Pitt Rebecca S, Sherman Jessica, Macdonald Mary Ellen
McGill University.
Can J Public Health. 2016 Mar 16;106(8):e539-45. doi: 10.17269/cjph.106.5028.
To identify low-income working families' health challenges and understand their barriers and facilitators to navigating those challenges.
We conducted a focused ethnographic study in a food bank in Montreal, Quebec. Using purposeful sampling, we recruited participants who had at least one employed family member and one live-in child. Sensitizing concepts included social determinants of health (SDH) and family strengths. Participant observation, focus groups and in-depth interviews constituted the primary means of data collection. Thematic and contextual analyses were conducted iteratively.
We recruited 25 participants, 22 clients (15 women and 7 men with up to 5 children per family) and 3 members of staff. All clients were immigrants, having been in Canada for a range of 2 months to 23 years, thus reflecting the ethnic demography of the site. Families described health as physical, mental and socio-cultural well-being. Challenges to well-being included insufficient finances, non-standard work, hurdles in professional equivalency, isolation, children's acculturation, inadequate access to health care and the Canadian winter. Personal and structural barriers and facilitators to navigating challenges centred on parents' sense of the challenges being finite, control over discrete dimensions of life and hope of children's future success. Families who incorporated these perceptions into their narratives seemed to describe the challenges as navigable. Importantly, the SDH model did not anticipate the degree to which challenges would be defined by immigration factors.
In order to help low-income working immigrant families face diverse challenges to well-being, community workers and policy-makers must consider the specific challenges of immigration and the importance of individual families' outlooks as they navigate them.
识别低收入在职家庭的健康挑战，并了解他们应对这些挑战的障碍和促进因素。
我们在魁北克省蒙特利尔的一家食品银行开展了一项聚焦人种志研究。通过立意抽样，我们招募了至少有一名在职家庭成员和一名同住子女的参与者。敏感概念包括健康的社会决定因素（SDH）和家庭优势。参与观察、焦点小组和深度访谈构成了主要的数据收集方式。我们反复进行了主题分析和情境分析。
我们招募了25名参与者，22名客户（15名女性和7名男性，每个家庭最多有5个孩子）和3名工作人员。所有客户都是移民，在加拿大居住的时间从2个月到23年不等，因此反映了该场所的种族人口构成。家庭将健康描述为身体、心理和社会文化层面的幸福。幸福面临的挑战包括资金不足、非标准工作、职业对等方面的障碍、孤立、儿童的文化适应、获得医疗保健的机会不足以及加拿大的冬季。应对挑战的个人和结构障碍及促进因素集中在父母对挑战有限性的认知、对生活各个方面的掌控以及对孩子未来成功的希望。将这些认知融入自身叙述的家庭似乎将挑战描述为可以应对的。重要的是，健康的社会决定因素模型没有预见到移民因素对挑战定义的程度。
为了帮助低收入在职移民家庭应对幸福面临的各种挑战，社区工作者和政策制定者在他们应对挑战时必须考虑移民的具体挑战以及各个家庭观念的重要性。
