How Do Health Schemas Inform Healthy Behaviours During Pregnancy? Qualitative Findings from the Be Healthy in Pregnancy (BHIP) Study
Maternal and Child Health Journal, Feb 25, 2022
Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for ... more Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women are frequently not engaging in healthy behaviours linked to appropriate weight gain. The purpose of the current study was to explore women’s values and beliefs related to weight, nutrition and physical activity during pregnancy and to describe how these beliefs influence their behaviours. As part of a larger randomized controlled trial, we conducted 20 focus groups with 66 pregnant women between 16 and 24-weeks gestation using a semi-structured interview guide. Focus groups were recorded and transcribed verbatim and analyzed using a grounded theory approach. Three personal health schemas emerged from the findings which illustrated women’s diverging beliefs about their health behaviours in pregnancy. ‘Interconnected health’ described beliefs regarding the impact their health had on that of their growing baby and awareness of risks associated with inappropriate weight gain. ‘Gestational weight gain as an indicator of health’ illustrated perceptions regarding how GWG impacted health and the utility of guidelines. Finally, ‘Control in pregnancy’ described the sense of agency over one’s body and health. Our results showed that health-related behaviours in pregnancy are driven by personal health schemas which are often discordant with clinical evidence. Interventions and health care provider advice aimed at behaviour modification would benefit from first understanding and addressing these schemas. Tackling the conflict between beliefs and behaviour may improve health outcomes associated with appropriate weight gain in pregnancy.
Historically, health research involving Indigenous peoples has been fraught with problems, includ... more Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally appropriate oral-data collection methods, excluding interviews and focus groups, for use with Indigenous people in Canada. Results suggest that photovoice, symbol-based reflection, circles and story-telling can be methodologically rigorous and culturally appropriate methods of collecting data with this population. Suggestions are made for researchers wishing to use these methods to promote respectful and collaborative research partnerships with Indigenous peoples in Canada.
A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and ... more A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12-17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. Although the intervention compared to control group was more likely to achieve GWG within recommendations (OR = 1.51; 95% CI (0.81, 2.80)) and total GWG was lower by 1.45 kg (95% CI: (-11.9, 8.88)) neither reached statistical significance. The intervention group achieved significantly higher protein intake at 26-28 week (mean difference (MD); 15.0 g/day; 95% CI (8.1, 21.9)) and 36-38 week gestation (MD = 15.2 g/day; 95% CI (9.4, 21.1)) and higher healthy diet scores (22.5 ± 6.9 vs. 18.7 ± 8.5, p < 0.005) but step counts were similar averaging 6335 steps/day. Pregnancy and infant birth outcomes were similar between groups. While the structured and monitored nutrition with counselling improved diet quality and protein intake and may have benefited GWG, the exercise goal of 10,000 steps/day was unachievable. The results can inform future recommendations for diet and physical activity in pregnancy.
Background: In Canada, approximately 13% of the population lives with multiple chronic conditions... more Background: In Canada, approximately 13% of the population lives with multiple chronic conditions. Newcomers, including refugees, have the same or higher risk of developing chronic diseases as their host population. In 2015-2016, Canada welcomed almost 40, 000 newcomers from Syria. This study aimed to (1) understand adult newcomer health needs for self-management of non-infectious chronic conditions; and (2) identify strategies to improve access to health care services to meet these needs. Methods: This study used a qualitative descriptive design. Interviews and focus groups were conducted with consenting newcomers, service providers and community agency administrators. Interview guides were developed with input from community partners and snowball sampling was used. Results: Participants included 22 Syrian newcomers and 8 service providers/administrators. Findings revealed the initial year of arrival as one of multiple adjustments, often rendering chronic disease management to a lower priority. Self-care and self-management were not routinely incorporated into newcomer lives though community health agencies were proactive in creating opportunities to learn self-management practices. Gaps in access to care were prevalent, including mental health services which typically were not well developed for trauma and post-traumatic stress disorder (PTSD), particularly for men. Newcomers expressed frustration with lengthy wait times and not being able to access specialists directly. Youth frequently played a key role in translation and disseminating information about services to their families. Conclusion: Chronic disease management was a low priority for newcomers who were focussed on resettlement issues such as learning English or finding work. Provision of practical supports such as bus tickets, translation, and information about the healthcare system were identified as means of improving access to care.
Canadian’s attitudes toward immigration in the COVID-19 era
Migration Letters, Jul 20, 2021
Canada depends on immigration for economic and demographic growth. But fears of COVID-19 and atte... more Canada depends on immigration for economic and demographic growth. But fears of COVID-19 and attempts to control its spread have resulted in governments closing borders and/or restricting immigration. Concurrently, increased discrimination against people from Asia, and immigrants in general, has been observed. Based on a national survey, this paper examines whether Canadian’s attitudes toward immigration have shifted with the pandemic. Results suggest that Canadians have concerns regarding immigration and would prefer to see immigration numbers reduced. Increased racism and discrimination directed toward immigrants and racialized individuals is also noted.
Canadian Journal of Nursing Research Archive, Feb 19, 2018
In Canada, Indigenous infants experience significant health disparities when compared to non-Indi... more In Canada, Indigenous infants experience significant health disparities when compared to non-Indigenous infants, including significantly higher rates of birth complications and infant mortality rates. The use of primary health care is one way to improve health outcomes; however, Indigenous children may use health services less often than non-Indigenous children. To improve health outcomes within this growing population, it is essential to understand how caregivers, defined here as mothers, select and use health services in Canada. This integrative review is the first to critique and synthesize what is known of how Indigenous mothers in Canada experience selecting and using health services to meet the health needs of their infants. Themes identified suggest both Indigenous women and infants face significant challenges; colonialism has had, and continues to have, a detrimental impact on Indigenous mothering; and very little is known about how Indigenous mothers select and use health services to meet the health of their infants. This review revealed significant gaps in the literature and a need for future research. Suggestions are made for how health providers can better support Indigenous mothers and infants in their use of health services, based on what has been explored in the literature to date. Keywords Canadian health services, infants, maternal/child, transcultural nursing, Indigenous people, equitable health access In Canada, Indigenous infants experience significant health disparities when compared to non-Indigenous infants, including significantly higher rates of birth complications and infant mortality rates (10.2 to 23.1 vs. 5 deaths per 1000 live births) (Smylie, Crengle, Freemantle, & Taualii, 2010; Smylie, Fell, Ohlsson, & Joint Working Group on First Nations, Indian, Inuit, 2010). Indigenous peoples, including First Nations, Me´tis and Inuit, are the fastest growing cultural group within Canada, with a population increase of 22% between 2006 and 2011 (Statistics Canada, 2013). It is therefore essential to understand the health needs of Indigenous infants to improve the health outcomes of this growing population. Due to colonization, Indigenous people were forced to relocate to reserves, and lost their traditional governance structures, lifestyles, and cultures (The Truth and Reconciliation Commission of Canada, 2012). Later, Indigenous children were removed from their homes to attend residential schools where they often experienced situations of neglect and abuse (The Truth and Reconciliation Commission of Canada, 2012). The impacts of these traumas have caused multigenerational effects on child development, self-worth, and health
Access to palliative care, and more specifically the alleviation of avoidable physical and psycho... more Access to palliative care, and more specifically the alleviation of avoidable physical and psychosocial suffering is increasingly recognized as a necessary component of humanitarian response. Palliative approaches to care can meet the needs of patients for whom curative treatment may not be the aim, not just at the very end of life but alleviation of suffering more broadly. In the past several years many organizations and sectoral initiatives have taken steps to develop guidance and policies to support integration of palliative care. However, it is still regarded by many as unfeasible or aspirational in crisis contexts; particularly where care for persons with life threatening conditions or injuries is logistically, legally, and ethically challenging. This article presents a synthesis of findings from five qualitative sub-studies within a research program on palliative care provision in humanitarian crises that sought to better understand the ethical and practical dimensions of huma...
‘Strange eyes’: Immigrant perceptions of racism during the COVID‐19 pandemic
Population, Space and Place
As the COVID‐19 pandemic emerged, instances of anti‐immigrant racism and more specifically anti‐A... more As the COVID‐19 pandemic emerged, instances of anti‐immigrant racism and more specifically anti‐Asian racism appeared to increase across Canada. Recognising the need to further explore and document racism and its link with the COVID‐19 pandemic, this paper explores the impact of COVID‐19 on the experiences of racism and discrimination. Using neoracism as a theoretical framework, the research is set in the city of Hamilton, Ontario, a city that has struggled with high levels of racism and discrimination in recent years. The paper draws upon both an online survey as well as interviews that explored the lived experiences of racialized individuals within the city and their experiences with racism as the pandemic progressed. Results note that individuals felt that racism and discrimination increased during the pandemic and was experienced in housing, the labour force and other public situations.
International Journal of Qualitative Methods, 2019
The Two-Eyed Seeing framework advocates viewing the world with one eye grounded in Indigenous kno... more The Two-Eyed Seeing framework advocates viewing the world with one eye grounded in Indigenous knowledges while the other eye is grounded in Westernized knowledges. Research funding bodies have recently advocated for its use in research with Indigenous peoples, yet its interpretation and application in the literature has been inconsistent. To contribute to its maturation as a framework, this article describes the application of Two-Eyed Seeing to a community-engaged study aimed at understanding how Indigenous mothers experience using health care to meet the health needs of their infants in Hamilton, Ontario, Canada. Two-Eyed Seeing was applied to the research while applying the four R’s as suggested by Kirkness and Barnhardt’s: relevance, respect, responsibility, and reciprocity. While providing practical applications of this framework to research with Indigenous mothers and infants in an urban off-reserve setting, this article also contributes an approach to data analysis that incor...
International Journal of Environmental Research and Public Health
This qualitative study explored the commonalities and differences among the experiences of visibl... more This qualitative study explored the commonalities and differences among the experiences of visible minority Transnational Carer–Employees (TCEs) before and after COVID-19. TCEs are immigrants who live and work in the country of settlement while providing caregiving across international borders. Purposive and snowball sampling resulted in the participation of 29 TCEs of Pakistani, Syrian, African, and South American origin living in London, Ontario. Thematic analysis of the dataset using the ATLAS.ti software, Version 23.2.1., generated three themes: (1) feelings associated with transnational care; (2) employment experiences of TCEs; and (3) coping strategies for well-being. The results of the secondary analysis conducted herein suggested that there are more similarities than differences across the four cohorts. Many participants felt a sense of satisfaction at being able to fulfill their care obligations; however, a different outlook was observed among some Syrian and African origin...
This study explores how teenage Syrian refugees use their social networks to cope with stressors.... more This study explores how teenage Syrian refugees use their social networks to cope with stressors. Through interviews with nine youth aged 16 to 18 living in Ontario, Canada, stressors related to pre- and post-migration emerged. Family, peers, school staff, and organizations were identified as social networks, each having unique reasons why they were selected. Coping was categorized as individualistic or collectivistic. Teenage Syrian refugees draw upon social resources to navigate situations they are faced with, and cultural values influence the stress and coping process. Findings have implications for mental health care providers and policy-makers focused on migrant resettlement.
Background This case analysis describes dilemmas and challenges of ethical partnering encountered... more 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 research partnerships, which is the focus of this case analysis. Discussion There exist ongoing challenges for international collaborative research in humanitarian conflict-induced settings. Research partnerships were crucial for connecting with key stakeholders associated with the full ...
How Do Health Schemas Inform Healthy Behaviours During Pregnancy? Qualitative Findings from the Be Healthy in Pregnancy (BHIP) Study
Maternal and Child Health Journal, Feb 25, 2022
Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for ... more Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women are frequently not engaging in healthy behaviours linked to appropriate weight gain. The purpose of the current study was to explore women’s values and beliefs related to weight, nutrition and physical activity during pregnancy and to describe how these beliefs influence their behaviours. As part of a larger randomized controlled trial, we conducted 20 focus groups with 66 pregnant women between 16 and 24-weeks gestation using a semi-structured interview guide. Focus groups were recorded and transcribed verbatim and analyzed using a grounded theory approach. Three personal health schemas emerged from the findings which illustrated women’s diverging beliefs about their health behaviours in pregnancy. ‘Interconnected health’ described beliefs regarding the impact their health had on that of their growing baby and awareness of risks associated with inappropriate weight gain. ‘Gestational weight gain as an indicator of health’ illustrated perceptions regarding how GWG impacted health and the utility of guidelines. Finally, ‘Control in pregnancy’ described the sense of agency over one’s body and health. Our results showed that health-related behaviours in pregnancy are driven by personal health schemas which are often discordant with clinical evidence. Interventions and health care provider advice aimed at behaviour modification would benefit from first understanding and addressing these schemas. Tackling the conflict between beliefs and behaviour may improve health outcomes associated with appropriate weight gain in pregnancy.
Historically, health research involving Indigenous peoples has been fraught with problems, includ... more Historically, health research involving Indigenous peoples has been fraught with problems, including researchers not addressing Indigenous research priorities and then subsequently often failing to utilize culturally appropriate methods. Given this historical precedence, some Indigenous populations may be reluctant to participate in research projects. In response to these concerns, the Government of Canada has developed the Tri-Council Policy Statement (TCPS2): Research Involving the First Nations, Inuit and Métis Peoples of Canada, which stipulates the requirements for research collaborations with Indigenous communities. Utilizing this policy as an ethical standard for research practices, this paper describes, critiques and synthesizes the literature on culturally appropriate oral-data collection methods, excluding interviews and focus groups, for use with Indigenous people in Canada. Results suggest that photovoice, symbol-based reflection, circles and story-telling can be methodologically rigorous and culturally appropriate methods of collecting data with this population. Suggestions are made for researchers wishing to use these methods to promote respectful and collaborative research partnerships with Indigenous peoples in Canada.
A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and ... more A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12-17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. Although the intervention compared to control group was more likely to achieve GWG within recommendations (OR = 1.51; 95% CI (0.81, 2.80)) and total GWG was lower by 1.45 kg (95% CI: (-11.9, 8.88)) neither reached statistical significance. The intervention group achieved significantly higher protein intake at 26-28 week (mean difference (MD); 15.0 g/day; 95% CI (8.1, 21.9)) and 36-38 week gestation (MD = 15.2 g/day; 95% CI (9.4, 21.1)) and higher healthy diet scores (22.5 ± 6.9 vs. 18.7 ± 8.5, p < 0.005) but step counts were similar averaging 6335 steps/day. Pregnancy and infant birth outcomes were similar between groups. While the structured and monitored nutrition with counselling improved diet quality and protein intake and may have benefited GWG, the exercise goal of 10,000 steps/day was unachievable. The results can inform future recommendations for diet and physical activity in pregnancy.
Background: In Canada, approximately 13% of the population lives with multiple chronic conditions... more Background: In Canada, approximately 13% of the population lives with multiple chronic conditions. Newcomers, including refugees, have the same or higher risk of developing chronic diseases as their host population. In 2015-2016, Canada welcomed almost 40, 000 newcomers from Syria. This study aimed to (1) understand adult newcomer health needs for self-management of non-infectious chronic conditions; and (2) identify strategies to improve access to health care services to meet these needs. Methods: This study used a qualitative descriptive design. Interviews and focus groups were conducted with consenting newcomers, service providers and community agency administrators. Interview guides were developed with input from community partners and snowball sampling was used. Results: Participants included 22 Syrian newcomers and 8 service providers/administrators. Findings revealed the initial year of arrival as one of multiple adjustments, often rendering chronic disease management to a lower priority. Self-care and self-management were not routinely incorporated into newcomer lives though community health agencies were proactive in creating opportunities to learn self-management practices. Gaps in access to care were prevalent, including mental health services which typically were not well developed for trauma and post-traumatic stress disorder (PTSD), particularly for men. Newcomers expressed frustration with lengthy wait times and not being able to access specialists directly. Youth frequently played a key role in translation and disseminating information about services to their families. Conclusion: Chronic disease management was a low priority for newcomers who were focussed on resettlement issues such as learning English or finding work. Provision of practical supports such as bus tickets, translation, and information about the healthcare system were identified as means of improving access to care.
Canadian’s attitudes toward immigration in the COVID-19 era
Migration Letters, Jul 20, 2021
Canada depends on immigration for economic and demographic growth. But fears of COVID-19 and atte... more Canada depends on immigration for economic and demographic growth. But fears of COVID-19 and attempts to control its spread have resulted in governments closing borders and/or restricting immigration. Concurrently, increased discrimination against people from Asia, and immigrants in general, has been observed. Based on a national survey, this paper examines whether Canadian’s attitudes toward immigration have shifted with the pandemic. Results suggest that Canadians have concerns regarding immigration and would prefer to see immigration numbers reduced. Increased racism and discrimination directed toward immigrants and racialized individuals is also noted.
Canadian Journal of Nursing Research Archive, Feb 19, 2018
In Canada, Indigenous infants experience significant health disparities when compared to non-Indi... more In Canada, Indigenous infants experience significant health disparities when compared to non-Indigenous infants, including significantly higher rates of birth complications and infant mortality rates. The use of primary health care is one way to improve health outcomes; however, Indigenous children may use health services less often than non-Indigenous children. To improve health outcomes within this growing population, it is essential to understand how caregivers, defined here as mothers, select and use health services in Canada. This integrative review is the first to critique and synthesize what is known of how Indigenous mothers in Canada experience selecting and using health services to meet the health needs of their infants. Themes identified suggest both Indigenous women and infants face significant challenges; colonialism has had, and continues to have, a detrimental impact on Indigenous mothering; and very little is known about how Indigenous mothers select and use health services to meet the health of their infants. This review revealed significant gaps in the literature and a need for future research. Suggestions are made for how health providers can better support Indigenous mothers and infants in their use of health services, based on what has been explored in the literature to date. Keywords Canadian health services, infants, maternal/child, transcultural nursing, Indigenous people, equitable health access In Canada, Indigenous infants experience significant health disparities when compared to non-Indigenous infants, including significantly higher rates of birth complications and infant mortality rates (10.2 to 23.1 vs. 5 deaths per 1000 live births) (Smylie, Crengle, Freemantle, & Taualii, 2010; Smylie, Fell, Ohlsson, & Joint Working Group on First Nations, Indian, Inuit, 2010). Indigenous peoples, including First Nations, Me´tis and Inuit, are the fastest growing cultural group within Canada, with a population increase of 22% between 2006 and 2011 (Statistics Canada, 2013). It is therefore essential to understand the health needs of Indigenous infants to improve the health outcomes of this growing population. Due to colonization, Indigenous people were forced to relocate to reserves, and lost their traditional governance structures, lifestyles, and cultures (The Truth and Reconciliation Commission of Canada, 2012). Later, Indigenous children were removed from their homes to attend residential schools where they often experienced situations of neglect and abuse (The Truth and Reconciliation Commission of Canada, 2012). The impacts of these traumas have caused multigenerational effects on child development, self-worth, and health
Access to palliative care, and more specifically the alleviation of avoidable physical and psycho... more Access to palliative care, and more specifically the alleviation of avoidable physical and psychosocial suffering is increasingly recognized as a necessary component of humanitarian response. Palliative approaches to care can meet the needs of patients for whom curative treatment may not be the aim, not just at the very end of life but alleviation of suffering more broadly. In the past several years many organizations and sectoral initiatives have taken steps to develop guidance and policies to support integration of palliative care. However, it is still regarded by many as unfeasible or aspirational in crisis contexts; particularly where care for persons with life threatening conditions or injuries is logistically, legally, and ethically challenging. This article presents a synthesis of findings from five qualitative sub-studies within a research program on palliative care provision in humanitarian crises that sought to better understand the ethical and practical dimensions of huma...
‘Strange eyes’: Immigrant perceptions of racism during the COVID‐19 pandemic
Population, Space and Place
As the COVID‐19 pandemic emerged, instances of anti‐immigrant racism and more specifically anti‐A... more As the COVID‐19 pandemic emerged, instances of anti‐immigrant racism and more specifically anti‐Asian racism appeared to increase across Canada. Recognising the need to further explore and document racism and its link with the COVID‐19 pandemic, this paper explores the impact of COVID‐19 on the experiences of racism and discrimination. Using neoracism as a theoretical framework, the research is set in the city of Hamilton, Ontario, a city that has struggled with high levels of racism and discrimination in recent years. The paper draws upon both an online survey as well as interviews that explored the lived experiences of racialized individuals within the city and their experiences with racism as the pandemic progressed. Results note that individuals felt that racism and discrimination increased during the pandemic and was experienced in housing, the labour force and other public situations.
International Journal of Qualitative Methods, 2019
The Two-Eyed Seeing framework advocates viewing the world with one eye grounded in Indigenous kno... more The Two-Eyed Seeing framework advocates viewing the world with one eye grounded in Indigenous knowledges while the other eye is grounded in Westernized knowledges. Research funding bodies have recently advocated for its use in research with Indigenous peoples, yet its interpretation and application in the literature has been inconsistent. To contribute to its maturation as a framework, this article describes the application of Two-Eyed Seeing to a community-engaged study aimed at understanding how Indigenous mothers experience using health care to meet the health needs of their infants in Hamilton, Ontario, Canada. Two-Eyed Seeing was applied to the research while applying the four R’s as suggested by Kirkness and Barnhardt’s: relevance, respect, responsibility, and reciprocity. While providing practical applications of this framework to research with Indigenous mothers and infants in an urban off-reserve setting, this article also contributes an approach to data analysis that incor...
International Journal of Environmental Research and Public Health
This qualitative study explored the commonalities and differences among the experiences of visibl... more This qualitative study explored the commonalities and differences among the experiences of visible minority Transnational Carer–Employees (TCEs) before and after COVID-19. TCEs are immigrants who live and work in the country of settlement while providing caregiving across international borders. Purposive and snowball sampling resulted in the participation of 29 TCEs of Pakistani, Syrian, African, and South American origin living in London, Ontario. Thematic analysis of the dataset using the ATLAS.ti software, Version 23.2.1., generated three themes: (1) feelings associated with transnational care; (2) employment experiences of TCEs; and (3) coping strategies for well-being. The results of the secondary analysis conducted herein suggested that there are more similarities than differences across the four cohorts. Many participants felt a sense of satisfaction at being able to fulfill their care obligations; however, a different outlook was observed among some Syrian and African origin...
This study explores how teenage Syrian refugees use their social networks to cope with stressors.... more This study explores how teenage Syrian refugees use their social networks to cope with stressors. Through interviews with nine youth aged 16 to 18 living in Ontario, Canada, stressors related to pre- and post-migration emerged. Family, peers, school staff, and organizations were identified as social networks, each having unique reasons why they were selected. Coping was categorized as individualistic or collectivistic. Teenage Syrian refugees draw upon social resources to navigate situations they are faced with, and cultural values influence the stress and coping process. Findings have implications for mental health care providers and policy-makers focused on migrant resettlement.
Background This case analysis describes dilemmas and challenges of ethical partnering encountered... more 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 research partnerships, which is the focus of this case analysis. Discussion There exist ongoing challenges for international collaborative research in humanitarian conflict-induced settings. Research partnerships were crucial for connecting with key stakeholders associated with the full ...
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Papers by Olive Wahoush