Finding Their Way: A qualitative study of adolescent migration between the Dominican Republic and th

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Finding Their Way A qualitative study of
adolescent migration between the Dominican
Republic and the United States
A Collaborative Study conducted by Profamilia,
Dominican Republic and The Heilbrunn Department
of Population and Family Health, Columbia
University NYC

• Linda F. Cushman, Ph.D., Francisco Caceres Ureña,
  Ph.D., Leopoldina Cairo, PhD, Ana
  Jimenez-Bautista, MSW, Germania Estevez, B.S.

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Dominican Republic
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Dominicans in NYC

• 1990
• 225,017 people
• (37 increase)
• From The Newest New Yorkers. 2004

• 2000
• 369,186 people

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Migration

• Emigration
• Immigration
• Circular Migration

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Families in Transition

• Tengo un pie aqui y el otro alla

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Study Methods

• Qualitative Paradigm
• IRB Approval/consent forms/information sheets
• Key informant interviews (8 U.S. 5 DR)
• Focus groups primary data collection method
• Segmentation by age and current residence
• Convenience Sampling for Parents and Teens
  segmentation
  
• Addition of Snowball sampling techniques

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Content

• Primary motivators for adolescent migration, and
  how decisions are made
  
• Access to reproductive health services
  perceptions regarding health services in the two
  countries
  
• Emotional impact of migration
• Some elements to consider in serving immigrant
  adolescents in NYC/RD

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Study Focus GroupsGroups17 N119

• Dominican Republic
• 5 parent groups
• (Santo Domingo, Santiago, y San Jose
• de las Matas)
• 5 adolescent groups
• (various communities)

• New York City
• 3 parent groups
• 4 adolescent groups
• All New York City/Washington Hts

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Analysis

• Bi-national analysis team 5 members
• Identification of main themes
• Separate grids for adolescent and parent data
• Comparison of US/DR within each grid

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RQ 1 Reasons for Adolescents Migration

• Specific reasons for migration for teens and
  parents centered around issues of
  
• Discipline and social control
• Lifestyle/economic factors
• Family relations

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Social Regulation of Adolescent Behavior US to
DR

• Parents are decision-makers regarding adolescent
  moves
  
• Concerns about school performance, sexual
  activity, drug use, other
  
• Concerns at community level (gangs, violence,
  supervision)

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Economic/Lifestyle Factors

• Perceived economic/educational opportunity in
  either country
  
• Unfulfilled economic expectations
• Family needs (health care, housing, etc.)

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RQ 2 Access to Health Services

• Both parents and teens recognized a 2-tier system
  of health care in both countries, but
  particularly in the DR.
  
• Parental perspectives were different from
  adolescents perspectives regarding access and
  migration. Parents felt the access to health
  services was not highly affected by migration.
• Teens felt that migration did affect their access
  to services, especially reproductive health
  services. They were also more likely to state
  that health care access and quality is somewhat
  better in the US.

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Access to Reproductive Health Services

• Adolescent view
• Reproductive health services readily available in
  the US
  
• Interruption of and a greater degree of
  difficulty obtaining reproductive and sexual
  health services in DR
  
• Unaware of programs catering to adolescents in
  DR
  
• Other deterrents in DR include lack of
  adolescent specialization, shame in using the
  services, stigmatizing environment and religious
  influences.

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RQ 3 Emotional Implications of Migration

• Adolescent view
• Adaptation to either country is difficult.
  Separation from friends and family caused sadness
  and anxiety.
  
• DR to US main stressors separation from
  care-providers (especially family members other
  than parents) , blended families, language,
  academic pressures, fear (violence, gangs,
  overwhelming school structure), and movement
  restrictions.

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RQ 3 Emotional Implications of Migration

• ADOLESCENTS, cont.
• US to DR main stressors anger regarding
  punishment, (some perceive an opportunity to
  straighten up)
  
• Language, new educational system
• Lack of accommodations (electricity, mosquitoes,
  lack of fast food restaurants)
  
• More attentive adults, control but less
  restrictions and opportunities to have more
  fun!!
  

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Emotional Impact of Migration

• Parental Perspective
• Separation, sadness, anxiety and depression, loss
  of family/community
  
• The adaptation process is short term and that
  once it is overcome it has positive outcomes from
  the teen.
  
• Adaptation to DR is easier Dominican community
  relations and extended family network.

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Overarching Findings

• Migration and repeat or circular migration can be
  seen as an adaptive, family-based process
  employed to address specific micro (behavioral)
  and macro (societal) issues/concerns
• Cultural differences in regulation of
  adolescents DR less formal more
  community-based (more freedom yet more safety
  and monitoring in DR)
• Theory of family formation, family dynamics
  transnational field (works in both directions)
  
• Reasons for migration contain seeds of repeat
  migration
  

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Considerations for Service Providers

• In General
• Include parents as they are the decision-makers.
  
  
• Consider and uphold the value and importance of
  privacy and confidentiality
  
• Resource Development
• Investigate and make available information on
  programs on health, and especially reproductive
  health to teens traveling to DR (accomplished)
  
• Be knowledgeable of and have resources to
  coordinate and facilitate services on both sides
  of the air bridge
  
• Further research needs to include focus on rural
  teens in the DR and Dominican teens recruited
  from other areas in New York (within and outside
  Washington Heights) as well as other high
  migration areas (e.g. Miami)

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Considerations

• In our discussions with adolescents and their
  families
  
• Educate the adolescents to consider the possible
  consequences
  
• Explore availability of. and help identify a more
  protective network/ community in the US
  
• Explore and reframe reality versus perception of
  danger for parents and teens
  
• Consider migration situation during assessments
  and re-assess periodically. Connect parents and
  teens with similar circumstances.
  
• Ask about meaningful relatives and friends left
  behind. Attempt to assist in communication and
  relationship building between individuals in both
  countries (e.g. Skype)
• Educate parents on preparing their children for
  migration educate teens on likely experiences
  

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Selected Bibliography

• Flores, Glen, and Ruth Enid Zambrana. The
  Health of Children and Youth. in Health Issues
  in the Latino Community. Eds. Marilyn
  Aguirre-Molina, Carlos Molina, and Ruth Enid
  Zambrana. San Francisco Jossey-Baas, 2001
• Gil, Andres, and William Vega. Latino Drug Use
  Scope, Risk Factors, and Reduction Strategies.
  in Health Issues in the Latino Community. Eds.
  Marilyn Aguirre-Molina, Carlos Molina, and Ruth
  Enid Zambrana. San Francisco Jossey-Baas, 2001
• Guarnizo, Luis E. Los Dominicanyorks The making
  of a binational society. Annals of the American
  Academy of Political and Social Science. V. 533
  (1994). P. 70-86

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Bibliography continued

• Hernandez, Ramona. The mobility of Workers Under
  Advanced Capitalism Dominican Migration to the
  United States. New York Columbia University
  Press, 2002
• LaRoche, Martin J. The Association of Social
  Relations and Depression Levels Among Dominicans
  in the United States Hispanic Journal of
  Behavioral Sciences. V. 21 no. 24 (november 1999)
  p. 420-30
• Suarez-Orozco, Carola, Irina Todorova, and
  Josephine Louie. Making Up For Lost Time The
  Experience of Separation and Reunification Among
  Immigrant Families. Family Process. V. 41, no 4
  (2002) p. 625-643