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The physical and mental health problems of refugee and migrant fathers: findings from an Australian population-based study of children and their families.

ABSTRACT: OBJECTIVES:The aim of this study was to report on the physical and mental health of migrant and refugee fathers participating in a population-based study of Australian children and their families. DESIGN:Cross-sectional survey data drawn from a population-based longitudinal study when children were aged 4-5 years. SETTING:Population-based study of Australian children and their families. PARTICIPANTS:8137 fathers participated in the study when their children were aged 4-5 years. There were 131 (1.6%) fathers of likely refugee background, 872 (10.7%) fathers who migrated from English-speaking countries, 1005 (12.4%) fathers who migrated from non-English-speaking countries and 6129 (75.3%) Australian-born fathers. PRIMARY OUTCOME MEASURES:Fathers' psychological distress was assessed using the self-report Kessler-6. Information pertaining to physical health conditions, global or overall health, alcohol and tobacco use, and body mass index status was obtained. RESULTS:Compared with Australian-born fathers, fathers of likely refugee background (adjusted OR(aOR) 3.17, 95%?CI 2.13 to 4.74) and fathers from non-English-speaking countries (aOR 1.79, 95%CI 1.51 to 2.13) had higher odds of psychological distress. Refugee fathers were more likely to report fair to poor overall health (aOR 1.95, 95%?CI 1.06 to 3.60) and being underweight (aOR 3.49, 95%?CI 1.57 to 7.74) compared with Australian-born fathers. Refugee fathers and those from non-English-speaking countries were less likely to report light (aOR 0.25, 95%?CI 0.15 to 0.43, and aOR 0.30, 95%?CI 0.24 to 0.37, respectively) and moderate to harmful alcohol use (aOR 0.04, 95%?CI 0.10 to 0.17, and aOR 0.14, 95%?CI 0.10 to 0.19, respectively) than Australian-born fathers. Finally, fathers from non-English-speaking and English-speaking countries were less likely to be overweight (aOR 0.62, 95%?CI 0.51 to 0.75, and aOR 0.84, 95%?CI 0.68 to 1.03, respectively) and obese (aOR 0.43, 95%?CI 0.32 to 0.58, and aOR 0.77, 95%?CI 0.61 to 0.98, respectively) than Australian-born fathers. CONCLUSION:Fathers of refugee background experience poorer mental health and poorer general health than Australian-born fathers. Fathers who have migrated from non-English-speaking countries also report greater psychological distress than Australian-born fathers. This underscores the need for primary healthcare services to tailor efforts to reduce disparities in health outcomes for refugee populations that may be vulnerable due to circumstances and sequelae of forced migration and to recognise the additional psychological stresses that may accompany fatherhood following migration from non-English-speaking countries. It is important to note that refugee and migrant fathers report less alcohol use and are less likely to be overweight and obese than Australian-born fathers.

SUBMITTER: Giallo R

PROVIDER: S-EPMC5702027 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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The physical and mental health problems of refugee and migrant fathers: findings from an Australian population-based study of children and their families.

Giallo Rebecca R Riggs Elisha E Lynch Claire C Vanpraag Dannielle D Yelland Jane J Szwarc Josef J Duell-Piening Philippa P Tyrell Lauren L Casey Sue S Brown Stephanie Janne SJ

BMJ open 20171117 11

<h4>Objectives</h4>The aim of this study was to report on the physical and mental health of migrant and refugee fathers participating in a population-based study of Australian children and their families.<h4>Design</h4>Cross-sectional survey data drawn from a population-based longitudinal study when children were aged 4-5 years.<h4>Setting</h4>Population-based study of Australian children and their families.<h4>Participants</h4>8137 fathers participated in the study when their children were aged ...[more]

PMID: 29151045

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Project description:IntroductionInequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006-2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia.Methods and analysisThis is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1-4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe).Ethics and disseminationEthics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12611000532909).

Project description:BackgroundWomen from migrant and refugee backgrounds who live in high-income countries are at increased risk of adverse perinatal outcomes, including mental health issues, preterm birth and maternal and infant mortality. There is a need to implement and evaluate models of care to meet their specific needs in order to improve health outcomes, their experiences of care, and overcome barriers to access. In Sydney, Australia, a unique model of care was implemented to support women and families from migrant and refugee backgrounds to access health and community-based services through the continuum of pregnancy to the early parenting period. This model of care is known as the Cross Cultural Workers (CCWs) in Maternity and Child and Family Health Service (the CCW Service). The aim of this study was to explore the perceptions of service providers regarding the CCW Service and identify recommendations for improvement.MethodsA mixed-methods study was conducted consisting of surveys and face to face semi-structured interviews. Service providers were recruited from hospital-based maternity and community-based services. Survey data were analysed descriptively. Interviews were analysed using qualitative content analysis.ResultsSixty-nine service providers completed surveys and 19 were interviewed. The CCW Service was highly regarded by service providers who perceived it to be critical in improving care for women from migrant and refugee backgrounds. The overarching theme from the interviews was the ability of the CCW Service to act as a 'bridge to health' through the provision of culturally responsive care. There were three main categories; supporting access to health and community-based services, improving the healthcare experience, and organisational factors, including part-time hours, capacity, heavy workloads and confusion/lack of clarity regarding the CCW role, which affected CCWs' capacity to optimally support service providers in providing culturally responsive care. These limitations meant CCWs were not able to meet demand, and fully operationalise the model.ConclusionService providers perceived the CCW model to be a culturally responsive model of care tailored to the needs of women and families from migrant and refugee backgrounds, that reduces barriers to access, and has the potential to improve perinatal outcomes, and women's experience and satisfaction with care.

Dataset Information

The physical and mental health problems of refugee and migrant fathers: findings from an Australian population-based study of children and their families.

Publications

The physical and mental health problems of refugee and migrant fathers: findings from an Australian population-based study of children and their families.

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