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Au A, Murad-Kassam S, Mukanoheli V, Idrees S, Ben Mabrouk E, Abdi K, Kennedy M, Whitfield K, Salma J. Immigrant Older Adults' Experiences of Aging in Place and Their Neighborhoods: A Qualitative Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:904. [PMID: 39063481 PMCID: PMC11277252 DOI: 10.3390/ijerph21070904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
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.
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Affiliation(s)
- Alesia Au
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Sadaf Murad-Kassam
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Vestine Mukanoheli
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Sobia Idrees
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Esra Ben Mabrouk
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Khadija Abdi
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
| | - Megan Kennedy
- Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Kyle Whitfield
- Faculty of Science, School of Urban and Regional Planning, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Jordana Salma
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB T6G 1C9, Canada; (S.M.-K.); (V.M.); (S.I.); (E.B.M.); (K.A.); (J.S.)
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Wong V, Franke T, McKay H, Tong C, Macdonald H, Sims-Gould J. Adapting an Effective Health-Promoting Intervention-Choose to Move-for Chinese Older Adults in Canada. J Aging Phys Act 2024; 32:151-162. [PMID: 37917970 DOI: 10.1123/japa.2023-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/04/2023] [Accepted: 08/07/2023] [Indexed: 11/04/2023]
Abstract
Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations.
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Affiliation(s)
- Venessa Wong
- Active Aging Research Team, Vancouver, BC,Canada
| | - Thea Franke
- Active Aging Research Team, Vancouver, BC,Canada
| | | | - Catherine Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
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Wood J, Stolee P, Tong C. Understanding the Patient Experience of Foreign-Born Older Adults: A Scoping Review of Older Immigrants Receiving Health Care in Canada. Can J Aging 2023; 42:657-667. [PMID: 37424439 DOI: 10.1017/s0714980823000235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
In Canada, foreign-born older adults (FBOAs) have a higher prevalence of chronic conditions and poorer self-reported physical and mental health than their Canadian-born peers. However, very little research has explored FBOAs' experiences of health care after immigration. This review aims to understand the patient experiences of older immigrants within the Canadian health care system. Employing Arksey and O'Malley's framework for scoping reviews, we searched six databases and identified 12 articles that discussed the patient experience of this population. Although we sought to understand patient experience, the studies largely focused on barriers to care, including: communication difficulties, lack of cultural integration, systematic barriers in health care, financial barriers, and intersecting barriers related to culture and gender.This review provides insight into new areas of research and advocates for strengthened policy and/or programming. Our review also highlights that there is a paucity of literature for an ever-growing segment of the Canadian population.
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Affiliation(s)
- Jessica Wood
- Global Health, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Paul Stolee
- School of Public Health & Health Systems, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Catherine Tong
- School of Public Health & Health Systems, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
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Puplampu VA, Silversides HP, Phillips KLR. A Scoping Review on Older Adults from Africa Social Connectedness Experiences in North America. J Cross Cult Gerontol 2023:10.1007/s10823-023-09479-1. [PMID: 37209245 DOI: 10.1007/s10823-023-09479-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
The percentage of older adult immigrants in Canada and the United States is increasing with older adult immigrants from Africa forming a small proportion of the population, but one of the fastest growing groups in the area. Depending on the circumstances leading to the move, migration can be very stressful, especially for older adults. The purpose of this scoping review is to summarize the evidence on the social connectedness of older African immigrants in Canada and the United States. The researchers searched databases including Cochrane Library, BMJ Online, CINAHL, Medline (Ovid), PsycInfo (Ovid), PsycArticles (Ovid), Web of Science, SpringerLINK, CBCA Canadian Business and Current Affairs Database, Academic Search Complete, Sage Journals Online, ABI/Inform, Emerald Fulltext, Expanded Academic ASAP, General OneFile, Joanna Briggs Institute EBP Database, Journals@Ovid, JSTOR, Oxford Journals Online, Taylor & Francis Journals, Wiley Online Library, ProQuest Dissertations and Thesis Global, and Google Scholar from 2000-2020. Four manuscripts met the search inclusion criteria of published peer-reviewed and unpublished research studies in the English language on aging, older adult, social connectedness, African immigrants, Canada, and the United States. The authors found limited studies on African older adult immigrants' social connectedness in Canada and the United States with dearth of research on the older adults' access to health care, use of smart technology and social media to promote their health and social connectedness which are gaps in the literature that should be researched in the future.
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Affiliation(s)
- Vivian A Puplampu
- Faculty of Nursing, University of Regina, Saskatoon Campus, 111-116 Research Drive, Saskatoon, SK, S7N 3R3, Canada.
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Braga LDS, Vaz CT, Silva DNM, Machado EL, Friche AADL. [Discrimination perceived by elderly adults in the use of health services: an integrative review]. CIENCIA & SAUDE COLETIVA 2023; 28:155-169. [PMID: 36629561 DOI: 10.1590/1413-81232023281.08662022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/25/2022] [Indexed: 01/11/2023] Open
Abstract
This paper analyzes the current evidence on discrimination perceived by elderly adults (> 50 years) in the use of health services and identifies factors associated with this discriminatory experience. It involved an integrative literature review, carried out on the Biblioteca Virtual de Saúde, CINAHL, Medline, Scopus, and Web of Science search websites, in June/2021. The key words used were social discrimination or ageism; middle-aged, or aged 80 and over or elderly; health services or health services for the elderly, including synonyms, in Portuguese, English, and Spanish. The search strategy identified 1,165 articles; 19 met the eligibility and inclusion criteria and were included in this integrative review. They comprise quantitative and qualitative studies published between 2002 and 2021; about 60% carried out in the United States and Australia. The prevalence of discrimination in the use of health services ranged from 2% to 42%. The report of discriminatory practices was associated with ethnic-racial characteristics, sex, age, sexual orientation, physical appearance, and social class. By giving visibility to the theme, this work aims to stimulate the definition of concrete ways to tackle discrimination, in an attempt to interrupt the perpetration of inequities in the health care area.
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Affiliation(s)
- Luciana de Souza Braga
- Núcleo de Estudos em Envelhecimento e Saúde Pública, Universidade Federal de Minas Gerais e Fiocruz Minas. Av. Professor Alfredo Balena 190. 30130-100 Belo Horizonte MG Brasil. .,Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Camila Teixeira Vaz
- Núcleo de Estudos em Envelhecimento e Saúde Pública, Universidade Federal de Minas Gerais e Fiocruz Minas. Av. Professor Alfredo Balena 190. 30130-100 Belo Horizonte MG Brasil. .,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Campus Centro-Oeste Dona Lindu, Universidade Federal de São João del-Rei. Divinópolis MG Brasil
| | - Danielle Nunes Moura Silva
- Programa de Pós-Graduação em Ciências Fonoaudiológicas, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Elaine Leandro Machado
- Núcleo de Estudos em Envelhecimento e Saúde Pública, Universidade Federal de Minas Gerais e Fiocruz Minas. Av. Professor Alfredo Balena 190. 30130-100 Belo Horizonte MG Brasil. .,Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Amélia Augusta de Lima Friche
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Observatório de Saúde Urbana de Belo Horizonte, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil.,Programa de Pós-Graduação em Ciências Fonoaudiológicas, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
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Access to Long-Term Care for Minority Populations: A Systematic Review. Can J Aging 2022; 41:577-592. [PMID: 35331343 DOI: 10.1017/s0714980822000046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
It has been shown that there is disparity in access to long-term care and other services for minority populations. This study assessed long-term care access among older individuals belonging to minority populations including visible, ethnocultural, linguistic, and sexual minorities. Barriers and facilitators influencing admission were identified and evaluated.A search for articles from 10 databases published between January 2000 and January 2021 was conducted. Included studies evaluated factors affecting minority populations' admission to long-term care, and non-residents' perceptions of future admission. This review was registered with PROSPERO: CRD42018038662. Sixty included quantitative and qualitative studies, ranging in quality from fair to excellent. Findings suggest minority status is associated with reduced admission to long-term care, controlling for confounding variables. Barriers identified include discordant language, fear of discrimination, lack of information, and family obligations. Findings suggest that minority populations experienced barriers accessing long-term care and had unmet cultural and language needs while receiving care in this setting.
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Tong CE, Lopez KJ, Chowdhury D, Arya N, Elliott J, Sims-Gould J, Grindrod K, Stolee P. Understanding racialised older adults' experiences of the Canadian healthcare system, and codesigning solutions: protocol for a qualitative study in nine languages. BMJ Open 2022; 12:e068013. [PMID: 36216419 PMCID: PMC9557314 DOI: 10.1136/bmjopen-2022-068013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Racialised immigrant older adults (RIOAs) in Canada have poorer self-rated health and are more likely to report chronic conditions, while they concurrently experience well-documented challenges in navigating and accessing the healthcare system. There is strong evidence that patient and caregiver engagement in their healthcare leads to improved management of chronic disease and better health outcomes. International research suggests that engagement has the potential to reduce health disparities and improve quality of care. We aim to (1) describe what role(s) RIOAs are/are not taking in their own healthcare, from the perspectives of participant groups (RIOAs, caregivers and healthcare providers (HCPs)); and (2) develop a codesign process with these participants, creating linguistically aligned and culturally aligned tools, resources or solutions to support patient engagement with RIOAs. METHODS AND ANALYSIS Using a cross-cultural participatory action research approach, our work will consist of three phases: phase 1, strengthen existing partnerships with RIOAs and appropriate agencies and cultural associations; phase 2, on receipt of informed consent, in-depth interviews with RIOAs and caregivers (n=~45) and HCPs (n=~10), professionally interpreted as needed. Phase 3, work with participants, in multiple interpreted sessions, to codesign culturally sensitive and linguistically sensitive/aligned patient engagement tools. We will conduct this research in the Waterloo-Wellington region of Ontario, in Arabic, Bangla, Cantonese, Hindi, Mandarin, Punjabi, Tamil and Urdu, plus English. Data will be transcribed, cleaned and entered into NVivo V.12, the software that will support team-based analysis. Analysis will include coding, theming and interpreting the data, and, preparing narrative descriptions that summarise each language group and each participant group (older adults, caregivers and HCPs), and illustrate themes. ETHICS AND DISSEMINATION Ethics clearance was obtained through the University of Waterloo Office of Research Ethics (ORE #43297). Findings will be disseminated through peer-reviewed publications, presentations and translated summary reports for our partners and participants.
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Affiliation(s)
- Catherine E Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Kimberly J Lopez
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, Ontario, Canada
| | - Diya Chowdhury
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Neil Arya
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jacobi Elliott
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Joanie Sims-Gould
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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The Role of Immigrant Admission Classes on the Health and Well-being of Immigrants and Refugees in Canada: A Scoping Review. J Immigr Minor Health 2022; 24:1045-1060. [PMID: 35303219 DOI: 10.1007/s10903-022-01352-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2022] [Indexed: 10/18/2022]
Abstract
Many countries offer different pathways through which migrants can enter a new country. In Canada, there are three main immigrant admission classes: economic, family, and refugee. Previous research suggests that there are differences in health outcomes among various subgroups of migrants. A scoping review was conducted to characterize the role of immigrant admission classes on the health and well-being of immigrants and refugees in Canada. MEDLINE, Embase, PsycINFO, Sociological Abstracts, and EconLit databases were searched for quantitative studies published in English after 1990. The screening and selection process identified 27 relevant studies. Studies were categorized into four key reported outcomes: health care and services utilization, self-rated health and mental health, medical conditions and chronic illnesses, and social integration and satisfaction. Findings confirm that certain subgroups have worse health outcomes after arrival, particularly refugees, family class and other dependent immigrants. Health outcomes vary significantly across immigrant subgroups defined by the admission class through which they entered Canada.
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Koehn SD, Donahue M, Feldman F, Drummond N. Fostering trust and sharing responsibility to increase access to dementia care for immigrant older adults. ETHNICITY & HEALTH 2022; 27:83-99. [PMID: 31416342 DOI: 10.1080/13557858.2019.1655529] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 05/28/2019] [Indexed: 06/10/2023]
Abstract
Objectives: This paper explores the role of immigrant-serving agencies in facilitating access to dementia services and supports provided by dementia service agencies (particularly the health authority and local chapters of the Alzheimer Society) through their propensity to develop trusting relationships between staff and clients.Design: Our research is a qualitative case study of Punjabi and Korean speakers living in the Lower Mainland of BC, Canada. Data are drawn from interviews with 15 dyads of persons with dementia and their family caregivers (10 Punjabi, 5 Korean), six focus groups (one focus group with each of 8-10 older men, older women, and mixed gender working age adults in each community). We also interviewed 20 managerial and frontline staff of dementia service agencies, i.e. the health authority and the local Alzheimer Society (n = 11) and two immigrant-serving agencies (n = 9), each dedicated to either Punjabi or Korean-speaking clients. We adopted the Candidacy framework for understanding access to dementia services and supports and the concept of trust as guiding precepts in this study.Results: Families of persons with dementia are pivotal to identification of a problem requiring professional help, navigation to appropriate services and acceptance of services offered. However, trust in family members should not be taken for granted, since family dynamics are complex. Alternative sources of trusted support are therefore needed. Immigrant-serving agencies are more often instrumental in establishing trusted relationships between their staff and clients, but they often lack detailed knowledge about heath conditions, their treatment and management, and they lack power to implement statutory care.Conclusions: Partnerships between mainstream mental health/dementia services and the community sector have proven successful in increasing the accessibility of specialized resources, while maximizing their combined trustworthiness, accessibility and effectiveness. Such partnerships should become fundamental components of health service strategy and provision for vulnerable and underserved immigrant older adults.
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Affiliation(s)
| | | | - Fabio Feldman
- Clinical Quality & Patient Safety, Fraser Health, Surrey, Canada
| | - Neil Drummond
- Primary Care, Department of Family Medicine, University of Alberta, Edmonton, Canada
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Sidani S, Guruge S, Illanko K. The Experiences and Determinants of Sleep Problems of Immigrant and Canadian-Born Older Adults-Analysis of Canadian Longitudinal Study on Aging Baseline Data. Can J Nurs Res 2021; 54:168-176. [PMID: 34482751 DOI: 10.1177/08445621211009405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Souraya Sidani
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Kandasamy Illanko
- Department of Computer and Electrical Engineering, Ryerson University, Toronto, ON, Canada
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Lucchese SP, Bishop S, Guruge S, Zanchetta MS, Pirner D. Finding the Silver Lining: Aging Well Amongst Older Brazilian Women in the Post-Migration Context. Can J Nurs Res 2021; 54:156-167. [PMID: 33752458 DOI: 10.1177/08445621211004332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
| | - Susan Bishop
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Sepali Guruge
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | | | - Diane Pirner
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
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Farid D, Li P, Da Costa D, Afif W, Szabo J, Dasgupta K, Rahme E. Undiagnosed depression, persistent depressive symptoms and seeking mental health care: analysis of immigrant and non-immigrant participants of the Canadian Longitudinal Study of Aging. Epidemiol Psychiatr Sci 2020; 29:e158. [PMID: 32792036 PMCID: PMC7443777 DOI: 10.1017/s2045796020000670] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/04/2020] [Accepted: 07/14/2020] [Indexed: 12/19/2022] Open
Abstract
AIMS Early diagnosis and treatment of depression are associated with better prognosis. We used baseline data of the Canadian Longitudinal Study on Aging (2012-2015; ages 45-85 years) to examine differences in prevalence and predictors of undiagnosed depression (UD) between immigrants and non-immigrants at baseline and persistent and/or emerging depressive symptoms (DS) 18 months later. At this second time point, we also examined if a mental health care professional (MHCP) had been consulted. METHODS We excluded individuals with any prior mood disorder and/or current anti-depressive medication use at baseline. UD was defined as the Center for Epidemiological Studies Depression 10 score ⩾10. DS at 18 months were defined as Kessler 10 score ⩾19. The associations of interest were examined in multivariate logistic regression models. RESULTS Our study included 4382 immigrants and 18 620 non-immigrants. The mean age (standard deviation) in immigrants was 63 (10.3) years v. 65 (10.7) years in non-immigrants and 52.1% v. 57.1% were male. Among immigrants, 12.2% had UD at baseline of whom 34.2% had persistent DS 18 months later v. 10.6% and 31.4%, respectively, among non-immigrants. Female immigrants were more likely to have UD than female non-immigrants (odds ratio 1.50, 95% confidence interval 1.25-1.80) but no difference observed for men. The risk of persistent DS and consulting an MHCP at 18 months did not differ between immigrants and non-immigrants. CONCLUSIONS Female immigrants may particularly benefit from depression screening. Seeking mental health care in the context of DS should be encouraged.
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Affiliation(s)
- D. Farid
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - P. Li
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - D. Da Costa
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
| | - W. Afif
- Department of Medicine, Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada
| | - J. Szabo
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- Chronic Viral Illnesses Service, McGill University Health Center, Montreal, Quebec, Canada
| | - K. Dasgupta
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, Division of General Internal Medicine, McGill University, Montreal, Quebec, Canada
| | - E. Rahme
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine, Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada
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Conducting a Mixed-Methods Study with Older Adults in Five Languages: Lessons from the Field. Can J Aging 2020; 40:321-330. [PMID: 32616105 DOI: 10.1017/s0714980820000100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
One third of older adults in Canada are foreign-born, yet there is a dearth of literature on this population. When our team set out to engage in a mixed-methods study on the physical activity and mobility of foreign-born older adults (FBOAs), we found limited guidance. The objective of this Research Note is to share the lessons that we learned in implementing a mixed-methods study in five languages, with 49 visible minority FBOAs from diverse ethno-cultural groups. With an emphasis on practical implementation, here we share our reflections on early community engagement, linguistic accessibility and literacy considerations, facilitating communication with the research team, creating a support role for multilingual family members, organisational suggestions, and working with interpreters and monolingual transcribers. The older Canadian population is projected to become increasingly diverse in the coming decades, and it is our hope that this note will further facilitate research in this understudied area.
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Davison KM, Lin S(L, Tong H, Kobayashi KM, Mora-Almanza JG, Fuller-Thomson E. Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051493. [PMID: 32110904 PMCID: PMC7084187 DOI: 10.3390/ijerph17051493] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 12/18/2022]
Abstract
The main purpose of this study was to compare the lifetime prevalence of anxiety disorders among foreign-born and Canadian-born adults in middle and later life. Using baseline data of the Canadian Longitudinal Study on Aging (2010–2015), multivariable binary logistic regression was conducted to investigate anxiety diagnosis and immigrant status, while controlling for socio-economic, health-related, and nutrition covariates. Of 26,991 participants (49.3% men, 82.5% Canadian born, 58.5% aged 45–65 years), the overall prevalence of self-reported physician diagnosis of anxiety disorders was 8.5%, with immigrants being lower than Canadian-born respondents (6.4% vs. 9.3%, p < 0.001). After accounting for all covariates, the adjusted odds ratio (aOR) for anxiety disorders was lower among immigrants (aOR = 0.77, 95% CI: 0.67–0.88) compared to those who were Canadian born. Identified risk factors included: younger age (aORs = 1.79–3.52), being a woman (aOR = 1.25, 95% CI: 1.07–1.46), single status (aOR = 1.27, 95% CI: 1.09–1.48), lower income (aORs = 1.28–2.68), multi-morbidities (aORs = 2.73–5.13), chronic pain (aOR = 1.31, 95% CI: 1.18–1.44), lifetime smoking ≥ 100 cigarettes (aOR = 1.35, 95% CI: 1.23–1.48), BMI < 18.5 (aOR = 1.87, 95% CI: 1.20–2.92), body fat ≥ 26% (aORs = 1.28–1.79), fruit and vegetable intake (<3/day; aORs = 1.24–1.26), and pastry consumption (>1/day; aOR = 1.55, 95% CI: 1.12–1.15) (p < 0.05). Targeting socio-economic and nutritional risk factors may reduce the burden of anxiety disorders in middle and late adulthood.
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Affiliation(s)
- Karen M. Davison
- Health Science, Kwantlen Polytechnic University, Surrey, BC V3W 2M8, Canada;
- Department of Psychology, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA
- Correspondence: ; Tel.: +1-604-300-0331
| | - Shen (Lamson) Lin
- Factor-Inwentash Faculty of Social Work and Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada (E.F.-T.)
| | - Hongmei Tong
- Faculty of Health and Community Studies, MacEwan University; Edmonton, AB T5J 4S2, Canada;
| | - Karen M. Kobayashi
- Department of Sociology, University of Victoria; Victoria, BC V8W 2Y2, Canada;
| | | | - Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work and Institute for Life Course & Aging, University of Toronto, Toronto, ON M5S 1V4, Canada (E.F.-T.)
- Department of Family & Community Medicine and Faculty of Nursing, University of Toronto, Toronto, ON M5G 1V7 & M5T 1P8, Canada
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15
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Abstract
RÉSUMÉLe vieillissement et l’immigration ont significativement transformé la composition démographique au Canada, et les immigrants y représentent une proportion croissante de la population adulte plus âgée. L’accès adéquat aux services de santé est essentiel au bien-être et à l’inclusion sociale de cette population. Cet examen de la portée porte sur les connaissances actuelles concernant l’accès des immigrants d’âge avancé aux médecins omnipraticiens et à leur consultation, considérant que ces médecins jouent un rôle central dans la prestation de soins de première ligne, dans les soins préventifs et les soins de santé mentale. Le modèle en 5 étapes d’Arksey et O’Malley a été utilisé pour effectuer des recherches dans une grande variété de bases de données pour des articles publiés en anglais dans des revues avec comité de pairs concernant ce sujet dans le contexte canadien. Un total de 31 articles répondant aux critères d’inclusion ont été examinés en détail. Ces articles ont été classés en fonction de l’information disponible sur leurs auteurs, la population à l’étude, la méthodologie, le domaine de la santé et les obstacles mentionnés. Trois thèmes principaux ont émergé de cet examen de portée : l’accès et l’utilisation des soins de première ligne, la promotion de la santé et le dépistage du cancer, ainsi que l’utilisation des services de santé mentale. Les immigrants d’âge avancé font face à des obstacles en termes d’accès aux soins et ceux-ci seraient liés à la littératie en santé, à la langue, à la culture, aux croyances en matière de santé, aux inégalités spatiales et à des circonstances structurelles. L’examen de la portée présente de manière détaillée l’accès aux soins des personnes âgées immigrantes au Canada, et permet de dériver des implications sur les politiques qui permettraient de répondre à leurs besoins qui sont non comblés dans le domaine de la santé.
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Salami B, Salma J, Hegadoren K. Access and utilization of mental health services for immigrants and refugees: Perspectives of immigrant service providers. Int J Ment Health Nurs 2019; 28:152-161. [PMID: 29984880 DOI: 10.1111/inm.12512] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 12/01/2022]
Abstract
Immigrant and refugee populations experience life stressors due to difficult migration journeys and challenges in leaving one country and adapting to another. These life stressors result in adverse mental health outcomes when coupled with a lack of adequate support-enhancing resources. One area of support is access to and use of mental health services to prevent and address mental health concerns. Immigrant service providers in Canada support the integration and overall well-being of newcomers. This study focuses on immigrant service providers' perceptions of access to and use of mental health services for immigrants and refugees in Alberta. A qualitative descriptive design was used to collect and analyse the perspectives of 53 immigrant service providers recruited from nine immigrant serving agencies in Alberta between November 2016 and January 2017. Data were collected using a combination of individual interviews and focus groups, followed by thematic data analysis to identify relevant themes. Barriers to access and use of mental health services include language barriers, cultural interpretations of mental health, stigma around mental illness, and fear of negative repercussions when living with a mental illness. Strategies to improve mental health service delivery include developing community-based services, attending to financial barriers, training immigrant service providers on mental health, enhancing collaboration across sectors in mental health service delivery, and advancing the role of interpreters and cultural brokers. Overall, immigrant service providers present a nuanced view of the complex and inter-related barriers immigrants and refugees experience and identify potential approaches to enhancing mental health service delivery.
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Affiliation(s)
- Bukola Salami
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
| | - Jordana Salma
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen Hegadoren
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
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Psychometric Properties of the Inventory of Attitudes Toward Seeking Mental Health Services (Chinese Version). Can J Aging 2018; 37:234-244. [PMID: 29552991 DOI: 10.1017/s0714980818000041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ABSTRACTResearch on underutilization patterns of mental health services among older Chinese immigrants is limited, partly due to the absence of translated, psychometrically sound measures for assessing attitudes towards seeking help. In this study we interviewed 200 older Chinese Canadian immigrants using a translated version of the Inventory of Attitudes Toward Seeking Mental Health Services scale (IASMHS), and assessed mental health care utilization over the past 12 months and intentions to seek help. Confirmatory factor analysis failed to replicate the original three-factor structure; thus, we used exploratory factor analysis to create a 20-item Chinese version, the C-IASMHS. It had acceptable internal consistency and was positively correlated with intentions to seek help. The Help-Seeking Propensity subscale had the strongest psychometric properties whereas the Psychological Openness subscale performed poorly based on factor analysis results and unacceptable internal consistency. Future research should focus on the conceptual equivalence of psychological openness among Chinese older adults.
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Social Isolation in Chinese Older Adults: Scoping Review for Age-Friendly Community Planning. Can J Aging 2017; 36:223-245. [PMID: 28412982 DOI: 10.1017/s0714980817000101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Chinese older adults may be at increased risk of social isolation and loneliness, and a fragmented understanding exists about the challenges they face for social participation in their neighbourhoods and communities. A scoping review was undertaken to describe the current knowledge on social isolation and loneliness in urban-dwelling Chinese older adults living in Western societies to inform future research, practice, and policy in Canada. Nineteen articles met the inclusion criteria. The World Health Organization's age-friendly community framework contextualized the study findings. Studies identified issues related to (1) social participation; (2) community support and health services; (3) housing; (4) community and information; (5) respect and social inclusion; (6) outdoor spaces and public buildings; (7) civic participation and employment; and (8) transportation. Social isolation and loneliness is a growing concern in this population in Canada, and additional research is needed to identify its scope and effective interventions.
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