Transnational Healthcare Practices Among Afghan, Syrian, and Ukrainian Refugee Older Adults in the Greater Toronto Area: A Study Protocol.

The global population of older adults is growing rapidly, and refugees are now a significant proportion of the older adult population in Canada. Transnational healthcare practices (THPs)-seeking health information or services from the country of origin-may be an essential strategy used by refugee older adults in Canada, but few studies have explored this phenomenon. This is a protocol for a study, which is aimed at developing a comprehensive understanding of the role THPs play in the lives of older adults from three refugee groups (Afghan, Syrian and Ukrainian) (re)settled in the Greater Toronto Area (GTA), Canada. It will be informed by Constructivist Grounded Theory and will consist of three phases. Phase 1 will involve semi-structured individual interviews with Afghan, Syrian, and Ukrainian refugee older adults living in the GTA (n = 75-90) to explore their perspectives and experiences with various types of THP. Phase 2 will also involve semi-structured interviews with 75-90 refugee older adults from the three communities to examine the role of THP in stress, coping, and resilience in the context of health promotion, illness diagnosis, and disease management as well as the individual and contextual factors driving the use of THPs. Phase 3 will involve six focus groups (n = 36-48) with refugee older adults from these communities to explore what information, care, supports, technology, and services are needed to manage their health and illnesses locally. This project will advance knowledge in the areas of (re)settlement and integration, aging, local healthcare access, and THPs among refugee older adults in Canada. The findings will inform more effective integration policies and the delivery of efficient and equitable health information, care, support, technology, and services that address the healthcare needs of refugee older adults, enabling them to age well and age in place.