Abstract
Canada received over 140,000 refugees and asylum seekers between 2015 and 2017. This paper presents a protocol with the purpose of generating robust baseline data on the oral health of this population and build a long-term program of research to improve their access to dental care in Canada. The three-phase project uses a sequential mixed methods design, with the Behavioral Model for Vulnerable Populations as the conceptual framework. In Phase 1a, we will conduct five focus groups (six to eight participants per group) in community organizations in Ontario, Canada, to collect additional sociocultural data for the research program. In Phase 1b, we will use respondent-driven sampling to recruit 420 humanitarian migrants in Ontario and Quebec. Participants will complete a questionnaire capturing socio-demographic information, perceived general health, diet, smoking, oral care habits, oral symptoms, and satisfaction with oral health. They will then undergo dental examination for caries experience, periodontal health, oral pain, and traumatic dental injuries. In Phase 2, we will bring together all qualitative and quantitative results by means of a mixed methods matrix. Finally, in Phase 3, we will hold a one-day meeting with policy makers, dentists, and community leaders to refine interpretations and begin designing future oral health interventions for this population.
Highlights
According to the United Nations (UN), there were 25.4 million refugees and 3.1 million asylum seekers globally by the end of 2017 [1]
Our research protocol attends to this gap, answering the overarching research question: What is the oral health status of newly arrived adult humanitarian migrants and how can oral health services better meet their needs? We have four sub-questions: Research Question (RQ) 1: How do newly arrived humanitarian migrants understand/perceive oral health?
We have developed our questionnaire with questions from these Behavioral Model for Vulnerable Populations (BMVP) domains; specific variables from these domains will be used in our analysis
Summary
According to the United Nations (UN), there were 25.4 million refugees and 3.1 million asylum seekers (humanitarian migrants) globally by the end of 2017 [1]. In 2008, the World Health Assembly adopted a resolution calling on member states to improve the health of migrants [3] These treaties morally oblige host countries to attend to the wellbeing of this population through health and social services policy. Humanitarian migrants often arrive in their host countries with poor health, limited finances, linguistic challenges, and greatly-reduced family and community support. They are severely disadvantaged when entering a new sociocultural and political system, and vulnerable to multiple health risks [4]. While humanitarian migrants often arrive after harried journeys, potentially with months or years in refugee camps and poor overall health, there is little information on their oral health status or experiences seeking oral health care [7,8]. High-quality data are needed to help service providers and policy makers understand both individual and system level barriers and facilitators to their oral health (e.g., sociocultural [13], religious [10,14]) in order to design appropriate policy and services [15]
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