Acculturative Challenges and Help-Seeking Barriers Among Immigrants and Refugees (IRs) from the Middle East and North Africa (MENA), Central Asia (CA), and Ukraine in the United States (US) from the Perspective of Service Providers (SPs) and Caregivers

Background and Purpose: This integrated qualitative study explores the acculturative challenges and help-seeking barriers faced by three immigrant and refugee (IR) groups—MENA, CA, and Ukrainian IRs—in the United States (US). The study addresses gaps in understanding the diverse experiences of these populations from the perspectives of caregivers of children and adolescents and service providers (SPs) working with them. By listening to the perspectives of SPs and caregivers, the study aims to inform the delivery of culturally sensitive support services and interventions to better support the well-being and adaptation of IRs benefitting SDG # 3 on Good Health and Well-being.

Methods: Data were collected through semi-structured interviews with 24 MENA refugee caregivers (11 fathers, 13 mothers) and 15 SPs serving MENA refugees (resettlement case workers, counselors, and educators), 42 CA immigrant caregivers (21 fathers, 21 mothers), and 20 (11 fathers, 9 mothers) Ukrainian refugee caregivers in South and Midwestern states. Interviews were recorded, transcribed, translated into English, and analyzed using Nvivo 12 and grounded theory methods.

Results: The findings highlight common themes across the three groups, revealing resilient adaptation, trauma from conflicts and displacement, and acculturative challenges and barriers to help-seeking. MENA refugees experience challenges around patriarchal family norms enabling domestic violence, stigma around mental health, and concerns about loss of cultural identity leading to family conflict. CA immigrants face gender-role conflicts, reduced professional status, and barriers to accessing support services due to stigmatization and language barriers. Ukrainian refugees demonstrate resilience in the face of displacement but cope with trauma and struggle with underemployment, economic challenges, increased family conflicts, and language barriers. Despite these challenges, all groups express resilience and hopefulness. Across the three groups, the narratives express a belief in the benefits of resettlement in the US, particularly around the educational opportunities for youth.

Conclusions: The study’s results underscore the need for tailored support services and interventions to address the culturally specific challenges faced by IRs from MENA, CA, and Ukraine. The narratives identify a gap between the needs of these populations and the assistance they currently receive, as support services in the US have not historically prepared for culturally sensitive engagement with these subpopulations. Policy and practice could potentially improve engagement with these groups by prioritizing trauma-informed responses, gender-specific support, and culturally specific training for SPs. Innovative language programs like automated translation, on-demand interpreters international video conferencing, and community-based clubs might contribute to overcoming language-related barriers for older cohorts. Legal support for managing immigration issues, housing, health care, and employment are all emphasized as needs to facilitate acculturation and integration into US society.

The results suggest that public schools are serving as crucial points of contact between immigrant populations, native populations, and social services. Schools offer a unique institutional space to address cultural constructions and normative differences surrounding gender roles and mental health for younger generations of IRs. The perception of schools as a positive institution potentially provides a reservoir of good will in this subpopulation for expanding the uptake of tailored services using schools as entry points.