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Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.

https://arctichealth.org/en/permalink/ahliterature126329
Source
Matern Child Health J. 2013 Feb;17(2):292-8
Publication Type
Article
Date
Feb-2013
Author
Mónica Ruiz-Casares
Cécile Rousseau
Audrey Laurin-Lamothe
Joanna Anneke Rummens
Phyllis Zelkowitz
François Crépeau
Nicolas Steinmetz
Author Affiliation
Department of Psychiatry, McGill University, Montreal, Canada. monica.ruizcasares@mcgill.ca
Source
Matern Child Health J. 2013 Feb;17(2):292-8
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attitude of Health Personnel
Canada
Child
Female
Health Care Surveys
Health Policy
Health Services - utilization
Health Services Accessibility - statistics & numerical data
Healthcare Disparities
Human Rights
Humans
Middle Aged
Pregnancy
Pregnant Women
Questionnaires
Socioeconomic Factors
Transients and Migrants - statistics & numerical data
Young Adult
Abstract
Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.
PubMed ID
22399247 View in PubMed
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Health materials and strategies for the prevention of immigrants' weight-related problems.

https://arctichealth.org/en/permalink/ahliterature149055
Source
Qual Health Res. 2009 Sep;19(9):1259-72
Publication Type
Article
Date
Sep-2009
Author
Manuela Ferrari
Stacey Tweed
Joanna Anneke Rummens
Harvey A Skinner
Gail McVey
Author Affiliation
University of Toronto, Ontario, Canada.
Source
Qual Health Res. 2009 Sep;19(9):1259-72
Date
Sep-2009
Language
English
Publication Type
Article
Keywords
Awareness
China - ethnology
Culture
Emigrants and Immigrants - psychology - statistics & numerical data
Focus Groups
Health education
Health promotion
Health Services Accessibility
Humans
Mothers - education - psychology
Obesity - epidemiology - prevention & control
Ontario - epidemiology
Qualitative Research
Sri Lanka - ethnology
Weight Loss
Abstract
Existing health education materials dealing with healthy eating, active living, and body image were examined by immigrant parents of elementary school children to determine their relevance, cultural competence, and accessibility. A total of 13 immigrant mothers from Sri Lanka and China participated in a series of three focus groups. Study findings indicate that the present health education materials intended to help prevent weight-related problems could be improved to better meet the needs of new immigrant families. Immigrant mothers who participated in the study expressed their preferences for health education materials and prevention interventions undertaken in a culturally relevant/competent, knowledge-sharing, participatory manner. Acting on these suggestions could help practitioners and public health agencies develop more effective strategies that meet the requirements of ethno-cultural immigrant communities.
PubMed ID
19690207 View in PubMed
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Perinatal outcomes of uninsured immigrant, refugee and migrant mothers and newborns living in Toronto, Canada.

https://arctichealth.org/en/permalink/ahliterature113429
Source
Int J Environ Res Public Health. 2013 Jun;10(6):2198-213
Publication Type
Article
Date
Jun-2013
Author
Karline Wilson-Mitchell
Joanna Anneke Rummens
Author Affiliation
Midwifery Education Program, Ryerson University, 350 Victoria Street, Toronto,Ontario, Canada. k.wilsonmitchell@ryerson.ca
Source
Int J Environ Res Public Health. 2013 Jun;10(6):2198-213
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adult
Emigrants and Immigrants - statistics & numerical data
Female
Health Services Accessibility
Humans
Infant, Newborn
Medically Uninsured - statistics & numerical data
Mothers
National Health Programs
Ontario - epidemiology
Perinatal Care - statistics & numerical data
Pregnancy
Pregnancy outcome
Refugees - statistics & numerical data
Retrospective Studies
Transients and Migrants - statistics & numerical data
Abstract
Canadian healthcare insurance is not universal for all newcomer populations. New immigrant, refugee claimant, and migrant women face various barriers to healthcare due to the lack of public health insurance coverage. This retrospective study explored the relationships between insurance status and various perinatal outcomes. Researchers examined and compared perinatal outcomes for 453 uninsured and provincially insured women who delivered at two general hospitals in the Greater Toronto Area between 2007 and 2010. Data on key perinatal health indicators were collected via chart review of hospital medical records. Comparisons were made with regional statistics and professional guidelines where available. Four-in-five uninsured pregnant women received less-than-adequate prenatal care. More than half of them received clearly inadequate prenatal care, and 6.5% received no prenatal care at all. Insurance status was also related to the type of health care provider, reason for caesarean section, neonatal resuscitation rates, and maternal length of hospital stay. Uninsured mothers experienced a higher percentage of caesarian sections due to abnormal fetal heart rates and required more neonatal resuscitations. No significant difference was found for low birth weight, preterm birth, NCIU admissions, postpartum hemorrhage, breast feeding, or intrapartum care provided.
Notes
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PubMed ID
23727901 View in PubMed
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Self-management, health service use and information seeking for diabetes care among Black Caribbean immigrants in Toronto.

https://arctichealth.org/en/permalink/ahliterature105106
Source
Can J Diabetes. 2014 Feb;38(1):32-7
Publication Type
Article
Date
Feb-2014
Author
Ilene Hyman
Enza Gucciardi
Dianne Patychuk
Joanna Anneke Rummens
Yogendra Shakya
Dragan Kljujic
Mehreen Bhamani
Fedaa Boqaileh
Author Affiliation
University of Toronto, Toronto, Ontario, Canada. Electronic address: i.hyman@utoronto.ca.
Source
Can J Diabetes. 2014 Feb;38(1):32-7
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adult
African Continental Ancestry Group
Caribbean Region - ethnology
Chi-Square Distribution
Diabetes Mellitus, Type 2 - ethnology
Emigrants and Immigrants
Female
Humans
Male
Middle Aged
Ontario
Patient Acceptance of Health Care - ethnology - statistics & numerical data
Self Care - methods
Abstract
The objective of this research was to explore self-management practices and the use of diabetes information and care among Black-Caribbean immigrants with type 2 diabetes.
The study population included Black-Caribbean immigrants and Canadian-born participants between the ages of 35 to 64 years with type 2 diabetes. Study participants were recruited from community health centres (CHCs), diabetes education centres, hospital-based diabetes clinics, the Canadian Diabetes Association and immigrant-serving organizations. A structured questionnaire was used to collect demographics and information related to diabetes status, self-management practices and the use of diabetes information and care.
Interviews were conducted with 48 Black-Caribbean immigrants and 54 Canadian-born participants with type 2 diabetes. Black-Caribbean immigrants were significantly more likely than the Canadian-born group to engage in recommended diabetes self-management practices (i.e. reduced fat diet, reduced carbohydrate diet, non-smoking and regular physical activity) and receive regular A1C and eye screening by a health professional. Black-Caribbean immigrant participants were significantly more likely to report receiving diabetes information and care through a community health centre (CHC) and nurses and dieticians than their Canadian-born counterparts.
CHCs and allied health professionals play an important role in the management of diabetes in the Black-Caribbean immigrant community and may contribute to this group's favourable diabetes self-management profile and access to information and care. Additional research is necessary to confirm whether these findings are generalizable to the Black-Caribbean community in general (i.e. immigrant and non-immigrant) and to determine whether the use of CHCs and/or allied health professionals is associated with favourable outcomes in the Black-Caribbean immigrant community as well as others.
PubMed ID
24485211 View in PubMed
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