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Developing population interventions with migrant women for maternal-child health: a focused ethnography.

Gagnon AJ, Carnevale F, Mehta P, Rousseau H, Stewart DE - BMC Public Health (2013)

Bottom Line: Several interventions related to services were described which varied in type and quality; these were generally found to be effective.A wealth of data was provided by participants on factors and processes related to the maternal-child health care of international migrants and associated population interventions.Our results offer a challenge to key stakeholders to improve existing interventions and create new ones based on the experiences and views of international migrant women themselves.

View Article: PubMed Central - HTML - PubMed

Affiliation: Ingram School of Nursing, McGill University, 3506 University St., Room 207, Montreal QC H3A 2A7, Canada. anita.gagnon@mcgill.ca

ABSTRACT

Background: Literature describing effective population interventions related to the pregnancy, birth, and post-birth care of international migrants, as defined by them, is scant. Hence, we sought to determine: 1) what processes are used by migrant women to respond to maternal-child health and psychosocial concerns during the early months and years after birth; 2) which of these enhance or impede their resiliency; and 3) which population interventions they suggest best respond to these concerns.

Methods: Sixteen international migrant women living in Montreal or Toronto who had been identified in a previous study as having a high psychosocial-risk profile and subsequently classified as vulnerable or resilient based on indicators of mental health were recruited. Focused ethnography including in-depth interviews and participant observations were conducted. Data were analyzed thematically and as an integrated whole.

Results: Migrant women drew on a wide range of coping strategies and resources to respond to maternal-child health and psychosocial concerns. Resilient and vulnerable mothers differed in their use of certain coping strategies. Social inclusion was identified as an overarching factor for enhancing resiliency by all study participants. Social processes and corresponding facilitators relating to social inclusion were identified by participants, with more social processes identified by the vulnerable group. Several interventions related to services were described which varied in type and quality; these were generally found to be effective. Participants identified several categories of interventions which they had used or would have liked to use and recommended improvements for and creation of some programs. The social determinants of health categories within which their suggestions fell included: income and social status, social support network, education, personal health practices and coping skills, healthy child development, and health services. Within each of these, the most common suggestions were related to creating supportive environments and building healthy public policy.

Conclusions: A wealth of data was provided by participants on factors and processes related to the maternal-child health care of international migrants and associated population interventions. Our results offer a challenge to key stakeholders to improve existing interventions and create new ones based on the experiences and views of international migrant women themselves.

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Suggested intervention modifications within education/daycare, housing, employment, immigration, welfare, and health sectors in the model.
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Figure 2: Suggested intervention modifications within education/daycare, housing, employment, immigration, welfare, and health sectors in the model.

Mentions: Vulnerable mothers described referral as a type of service in exclusively positive terms. Both vulnerable and resilient mothers described information/advice, teaching, child care and development, and provision of tangible items in more positive terms than negative. Participants also suggested modifications and creation of new programs that they considered necessary. These programs were categorized according to the Population Health Promotion Model [4]. Each suggestion was placed into the corresponding level of what, how, and who suggested by the cubed model. Those programs that were deemed to fit the ‘who’ level of ‘sector/system’ have been presented in Figure 2. The remaining suggestions can be found in Table 4.


Developing population interventions with migrant women for maternal-child health: a focused ethnography.

Gagnon AJ, Carnevale F, Mehta P, Rousseau H, Stewart DE - BMC Public Health (2013)

Suggested intervention modifications within education/daycare, housing, employment, immigration, welfare, and health sectors in the model.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3733625&req=5

Figure 2: Suggested intervention modifications within education/daycare, housing, employment, immigration, welfare, and health sectors in the model.
Mentions: Vulnerable mothers described referral as a type of service in exclusively positive terms. Both vulnerable and resilient mothers described information/advice, teaching, child care and development, and provision of tangible items in more positive terms than negative. Participants also suggested modifications and creation of new programs that they considered necessary. These programs were categorized according to the Population Health Promotion Model [4]. Each suggestion was placed into the corresponding level of what, how, and who suggested by the cubed model. Those programs that were deemed to fit the ‘who’ level of ‘sector/system’ have been presented in Figure 2. The remaining suggestions can be found in Table 4.

Bottom Line: Several interventions related to services were described which varied in type and quality; these were generally found to be effective.A wealth of data was provided by participants on factors and processes related to the maternal-child health care of international migrants and associated population interventions.Our results offer a challenge to key stakeholders to improve existing interventions and create new ones based on the experiences and views of international migrant women themselves.

View Article: PubMed Central - HTML - PubMed

Affiliation: Ingram School of Nursing, McGill University, 3506 University St., Room 207, Montreal QC H3A 2A7, Canada. anita.gagnon@mcgill.ca

ABSTRACT

Background: Literature describing effective population interventions related to the pregnancy, birth, and post-birth care of international migrants, as defined by them, is scant. Hence, we sought to determine: 1) what processes are used by migrant women to respond to maternal-child health and psychosocial concerns during the early months and years after birth; 2) which of these enhance or impede their resiliency; and 3) which population interventions they suggest best respond to these concerns.

Methods: Sixteen international migrant women living in Montreal or Toronto who had been identified in a previous study as having a high psychosocial-risk profile and subsequently classified as vulnerable or resilient based on indicators of mental health were recruited. Focused ethnography including in-depth interviews and participant observations were conducted. Data were analyzed thematically and as an integrated whole.

Results: Migrant women drew on a wide range of coping strategies and resources to respond to maternal-child health and psychosocial concerns. Resilient and vulnerable mothers differed in their use of certain coping strategies. Social inclusion was identified as an overarching factor for enhancing resiliency by all study participants. Social processes and corresponding facilitators relating to social inclusion were identified by participants, with more social processes identified by the vulnerable group. Several interventions related to services were described which varied in type and quality; these were generally found to be effective. Participants identified several categories of interventions which they had used or would have liked to use and recommended improvements for and creation of some programs. The social determinants of health categories within which their suggestions fell included: income and social status, social support network, education, personal health practices and coping skills, healthy child development, and health services. Within each of these, the most common suggestions were related to creating supportive environments and building healthy public policy.

Conclusions: A wealth of data was provided by participants on factors and processes related to the maternal-child health care of international migrants and associated population interventions. Our results offer a challenge to key stakeholders to improve existing interventions and create new ones based on the experiences and views of international migrant women themselves.

Show MeSH