 2013 and 2015. Data analysis involved delineating units of meaning from the data, clustering units of meaning to form thematic statements, and extracting themes. RESULTS: African immigrant and refugee families experienced challenges in their quest to access primary health care that were represented by three themes: Expectations not quite met, facing a new life, and let's buddy up to improve access. On the theme of expectations not quite met, families struggled to understand and become familiar with a new health system that presented with a number of barriers including lengthy wait times, a shortage of health care providers, high cost of medication and non-basic health care, and less than ideal care. On the theme of facing a new life, immigrant and refugee families talked of the difficulties of getting used to their new and unfamiliar environments and the barriers that impact their access to health care services. They talked of challenges related to transportation, weather, employment, language and cultural differences, and lack of social support in their quest to access health care services. Additionally, families expressed their lack of social support in accessing care. Privately sponsored families and families with children experienced even less social support. Importantly, in the theme of let's buddy up to improve access, families recommended utilizing networking approaches to engage and improve their access to primary health care services. CONCLUSIONS: African immigrant and refugee families experience barriers to accessing primary health care. To improve access, culturally relevant programs, collaborative networking approaches, and policies that focus on addressing social determinants of health are needed.

African Refugee Youth's Experiences of Navigating Different Cultures in Canada: A "Push and Pull" Experience.

Refugee youth face challenges in navigating different cultures in destination countries and require better support. However, we know little about the adaptation experiences of African refugee youth in Canada. Accordingly, this paper presents the adaptation experiences of African refugee youth and makes recommendations for ways to support youth. Twenty-eight youth took part in semi-structured interviews. Using a thematic analysis approach, qualitative data revealed four themes of: (1) 'disruption in the family,' where youth talked about being separated from their parent(s) and the effect on their adaptation; (2) 'our cultures are different,' where youth shared differences between African and mainstream Canadian culture; (3) 'searching for identity: a cultural struggle,' where youth narrated their struggles in finding identity; and (4) 'learning the new culture,' where youth narrated how they navigate African and Canadian culture. Overall, the youth presented with challenges in adapting to cultures in Canada and highlighted how these struggles were influenced by their migration journey. To promote better settlement and adaptation, youth could benefit from supports and activities that promote cultural awareness with attention to their migration experiences. Service providers could benefit from newcomer-friendly and culturally sensitive training on salient ways of how experiences of multiple cultures affect integration outcomes.

Healthy Canadian adolescents' perspectives of cancer using metaphors: a qualitative study.

OBJECTIVES: Cancer has been described using metaphors for over 4 decades. However, little is known about healthy adolescents' perspectives of cancer using metaphors. This paper reports on findings specific to adolescents' perspectives of cancer using metaphors. The findings emerged from a qualitative ethnographic study that sought to understand Canadian adolescents' conceptualisation of cancer and cancer prevention. DESIGN: To arrive at a detailed description, data were obtained using individual interviews, focus groups and photovoice. SETTING: 6 high schools from a western Canada province. PARTICIPANTS: 75 Canadian adolescents. RESULTS: Use of 4 metaphors emerged from the data: loss (cancer as the sick patient and cancer as death itself); military (cancer as a battle); living thing (haywire cells and other living things) and faith (cancer as God's will) metaphors, with the loss and military metaphors being the ones most frequently used by adolescents. Adolescents' descriptions of cancer were partly informed by their experiences with family members with cancer but also what occurs in their social worlds including mass media. Adolescents related cancer to emotions such as sadness and fear. Accordingly, more holistic and factual cancer descriptions, education and psychosocial support are needed to direct cancer messaging and clinical practice. CONCLUSIONS: Findings from this study suggest that the public and healthcare providers be more aware of how they communicate cancer messages.