Transnational health care practices among Afghan, Syrian and Ukrainian refugee older adults in the Greater Toronto Area

Project Lead(s)
Sepali Guruge, Lu Wang, Kateryna Metersky
Team Members
Areej Al-Hamad, Yasin Yasin, Lixia Yang, Jordana Salma, Cristina Catallo, Zhixi Zhuang
Refugees are forced to migrate often due to war and other civil, political, social environmental and economic unrest. While this population exhibits high levels of resilience, they often face considerable physical and mental health consequences as well as major barriers to (re)settling in a new country.

Objective
Transnational health care practices (THP) are part of a response to lack of access to care and unmet health needs related to language, geographic access, cost, wait times and perceived service quality, particularly later in life. A considerable research gap exists in Canada and elsewhere on THP among refugees, and refugee older adults, in particular.
The overall study purpose is to generate a comprehensive understanding of the role THPs play in the lives of Afghan, Syrian, and Ukrainian refugee older adults in the Greater Toronto Area (GTA), and the factors, processes, and stakeholders that shape these refugee older adults’ perceptions of, access to, and engagement with THPs.

Research question(s)
- How are refugee older adults perceiving and experiencing THP in terms of quality, effectiveness, and related contextual factors?
- What is the role of THP in terms of stress perception, coping, and resilience in the context of health promotion, illness diagnosis, and disease management among refugee older adults?
- What health-related information, care, supports, technology use and services need to be in place in the GTA for Afghan, Syrian, and Ukrainian refugee older adults to manage their health and wellbeing locally?

Methodology
This study will adopt a constructivist grounded theory approach, a qualitative inductive method that helps explore the presence of social processes associated with complexities of worldviews and multiple realities. Constructivist grounded theory will be used to combine interpretivism, critical theory, and social constructivism. Activities carried out in the study include scoping reviews, individual interviews with a purposeful sample of Afghan, Syrian, and Ukrainian refugee older adults living in the GTA, and a set of focus groups.

Status
The projetc is currently ongoing.
Expected completion date: December 2026
Publications
Yasin, Y. M., Al-Hamad, A., Guruge, S., Metersky, K., Catallo, C., Wang, L., Yang, L., Zhuang, Z., & Salma, J. (2024). Healthcare practices among refugee older adults: A scoping review protocol. Open Science Framework. https://doi.org/10.17605/OSF.IO/J8V4U (external link)
Yasin, Y. M., Al-Hamad, A., Guruge, S., Metersky, K., Catallo, C., Wang, L., Yang, L. Zhuang, Z., Salma, J., MacKenzie-Ede, F., Charbonneau, K., & Ravichandran, A. (2024). Healthcare practices among refugee older adults: A scoping review protocol. International Health Trends and Perspectives, 4(2), 310–316. https://journals.library.torontomu.ca/index.php/ihtp/article/view/2240

Key words
Greater Toronto Area; older adults; refugees; refugee older adults; transnational healthcare practices