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Filmer T, Ray R, Glass BD. Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review. Res Social Adm Pharm 2023; 19:977-988. [PMID: 36868911 DOI: 10.1016/j.sapharm.2023.02.016] [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: 03/24/2022] [Revised: 02/03/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction. OBJECTIVE The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries. METHODS A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria. RESULTS A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building. CONCLUSIONS While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..
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Affiliation(s)
- Tamara Filmer
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Robin Ray
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, 1 James Cook Drive, Douglas, QLD, 4811, Australia.
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2
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Ravichandiran N, Mathews M, Ryan BL. Utilization of healthcare by immigrants in Canada: a cross-sectional analysis of the Canadian Community Health Survey. BMC PRIMARY CARE 2022; 23:69. [PMID: 35387597 PMCID: PMC8985249 DOI: 10.1186/s12875-022-01682-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/31/2022] [Indexed: 11/21/2022]
Abstract
Background Immigrants to Canada face unique barriers to health care, which leads to inequities in health care utilization. Lower utilization of health care by immigrants to Canada is associated with the deteriorating health of individual immigrants as well as increased costs to the health care system. The existing literature suggests that time since immigration is an important predictor for utilization of health care for Canadian immigrants; however, few studies have included this variable in their analysis. This study aims to examine the relationships between having a regular health care provider and time since immigration, and number of medical consultations in the past year and time since immigration. Methods A secondary cross-sectional data analysis using Andersen and Newman’s Framework of Health Service Utilization and data from the 2015–2016 Canadian Community Health Survey (CCHS) was conducted to examine health care utilization among immigrants in Canada. We used multiple logistic regression to examine the relationship between time since immigration and having a regular physician and negative binomial regression to compare the number of consultations of recent (less than 10 years since immigration) and established (10 or more years since immigration) immigrants. Results Eighty four percent of immigrant respondents to CCHS 2015–2016 had a regular health care provider. After controlling for other independent variables, established immigrants were 1.75 (95% confidence interval: 1.45–2.10) times more likely to have a regular health care provider compared to recent immigrants. Immigrants had a mean of 3.37 (standard deviation 4.53) medical consultations in the preceding year. There was no difference in the mean number of medical consultations by recent and established immigrants. Conclusions After controlling for other independent variables, this study found that time since immigration had a significant effect on having a regular provider but not on number of consultations. Differences in health care utilization for recent and for established immigrants observed in this study may be partially explained by Canada’s evolving immigration policy and the economic and social integration of immigrants over time.
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Kuo SF, Chen IH, Huang TW, Miao NF, Peters K, Chung MH. Self-Efficacy Mediates Acculturation and Respite Care Knowledge of Immigrant Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010595. [PMID: 34682340 PMCID: PMC8536004 DOI: 10.3390/ijerph182010595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
Past studies have shown that acculturation and self-efficacy can affect respite care knowledge, which are notable issues among immigrant caregivers due to the rapid increasing aging family members. The aim of this study was to investigate relationships among acculturation, self-efficacy, and respite care knowledge in immigrant caregivers, and to determine the mediating effects of self-efficacy on the relationship between acculturation and respite care knowledge. A cross-sectional design was used. We enrolled 134 female immigrant caregivers who had married Taiwanese men and lived with care recipients who used LTC services. Based on Baron and Kenny' mediating analytic framework, multiple regression and Sobel tests were used to examine whether self-efficacy mediated the relationship between acculturation and respite care knowledge. The findings showed that after controlling for confounding factors, acculturation and self-efficacy separately affected respite care knowledge (B = 0.229, standard error (SE) = 0.084; B = 0.123, SE = 0.049, respectively). Acculturation had a positive impact on respite care knowledge through self-efficacy (B = 0.181, SE = 0.084). Therefore, self-efficacy partially mediated the effect of acculturation on respite care knowledge, and accounted for 20.9% of the total mediating effect in this study. Acculturation predicted immigrant caregiver' respite care knowledge partially through self-efficacy. The association between acculturation and respite care knowledge was partially mediated by immigrant caregivers' self-efficacy. As a result, it was proposed that boosting self-efficacy could increase and drive immigrant caregivers' respite care knowledge. To assist this population in obtaining enough resources, targeted educational programs to promote immigrant caregivers' self-efficacy should be designed and implemented. Furthermore, health care practitioners should be aware of the relevance of immigrant caregivers' acculturation.
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Affiliation(s)
- Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan; (S.-F.K.); (I.-H.C.); (T.-W.H.)
| | - I-Hui Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan; (S.-F.K.); (I.-H.C.); (T.-W.H.)
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan; (S.-F.K.); (I.-H.C.); (T.-W.H.)
| | - Nae-Fang Miao
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan;
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia;
| | - Min-Huey Chung
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan; (S.-F.K.); (I.-H.C.); (T.-W.H.)
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 6317); Fax: +886-2-2377-2842
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4
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Padalko A, Gawaziuk J, Chateau D, Sareen J, Logsetty S. Social Determinants Associated with Pediatric Burn Injury: A Population-Based, Case-Control Study. J Burn Care Res 2020; 41:743-750. [PMID: 32352522 DOI: 10.1093/jbcr/iraa045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Social determinants of health (SDoH) influence risk of injury. We conducted a population-based, case-control study to identify which social determinants influence burn injury in children. Children (≤16 years of age) admitted to a Canadian regional burn center between January 1, 1999 and March 30, 2017 were matched based on age, sex, and geographic location 1:5 with an uninjured control cohort from the general population. Population-level administrative data describing the SDoH at the Manitoba Center for Health Policy (MCHP) were compared between the cohorts. Specific SDoH were chosen based on a published systematic review conducted by the research team. In the final multivariable model, children from a low-income household odds ratio (OR) (95% confidence interval) 1.97 (1.46, 2.65), in care 1.57 (1.11, 2.21), from a family that received income assistance 1.71 (1.33, 2.19) and born to a teen mother 1.43 (1.13, 1.81) were significantly associated with an increased risk of pediatric burn injury. This study identified SDoH that are associated with an increased risk of burn injury. This case-control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Identifying children at increased potential risk allows targeting of burn risk reduction and home safety programs.
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Affiliation(s)
- Adam Padalko
- BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Justin Gawaziuk
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Canada; From the
| | - Dan Chateau
- Manitoba Centre for Health Policy, Winnipeg, Canada.,Department of Community Health Sciences, Winnipeg, Canada
| | - Jitender Sareen
- Department of Community Health Sciences, Winnipeg, Canada.,Department of Psychiatry, Winnipeg, Canada
| | - Sarvesh Logsetty
- Department of Psychiatry, Winnipeg, Canada.,Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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5
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Heizomi H, Iraji Z, Vaezi R, Bhalla D, Morisky DE, Nadrian H. Gender Differences in the Associations Between Health Literacy and Medication Adherence in Hypertension: A Population-Based Survey in Heris County, Iran. Vasc Health Risk Manag 2020; 16:157-166. [PMID: 32368074 PMCID: PMC7186197 DOI: 10.2147/vhrm.s245052] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/19/2020] [Indexed: 12/27/2022] Open
Abstract
Objective We examined the gender-based associations of health literacy (HL) with self-reported medication adherence (MEDA) among patients with primary hypertension (pHTN). Patients and Methods The subjects were recruited from the general population through all health centers of the Heris county, east Azarbaijan. They were to be adults (30+ years age), with pHTN of any stage, of any gender, and without comorbid illness. All underwent detailed face-to-face interview. We used valid questionnaires for HL and MEDA. Hierarchical regression was done to establish the association between MEDA, socio-demographic variables, and nine HL domains by gender. Other statistical procedures were also done. Results A total of 300 (48.6% males, mean age: 56.7±9.3) subjects participated; 43.0% were uneducated, 73.0% had moderate socioeconomic status, 68.0% had poor HL, and 7.0% maintained high adherence. Men were better in reading skills (p=0.002), and accessing (p=0.01) and using (p=0.02) health information, but women were better in health knowledge (p=0.004). The average regression estimate (±standard deviation) between HL and MEDA was 0.37±0.09, lower among men (0.361±0.11) than women (0.396±0.08), p=0.003. Upon hierarchical regression, the association between HL and MEDA was significant for communication and decision-making skills alone among both men (34.5%) and women (40.6%), individually. Conclusion HL had substantial association with MEDA among those with HTN, for both men and women, particularly the communication and decision-making. With considerations on gender differences, this association should be confirmed through interventional studies to help make HL a formal mitigating strategy for MEDA and other public health goals.
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Affiliation(s)
- Haleh Heizomi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeynab Iraji
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rogayeh Vaezi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Devender Bhalla
- Pôle Universitaire Euclide, Intergovernmental UN Treaty 49006/49007®, Bangui, Central African Republic.,Iranian Epilepsy Association®, Tehran, Iran.,Nepal Interest Group of Epilepsy and Neurology (NiGEN), Kathmandu, Nepal
| | - Donald E Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Haidar Nadrian
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.,Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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EPA guidance on cultural competence training. Eur Psychiatry 2020; 30:431-40. [DOI: 10.1016/j.eurpsy.2015.01.012] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/30/2015] [Accepted: 01/30/2015] [Indexed: 11/22/2022] Open
Abstract
AbstractThe stress of migration as well as social factors and changes related to the receiving society may lead to the manifestation of psychiatric disorders in vulnerable individuals after migration. The diversity of cultures, ethnicities, races and reasons for migration poses a challenge for those seeking to understand how illness is experienced by immigrants whose backgrounds differ significantly from their clinicians. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient's own culture as well as from the perspective of the clinician's cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. To reach these aims, both individual and organizational competence are needed, as well as teaching competence in terms of educational leadership. The WPA Guidance on Mental Health and Mental Health Care for Migrants and the EPA Guidance on Mental Health Care for Migrants list a series of recommendations for policy makers, service providers and clinicians; these are aimed at improving mental health care for immigrants. The authors of this paper would like to underline these recommendations and, focusing on cultural competency and training, believe that they will be of positive value.
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Saunders NR, Gill PJ, Holder L, Vigod S, Kurdyak P, Gandhi S, Guttmann A. Use of the emergency department as a first point of contact for mental health care by immigrant youth in Canada: a population-based study. CMAJ 2019; 190:E1183-E1191. [PMID: 30301742 DOI: 10.1503/cmaj.180277] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Emergency department visits as a first point of contact for people with mental illness may reflect poor access to timely outpatient mental health care. We sought to determine the extent to which immigrants use the emergency department as an entryway into mental health services. METHODS We used linked health and demographic administrative data sets to design a population-based cohort study. We included youth (aged 10-24 yr) with an incident mental health emergency department visit from 2010 to 2014 in Ontario, Canada (n = 118 851). The main outcome measure was an emergency department visit for mental health reasons without prior mental health care from a physician on an outpatient basis. The main predictor of interest was immigrant status (refugee, non-refugee immigrant and non-immigrant). Immigrant-specific predictors included time since migration, and region and country of origin. We used Poisson models to estimate adjusted rate ratios (aRRs) and 95% confidence intervals (CIs). RESULTS The cohort included 2194 (1.8%) refugee, 6680 (5.6%) non-refugee immigrant and 109 977 (92.5%) nonimmigrant youth. Rates of first mental health contact in the emergency department were higher among refugee (61.3%) and non-refugee immigrant youth (57.6%) than non-immigrant youth (51.3%) (refugee aRR 1.17, 95% CI 1.13-1.21; non-refugee immigrant aRR 1.10, 95% CI 1.08-1.13). Compared with non-refugee immigrants, refugees had a higher rate of first mental health contact in the emergency department (aRR 1.06, 95% CI 1.02-1.11). We also observed higher rates among recent versus longer-term immigrants (aRR 1.10, 95% CI 1.05-1.16) and immigrants from Central America (aRR 1.17, 95% CI 1.08-1.26) and Africa (aRR 1.15, 95% CI 1.06-1.24) versus from North America and Western Europe. INTERPRETATION Immigrant youth are more likely to present with a first mental health crisis to the emergency department than non-immigrants, with variability by region of origin and time since migration. Immigrants may face barriers to access and use of outpatient mental health services from a physician. Efforts are needed to reduce stigma and identify mental health problems early, before crisis, among immigrant populations.
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Affiliation(s)
- Natasha Ruth Saunders
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont.
| | - Peter J Gill
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Laura Holder
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Simone Vigod
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Paul Kurdyak
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Sima Gandhi
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Astrid Guttmann
- The Hospital for Sick Children (Saunders, Gill, Guttmann); Department of Pediatrics (Saunders, Gill, Guttmann), University of Toronto; ICES (Saunders, Holder, Vigod, Kurdyak, Gandhi, Guttmann); Child Health Evaluative Sciences (Saunders, Guttmann), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Vigod, Kurdyak, Guttmann), University of Toronto; Women's College Research Institute (Vigod), Women's College Hospital; Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
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8
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Rodriguez-Torres SA, McCarthy AM, He W, Ashburner JM, Percac-Lima S. Long-Term Impact of a Culturally Tailored Patient Navigation Program on Disparities in Breast Cancer Screening in Refugee Women After the Program's End. Health Equity 2019; 3:205-210. [PMID: 31106287 PMCID: PMC6524343 DOI: 10.1089/heq.2018.0104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Purpose: To examine the long-term effects of a patient navigation (PN) program for mammography screening tailored to refugee women and to assess screening utilization among these women after PN ended. Methods: We assessed the proportion of patients completing mammography screening during the prior 2 years during 2012–2016 for refugee women who had previously received PN compared with that of English-speaking women cared for at the same health center during the same period, both overall and stratifying by age. We used logistic regression to compare screening completion between refugees and English speakers, adjusting for age, race, insurance status, number of clinic visits, and clustering by primary care physician and to test trends in screening over time. Results: In 2012, the year when the funding for PN ceased, among 126 refugee women eligible for breast cancer screening, mammography screening rates were significantly higher among refugees (90.5%, 95% confidence interval [CI]: 83.5–94.7%) than among English speakers (81.9%, 95% CI: 76.2–86.5%, p=0.006). By 2016, screening rates decreased among refugee women (76.5%, 95% CI: 61.6–86.9%, p=0.023) but were not statistically significantly different from those among English-speaking women (80.5%, 95% CI: 74.4–85.3%, p=0.460). Screening prevalence for refugee women remained above the pre-PN program screening levels, and considerably so in women <50 years. Conclusion: The culturally and language-tailored PN program for refugee women appeared to have persistent effects, with refugee women maintaining similar levels of mammography screening to English-speaking patients 5 years after the PN program's end.
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Affiliation(s)
| | - Anne Marie McCarthy
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Wei He
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeffrey M Ashburner
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sanja Percac-Lima
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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9
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Lanzara R, Scipioni M, Conti C. A Clinical-Psychological Perspective on Somatization Among Immigrants: A Systematic Review. Front Psychol 2019; 9:2792. [PMID: 30705662 PMCID: PMC6344401 DOI: 10.3389/fpsyg.2018.02792] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/31/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Somatic and psychopathological conditions (e.g., anxiety, depression, post-traumatic stress disorder, and somatization) are frequent among immigrants belonging to various ethnic groups. Worldwide findings on the epidemiology regarding specific mental conditions still vary with respect to different migration samples and migration contexts. This inconsistency also holds true in the incidence of somatization among migrants. We carried out a systematic review analyzing the relationship between migration and somatization by providing a qualitative data synthesis of original research articles on the topic. Methods: According to PRISMA guidelines, we conducted a systematic search of the literature on PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. The articles were selected using multiple combinations of relevant search terms (e.g., defined somatization and related disorders, and migration status). Each database was searched systematically from January 2000 to December 2017. Results: The initial search identified 338 records, of which 42 research reports met the predefined inclusion criteria and were analyzed. Most studies (n = 38; 90%) were cross-sectional. The main findings of this study are that migrants with somatization exhibited more psychological distress, had an increased perceived need for healthcare service utilization, and reported more post-migration living difficulties and/or post-traumatic stress disorder than those without somatization. It was also found that specific individual features mediate the association between somatization and migration. The prevalence and correlates of somatization were found to vary across the immigrant groups, depending on cultural variation in reasons for migration, stress exposure, explanatory models of illness, coping, and other individual variables. Conclusion: Somatization is a challenge for health professionals due to its vague nature. In this regard, clinical management of immigrant patients should include further efforts to address emotional distress, with special attention to social, cultural, and linguistic differences.
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Affiliation(s)
- Roberta Lanzara
- Department of Psychological, Health and Territorial Sciences, Università degli Studi G. d'Annunzio Chieti e Pescara, Chieti, Italy
| | - Mattia Scipioni
- Department of Psychological, Health and Territorial Sciences, Università degli Studi G. d'Annunzio Chieti e Pescara, Chieti, Italy
| | - Chiara Conti
- Department of Psychological, Health and Territorial Sciences, Università degli Studi G. d'Annunzio Chieti e Pescara, Chieti, Italy
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10
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Gilliland JA, Shah TI, Clark A, Sibbald S, Seabrook JA. A geospatial approach to understanding inequalities in accessibility to primary care among vulnerable populations. PLoS One 2019; 14:e0210113. [PMID: 30615678 PMCID: PMC6322734 DOI: 10.1371/journal.pone.0210113] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/16/2018] [Indexed: 11/18/2022] Open
Abstract
Many Canadians experience unequal access to primary care services, despite living in a country with a universal health care system. Health inequalities affect all Canadians but have a much stronger impact on the health of vulnerable populations. Health inequalities are preventable differences in the health status or distribution of health resources as experienced by vulnerable populations. A geospatial approach was applied to examine how closely the distribution of primary care providers (PCPs) in London, Ontario meet the needs of vulnerable populations, including people with low income status, seniors, lone parents, and linguistic minorities. Using enhanced two step floating catchment area (E2SFCA) method, an index of geographic access scores for all PCPs and PCPs speaking French, Arabic, and Spanish were separately developed at the dissemination area (DA) level. To analyze how PCPs are distributed, comparative analyses were performed in association with specific vulnerable groups. Geographical accessibility to all PCPs, and PCPs who speak specific minority languages vary considerably across the city of London. Access scores for French- and Arabic-speaking PCPs are found comparatively high (mean = 2.85 and 1.01 respectively) as compared to Spanish-speaking PCPs (mean = 0.47). Additionally, many areas with high proportions of vulnerable populations experience low accessibility. Despite its exploratory nature, this study offers insight into intra-urban distributions of geographical accessibility to primary care resources for vulnerable groups. These findings can facilitate health researchers and policymakers in the development of recommendations to increase levels of accessibility of specific population groups in underserved areas.
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Affiliation(s)
- Jason A. Gilliland
- Department of Geography, Western University, London, ON, Canada
- Human Environments Analysis Laboratory, Western University, London, ON, Canada
- School of Health Studies, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Paediatrics, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Children’s Health Research Institute, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Tayyab I. Shah
- Department of Geography, Western University, London, ON, Canada
- Human Environments Analysis Laboratory, Western University, London, ON, Canada
| | - Andrew Clark
- Department of Geography, Western University, London, ON, Canada
- Human Environments Analysis Laboratory, Western University, London, ON, Canada
| | - Shannon Sibbald
- School of Health Studies, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Family Medicine, Western University, London, ON, Canada
| | - Jamie A. Seabrook
- Human Environments Analysis Laboratory, Western University, London, ON, Canada
- Department of Paediatrics, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Children’s Health Research Institute, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
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11
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Shishehgar S, Gholizadeh L, DiGiacomo M, Green A, Davidson PM. Health and Socio-Cultural Experiences of Refugee Women: An Integrative Review. J Immigr Minor Health 2018; 19:959-973. [PMID: 26976004 DOI: 10.1007/s10903-016-0379-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Approximately half of the global refugee population are women, yet they remain largely understudied from the perspective of gender. The aim of this review was to investigate the impact of refugee women's resettlement and socio-cultural experiences on their health. This review also explored factors promoting resilience in refugee women. Eight databases were searched for peer-reviewed manuscripts published from 2005 to 2014. Grey literature was also reviewed. Data were extracted for population, data collection methods, data analysis, and findings. The Resource-Based Model was used as an overarching framework for data synthesis. Following the screening of titles and abstracts, 20 studies met the study inclusion criteria. Cultural factors, social and material factors, personal factors, and resilience factors were identified as main themes influencing the health of refugee women. Promotion of factors that enables resettlement is important in promoting the health and wellbeing of refugee women.
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Affiliation(s)
- Sara Shishehgar
- Faculty of Health, University of Technology Sydney, Level 7, 235 Jones Street, Ultimo, NSW, 2007, Australia.
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, Level 7, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Michelle DiGiacomo
- Faculty of Health, University of Technology Sydney, Level 7, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Anna Green
- Faculty of Health, University of Technology Sydney, Level 7, 235 Jones Street, Ultimo, NSW, 2007, Australia
| | - Patricia M Davidson
- Faculty of Health, University of Technology Sydney, Level 7, 235 Jones Street, Ultimo, NSW, 2007, Australia.,Johns Hopkins University, Baltimore, MD, USA
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12
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Drewniak D, Krones T, Wild V. Do attitudes and behavior of health care professionals exacerbate health care disparities among immigrant and ethnic minority groups? An integrative literature review. Int J Nurs Stud 2017; 70:89-98. [PMID: 28236689 DOI: 10.1016/j.ijnurstu.2017.02.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/21/2016] [Accepted: 02/10/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Recent investigations of ethnicity related disparities in health care have focused on the contribution of providers' implicit biases. A significant effect on health care outcomes is suggested, but the results are mixed. The purpose of this integrative literature review is to provide an overview and synthesize the current empirical research on the potential influence of health care professionals' attitudes and behaviors towards ethnic minority patients on health care disparities. DESIGN Integrative literature review. DATA SOURCES Four internet-based literature indexes - MedLine, PsychInfo, Sociological Abstracts and Web of Science - were searched for articles published between 1982 and 2012 discussing health care professionals' attitudes or behaviors towards ethnic minority patients. REVIEW METHODS Thematic analysis was used to synthesize the relevant findings. RESULTS We found 47 studies from 12 countries. Six potential barriers to health care for ethnic minorities were identified that may be related to health care professionals' attitudes or behaviors: Biases, stereotypes and prejudices; Language and communication barriers; Cultural misunderstandings; Gate-keeping; Statistical discrimination; Specific challenges of delivering care to undocumented migrants. CONCLUSIONS Data on health care professionals' attitudes or behaviors are both limited and inconsistent. We thus provide reflections on methods, conceptualization, interpretation and the importance of the geographical or socio-political settings of potential studies. More empirical data is needed, especially on health care professionals' attitudes or behaviors towards (irregular) migrant patients.
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Affiliation(s)
- Daniel Drewniak
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland.
| | - Tanja Krones
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland; Clinical Ethics, University Hospital Zurich, c/o Dermatologische Klinik, Gloriastrasse 31, 8091 Zurich, Switzerland.
| | - Verina Wild
- Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland; Chair of Philosophy IV, Ludwig-Maximilians-University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany.
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13
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Degelman ML, Herman KM. Immigrant status and having a regular medical doctor among Canadian adults. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 107:e75-e80. [PMID: 27348114 PMCID: PMC6972360 DOI: 10.17269/cjph.107.5205] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 01/13/2016] [Accepted: 11/19/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE New immigrants generally arrive in Canada with a health advantage over their Canadian counterparts, but lose that advantage over time. Difficulties in acquiring a physician may contribute. Past studies relied on older data, and lacked control for many confounders and assessment of gender differences. We assessed the relationship between immigrant status and having a regular doctor among Canadian adults. METHODS Cross-sectional data from the 2011-2012 Canadian Community Health Survey were self-reported by 73,958 respondents aged 18-64, representing >20 million Canadian adults. The relationship between immigrant status and having a doctor was analyzed using χ2 and logistic regression analyses stratified by gender. Age, body mass index, race, education, province of residence, physical activity, chronic conditions, self-perceived health, and number of children in household were controlled. RESULTS Approximately 77% of males and 87% of females reported having a doctor. About 7% of respondents reported being new immigrants in Canada (0-9 years), while 16% were established immigrants (≥10 years). For males (M) and females (F) respectively, 78% and 88% of non-immigrants, 55% and 68% of new immigrants, and 84% and 91% of established immigrants reported having a doctor (p < 0.001). Compared to non-immigrants, new immigrants were significantly less likely to have a doctor (OR (95% CI) M: 0.43 (0.38-0.47); F: 0.36 (0.32-0.41)), while established immigrants were significantly more likely to have a doctor (M: 1.13 (1.03-1.24); F: 1.16 (1.03-1.30)). CONCLUSION New Canadian immigrants are less likely to have a regular doctor compared to non-immigrants, and should be targeted by policies and programs facilitating finding a doctor.
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Affiliation(s)
- Michelle L Degelman
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Katya M Herman
- Faculty of Kinesiology and Health Studies, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada.
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14
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Shommu NS, Ahmed S, Rumana N, Barron GRS, McBrien KA, Turin TC. What is the scope of improving immigrant and ethnic minority healthcare using community navigators: A systematic scoping review. Int J Equity Health 2016; 15:6. [PMID: 26768130 PMCID: PMC4714538 DOI: 10.1186/s12939-016-0298-8] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 01/07/2016] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Immigrants are among the most vulnerable population groups in North America; they face multidimensional hurdles to obtain proper healthcare. Such barriers result in increased risk of developing acute and chronic conditions. Subsequently a great deal of burden is placed on the healthcare system. Community navigator programs are designed to provide culturally sensitive guidance to vulnerable populations in order to overcome barriers to accessing healthcare. Navigators are healthcare workers who support patients to obtain appropriate healthcare. This scoping review systematically searches and summarizes the literature on community navigators to help immigrant and ethnic minority groups in Canada and the United States overcome barriers to healthcare. METHODS We systematically searched electronic databases for primary articles and grey literature. Study selection was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Articles were selected based on four criteria: (1) the study population was comprised of immigrants or ethnic minorities living in Canada or the United States; (2) study outcomes were related to chronic disease management or primary care access; (3) the study reported effects of community navigator intervention; (4) the study was published in English. Relevant information from the articles was extracted and reported in the review. RESULT Only one study was found in the literature that focused on navigators for immigrants in Canada. In contrast, 29 articles were found that reported navigator intervention programs for immigrant minorities in the United States. In these studies navigators trained and guided members of several ethnic communities for chronic disease prevention and management, to undertake cancer screening as well as accessing primary healthcare. The studies reported substantial improvement in the immigrant and ethnic minority health outcomes in the United States. The single Canadian study also reported positive outcome of navigators among immigrant women. CONCLUSION Navigator interventions have not been fully explored in Canada, where as, there have been many studies in the United States and these demonstrated significant improvements in immigrant health outcomes. With many immigrants arriving in Canada each year, community navigators may provide a solution to reduce the existing healthcare barriers and support better health outcomes for new comers.
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Affiliation(s)
- Nusrat Sharmeen Shommu
- Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada.
| | - Salim Ahmed
- Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada.
| | - Nahid Rumana
- Sleep Center, Foothills Medical Center, University of Calgary, 1403 29 Street NW, Calgary, AB, Canada.
| | - Gary R S Barron
- Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada.
| | - Kerry Alison McBrien
- Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. .,Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4Z6, Canada.
| | - Tanvir Chowdhury Turin
- Department of Family Medicine, Room G012F, Health Sciences Center, University of Calgary, 3330 Hospital Drive Northwest, Calgary, AB, T2N 4N1, Canada. .,Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive Northwest, Calgary, AB, T2N 4Z6, Canada.
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15
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George U, Thomson MS, Chaze F, Guruge S. Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13624-48. [PMID: 26516884 PMCID: PMC4627052 DOI: 10.3390/ijerph121013624] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 09/24/2015] [Accepted: 10/20/2015] [Indexed: 11/16/2022]
Abstract
The Mental Health Commission of Canada's (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Over two decades of relevant literature on immigrants' health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed.
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Affiliation(s)
- Usha George
- Faculty of Community Services, Ryerson University, 99 Gerrard Street East, SHE-690; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Mary S Thomson
- Faculty of Community Services, Ryerson University, 99 Gerrard Street East, SHE-690; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Ferzana Chaze
- Community Studies, Sheridan College, 7899 McLaughlin Road, Brampton, ON L6Y 5H9, Canada.
| | - Sepali Guruge
- School of Nursing; Ryerson University, Faculty of Community Services; 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
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16
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Barriers to Access of Primary Healthcare by Immigrant Populations in Canada: A Literature Review. J Immigr Minor Health 2015; 18:1522-1540. [DOI: 10.1007/s10903-015-0276-z] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Saadi A, Bond BE, Percac-Lima S. Bosnian, Iraqi, and Somali Refugee Women Speak: A Comparative Qualitative Study of Refugee Health Beliefs on Preventive Health and Breast Cancer Screening. Womens Health Issues 2015. [DOI: 10.1016/j.whi.2015.06.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Shishehgar S, Gholizadeh L, DiGiacomo M, Davidson PM. The impact of migration on the health status of Iranians: an integrative literature review. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2015; 15:20. [PMID: 26275716 PMCID: PMC4537565 DOI: 10.1186/s12914-015-0058-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/20/2015] [Indexed: 02/02/2023]
Abstract
Background Immigration, both voluntary and forced, is driven by social, political and economic factors. Accordingly, some discussions and debates have emerged in recent years about the impact of migration on the health status of migrants. The aim of this review was to identify the impact of migration on the health status of Iranian immigrants and present a conceptual framework to facilitate the design and delivery of services and supports for this particular immigrant group. Methods Data for this integrative review were collected from Medline, PsycINFO, Scopus, ProQuest, Academic Search Complete, CINAHL, and Google Scholar search engine. The database search was limited to peer-reviewed literature, published in English, between 1980 and 2013. Results Twenty six articles were included in the review. Analysis revealed several factors influencing the mental health of immigrants, including language insufficiency; unemployment; sense of discrimination; cultural shock; lack of social support; lack of information about health care services; and intimate partner violence. Conclusion Findings of this review have contributed to development of a conceptual framework that delineates the impact of migration on Iranian immigrants’ health. This conceptualization may also help in addressing the needs of other vulnerable groups during the transition phase of migration.
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Affiliation(s)
- Sara Shishehgar
- Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Michelle DiGiacomo
- Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, Australia.
| | - Patricia M Davidson
- Faculty of Health, University of Technology Sydney, Sydney, Australia. .,School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
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19
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Nikbakht Nasrabadi A, Sabzevari S, Negahban Bonabi T. Iranian Women's Experiences of Health Information Seeking Barriers: A Qualitative Study in Kerman. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e25156. [PMID: 25834743 PMCID: PMC4376996 DOI: 10.5812/ircmj.25156] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 11/29/2014] [Accepted: 12/31/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND Women as active health information seekers play a key role in determining lifestyle and possible implementation of preventive measures, thereby improving the health of individuals, families and society. Although studies indicate that equipping people with adequate health information leads to optimal health outcomes, sometimes the complexity of human behavior and presence of barriers and limitations expose them to challenges. OBJECTIVES This study was designed to explore women's experiences of health information seeking barriers. PATIENTS AND METHODS In this qualitative content analysis study, data collection was conducted regarding inclusion criteria, through purposive sampling and semi-structured interviews with 17 women and using documentation and field notes until data saturation. Qualitative data analysis was performed constantly and simultaneously with data collection. RESULTS Five central themes were emerged to explain women's experiences of barriers to health information seeking as inadequate support from health care system, shame and embarrassment, costs, wrong ideas and beliefs and inadequate health literacy. CONCLUSIONS It seems the accurate and evidence-based review of the current health system is crucial to support the health informative requirements in a community-based approach, respecting the community cultural-religious beliefs and client participation in health care and according to local resources.
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Affiliation(s)
- Alireza Nikbakht Nasrabadi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Sakineh Sabzevari
- Department of Medical Sergical Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Tayebeh Negahban Bonabi
- Department of Community Health Nursing, School of Nursing and Midwifery, kerman University of Medical Sciences, Kerman, IR Iran
- Corresponding Author: Tayebeh Negahban Bonabi,Department of Community Health Nursing, School of Nursing and Midwifery, kerman University of Medical Sciences, Kerman, IR Iran.Tel: +983434255900, Fax:+983434258497, E-mail:
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20
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Bragazzi NL, Puente GD, Natta WM. Somatic perception, cultural differences and immigration: results from administration of the Modified Somatic Perception Questionnaire (MSPQ) to a sample of immigrants. Psychol Res Behav Manag 2014; 7:161-6. [PMID: 24966706 PMCID: PMC4062560 DOI: 10.2147/prbm.s55393] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The number of immigrants in Italy has doubled every 10 years from 1972 and Genoa hosts two large communities of immigrants from South America and Africa. We investigated differences in the somatic perception between immigrants and Italians and between South Americans and Africans living in the city of Genoa. During a 7 month period, an anonymous questionnaire asking for sociodemographic information and the Modified Somatic Perception Questionnaire (MSPQ) were administered to all immigrants accessing an outpatient clinic or the general practitioners offices. MSPQ mean scores were significantly higher in immigrant patients than in Italian patients, after adjusting for sex and age differences. We found no differences between South Americans and Africans in MSPQ score. The tendency to express discomfort through physical symptoms appears to be related to being a foreigner who arrived in Italy through a migratory trip and also to being a person who comes from a cultural context that is very different from the one of developed countries.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Giovanni Del Puente
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Werner Maria Natta
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy
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Becoming resilient: promoting the mental health and well-being of immigrant women in a canadian context. Nurs Res Pract 2012; 2012:576586. [PMID: 22754696 PMCID: PMC3382948 DOI: 10.1155/2012/576586] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 03/08/2012] [Accepted: 04/07/2012] [Indexed: 11/17/2022] Open
Abstract
This paper reports on grounded theory findings that are relevant to promoting the mental health and well-being of immigrant women in Canada. The findings illustrate how relationships among settlement factors and dynamics of empowerment had implications for “becoming resilient” as immigrant women and how various health promotion approaches enhanced their well-being. Dimensions of empowerment were embedded in the content and process of the feminist health promotion approach used in this study. Four focus groups were completed in Toronto, Ontario, Canada with 35 racialized immigrant women who represented diverse countries of origin: 25 were from Africa; others were equally represented from South Asia (5), Asia (5), and Central or South America and the Caribbean (5). Participants represented diverse languages, family dynamics, and educational backgrounds. One focus group was conducted in Somali; three were conducted in English. Constructivist grounded theory, theoretical sampling, and a critical feminist approach were chosen to be congruent with health promotion research that fostered women's empowerment. Findings foreground women's agency in the study process, the ways that immigrant women name and frame issues relevant to their lives, and the interplay among individual, family, community, and structural dynamics shaping their well-being. Implications for mental health promotion are discussed.
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