Date of Award

Fall 2011

Degree Type

Thesis

Degree Name

Doctor of Philosophy (PhD)

Department

Health Sciences

Supervisor

Ruta Valaitis

Co-Supervisor

Margaret Black

Language

English

Committee Member

Bruce Newbold, Jan Sargeant

Abstract

Introduction

Canadian health and social service systems need to adapt to new challenges posed by the unique primary health care (PHC) needs of recent immigrant families. Community-based service providers are the first to experience changing responsibilities. Providers in communities with limited experience in working with immigrants may benefit from shared skills and modeled cultural competencies when working with new arrivals.

Purpose

This case study describes how a set of community-based service organizations addressed the PHC needs of recent immigrant families with young children living within a mid-sized urban centre in Atlantic Canada. The roles of organizational brokers and of competence trust among service providers were examined to determine their influence on the capacities of the service network overall.

Methods

Methods from social network analysis and descriptive qualitative inquiry were applied in this study. Organizational ecology contructs framed the research questions and propositions. An intersectoral approach to PHC was adopted to define the services network. Results derived from the network survey and key informant interviews were triangulated to develop a final interpretation.

Results

The study network constituted a relatively cohesive group of service providers. Network participation became more selective depending on the issue experienced by families. Network interactions were facilitated by broker organizations; some brokers actively engaged in the development of cultural competency capacities among network members. Trust in the other provider organization’s cultural competencies (competence trust) with recent immigrant families positively influenced the quality of working relationships.

Conclusions

Broker organizations can play a significant role in network capacity development through the promotion of cultural competencies in partnering organizations and by making connections across service sectors. The cultural competence of partnering organizations is an important pre-condition of trust for service providers committed to the needs of recent immigrant families. Having trusting relationships among providers can facilitate exchange and enable access to services. Nurses have the potential to participate in the advancement of culturally competent service systems.

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