Search

Early intervention programmes are designed to address complex inequities for Canadian families living with low income, affecting social relationships, well-being and mental health. However, there is limited understanding of resiliency and change in families living with low income over time. We conducted a mixed methods study with recent immigrant, other Canadian-born, and Aboriginal families living with low income, who attended a two-generation preschool programme (CUPS One World) between 2002 and 2008. The aim of this study was to develop an understanding of the processes of change. We included 134 children and their caregivers living with low income, and experiencing mental health problems, addiction or social isolation. Children's receptive language, a proxy for school readiness, was measured at programme intake, exit, and age 10 years using the Peabody Picture Vocabulary Test 3rd Edition (PPVT-III). In Phase I (quantitative), we identified children with receptive language scores in the top and bottom 25th percentile, informing participant selection for Phase II. In Phase II (qualitative), we engaged in constructivist grounded theory to explore experiences of 14 biological mothers, after their children (n = 25) reached age 10 years. Interviews were conducted between June and September 2015. The core category, Stepping Stones to Resiliency, encompassed Perceptions of Family, Moving Forward, Achieving Goals, and Completely Different. Perceptions of Family influenced families' capabilities to move across the Stepping Stones to Resiliency. Stepping Stones to Resiliency provides a lens from which to view others in their daily challenges to break free of painful intergenerational cycles. It is a reminder of our struggle, our shared humanness, and that movement towards resiliency is more difficult for some than others. Our findings challenge traditional episodic, biomedical treatment paradigms for low-income families also experiencing intergenerational cycles of mental health problems, addictions, social isolation, and family violence., (© 2017 John Wiley & Sons Ltd.)

This paper examines the process of professional resocialization among internationally educated health care professionals (IEHPs) in Canada. Analyzing data from qualitative interviews with 179 internationally educated physicians, nurses, and midwives and 70 federal, provincial and regional stakeholders involved in integration of IEHPs, we examine (1) which aspects of professional work are modified in transition to a new health care system; (2) which aspects of professional practice are learned by IEHPs in the new health environment, and (3) how IEHPs maintain their professional identity in transition to a new health care system. In doing so, we compare the accounts of IEHPs with the policy stakeholders' positions and analyze the similarities and the differences across three health care professions (medicine, nursing, and midwifery). This enables us to explore the issue of professional resocialization from the analytical intersection of gender, professional dominance, and institutional/organizational lenses., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Health coaching is a new intervention offering a one-on-one focused self-management support program. This study implemented a health coaching pilot in primary care clinics in Eastern Ontario, Canada to evaluate the feasibility and acceptability of integrating health coaching into primary care for patients who were either at risk for or diagnosed with diabetes., Methods: We implemented health coaching in three primary care practices. Patients with diabetes were offered six months of support from their health coach, including an initial face-to-face meeting and follow-up by email, telephone, or face-to-face according to patient preference. Feasibility was assessed through provider focus groups and qualitative data analysis methods., Results: All three sites were able to implement the program. A number of themes emerged from the focus groups, including the importance of physician buy-in, wide variation in understanding and implementing of the health coach role, the significant impact of different systems of team communication, and the significant effect of organizational structure and patient readiness on Health coaches' capacity to perform their role., Conclusions: It is feasible to implement health coaching as an integrated program within small primary care clinics in Canada without adding additional resources into the daily practice. Practices should review their organizational and communication processes to ensure optimal support for health coaches if considering implementing this intervention.

Most research on the phenomenon of "brain drain" (one-way flow of highly skilled/educated individuals) has focused on movement between the least developed and most highly developed countries. Therefore, the significance of patterns of migration to middle-income countries such as those in Latin America is less clear. The aim of this study was to outline key features of international health worker "brain drain" to Chile to promote discussion and further research on this phenomenon as it pertains to the Latin American region. The study compared immigrant health workers living in Chile to both Chilean-born health workers and other immigrants living in Chile using a qualitative nationwide dataset (the results of Chile's 2009 National Socioeconomic Characterization Survey). Demographic, socioeconomic, and health-related variables were included in the analyses, which were weighted by population to obtain nationally representative estimates. In 2009, immigrant health workers represented 2.2% of all health personnel and 2.6% of all resident immigrants in the country. While most immigrant health workers had a universitylevel education, about 25% had only a high school-level education or less. There was no statistically significant difference between the distribution of immigrant health workers' household income and that of Chilean-born health workers. A significantly higher proportion of the immigrant group reported no entitlement to health care provision. While the results of this study do not indicate a significant international health worker "brain drain" to Chile, they do suggest distinctive patterns of migration within the Latin American region. Future studies in Chile could confirm the validity of these results, using a larger sample of immigrant health workers.

This article examines how much women know about government services and benefits and discusses why this type of knowledge matters. Using data from a survey as well as focus groups conducted in Montreal and Toronto, we show that the women who are most likely to need information about these programs are often the least likely to be aware of them. This is especially true of low-income women, older women, and women who came to Canada as immigrants. We end by suggesting some steps that could be taken to address these knowledge gaps.

This article uses accessibility as an analytical tool to examine health care access among immigrants in a multicultural urban setting. It applies and improves on two widely used accessibility models—the gravity model and the two-step floating catchment area model—in measuring spatial accessibility by Mainland Chinese immigrants in the Toronto Census Metropolitan Area. Empirical data on physician-seeking behaviors are collected through two rounds of questionnaire surveys. Attention is focused on journey to physician location and utilization of linguistically matched family physicians. Based on the survey data, a two-zone accessibility model is developed by relaxing the travel threshold and distance impedance parameters that are traditionally treated as a constant in the accessibility models. General linear models are used to identify relationships among spatial accessibility, geography, and socioeconomic characteristics of Mainland Chinese immigrants. The results suggest a spatial mismatch in the supply of and demand for culturally sensitive care, and residential location is the primary factor that determines spatial accessibility to family physicians. The article yields important policy implications.

This paper examines the development of inter-ethnic friendships between immigrants and Canadians. It uses longitudinal data from three waves of the Canadian LSIC survey, in which newly arrived immigrants were followed during the first 4 years of settlement. It is found that pre-migration characteristics play an important role in the development of inter-ethnic friendships: immigrants who arrive at a younger age and for economic reasons, as well as those who are highly educated and have a cross-ethnic partner at the moment of arrival, establish more inter-ethnic friendships over time. In addition, post-migration characteristics affect the formation of inter-ethnic friendships. Such friendships are more common among immigrants who embrace Canadian traditions and acquire the host-country language, as well as among those who work in international settings and inhabit ethnically mixed neighborhoods. The effects of pre-migration characteristics are partially mediated by post-migration characteristics. Our findings point out that economic, cultural, and spatial integration are all conducive to inter-ethnic friendships.

Objective: Immigrants are a vital component of the current and future ethnic aging population in Canada. This study was undertaken to explore the health status of elderly Chinese immigrants in a western Canadian city and to identify the major determinants of their physical and psychological well-being., Method: Using a 50% random sample of elderly Chinese residing in three residential complexes occupied exclusively by individuals of ethnic Chinese origin located in downtown Calgary, a total of 147 Chinese seniors were interviewed in their homes by trained, bilingual interviewers using a structured questionnaire that covered a wide range of topics including health status, social network, living arrangements, use of health-related services, and socio-demographic information., Data Analysis: Descriptive and inferential analyses were conducted using the Statistical Package for the Social Sciences. A principal component factor analysis using varimax rotation was performed to explore the underlying factorial structure of the seven items measuring well-being. The internal consistency of all scales used was assessed by Cronbach's alpha reliability test. Two multiple ordinary least-squares (OLS) regression models were constructed to identify the major determinants of respondents' physical and psychological well-being., Results: The findings revealed that a majority of the participants described their physical health as good or very good. Results of multiple OLS regression analysis demonstrated that education, country of origin, use of medications, physical mobility, and perceived financial needs were significantly associated with physical well-being, whereas sex, marital status, length of residence, education, and physical mobility were significantly related to psychological well-being., Conclusion: Healthcare professionals, service providers, and policy-makers need to understand the significant impact of the various socio-demographic and background variables that contribute to the well-being of community-dwelling Chinese elderly immigrants. The provision of culturally sensitive and linguistically appropriate healthcare, social, and medical services is needed for the growing older Chinese population. Future studies should compare the health status of foreign-born Chinese seniors with those who were native-born, as well those co-residing with adult children.

We use data from three waves of the Longitudinal Survey of Immigrants to Canada to compare how pre-immigration experience in hi-tech and regulated occupations affects employment outcomes. While differences do decline over time, those with experience in an unregulated hi-tech occupation are more likely to be employed sooner in a matching and/or full time job. Immigrants with hi-tech occupational experience are more likely to have their foreign experience accepted, possibly due to the transferability of these skills and the absence of institutional barriers. These findings indicate important sectoral, regulatory, and institutional differences in the treatment of pre-immigration experience, with policy implications.

We compare the retirement prospects of immigrant men with their native-born counterparts. Using data from the Survey of Labour and Income Dynamics, we estimate a significant gap of 43 percent in private pension income and 30 percent in private pension contributions between immigrants and the native born. The gap in public pension incomes is negligible and reduces the overall pension gap, but only partially. Furthermore, the pension income and contribution gap is significantly larger for more recently arrived immigrant cohorts, consistent with evidence of weaker earnings for this group. We provide age profiles of pension income and contributions and discuss problems in interpreting the results without adjusting for age. Controlling for age and earnings differences, immigrants are still about 11 percent less likely to make contributions to a private pension program, but there is no difference in the contribution rates out of earnings of those who contribute. Recently arrived immigrants are significantly less likely to make contributions to a private pension program and appear to be neglecting private pension contribution opportunities more than earlier immigrants and the native born, which may have adverse implications for Canada's public retirement programs.

During the past decade, Manitoba's Provincial Nominee Program (MPNP) has increased immigration to the province and dispersed immigrants more widely within Manitoba. At the same time, the rapid growth of the program and the decentralized way in which it has been implemented have contributed to some challenges. This ten-year analysis of the MPNP finds that many places in Manitoba are experiencing settlement service gaps, and that immigrants and communities are taking on much of the burden for MPNP application and settlement. In addition, the analysis demonstrates that the fragmented way in which the MPNP has been marketed and implemented (i.e., by relying on particular employers, consultants, and ethnocultural organizations) has resulted in a sort of ethnocultural inequality where certain groups are ushered into the province-often to perform particular occupations-while others are bypassed.

Aim: Little or no attempt has been made to determine why nurses leave Canada, remain outside of Canada, or under what circumstances might return to Canada. The purpose of this study was to gain an understanding of Canadian-educated registered nurses working in the USA., Data Sources: Data for this study include the 1996, 2000 and 2004 USA National Sample Survey of Registered Nurses and reports from the same time period from the Canadian Institute for Health Information., Findings: This research demonstrates that full-time work opportunities and the potential for ongoing education are key factors that contribute to the migration of Canadian nurses to the USA. In addition, Canada appears to be losing baccalaureate-prepared nurses to the USA., Discussion: These findings underscore how health care policy decisions such as workforce retention strategies can have a direct influence on the nursing workforce. Policy emphasis should be on providing incentives for Canadian-educated nurses to stay in Canada, and obtain full-time work while continuing to develop professionally., Conclusion: Findings from this study provide policy leaders with important information regarding employment options of interest to migrating nurses., Study Limitations: This study describes and contrasts nurses in the data set, thus providing information on the context of nurse migration from Canada to the USA. Data utilized in this study are cross-sectional in nature, thus the opportunity to follow individual nurses over time was not possible.

Immigrants account for 20% of the population and 60% of total population growth in Canada (Statistics Canada 2001). The majority of immigrants are accepted for entry to Canada under the Skilled Worker Program in order to fill employment shortages in the labour market (CIC 2007). Recent research has revealed that an increasing number of immigrants who gain entry under this programme face significant barriers to employment. As a result, many remain unemployed or accept employment outside of and below their field of education and training. However, the impacts such employment circumstances have on the health of immigrants have not yet been examined. This paper presents the results of a collaborative research project that explores the health impacts of under/unemployment among skilled immigrants in Mississauga, Ontario, Canada. In-depth interviews are used to examine the experiences of employment and perceptions of subsequent health impacts among 22 recent immigrants. The participants most frequently identified mental health impacts due to a lack of income, loss of employment-related skills, loss of social status and family pressures. These health concerns are also extended to family members. In addition to mental health, physical health is perceived to be affected by employment circumstances through high levels of stress and strenuous working conditions. These findings shed light on the nature of the links between employment and health relationship as well as determinants of immigrant health. Additional research is required to examine the long-term effects of under/unemployment.

During the mass Jewish immigration of Eastern-European Jews to Canada in the first decades of the twentieth century, Yiddish publications offered a primary forum for a group of local writers to negotiate with their new identities as Canadian Jews. Within this wider process, Montreal writers H.M. Caiserman and B.G. Sack authored studies of Canadian literature in the early 1920s centred on Mohawk-English writer E. Pauline Johnson (Tekahionwake). What these essays show is that, despite the long-standing association of Canada's Jewish population with the country's dominant English culture, their status as "other" impelled leading members of the local Yiddish cultural milieu to seek out literary models among other historically marginalized groups. For Caiserman and Sack, Johnson's Native heritage offered a model for resistance to assimilation into Canada's dominant culture. In contrast, the advent of literature responding to the Nazi Holocaust by A.M. Klein and Eli Mandel, Native peoples became a symbol of loss and vanished landscapes.

Background: Most immigrants to Canada now come from Asia, the Middle East, the Caribbean and Africa, where cultures and languages often differ significantly from the Canadian context. Subgroups of immigrants experience disparities in health. Inability to communicate in an official language in Canada may be a marker of risk for poor health due to both pre- and post-migration factors. We aimed to study the relationship between language proficiency and self-reported health., Methods: We conducted a cross-sectional analysis of the first two surveys of the Longitudinal Survey of Immigrants to Canada (2001, 2003), a population-based cohort study of new immigrants to Canada. Specifically, we used logistic regression analyses to examine the relationship between self-reported health and language proficiency by sex, controlling for a range of health determinants at 6 months (wave 1) and 2 years (wave 2) after arrival., Results: After controlling for covariates (age, sex, education, region of birth, immigrant class, job satisfaction, access to health care), analysis of the wave 1 survey showed that poor proficiency in English or French is significantly related to the self-reported poor health (OR=2.0, p<0.01). And this relationship was consistent in the wave 2 survey (OR=1.9, p<0.01). We also found that this statistically significant association between poor language proficiency and self-reported health holds only for women (wave 1 survey OR=2.6, p <0.01, wave 2 survey OR=2.2, p<0.01), not for men., Conclusion: The association between poor language proficiency and poor self-reported health, and particularly its significantly greater impact on women, has implications for language training, health care and social services, and health information.

This study examines the ethnic identity experiences of second-generation Finnish immigrant youth in Canada. The study draws from interviews conducted among second-generation Finnish immigrant youth in Ottawa. How these individuals identify with the Finnish ethnic group and engage in ethnic culture may play a pivotal role in the continuance of Finnish culture in Canada. Therefore, it is necessary to understand not only whether second-generation Finnish immigrants identify with their ethnic group, but also how they do so. We found that the youth identified with their Finnish ethnicity on a symbolic level, participating occasionally in the local ethnic community, but not living within ethnic culture on a day-to-day basis. They identify strongly with being Canadian and have an appreciation of multiculturalism and contrast it with Finnish society when they visit Finland.

This article examines the bicultural identity formation and cultural experiences internalized by second-generation Indo-Canadians in their efforts to accommodate the "best of both worlds" into their lifestyle. The objectives of this article are to educate the reader to become cognizant of the bicultural issues encountered by second-generation Indo-Canadians; to demonstrate interventions suitable for the second-generation Indo-Canadian populations; and to increase the readers' understanding of bicultural identity formation. What becomes evident is that intergenerational dialogue has a profound impact on the bicultural identity formation of this population. It will serve to guide these individuals to find a third space (Bhabha 2004) or zone of proximal development (ZPD) to encourage evolvement of their bicultural identity (Cummins 1996; Gutiérrez et al. 1999).