Women In Winnipeg Research Articles

A QUALITATIVE STUDY ON NEEDS AND BARRIERS TO MENTAL HEALTHCARE SERVICE ACCESS BY REFUGEE WOMEN IN WINNIPEG, MANITOBA, CANADA

The world refugee crisis is currently at a record level. Refugees have an increased risk of developing mental illness like post-traumatic stress disorder (PTSD), depression, and somatic symptoms because of their exposure to violence. Despite increased healthcare needs, refugees face considerable barriers in accessing services. Women refugees may have unique mental healthcare needs due to their vulnerability to gender-based violence and abuse during flight from war. This study explores the mental healthcare need, availability of support and barriers in accessing services among Syrian refugee women in Winnipeg. Semi-structured interviews were conducted with nine refugee women and six service providers/decision makers. The data were analyzed using a qualitative thematic approach aided by NVivo 12 qualitative software. The most cited barriers in accessing mental healthcare services were language, weather, unemployment, stigma, system navigation, different understandings of mental health and illness, and lack culturally competent care. Results from this study can inform decision makers of issues requiring policy responses to improve mental healthcare for refugee women in Manitoba.

User and Provider Perspectives on Improving Mental Healthcare for Syrian Refugee Women in Winnipeg, Manitoba, Canada

Introduction: Refugees have higher risk of developing mental illness like anxiety, depression and Post-Traumatic Stress Disorder as they flee from violence. Women refugees may have unique mental healthcare needs due to their vulnerability to gender-based violence and abuse during flight from war. The research question of this study was what the health system can do better to address the mental healthcare needs of refugee women in Winnipeg. Methods: Semi-structured interviews were conducted with 9 Syrian refugee women and 6 service providers/decision makers. The interviews were analyzed using qualitative inductive analysis and coded for themes based on recurring issues. Results: Limited understanding of mental health and illness among refugees, stigma, and the need for culturally competent care were noted by the service providers. System navigation, language, unemployment and safety of family members left behind in Syria were the main concerns of the refugee women. While there are many programs available for refugee women in Winnipeg, lack of collaboration and coordination among providers was identified. Conclusions: This study recommends that service providers use resources developed by UNHCR and Canadian physicians in providing culturally competent care, decision makers take leadership roles in implementing better collaboration among agencies, employers be open in hiring refugees and everyone in the society ensures that the refugee women feel welcomed and included.

Health behaviour in the face of cultural conflict: perceptions of immigrant Muslim women

PurposeThe purpose of this paper is to describe immigrant Muslim women’s perceived barriers and facilitators to health behaviours relating to the interface between the cultural backgrounds of the participants and the predominant culture in Canada.Design/methodology/approachA case study approach was taken to conduct ten in-depth semi-structured interviews followed by three focus groups with immigrant women in Winnipeg, Canada. A demographic questionnaire, acculturation scale, and interview guides were used for data collection. Constant comparison analytic method was utilised to extract and refine themes.FindingsA total of 32 adult Muslim women who had emigrated from 14 countries in Asia and Africa participated in this study. Most of the participants had medium to high levels of acculturation and enculturation. Through the in-depth analysis of the participants’ insights, these factors emerged as determinants of health behaviours related to cultural interactions: changes in gender role, mistrusting the unfamiliar, feelings of alienation, new construction of time, and reconstruction of private and public spheres. These themes display the participants’ conceptual and practical adaptations in Canada.Research limitations/implicationsThe perspectives of those with poor spoken English language skill and the participants’ history of immigration were not obtained in this study limiting the study’s findings.Practical implicationsThis paper reveals factors that potentially influence immigrant Muslim women’s health behaviours and should be considered when designing health promotion programs for similar groups.Originality/valueThis is the first paper focusing on cultural determinants of immigrant Muslim women’s health behaviour in a non-metropolitan Canadian city. Findings can help health promoters design culturally competent programs for this growing population to garner its greater participation.

Projecting Cracks, Bending Borders: Exploring Gendered Racial Violence in Un/bound

This article engages performance art as a critical intersticiality in which to excavate those necropolitical forces that mobilize human rights for (white) settlers across the same civic spaces in which racialized others are brutalized and die, in Canada, in 2016. Moving with several scholars of antiracism, dance studies and Indigenous theory, I self-reflexively analyze my piece “Un/bound,” that explores gendered racial violence against Indigenous women in Winnipeg, Manitoba. Contextualizing my performance within the larger installation Storying and Unsettling Ourselves,I discuss the powers of art to incite shifts in consciousness, where settlers, as artist-scholars, move from spaces of guilt into spaces of direct action in the struggle against colonial violence in Canada, and across the hemispheres.

Infectious syphilis in women: what’s old is new again?

The aim of this study was to examine trends in infectious syphilis epidemiology among women in Winnipeg, Canada. A descriptive study of syphilis among Winnipeg residents between 2003 and 30 June 2015 was undertaken. Adjusted rate ratios (ARR) and 95% confidence intervals (95%CI) from Poisson regression analyses are reported. Characteristics of men and women were compared using logistic regression, with adjusted odds ratios (AOR) reported. Between 2014 and 2015, the rate of syphilis was 1.7/100,000, representing a five-fold increase since 2006-2013. All cases have been heterosexual, 90% 20-39 years of age, and 59% living in Winnipeg's inner core. Approximately 24% were pregnant at diagnosis; no cases of congenital syphilis have been reported. Compared to men, women were more likely to report alcohol use (AOR: 3.8, 95% CI: 1.2-11.9) and co-infection with chlamydia (AOR: 5.0, 95% CI: 1.1-22.9). In conclusion, the rates of infectious syphilis are increasing among women. Prenatal screening and education for inner-core women and the health care providers serving them should be prioritized.

Perceptions of barriers, facilitators and motivators related to use of prenatal care: A qualitative descriptive study of inner-city women in Winnipeg, Canada.

Objective:The objective of this qualitative descriptive study was to explore the perceptions of women living in inner-city Winnipeg, Canada, about barriers, facilitators, and motivators related to their use of prenatal care.Methods:Individual, semi-structured interviews were conducted in person with 26 pregnant or postpartum women living in inner-city neighborhoods with high rates of inadequate prenatal care. Interviews averaged 67 min in length. Recruitment of participants continued until data saturation was achieved. Inductive content analysis was used to identify themes and subthemes under four broad topics of interest (barriers, facilitators, motivators, and suggestions). Sword’s socio-ecological model of health services use provided the theoretical framework for the research. This model conceptualizes service use as a product of two interacting systems: the personal and situational attributes of potential users and the characteristics of health services.Results:Half of the women in our sample were single and half self-identified as Aboriginal. Participants discussed several personal and system-related barriers affecting use of prenatal care, such as problems with transportation and child care, lack of prenatal care providers, and inaccessible services. Facilitating factors included transportation assistance, convenient location of services, positive care provider qualities, and tangible rewards. Women were motivated to attend prenatal care to gain knowledge and skills and to have a healthy baby.Conclusion:Consistent with the theoretical framework, women’s utilization of prenatal care was a product of two interacting systems, with several barriers related to personal and situational factors affecting women’s lives, while other barriers were related to problems with service delivery and the broader healthcare system. Overcoming barriers to prenatal care and capitalizing on factors that motivate women to seek prenatal care despite difficult living circumstances may help improve use of prenatal care by inner-city women.

Influences on Young Muslim Women in Winnipeg: Preliminary Report on Key Informant Interviews

Following the September 11, 2001 attacks, Islam transitioned from obscurity to notoriety in the Canadian psyche. Muslim women came to be perceived as subjugated women in need of protection by the Canadian state. Yet even as these perceptions ascended, it also became clear that there is little empirical research on the lives of young Muslim women living in Canada, including research about whether such marriage practices exist. The community of Muslims who have immigrated to Winnipeg from South Asian countries (Pakistan, India, Afghanistan and Bangladesh) and their Canadian-born children is small but growing. For this research we interviewed key informants to determine the influences on young Muslim women in this community when they make important life decisions related to post-secondary education, employment, religious identity and practises, marriage, having children, divorce, immigration and citizenship, and gendered violence. The preliminary results of this research are set out in this report. The key informant research is the first part of a larger project that aspires, among other things, to weave together the insights pulled from various research methodologies to create a richer tapestry of the lives of young Muslim women. This research focuses on the potential for discrimination at the axis of religion, gender, age-related vulnerability and race or ethnicity.

Patient and caregiver perspectives of health provision practices for First Nations and Métis women with gestational diabetes mellitus accessing care in Winnipeg, Manitoba.

BackgroundMore North American Indigenous women are diagnosed with gestational diabetes mellitus (GDM) than the general population. Despite the number of health problems associated with GDM, few studies have been conducted that explore Indigenous women’s understandings of GDM in an effort to develop appropriate and effective health strategies.MethodsA qualitative investigation was conducted to describe the experiences of First Nations and Métis women with GDM. Unstructured interviews and focus groups initially took place with 25 advisors such as maternal care providers and community representatives. Semi-structured explanatory model interviews were subsequently carried out with 29 First Nations and Métis women in Winnipeg, Manitoba, Canada.ResultsDivisions in health services, communication and cultural barriers exist, and limit prenatal care access as well as the consistent interpretation of diabetes education messages.ConclusionsCollectively the results suggest living with GDM can be overwhelming and underscore the need for health care providers to encourage self-efficacy towards effective management practices in the context of cultural safety.

Barriers, motivators and facilitators related to prenatal care utilization among inner-city women in Winnipeg, Canada: a case-control study.

BackgroundThe reasons why women do not obtain prenatal care even when it is available and accessible are complex. Despite Canada’s universally funded health care system, use of prenatal care varies widely across neighborhoods in Winnipeg, Manitoba, with the highest rates of inadequate prenatal care found in eight inner-city neighborhoods. The purpose of this study was to identify barriers, motivators and facilitators related to use of prenatal care among women living in these inner-city neighborhoods.MethodsWe conducted a case–control study with 202 cases (inadequate prenatal care) and 406 controls (adequate prenatal care), frequency matched 1:2 by neighborhood. Women were recruited during their postpartum hospital stay, and were interviewed using a structured questionnaire. Stratified analyses of barriers and motivators associated with inadequate prenatal care were conducted, and the Mantel-Haenszel common odds ratio (OR) was reported when the results were homogeneous across neighborhoods. Chi square analysis was used to test for differences in proportions of cases and controls reporting facilitators that would have helped them get more prenatal care.ResultsOf the 39 barriers assessed, 35 significantly increased the odds of inadequate prenatal care for inner-city women. Psychosocial issues that increased the likelihood of inadequate prenatal care included being under stress, having family problems, feeling depressed, “not thinking straight”, and being worried that the baby would be apprehended by the child welfare agency. Structural barriers included not knowing where to get prenatal care, having a long wait to get an appointment, and having problems with child care or transportation. Attitudinal barriers included not planning or knowing about the pregnancy, thinking of having an abortion, and believing they did not need prenatal care. Of the 10 motivators assessed, four had a protective effect, such as the desire to learn how to protect one’s health. Receiving incentives and getting help with transportation and child care would have facilitated women’s attendance at prenatal care visits.ConclusionsSeveral psychosocial, attitudinal, economic and structural barriers increased the likelihood of inadequate prenatal care for women living in socioeconomically disadvantaged neighborhoods. Removing barriers to prenatal care and capitalizing on factors that motivate and facilitate women to seek prenatal care despite the challenges of their personal circumstances may help improve use of prenatal care by inner-city women.

Governing women's morality

The veiling of Muslim women is subject to strongly contested ideas about whether the veil is a symbol of women's subordination to an oppressive tradition or a means of emancipation from that tradition. This article suggests that women's own personal reasons for veiling must be analysed. Data collected from published documents from Muslim organizations allows for demonstration that the veil is configured as central to an Islamic moral code of female modesty. A further analysis of findings from interviews conducted with veiled Muslim women in Winnipeg shows the nuanced ways in which women enact this code.

Personality differences between users of wine, beer and spirits in a community sample: the Winnipeg Health and Drinking Survey.

To date there are many studies describing the protective and risk factors associated with alcohol consumption and cardiovascular health (the U- or J-shaped curve). These studies have only accounted for part of the effects. One hypothesis is that personality differences may account for some of the unexplained variance. It is also unclear if wine, beer and distilled spirits have equivalent effects on health. The purpose of this study is to describe the differences in personality among users of wine, beer and spirits. Data were from a community sample of 1,257 men and women in Winnipeg, Manitoba, Canada, that was first enrolled in 1989-90. We examined and compared the demographic and personality characteristics of wine, beer and spirits drinkers in this sample. The groups differed significantly on the dimensions of extraversion, psychoticism and reducer-augmenter in univariate tests. In multivariate models, for the total sample and for females, predominant drinking of wine was associated with low scores on the Vando scale (augmenters). Higher consumption of beer among males was associated with higher levels of neuroticism. In these instances, personality does contribute to the characterization of groups.

Older Women's Community Mobility: A Qualitative Exploration

ABSTRACTMany of the limitations experienced by community-dwelling older women are related to mobility within their communities. This qualitative study explored community mobility from the perspective of older, community-dwelling women in Winnipeg, Manitoba. Semi-structured interviews were completed with 23 older women (mean age 75.9 years) identified through an existing database. In addition to travels to conduct instrumental activities of daily living and participate in social and recreational activities, the women in the study described trips to fulfil social obligations (e.g., attending funerals, visiting sick friends) and emphasized the importance of these trips. The women's travels through the city were influenced by their perception of risk and the strategies they employed to minimize or avoid risk during the day, in the evening, and during bad weather. Autonomous community mobility provided the women with a sense of independence and control. The findings have potential implications for health care providers and community programmers who work to maintain older women in the community.

Satisfaction of Women Attending the Manitoba Breast Screening Program

Background. This study evaluated the satisfaction of women who attended the Manitoba Breast Screening Program (MBSP) during the first 17 months of operation and examined differences in satisfaction by screening location and screening result. The setting was the province of Manitoba, Canada.Methods. A breast screening program satisfaction questionnaire comprising six subscales was mailed to 1,331 randomly chosen women in five different categories who attended the MBSP. Four categories were based on location of screen (city of Brandon vs city of Winnipeg) and screen result (normal vs abnormal) and one category comprised women who were screened at a mobile unit. Eighty-eight percent of all questionnaires were returned. Data analyses included analyses of variance to examine the effect of location and result on satisfaction scores and logistic regression to explore the variables associated with reported satisfied and not satisfied responses to each satisfaction subscale.Results. All satisfaction scores were above 80 of 100, indicating high levels of satisfaction. A significant difference in satisfaction scores between women in Winnipeg and women in Brandon was found for the convenience and accessibility (P = 0.0153) and the information transfer subscales (P = 0.0150). A significant difference was found between women with abnormal and women with normal screen results for all subscales (P < 0.01). Women were 4.5 times more likely to be dissatisfied on the general satisfaction subscale if they had an abnormal screen result (95% CI 1.9,10.4).Conclusions. High levels of satisfaction were reported for all aspects of screening at the MBSP. However, women were less likely to be satisfied with program convenience and accessibility. Women with an abnormal result reported lower levels of satisfaction on all subscales. Some women with an abnormal screening result were confused about what their results meant and why they were sent for additional diagnostic tests. As a result of these findings, numerous changes were made to the MBSP.