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Evidence that immigrants tend to be underserved by the health-care system in the hosting country is well documented. While the impacts of im/migration on health-care utilisation patterns have been addressed to some extent in the existing literature, the conventional approach tends to homogenise the experience of racialised and White immigrants, and the intersecting power axes of racialisation, immigration and old age have been largely overlooked. This paper aims to consolidate three macro theories of health/behaviours, including Bronfenbrenner's ecological theory, the World Health Organization's paradigm of social determinants of health and Andersen's Behavioral Model of Health Service Use, to develop and validate an integrated multilevel framework of health-care access tailored for racialised older immigrants. Guided by this framework, a narrative review of 35 Canadian studies was conducted. Findings reveal that racial minority immigrants' vulnerability in accessing health services are intrinsically linked to a complex interplay between racial-nativity status with numerous markers of power differences. These multilevel parameters range from socio-economic challenges, cross-cultural differences, labour and capital adequacy in the health sector, organisational accessibility and sensitivity, inter-sectoral policies, to societal values and ideology as forms of oppression. This review suggests that, counteracting a prevailing discourse of personal and cultural barriers to care, the multilevel framework is useful to inform upstream structural solutions to address power imbalances and to empower racialised immigrants in later life. [ABSTRACT FROM AUTHOR]

There is a need to identify barriers to participation as well as recruitment strategies to engage minority parents of young children in health-oriented research. This paper offers insights on strategies and challenges in recruiting black immigrant mothers living in Ottawa (Canada) for a community-based health-oriented research project among 6-to-12-year-old children. We recruited 259 mother-child dyads. Most participants were recruited by team members during community events, fairs, religious gatherings, etc. Other successful strategies included referral from participants, community partners, and through research team members' networks. Mass media strategies were mostly ineffective. Instant and meaningful incentives, developing community partnerships, building and ensuring study legitimacy and trust, placing convenience of participants ahead of that of research team members, doing community outreach, and taking contact information on the spot, as well as using word-of-mouth were essential to recruiting. This study clearly indicates the importance of adopting multiple recruitment strategies. [ABSTRACT FROM AUTHOR]