Culturally Adaptive Walking Intervention for Korean-Chinese Female Migrant Workers

Coproducing a culturally sensitive storytelling video intervention to improve psychosocial well-being: a multimethods participatory study with Nepalese migrant workers

OBJECTIVE

This study aimed to coproduce a culturally adaptive storytelling video intervention to support the psychosocial well-being of Nepalese migrant workers.

DESIGN

A multimethods participatory study was conducted involving three different but interconnected phases: (1) formative research involving a systematic review, pilot survey and stakeholder consultations; (2) exploration and analysis of Nepalese literature relevant to contemporary migration; and (3) coproduction of a storytelling video intervention, using participatory workshops.

PARTICIPANTS AND SETTINGS

Convenience sample of outgoing and returnee migrant workers from the Gulf Cooperation Council (GCC) countries, their families and other relevant stakeholders in Dhading District of Bagmati Province, Nepal.

RESULTS

The systematic review of 33 included studies identified five key health issues: mental health; occupational hazards; sexual health; healthcare access; and infectious diseases. In the survey (n=60), workers reported various health problems including fever/common cold (42%); mental health problems (25%); and verbal abuse (35%). Twenty interviewees identified issues related to physical health (eg, pneumonia, kidney disease) as well as mental health (eg, anxiety, depression). Nepalese literary resources primarily portrayed themes of: separation; hopelessness and helplessness; and poor workplace environments. Drawing on these findings and iterative workshops with stakeholders, a culturally sensitive storytelling video intervention was coproduced to support the psychosocial well-being of Nepalese migrant workers in GCC countries. The intervention used an animated video format with audio narration and subtitles, presenting a story centred around the struggles of an archetypal male migrant worker and their use of coping strategies for dealing with adversities.

CONCLUSIONS

This is a feasibility study conducted in a single district of Nepal; as such, the findings should be generalised cautiously. Despite these limitations, the project is testament to the value of participatory methods in the development of culturally sensitive public health interventions for marginalised groups, and points to the utility of coproduced storytelling formats in migrant health contexts. Future research is needed to evaluate feasibility and acceptability of the intervention as well as the outcomes and experiences of migrant workers who engaged with the video.

Factors Influencing Physical Activity Participation among Midlife Immigrant Women: A Systematic Review

Immigrant women are less likely to be physically active and face many barriers to participation in physical activity. This systematic review aims to identify the influencing factors and adaption approaches of physical activity interventions among midlife immigrant women. A systematic literature search was performed using various databases, such as MEDLINE, PsycINFO, and CINAHL, in February 2021. Studies were included if they investigated midlife immigrant women participating in physical activity interventions and were published in an English peer-reviewed journal in or after 2000. Twenty-two papers were included in this review. Guided by the Ecosocial theory, thematic analysis was utilized for data analysis. Among midlife immigrant women, influencing factors associated with physical activity participation included individual factors (a lack of time, current health status, motivation, and a lack of proficiency in various life skills), familial factors (familial support and seasonality), and community factors (social support and neighbourhood environment). The appropriate adaptation of physical activity interventions included adjustments in language, physical activity intensity, physical activity duration, logistical intervention adjustments and other potential technology-based adjustments. The findings can inform community stakeholders, healthcare professionals and researchers to design appropriate physical activity interventions that meet the needs of midlife immigrant women and improve their health outcomes.

Effect of a Pedometer-Based, 24-Week Walking Intervention on Depression and Acculturative Stress among Migrant Women Workers

Little research has examined exercise-based interventions meant to alleviate depressive symptoms among Korean-Chinese migrant women workers living in Korea. Thus, this study evaluated the effectiveness of a 24-week walking program on reducing depressive symptoms and acculturative stress levels in this population. This quasi-experimental sequential walking program was conducted with 132 Korean-Chinese women over a period of 24 weeks. Participants were divided into either a standard treatment group (n = 69) or enhanced treatment group (n = 63). All participants were instructed to walk using a pedometer. The enhanced treatment group also received mobile text messages designed to encourage walking adherence and improve acculturation. Participants were asked to complete two structured questionnaires, the Centre for Epidemiologic Studies Depression Scale and the Acculturative Stress Scale, to evaluate the intervention programs. At the end of the program, both groups exhibited decreased depression scores, but the decrease in the enhanced treatment group was more significant both at weeks 12 and 24. Acculturative stress was also found to have decreased at weeks 12 and 24. Our findings show the walking program reduced the depressive symptoms and acculturative stress levels among the Korean-Chinese women in this study. Further studies will be needed to analyze the relationship between walking step count and mental health considering exercise intensity.

Engaging stakeholders in the co-development of programs or interventions using Intervention Mapping: A scoping review

BACKGROUND

Health care innovations tailored to stakeholder context are more readily adopted. This study aimed to describe how Intervention Mapping (IM) was used to design health care innovations and how stakeholders were involved.

METHODS

A scoping review was conducted. MEDLINE, EMBASE, Cochrane Library, Scopus and Science Citation Index were searched from 2008 to November 2017. English language studies that used or cited Intervention Mapping were eligible. Screening and data extraction were done in triplicate. Summary statistics were used to describe study characteristics, IM steps employed, and stakeholder involvement.

RESULTS

A total of 852 studies were identified, 449 were unique, and 333 were excluded based on title and abstracts, 116 full-text articles were considered and 61 articles representing 60 studies from 13 countries for a variety of clinical issues were included. The number of studies published per year increased since 2008 and doubled in 2016 and 2017. The majority of studies employed multiple research methods (76.7%) and all 6 IM steps (73.3%). Resulting programs/interventions were single (55.4%) or multifaceted (46.4%), and 60.7% were pilot-tested. Programs or interventions were largely educational material or meetings, and were targeted to patients (70.2%), clinicians (14.0%) or both (15.8%). Studies provided few details about current or planned evaluation. Of the 4 (9.3%) studies that reported impact or outcomes, 3 achieved positive improvements in patient or professional behaviour or patient outcomes. Many studies (28.3%) did not involve stakeholders. Those that did (71.7%) often involved a combination of patients, clinicians, and community organizations. However, less than half (48.8%) described how they were engaged. Most often stakeholders were committee members and provide feedback on program or intervention content or format.

CONCLUSIONS

It is unclear if use of IM or stakeholder engagement in IM consistently results in effective programs or interventions. Those employing IM should report how stakeholders were involved in each IM step and how involvement influenced program or intervention design. They should also report the details or absence of planned evaluation. Future research should investigate how to optimize stakeholder engagement in IM, and whether use of IM itself or stakeholder engagement in IM are positively associated with effective programs or interventions.