Homestay Hosting Dynamics and Refugee Well-Being: Protocol for a Scoping Review.

BACKGROUND: The process of refugee resettlement and integration into new communities is a complex and multifaceted challenge, not only for the refugees themselves but also for the host families involved in homestay housing arrangements. While these homestay arrangements are designed to facilitate smoother transitions and enhance the well-being of refugees, the nuanced dynamics of these interactions and their overall impact on both refugees and their host families remain underexplored. Understanding the experiences of refugees and their host families is vital for effective refugee settlement, integration, and well-being. However, the intricacies of homestay refugee hosting, their interactions with host families, and the impact on their well-being are still unclear and ambiguous. OBJECTIVE: The aim of this scoping review is to examine the breadth of literature on the experiences of refugees living in homestay arrangements with their host families. This review seeks to understand how these dynamics influence refugee well-being, including their integration, social connections, and mental health. Additionally, this scoping review aims to synthesize existing literature on homestay hosting dynamics, focusing on the experiences of refugees and their host families, to identify gaps in knowledge and suggest areas for future research. METHODS: This scoping review follows Joanna Briggs Institute methodology and will search databases such as CINAHL, SOCIndex, MEDLINE through EBSCO; APA PsycInfo, Scopus through OVID; and Web of Science Core Collection, ProQuest Dissertations, and Theses, and SciELO Citation Index, focusing on literature from 2011 onward, in English, in relation to refugee groups in different host countries, including all types of literature. Literature will be screened by 2 independent reviewers, with disagreements resolved by consensus or a third reviewer. A custom data extraction tool will be created by the research team. RESULTS: The results will be organized in tables or diagrams, accompanied by a narrative overview, emphasizing the main synthesized findings related to the dynamics of homestay hosting with host families and refugee well-being. No critical appraisal will be conducted. This scoping review is expected to identify research gaps that will inform the development of homestay refugee hosting models, policies, and practices. It will also offer insights into best practices and policy recommendations to improve homestay hosting programs, ultimately contributing to more effective refugee settlement and integration strategies. CONCLUSIONS: Understanding the intricate dynamics of homestay hosting arrangements is crucial for developing policies and programs that support the well-being of refugees and the families that host them. This scoping review will shed light on the current knowledge landscape, identify research gaps, and suggest ways to enhance the homestay hosting experience for all parties involved. Through this work, we aim to contribute to the development of more inclusive, supportive, and effective approaches to refugee hosting, resettlement, and integration. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56242.

Newcomer Women's Experiences with Perinatal Care During the Three-Month Health Insurance Waiting Period in Ontario, Canada.

BACKGROUND: The three-month health insurance waiting period in Ontario reinforces health inequities for newcomer women and their babies. Little is known about the systemic factors that shape newcomer women's experiences during the OHIP waiting period. PURPOSE: To examine the factors that shaped newcomer women's experiences with perinatal care during the three-month health insurance waiting period in Ontario, Canada. METHODS: This qualitative study was informed by an intersectional framework, and guided by a critical ethnographic method. Individual interviews were conducted with four newcomer women and three perinatal healthcare professionals. Participant observations at recruitment and interview sites were integral to the study design. RESULTS: The key systemic factors that shaped newcomer women's experiences with perinatal care included social identity, migration, and the healthcare system. Social identities related to gender, race, and socio-economic status intersected to form a social location, which converged with newcomer women's experiences of social isolation and exclusion. These experiences, in turn, intersected with Ontario's problematic perinatal health services. Together, these factors form systems of oppression for newcomer women in the perinatal period. CONCLUSIONS: Given the health inequities that can result from these systems of oppression, it is important to adopt an upstream approach that is informed by the Human Rights Code of Ontario to improve accessibility to and the experiences of perinatal care for newcomer women.

Immigrants' and refugees' experiences of access to health and social services during the COVID-19 pandemic in Toronto, Canada.

OBJECTIVE: In 2020, the World Health Organization reported that immigrants were the most vulnerable to contracting COVID, due to a confluence of personal and structural barriers. This study explored how immigrants and refugees experienced access to health and social services during the first wave of COVID-19 in Toronto, Canada. METHODS: This study analyzed secondary data from a qualitative study that was conducted between May and September 2020 in Toronto that involved semi-structured interviews with 72 immigrants and refugees from 21 different countries. The secondary data analysis was informed by critical realism. RESULTS: The vast majority of participants experienced fear and anxiety during the COVID-19 outbreak but through a combination of self-reliance and community support came to terms with the realities of the pandemic. Some even found the lifestyle changes engendered by the pandemic a positive experience. CONCLUSIONS: Self-reliance may hinder help-seeking and augment the threat of COVID-19. This is particularly a concern for the most vulnerable immigrants, who experience multiple disruptions in their health care, have limited material resources and social supports, and perhaps are still dealing with the challenges of settling in the new country.

The Experiences and Determinants of Sleep Problems of Immigrant and Canadian-Born Older Adults-Analysis of Canadian Longitudinal Study on Aging Baseline Data.

BACKGROUND: Although prevalent, limited knowledge is available on the experience of sleep problems (i.e., disturbance in sleep latency and in sleep maintenance) and their determinants in immigrant older adults. PURPOSE: To compare immigrant and Canadian-born older adults' experiences of: 1) sleep problems, 2) determinants of sleep problems, categorized into precipitating and perpetuating factors, and 3) determinants most significantly contributing to each sleep problem. METHODS: Baseline data obtained by the comprehensive cohort of the Canadian Longitudinal Study on Aging were analyzed. Participants 55+ years of age and with complete data on their country of birth comprised the sample, with 18,245 Canadian-born and 4,257 immigrant older adults. Single or multiple items were used to assess the precipitating (chronic condition, sleep disorders, pain, depressive symptoms, psychological distress, education, marital and socio-economic status) and perpetuating (smoking, alcohol consumption, physical activity) factors. Chi-square test and independent sample t-test were used in the comparison and multiple regression was applied to determine the most significant determinant of each sleep problem in each group of older adults. RESULTS: Despite differences in a few determinants of sleep problems, the set of factors contributing to disturbance in sleep latency and maintenance was comparable for Canadian-born and immigrant older adults, and included: having a sleep disorder and high level of depressive symptoms and psychological distress. CONCLUSION: The findings highlight the importance of public health campaigns to increase older adults' awareness of sleep problems, the factors that may contribute to disturbance in sleep, and strategies to prevent and/or manage sleep problems.

Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context.

STUDY BACKGROUND: The aging population in Canada has been increasing steadily over the past 40 years, however, there is limited information about the meaning of aging well amongst older Brazilian women in Canada. METHODS: A Heideggerian interpretive phenomenology study was conducted to understand the meaning of aging well amongst older Brazilian women in the post-migration context living in the Greater Toronto Area (GTA) in Ontario, Canada. RESULTS: Eight older Brazilian women residing in the GTA were recruited through purposive and snowball sampling and participated in individual face-to-face interviews. Through data analysis and the incorporation of Heidegger's four existentials of human existence, the themes that emerged were (a) Embracing being part of a mosaic, (b) Aging with grace, (c) Chasing your dreams and (d) Being a bridge and not a fence. The overarching theme was: Finding the silver lining: Aging well. CONCLUSION: This study informs nursing practice, research and policy development to advance the health of older immigrant adults in Canada.

Elder abuse risk factors: Perceptions among older Chinese, Korean, Punjabi, and Tamil immigrants in Toronto.

OBJECTIVES: Elder abuse is a significant concern worldwide. Several factors are reported to increase the risk for elder abuse, but little is known about which factors are most relevant to immigrant communities. This study explored perceptions of risk factors for elder abuse among older immigrants, which is the first step toward designing effective interventions. METHODS: This cross-sectional quantitative study was conducted between 2017 and 2019 in the Greater Toronto Area, Ontario, Canada and involved a convenience sample (N = 173) of older women and men from Chinese, Korean, Punjabi, and Tamil immigrant communities. Participants completed a questionnaire about the frequency and importance of risk factors of elder abuse in their respective community. Descriptive statistics were used to analyze the data within each immigrant community and analysis of variance to compare the factor ratings across communities. RESULTS: The immigrant communities differed (p < .05) in their perception of the risk factors. Factors rated as frequent and important (x̅ > 2.0 - midpoint of the rating scale) were social isolation, financial dependence, and lack of knowledge of English for Korean; financial dependence, physical dependence, and emotional dependence for Chinese; lack of knowledge of English, emotional dependence, and physical dependence for Tamil; and social isolation for Punjabi. CONCLUSION: The findings highlight the need for collaboration among public health and social services to work with immigrant communities in co-designing interventions to address these key risk factors and thereby reduce the risk of elder abuse.

COVID-19 restrictions: experiences of immigrant parents in Toronto.

Parenting is a demanding undertaking, requiring continuous vigilance to ensure children's emotional, physical, and spiritual well-being. It has become even more challenging in the context of COVID-19 restrictions that have led to drastic changes in family life. Based on the results of a qualitative interpretive descriptive study that aimed to understand the experiences of immigrants living in apartment buildings in the Greater Toronto Area, Ontario, Canada, this paper reports the experiences of 50 immigrant parents. During the summer and fall of 2020, semi-structured interviews were conducted by phone or virtually, audio-recorded, then translated and transcribed. The transcripts were analyzed using thematic analysis. Results revealed that parenting experiences during the pandemic entailed dealing with changing relationships, coping with added burdens and pressures, living in persistent fear and anxiety, and rethinking lifestyles and habits. Amid these changes and challenges, some parents managed to create opportunities for their children to improve their diet, take a break from their rushed lives, get in touch with their cultural and linguistic backgrounds, and spend more quality time with their family. While immigrant parents exhibit remarkable resilience in dealing with the pandemic-related meso and macro-levels restrictions, funding and programs are urgently needed to support them in addressing the impact of these at the micro level.

Examining Different Strategies for Stigma Reduction and Mental Health Promotion in Asian Men in Toronto.

Mental illness stigma has detrimental effects on health and wellbeing. Approaches to address stigma in racialized populations in Western nations need to emphasize inclusivity, social justice, and sociocultural intersectionality of determinants of health. The current paper evaluates three intervention approaches to reduce stigma of mental illness among Asian men in Toronto, Canada. Participants received one of four group interventions: psychoeducation, Acceptance and Commitment Therapy (ACT), Contact-based Empowerment Education (CEE), and a combination of ACT+CEE. Self-report measures on stigma (CAMI, ISMI) and social change (SJS) were administered before and after the intervention. A total of 535 Asian men completed the interventions. Overall analyses found that all intervention approaches were successful in reducing stigma and promoting social change. Subscale differences suggest that CEE may be more broadly effective in reducing mental illness stigmatizing attitudes while ACT may be more specifically effective in reducing internalized stigma. More work needs to be done to elucidate mechanisms that contribute to socioculturally-informed mental illness stigma interventions for racialized communities and traditionally marginalized populations.

Ampliando vozes sobre violência obstétrica: recomendações de advocacy para enfermeira(o) obstetra / Expandiendo las voces sobre la violencia obstétrica: recomendaciones para la advocacy por enfermera(o) obstetra / Amplifying voices on obstetric violence: recommendations for advocacy by an obstetric nurse

Resumo Objetivos explorar as demandas das mulheres, bem como do público em geral, para melhorar a qualidade da assistência obstétrica; discutir as mudanças potenciais sugeridas pelos respondentes para tal prática assistencial. Método pesquisa multicêntrica realizada por meio da plataforma Opinio, explorando opiniões dos participantes de três cidades da região Sudeste do Brasil. Tratamento dos dados por estatística descritiva e análise temática. Resultados respondentes (n=414) na faixa etária 33-37 anos (26%), incluindo mulheres (75%) com mais de 15 anos de escolaridade, casadas (45%) e com um filho (35%), revelaram lacuna de conhecimentos sobre a violência obstétrica e os direitos da mulher. Jornal, rádio e televisão são as principais fontes de informação. O enfrentamento da violência obstétrica dar-se-ia por apoio familiar. Para a práxis renovada sugeriu-se a educação coletiva sobre direitos aos cuidados obstétricos (53,1%) e o atendimento humanizado (38,2%) mobilizando o poder profissional para consolidar a humanização. Temas analíticos centrais incluíram situação vivenciada pelas mulheres e contexto idealizado de prática. Conclusão e Implicações para a prática o debate incrementa a humanização e a governança compartilhada. Recomendações propostas para advocacy coadunam com a perspectiva global da promoção de saúde das mulheres e liderança social.

Resumen Objetivos explorar las demandas de las mujeres, así como del público en general, para mejorar la calidad de la atención obstétrica; Discutir los posibles cambios sugeridos por los encuestados para esta práctica de cuidado y, Proponer recomendaciones para la promoción por la enfermera en cuestiones de violencia obstétrica. Método investigación multicéntrica realizada a través de la plataforma Opinio, explorando las opiniones de los participantes de tres ciudades en el sureste de Brasil. Tratamiento de datos mediante estadísticas descriptivas y análisis temáticos. Resultados demandados (n-414) de 33 a 37 años (26%) incluyendo mujeres (75%) con más de 15 años de escolarización, casado (45%) y con un niño (35%) reveló una brecha de conocimiento sobre la violencia obstétrica y los derechos de las mujeres. El periódico, la radio y la televisión son las principales fuentes de información. La confrontación se basaría en el apoyo de la familia. Para la renovada praxis, se sugirió la educación colectiva sobre los derechos de atención obstétrica (53,1%) y la atención humanizada (38,2%) movilizar el poder profesional para consolidar la humanización. Los temas analíticos centrales incluyeron una situación experimentada por las mujeres y un contexto idealizado de práctica. Conclusión e implicaciones para la práctica el debate aumenta la humanización y la gobernanza compartida. Las recomendaciones propuestas para la promoción son coherentes con la perspectiva mundial de la promoción de la salud y el liderazgo social de las mujeres.

Abstract Objectives Explore women's and the general public's demands to improve the quality of obstetric care. Discuss respondents' suggestions to improve obstetric care, and propose recommendations for nursing advocacy in matters of obstetric violence. Method A multi-site online survey (in three cities in Brazil's southeastern region) hosted by Opinio platform exploring the respondents' opinions. Data was analyzed by descriptive statistics and thematic analysis. Results Respondents (n=414) aged 33-37 years (26%), including women (75%) with more than 15 years of schooling, who are married (45%) and with one child (35%), demonstrated a knowledge gap on obstetric violence and women's rights. Newspapers, radio, and television were cited as the main sources of information. Family support was a suggested strategy to deal with obstetric violence. For the renewed praxis, collective education on obstetric care rights (53.1%) and humanized care (38.2%) were suggested to mobilize professional power to consolidate humanization in care. Central analytical themes included situations faced by women and an idealized context of practice. Conclusion and implications for practice Discussion in organizations increases humanization and shared governance. Recommendations proposed for advocacy are consistent with the global perspective of women's health promotion and social leadership.

Brasil-Canadá: Lançando Sementes Através De Consulta Comunitária sobre o enfrentamento da violência contra a mulher / Brasil-Canadá: Lanzando semillas por medio de consulta comunitaria sobre la lucha contra la violencia contra la mujer / Brazil-Canada: Launching seeds through community consultation on tackling violence against women

RESUMO Objetivos Relatar a primeira experiência da Cátedra de Pesquisa em Saúde Urbana (Universidade Ryerson-Canadá) no Brasil, em colaboração com a Universidade Federal da Paraíba por meio de uma consulta de opinião comunitária sobre as estratégias de enfrentamento da violência contra a mulher, e oferecer subsídios que estimulem uma visão renovada de colaborações e parcerias internacionais entre programas de Enfermagem. Método Abordagem descritiva do tipo relato de experiência de docentes e discentes de Enfermagem brasileiros e canadenses, desde o processo de planejamento até a análise das informações obtidas. Resultados Essa experiência foi fundamental para o estabelecimento de colaborações científicas recentemente implementadas e em planejamento, consolidando o potencial da Enfermagem em participar de acordos científicos e tecnológicos entre Brasil-Canadá. Conclusão e Implicações para a prática Recomendamos que programas de graduação e pós-graduação de Enfermagem no Brasil promovam o intercâmbio de seu corpo social com diversos países, não apenas em projetos de pesquisa, mas também em projetos de desenvolvimento social valorizados igualmente na construção de um corpo de conhecimentos para a Enfermagem global.

RESUMEN Objetivos Presentar un informe de la primera experiencia de la Cátedra de investigación en salud urbana (Universidad Ryerson- Canadá) en Brasil en colaboración con la Universidad Federal de Paraíba a través de una consulta de opinión a la comunidad sobre estrategias para enfrentar la violencia contra las mujeres y ofrecer información para estimular una visión renovada de colaboración internacional y asociación entre programas de enfermería. Método Un diseño descriptivo con el informe de las experiencias de estudiantes y miembros de las facultades de enfermería canadienses y brasileños sobre el proceso desde la panificación de la consulta hasta el análisis de la información acumulada. Resultados Esta experiencia fue fundamental para establecer nueva colaboración científica recientemente implementada y en la panificación para consolidar así el potencial de la enfermería para participar en los acuerdos científicos y tecnológicos de Brasil y Canadá. Conclusión e Implicaciones para la práctica A los estudiantes en los programas de licenciatura y posgrado en enfermería brasileña se les recomienda que promuevan el intercambio de sus agentes sociales con otros países, no solo para proyectos de investigación, pero también para el desarrollo social, los que son igualmente valorados para la construcción del conocimiento específico de la enfermería global.

ABSTRACT Objectives To report the first experience of the Research Chair in Urban Health (Ryerson University-Canada) in Brazil in collaboration with the Federal University of Paraíba through a community opinion consultation about strategies to face violence against women. This experience also offers insights to stimulate renewed visions of international collaborations and partnerships among nursing programs. Method A descriptive design with the report of experience of Canadian and Brazilian nursing faculty and students about the process from the consultation planning to the analysis of the gathered information. Results This experience was fundamental to establish new scientific collaborations recently implemented and in planning. It demonstrates the nursing potential to participate in Brazil-Canada technological and scientific agreements. Conclusion and Implications for practice Brazilian Nursing undergraduate and graduate programs are recommended to promote an exchange of their faculty and administrative staff with several countries. These exchanges would not be only for research projects but also for social development projects, which are equally valued for the creation of global, nursing-specific knowledge.

Understanding Social Network and Support for Older Immigrants in Ontario, Canada: Protocol for a Mixed-Methods Study.

BACKGROUND: Older adults are the fastest growing age group worldwide and in Canada. Immigrants represent a significant proportion of older Canadians. Social isolation is common among older adults and has many negative consequences, including limited community and civic participation, increased income insecurity, and increased risk of elder abuse. Additional factors such as the social, cultural, and economic changes that accompany migration, language differences, racism, and ageism heighten older immigrants' vulnerability to social isolation. OBJECTIVE: This mixed-methods sequential (qualitative-quantitative) study seeks to clarify older immigrants' social needs, networks, and support and how these shape their capacity, resilience, and independence in aging well in Ontario. METHODS: Theoretically, our research is informed by an intersectionality perspective and an ecological model, allowing us to critically examine the complexity surrounding multiple dimensions of social identity (eg, gender and immigration) and how these interrelate at the micro (individual and family), meso (community), and macro (societal) levels in diverse geographical settings. Methodologically, the project is guided by a collaborative, community-based, mixed-methods approach to engaging a range of stakeholders in Toronto, Ottawa, Waterloo, and London in generating knowledge. The 4 settings were strategically chosen for their diversity in the level of urbanization, size of community, and the number of immigrants and immigrant-serving organizations. Interviews will be conducted in Arabic, Mandarin, and Spanish with older women, older men, family members, community leaders, and service providers. The study protocol has received ethics approval from the 4 participating universities. RESULTS: Quantitative and qualitative data collection is ongoing. The project is funded by the Social Sciences and Humanities Council of Canada. CONCLUSIONS: Comparative analyses of qualitative and quantitative data within and across sites will provide insights about common and unique factors that contribute to the well-being of older immigrants in different regions of Ontario. Given the comprehensive approach to incorporating local knowledge and expert contributions from multilevel stakeholders, the empirical and theoretical findings will be highly relevant to our community partners, help facilitate practice change, and improve the well-being of older men and women in immigrant communities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12616.

Gender Differences in Perpetuating Factors, Experience and Management of Chronic Insomnia.

The higher prevalence of insomnia in women has been attributed to biological factors, which are less likely than cognitive and behavioral factors to play a role in perpetuating insomnia. Gender differences in perpetuating factors have not been extensively examined. This study compared men's and women's self-reports of factors that perpetuate insomnia; experience of symptoms, perceived severity and impact on daytime functioning; and use of strategies to manage insomnia. Data were collected at baseline, using reliable and valid measures, in a project that evaluated behavioral therapies for insomnia. The sample (N = 739) consisted of women (62.4%) and men (37.6%). Gender differences were found in: 1) perpetuating factors: men took more naps and held more unhelpful beliefs about insomnia, whereas women experienced higher pre-sleep arousal; 2) perception of insomnia severity: higher among women; 3) perceived impact of insomnia: higher fatigue among women; and 4) use of strategies (higher in women) to manage insomnia. Gender differences were of a small size but could be associated with women's stress, expression of somatic symptoms, and interest in maintaining their own health to meet multiple role demands.

Older Immigrants' Access to Primary Health Care in Canada: A Scoping Review.

ABSTRACTAging and immigration have significantly shaped the population composition in Canada, where immigrants make up increasingly large proportions of the older adult population. This scoping review examines the existing knowledge surrounding older immigrants' access to, and utilization of, primary care physicians, who play a pivotal role in the delivery of primary care, preventive care, and mental health care. We applied Arksey and O'Malley's five-stage framework to search databases for Canadian-based, peer-reviewed English-language articles on the topic and examined 31 articles in detail. Three focus areas emerged: access and utilization of primary care, health promotion and cancer screening, and utilization of mental health services. Older immigrants face intertwining access barriers related to health literacy, language, culture, health beliefs, spatial inequality, and structural circumstances. The review provides a thorough understanding of the status of access to care among older immigrants in Canada, and yields policy implications to address their unmet health needs.

Developing a comprehensive understanding of elder abuse prevention in immigrant communities: a comparative mixed methods study protocol.

INTRODUCTION: Older adults are the fastest growing age group in Canada. Elder abuse has significant individual and societal implications, so it is critical to address. While interest in this topic is increasing, little is known about the risk factors for elder abuse in immigrant communities in Canada, or about culturally relevant strategies to address these risk factors. METHODS AND ANALYSIS: This mixed-methods study is guided by the intersectionality and ecological frameworks. We will include two long-term (ie, established) and two recent immigrant communities from East Asian and South Asian communities in the Greater Toronto Area: Chinese, Korean, Punjabi and Tamil. Through structured group interviews, we will first identify factors that contribute to elder abuse within and across each of the immigrant communities and then explore culturally relevant strategies to address those risk factors. Group interviews will be conducted separately with five stakeholder groups in each of the four languages: older women, older men, family members, community leaders and service providers. Quantitative and qualitative data will be analysed at the level of the particular interview groups, subgroups and communities, and will be integrated across communities to identify common and unique risk factors and strategies to address elder abuse. ETHICS AND DISSEMINATION: The study protocol has received ethics approval from the two universities associated with the research team. Given the comprehensive approach to incorporate local knowledge and expert contributions from multi-level stakeholders, the empirical and theoretical findings will facilitate practice change and improve the well-being of older men and women in immigrant communities.

Intimate Partner Violence Among Older Portuguese Immigrant Women in Canada.

One third of the immigrant population around the world is made up of women. Of these women, many belong to the Portuguese community. Immigrants account for more than one in five Canadians. The Portuguese older immigrant women living in Canada are vulnerable to be victims of intimate partner violence (IPV), which is a prevalent and important global health issue that affects differently diverse groups. There are few available researches regarding IPV on this population. The objective of this study is to understand how Portuguese older immigrant women living in Canada experience IPV. This is a qualitative study with a social phenomenological focus. Alfred Schutz's motivation theory was used to analyze the impulses that led older women to face IPV. The data were collected from July to October 2013 in the Greater Toronto Area. Ten women 60 years or older were included in the study. The participants perceived themselves as being victimized by their current or ex partners. They are unhappy and suffer from a variety of health problems, which they related to their experience of IPV. These factors, along with participants' personal beliefs, and their legal situations as immigrants in Canada, made them act, either in a way that would try to maintain their relationships, or tried to escape the violent situation. IPV is a complex phenomenon, with different perceptions surrounding it. The experiences of the older immigrant women showed that ending the marriage is not always a possibility to them because of cultural issues and their immigrant status in Canada. Some women wish help and support to improve their relationships.

Novas vidas, novos desafios: acesso a serviços de violência por parceiro íntimo para mulheres imigrantes de língua portuguesa / New lives, new challenges: access to intimate partner violence services for portuguese-speaking immigrant women

A violência por parceiro íntimo é um problema global e mais comum sofrida pelas mulheres. Este estudo explorou barreiras aos serviços de saúde relacionadas à violência por parceiro íntimo entre mulheres imigrantes de língua portuguesa em Toronto, Canadá. Estudo exploratório de discussões em grupo com 12 mulheres imigrantes de língua portuguesa. Os resultados esclarecem lutas enfrentadas pelas mulheres imigrantes e seus caminhos para cuidar e buscar ajuda. O medo de serem deportadas, a obtenção de evidências de abuso e a falta de serviços no idioma específico foram as barreiras relatadas. Fé e religião foram apontadas como fatores-chave no apoio a resiliência das mulheres, quando disponíveis os serviços comunitários no idioma específico. Enfermeiros que prestam assistência às mulheres que lidam com a violência por parceiro íntimo devem repensar o escopo de suas ações de defesa para abordar essas barreiras estruturais, construindo alianças com organizações para melhor servir e proteger as mulheres em situações vulneráveis.

Intimate partner violence is a global health issue and the most common form of violence experienced by women. This study explored barriers to accessing help to Intimate partner violence related health services among Portuguese-speaking immigrant women in Toronto, Canada. Exploratory study conducted by a survey and focus group discussions with 12 Portuguese-speaking immigrant women. Results clarify the struggles faced by Portuguese-speaking immigrant women and their pathways to care and help-seeking. Participants reported that the fear of being deported, obtaining evidence of abuse, and lack of language-specific services were the key barriers to seeking help. When available, language-specific community-based services, along with faith and religion, were noted as key factors that supported women's resilience. Nurses who provide care and services to women who are dealing with Intimate partner violence should rethink the scope of their advocacy actions toward addressing these structural barriers by building alliances with organizations to better serve and protect women in such vulnerable situations.

Healthcare needs and health service utilization by Syrian refugee women in Toronto.

OBJECTIVE: Access to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Canada by May 2018, 80% of whom are women and children. We explored the healthcare needs of newcomer Syrian women, their experiences in accessing and using health services, and the factors and conditions that shape whether and how they access and utilize health services in the Greater Toronto Area (GTA). METHOD: This community-based qualitative descriptive interpretive study was informed by Yang & Hwang (2016) health service utilization framework. Focus group discussions were held with 58 Syrian newcomer women in the GTA. These discussions were conducted in Arabic, audio-recorded with participants' consent, translated into English and transcribed, and analyzed using thematic analysis. RESULTS: Participants' health concerns included chronic, long-term conditions as well as new and emerging issues. Initial health insurance and coverage were enabling factors to access to services, while language and social disconnection were barriers. Other factors, such as beliefs about naturopathic medicine, settlement in suburban areas with limited public transportation, and lack of linguistically, culturally, and gender-appropriate services negatively affected access to and use of healthcare services. CONCLUSION: Responding to the healthcare needs of Syrian newcomer women in a timely and comprehensive manner requires coordinated, multi-sector initiatives that can address the financial, social, and structural barriers to their access and use of services.

Stigma associated with mental illness among Asian men in Vancouver, Canada.

BACKGROUND:: Due to racism, xenophobic nationalism, acculturation pressures and patriarchal social relations, Asian men in Western societies may be particularly susceptible to negative experiences and beliefs regarding mental illness and treatment services. AIMS:: We examine factors associated with stigma toward mental illness among Asian men in Canada. METHODS:: Between 2013 and 2017, 428 self-identified Asian men living in proximity to Vancouver, Canada, were recruited and completed self-administered questionnaires assessing social stigma and self-stigma. The degree to which these variables were associated with the men's sociodemographic characteristics was analyzed. RESULTS:: Multivariable regression revealed that social stigma was significantly predicted by age, immigration, employment status and experience with mental illness. Together, these variables accounted for 12.36% of variance in social stigma. Interaction terms were added to the regression models to examine whether the effects of immigration on social stigma varied by age and experience with mental illness, but none of the interaction terms were statistically significant. Among the 94 Asian men identified as living with mental illness, self-stigma was predicted by age, immigration and employment status, which together accounted for 14.97% of variance in self-stigma. CONCLUSION:: These results offer new knowledge about the factors predicting stigma toward mental illness among Asian men in Western societies.

Study protocol: Mobilizing Asian men in Canada to reduce stigma of mental illness.

BACKGROUND: The available evidence on interventions addressing the stigma of mental illness is limited because of small samples, lack of diversity in study samples, and exclusion of people living with mental illness. To date, no published studies have evaluated anti-stigma interventions for Asian men in Canada. Aim This paper describes the protocol of a study to evaluate psychological and collective empowerment interventions (ACT, CEE, and ACT+CEE) in addressing self-stigma and social stigma in Asian communities in three urban settings in Canada: Toronto, Calgary and Vancouver. The study targets Asian men living with or affected by mental illness, and community leaders interested in stigma reduction and advocacy. METHODS: Guided by a population health promotion framework and an ecological approach to health, the study will use a repeated measure design with mixed methods for data collection. In total, 2160 participants will be enrolled to detect moderate-to-large effect sizes, while accounting for possible attrition. Participants will be randomly assigned to one of three interventions or a control group, using a randomization matrix. Established measures will be used to collect outcome data at pretest, post-test, and 3 and 6 months follow-up, along with focus group discussions and monthly activity logs. Mixed linear models will compare participants' stigma, psychological flexibility, valued life domains, mindfulness, and empowerment readiness within and between groups. DISCUSSION: The project will generate new knowledge on the applicability and effectiveness of evidence-based psychological and collective empowerment interventions (ACT, CEE, and ACT+CEE) in addressing stigma of mental illness and mobilizing community leadership.