Jennifer Phillimore

Refugees, acculturation strategies, stress and integration

The advent of super-diversity and politicisation of migration has been accompanied by heightened interest in migrant settlement. Much has been written in policy and academic fields about the importance of integration, particularly in relation to the settlement of refugees. However, little attention has been paid to the varied settlement experiences of individual refugees, or how personal, cultural and experiential factors combine to influence settlement experiences. This paper turns to cross-cultural psychologys discussion of acculturation processes and, in particular, Berrys acculturation strategies (Berry, 1997) to look at the different factors that influence acculturation and how these factors impact upon the ability of individual refugees to integrate. Using qualitative data collected from 138 interviews with refugees living in Birmingham, England, the paper shows how a range of group and individual factors, relating to their experiences both in refugees’ home and host countries, influences the acculturation strategies adopted by different refugees. It shows that in the current policy environment many refugees lack choice about acculturation strategy, are vulnerable to psychosocial stress and struggle to integrate.

Understanding healthcare practices in superdiverse neighbourhoods and developing the concept of welfare bricolage: Protocol of a cross-national mixed-methods study

BackgroundDiversity in Europe has both increased and become more complex posing challenges to both national and local welfare state regimes. Evidence indicates specific barriers for migrant, faith and minority ethnic groups when accessing healthcare. However, previous studies of health in diverse cities in European countries have mainly adopted an ethno-national focus. Taking into account the new complexity of diversity within cities, a deeper and multi-faceted understanding of everyday health practices in superdiverse contexts is needed to support appropriate healthcare provision.Methods/DesignThis protocol describes a mixed method study investigating how residents in superdiverse neighbourhoods access healthcare. The study will include participant observation and qualitative interviewing as well as a standardised health survey and will be carried out in eight superdiverse neighbourhoods – with varying deprivations levels and trajectories of change – in four European countries (Germany, Portugal, Sweden and UK). In each neighbourhood, trained polylingual community researchers together with university researchers will map formal and informal provision and infrastructures supportive to health and healthcare. In-depth interviews with residents and healthcare providers in each country will investigate local health-supportive practices. Thematic analysis will be used to identify different types of help-seeking behaviours and support structures across neighbourhoods and countries. Using categories identified from analyses of interview material, a health survey will be set up investigating determinants of access to healthcare. Complex models, such as structural equation modelling, will be applied to analyse commonalities and differences between population groups, neighbourhoods and countries.DiscussionThis study offers the potential to contribute to a deeper understanding of how residents in superdiverse neighbourhoods deal with health and healthcare in everyday practices. The findings will inform governmental authorities, formal and informal healthcare providers how to further refine health services and how to achieve equitable access in diverse population groups.

Reciprocity for new migrant integration: resource conservation, investment and exchange

ABSTRACT In this paper we bring a new perspective to the understanding of migrant integration. We focus on how new migrants use reciprocity to make and sustain connections. In turn, we identify integration resources accessed through those connections and associated acts of reciprocal exchange. Using qualitative data collected in retrospective interviews from a maximum variation sample of new migrants arriving in the U.K. up to two years before interview, we identify five interconnected sub-types of reciprocity and explore how these are used to replace or substitute resources lost through the act of migration. We argue that, contrary to Hobfoll’s [2011, “Conservation of Resource Caravans and Engaged Settings.” Journal of Occupational and Organizational Psychology 84: 116–122. doi:10.1111/j.2044-8325.2010.02016.x] ideas about conservation of resources in crisis, migrants use resource exchange strategies to develop social networks which may form important buffers against migratory stress and aid access to functional, psychological and affective resources that can further integration. The paper concludes by highlighting the significance of reciprocity in moving the theorisation of integration in new a new direction.

Recent migrants' perspectives on antibiotic use and prescribing: a qualitative study

Background Currently there is great interest in antibiotic prescribing practices in the UK, but little is known about the experiences of the increasing numbers of recent migrants (those present in the UK for >1 year but <5 years) registered at GP practices. Qualitative research has suggested that reasons for not prescribing antibiotics may not be clearly communicated to migrants. Aim This study aimed to explore the factors that shape migrants’ experiences of and attitudes to antibiotics, and to suggest ways to improve effective communication around their use. Design and setting A qualitative study on recent migrants’ health beliefs, values, and experiences in a community setting in primary care. Method Twenty-three recent migrants were interviewed in their preferred language by trained community researchers. The research team conducted a thematic analysis, focusing on health beliefs, engaging with health services, transnational medicine, and concepts of fairness. Experiences around antibiotics were a strong emerging theme. Results Three reasons were identified for antibiotics seeking: first, holding an ‘infectious model’ of illness implying that antibiotics are required quickly to avoid illness becoming worse or spreading to others; second, reasoning that other medications will be less effective for people ‘used to’ antibiotics’; and third, perceiving antibiotic prescription as a sign of being taken seriously. Some participants obtained antibiotics from their country of origin or migrant networks in the UK; others changed their mind and accepted alternatives. Conclusion Primary care professionals should aim to understand migrants’ perspectives to improve communication with patients. Further research is needed to identify different strategies needed to respond to the varying understandings of antibiotics held by migrants.