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Open Access Publications from the University of California

Scholarly Works (3 results)

  • Thesis
  • Peer Reviewed
UC San Diego Electronic Theses and Dissertations (2024)

Introduction: Maternal morbidity remains a grand global health challenge with gestational hypertension (G-HTN) being one of the leading causes. Previous research found an association between low hypertension management among marginalized communities and the social determinants of health, especially among displaced populations, including refugees. Migration stressors are prevalent in refugees, but limited research describes how these experiences affect pregnancy. Little is known about refugee women’s experiences with G-HTN management, especially in countries of first asylum, such as Jordan, which hosts around 1.3 million Syrian refugees. This qualitative study offers an analysis of the multilevel barriers related to G-HTN management among refugee women living in Jordan in 2023.Methods: The study utilizes the social-ecological model of health to examine barriers to G-HTN management. We recruited a total of twenty community-dwelling Syrian refugee women with a history of or current G-HTN through a refugee community center in Jordan. Ten in-depth interviews and one focus group were conducted by a trained native-speaker research team. Interviews were conducted in Arabic, transcribed, translated, and coded using inductive thematic analysis. Results: At the personal level, participants expressed a general knowledge about G-HTN. On the interpersonal level, loss of social support emerged as a significant barrier. Many individuals were uncomfortable sharing their personal lives with current social networks, resulting in feelings of isolation when it came to asking for resources and expressing the need to receive extra guidance on self-management from providers. At the institutional level, barriers included healthcare costs and the absence of institutional support in providing blood pressure monitors. On the community level, cultural and societal expectations around reproduction, such as approval of contraception use, created stress, impacting their ability to manage their health. At the policy level, women noted the limited policies to allow refugee women to join the local workforce. Discussion: Like other chronic health conditions, G-HTN and its management are detrimentally influenced by the overall status of the healthcare infrastructure for refugees. Addressing barriers across the SEM would likely increase the effective management of G-HTN among refugee women in countries of first asylum.

    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2023)

    Background

    Refugee women who leave their country due to persecution and violence have multiple barriers to sexual and reproductive health (SRH) services. The COVID-19 pandemic added an additional barrier to in-person reproductive health education, dialogue, and clinical care. This study aimed to assess the potential of using virtual group meetings as a forum for refugee women to learn about and discuss reproductive health concerns such as cervical cancer screening, family planning, childbirth, and postpartum care.

    Method

    We conducted semi-structured interviews with 36 refugee women and stakeholders to assess factors that impact refugee women's receptiveness for virtual platforms to obtain information and engage in discussions on reproductive health. Thematic analysis was conducted using the software Dedoose.

    Results

    Openness to engage in virtual platforms varied by refugee community, women's demographic, and life experience. The women's involvement with local refugee groups facilitated their engagement with virtual platforms. Furthermore, individuals' family structure and marital relationship, along with literacy and English proficiency, and access to and familiarity with technology impacted engagement. Virtual groups needed to mirror confidentiality and women expressed a strong preference that groups were all-women.

    Conclusion

    Refugee women are receptive to virtual groups on SRH when they are offered in a culturally appropriate manner that considers the living situations and access to technology after arrival to the USA. Findings from this study provide a framework to develop and tailor effective virtual or hybrid virtual-in-person programs for women in refugee communities.
      Cover page: Refugee Women’s Receptiveness for Virtual Engagement on Reproductive Health During the COVID-19 Pandemic
      • Article
      • Peer Reviewed
      UC San Diego Previously Published Works (2023)
      BACKGROUND: Mounting evidence is revealing disparities in cognitive function and heightened dementia risk among refugees, yet research in this area remains scant. Despite bearing most of the worlds refugee burden, limited-resource countries like Jordan are facing challenges when dealing with refugee health. There is a lack of research on the attitudes toward dementia and the cognitive healthcare gaps among refugees in Jordan. METHODS: 32 older (≥ 55 years) Syrian refugees resettled in Jordan were recruited through a local community-based organization and interviewed in four focus groups (2 female and 2 male groups). Interviews were transcribed and translated, then coded using inductive thematic analysis. RESULTS: Mean age of the sample was 60.1 years and 53.1% were female. Only 34.4% rated their memory as good or excellent. Themes were organized using the socioecological model: 1) At the individual level, participants believed high levels of stress, including low socioeconomic status, poor health, and traumatic history from their refugee experience increased their dementia risk. 2) Interpersonally, there is a fear of dementia due to the possible impact and burden on loved ones, particularly with the stigma surrounding dementia. 3) At the community level, participants noted that resettlement in Jordan - with a shared language, religion, and culture - offered protective effects due to facilitated access to social connection, information, and mental health self-care. 4) At the institution and policy level, participants believed older refugees faced restrictive policies for economic aid, healthcare, and employment, presenting a significant barrier to healthy aging. CONCLUSIONS: Findings from this study are the first to examine the attitudes of Syrian refugees in Jordan toward dementia and cognitive aging. These results could provide essential data inclusive of refugees as Jordan develops its National Dementia Plan. Investing in dementia awareness interventions and age-friendly neighborhoods may benefit aging refugees in limited-resources settings.
        Cover page: Attitudes toward dementia and cognitive aging among Syrian refugees resettled in Jordan: a qualitative study.
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