Migration and health study: a socio-ecological analysis of sexual health among migrants in Manitoba, Canada.

BACKGROUND: To develop effective public health policies, programs, and services tailored to the unique sexual health needs of migrant populations, it is essential to understand the myriad socio-ecological factors that influence their sexual health. This qualitative community-based participatory study aimed to explore factors influencing migrants' sexual health at different socio-ecological levels in a Canadian setting. METHODS: Participants (n = 34) from African, Caribbean, Black; Latin American; South Asian; Middle Eastern, as well as East and Southeast Asian communities were recruited across Manitoba using printed flyers, community organizations, and social media. Individual interviews, conducted in English, French, Mandarin, Cantonese, Tagalog, Arabic, Swahili, and Tigrinya languages, explored questions relating to sexual health and experiences with service providers. Data were analyzed using reflexive thematic analysis and socio-ecological systems theory. RESULTS: The study uncovered a range of individual, interpersonal, institutional, and socio-structural factors that affect the sexual health of migrants in Manitoba. Individual factors such as sexual health knowledge and testing practices, interpersonal factors like the type of sexual partnerships, institutional factors such as sexual health information needs, language, and service access barriers, and structural-level factors like gender norms and HIV stigma exerted a significant influence on the sexual health practices of study respondents. Sexual health awareness was influenced by various factors including length of time in Canada and involvement in community-based services. Study respondents identified issues related to access to HIV testing and sexual health information, as well as language barriers, racism in healthcare, and HIV stigma. Gender and social norms played a significant role in discouraging communication about sex and safer sex practices. CONCLUSIONS: The study highlights the complex interplay of factors that influence the sexual health of migrants, and the need for targeted sexual health awareness campaigns and provision of sexual health information in languages spoken by migrants. Public health interventions focused on improving the sexual health outcomes for migrants should consider the socio-ecological elements identified in this study. These findings can inform public health campaigns to increase access to services and address sexual health inequities among migrant communities in Canada.

Intersectionality of Resilience: A Strengths-Based Case Study Approach With Indigenous Youth in an Urban Canadian Context.

By bringing together two important areas of contemporary health research-resilience among Indigenous youth and intersectionality theory-this study advances an intersectionality of resilience framework that exposes intersecting forms of oppression within inner city urban contexts, while also critically reframing intersectionality to include strength-based perspectives of overlapping individual, social, and structural resilience-promoting processes. Drawing on Indigenous methodologies, a "two-eyed seeing" approach, and Stake's case study methodology involving multiple data sources (i.e., four sharing circles, 38 conversational interviews, four rounds of photovoice, and naturalistic interactions that occurred with 28 youth over an entire year), this qualitative study outlines three intersecting processes that facilitate youth resilience and wellness in various ways: (a) strengthening cultural identity and family connections; (b) engagement in social groups and service to self and community; and (c) practices of the arts and a positive outlook. In the end, implications for research, clinical practice, and health or community interventions are also discussed.

Land and nature as sources of health and resilience among Indigenous youth in an urban Canadian context: a photovoice exploration.

BACKGROUND: Population and environmental health research illustrate a positive relationship between access to greenspace or natural environments and peoples' perceived health, mental health, resilience, and overall well-being. This relationship is also particularly strong among Canadian Indigenous populations and social determinants of health research where notions of land, health, and nature can involve broader spiritual and cultural meanings. Among Indigenous youth health and resilience scholarship, however, research tends to conceptualize land and nature as rural phenomena without any serious consideration on their impacts within urban cityscapes. This study contributes to current literature by exploring Indigenous youths' meaning-making processes and engagements with land and nature in an urban Canadian context. METHODS: Through photovoice and modified Grounded Theory methodology, this study explored urban Indigenous youth perspectives about health and resilience within an inner-city Canadian context. Over the course of one year, thirty-eight in-depth interviews were conducted with Indigenous (Plains Cree First Nations and Métis) youth along with photovoice arts-based and talking circle methodologies that occurred once per season. The research approach was also informed by Etuaptmumk or a "two-eyed seeing" framework where Indigenous and Western "ways of knowing" (worldviews) can work alongside one another. RESULTS: Our strength-based analyses illustrated that engagement with and a connection to nature, either by way of being present in nature and viewing nature in their local urban context, was a central aspect of the young peoples' photos and their stories about those photos. This article focuses on three of the main themes that emerged from the youth photos and follow-up interviews: (1) nature as a calming place; (2) building metaphors of resilience; and (3) providing a sense of hope. These local processes were shown to help youth cope with stress, anger, fear, and other general difficult situations they may encounter and navigate on a day-to-day basis. CONCLUSIONS: This study contributes to the literature exploring Indigenous youths' meaning-making process and engagements with land and nature in an urban context, and highlights the need for public health and municipal agencies to consider developing more culturally safe and meaningful natural environments that can support the health, resilience, and well-being of Indigenous youth within inner-city contexts.

Re-imagining miyo-wicehtowin: Human-nature relations, land-making, and wellness among Indigenous youth in a Canadian urban context.

Relationships to land and nature have long been recognized globally as a central Indigenous determinant of health. As more Indigenous peoples migrate to larger urban centers, it is crucial to better understand how these relationships are maintained or function within urban spaces. This article outlines the results of a year-long collaborative study that qualitatively explored Indigenous young peoples' connections between "land," nature, and wellness in an urban Canadian context. Thirty-eight semi-structured interviews were conducted with 28 Cree and Métis Indigenous youth living within Saskatoon, Saskatchewan. A strength based analysis focused on re-imagining miyo-wicehtowin; that is, the processes of youths' self-determination and agency that build positive human-nature relationships and enact "land-making" amidst their urban spaces. This research critically engages environmental dispossession and repossession to more readily consider decolonizing land-based approaches to health and wellness among urban contexts. Future empirical and methodological directions for exploring human-nature relationships in urban health research are also offered.