title: Immigrant women's experiences of postpartum depression in Canada: a protocol for systematic review using a narrative synthesis.
abstract: BACKGROUND
  Literature documents that immigrant women in Canada have a higher prevalence of postpartum depression symptomatology than Canadian-born women. There exists a need to synthesize information on the contextual factors and social determinants of health that influence immigrant women's reception of and behavior in accessing existing mental health services. Our research question is: what are the ethnoculturally defined patterns of help-seeking behaviors and decision-making and other predictive factors for therapeutic mental health care access and outcomes with respect to postpartum depression for immigrant women in Canada?
  
  
  METHODS
  Our synthesis incorporates a systematic review using narrative synthesis of reports (peer- and non-peer reviewed) of empirical research and aims to provide stakeholders with perspectives on postpartum mental health care services as experienced by immigrant women. To reach this goal we are using integrated knowledge translation, thus partnering with key stakeholders throughout the planning, implementation and dissemination stages to ensure topic relevancy and impact on future practice and policy. The search and selection strategies draw upon established systematic review methodologies as outlined by the Centre for Reviews and Dissemination and also incorporate guidelines for selection and appraisal of gray literature. Two search phases (a database and a gray literature phase) will identify literature for screening and final selection based on an inclusion/exclusion checklist. Quality appraisal will be performed using the tools produced by the Centre for Evidence Based Management. The narrative synthesis will be informed by Popay et al. (2006) framework using identified tools for each of its four elements. The integrated knowledge translation plan will ensure key messages are delivered in an audience-specific manner to optimize their impact on policy and practice change throughout health service, public health, immigration and community sectors.
  
  
  CONCLUSIONS
  The narrative synthesis methodology will facilitate understandings and acknowledgement of the broader influences of theoretical and contextual variables, such as race, gender, socio-economic status, pre-migration history and geographical location. Our review aims to have a substantive and sustainable impact on health outcomes, practice, programs and/or policy in the context of postpartum mental health of immigrant women. PROSPERO registration number CRD42012003020.
authors: Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Avenue, Edmonton AB T6G 1C9, Canada. gina.higginbottom@ualberta.ca.
authors: Gina M A
authors: GM
authors: Higginbottom
authors: Myfanwy
authors: M
authors: Morgan
authors: Joyce
authors: J
authors: O'Mahony
authors: Yvonne
authors: Y
authors: Chiu
authors: Deb
authors: D
authors: Kocay
authors: Mirande
authors: M
authors: Alexandre
authors: Joan
authors: J
authors: Forgeron
authors: Marilyn
authors: M
authors: Young
mesh_terms: D002170:Canada; D016206:Databases, Bibliographic; D003657:Decision Making; D019052:Depression, Postpartum / Q000208:ethnology* / Q000628:therapy*; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006801:Humans; D008605:Mental Health Services; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012107:Research Design; D000078202:Systematic Reviews as Topic
references: Syst Rev. 2012 May 31;1:27
references: 22651573
references: J Obstet Gynecol Neonatal Nurs. 2008 May-Jun;37(3):290-300
references: 18507600
references: J Immigr Minor Health. 2013 Apr;15(2):300-14
references: 22711219
references: Can J Psychiatry. 2008 Feb;53(2):121-4
references: 18357931
references: J Epidemiol Community Health. 2011 May;65(5):467-72
references: 21282138
references: Issues Ment Health Nurs. 2011;32(5):279-90
references: 21574842
references: Soc Sci Med. 2012 May;74(10):1610-21
references: 22464222
references: Nurs Ethics. 2008 Jan;15(1):52-61
references: 18096581
references: J Psychiatr Ment Health Nurs. 2010 Dec;17(10):917-28
references: 21078007
references: Health Care Women Int. 2008 Jul;29(6):593-617
references: 18569046
references: Matern Child Health J. 2008 Jan;12(1):101-11
references: 17592762
references: Matern Child Health J. 2011 Oct;15(7):866-75
references: 18256913
references: J Obstet Gynecol Neonatal Nurs. 2006 Nov-Dec;35(6):717-27
references: 17105636
references: Afr J Psychiatry (Johannesbg). 2010 Nov;13(5):357-65
references: 21390406
references: Health Res Policy Syst. 2009 Jun 10;7:15
references: 19515260
references: Obstet Gynecol Surv. 2012 May;67(5):313-23
references: 22624779
references: J Obstet Gynaecol Can. 2008 Mar;30(3):229-238
references: 18364100
references: BMC Public Health. 2011 May 11;11:302
references: 21569372
references: BMC Health Serv Res. 2008 Oct 03;8:203
references: 18834521
references: J Immigr Minor Health. 2012 Apr;14(2):223-9
references: 21559966
references: Soc Sci Med. 2006 Aug;63(4):1060-71
references: 16574289
references: Health Care Women Int. 2008 Jul;29(6):568-92
references: 18569045