Methods: The study utilized an exploratory design consisting of face-to-face interviews, with a nonrandom sample of Kurds aged 50 or over using a snowball sampling technique in Nashville, TN which has the largest population of Kurds living outside of the Middle East. Interviews were conducted at the Kurdistan Cultural Institute or participants' homes by trained bi-lingual interviewers. A total of 70 Kurdish immigrants and refugees (47.1% male and 52.9% female) agreed to participate in the study. Bivariate and multivariate analyses were utilized.
Results: Approximately 88% of study participants indicated that they had at least one service need. Most also identified having multiple service needs simultaneously. For example, 63% of participants had service needs in at least 3 different areas and 25.7% of study participants had 7 different types of service needs. This study found that service needs in health and finance (68.6%) were highest followed by housing (55.7%), transportation (48.6%), communication (48.6%), social support (47.1%), and nutrition (44.3%). Regarding their service uses, the ratio between their service needs and help sought indicated that the utilization of housing service was highest (0.71) followed by transportation (0.67), communication (0.67), health (0.66), finance (0.52), social support (0.51) and nutrition (0.41). Participants experienced barriers to services. The most significant one was the language barrier (the professionals do not speak my language). Cultural barriers (e.g., the professionals do not understand my culture) were also identified. In addition, the lack of money to go for help and lack of knowledge regarding available services were negatively related to their help seeking behaviors. Bivariate and regression analyses tested the relationship between the various social demographic characteristics, acculturation, language competency, and service uses but few were significantly related to the service uses in this population. One interesting finding was that lack of money significantly reduced the ratio between services needed and help sought.
Conclusions and Implications: These results indicate that Kurdish refugees and immigrants are experiencing multiple service needs yet they do not seek help to meet their service needs. This study also highlighted existing barriers to services among Kurdish refugees and immigrants, which accentuates the need for the development and implementation of culturally competent services for this unique population. Further studies with this population will play a crucial role in promoting our knowledge and development of culturally competent practices.