Health promotion in emerging collectivist communities: A study of dietary acculturation in the South Sudanese community in Logan City, Australia

Issue addressed

Understanding dietary acculturation within collectivist communities is required to develop and tailor appropriate health promotion strategies to prevent diet‐related chronic diseases. This research explores the journey of the South Sudanese community living in Logan City, Australia in establishing new norms around food choices and practices over time.

Methods

Three semi‐structured group interviews and a final community forum of women (n = 20) from the South Sudanese community were conducted. These explored changes in and influences on dietary practices post‐settlement. Sessions were recorded, transcribed and thematically analysed using inductive and deductive approaches. Feedback on findings from participants and community members was incorporated.

Results

Participants reported dietary acculturation phases, including assimilation, reflection and separation, with a return to traditional foods over time. Factors influencing the transition between phases included; the characteristics of the collectivist community such as shared knowledge, experiences and resources, increased accessibility to traditional foods, and increased food and health literacy as responses to emerging diet‐related health issues.

Conclusions

The Logan City South Sudanese community has navigated a new and complex food environment with positive long‐term dietary outcomes; however, the initial decline in health due to poor diet on arrival may have been prevented.

So what?

Early intervention and culturally appropriate health promotion strategies that are co‐designed and tailored to the characteristics and strengths of newly settled collectivist communities are needed. These should promote the benefits of healthy traditional food habits, while assisting communities to successfully navigate a new food environment.

Predictors of Dietary Diversity of Indigenous Food-Producing Households in Rural Fiji

Fiji, like other Pacific Islands, are undergoing economic and nutrition transitions that increase the risk of noncommunicable diseases (NCDs) due to changes of the food supply and dietary intake. This study aimed to examine dietary diversity (DD) in indigenous food-producing households in rural Fiji. Surveys were conducted with households from the Nadroga-Navosa, Namosi and Ba Provinces of Western Fiji in August 2018. Participants reported on foods consumed in the previous 24 h per the Household Dietary Diversity Score. Data was analysed using multinomial logistic regression. Of the 161 households, most exhibited medium DD (66%; M = 7.8 ± 1.5). Commonly consumed foods included sweets (98%), refined grains (97%) and roots/tubers (94%). The least consumed foods were orange-fleshed fruits (23%) and vegetables (35%), eggs (25%), legumes (32%) and dairy (32%). Households with medium DD were more likely to be unemployed (OR 3.2, p = 0.017) but less likely to have ≥6 occupants (OR = 0.4, p = 0.024) or purchase food ≥2 times/week (OR = 0.2, p = 0.023). Households with low DD were more likely to have low farm diversity (OR = 5.1, p = 0.017) or be unemployed (OR = 3.7, p = 0.047) but less likely to have ≥6 occupants (OR = 0.1, p = 0.001). During nutrition transitions, there is a need for public health initiatives to promote traditional diets high in vegetables, fruits and lean protein and agricultural initiatives to promote farm diversity.

Factors related to privacy of Somali refugees in health care

BACKGROUND

Privacy is one of the key principles in health care and requires understanding of the cultural aspects of patients' privacy. In Western cultures privacy is focused on the individual, however, in some non-Western cultures, privacy is linked to the collectivism of the community or religion.

OBJECTIVES

The objective of this study is to describe the factors related to the realisation of privacy of Somali refugees in health care by describing the factors related to the patient, healthcare professional and interpreter.

RESEARCH DESIGN

The data were collected from Somali refugees (N = 29) using a qualitative questionnaire and were analysed by deductive content analysis based on factors related to the patient, healthcare professional and interpreter.

ETHICAL CONSIDERATION

Ethical approval was obtained from the University of Turku, and research permissions were obtained from all participating institutions.

FINDINGS

Factors related to the patient were as follows: privacy was realised when the patient had self-determination; was able to act according to Somali culture; had knowledge and understanding of treatment; and trusted the healthcare professional. Factors related to the healthcare professional were as follows: the healthcare professional was expected to be of the same gender as the patient, act professionally, focus on the health issues, and to have knowledge and understanding of the Somali culture. Factors related to the interpreter were as follows: the presence and Somali background of the interpreter decreased privacy; the interpreter was expected to be of the same gender as the patient; to have competence and to behave professionally.

DISCUSSION

Gender congruence, professionalism and caring attitude and common understanding between the Somali patient and Finnish provider increase the privacy of Somali patients.

CONCLUSION

Somali patients' privacy can be improved by increasing healthcare professionals' understanding of Somali culture, acknowledging the importance of gender concordance in relation to healthcare professionals and interpreters, and the effect of the presence of the interpreter on patients' privacy.

How Social Interaction Affects Purchase Intention in Social Commerce: A Cultural Perspective

In the context of social commerce, the influence of culture on consumers’ behavior and attitude is more significant. This paper empirically analyzes the influence of social interaction (perceived risk, trust, and intimacy) on consumers’ purchase intention in social commerce, and the antecedent effect of cultural dimensions (uncertainty avoidance and individualism/collectivism) on social interaction is also explored. Data were collected in China and France from consumers who had prior online shopping experience on social commerce websites. The results show that the impact of perceived risk on subsequent purchase intention in social commerce will be transferred by trust and intimacy to a certain extent. The intimacy between users contributes to trust-building, and both of their positive impacts on purchase intention would show distinct effects in different cultures. Besides, cultural dimensions are proved to have a significant effect on users’ social interaction. Although high uncertainty avoidance brings perceived risk, it can promote subsequent trust-building. These findings help provide managerial insights for social commerce community to establish effective trust mechanism in a multicultural context.

In Sickness and Health: Views on Child Health From a Mayan Village

INTRODUCTION

Guatemala is the only country in Central America with a majority indigenous population. Most indigenous Mayans prefer to seek health advice from family members. It is important to understand the beliefs of Mayan caregivers. The purpose of this study was to examine indigenous ways of explaining health and illness in the context of one Mayan village.

METHOD

We applied a qualitative descriptive design in summer 2017. Interviews were conducted in Spanish with 10 Mayan caregivers, who were primarily female, between ages 19 and 50 years, in Guatemala. The sample was drawn from families who received a water filter the previous year.

RESULTS

Health was explained by access to food, including local herbs, and clean water. Illness was explained by bodily symptoms and behavioral changes.

DISCUSSION

Findings align with several United Nations 2030 Sustainable Development Goals and suggest a need to strategize with global partners.

Ethical, social, and cultural issues related to clinical genetic testing and counseling in low- and middle-income countries: a systematic review

PURPOSE

We performed a systematic review of the ethical, social, and cultural issues associated with delivery of genetic services in low- and middle-income countries (LMICs).

METHODS

We searched 11 databases for studies addressing ethical, social, and/or cultural issues associated with clinical genetic testing and/or counselling performed in LMICs. Narrative synthesis was employed to analyze findings, and resultant themes were mapped onto the social ecological model (PROSPERO #CRD42016042894).

RESULTS

After reviewing 13,308 articles, 192 met inclusion criteria. Nine themes emerged: (1) genetic counseling has a tendency of being directive, (2) genetic services have psychosocial consequences that require improved support, (3) medical genetics training is inadequate, (4) genetic services are difficult to access, (5) social determinants affect uptake and understanding of genetic services, (6) social stigma is often associated with genetic disease, (7) family values are at risk of disruption by genetic services, (8) religious principles pose barriers to acceptability and utilization of genetic services, and (9) cultural beliefs and practices influence uptake of information and understanding of genetic disease.

CONCLUSION

We identified a number of complex and interrelated ethical, cultural, and social issues with implications implications for further development of genetic services in LMICs.

'Half a woman, half a man; that is how they make me feel': a qualitative study of rural Jordanian women's experience of infertility

Infertility is a health problem encompassing physical, psychological and social consequences that may threaten women's quality of life. Few studies have been conducted in Jordan examining rural women's experiences of infertility. This study aimed to explore responses to infertility and its consequences in the Jordanian rural sociocultural context. Using a descriptive qualitative design, data were collected between April and September 2016 from a fertility clinic in a military hospital in Northern Jordan. Semi-structured interviews were conducted with 14 purposively selected Jordanian women. Data were analysed using thematic analysis. Findings revealing women's responses to infertility included: submission and docility, self-isolation, internalisation and persistence in getting pregnant by seeking modern and traditional methods of treatment. The impact of infertility complicated women's everyday living through their experiences of violence, kinship and patriarchal interference, stigma, negative perceptions of the infertile woman, and other's surveillance of their sexuality. Women living in rural areas of Jordan have negative experiences of infertility that are ingrained in sociocultural beliefs about fertility and reproduction. Healthcare professionals are encouraged to raise public awareness about infertility's adverse consequences and to help families by enhancing positive responses to infertility.