{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:32:07Z","timestamp":1760239927086,"version":"build-2065373602"},"reference-count":36,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T00:00:00Z","timestamp":1550016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT156265"],"award-info":[{"award-number":["PJT156265"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/ijerph16040542","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T03:21:46Z","timestamp":1550114506000},"page":"542","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Oral Health of Refugees and Asylum Seekers in Canada: A Mixed Methods Study Protocol"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0581-827X","authenticated-orcid":false,"given":"Mary Ellen","family":"Macdonald","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, McGill University, 500-2001 McGill College, Montr\u00e9al, QC H3A 1G1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark T.","family":"Keboa","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, McGill University, 500-2001 McGill College, Montr\u00e9al, QC H3A 1G1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4580-1744","authenticated-orcid":false,"given":"Nazik M.","family":"Nurelhuda","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herenia P.","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franco","family":"Carnevale","sequence":"additional","affiliation":[{"name":"Ingram School of Nursing, McGill University, 680 Sherbrooke West 1800, Montr\u00e9al, QC H3A 2M7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"McNally","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Dalhousie University, 5981 University Avenue, Halifax, NS B3H 4R2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonica","family":"Singhal","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, University of Toronto, 124 Edward St, Toronto, ON M5G 1G6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khady","family":"Ka","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, McGill University, 500-2001 McGill College, Montr\u00e9al, QC H3A 1G1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belinda","family":"Nicolau","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, McGill University, 500-2001 McGill College, Montr\u00e9al, QC H3A 1G1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,13]]},"reference":[{"key":"ref_1","unstructured":"United Nations High Commissioner for Refugees (2017). Global Trends: Forced Displacement in 2017, Available online: http:\/\/www.unhcr.org\/globaltrends2017\/."},{"key":"ref_2","unstructured":"Government of Canada (2017, September 03). Resettled Refugees: Monthly IRCC Updates, Available online: http:\/\/open.canada.ca\/data\/en\/dataset\/4a1b260a-7ac4-4985-80a0-603bfe4aec11?_ga=2.36990112.1290328107.1504484075-50681910.1504484075."},{"key":"ref_3","unstructured":"World Health Organization (2010). The Health of Migrants: The Way Forward. Report of a Global Consultation, Madrid, Spain, 3\u20135 March 2010, WHO. Available online: http:\/\/www.who.int\/hac\/events\/consultation_report_health_migrants_colour_web.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/13557850802609956","article-title":"The short-term health of Canada\u2019s new immigrant arrivals: Evidence from LSIC","volume":"14","author":"Newbold","year":"2009","journal-title":"Ethn. Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/s10903-010-9414-9","article-title":"A review on the oral health impacts of acculturation","volume":"13","author":"Gao","year":"2011","journal-title":"J. Immigr. Minority Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s10903-007-9098-y","article-title":"Health and humanitarian migrants\u2019 economic participation","volume":"12","author":"Khoo","year":"2010","journal-title":"J. Immigr. Minority Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12992-016-0200-x","article-title":"The oral health of refugees and asylum seekers: A scoping review","volume":"12","author":"Keboa","year":"2016","journal-title":"Glob. Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s10903-013-9785-9","article-title":"The oral health status of recent immigrants and refugees in Nova Scotia, Canada","volume":"16","author":"Ghiabi","year":"2014","journal-title":"J. Immigr. Minor. Health"},{"key":"ref_9","first-page":"E824","article-title":"Guidelines for Immigrant Health Appendix 16: Dental disease: Evidence review for newly arriving immigrants and refugees","volume":"183","author":"McNally","year":"2011","journal-title":"Can. Med. Assoc. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1071\/AH090618","article-title":"Refugees and oral health: Lessons learned from stories of Hazara refugees","volume":"33","author":"Whelan","year":"2009","journal-title":"Aust. Health Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1111\/cdoe.12165","article-title":"The deterioration of Canadian immigrants\u2019 oral health: Analysis of the Longitudinal Survey of Immigrants to Canada","volume":"43","author":"Calvasina","year":"2015","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_12","unstructured":"King, C. (2012). Understanding the Oral Health Needs of Government Assisted Refugees, Simon Fraser University."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Butani, Y., Weintraub, J., and Barker, J.C. (2008). Oral health-related cultural beliefs for four racial\/ethnic groups: Assessment of the literature. BMC Oral Health, 8.","DOI":"10.1186\/1472-6831-8-26"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Prowse, S., Schroth, R.J., Wilson, A., Edwards, J.M., Sarson, J., Levi, J.A., and Moffatt, M.E. (2014). Diversity considerations for promoting early childhood oral health: A pilot study. Int. J. Dent.","DOI":"10.1155\/2014\/175084"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/0022034511402015","article-title":"Global oral health inequalities: The view from a research funder","volume":"23","author":"Garcia","year":"2011","journal-title":"Adv. Dent. Res."},{"key":"ref_16","first-page":"1273","article-title":"The Behavioral Model for Vulnerable Populations: Application to medical care use and outcomes for homeless people","volume":"34","author":"Gelberg","year":"2000","journal-title":"Health Serv. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/j.1600-0528.2009.00471.x","article-title":"Predictors of dental care utilization among working poor Canadians","volume":"37","author":"Muirhead","year":"2009","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.1600-0528.2009.00495.x","article-title":"Applying Andersen\u2019s behavioural model to oral health: What are the contextual factors shaping perceived oral health outcomes?","volume":"37","author":"Baker","year":"2009","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_19","unstructured":"Statistics Canada (2017, August 13). Canadian Health Measures Survey (CHMS) Data User Guide: Cycle 1, Available online: http:\/\/www23.statcan.gc.ca\/imdb-bmdi\/pub\/document\/5071_D2_T1_V1-eng.htm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1111\/j.1600-0528.2009.00490.x","article-title":"Development and evaluation of an oral health literacy instrument for adults","volume":"37","author":"Sabbahi","year":"2009","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1177\/1363461506070796","article-title":"The McGill Illness Narrative Interview (MINI): An interview schedule to elicit meanings and modes of reasoning related to illness experience","volume":"43","author":"Groleau","year":"2006","journal-title":"Transcult. Psychiatry"},{"key":"ref_22","unstructured":"Keboa, M.T. (2017). Understanding Oral Health and Dental Care Pathways of Refugees and Asylum Seekers in Montreal, McGill University. Manuscript-Based."},{"key":"ref_23","unstructured":"Creswell, J.W. (2003). Research Design: Qualitative, Quantitative and Mixed Methods Approaches, Sage Publications."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1111\/j.1475-6773.2011.01344.x","article-title":"Methodological reporting in qualitative, quantitative, and mixed methods health services research articles","volume":"47","author":"Wisdom","year":"2012","journal-title":"Health Serv. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1177\/2380084417705823","article-title":"Applied Mixed Methods in Oral Health Research: Importance and Example of a Training Program","volume":"2","author":"Nicolau","year":"2017","journal-title":"JDR Clin. Transl. Res."},{"key":"ref_26","unstructured":"Krueger, R.A., and Casey, M.A. (2000). Focus Groups: A Practical Guide for Applied Research, Sage."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1080\/13557858.2016.1246518","article-title":"Are immigrants healthier than native-born Canadians? A systematic review of the healthy immigrant effect in Canada","volume":"22","author":"Vang","year":"2017","journal-title":"Ethn. Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Font, J., and M\u00e9ndez, M. (2013). Surveying Ethnic Minorities and Immigrant Populations: Methodological Challenges and Research Strategies, Amsterdam University Press. IMISCOE.","DOI":"10.1515\/9789048519187"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/1475-9276-10-56","article-title":"Cross-border movement and women\u2019s health: How to capture the data","volume":"10","author":"Merry","year":"2011","journal-title":"Int. J. Equity Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.0081-1750.2004.00152.x","article-title":"Sampling and estimation in hidden populations using Respondent-Driven Sampling","volume":"34","author":"Salganik","year":"2004","journal-title":"Sociol. Methodol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"i98","DOI":"10.1007\/s11524-006-9106-x","article-title":"Variance estimation, design effects, and sample size calculations for respondent-driven sampling","volume":"83","author":"Salganik","year":"2006","journal-title":"J. Urban Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"654","DOI":"10.2105\/AJPH.41.6.654","article-title":"The determination of sample size","volume":"41","author":"Cornfield","year":"1951","journal-title":"Am. J. Public Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0304-3959(87)91074-8","article-title":"The short-form McGill Pain Questionnaire","volume":"30","author":"Melzack","year":"1987","journal-title":"Pain"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/nur.20390","article-title":"Strengthening data quality in studies of migrants not fluent in host languages: A Canadian example with reproductive health questionnaires","volume":"33","author":"Strohschein","year":"2010","journal-title":"Res. Nurs. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1037\/a0027127","article-title":"Model selection and psychological theory: A discussion of the differences between the Akaike information criterion (AIC) and the Bayesian information criterion (BIC)","volume":"17","author":"Vrieze","year":"2012","journal-title":"Psychol. Methods"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"c4587","DOI":"10.1136\/bmj.c4587","article-title":"Three techniques for integrating data in mixed methods studies","volume":"341","author":"Murphy","year":"2010","journal-title":"BMJ"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/4\/542\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:31:53Z","timestamp":1760185913000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/4\/542"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,13]]},"references-count":36,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,2]]}},"alternative-id":["ijerph16040542"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16040542","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2019,2,13]]}}}