'Like a life in a cage': Understanding child play and social interaction in Somali refugee families in the UK

'At the heart of the community' - a Somali woman's experience of 'alignment' of support to escape social isolation in pregnancy and early motherhood

PURPOSE

Stresses in pregnancy and early motherhood can affect women's health and wellbeing, and babies' development. Migrant women face compounding stressors from the intersection of gender, race, social class, migration, and language. We explored one Somali woman's experience of pregnancy and the transition to motherhood, following migration to an urban environment in the Global North, aiming to understand resilience in this specific socio-cultural context.

METHODS

This case study used interpretative phenomenological analysis of a single two-hour semi-structured interview with a Somali woman in the UK to explore how this experience may have relevance for communities and practitioners in the Global North.

RESULTS

We identified two overarching themes in this woman's experience: "vicious" and "virtuous" circles, attempting to make sense of her experience of isolation and lack of wellbeing, and subsequent confidence, engagement, and community-building.

CONCLUSIONS

An experience of "alignment" in social relationships appeared to make possible the shift from "vicious" to "virtuous" circle, which enabled escape from social isolation. This account of transformation-from social isolation to community contribution-underlines the role of community organizations facilitating positive social networks and peer support during pregnancy and early motherhood.

Retheorising 'Risky' Play in a Global Context: Addressing the Safety Needs of Refugee and Displaced Families

A wealth of scholarship demonstrates the developmental benefits of risky play for children. However, this scholarship has overwhelmingly focused on the experiences of children and their caregivers from Euro-Western nations. It is imperative to explore child and caregiver perspectives on child risk, injury and play in communities where children experience a disproportionate burden of injuries resulting from play such as in refugee communities. For this research, we focused on Syrian refugee camps (n = 3) and villages (n = 4) across Lebanon and conducted semi-structured interviews with children (n = 79) and caregivers (n = 56) to explore perspectives on child risk, injury and play. Our approach was informed through tenets of post-structural feminist theory, and a critical discourse analysis was conducted. Two major discourses were identified: (1) children engage in dangerous and injurious play; and (2) environmental and social barriers limit play opportunities. Findings suggest that the children often experienced discrimination and severe injuries as a result of engagement in play which resulted in long-term financial and physical burdens. These findings challenge Euro-Western risky play paradigms and inform injury prevention and play scholarship with the voices of families from equity-deserving communities.

Somali refugees in urban neighborhoods: an eco-social study of mental health and wellbeing

Background

Impact of pre-migration trauma and post-migration settlement on refugee mental health and wellbeing is well-documented. However, little research has focused on the specific places where refugees settle and spend their daily lives within the post-migration context. This study adopts an eco-social perspective to explore the relationship between urban neighborhoods and refugee mental health and wellbeing.

Methods

We conducted twenty-six qualitative interviews with Somali refugees in London and Bristol in the UK. The transcripts were coded using an inductive approach and analyzed through thematic analysis.

Results

Somali refugees navigate a complex urban environment comprising various neighborhood features which include important places near home, interactions with neighbors, and community spaces. While these features afford them resources to improve mental health and wellbeing, they also present challenges such as high urban density, exposure to violence or discrimination, and neighborhood disorder.

Conclusion

The societal and physical features of urban neighborhoods intersect with refugee experiences of adversity, trauma and stress over time. As eco-social niches, urban neighborhoods are both accommodating, safe and familiar, as well as alien, threatening and unwelcoming. To support mental health and wellbeing and ensure successful settlement, it is essential to recognize the agency of refugees and provide continuous support throughout the entire asylum process and after, ensuring stable and safe living conditions.

"In small places, close to home": Urban environmental impacts on child rights across four global cities

Urban environments influence child behaviours, exposures and experiences and may affect health, development, achievement and realization of fundamental human rights. We examined the status of eleven UN Convention on the Rights of the Child articles, in a multi-case study across four global cities. Within all study cities, children experienced unequal exposure to urban environmental risks and amenities. Many violations of child rights are related to car-based transportation systems and further challenged by pressures on urban systems from rapid population increases in the context of climate change. A child rights framework provides principles for a collective, multi-sectoral re-imagination of urban environments that support the human rights of all citizens.

Exploring Mental Health and Development in Refugee Children Through Systematic Play Assessment

To evaluate a standardized play observation as a measure of young children's mental health and development in a clinical and refugee population. We conducted individual play observations with 70 refugee children aged 3- to 6-years and compared them to a clinical group of 111 age-matched children regarding their level of play development, social interaction during play, traumatic re-enactments, and emotionless-cold play. Additionally, we assessed children's mental health, social-emotional development and markers of adversity by parent and educator report as well as their IQ-test scores and learning performance and related these factors to the play variables. Play variables were significantly correlated with IQ-test scores (r = 0.184, p = 0.037), learning performance (r = 0.208, p = 0.010) and vocabulary (r = 0.208, p = 0.021) in the comparison group and with social-emotional development in educator report (r = 0.368, p = 0.011), time spent in Germany (r = 0.342, p < 0.001) and parental distress (r = - 0.292, p = 0.034) in the refugee group. Children with more parent-reported adverse experiences showed less social-interactive play in the overall sample (r = - 0.178, p = 0.011). Our child-centered approach to standardized play observation augments information obtained from parent and educator reports and can provide valuable insights in subgroups where other commonly used tests are not available or applicable.

Developmental referrals of pre-school children in a diverse community in England: The importance of parental migration for referral rates

BACKGROUND

Children born to migrant parents have higher rates of language difficulties, intellectual disability and autism. This study explores the relationship between migration, ethnicity and reasons for early years referrals to community paediatrics in a diverse multi-cultural population in a city in south west England.

METHODS

Observational retrospective study from a community paediatric service serving a multi-cultural urban population from June 2012 to February 2016. We tested associations of ethnicity and parental birth origin with reason for referral (developmental or non-developmental) for children under 5 years old and estimated crude rate ratios for referrals using population census data.

RESULTS

Data were available for 514 children (52% white or mixed race, 16% Asian, 21% African diaspora, and 11.5% Somali); 53% had two UK-born parents while 22% had two migrant (non-UK-born) parents. Referrals were for developmental reasons in 307 (60%) including 86 for possible autism. Parental birth origin and ethnicity were associated with reason for referral (p < 0.001). Children from African diaspora, Asian or Somali backgrounds had more than twice the rate (rate ratio [RR] 2.37, 95% CI 1.88-2.99, p < 0.001) of developmental referrals compared with white or mixed-race children. Children of Somali or African diaspora ethnicity were, respectively, six-times (RR 5.99, 95% CI 3.24-10.8, p < 0.001) and four times (RR 4.23, 95% CI 2.44-7.29, p < 0.001) more likely to be referred for possible autism spectrum than their white or mixed-race peers. Developmental referral as a proportion of all referrals was twice as high among children with one migrant parent (20.4%) and three times as high among children with two migrant parents (29.5%), compared with children whose parents were both UK-born (10.7%).

CONCLUSIONS

This study supports the importance of ethnicity and parental migration as factors in young children experiencing developmental difficulties, especially concerns about social communication or autism.

Influence of Neighborhood Built Environments on the Outdoor Free Play of Young Children: a Systematic, Mixed-Studies Review and Thematic Synthesis

Urban environments shape early childhood exposures, experiences, and health behaviors, including outdoor free play, influencing the physical, cognitive, social, and emotional development of young children. We examined evidence for urban or suburban built environment influences on outdoor free play in 0-6-year-olds, considering potential differences across gender, culture, and geography. We systematically searched seven literature databases for relevant qualitative, quantitative, and mixed methods studies: of 5740 unique studies, 53 met inclusion criteria. We assessed methodological quality and thematically synthesized findings from included studies. Three broad themes, features of spaces for play, routes, and social factors intersected to influence the availability, accessibility, and acceptability of neighborhoods for young children's outdoor free play across diverse cultural and geographic contexts. Proximity to formal or informal space for play, protection from traffic, pedestrian environment, green and natural environments, and opportunity for social connection supported outdoor free play. Family and community social context influenced perceptions of and use of space; however, we did not find consistent, gendered differences in built environment correlates of outdoor free play. Across diverse contexts, playable neighborhoods for young children provided nearby space for play, engaging routes protected from traffic and facilitated frequent interaction between people, nature, and structures.

Perceived environmental barriers and facilitators of refugee children's physical activity in/around refugee accommodation: a qualitative case study in Berlin

BACKGROUND

Previous research have identified built environmental attributes associated with refugee children's physical activity (PA); however, there is a lack of research focusing on refugee children's environmental perceptions at the individual level. We examined the perceived environmental barriers and facilitators of refugee children's PA.

METHODS

Perceptions of PA environments by refugee children (n = 15, 6 to 13 years old) and their parents (n = 10) were captured by questionnaires and drawing workshops from one refugee accommodation in Berlin. Besides, photovoice was conducted with three children to obtain an in-depth understanding of their experiences of existing environments for PA. Research was applied between June and July 2019. All research material was transcribed and analysed using thematic analysis.

RESULTS

Refugee children and their parents identified micro-environments as the centre of children's daily PA, they usually played indoors but most parents perceived there was no spaces. In meso environments, children and parents thought there were insufficient spaces and were worried about neighbourhood safety. Furthermore, parents concerned more about 'space accessibility' for their children's playing purposes instead of 'space quality (e.g., equipment)' . Children also indicated the importance of informal spaces for their PA.

CONCLUSIONS

Refugee children perceive a lack of space and safety when attempting to play in the existing micro and meso environments. Related practitioners should focus on providing more play spaces in micro environments and safe access to existing neighbourhood playfields. These efforts can augment much-needed research on strategies to better integrate refuge facilities to their urban context and essential in minimising current health and spatial inequality issues these vulnerable groups face across Germany and worldwide.

Understanding Spatial Characteristics of Refugee Accommodations Associated with Refugee Children’s Physical Activity in Microenvironments: Six Case Studies in Berlin

Refugee children often spend a considerable amount of time in refugee accommodations with limited space and limited access to communal facilities. Such environmental settings make it difficult for refugee children to engage in physical activity (PA), which is essential for their health and social inclusion. While there is a strong evidence base for environmental attributes associated with non-refugee children’s PA, only a few studies have focused on refugee children. This article presents an exploratory study on the spatial characteristics of six refugee accommodations in Berlin and their relation to school-aged refugee children’s opportunities to engage in PA. Micro-environmental attributes included building typology and availability, size, and access to communal PA spaces using Space Syntax. PA opportunities were assessed using staff surveys, interviews, and field trips. Results indicated that none of the case studies provided a comprehensive range of PA opportunities. They also revealed unequal access within the facilities. Whereas the role of size was inconsistent, vital predictors included fewer floors and corridors with easy access to internal and external PA spaces. Our recommendations include prioritizing compact buildings with moderate heights when retrofitting existing facilities and raising awareness for the importance of active play for this vulnerable group.

Parenting in place: The reception centre as the spatial context for laying the foundations for asylum-seeking children's healthy development

Brain architecture is shaped by early childhood experiences, which thus affect future physical and mental health. These experiences consist primarily of parenting, intertwined with environment. The mental health of migrants has received much attention in research; however, early childhood experiences and the spatiality of parenting have largely been ignored. This study examines asylum-seeking parents' perceptions of parenting their 2-6-year-old children, focusing on the spatial context of the reception centre. We conducted 26 semi-structured interviews among parents in three reception centres in Finland. The results show that parenting was challenged by all three dimensions of place: location, locale and sense of place. The findings indicate that for parents, the reception centre is an essential factor interacting with parenting, enabling or impeding caregiving. These findings are discussed from the viewpoints of transnationalism, insufficient children's spaces and activities and lost sense of place. We urge policy-makers to improve the spatial context for parenting in reception centres by ensuring adequate children's spaces and activities, including opportunities for early learning, privacy of the family, parents' social support and possibilities for establishing everyday routines. We suggest that these improvements would have far-reaching beneficial implications for the healthy development and future mental health of asylum-seeking children.

Living with transience in high-risk humanitarian spaces: the gendered experiences of international staff and policy implications for building resilience

Deployment in a crisis zone is a perilous undertaking. Little is known right now about how humanitarian workers relate social and professional goals to lived experiences of high-risk environments. In South Sudan, ranked as the most dangerous country globally for aid workers, 20 international humanitarian staff were interviewed to examine their sense of place, well-being, and vocation, using thematic and interpretative phenomenological analysis. Subjectivities of humanitarian space hinged upon negotiating physical hardships and social relationships: Juba, the capital, was described as a 'prison' and a 'party hotspot'. For expatriate staff, making sense of spatial, social, and professional transience was sharply gendered and rooted in the subjectivities of risk-taking, crisis management, and career-building. Two policy measures are highlighted here to address the implications of transience for human well-being and organisational effectiveness. Efforts to support teams and structure work environments, altering the humanitarian and vocational bubble, will help to develop resilience at the heart of humanitarian systems.

Built-environment attributes associated with refugee children's physical activity: a narrative review and research agenda

Research has identified built environmental attributes associated with children’s physical activity (PA); however, less is known for environmental correlates of refugee children’s PA. This narrative review summarised the current evidence of associations between built environment attributes and refugee children’s PA. Six databases were searched with three sets of terms related to exposure (built environment); outcome (PA); and target population (refugee children aged 6–12 years). Eight studies (one quantitative; seven qualitative) met the inclusion criteria. Key PA barriers were limited play space and lack of neighbourhood safety. Design of refugee facilities and surrounding environments should provide better access to formal, informal and safe spaces for children’s play.

Residential mobility, mental health, and community violence exposure among Somali refugees and immigrants in North America

Refugees and immigrants resettled in high income countries often later experience a new phase of residential uncertainty in search of safe and secure housing. This study investigated the effect of past year housing stability on symptoms of posttraumatic stress disorder (PTSD) and exposure to neighborhood violence among a sample of 1^st and 2nd generation Somali young adults (N = 198) living in urban areas in North America. In one year, 8.1% of the sample experienced a forced move and 20.7% of the sample moved voluntarily. Discrimination, neighborhood violence, economic insecurity, and interpersonal conflict precipitated forced moves. Forced moves were associated with worsening PTSD symptomology over one year, while voluntary moves were associated with improvements in symptoms. The current study provides evidence of the importance of safe, stable housing for the mental health of young adult immigrants.