Access Barriers to Services by Immigrant Mothers of Children with Autism in Canada.

Equal access for autism services remains suboptimal for diverse groups. In Canada, little is known about the barriers immigrant mothers face accessing services and support for their children with developmental disabilities. In this qualitative study, 21 immigrant mothers of children with Autism, from a diverse ethno cultural background, were interviewed in Toronto, Canada. We apply House's (1981) four domains of social support to analyze findings. Structural support challenges, such as delays in diagnosis, fragmented and dispersed services were common, followed by instrumental challenges due to loss of social ties and stigma. Lack of expected support from partners, and negative perceptions of services, were identified as emotional and perceptive challenges. Focused attention is required to address inequalities within the context of current access pathways for autism.

Neighborhood settings, types of social capital and depression among immigrants in Toronto.

PURPOSE: Few studies consider the associations between neighborhood social capital and immigrant's mental health. We examined associations between bonding, bridging and linking social capital and depression among immigrants in Toronto neighborhoods. METHODS: We used data on immigrants from the neighborhood effects on health and well-being (NEHW) study, conducted in 47 randomly selected greater Toronto area neighborhoods (sample = 916), and a study of one low-income, immigrant receiving neighborhood (IRN) (sample = 600). We conducted logistic regression models for depression (Epidemiologic Studies Depression Scale, CES-D) and social capital types: bonding (social cohesion and informal social control), bridging (group membership) and linking (engagement in political activities), while adjusting for different covariates. RESULTS: The prevalence of depression was 22.9 % in IRN and 21.4 % in NEHW. The associations between social capital types and depression differed in each sample. Lower social cohesion (bonding) was associated with higher depression in NEHW only. Lower linking social capital (never participated in political activities) was associated with lower depression in IRN only. These associations were consistent after adjustment for different covariates. CONCLUSIONS: Results suggest that social cohesion might have a protective effect from depression among immigrants in NEHW. In IRN, lower linking social capital associated with lower depression might reflect opposite direction association. Bridging social capital was not associated with depression in either sample, indicating that current community building might be insufficient to impact depression. Different pathways might explain how depression among immigrants is impacted by social capital types operating in different neighborhood settings; this could be examined in future longitudinal studies.

Stressors and Barriers to Services for Immigrant Fathers Raising Children with Developmental Disabilities.

This narrative review examines research on the experiences of immigrant fathers raising children with developmental disabilities, and considers the findings within the Canadian context. Applying Green, Johnson & Adams' (Journal of Chiropractic Medicine, 5(3), 101-117, 2006) methodology, a step-by-step process was followed to conduct the review. Four databases (PsychINFO, PubMed, CINAHL and Sociological Abstracts) were used for the search. A total of 39 articles were found to be relevant after applying the inclusion/exclusion criteria. Also 20 articles from published reference lists and peer-reviewed journal articles, located through Google Scholar, complimented the initial search. Along with House's (1981) four dimensions of social support, an intersectional approach underpinned the analysis of findings. Four themes were identified which included: economic challenges, social influences, cultural influences, and the changing gender roles of fathers. Stressors and barriers to accessing health services in the post-migration setting were examined. Based on the review's findings, the paper recommends 1) addressing income inequality, 2) improving access to health care, social and developmental services, 3) improving cultural-sensitivity of health care, social and developmental services, and 4) increasing participation of fathers. Overall, a more systemic understanding of immigrant fathers' experiences is called for, taking into account their multiple social locations.

"It is an Issue of not Knowing Where to Go": Service Providers' Perspectives on Challenges in Accessing Social Support and Services by Immigrant Mothers of Children with Disabilities.

In Canada little is known about the challenges immigrant mothers of children with disabilities encounter in accessing formal and informal social support. This paper presents the perspectives of service providers on the mothers' challenges. Data was collected from 27 service providers in Toronto, Canada in 2012 through in-depth interviews. The interview guide was informed by published literature on families of children with special needs. Level one analyses entailed descriptive analyses; and level two consisted of applying House's 4 domains of social support to organize the themes. Following House's domains, challenges to (1) Structural support, (2) Instrumental support, (3) Emotional support, and (4) Perception of support were identified. Among providers who work with families of children with disabilities there is recognition of the mothers' particular challenges in light of their immigration status. Language and communication are significant barriers for immigrant mothers in accessing social support.

Are residents of downtown Toronto influenced by their urban neighbourhoods? Using concept mapping to examine neighbourhood characteristics and their perceived impact on self-rated mental well-being.

BACKGROUND: There is ample evidence that residential neighbourhoods can influence mental well-being (MWB), with most studies relying on census or similar data to characterize communities. Few studies have actively investigated local residents' perceptions. METHODS: Concept mapping was conducted with residents from five Toronto neighbourhoods representing low income and non-low income socio-economic groups. These residents participated in small groups and attended two sessions per neighbourhood. The first session (brainstorming) generated neighbourhood characteristics that residents felt influenced their MWB. A few weeks later, participants returned to sort these neighbourhood characteristics and rate their relative importance in affecting residents' 'good' and 'poor' MWB. The data from the sorting and rating groups were analyzed to generate conceptual maps of neighbourhood characteristics that influence MWB. RESULTS: While agreement existed on factors influencing poor MWB (regardless of neighbourhood, income, gender and age), perceptions related to factors affecting good MWB were more varied. For example, women were more likely to rank physical beauty of their neighbourhood and range of services available as more important to good MWB, while men were more likely to cite free access to computers/internet and neighbourhood reputation as important. Low-income residents emphasized aesthetic attributes and public transportation as important to good MWB, while non-low-income residents rated crime, negative neighbourhood environment and social concerns as more important contributors to good MWB. CONCLUSION: These findings contribute to the emerging literature on neighbourhoods and MWB, and inform urban planning in a Canadian context.

Tackling inequity through a Photovoice project on the social determinants of health: translating Photovoice evidence to community action.

St. Jamestown is the most densely populated vertical immigrant-receiving urban neighbourhood in Canada. The Photovoice project engaged and empowered immigrant residents of St. Jamestown to influence public policy and secure improved local services for promoting health and well-being. Twenty-seven residents used photography and storytelling to record neighbourhood characteristics and their implications on residents' health and well-being. Eight participants presented recommendations actionable at neighbourhood level to the councillor and worked with the city to carry out the recommendations made that were recognized as important for neighbourhood residents' health and well-being. The results indicate Photovoice can be used to generate dialogue on community concerns and priorities and promote community action.

Concept mapping of photovoices: sequencing and integrating methods to understand immigrants' perceptions of neighborhood influences on health.

This inquiry successfully sequenced and integrated 2 participatory research methods: photovoice and concept mapping. In the photovoice phase, immigrant residents shared perceptions and thoughts of their neighborhood through photographs and stories, capturing neighborhood characteristics that influence their health and well-being. In the concept mapping phase, active involvement of immigrant residents was facilitated to systematically organize and build consensus around the wide range of neighborhood factors identified from the photovoice work. The combination of these 2 participatory methods resulted in a conceptual framework of factors influencing immigrants' health and well-being, whereas the photographs with captions facilitated interpretation and action at multiple levels.