Medicine and Health Sciences Commons^™

Exploring Cultural, Health, And Technology Intersections: A Focus On Migrant Experiences, Merna Mina, Sahij Gill

Bridges: An Undergraduate Journal of Contemporary Connections

Despite the plethora of theories and frameworks addressing culture, health, and technology adoption, there remains a notable absence of a unifying theory that comprehensively encompasses all three aspects, particularly concerning newcomers. The Health Belief Model, for example, underscores individual perceptions and attitudes toward health yet fails to consider the intricate interplay between cultural factors and technology adoption among immigrant populations. The Healthy Immigrant Effect, which posits that immigrants often exhibit better health outcomes than native-born individuals, does not mention the role of technology on health outcomes. Acculturation theories, while shedding light on the adaptation process, often fall short of explaining …

Inclusive Integration Of Refugees And Migrants In Djibouti's National Healthcare System: Current Situation And Prospects For Improvement, Farhan Houssein Ali, Njah Mansour, Kenza Hassouni

Health Sciences

Cet examen narratif vise à décrire et synthétiser les données actuelles sur la situation des migrants et des réfugiés à Djibouti, ainsi que les progrès de la stratégie d'intégration inclusive mise en œuvre par le gouvernement djiboutien. Il s'appuie sur diverses sources, notamment la littérature grise et les publications scientifiques. Les résultats indiquent que le nombre de migrants et de réfugiés est en augmentation constante depuis 2019, avec un état de santé vulnérable et des risques sanitaires alarmants. Il est urgent d'accélérer la mise en œuvre de la stratégie tout en l'adaptant aux données actuelles et d'établir un système fiable …

Healthcare Practices In The United States Aimed At Improving Care And Language Access Services For Limited English Proficiency Refugees: A Systematic Review, Bemnet Kebede

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: The United States has accepted over 3 million refugees from all around the world since 1975. However, many Limited English Proficiency (LEP) refugees face significant barriers when seeking healthcare due to limited access, lack of knowledge, mistrust in physicians, language differences, cultural concerns, and overall complexity of the U.S. healthcare system. The purpose of this systematic review was to identify practices in the last 10 years that have improved healthcare and language access services for LEP refugees living in the U.S.

Methods: A search was conducted in four electronic databases PubMed, Embase, CINAHL, and Scopus from January 2013 to …

Enhancing Efficiency Of The Nutrition Education For Utah Refugees, Habiba Ali Nur

All Graduate Theses and Dissertations, Fall 2023 to Present

Refugees face many challenges related to obtaining and preparing adequate and culturally acceptable and desirable foods in their resettlement communities. These challenges often lead to risk of food insecurity and chronic diseases. A review of literature identified the existing delivery strategies and highlighted the need for nutrition education tailored to the refugees’ conditions. This study identified some of the barriers that refugees face, including the English language, transportation, finding items in grocery stores, availability of ingredients and equipment needed for cooking, affordability of food and budgeting. It also highlighted participants’ preference for having nutrition education.

To overcome these challenges, the …

Designing For Community Engagement: User-Friendly Refugee Wellness Center Planning Process And Concept, A Health Design Case Study, Ellen Solomon, Brandon Joa, Shandon Coffman, Billie Faircloth, Marc Altshuler, Bon Ku

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Refugee and immigrant populations have diverse cultural factors that affect their access to health care and must be considered when building a new clinical space. Health design thinking can help a clinical team evaluate and consolidate these factors while maintaining close contact with architects, patients' community leaders, and hospital or institutional leadership. A diverse group of clinicians, medical students, community leaders and architects planned a clinic devoted to refugee and immigrant health, a first-of-its-kind for South Philadelphia.

METHODS: The planning process and concept design of this wellness center is presented as a design case study to demonstrate how principles …

The Covid-19 Pandemic And Immigration- A Case Study Of Sweden, Sayantan Ghosal

International Journal on Responsibility

The Covid-19 pandemic has brought challenges to the trend of immigration, rules of immigration, and immigrants in the state. For those Swedish employers who employ non-EU citizens, the outbreak has created several business immigration-related issues. In addition to this, refugees are also a vulnerable group in society who face several challenges ranging from asylum to integration. Compromised living conditions and health facilities put them at greater health risks if infected with the virus. The long-term consequences of this pandemic in the case of refugees may also take the form of unemployment and social isolation. The paper focuses on labour immigrants …

Refugee Women’S Receptiveness For Virtual Engagement On Reproductive Health During The Covid-19 Pandemic, Heike Thiel De Bocanegra, Zahra Goliaei, Nossin Khan, Sereen Banna, Rawnaq Behnam, Sheila K Mody

Faculty Publications & Research of the TUC Public Health Program

BACKGROUND: Refugee women who leave their country due to persecution and violence have multiple barriers to sexual and reproductive health (SRH) services. The COVID-19 pandemic added an additional barrier to in-person reproductive health education, dialogue, and clinical care. This study aimed to assess the potential of using virtual group meetings as a forum for refugee women to learn about and discuss reproductive health concerns such as cervical cancer screening, family planning, childbirth, and postpartum care.

METHOD: We conducted semi-structured interviews with 36 refugee women and stakeholders to assess factors that impact refugee women's receptiveness for virtual platforms to obtain information …

Post-Resettlement Food Insecurity: Afghan Refugees And Challenges Of The New Environment, Zahra Goliaei, Mariaelena Gonzalez, Karina Diaz Rios, Mamata Pokhrel, Nancy J Burke

Faculty Publications & Research of the TUC Public Health Program

BACKGROUND: Lack of access to adequate, safe, and nutritious food is a major concern for the Afghan population due to ongoing war and humanitarian crises. Recently resettled Afghan refugees in the US continue to face challenges securing adequate, nutritious food resources in new environments. This study examined Afghan refugees' food access and insecurity in the San Joaquin Valley, California.

METHODS: Semi-structured, in-depth interviews were conducted to collect the perspectives and experiences of key informants and newly arrived Afghan refugees.

RESULTS: This study highlights environmental and structural factors (availability and accessibility of grocery stores; availability of religious-appropriate items in the stores; …

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

Bridging Cultural Barriers To Perinatal Mental Health Care In New Americans, Madeline Yvette Powell

Family Medicine Clerkship Student Projects

Perinatal mental health outcomes are worse in New Americans, particularly in refugee patients. Mental health stigma and cultural differences in views on mental illness impact New Americans’ willingness to discuss mental health concerns with healthcare workers. This is in addition to language barriers, time constraints, financial barriers, and general mistrust of medical professionals.

The Impact Of Trauma Subtypes On Ptsd Severity In Syrian Child And Adolescent Refugees, Liza Hinchey, Lana Grasser, Bassem Saad, Kathleen Gorski, Arash Javanbakht, May Chammaa

Medical Student Research Symposium

Background:

Child and adolescent refugee populations are at increased risk for psychiatric disorders including posttraumatic stress disorder (PTSD) and anxiety. Recent studies have demonstrated different symptomatology based on the type(s) of traumatic events experienced. Cluster analyses based on the Life Events Checklist (LEC) indicate three trauma subtypes: accidental/injury, victimization, and predominant death threat. Extending this line of research from adults to youth may lead to better understanding of the unique impacts of trauma subtypes on symptoms for improved prediction of risk and resilience.

Methods:

Refugee participants were recruited within 1 month of their resettlement in the U.S. Data used were …

Developing A Sexual Health Consent Strategy For Refugees: A Qualitative Approach, Amita Tuteja, Elisha Riggs, Lena Sanci, Lester Mascarenhas, Anna Power, Di Vanvliet, Katrina Sangster, Kimberley Mcguinness, Meredith Temple-Smith

The Qualitative Report

We report the development of a strategy for obtaining a truly voluntary and informed consent for sexual and reproductive health (SRH) research with Burma-born refugees settled in Australia. Using a qualitative descriptive research design, we interviewed 29 providers of refugee services (PRS) including health care professionals (doctors, nurses, midwives), bilingual supporting staff (interpreters, social workers, settlement workers, community liaison officers) and administrative staff (practice managers, reception staff) who provide primary care services to refugees. Interviews were audio recorded, transcribed, and subjected to thematic analysis. Four themes emerged: (a) unique values of Burma-born people, (b) unfamiliarity with Western concepts of research, …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

A Case Analysis Of Partnered Research On Palliative Care For Refugees In Jordan And Rwanda, Sonya De Laat, Olive Wahoush, Rania Jaber, Wejdan Khater, Emmanuel Musoni, Ibraheem Abu Siam, Lisa Schwartz, Matthew Hunt, Lynda Redwood-Campbell, Laurie Elit, Elysée Nouvet, Rachel Yantzi, Kevin Bezanson, Carrie Bernard, Takhliq Amir, Ani Chénier, Gautham Krishnaraj, Corinne Schusterwallace

Health Studies Publications

© 2021, The Author(s). Background: This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitarian crisis settings. Two contexts are the focus of this case analysis: Jordan, an acute conflict-induced refugee situation, and Rwanda, a protracted conflict-induced refugee setting. The study’s main goal was to better understand ways humanitarian organizations and health care providers might best support ethically and contextually appropriate palliative care in humanitarian contexts. An unintended outcome of the research was learning lessons about ethical dimensions of transnational …

'It Is A Disease Which Comes And Kills Directly': What Refugees Know About Covid-19 And Key Influences Of Compliance With Preventive Measures, Adelaide Lusambili, Michela Martini, Faiza Abdirahaman, Asante Abena, Joseph Guni, Sharon Ochieng, Stanley Luchters

Population Health, East Africa

Background: Refugees are at increased risk for COVID-19 infection in part due to their living conditions, which make it harder to adopt and adhere to widely accepted preventive measures. Little empirical evidence exists about what refugees know about COVID-19 and what they do to prevent infection. This study explored what refugee women and their health care workers understand about COVID-19 prevention, the extent of their compliance to public health recommendations, and what influences the adoption of these measures.

Methods: In October 2020, we conducted 25 in-depth interviews with facility and community health care staff (n = 10) and refugee women …

Health Of Asylees Compared To Refugees In The United States Using Domestic Medical Examination Data, 2014-2016: A Cross-Sectional Analysis., Gayathri S Kumar, Clelia Pezzi, Colleen Payton, Blain Mamo, Kailey Urban, Kevin Scott, Jessica Montour, Nuny Cabanting, Jenny Aguirre, Rebecca Ford, Stephen E Hughes, Breanna Kawasaki, Lori Kennedy, Emily S Jentes

College of Population Health Faculty Papers

Background: Between 2008 and 2018, persons granted asylum (asylees) increased by 168% in the United States. Asylees are eligible for many of the same domestic benefits as refugees under the US Refugee Admissions Program (USRAP), including health-related benefits such as the domestic medical examination. However, little is known about the health of asylees to guide clinical practice.

Methods: We conducted a retrospective cross-sectional analysis of domestic medical examination data from 9 US sites from 2014 to 2016. We describe and compare demographics and prevalence of several infectious diseases such as latent tuberculosis infection (LTBI), hepatitis B and C virus (HBV, …

Operationalizing Culture: Refugees, Migration, And Mental Health In The Wake Of The Vietnam War, Helena Bui

The Yale Undergraduate Research Journal

!e end of the Vietnam War led to the migration of hundreds of thousands of Vietnamese refugees to the United States a"er political and economic upheaval. As another result, the refugees’ years of warfare, trauma, death, and injury began to manifest as unprecedented mental health issues that American physicians and researchers sought to understand. In this paper, I argue that American medical professionals— in good faith—operationalized [Vietnamese] culture to help themselves and their colleagues understand the mental health issues of Vietnamese refugees. Yet this operationalization acted as a double-edged sword. Viewing Western mental health discourse through the lens of Vietnamese …

Barriers Associated With Mental Health Services For People With Refugee Background In Douglas County, Mustapha Barry

Capstone Experience

INTRODUCTION: The United States of America has been one of the leading countries where refugees from all over the world seek safety and security under the refugee resettlement program. Research suggests that refugees underutilize mental health services throughout the United States, despite the higher rates of mental health issues among refugees.

OBJECTIVE: This study explored barriers, support services, and factors associated with mental health services utilization among people with refugee backgrounds in Douglas County, Nebraska.

METHODS: Data from 30 participants were collected through a telephone survey and analyzed to determine participant’s level of mental health services utilization, barriers to mental …

How Art Therapy Can Ethically Address Symptoms Of Trauma With Asylum Seekers And Refugees, A Literature Review, Lydia Klauck

Expressive Therapies Capstone Theses

Asylum seekers at the Southern border of the United States of America have experienced a number of complex traumas due to premigration experiences in their country of origin as well as anti-immigration laws that cause further oppression and discrimination. The intention of this capstone thesis is to examine how art therapy can ethically address the symptoms of trauma seen in asylum seekers and refugees in the United States. This literature review looked at arts-based and qualitative studies conducted in other countries as well as literature about trauma-informed treatment within the psychotherapy field in order to address the gap in the …

Comparing The Health And Welfare Of Refugees And Non-Refugees At The Outset Of The Covid-19 Pandemic: The Results Of A Community Needs Assessment., Matthew J. Lyons, Mary Helen O'Connor, Iris Feinberg, Daniel J. Whitaker, Michael Eriksen, Ashli Owen-Smith, Saiza Jivani, Mohammad Tamer, Esther Kim, Ganaro Makor

Journal of Refugee & Global Health

Refugees are a vulnerable population who experience significant health disparities. They may also be at disproportionately high risk of adverse outcomes due to the COVID-19 pandemic. This paper presents the results of a community needs assessment to investigate the impact of the pandemic on health and welfare in a refugee relocation community in the United States. A multilingual data collection team made up of refugees surveyed 179 participants (128 refugees vs. 51 non-refugees). Only 55.9% of refugee respondents said they would be able to provide enough food for their family this week, compared with 84.0% of non-refugees (p < 0.01), and this difference was even greater for food next week …

Health Belief Model Implications For Cervical Cancer Screening Among Refugee Women In Omaha, Nebraska, Na-Omi Hassane Dan Karami

Capstone Experience

Literature gap

According to the World Health Organization (2020), cervical cancer is among the top four most common cancers in women. However, refugee women are the least screened for cervical cancer. There is limited research examining the uptake of cervical cancer screenings among refugee women using the health belief model. Little is known about barriers and facilitators associated with the uptake of cervical cancer screening among refugee women in Nebraska.

Objectives:

The purpose of the study is to assess the health behavior of refugee women in Omaha towards cervical cancer screening via the health belief model and to determine the …

Factors Affecting Pregnancy Outcome In Refugee Mothers In Lebanon, Hesham Elshal, Mohammad Chour, Sirine Abdel Halim, Sadika Kharpoutli, Hind Raad, Sami Abou Alfa, Rida Maaliki, Zeina Makki

BAU Journal - Health and Wellbeing

In recent years, Lebanon has been a destination for less privileged refugees who seek better living conditions and shelter from regional wars, conflicts and instabilities. Recently, it is estimated that more than 20% of residents in Lebanon are Syrian refugees who live under questionable conditions regarding quality of life. Pregnant women, among their population, are considered more vulnerable to the effect of such living conditions. This study aimed at assessment of pregnancy outcome (birth weight, infant complications…) in a sample of women in refugees areas who have recently given birth and relate this outcome to multiple factors including socioeconomic status …

Women Refugees, Resilience And Gardening In The U.S. [Poster], Kari Hartwig, Gao Lee, Raw Raen

Public Health Faculty Scholarship

Background: Refugees’ experience of integration into a new country and culture is often different from other immigrants. Many refugees are moving to escape torture, war, persecution and other hardships that require them to leave their home country. One concept of resilience refers to the ability to adapt and adjust to physical, emotional, and psychological stressors. The purpose of this qualitative research was to explore the relationship between gardening and resilience for refugee women (Bhutanese, Hmong and Karen) living in the Twin Cities of Minnesota.Methods: This qualitative study design, combined focus groups and face-to-face interviews with Bhutanese, Karen, and Hmong women …

Us Vs. Wales: Comparing And Improving Refugee Health Policy, Payton Ramsey

Senior Theses

Inadequate strides have been made to bolster the short and long-term health of growing numbers of refugees awaiting resettlement. The United Nations Higher Commission for Refugees (UNHCR), as well as many countries of resettlement, guarantee the right to health as signatories of the UN 1951 Refugee Convention, but in many situations refugee accessibility to healthcare and health resources is limited by time restrictions on benefits, immigration status, and/or financial circumstances.

This thesis provides a synopsis of the historical roots of current policies and legislative frameworks relating to refugee health for Wales and the US. Through the analysis of governmental policy …

The Experiences Of Iraqi Refugees In Canada: A Life History Study Of War And Resilience In The Aftermath Of Migration, Nada Nessan

Electronic Thesis and Dissertation Repository

This thesis reports on a life history narrative on the experiences of Iraqi refugees who resettled in Canada after living through war. The aim of this study is to help change the narrow perspectives on the mental health of war affected populations to a broader perception shaped by cultural and social aspects and to inform the development of meaningful and cultural relevant programs and policies with a particular attention to the concept of resilience.

The first part of the study presents the chronological narratives, or profiles. of eight participants. The second part of the study is a thematic discussion of …

The Lived Experience Of Syrian Refugees In Canada: A Phenomenological Study, Khaldoun Aldiabat, Enam Alsrayheen, Catherine Aquino-Russell, Michael Clinton, Roger Russell

The Qualitative Report

Health care providers in Canada are expected to take care of people from a variety of cultural backgrounds, and it is difficult for health care providers to deeply understand the lived experiences of some individuals to provide them with culturally sensitive care. Syrian refugees comprise one such group of newcomers to Canada. This phenomenological study aimed to uncover the meaning of the lived experiences of Syrian refugees using Giorgi’s (2009) method. Seven participants’ descriptions were viewed through the lens of the social determinants of health model. Seven essences of the general structural description or the meaning Syrian refugees gave to …

“We Have A Lot Of Home Deliveries” A Qualitative Study On The Impact Of Covid-19 On Access To And Utilization Of Reproductive, Maternal, Newborn And Child Health Care Among Refugee Women In Urban Eastleigh, Kenya, Adelaide Lusambili, Michela Martini, Faiza Abdirahman, Abena Asante, Sharon Ochieng, Joseph N. Guni, Rose Maina, Stanley Luchters

Population Health, East Africa

Background: Little is known about how pregnant refugee women, and the frontline health care workers who serve them, are affected by the COVID-19 pandemic in terms of health, and health service access. Women refugees are classified as a vulnerable group with regard to pregnancy outcomes and access to maternal care, and may be disproportionally at risk for COVID-19 infection as they are likely to face unique barriers to information and access to reproductive health services during the pandemic. Few studies identify gaps that could inform potential interventions to improve service uptake for refugee women, particularly in the context of …

Mitigating Toxic Stress In Children Affected By Conflict And Displacement, Anushka Ataullahjan, Muthanna Samara, Theresa S. Betancourt, Zulfiqar Ahmed Bhutta

Woman and Child Health

Anushka Ataullahjan and colleagues describe the myriad stressors related to conflict and displacement experienced by children and how best to reduce their negative effect

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …