The relationship between refugee family dynamics - such as poor communication and responsiveness, lack of cohesion, and intergenerational conflict - and physical and psychological health is complex. Little research has been conducted with the aim of better understanding the role of family dynamics in promoting or degrading the health of refugees. Factors such as migration daily stressors have a theoretical impact on both refugee family dynamics and refugee health, yet few studies have used appropriate statistical methods to capture these complex relationships, resulting in a severe lack of family-based resources and interventions to address these issues. The objective of this International Research Scientist Development Award (IRSDA) is to study refugee family dynamics and their association with migration daily stressors, resource utilization and family health among Sri Lankan Tamil refugees in the Gummidipoondi refugee camp in India. Preliminary work (George, 2009) from the Gummidipoondi refugee camp suggests that refugees with families may have more negative health outcomes than other refugees in the camp. The results of this IRDSA K01 research study and training program will inform future work developing family-based, culturally appropriate interventions for the promotion of Sri Lankan Tamil refugee well-being.
The specific aims of this mixed method research proposal are: 1) To examine the longitudinal associations among migration daily stressors, resource utilization, family dynamics, and parent/adolescent health in order to identify critical areas for intervention development~ and 2) To identify culturally appropriate interpretations of findings related to family dynamics from Aim 1 and strategies for developing interventions for Sri Lankan Tamil refugee families. This approach is innovative because of the integration of quantitative data with the refugee community's experiential knowledge to identify critical areas for intervention development. This proposed research is significant because the study outcomes - a refined conceptual model for understanding refugee family dynamics, and a research design that identifies intervention strategies using longitudinal and qualitative methods - will lead to dialectical development of tes designs and findings across cultures. Ultimately, such knowledge has the potential to inform specific health care support for refugee families that will have a positive impact on public health
The proposed research is relevant to public health because it will lead to the development of a refined model of refugee family dynamics, providing information on critical areas for interventions that will not only improve the quality of life for refugees, but also reduce the cost of health care provided by host countries, particularly low- or middle-income host countries (LMIC's). The importance of this study is that it promotes the National Institute of Health Fogarty International Center's mission of conducting global health research by building partnerships between health research institutions in the U.S. and LMIC's, and training the next generation of scientists to reduce the burden of disease, promote health, and extend longevity for all people.