*Strengths and Limitations*

The strength of our study is that we engaged 28 youth from diverse backgrounds to arrive at study findings. We included the languages of English, French, and Kiswahili in our interviews and worked with translators and back interpreters to allow youth to present their perspectives in a language they were most comfortable with. In spite of the strengths, we did not examine refugee youth's perspectives over time. We were not able to show how youth's perspective evolved overtime. Also, although youth in our study were of different ages, their experiences were similar. Needed is longitudinal research that examines how refugee youth's experiences change over time after arriving at their final destination country. Such research could also examine for differences or similarities based on age and sex.

#### **5. Conclusions**

African refugee youth arrive in Canada with their own cultural beliefs and experience challenges in adapting to the culture in Canada. These youth present with challenges of family disruptions, cultural conflicts, and their evolving identity, yet they receive limited support. In the wake of increasing immigration because of reasons that include war, refugee youth could greatly benefit from opportunities to develop cultural awareness with attention to experiences of facing new cultures. Additionally, services providers including those who provide social, educational, and health supports could pay greater attention to the unique needs of refugee youth especially those who are relieving adaptation challenges and offer better settlement support.

**Author Contributions:** Conceptualization, R.L.W.; methodology, R.L.W. and D.S.B.; formal analysis, R.L.W. and D.S.B.; writing—original draft preparation, R.L.W. and D.S.B.; writing—review and editing, R.L.W. and D.S.B.; project administration, R.L.W.; funding acquisition, R.L.W. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was supported by an operating grant from the Canadian Institutes of Health Research (Grant number: CIHR MOP-123481). First author (R.L.W.) is supported by a Tier 1 Canadian Research Chair (CRC) in Child and Family Engagement in Health Research and Healthcare (CIHR Canadian Research Chair No. 950-231845).

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Education and Nursing Research Ethics Board at the University of Manitoba (protocol code #E2012:089 and 3 October 2012).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study. Assent was obtained from youth who were 17 years old and younger in addition to consent from their parents.

**Data Availability Statement:** Due to ethical restrictions related to protecting participant privacy imposed by the University of Manitoba Education/Nursing Research Ethics Board of the University of Manitoba, the full, qualitative dataset (i.e., interview transcripts and field notes) cannot be made publicly available. Public availability would compromise patient confidentiality or participant privacy.

**Acknowledgments:** We thank all the youth that took part in this study for their contribution.

**Conflicts of Interest:** We declare that we have no competing interests.
