1
|
Jiang W, Yang Y, He Y, Liu Q, Deng X, Hua Y, Hayixibayi A, Ni Y, Guo L. Contribution of diversity of social participation on the mental health of humanitarian migrants during resettlement. Epidemiol Psychiatr Sci 2024; 33:e29. [PMID: 38779823 PMCID: PMC11362679 DOI: 10.1017/s2045796024000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/20/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
AIMS By the end of 2022, an estimated 108.4 million individuals worldwide experienced forced displacement. Identifying modifiable factors associated with the mental illness of refugees is crucial for promoting successful integration and developing effective health policies. This study aims to examine the associations between the changes in the diversity of social participation and psychological distress among refugees throughout the resettlement process, specifically focusing on gender differences. METHODS Utilizing data from three waves of a longitudinal, nationally representative cohort study conducted in Australia, this study involved 2399 refugees interviewed during Wave 1, 1894 individuals interviewed during Wave 3 and 1881 respondents during Wave 5. At each wave, we assessed psychological distress and 10 types of social participation across 3 distinct dimensions, including social activities, employment and education. The primary analysis employed mixed linear models and time-varying Cox models. Gender-stratified analyses and sensitivity analyses were performed. RESULTS Refugees engaging in one type or two or more types of social participation, compared with those not engaging in any, consistently had lower psychological distress scores (β = -0.62 [95% confidence interval (CI), -1.07 to -0.17] for one type of social participation; β = -0.57 [95% CI, -1.04 to -0.10] for two or more types of social participation) and a reduced risk of experiencing psychological distress (hazard ratio [HR] = 0.81 [95% CI, 0.65-0.99] for one type of social participation; HR = 0.77 [95% CI, 0.61-0.97] for two or more types of social participation) during the resettlement period. When stratifying the results by gender, these associations in the adjusted models only remained significant in male refugees. Moreover, three specific types of social participation, namely sporting activities, leisure activities and current employment status, were most prominently associated with a reduced risk of psychological distress. CONCLUSIONS The findings of this cohort study suggest that social participation was consistently associated with reduced risks of psychological distress among male refugees during resettlement. These findings highlight the significance of promoting meaningful social participation and interaction may be an effective strategy to improve the mental health of refugees and facilitate their successful integration into society, especially among male refugees.
Collapse
Affiliation(s)
- Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yuwei Yang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People’s Republic of China
| | - Yitong He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Qianyu Liu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Alimila Hayixibayi
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Yanyan Ni
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
| |
Collapse
|
2
|
Veginadu P, Gussy M, Calache H, Masood M. Factors associated with access to dental care among refugees: A systematic review of quantitative studies. Community Dent Oral Epidemiol 2023; 51:729-737. [PMID: 36575988 DOI: 10.1111/cdoe.12835] [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: 07/07/2022] [Revised: 11/19/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To identify, appraise and synthesize the published evidence from quantitative studies on the individual and contextual-level factors determining access to dental care among refugees worldwide. METHODS A systematic literature search was conducted until the last week of February 2022 in four electronic databases - MEDLINE, Embase, Web of Science (all databases) and APA PsycINFO - without any restrictions. Quantitative studies published in English language and meeting the a priori eligibility criteria were reviewed and data extracted. Quality assessment was conducted using the National Institutes of Health tool. The identified factors were stratified according to the framework of the Behavioural Model of Health Services Use, and the evidence related to each of these factors was summarized in tables. Narrative synthesis of the findings was conducted. RESULTS The search retrieved 6776 unique records, of which 69 were deemed eligible for full-text screening and nine studies were included in the final data analysis and synthesis. The studies were rated to be of 'fair' quality at best. Self-reported previous dental visits was the most commonly used measure of access. Associations between individual-level factors and dental care access were most frequently examined (predisposing [n = 6], need [n = 2] and enabling [n = 1]), while the contextual-level factors were rarely examined (predisposing and enabling [n = 1, each]). CONCLUSIONS Individual-level predisposing factors, such as English language proficiency, education, health and dental literacy and acculturation and integration, were shown to be significantly associated with refugees' access. There is limited evidence to determine the effect of individual enabling and need and contextual factors.
Collapse
Affiliation(s)
- Prabhakar Veginadu
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Menzies School of Health Research, Alice Springs, Northern Territory, Australia
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Hanny Calache
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Mohd Masood
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Dental Institute, University of Turku, Turku, Finland
| |
Collapse
|
3
|
Marjadi B, Flavel J, Baker K, Glenister K, Morns M, Triantafyllou M, Strauss P, Wolff B, Procter AM, Mengesha Z, Walsberger S, Qiao X, Gardiner PA. Twelve Tips for Inclusive Practice in Healthcare Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4657. [PMID: 36901666 PMCID: PMC10002390 DOI: 10.3390/ijerph20054657] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
This paper outlines practical tips for inclusive healthcare practice and service delivery, covering diversity aspects and intersectionality. A team with wide-ranging lived experiences from a national public health association's diversity, equity, and inclusion group compiled the tips, which were reiteratively discussed and refined. The final twelve tips were selected for practical and broad applicability. The twelve chosen tips are: (a) beware of assumptions and stereotypes, (b) replace labels with appropriate terminology, (c) use inclusive language, (d) ensure inclusivity in physical space, (e) use inclusive signage, (f) ensure appropriate communication methods, (g) adopt a strength-based approach, (h) ensure inclusivity in research, (i) expand the scope of inclusive healthcare delivery, (j) advocate for inclusivity, (k) self-educate on diversity in all its forms, and (l) build individual and institutional commitments. The twelve tips are applicable across many aspects of diversity, providing a practical guide for all healthcare workers (HCWs) and students to improve practices. These tips guide healthcare facilities and HCWs in improving patient-centered care, especially for those who are often overlooked in mainstream service provision.
Collapse
Affiliation(s)
- Brahmaputra Marjadi
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Joanne Flavel
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Stretton Health Equity, Stretton Institute, School of Social Sciences, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Kirsten Baker
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Australian Research Consortium in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Kristen Glenister
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Department of Rural Health, The University of Melbourne, Wangaratta, VIC 3677, Australia
| | - Melissa Morns
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Mel Triantafyllou
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia
| | - Penelope Strauss
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Telethon Kids Institute, The University of Western Australia, Nedlands, WA 6009, Australia
| | - Brittany Wolff
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- School of Psychological Sciences, The University of Western Australia, Crawley, WA 6009, Australia
| | - Alexandra Marie Procter
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- School of Public Health, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Zelalem Mengesha
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- Centre for Primary Health Care and Equity, The University of New South Wales, UNSW, Sydney, NSW 2025, Australia
| | - Scott Walsberger
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- ACON, Surry Hills, NSW 2010, Australia
| | - Xiaoxi Qiao
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Paul A. Gardiner
- Diversity, Equity and Inclusion Special Interest Group, Public Health Association of Australia, Deakin, ACT 2600, Australia
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| |
Collapse
|
4
|
Jawahar Z, Elmer S, Hawkins M, Osborne RH. Application of the optimizing health literacy and access (Ophelia) process in partnership with a refugee community in Australia: Study protocol. Front Public Health 2023; 11:1112538. [PMID: 36895685 PMCID: PMC9989023 DOI: 10.3389/fpubh.2023.1112538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/03/2023] [Indexed: 02/23/2023] Open
Abstract
Refugees experience health inequities resulting from multiple barriers and difficulties in accessing and engaging with services. A health literacy development approach can be used to understand health literacy strengths, needs, and preferences to build equitable access to services and information. This protocol details an adaptation of the Ophelia (Optimizing Health Literacy and Access) process to ensure authentic engagement of all stakeholders to generate culturally appropriate, needed, wanted and implementable multisectoral solutions among a former refugee community in Melbourne, Australia. The Health Literacy Questionnaire (HLQ), widely applied around the world in different population groups, including refugees, is usually the quantitative needs assessment tool of the Ophelia process. This protocol outlines an approach tailored to the context, literacy, and health literacy needs of former refugees. This project will engage a refugee settlement agency and a former refugee community (Karen people origin from Myanmar also formerly knowns as Burma) in codesign from inception. A needs assessment will identify health literacy strengths, needs, and preferences, basic demographic data and service engagement of the Karen community. This community will be engaged and interviewed using a semi-structured interview based on the Conversational Health Literacy and Assessment Tool (CHAT) will cover supportive professional and personal relationships, health behaviors, access to health information, use of health services, and health promotion barriers and support. Using the needs assessment data, vignettes portraying typical individuals from this community will be developed. Stakeholders will be invited to participate in ideas generation and prioritization workshops for in-depth discussion on what works well and not well for the community. Contextually and culturally appropriate and meaningful action ideas will be co-designed to respond to identified health literacy strengths, needs, and preferences of the community. This protocol will develop and test new and improved methods that are likely to be useful for community-based organizations and health services to systematically understand and improve communication, services and outcomes among disadvantaged groups, particularly migrants and refugees.
Collapse
Affiliation(s)
- Zaman Jawahar
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Shandell Elmer
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Melanie Hawkins
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, VIC, Australia
| |
Collapse
|
5
|
Nissen A, Hynek KA, Scales D, Hilden PK, Straiton M. Chronic pain, mental health and functional impairment in adult refugees from Syria resettled in Norway: a cross-sectional study. BMC Psychiatry 2022; 22:571. [PMID: 36002823 PMCID: PMC9404590 DOI: 10.1186/s12888-022-04200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Limited research exists on pain and especially the co-occurrence of pain and mental ill health in general refugee populations. The present study aimed to approximate the prevalence of chronic pain (CP) among adult refugees from Syria resettled in Norway; investigate the association between CP and mental ill health; and explore how CP and mental ill health associate with both perceived general health and functional impairment. Gender as potential effect modifier in these associations was also examined. METHODS Cross-sectional, postal survey questionnaire. INCLUSION CRITERIA ≥ 18 years old; refugee from Syria; and arrived in Norway between 2015 and 2017. Study sample was randomly drawn from full population registries, and n = 902 participated (participation rate ≈10%). CP was measured with 10 items on pain lasting for ≥ 3 consecutive months last year. Symptoms of anxiety, depression and PTSD were measured with the HSCL and HTQ scales, respectively. Ordered and binomial logistic regressions were used in analyses. Gender was tested as effect modifier with Wald test for interaction. RESULTS In the sample overall, the proportion of participants who reported severe CP was 43.1%. There was strong evidence that anxiety, depression and PTSD were associated with higher levels of CP. In fully adjusted regression models, including both CP and mental health variables, CP was strongly associated with poor perceived general health whereas mental health showed much weaker associations. The association between mental health (anxiety and PTSD) and functional impairment was highly gender specific, with strong associations in men but not in women. CP was strongly associated with functional impairment with no difference across gender. CONCLUSION The study shows a high burden of CP in a general population of adult refugees from Syria with likely substantial adverse consequences for daily functioning. The strong association between CP and mental ill health suggests personnel working with refugees' health should be attuned to their co-occurrence as both problems may need to be addressed for either to be effectively mitigated. A clear mismatch exists between the burden on health caused by pain in general refugee populations and the amount of available evidence to guide mitigating strategies. TRIAL REGISTRATION NCT03742128.
Collapse
Affiliation(s)
- Alexander Nissen
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484, Oslo, Norway.
| | - Kamila Angelika Hynek
- grid.418193.60000 0001 1541 4204Division for Mental and Physical Health, Norwegian Institute of Public Health, Skøyen, PO Box 222, 0213 Oslo, Norway
| | - David Scales
- grid.5386.8000000041936877XSection of Hospital Medicine, Division of General Internal Medicine, Department of Internal Medicine, Weill Cornell Medicine, 525 E 68th Street, Box 331, New York, NY 10065 USA
| | - Per Kristian Hilden
- grid.504188.00000 0004 0460 5461Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484 Oslo, Norway
| | - Melanie Straiton
- grid.418193.60000 0001 1541 4204Division for Mental and Physical Health, Norwegian Institute of Public Health, Skøyen, PO Box 222, 0213 Oslo, Norway
| |
Collapse
|
6
|
Mwanri L, Fauk NK, Ziersch A, Gesesew HA, Asa GA, Ward PR. Post-Migration Stressors and Mental Health for African Migrants in South Australia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137914. [PMID: 35805574 PMCID: PMC9265307 DOI: 10.3390/ijerph19137914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/04/2023]
Abstract
We conducted a qualitative study involving African migrants (n = 20) and service providers (n = 10) in South Australia to explore mental health stressors, access to mental health services and how to improve mental health services for African migrant populations. This paper presents the views and experiences of African migrants about the post-migration stressors they faced in resettlement that pose mental health challenges. The participants were recruited using the snowball sampling technique. To align with the COVID-19 pandemic protocol, the data collection was conducted using one-on-one online interviews through Zoom or WhatsApp video calls. Data analysis was guided by the framework analysis. The post-migration stressors, including separation from family members and significant others, especially spouses, imposed significant difficulties on care provision and in managing children’s attitudes and behavior-related troubles at school. African cultural practices involving the community, especially elders in care provision and disciplining children, were not consistent with Australian norms, compounding the mental health stressors for all involved. The African cultural norms, that do not allow young unmarried people to live together, also contributed to child–parent conflicts, enhancing parental mental stressors. Additionally, poor economic conditions and employment-related difficulties were post-migration stressors that the participants faced. The findings indicate the need for policy and intervention programs that address the above challenges. The provision of interventions, including social support such as subsidized or free childcare services, could help leverage their time and scheduled paid employment, creating time for effective parenting and improving their mental health and wellbeing. Future studies exploring what needs to be achieved by government and non-governmental institutions to support enhanced access to social and employment opportunities for the African migrant population are also recommended.
Collapse
Affiliation(s)
- Lillian Mwanri
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia; (N.K.F.); (H.A.G.); (G.A.A.); (P.R.W.)
- Correspondence:
| | - Nelsensius Klau Fauk
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia; (N.K.F.); (H.A.G.); (G.A.A.); (P.R.W.)
- Institute of Resource Governance and Social Change, Kupang 85227, Indonesia
| | - Anna Ziersch
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia;
| | - Hailay Abrha Gesesew
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia; (N.K.F.); (H.A.G.); (G.A.A.); (P.R.W.)
- College of Health Sciences, Mekelle University, Mekelle P.O. Box 231, Tigray, Ethiopia
| | - Gregorius Abanit Asa
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia; (N.K.F.); (H.A.G.); (G.A.A.); (P.R.W.)
| | - Paul Russell Ward
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia; (N.K.F.); (H.A.G.); (G.A.A.); (P.R.W.)
| |
Collapse
|
7
|
Altun A, Soh SE, Brown H, Russell G. The association between chronic pain and pre-and-post migration experiences in resettled humanitarian refugee women residing in Australia. BMC Public Health 2022; 22:911. [PMID: 35525945 PMCID: PMC9080158 DOI: 10.1186/s12889-022-13226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/04/2022] [Indexed: 12/04/2022] Open
Abstract
Background Refugee women are potentially at increased risk for chronic pain due to circumstances both in the pre-migration and post-settlement setting. However, this relationship between refugee-related challenges introduced along their migration trajectories and chronic pain remains unclear. This study will therefore examine the association between pre- and post-migration factors and chronic pain in refugee women five years into resettlement in Australia. Methods The first five waves of data from the ‘Building a New Life in Australia’ longitudinal study of humanitarian refugees living in Australia was analysed using logistic regression models to investigate the association between predictor variables and chronic pain. The study outcome was chronic pain and predictors were migration process and resettlement factors in both the pre-and post-settlement setting. Results Chronic pain was reported in 45% (n = 139) of women, and among these a further 66% (n = 120) also reported having a long-term disability or health condition that had lasted 12 months. Pre- migration factors such as increasing age (OR 1.08; 95% CI 1.05, 1.11) and women who migrated under the Women at Risk Visa category (OR 2.40; 95% CI 1.26, 4.56) had greater odds of experiencing chronic pain. Interestingly, post migration factors such as women with better general health (OR 0.04; 95% CI 0.01, 0.11) or those who settled within metropolitan cities (OR 0.29; 95% CI 0.13, 0.68) had lower odds of experiencing chronic pain, and those who experience discrimination (OR 11.23; 95% CI 1.76, 71.51) had greater odds of experiencing chronic pain. Conclusion Our results show that there is a high prevalence of chronic pain in refugee women across the initial years of resettlement in Australia. This may be in part due to pre-migration factors such as age and migration pathway, but more significantly the post migration context that these women settle into such as rurality of settlement, poorer general health and perceived discriminatory experiences. These findings suggest that there may be many unmet health needs which are compounded by the challenges of resettlement in a new society, highlighting the need for increased clinical awareness to help inform refugee health care and settlement service providers managing chronic pain. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13226-5.
Collapse
Affiliation(s)
- Areni Altun
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. .,Department of General Practice, Monash University, Melbourne, Australia.
| | - Sze-Ee Soh
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Helen Brown
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Grant Russell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Department of General Practice, Monash University, Melbourne, Australia
| |
Collapse
|
8
|
Davidson N, Hammarberg K, Romero L, Fisher J. Access to preventive sexual and reproductive health care for women from refugee-like backgrounds: a systematic review. BMC Public Health 2022; 22:403. [PMID: 35220955 PMCID: PMC8882295 DOI: 10.1186/s12889-022-12576-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Globally, the number of forcibly displaced women is growing. Refugee and displaced women have poorer health outcomes compared to migrant and host country populations. Conflict, persecution, violence or natural disasters and under-resourced health systems in their country of origin contribute to displacement experiences of refugee and displaced women. Poor health outcomes are further exacerbated by the migration journey and challenging resettlement in host countries. Preventive sexual and reproductive health (SRH) needs of refugee and displaced women are poorly understood. The aim was to synthesise the evidence about access to preventive SRH care of refugee and displaced women. Methods A systematic review of qualitative, quantitative and mixed methods studies of women aged 18 to 64 years and health care providers' (HCPs’) perspectives on barriers to and enablers of SRH care was undertaken. The search strategy was registered with PROSPERO in advance of the search (ID CRD42020173039). The MEDLINE, PsycINFO, Embase, CINAHL, and Global health databases were searched for peer-reviewed publications published any date up to 30th April 2020. Three authors performed full text screening independently. Publications were reviewed and assessed for quality. Study findings were thematically extracted and reported in a narrative synthesis. Reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Results The search yielded 4083 results, of which 28 papers reporting 28 studies met inclusion criteria. Most related to contraception and cervical or breast cancer screening. Three main themes and ten subthemes relating to SRH care access were identified: interpersonal and patient encounter factors (including knowledge, awareness, perceived need for and use of preventive SRH care; language and communication barriers), health system factors (including HCPs discrimination and lack of quality health resources; financial barriers and unmet need; HCP characteristics; health system navigation) and sociocultural factors and the refugee experience (including family influence; religious and cultural factors). Conclusions Implications for clinical practice and policy include giving women the option of seeing women HCPs, increasing the scope of practice for HCPs, ensuring adequate time is available during consultations to listen and develop refugee and displaced women’s trust and confidence, strengthening education for refugee and displaced women unfamiliar with preventive care and refining HCPs’ and interpreters’ cultural competency. More research is needed on HCPs’ views regarding care for refugee and displaced women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12576-4.
Collapse
|
9
|
Kunin M, Ali R, Yugusuk C, Davis A, McBride J. Providing Care by Telephone to Refugees and Asylum Seekers: An Evaluation of Telephone Mode-of-Care in Monash Health Refugee Health and Wellbeing Clinic in Victoria, Australia. Health Serv Insights 2022; 15:11786329221134349. [DOI: 10.1177/11786329221134349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
An evaluation of accessibility, appropriateness, acceptability and efficiency of telephone consultations, implemented at Monash Health Refugee Health and Wellbeing (MH RHW) throughout the COVID-19 pandemic, was conducted. A convergent mix-methods design was used, with both patients (n = 50) and clinicians (n = 11) participating in a survey, and two focus groups (n = 14) involving clinicians being conducted. Service utilization data was sourced from the MH RHW database. During May to December 2020, 61% (n = 3012) of the consultations were conducted by telephone, 42% (n = 11) of these required interpreters in a 3-way conversation Most patients were satisfied with telephone as a medium for providing care and with the quality of telephone-based care. Similarly, clinicians considered telephone consultations to be an acceptable mode-of-care for most patients during the pandemic, however, expressed caution in relation to certain patient cohort. Finally, the provision of care by telephone was considered no more efficient than face-to-face service provision, as reflected in the time required for each consultation, with some clinicians reporting adverse workload outcomes. This study highlighted the benefits and challenges of telephone consultations from patient and clinician perspectives. It also highlighted the types of patients that may not be suited to telephone consultations. Overall, this study showed that telephone service delivery is a feasible option in providing care to people of refugee background and should be considered in future decisions as an ongoing Medicare (Australia’s universal healthcare insurance scheme) billing item. However, clinical discretion should prevail in determining the most appropriate means of delivering care.
Collapse
Affiliation(s)
- Marina Kunin
- Monash Health Refugee Health and Wellbeing, Monash Health, Dandenong, VIC, Australia
| | - Razia Ali
- Monash Health Refugee Health and Wellbeing, Monash Health, Dandenong, VIC, Australia
| | - Chris Yugusuk
- Monash Health Refugee Health and Wellbeing, Monash Health, Dandenong, VIC, Australia
| | - Annette Davis
- Monash Health Community Strategy and Support, Dandenong, VIC, Australia
| | - Jacquie McBride
- Monash Health Refugee Health and Wellbeing, Monash Health, Dandenong, VIC, Australia
| |
Collapse
|
10
|
Georgeou N, Schismenos S, Wali N, Mackay K, Moraitakis E. A Scoping Review of Aging Experiences Among Culturally and Linguistically Diverse People in Australia: Toward Better Aging Policy and Cultural Well-Being for Migrant and Refugee Adults. THE GERONTOLOGIST 2021; 63:182-199. [PMID: 34969076 PMCID: PMC9872767 DOI: 10.1093/geront/gnab191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Australia's population is growing, aging, and becoming more ethnically diverse, resulting in barriers and challenges around social inclusion for non-English-speaking migrants and refugees. This scoping review investigates the experiences of aging within Australia among older adults from culturally and linguistically diverse (CALD) migrant and refugee backgrounds to identify barriers to social integration. RESEARCH DESIGN AND METHODS A scoping review of English language literature and gray literature on the experiences of aging among CALD migrants and refugees living in Australia was conducted from January 2000 to January 2021, according to Arksey and O'Malley's review process. A total of 34 studies were identified for analysis. RESULTS Three primary themes were identified: (a) sociocultural similarities in settlement experiences, (b) engagement with technology for social connection, and (c) engagement with family and community networks. DISCUSSION AND IMPLICATIONS Aging, language, sociocultural, and technology contexts shape attitudes to belonging, as well as access to sociomedical services. We argue a cultural well-being framework may assist in developing policy for improved social integration of older CALD adults. As the focus is on social and cultural experiences, all studies with a primary focus on medical and other chronic conditions were excluded. Future studies could include health-related articles to present a more comprehensive approach regarding older CALD adult needs. Follow-up research could focus on the impact of the coronavirus disease 2019 pandemic on the experiences of older adults in Australia, in particular those of CALD backgrounds.
Collapse
Affiliation(s)
- Nichole Georgeou
- School of Social Sciences, Humanitarian and Development Research Initiative (HADRI), Western Sydney University, Sydney, New South Wales, Australia
| | - Spyros Schismenos
- Address correspondence to: Spyros Schismenos, PhD, School of Social Sciences, Humanitarian and Development Research Initiative (HADRI), Western Sydney University, Kingswood Campus, P.G.86 Second Ave, Kingswood, Sydney, NSW 2747, Australia. E-mail:
| | - Nidhi Wali
- School of Social Sciences, Humanitarian and Development Research Initiative (HADRI), Western Sydney University, Sydney, New South Wales, Australia
| | - Karin Mackay
- School of Education, Humanitarian and Development Research Initiative (HADRI), Western Sydney University, Sydney, New South Wales, Australia
| | - Elfa Moraitakis
- SydWest Multicultural Services, Sydney, New South Wales, Australia
| |
Collapse
|
11
|
A qualitative exploration of the impact of knowledge and perceptions about hypertension in medication adherence in Middle Eastern refugees and migrants. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 3:100038. [PMID: 35480607 PMCID: PMC9030275 DOI: 10.1016/j.rcsop.2021.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Objectives Methods Results Conclusion
Collapse
|
12
|
García-Sierra R, Fernández-Cano MI, Manresa-Domínguez JM, Feijoo-Cid M, Moreno Gabriel E, Arreciado Marañón A, Ramos-Roure F, Segura-Bernal J, Torán-Monserrat P. Psychological Distress and Somatization in Immigrants in Primary Health Care Practices. Healthcare (Basel) 2020; 8:healthcare8040557. [PMID: 33322209 PMCID: PMC7763568 DOI: 10.3390/healthcare8040557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/02/2022] Open
Abstract
The process of international migration causes a situation of vulnerability in people’s health and greater difficulty in coping with disease. Furthermore, the adversities suffered during migration can trigger reactive signs of stress and cause anxious, depressive, confusional and somatic symptoms. This article studies the relationships between psychosocial risk, psychological distress and somatization in immigrants from four communities: Maghrebis, Sub-Saharans, South Americans and South Asian. A cross-sectional study was carried out with questionnaires on 602 immigrants who were surveyed in the primary care centers of an urban area of Catalonia. The instruments used were the Demographic Psychosocial Inventory (DPSI), the Brief Symptom Inventory (BSI) and the Somatic Symptom Inventory (SSI). The average psychosocial risk obtained was 0.35, with the highest values in the Sub-Saharan community. Psychological distress showed a mean value of 0.66, with the Sub-Saharan community scoring the lowest in all dimensions except depression. The average somatization values were 1.65, with the Sub-Saharan community scoring the least. The female gender is a risk factor for somatization and psychological distress. Perceived psychosocial risk is a predictor of psychological distress, but not somatization, suggesting that the use of more adaptive coping strategies could minimize the effect of the migration process on somatizations.
Collapse
Affiliation(s)
- Rosa García-Sierra
- Research Support Unit Metropolitana Nord, Primary Care Research Institut Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain; (R.G.-S.); (J.M.M.-D.); (E.M.G.); (F.R.-R.); (P.T.-M.)
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.F.-C.); (A.A.M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
| | - María Isabel Fernández-Cano
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.F.-C.); (A.A.M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Correspondence:
| | - Josep María Manresa-Domínguez
- Research Support Unit Metropolitana Nord, Primary Care Research Institut Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain; (R.G.-S.); (J.M.M.-D.); (E.M.G.); (F.R.-R.); (P.T.-M.)
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.F.-C.); (A.A.M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
| | - María Feijoo-Cid
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.F.-C.); (A.A.M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
| | - Eduard Moreno Gabriel
- Research Support Unit Metropolitana Nord, Primary Care Research Institut Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain; (R.G.-S.); (J.M.M.-D.); (E.M.G.); (F.R.-R.); (P.T.-M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
| | - Antonia Arreciado Marañón
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain; (M.F.-C.); (A.A.M.)
| | - Francesc Ramos-Roure
- Research Support Unit Metropolitana Nord, Primary Care Research Institut Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain; (R.G.-S.); (J.M.M.-D.); (E.M.G.); (F.R.-R.); (P.T.-M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
| | - Jordi Segura-Bernal
- Faculty of Psychology, Education Sciences and Sport, Ramon Llull University, 08022 Barcelona, Spain;
| | - Pere Torán-Monserrat
- Research Support Unit Metropolitana Nord, Primary Care Research Institut Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain; (R.G.-S.); (J.M.M.-D.); (E.M.G.); (F.R.-R.); (P.T.-M.)
- Multidisciplinary Research Group in Health and Society GREMSAS (2017 SGR 917), 08007 Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Girona, 17071 Girona, Spain
| |
Collapse
|
13
|
Stuart J, Nowosad J. The Influence of Premigration Trauma Exposure and Early Postmigration Stressors on Changes in Mental Health Over Time Among Refugees in Australia. J Trauma Stress 2020; 33:917-927. [PMID: 32949476 DOI: 10.1002/jts.22586] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 11/10/2022]
Abstract
As a result of the precarious conditions in which they migrate, refugees are likely to have experiences that increase their risk of mental health problems. Refugees tend to be predisposed to relatively high levels of distress upon resettlement, and a key predictor of these issues is traumatic experiences that occur before their arrival. Despite high initial levels of ill-health, on average, refugees tend to experience mental health recovery over time. However, both levels of mental health upon settlement and recovery over time may be negatively influenced by stressors in the postsettlement period. The present study examined changes in psychological distress and posttraumatic stress symptoms over 5 years among 2,169 refugees from various backgrounds, predominately from Iraq and Afghanistan, who participated in the Building a New Life in Australia (BNLA) study. A multivariate latent growth curve model found mental ill-health decreased on average, β = -.21 for distress and β = -.31 for PTSD, ps < .001, and premigration trauma exposure predicted more initial PTSD symptoms and reduced recovery over time, βIntercept = .21, βSlope = -.54, p < .001. Postmigration stressors, such as loneliness, financial concerns, and cultural integration, predicted higher levels of mental health problems as well as reduced recovery over time. These findings suggest that beyond trauma exposure, the mental health of refugees upon resettlement and their recovery over time is impacted by stressors in the early resettlement period, which has important implications for interventions and services to support and encourage well-being in refugee populations.
Collapse
Affiliation(s)
- Jaimee Stuart
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Jemima Nowosad
- School of Applied Psychology, Griffith University, Brisbane, Australia
| |
Collapse
|
14
|
Haj-Younes J, Strømme EM, Igland J, Kumar B, Abildsnes E, Hasha W, Diaz E. Changes in self-rated health and quality of life among Syrian refugees migrating to Norway: a prospective longitudinal study. Int J Equity Health 2020; 19:188. [PMID: 33109202 PMCID: PMC7590794 DOI: 10.1186/s12939-020-01300-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022] Open
Abstract
Background Forced migrants can be exposed to various stressors that can impact their health and wellbeing. How the different stages in the migration process impacts health is however poorly explored. The aim of this study was to examine changes in self-rated health (SRH) and quality of life (QoL) among a cohort of adult Syrian refugees before and after resettlement in Norway. Method We used a prospective longitudinal study design with two assessment points to examine changes in health among adult Syrian resettlement refugees in Lebanon accepted for resettlement in Norway. We gathered baseline data in 2017/2018 in Lebanon and subsequently at follow-up one year after arrival. The main outcomes were good SRH measured by a single validated item and QoL measured by WHOQOL-BREF. We used generalized estimating equations to investigate changes in outcomes over time and incorporated interaction terms in the models to evaluate effect modifications. Results In total, 353 subjects participated in the study. The percentage of participants reporting good SRH showed a non-significant increase from 58 to 63% RR, 95%CI: 1.1 (1.0, 1.2) from baseline to follow-up while mean values of all four QoL domains increased significantly from baseline to follow-up; the physical domain from 13.7 to 15.7 B, 95%CI: 1.9 (1.6, 2.3), the psychological domain from 12.8 to 14.5 B, 95%CI: 1.7 (1.3, 2.0), social relationships from 13.7 to 15.3 B, 95%CI: 1.6 (1.2, 2.0) and the environmental domain from 9.0 to 14.0 5.1 B, 95%CI: (4.7, 5.4). Positive effect modifiers for improvement in SRH and QoL over time include male gender, younger age, low level of social support and illegal status in transit country. Conclusion Our results show that good SRH remain stable while all four QoL domains improve, most pronounced in the environment domain. Understanding the dynamics of migration and health is a fundamental step in reaching health equity. Supplementary information Supplementary information accompanies this paper at 10.1186/s12939-020-01300-6.
Collapse
Affiliation(s)
- Jasmin Haj-Younes
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020, Bergen, Norway.
| | - Elisabeth Marie Strømme
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020, Bergen, Norway
| | - Bernadette Kumar
- Unit for Migration and health. Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway
| | - Eirik Abildsnes
- Department of Psychosocial Health, University of Agder, PO Box 422, 4604, Kristiansand, Norway
| | - Wegdan Hasha
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020, Bergen, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7800, 5020, Bergen, Norway.,Unit for Migration and health. Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway
| |
Collapse
|
15
|
Shrestha-Ranjit J, Payne D, Koziol-McLain J, Crezee I, Manias E. Availability, Accessibility, Acceptability, and Quality of Interpreting Services to Refugee Women in New Zealand. QUALITATIVE HEALTH RESEARCH 2020; 30:1697-1709. [PMID: 32495700 PMCID: PMC7410270 DOI: 10.1177/1049732320924360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A significant number of people have been displaced from their country of origin and become refugees. Good health is essential for refugees to actively engage and take up opportunities within the society in their host countries. However, negotiating a new and unfamiliar health system hinders refugees' ability to access and make use of the available health services. Communication difficulties due to language barriers are the most commonly cited challenges faced by refugees in accessing and utilizing health services post-resettlement. In this study, we aimed to examine effectiveness of interpreting services for refugee women in New Zealand. Data were collected through three sources: focus groups with Bhutanese women, focus group with Bhutanese men, and individual interviews with health professionals. The findings of this study reveal inadequacies and constraints in the provision of a socioculturally and linguistically effective interpreting service to Bhutanese women and provide evidence for recommendations to address these inadequacies.
Collapse
Affiliation(s)
| | - Deborah Payne
- Auckland University of Technology,
Auckland, New Zealand
| | | | - Ineke Crezee
- Auckland University of Technology,
Auckland, New Zealand
| | | |
Collapse
|
16
|
Strømme EM, Haj-Younes J, Hasha W, Fadnes LT, Kumar B, Igland J, Diaz E. Changes in health among Syrian refugees along their migration trajectories from Lebanon to Norway: a prospective cohort study. Public Health 2020; 186:240-245. [PMID: 32861924 DOI: 10.1016/j.puhe.2020.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Conflict-driven displacement is an indisputable social determinant of health. Yet, data on changes in health along the migration trajectories of refugees are scarce. This study aims to assess the longitudinal changes in somatic and mental health and use of medication among Syrian refugees relocating from a conflict-near transit setting in the Middle East to a resettlement setting in Europe. Further, we examine different health status trajectories and factors that predict health in the early postmigration period. STUDY DESIGN This is a prospective cohort study. METHODS Survey data were collected during 2017-2018 among adult Syrian refugees in Lebanon selected for quota resettlement and at follow-up approximately one year after resettlement in Norway. Our primary outcomes were non-communicable disease (NCD), chronic impairment, chronic pain, anxiety/depression, post-traumatic stress symptoms, and daily use of drugs. We estimated longitudinal changes in prevalence proportions using generalized estimating equations and evaluated effect modification of health outcomes. RESULTS Altogether, 353 Syrians participated. NCDs declined (12%-9%), while the prevalence of chronic impairment, chronic pain, and use of drugs remained nearly unchanged (29%-28%, 30%-28%, and 20%-18%) between baseline and follow-up. Conversely, mental health outcomes improved (anxiety/depression 33%-11%, post-traumatic stress disorder 5%-2%). Effect modifiers for improvement over time included younger age, short length of stay, and non-legal status in the transit country before resettlement in Europe. CONCLUSIONS We find that mental health outcomes improve from a conflict-near transit setting in Lebanon to an early resettlement setting in Norway, while somatic health outcomes remain stable. Temporal changes in health among moving populations warrant attention, and long-term changes need further scrutiny.
Collapse
Affiliation(s)
- E M Strømme
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - J Haj-Younes
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - W Hasha
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - L T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway; Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
| | - B Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway.
| | - J Igland
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway.
| | - E Diaz
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway; Unit for Migration and Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, 0213, Oslo, Norway.
| |
Collapse
|
17
|
Living a Healthy Life in Australia: Exploring Influences on Health for Refugees from Myanmar. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010121. [PMID: 31877976 PMCID: PMC6982124 DOI: 10.3390/ijerph17010121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Humanitarian migrants from Myanmar represent a significant refugee group in Australia; however, knowledge of their health needs and priorities is limited. This study aims to explore the meaning and influencers of health from the perspectives of refugees from Myanmar. METHOD Using a community-based participatory research (CBPR) design, a partnership was formed between the researchers, Myanmar community leaders and other service providers to inform study design. A total of 27 participants were recruited from a government-funded English language program. Data were collected using a short demographic survey and four focus groups, and were analysed using descriptive statistics and thematic analysis methods. RESULTS Key themes identified included: (1) health according to the perspectives of Australian settled refugees from Myanmar, (2) social connections and what it means to be part of community, (3) work as a key influence on health, and (4) education and its links with work and health. CONCLUSIONS This study outlined the inter-relationships between health, social connections, work and education from the perspectives of refugees from Myanmar. It also outlined how people from Myanmar who are of a refugee background possess strengths that can be used to manage the various health challenges they face in their new environment.
Collapse
|