In this formative research project, we seek to better understand the general barriers to refugee access to higher education. Using mixed methods research--which included surveys, interviews, and course data--we evaluate the benefits and challenges experienced by refugee students in Israel who are enrolled in Arizona State University's Education for Humanity programs. In the end, this case study resulted in 24 recommend programmatic changes designed to eliminate the barriers that prevent refugee students from accessing and succeeding in higher education.

In this formative research project, we seek to better understand the general barriers to refugee access to higher education. Using mixed methods research--which included surveys, interviews, and course data--we evaluate the benefits and challenges experienced by refugee students in Israel who are enrolled in Arizona State University's Education for Humanity programs. In the end, this case study resulted in 24 recommend programmatic changes designed to eliminate the barriers that prevent refugee students from accessing and succeeding in higher education.

This project is an investigation of the gene by environment (GxE) interactions’ effect on substance use outcomes among refugee communities. Substance use disorders (SUDs) are a major public health concern, affecting individuals and communities worldwide. The etiology of SUDs is complex, involving a combination of genetic, environmental, and social factors. In recent years, there has been growing interest in the role of gene by environment interactions in the development of SUDs, particularly in vulnerable populations such as refugees. Refugee populations are exposed to a range of environmental stressors that may interact with genetic factors to increase their risk of SUDs. However, a number of studies describe a “refugee paradox,” where despite having been exposed to risk factors that can lead to SUDs, they are less likely to develop SUDs. Understanding these gene by environment interactions in refugee communities is crucial for not only understanding this phenomenon, but developing effective prevention and treatment strategies for this population. This thesis aims to investigate the gene by environment interactions underlying substance use in refugee communities and to analyze different methods for gene by environment analyses, ultimately determining which method is best suited for this population.

Refugee women face many challenges to obtaining maternal, reproductive, and sexual health post-resettlement including the language barrier, navigating the healthcare system, finding childcare to attend appointments, and cultural mismatches between their beliefs and practices around the prenatal, childbirth, and postpartum periods and that of the healthcare system in which they resettle into. This cultural barrier poses a challenge to healthcare providers as well as it necessitates that they respect their patients’ cultural beliefs while still providing them with the highest standard of care. Cultural competency training has been used to assist providers in understanding and responding to cultural differences, but gaps still exist when it comes to navigating specific scenarios. The objective of this research was to conduct a literature review of studies pertaining to refugee maternal, reproductive, and sexual healthcare post-resettlement to investigate the following questions: how tensions between biomedically accepted best practices and cultural norms present themselves in these healthcare fields, how healthcare providers take into consideration their patients’ cultural beliefs and norms when providing maternal, reproductive, and sexual healthcare to refugee women, and what can be done to continue to improve the provision of culturally appropriate care to refugee women. Findings from twenty different studies that focused primarily on eight cultural groups identified that Cesarean sections, inductions, and certain family planning methods are significant points of contention regarding cultural norms for refugee women and that they prefer certain foods, birthing positions, and other cultural practices during the delivery. Healthcare providers consider their refugee patients’ cultural beliefs by creating relationships with them built on trust, utilizing community liaisons, and through attempts to accommodate cultural practices when possible. Some potential improvements offered to improve cultural competency were improved cultural competency training that focused on how healthcare providers ask questions and interact with their patients, increased partnership with refugee communities, and an emphasis on patient education surrounding interventions and procedures related to maternal and reproductive health that could cause hesitations. The results of this literature review accentuated the importance of relationships within the field of refugee women’s healthcare, between both refugee patients and their providers and refugee communities and the healthcare systems. Providing refugee women access to more culturally competent healthcare can increase their trust in the healthcare systems of the countries they resettle in and healthcare utilization that can contribute to improved health outcomes for refugee women and their children.

This study is a systematic review of the current literature surrounding intergenerational trauma in Southeast Asian (SEA) immigrant/refugee families. This review was guided upon using the 2020 PRISMA criteria and framework. After a parallel search across several databases, 14 articles were qualified for inclusion after reviewing exclusion criteria. Across these articles, five main aims were examined: the effect of trauma on parent mental health, the effect on child mental health, the effect on parenting, the effect on family dynamics/relationship, and an exploratory aim on current recommended interventions. The literature indicated that negative mental health outcomes were often present in parents and affected the quality of parenting. Child mental health was negatively affected through close interactions with the parent. Certain parenting behaviors and styles were associated with traumatized parents, which led to the development of attachment issues in children. Family dynamics and relationships were impacted by conflicting cultures and beliefs they were raised with in the United States and the ones taught at home by their parents. Current recommendations for interventions involve therapy, understanding culture and context of trauma, and as well as utilizing the support and influence of the community. There are many gaps in current research and more examination of intergenerational trauma amongst SEA populations is needed to better understand this complex issue in order to improve the relationship between parents, children, and overall family suffering from the effects of intergenerational trauma. Further recommendations for research, gaps in literature, and implications for this study are explored.