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Background: Australia is one of the leading countries resettling people from refugee-like backgrounds. Catch-up immunisation is a key priority in this cohort. However, few studies have included asylum seekers and the adult age group in their study sample. In addition, Electronic Health Records (EHR) has recently been recognised as a vital tool in big data analysis with the capacity to contribute to informed strategic decision making. As such, the main aim of this study is to explore EHR routinely used in a specialised refugee clinic in South East Queensland to estimate the extent of catch-up immunisation and assess the factors associated with under-immunisation among refugees and asylum seekers., Methods: A quantitative study involving a secondary data analysis on a pre-existing dataset was undertaken. Relevant data was extracted from the EHR in the clinic. SPSS was used to perform Statistical data analysis., Results: The majority of clients originated from Papua New Guinea, followed by Iran and Afghanistan. When assessing the uptake of catch-up immunisations among refugees and asylum seekers, MMR (Measles-Mumps-Rubella), Polio and DTP (Diphtheria-Tetanus-Pertussis) had the highest uptake, while HPV (Human Papilloma Virus), Pneumococcal and Hib (Haemophilus influenza type b) immunisations had the lowest uptake. Binary logistic regression revealed that the younger patients, the refugees (compared to asylum seekers) and those with a longer residential duration in Australia are at a higher risk of being under-immunised., Conclusion: This study indicates that the broader group of immigrants, and in particular refugees and asylum seekers, do not represent a homogenous group in terms of immunisation coverage, and that each cohort should be carefully considered during immunisation interventions and strategies. This will be particularly important during targeted health promotions and future immunisation programs in this cohort., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Organisational health literacy is a promising area of research that enables a focus on how systems and services can be designed in ways that are responsive to populations with varying states and levels of health literacy, knowledge, and practices, including African refugees. The challenge is how organisations and professionals do this in practice, and research in this area is in its early stages. This qualitative study examined barriers to implementing health literacy responsive care practices in primary health care settings in Australia. It also offered suggestions to potentially address the barriers to improving organisational health literacy. Methods: Refugees (n = 19), primary health care professionals (n = 14), and other key stakeholders (n = 19) were recruited through convenience and snowball strategies from three states in Australia: New South Wales, Victoria, and Queensland. All but one participant was interviewed face-to-face via Zoom. Semi-structured interview guides were used to guide the conversations. Transcriptions from audio recordings were analysed using directed content analysis. Results: Thirteen themes were extracted from the data. Themes were organised into the following categories: structural and systemic, organisational context, individual professional level, individual patient level, and socio-community level. Major structural and system-level factors affecting organisational health literacy included rigid systems and structures and limited time. Key organisation-level factors included inflexible organisational processes and policies, institutionalised othering, discrimination and racism, and lack of interpreters. Individual professional factors were poor communication with patients and cultural knowledge gaps. Linguistic issues and service mistrust were key individual patient-level factors. Socio-community factors included limited community engagement. Participants identified potential solutions to help services navigate out of the barriers and improve their response to health literacy. Conclusion: The findings suggest that mainstream services and organisations could improve timely and appropriate health care access and utilisation for refugees through strategies such as designing services and health literacy programs with refugee communities, promoting health literacy champions in the workforce, integrating health literacy and culturally responsive care plans and strategies into organisational priorities. [ABSTRACT FROM AUTHOR]

This paper reveals the nature of the actions, discussions and relationships which characterised teachers’ and associated school personnel’s efforts to engage poor and refugee students through a community garden located in a school in a low socio-economic urban area in south-east Queensland, Australia. These actions, discussions and relationships are described as both revealing and producing particular ‘practice architectures’ which help constitute conditions for practice—in this case, conditions for beneficial student learning. The paper draws upon interview data with teachers, other school staff and community members working in the school to reveal the interrelating actions, discussions and relationships involved in developing and using the garden for academic and non-academic purposes. By better understanding such interrelationships as practice architectures, the paper reveals how teachers and those in schooling settings learn to facilitate student learning practices that likely to assist some of the most marginalised students in schooling settings. [ABSTRACT FROM PUBLISHER]

This article revisits the concept of empowerment that has underpinned the global movement to address gendered violence. Using a critical praxis lens, the article explores different understandings of empowerment that arose in interviews with front-line domestic violence workers who support refugee and migrant women experiencing gendered violence in Queensland, Australia. Two-thirds of the participants are from refugee and migrant backgrounds themselves. The findings reflect the shift in the service sector from more macro understandings of empowerment, grounded in feminist activism, to more micro understandings. In a context of neoliberal, bureaucratic service delivery, and limited means to address gendered violence that focus on women leaving and legal interventions, empowerment is sometimes viewed in individualistic, therapeutic terms of self-help. There is evidence that domestic violence services, founded on theories of empowerment, are now implicated in the surveillance and risk tracking role of social work as a profession, which has implications for survivor centeredness, agency, and equal participation. However, there is also evidence that front-line workers are aware of structural failings and questioning individualistic conceptions of empowerment amid broader concerns of social justice. Empowerment is viewed as transformative, with possibilities for more collective models aimed at addressing social justice. Outlining implications for feminist scholarship and practice, I suggest empowerment might be revisited by considering the differences between and within groups; structural violence and the consequences of interventions for marginalized groups; collective strategies aimed at broader structural change, such as poverty and race; and by strengthening the capacity of communities to respond to violence. [ABSTRACT FROM AUTHOR]

This paper reports findings of an Australian study on cross-cultural communication and employment of several African birthplace groups of former refugees. The study was conducted in the greater Brisbane area in 2009–10 and collected both quantitative (based on a short questionnaire) and qualitative (based on 12 focus groups) data. Drawing on the uncertainty reduction theory (URT), the segmented labour market theory (SLMT) and Bourdieu's concepts of linguistic and cultural capital, the paper focuses on cross-cultural communication aspects of job search (particularly the job interview situation), the workplace (communication with supervisors and co-workers) and overcoming linguistic and cultural obstacles in building bridging social networks. Existing power relations that structure the communication process, especially the ‘symbolic power’ aspect of Australian ethnic relations, are the context of our analysis. We also report on gender differences that additionally structure these processes in the job search and workplace contexts. [ABSTRACT FROM PUBLISHER]

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Over 4000 African refugees have resettled in Queensland through the Australian government's Humanitarian Program. Research on the settlement geography of this immigrant group is, however, limited. The present study is set within the context of research and debates concerning the residential concentration and/or dispersion patterns of immigrant settlement in Australia. The paper investigates the settlement and secondary migration geography of eight African refugee communities in Southeast Queensland. Discrepancies are identified between the official data and the actual distribution according to community members' views obtained via focus group surveys and interviews. Preliminary results indicate that there is a relatively high rate of secondary migration in the African communities. The paper also discusses the two key factors underpinning this secondary migration: housing and social networks. These findings have implications for settlement service providers, particularly in the area of housing. [ABSTRACT FROM AUTHOR]

Refugees are a particularly vulnerable population who undergo nutrition transition as a result of forced migration. This paper explores how involvement in a community food garden supports African humanitarian migrant connectedness with their new country. A cross-sectional study of a purposive sample of African refugees participating in a campus-based community food garden was conducted. Semi-structured interviews were undertaken with twelve African humanitarian migrants who tended established garden plots within the garden. Interview data were thematically analysed revealing three factors which participants identified as important benefits in relation to community garden participation: land tenure, reconnecting with agri-culture, and community belonging. Community food gardens offer a tangible means for African refugees, and other vulnerable or marginalised populations, to build community and community connections. This is significant given the increasing recognition of the importance of social connectedness for wellbeing.

This paper explores the cross-cultural application of the Edinburgh Postnatal Depression Scale (EPDS) and the difficulties associated with administration to women from refugee backgrounds. Assessing women's comprehension of individual scale items identified problems associated with "Western" terminology and concepts. Re-interpretation of discrete items on the scale was often necessary, raising doubts about the objectivity and reliability of scores. Our findings call for a closer examination of the ethnocentric assumptions underpinning the EPDS items, and the need to incorporate a more diverse range of cross-cultural understandings into future iterations.

Providing health care to newly arrived refugees within the primary health care system has proved challenging. The primary health care sector needs enhanced capacity to provide quality health care for this population. The Primary Care Amplification Model has demonstrated its capacity to deliver effective health care to patients with chronic disease such as diabetes. This paper describes the adaption ofthe model to enhance the delivery ofhealth care to the refugee community. A 'beacon' practice with an expanded clinical capacity to deliver health care for refugees has been established. Partnerships link this practice with existing local general practices and community services. Governance involves collaboration between clinical leadership and relevant government and non-government organisations including local refugee communities. Integration with tertiary and community health sectors is facilitated and continuing education of health care providers is an important focus. Early incorporation of research in this model ensures effective feedback to inform providers of current health needs. Although implementation is currently in its formative phase, the Primary Care Amplification Model offers a flexible, yet robust framework to facilitate the delivery of quality health care to refugee patients.

Objective: The purpose of this paper was to identify and explicate coping and resilience themes employed by 13 re-settled Sudanese refugees., Method: A sample of 13 Sudanese refugees was asked to describe their experience of coping in the three periods of their migration, namely: pre migration from Sudan, transit, and post migration in their host country. Members of the sample participated in qualitative interviews conducted with the assistance a bilingual community worker., Results: Three themes that characterized the experience of re-settled refugees across all periods were: religious beliefs, social support and personal qualities. A fourth less salient, theme, comparison with others, also emerged in the post-migration context., Conclusions: A number of themes associated with coping and resilience in response to trauma were identified. These themes may be translated into strategies to assist in responding constructively to trauma. Such approaches may be used to improve the well-being of re-settled refugees in Australia.

This article aims to problematize individualistic strategies developed in western institutions to address violence against women and suggests more collective responses that engage refugee men. The data comes from a qualitative research project in Southeast Queensland, Australia. Thirty-one interviews with frontline workers from domestic violence and refugee settlement organizations reveal dissenting voices that challenge the hegemony of dominant groups who either advocate gender equality or overemphasize cultural differences. These dissenting voices suggest new knowledge being mobilized by refugees and associated communities, presenting opportunities for nongovernmental organizations and community groups to find ways to align across their differences toward a common goal. [ABSTRACT FROM AUTHOR]

Introduction: In response to the growing number of new refugees settling in Queensland and the well documented challenges this population experiences in accessing the right care, at the right time, in the right place, a coordinated partnership approach was initiated. This was supported by engaging key partners, including the refugee communities themselves, new integrated models of care, a Refugee Health Network Qld and a refugee health and wellbeing policy for Queensland. The paper will address the key elements of the partnership, lessons learned, outcomes of the collaboration and implications for transferability. Policy Context and objectives: A lack of policy in refugee health was identified as a key barrier to improving access to care for this population. Language and cultural barriers, low health literacy, unfamiliarity with the Australian health system and access to health professionals with the experience in refugee health all contributed to the complexity. Over a three year period the Partnership Advisory Group (Qld) (PAG Q) comprising of Primary Health Networks, Hospital and Health Services, NGOs, General Practices, refugee background communities and Universities, worked towards developing new models of care and policy change. This culminated in the launch by the Minister for Health Hon Cameron Dick of the first 'Refugee Health and Wellbeing: A policy and action plan for Queensland 2017-2020' and the funding of the inaugural Refugee Health Network Qld. The action plan provides a platform for achieving better health outcomes through modifying usual practice to meet the needs of this population. Targeted population: People from a refugee background, including asylum seekers, who settle in Queensland. Highlights (innovation, Impact and outcomes): Some of the many initiatives and outcomes of the PAG Q include; - an innovative community engagement framework with the consistent input by the Refugee Health Advisory Group made up of 11 (G11) consultants from diverse refugee background; - Refugee Health Connect (RHC), a care provider contact point for refugee health issues; - the Refugee Health Network and website as the one point of reference for refugee health resources; and, - Refugee Health Clinical leads. The coordinated approach has assisted in raising awareness of the issues for people of refugee background and has been a vehicle for harnessing new health professionals, services and policy makers in this space. Comments on transferability: The model including the partnership and community engagement frameworks have high transferability for all hard to reach population. Other integrated models of care across tertiary and primary sectors will be able to use some of the key findings to inform sustainability and engagement strategies. Conclusions (comprising key findings, discussion and lessons learned): A coordinated partnership approach with all key stakeholders, including communities, is essential for informing good practice, developing and sustaining integrated models of care, and policy support reflective of the issues and needs of a hard to reach population. [ABSTRACT FROM AUTHOR]

The contemporary refugee crisis is an ongoing global concern. For the many East European displaced persons who were resettled in Queensland following the Second World War, these events are particularly poignant. Their prior experiences of violence, incarceration and encampment are being echoed in current developments, and contribute to their approach towards these events today. While scholars have considered generalised public attitudes towards refugees, little comparative research exists to assess the impact of this situation on displaced persons in Australia. Even less knowledge exists to inform practitioners', scholars', and policy makers' understanding of how former refugees are engaging with this current crisis, and thus how resettled refugees can be supported as they reconcile their own experiences of violence and loss with public debate surrounding the validity of refugees' claims for asylum. This article shows that the displacement and trauma of post-war Polish, Ukrainian, and Latvian displaced persons retain an ongoing influence on their perceptions of crisis and displacement in the present. It reveals a unique response to mass refugee movements that speaks to their own experiences as displaced persons. This reflects the way in which these displaced families' remembered experiences have become crucial to their engagement with contemporary events and refugees. [ABSTRACT FROM AUTHOR]

How can songwriting show us the meaning of music and language for health and wellbeing in culturally and linguistically diverse mothers? This article examines the artistic processes in music-cum-health workshops involving new and expectant mothers and their midwives. The voices of the mothers of colour have been silenced historically and systemically. To give them social justice in a health context, singing is a powerful tool and songwriting links this tool to useful health messages. Through this article, the formation of a song on the placenta, a key part of the womb in childbearing, is traced through the stories of a music facilitator, a mother and a midwife. The storying highlights the importance of artistic processes for understanding the person within and their cultural identity. The article argues that cultural understanding of the participants in such arts-in-health programmes is important for socially just models of health care for those at the margins. Summary From being instrumentalized as interventions that are 'administered' with an aim to garner health outcomes, art-based participatory approaches are now recognized as capable of activating culturally founded wellbeing in individuals. Through this article, I propose that as the focus shifts from what art does for health to what art means for a healthy life, the cultural vitality inherent in individuals and societies can be better championed in arts-in-health discourses. I discuss the artistic processes in singing and songwriting in a perinatal context involving mothers from culturally and linguistically diverse backgrounds and their midwives. I argue for lenses to better understand the role of cultural practices in health research involving migrant and refugee communities. Using narrative inquiry, I trace intersecting trajectories wherein the storied life of a coloured mother is intercepted by that of a midwife, and of myself, a coloured female mother-researcher and facilitator. At the intersection emerges a song, as a process and product. This article advances that it is when artmaking processes are centred that the voices from the margins become heard, and it is when their voices are amplified that health research design becomes equitable and ethically sound. [ABSTRACT FROM AUTHOR]

This study explored the issues facing young Vietnamese who have a sibling with an illicit drug addiction and the coping strategies that they and their families employ. This paper concentrated on the results from interviews/focus groups of Vietnamese parents and young people. There were some areas of commonality between the responses of the parent and youth cohorts. Issues of shame, guilt, grief and lack of support were raised by both groups. The reactions of parents and siblings change over time, as the negative impact of the user's behaviour intensified and family systems become strained. There were significant differences in the responses of the two cohorts in relation to parental behaviour. The youth cohort generally was critical of parental behaviour towards both children who are using illicit drugs and their non-using siblings. [ABSTRACT FROM AUTHOR]

Refugee women-at-risk represent a distinct and vulnerable refugee population. We investigated the psychometric properties of the Multidimensional Loss Scale (MLS) with 104 women-at-risk, recently-arrived in Australia. Cross-sectional survey included: the MLS (indexing loss events and loss distress); Harvard Trauma Questionnaire (Indexing Trauma Events and Trauma Symptoms), and; Hopkins Symptom Checklist-37 (indexing anxiety, depression, and somatization symptoms). Exploratory factor analyses of MLS loss distress revealed a six-factor model (loss of symbolic self; loss of home; loss of interdependence; loss of past aspirations; interpersonal loss, and; loss of intrapersonal integrity). Cronbach alphas indicated satisfactory internal consistency for loss events (0.83) and distress (0.88). Correlations supported convergent validity of loss distress with trauma symptoms (r = 0.41) and divergent validity with anxiety (r = 0.09), Depression (r = 0.29), and somatic (r = 0.24) symptoms. Findings support MLS use in assessment of loss and associated distress with refugee women-at-risk. [ABSTRACT FROM AUTHOR]

Resettled refugees in Australia have been shown to exhibit a high prevalence of limited health literacy and are at greater risk of mismanaging their medication and not being able to access the healthcare services they need. The aim of the current study is to explore the barriers to accessing medicines and pharmacy services in Queensland, Australia, among resettled refugees from Africa; this research was conducted from the perspectives of healthcare professionals and people who help the refugees to resettle in their adopted country (resettlement workers). A 'generic qualitative' approach was used in this study. In-depth interviews were conducted among healthcare professionals (two GPs, nine pharmacists and three nurse practitioners) and resettlement workers. Participants were recruited via a purposive snowball sampling method in the cities of Brisbane and Townsville, Queensland, Australia. Twenty-four in-depth interviews were conducted; 14 with healthcare professionals. Three key themes emerged from the data: (1) Communication Barriers; (2) Navigating the Health System; and (3) Belief Systems and Culture. Perceptions of those 'at the coalface' – healthcare professionals and people who are responsible for assisting refugees to resettle in Australia – provide insight into the language and cultural challenges experienced by resettled refugees from Africa regarding access to the Australian health system, including medicines and pharmacy services. [ABSTRACT FROM AUTHOR]

The study assessed the prevalence of obesity and related conditions among Sudanese adult migrants living in Brisbane, Australia. Data were obtained on 314 Sudanese immigrants aged 18-70 years. Measured body mass index (BMI) and self-reported diabetes and hypertension were obtained. More than half (51 %) of participants were overweight or obese, 6.4 % reported having type 2 diabetes while 12.4 % had hypertension. The full adjusted regression model explained 28.1 % of the variance in BMI. Odds of reporting type 2 diabetes increased with age, BMI and were greater among participants rating health as poor/fair than those rating as good/very good/excellent. Odds of high blood pressure increased with age, BMI, and were higher among participants rating health as poor/fair than those as good/very good/excellent. Health promotion programs to prevent weight gain in this subpopulation will significantly reduce inequalities related to type 2 diabetes and improve cardio-vascular outcomes. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the differences in health status and use of health services among a group of refugee men in South-east Queensland. Topics covered include the levels of subjective health status reported by participants, the poor health status reported by men living in urban areas and the need for programs that facilitate refugees' access to primary health care.