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Charania NA, Tonumaipe'a D, Barbarich-Unasa TW, Iusitini L, Davis G, Pacheco G, Wilson D. Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand. Hum Vaccin Immunother 2024; 20:2301626. [PMID: 38205779 DOI: 10.1080/21645515.2023.2301626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. "We go with the norm" reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants' acceptance of routine vaccines before the pandemic. "Everything became difficult" explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. "It needed to have an ethnic-specific approach" highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. "People are now finding their voice" expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
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Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Daysha Tonumaipe'a
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Te Wai Barbarich-Unasa
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Georgina Davis
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Gail Pacheco
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Wilson
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
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Lowe J, Brooks J, Lawrence G, Baldwin JA, Kelley M, Wimbish-Tompkins R. Intertribal Talking Circle for the prevention of alcohol and drug use among Native American youth. Res Nurs Health 2024; 47:234-241. [PMID: 38281085 DOI: 10.1002/nur.22372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 11/06/2023] [Accepted: 12/24/2023] [Indexed: 01/29/2024]
Abstract
The purpose of this study was to examine the impact of a culturally based intervention, the Intertribal Talking Circle program, compared to a standard alcohol and drug abuse education, the Be A Winner program. Community-based participatory research was used to implement a two-condition, quasi-experimental study. The sample included 540 Native American youth ages 10-12 years old from three tribal areas in the United States. Data were collected at baseline, 6 and 12-months post-intervention for both the intervention and control groups using demographic, cultural identity, alcohol use, and drug use questionnaires. Regression models evaluated participants' improvement in decreasing alcohol and drug use and increasing cultural identity. Findings revealed that alcohol and drug use decreased more significantly among youth who participated in the Intertribal Talking Circle (ITC) intervention program than youth who participated in a standard alcohol and drug abuse education Be A Winner (BAW) program. Cultural identity also increased more significantly among participants who completed the Talking Circle intervention program. Native American youth ages 10-12 years old respond positively to a culturally based intervention for the reduction of alcohol and drug use. The findings highlight the importance of cultural values and identity and their significance in preventing and reducing alcohol and drug use among Native American youth.
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Affiliation(s)
- John Lowe
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA
| | - Jada Brooks
- UNC School of Nursing, Chapel Hill, North Carolina, USA
| | - Gary Lawrence
- Choctaw Nation Health Services Authority, One Choctaw Way, Talihina, Oklahoma, USA
| | - Julie A Baldwin
- Department of Health Sciences, Center for Health Equity Research (CHER), Northern Arizona University, Flagstaff, Arizona, USA
| | - Melessa Kelley
- School of Nursing, The University of Texas at Austin, Austin, Texas, USA
| | - Rose Wimbish-Tompkins
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA
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Hochstetler E, Taweh O, Mistry AJ, Metz P. Worcester Refugee Assistance Project: An Example of Strengths-Based, Community-Based, Culturally Sensitive Care. Child Adolesc Psychiatr Clin N Am 2024; 33:263-276. [PMID: 38395510 DOI: 10.1016/j.chc.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Refugee populations are diverse and can present with a variety of unique and complex circumstances. The purpose of this article is to examine an organization that provides care to refugee youth, the ways in which this is accomplished, and a few of the challenges that have been faced. Specifically, the work of this organization will be examined using a Systems of Care philosophy to demonstrate how using these concepts can assist in providing sensitive, high-quality care.
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Affiliation(s)
- Emily Hochstetler
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Omar Taweh
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Anushay J Mistry
- Children's Hospital Los Angeles, 4650 Sunset Boulevard, Los Angeles, CA 90027, USA
| | - Peter Metz
- University of Massachusetts, T.H. Chan School of Medicine, 55 Lake Avenue North, Worcester, MA 01655, USA
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Holman-Allgood I, Cline C, Durand C, Purvis RS, Mendoza Kabua P, Ayers BL. Providers' Perspectives of a Culturally Adapted CenteringPregnancy Intervention for Marshallese Women in Arkansas. Nurs Womens Health 2024; 28:117-127. [PMID: 38460942 PMCID: PMC10999336 DOI: 10.1016/j.nwh.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 03/11/2024]
Abstract
OBJECTIVE To explore health care providers' perspectives on the successes, challenges, and suggestions for future directions regarding the implementation of CenteringPregnancy for Marshallese women in Arkansas. DESIGN A descriptive qualitative design was used as an exploratory method. SETTING/LOCAL PROBLEM This study took place in northwest Arkansas. Arkansas is home to the largest Marshallese Pacific Islander population in the United States. Marshallese Pacific Islanders residing in the United States have disproportionally high rates of poor maternal and infant health outcomes, even compared to other Pacific Islanders. PARTICIPANTS Seven CenteringPregnancy providers from the University of Arkansas for Medical Sciences Northwest. INTERVENTION/MEASUREMENTS Individual interviews were conducted from February to March of 2023. Data were managed using MAXQDA12 software. Content analysis was used to analyze the data. Initial coding was completed to identify each data segment with short summations of emergent themes. The focused thematic codes that emerged were used to identify and develop the most salient thematic categories of the data, which became the thematic codes. RESULTS Three overarching themes emerged: Implementation Successes, Challenges to Implementation, and Future Suggestions to Improve Implementation and Sustainability. Each theme had representative subthemes. CONCLUSION Findings provide insight for future implementation of CenteringPregnancy for Marshallese and other Pacific Islander individuals.
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Gelaw KA, Atalay YA, Walle BG, Gesese MM, Assfaw BB, Gebeyehu NA. Prevalence and Associated Factors of Cultural Malpractice During the Perinatal Period in Ethiopia: A Systematic Review and Meta-Analysis. Reprod Sci 2024; 31:661-674. [PMID: 37917296 DOI: 10.1007/s43032-023-01383-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023]
Abstract
The health of the mother and children are potentially affected by several types of cultural malpractices that occur during the perinatal period. Ethiopia is a multi-ethnic nation where a variety of cultural practices are observed, especially during pregnancy, delivery, and the postpartum period. This study aimed to assess the prevalence and associated factors of cultural malpractice during the perinatal period in Ethiopia. Data searches were conducted in PubMed/Medline, Web of Science, Scopus, Google Scholar, African Journals Online, and the Cochrane Library. Data were extracted using Microsoft Excel, and analysis was done using STATA version 14. Less than a p-value of 0.05 was regarded to indicate potential publication bias: the funnel plot, Begg, and Egger's regression tests were used to examine publication bias. This study included 18 studies and 7880 mothers. The pooled prevalence of cultural malpractice during pregnancy, childbirth, and postpartum was 34.95% (95% CI: 27, 42.56), 31.18% (95% CI: 19.61, 42.76), and 45.83% (95% CI: 34.22, 57.45) respectively in Ethiopia. In addition, the following factors are statistically associated with the perinatal period: pregnancy: ANC follow-up (AOR = 3.06, 95%CI = 2.04, 4.58), educational status (AOR = 3.30, 95%CI = 1.99, 5.48), and residence (AOR 2.47, 95%CI, 1.601, 3.81); childbirth: ANC follow-up (AOR = 9.94, 95%CI = 2.05, 48.09), maternal age (AOR = 2.27, 95%CI = 1.56, 3.29), and maternal education (AOR = 10.37, 95%CI = 6.145, 17.51); during postpartum: ANC follow-up (AOR = 3.67, 95%CI = 1.96, 6.844), maternal education (AOR = 6.87, 95%CI = 3.26, 14.49), and residence AOR4.79, 95%CI, 2.97, 7.49). The pooled prevalence of cultural malpractice during the perinatal period was high. Health professionals should encourage beneficial practices through health education for a healthy perinatal period for mothers.
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Affiliation(s)
- Kelemu Abebe Gelaw
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
| | - Yibeltal Assefa Atalay
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Belete Gelaw Walle
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Molalegn Mesele Gesese
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Belete Birhan Assfaw
- Department of Psychiatry, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Strange KE, Mixer SJ, Embler P, Smith JL, Troutman-Jordan M. Influences of Faith on Rural Appalachian Older Adult Health: An Ethnonursing Study. J Transcult Nurs 2024; 35:112-124. [PMID: 38062764 DOI: 10.1177/10436596231213343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Rural Appalachian older adults (RAOAs) constitute a vulnerable population and experience significant health disparities. The combination of age, poverty, rural residence, health care provider shortages, and limited transportation increases risks for poor health outcomes. Spirituality enhances older adult health; however, little is known about spirituality-health linkages of RAOAs. Therefore, the purpose of this study was to discover the influences of spirituality on RAOA health. METHODOLOGY Culture Care Theory and ethnonursing method guided analysis of 32 RAOA interviews in community settings in East Tennessee. RESULTS "Faith" is an integral component of RAOA culture and health. Three themes were extrapolated: (a) Relationship with God is personal; (b) faith beliefs and practices influence health, illness, death, and dying; and [the need to] (c) "Open the door" for spiritual care. DISCUSSION Faith assessment and spiritual care recommendations contribute to culturally congruent care for RAOAs and may be transferable to care for other older adults.
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Call for Papers for a Special Issue Focused on Culturally Responsive Qualitative Health Research. Qual Health Res 2024; 34:279. [PMID: 38349787 DOI: 10.1177/10497323241233807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
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Keelan K, Pitama S, Wilkinson T, Lacey C. It's not special treatment… That's part of the Treaty of Waitangi! Organisational barriers to enhancing the Aged Residential Care environment for older Māori and Whānau in New Zealand. Int J Health Plann Manage 2024; 39:447-460. [PMID: 37990140 DOI: 10.1002/hpm.3734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND New Zealand's older Indigenous Māori people experience poorer health and reduced access to healthcare than their older non-Māori counterparts. Organisational factors (such as leadership or workforce) may influence the attitudes and perceptions of older Māori and their family (whānau) to use aged residential care services. Currently, there is a paucity of research surrounding the organisational barriers that impact the experiences of older Māori people who seek care in aged residential care (ARC) services. METHODS This study used a Kaupapa Māori qualitative research approach that legitimises Māori knowledge and critiques structures that subjugate Māori autonomy and control over their wellbeing. Interviews regarding their experiences of care were carried out with older Māori (n = 30) and whānau (family) members (n = 18) who had used, or declined to use an aged residential care facility. Narrative data were analysed inductively for themes that illustrated organisational barriers. RESULTS The key organisational theme was 'Culturally safe care', within which there were three barriers: 'Acceptability and Adequacy of Facility', 'Interface Between Aged Residential Care and Whānau Models of Care', and 'Workforce'. Collectively, these barriers emphasise the importance of an organisational approach to improving the quality of care delivered to older Māori and whānau in ARC. CONCLUSION Fostering a collective culture of equity within ARC provider services and equipping healthcare leaders and staff with the skills and knowledge to deliver culturally safe care is critical to addressing organisational barriers to ARC.
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Affiliation(s)
- Karen Keelan
- Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | - Suzanne Pitama
- Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | - Tim Wilkinson
- Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Māori Indigenous Health Innovation (MIHI), University of Otago, Christchurch, New Zealand
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Gordon J, Wongsomboon V, Alvarado Avila A, Lorenzo J, Mustanski B, Macapagal K. Experiences of Successful PrEP Uptake Among Adolescent Sexual Minority Men in the United States: A Qualitative Exploration. AIDS Educ Prev 2024; 36:1-15. [PMID: 38349349 DOI: 10.1521/aeap.2024.36.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Male adolescent sexual minorities are at elevated risk of HIV acquisition yet demonstrate low rates of PrEP uptake. Understanding the experiences of adolescents who have successfully accessed PrEP may inform ways to best support adolescents seeking PrEP. Adolescent sexual minorities (N = 100) who reported utilizing PrEP responded to open-ended items asking about their initial PrEP experiences and advice for others. Qualitative analysis suggested that adolescents' ability to access PrEP is influenced by managing parental involvement and seeking culturally competent health care providers. Additionally, they reported how the benefits and drawbacks of taking PrEP played a role in their PrEP use. Findings suggest that educational PrEP interventions targeted at this population could improve uptake by incorporating discussions on side effects and mental health benefits associated with PrEP use. Structural interventions are warranted that improve adolescents' ability to seek sexual health care independently and make room for parental involvement when adolescents could benefit from their support.
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Affiliation(s)
- Jacob Gordon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Val Wongsomboon
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Julianna Lorenzo
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brian Mustanski
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kathryn Macapagal
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Black C, Frederico M, Bamblett M. 'Healing through culture': Aboriginal young people's experiences of social and emotional wellbeing impacts of cultural strengthening programs. Child Abuse Negl 2024; 148:106206. [PMID: 37183121 DOI: 10.1016/j.chiabu.2023.106206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 03/31/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Cultural connection for Aboriginal young people promotes wellbeing, resilience and healing. There is little research on the social and emotional wellbeing (SEWB) impacts of cultural strengthening programs for Aboriginal young people, especially research that includes the perspectives of young people. There is even less research that includes the experiences of Aboriginal young people who have been in out-of-home care. OBJECTIVE The current study sought to address these research gaps by exploring the SEWB impacts of cultural strengthening programs by amplifying the voice of Aboriginal young people, including those who have been in out-of-home care. PARTICIPANTS AND SETTING Aboriginal young people involved in an innovative cultural strengthening program, the Narrun Yana art collective, established by the Victorian Aboriginal Child Care Agency (VACCA). Also participating was VACCA's Team Leader of Children and Youth Programs, thus providing both experiences of participating in and of organising cultural programs. METHOD A qualitative phenomenological approach was taken. Data consisted of semi-structured interviews with the team leader and two young people and written responses to the interview questions from one young person. RESULTS Lived experience provided evidence that cultural strengthening programs; help strengthen SEWB, including connection to self, relationships, community and culture; contribute to building resilience in the context of intergenerational trauma, cultural loss and racism; and encourage help-seeking, both informal support and accessing mental health services. Young people also viewed participating in the research as worthwhile. CONCLUSIONS Findings highlighted the importance of Aboriginal young people having opportunities to; connect to culture through participation in cultural strengthening programs, and engage in the design of these programs.
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Affiliation(s)
| | | | - Muriel Bamblett
- Victorian Aboriginal Child Care Agency (VACCA) and La Trobe University, Australia
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Fitzmaurice-Brown L. Whakarongo Mai: Listening to the views of tamariki, whānau and kaimahi within the Aotearoa New Zealand child protection system. Child Abuse Negl 2024; 148:106392. [PMID: 37573236 DOI: 10.1016/j.chiabu.2023.106392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 06/26/2023] [Accepted: 07/31/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND The Aotearoa New Zealand child protection system consistently fails Māori (Aotearoa New Zealand's Indigenous peoples), with recent reports calling for fundamental changes. Those longer-term shifts are necessary, but short-term changes are also needed. One such change is a shift in the way child protection decisions are made, and the ways in which tamariki (children) and whānau (families) are involved in those processes. OBJECTIVE This research sought to explore the views of a small group of Māori people with experience of the child protection system on one overarching question, "how should decisions about the safety and wellbeing of tamariki Māori be made, and what role should whānau and tamariki themselves play in that process?" PARTICIPANTS, METHOD AND SETTING Eight semi-structured interviews were conducted, seven of which were in person and one of which took place online. All participants were Māori, and all of them had involvement with the child protection system in either a personal or a professional capacity. Two of the participants were young people themselves. FINDINGS AND CONCLUSION Three overarching themes were identified: that the voices of tamariki, whānau and kaimahi (professionals) all have a place, but the current system doesn't strike the right balance, that the value of tikanga (Māori cultural values and practices) cannot be understated, but care is needed for whānau who may not know that tikanga, and that the challenges experienced by whānau in this context are often intergenerational. The paper concludes with a discussion of implications for law and policy.
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Affiliation(s)
- Luke Fitzmaurice-Brown
- Faculty of Law, Victoria University of Wellington, 55 Lambton Quay, Wellington, New Zealand.
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Praptomojati A, Icanervilia AV, Nauta MH, Bouman TK. A systematic review of Culturally Adapted Cognitive Behavioral Therapy (CA-CBT) for anxiety disorders in Southeast Asia. Asian J Psychiatr 2024; 92:103896. [PMID: 38199202 DOI: 10.1016/j.ajp.2023.103896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/19/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Cognitive Behavioral Therapy (CBT) has been proven an effective treatment for anxiety disorders. However, CBT still dominantly uses concepts and constructs rooted in Western cultures, and most research focuses on Western populations. It is unsure how this translates to non-Western cultures like Southeast Asia. AIMS Our objective is to explore which types of cultural adaptations in CBT have been implemented for anxiety disorders in Southeast Asia and their effectiveness. METHODS We systematically searched PubMed, PsycINFO, Embase, CENTRAL, GARUDA, and Google Scholar for CA-CBT for anxiety disorders in local communities in Southeast Asian countries. Data were analyzed using a narrative approach distinguishing between peripheral and core component adaptations. PROSPERO database preregistration number was CRD42022336376. RESULTS Seven studies (one randomized controlled trial, three quasi-experimental studies, and three case reports) were selected. Two studies made cultural adaptations in multiple components. Two studies modified core treatment components by incorporating local values in the CBT restructuring process. Three studies conducted cultural adaptation on peripheral treatment components: adaptation to materials and semantics, cultural examples and themes, and session structure. Three studies did not provide detailed information. One RCT study showed better improvement for those who got CA-CBT than those in treatment as usual (TAU). CONCLUSION The findings suggest some components to consider when conducting cultural adaptation. We could not establish the degree of superiority of CA-CBT over non-CA-CBT nor identify components with the most influence due to the limited number of studies found. Employing standard documentation in reporting trials is also important to increase transparency.
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Affiliation(s)
- Ardian Praptomojati
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; Faculty of Psychology, Universitas Gadjah Mada, Jl. Sosio Humaniora Bulaksumur, 55281 Yogyakarta, Indonesia.
| | - Ajeng Viska Icanervilia
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, RSUP. Dr. Sardjito, Jl. Kesehatan 1, Sekip, 55284 Yogyakarta, Indonesia; Clinical Epidemiology and Biostatistics Unit (CEBU), Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Litbang FK-KMK UGM Lantai 1, Jl. Medika, Senolowo, Mlati, Sleman, Yogyakarta, Indonesia
| | - Maaike H Nauta
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
| | - Theo K Bouman
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands
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Ghamrawi W, Benson J, Kennedy E. Communicating medical information with Aboriginal patients: lessons learned from GPs and GP registrars in Aboriginal primary health care. Aust J Prim Health 2024; 30:NULL. [PMID: 37710389 DOI: 10.1071/py23128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Aboriginal culture stands as the oldest continuous culture in the world. It gives paramount importance to a harmonious balance between personal connections to the body, spirit, and mind, as well as collective relationships with family, land, and community, integral to the wellbeing of Aboriginal people. However, obstacles can emerge for patients due to language barriers, cultural differences, or a historical lack of trust in the healthcare system. The establishment of Aboriginal Community Controlled Health Organisations (ACCHOs) has undoubtedly improved the healthcare experience for Aboriginal patients, yet there is limited research on the specific approaches utilised by general practitioners (GPs) working in these clinics. METHODS Twelve semi-structured interviews were conducted with two groups of GPs working in Aboriginal health. Each GP was presented with three scenarios and asked questions related to each scenario. Braun and Clarke's method of thematic analysis was applied to transcribed interviews. RESULTS Patient-doctor relationship, health literacy, and engagement with the health system emerged as key factors influencing communication with Aboriginal patients. Experienced GPs, despite differing clinical backgrounds, shared concise yet similar ideas to their less experienced counterparts. Notably, experienced GPs prioritised non-medical conversations and mindful body language, emphasising the importance of building strong patient relationships over other consultation aspects. CONCLUSIONS This research provides initial insights for GPs in Aboriginal health, comparing experienced GPs with more than 10years experience to novices. However, further research involving Aboriginal patients is needed to validate GP strategies and understand their significance from the patients' perspective.
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Affiliation(s)
- Wissam Ghamrawi
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia; and GPEx, Research Department, Unley, SA 5061, Australia
| | - Jill Benson
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia; and GPEx, Research Department, Unley, SA 5061, Australia
| | - Emma Kennedy
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia
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Jang Y, Hepburn K, Haley WE, Park J, Park NS, Ko LK, Kim MT. Examining cultural adaptations of the savvy caregiver program for Korean American caregivers using the framework for reporting adaptations and modifications-enhanced (FRAME). BMC Geriatr 2024; 24:79. [PMID: 38245703 PMCID: PMC10800033 DOI: 10.1186/s12877-024-04715-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/16/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) is a tool that systematically guides decision-making and reporting of adaptations made to evidence-based interventions. Using FRAME, we documented the process and outcomes of adapting the Savvy Caregiver Program (SCP) for Korean American dementia caregivers. METHODS Sequential adaptation was initiated with linguistic attunement, followed by pilot implementation and full adaptation. Our data-driven adaptation with multiple data sources and a feedback loop among multiple stakeholders yielded a total of 32 modifications, and each was coded according to the eight domains of FRAME: (1) what was modified, (2) who participated in recommending and deciding the modification to be made, (3) when the modification occurred, (4) whether the modification was planned, (5) whether the modification was fidelity-consistent, (6) whether the modification was temporary, (7) at what level of delivery, the modification was made, and (8) why the modification was made. RESULTS The areas of adaptation were evenly distributed across context (37.5%), content (31.2%), and training (31.2%). The primary reasons for modification were for engagement (62.5%), followed by fit with recipients (43.8%) and outcome improvement (31.1%). About 66% of the modifications were applied to the entire target group, and all modifications were fidelity-consistent. CONCLUSIONS The FRAME categorization provided a detailed understanding of the process and nature of adapting the SCP and served as a foundation for further implementation and scale-up. FRAME not only serves as a guide for adapting evidence-based interventions but also promotes their replicability and scalability.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA.
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea.
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, USA
| | - William E Haley
- School of Aging Studies, University of South Florida, Tampa, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, USA
| | - Linda K Ko
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, USA
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Santos RVPDS, Cruz Neto J, Bacelo SR, José OYF, Vergara-Escobar OJ, Machuca-Contreras F, de Moraes MCL, Lourenção LG, de Sousa ÁFL, de Oliveira LB, Mendes IAC, de Sousa AR. Migrant Men Living in Brazil during the Pandemic: A Qualitative Study. Int J Environ Res Public Health 2024; 21:109. [PMID: 38248571 PMCID: PMC10815311 DOI: 10.3390/ijerph21010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
This study aims to analyze the repercussions of the ongoing COVID-19 pandemic on the health of male immigrants, refugees, and asylum seekers in Brazil. A qualitative study involving 307 adult men living in Brazil during the COVID-19 pandemic was conducted. Data were collected between August 2021 and March 2022 and interpreted based on the Transcultural Nursing Theory. Cultural care repercussions were identified in various dimensions: technological: changes in daily life and disruptions in routine; religious, philosophical, social, and cultural values: changes stemming from disrupted social bonds, religious practices, and sociocultural isolation; political: experiences of political partisanship, conflicts, government mismanagement, a lack of immigration policies, human rights violations, and xenophobia; educational/economic: challenges arising from economic impoverishment, economic insecurity, unemployment, language difficulties, and challenges in academic and literacy development during the pandemic. The persistence of the COVID-19 pandemic in Brazil had significant repercussions for the health of migrant men, resulting in a transcultural phenomenon that requires sensitive nursing care. Implications for nursing: the uniqueness of cultural care in nursing and health, as most of the repercussions found were mostly negative, contributed to the increase in social and health vulnerabilities.
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Affiliation(s)
| | - João Cruz Neto
- Nursing Department, University for International Integration of the Afro-Brazilian Lusophony, Redenção 43900-000, CE, Brazil;
| | | | | | | | - Felipe Machuca-Contreras
- Virrectoría de Investigación y Postgrado., Universidad Autónoma de Chile, Santiago 7500912, Chile;
| | - Maria Cecilia Leite de Moraes
- School of Nursing, Federal University of Bahia, Salvador 40110-909, BA, Brazil; (R.V.P.d.S.S.); (M.C.L.d.M.); (A.R.d.S.)
| | | | | | - Layze Braz de Oliveira
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (L.B.d.O.); (I.A.C.M.)
| | - Isabel Amélia Costa Mendes
- Ribeirão Preto College of Nursing, Universidade de São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (L.B.d.O.); (I.A.C.M.)
| | - Anderson Reis de Sousa
- School of Nursing, Federal University of Bahia, Salvador 40110-909, BA, Brazil; (R.V.P.d.S.S.); (M.C.L.d.M.); (A.R.d.S.)
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16
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Garcia CN, Duran MC, Ramirez M. Refining Cultural Adaptations of a Behavioral Intervention for Latino Caregivers of People Living With Dementia: Qualitative Interview Study in Washington State. JMIR Aging 2024; 7:e53671. [PMID: 38206663 PMCID: PMC10811572 DOI: 10.2196/53671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND In the United States, Latino caregivers of individuals with dementia face unique challenges and an elevated risk of adverse health outcomes. Despite the increasing prevalence of Alzheimer disease and related dementias among Latino adults, few evidence-based interventions are tailored to their cultural context. To address this gap, we examined the cultural adaptations required for the STAR caregivers (STAR-C) virtual intervention, an evidence-based intervention that educates family caregivers to manage behavioral and psychological symptoms of dementia. While STAR-C has shown effectiveness, neither the original in-person nor the virtual intervention considered the distinct experiences of Latino caregivers, who often bring culturally significant values into caregiving interactions. OBJECTIVE This study's objective was to test and refine the preliminary cultural adaptations of the STAR-C web-based training modules for Latino caregivers of people living with dementia. METHODS Through qualitative interviews with 15 Latino caregivers in Washington State, we identified key adaptations to enhance the cultural relevance of the web-based training modules. RESULTS The interviews highlighted 4 main themes for adaptation: the delivery of the STAR-C web-based training modules, comprehensive dementia education, simplified problem-solving strategies, and prioritizing caregiver well-being. CONCLUSIONS This study's findings informed the development of culturally adapted STAR-C web-based training modules that aim to provide tailored support to Latino caregivers. While further research is needed to assess the efficacy of these adaptations, our work contributes to bridging the gap in dementia caregiving for Latino families, potentially reducing health disparities and enhancing health care services for this population.
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Affiliation(s)
- Celeste N Garcia
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Miriana C Duran
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
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Lor M, Hammes AM, Arcia A. Development of a culturally appropriate faces pain intensity scale for Hmong patients. Pain Med 2024; 25:89-92. [PMID: 37584702 DOI: 10.1093/pm/pnad109] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/13/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Maichou Lor
- University of Wisconsin-Madison, School of Nursing, Madison, WI 53705, United States
| | - Abby M Hammes
- University of Wisconsin-Madison, School of Nursing, Madison, WI 53705, United States
| | - Adriana Arcia
- University of San Diego Hahn School of Nursing and Health Science, San Diego, CA 92110, United States
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Naeem F, Khan N, Sohani N, Safa F, Masud M, Ahmed S, Thandi G, Mutta B, Kasaam A, Tello K, Husain MI, Husain MO, Kidd SA, McKenzie K. Culturally Adapted Cognitive Behaviour Therapy (CaCBT) to Improve Community Mental Health Services for Canadians of South Asian Origin: A Qualitative Study. Can J Psychiatry 2024; 69:54-68. [PMID: 37376808 PMCID: PMC10867407 DOI: 10.1177/07067437231178958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND South Asian (SA) Canadians are disproportionately affected by higher rates of mood and anxiety disorders. SA Canadians with depression report significant barriers to accessing mental health care and the highest proportion of unmet mental health needs. The Mental Health Commission of Canada (MHCC) advocates for culturally and linguistically relevant services for SA Canadians. Culturally adapted cognitive behavior therapy (CaCBT) has shown to be more effective than standard cognitive behavior therapy (CBT). Adapting CBT for the growing SA population in Canada will ensure equitable access to effective, culturally-appropriate mental health interventions. METHOD The study used a qualitative design to elicit stakeholder consultation via in-depth interviews. This study is reported using the criteria included in Consolidated Criteria for Reporting Qualitative Studies (COREQ). The analysis follows an ethnographic approach and was informed by the principles of emergent design. RESULTS Five themes were identified from the analysis, (i) Awareness and preparation: factors that impact the individual's understanding of therapy and mental illness. (ii) Access and provision: SA Canadians' perception of barriers, facilitators, and access to treatment. (iii) Assessment and engagement: experiences of receiving helpful treatment. (iv) Adjustments to therapy: modifications and suggestions to standard CBT. (v) Ideology and ambiguity: racism, immigration, discrimination, and other socio-political factors. CONCLUSIONS Mainstream mental health services need to be culturally appropriate to better serve SA Canadians experiencing depression and anxiety. Services must understand the family dynamics, cultural values and socio-political factors that impact SA Canadians to reduce attrition rates in therapy.
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Affiliation(s)
- Farooq Naeem
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nagina Khan
- Schizophrenia Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nazia Sohani
- Immigrant Services, Ottawa Newcomer Health Centre, Ottawa, ON, Canada
| | - Farhana Safa
- Punjabi Community Health Services, Brampton, ON, Canada
| | | | - Sarah Ahmed
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Gary Thandi
- Moving Forward Family Services, Vancouver, Canada
| | - Baldev Mutta
- Punjabi Community Health Services, Toronto, Canada
| | - Azaad Kasaam
- Department of Psychiatry, University of Ottawa, Ottawa, Canada
| | - Kamlesh Tello
- Access to Quality Mental Health Services, Mental Health Commission of Canada, Ottawa, ON, Canada
| | | | | | - Sean A. Kidd
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Kwame McKenzie
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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19
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Pennell T, Calder N, Glubb-Smith KJ. A quality improvement approach to improving recognition of Māori tamariki (children) and assessing barriers to culturally responsive care in a paediatric ward setting. Child Care Health Dev 2024; 50:e13176. [PMID: 37727080 DOI: 10.1111/cch.13176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/06/2023] [Accepted: 09/03/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Health inequity persists in Aotearoa (New Zealand) and internationally amongst most indigenous peoples. To address these health inequities, countries need to contend with the ramifications of entrenched historical, cultural and systemic failures. Within Aotearoa part of the solution to rectifying persistent health inequities lies in shifting everyday healthcare practices towards a more culturally responsive, patient-centred approach that utilises Māori knowledge and principles. Although the need for culturally responsive services in healthcare settings is clearly evident, most practitioners struggle with the challenge of creating a culturally safe environment. Further to these challenges, there are issues related to accurate recognition of ethnicity within the time constraints of an overwrought hospital environment. Within this environment, the correct identification of ethnicity is a fundamental step in the process of moving towards culturally responsive and more inclusive care. METHOD The research was concerned with indigenous Māori patients being consistently and correctly identified so that they might receive culturally appropriate interaction and treatment. The research specifically focused on the impact of introducing a customised sticker prompt on the front cover of clinical notes of Māori tamariki (children) to assist with correct ethnicity identification. Surveys were conducted on the paediatric ward over a 3-week period, prior to and during the intervention to evaluate the effect of the customised stickers. This study sought to (1) assess the efficacy of a sticker to improve recognition of Māori tamariki (children), (2) examine key barriers to identifying ethnicity and (3) identify wider impacts of a sticker prompt on clinical practice. RESULTS Results showed wide ranging positive impacts on clinical practice and culturally responsive care. Sixty-four per cent of participants indicated that the stickers were a useful tool to improve identification of Māori tamariki. Respondents reported increased accuracy of identifying patients by ethnicity, as well as improved awareness of existing ethnicity documentation, and increased engagement regarding cultural needs and ethnicity. CONCLUSIONS This study identified that sticker prompts are a useful tool for healthcare workers to improve recognition and awareness of ethnicity and to increase dialogue around cultural needs. The stickers led to increased consideration of the wider elements of holistic wellbeing and therefore improved culturally responsive care for Māori tamariki.
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Affiliation(s)
- Taylor Pennell
- Hauora a Toi Bay of Plenty, Te Whatu Ora, Wellington, New Zealand
- Royal Children's Hospital Emergency Department, Melbourne, Australia
| | - Nigel Calder
- Mathematics Education, Te Hononga, Division of Education, University of Waikato, Hamilton, New Zealand
- University of Exeter, Exeter, UK
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20
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Donovan RJ, Drane CF, Owen J, Murray L, Nicholas A, Anwar-McHenry J. Impact on stakeholders of a cultural adaptation of a social and emotional well-being intervention in an Aboriginal community. Health Promot J Austr 2024; 35:134-143. [PMID: 37026183 DOI: 10.1002/hpja.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
PURPOSE Australian Indigenous people conceptualise health broadly as situated within a social and emotional well-being (SEWB) framework. A consultation process with an Aboriginal community revealed that the fundamental principles of the population wide, community-based Act-Belong-Commit mental health promotion Campaign were consistent with Aboriginal people's understanding of SEWB and that a cultural adaptation of the Campaign would be welcomed in the community. The purpose of this paper is to present key stakeholders' feedback on the Campaign adaptation. METHODOLOGY Two years after implementation of the Campaign, individual in-depth interviews were conducted with a purposeful sample of n = 18 Indigenous and non-Indigenous stakeholders to identify ongoing issues in the community and assess their reactions to the Campaign implementation and perceptions of the effects of the Campaign on the community. RESULTS The two primary factors influencing stakeholder acceptance of the Campaign in the community were (i) the nature of the consultation process that clearly acknowledged that it was for the community to decide whether or not to adopt the Campaign and (ii) the ability of the Aboriginal Project Manager to gain the trust of the community, bring stakeholders together and illustrate the Act-Belong-Commit principles in her actions in the community. Stakeholders reported observing social and emotional well-being benefits for individuals, their families and the whole community. CONCLUSION Overall, the results suggest that the Act-Belong-Commit mental health promotion Campaign can be successfully culturally adapted as a community-based, social and emotional well-being Campaign in Aboriginal and Torres Strait communities. SO WHAT?: The Act-Belong-Commit cultural adaptation in Roebourne provides an evidence-based best practice model for the development of culturally appropriate mental health promotion campaigns in Indigenous communities around Australia.
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Affiliation(s)
- Robert J Donovan
- School of Human Sciences, University of Western Australia, Perth, WA, Australia
| | | | - Julie Owen
- Centre for Aboriginal Studies, Curtin University, Perth, WA, Australia
| | - Lesley Murray
- Healthy Kids Project, Western NSW Local Health District, Dubbo, NSW, Australia
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21
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Farsangi SN, Khodabandeh Shahraki S, Cruz JP, Farokhzadian J. Designing, implementing, and evaluating a mobile app-based cultural care training program to improve the cultural capacity and humility of nursing students. BMC Med Educ 2023; 23:979. [PMID: 38124035 PMCID: PMC10731749 DOI: 10.1186/s12909-023-04952-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Given the growing cultural diversity among healthcare clients, it is crucial for nursing education to have a clear mission: to effectively train future nurses by incorporating cultural care curricula. The goal is to equip them with the necessary cultural capacity and humility. This study focused on designing, developing, and evaluating a mobile app-based cultural care training program, with the aim of enhancing the cultural capacity and humility of nursing students. METHODS This experimental study utilized the five steps of the ADDIE instructional model (analysis, design, development, implementation, and evaluation) to design a mobile app-based cultural care training program. The first three steps involved designing and developing the program, drawing upon Purnell's model for cultural competence and Foronda's rainbow model of cultural humility. In the fourth step, the cultural care training program was implemented in 16 modules among 80 internship nursing students. These students were randomly assigned to either the intervention or control groups, with 40 students in each group. Finally, in the fifth step, the effectiveness of the mobile app-based program was evaluated by administering the Cultural Capacity Scale, and the Foronda Cultural Humility Scale before and one month after the cultural care training. The collected data were analyzed using SPSS22, employing techniques such as paired t-test, chi-square test, and independent samples t-test. RESULTS A total of 76 students completed the study, with 39 students in the intervention group and 37 students in the control group. Prior to the mobile app-based cultural care training program, there were no significant differences in cultural capacity and humility scores between the two groups (p > 0.05). However, following the completion of the program, the intervention group exhibited higher scores in cultural capacity and humility compared to the control group (p < 0.05). CONCLUSION Based on the findings, it can be concluded that the mobile app-based cultural care training program had a positive impact on the cultural capacity and humility of undergraduate nursing students. These results indicate the importance of nurse educators designing comprehensive training programs that incorporate innovative approaches to enhance cultural capacity and humility among nursing students at all academic levels.
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Affiliation(s)
- Sara Noori Farsangi
- Reproductive Health, Family and Population Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sedigheh Khodabandeh Shahraki
- Reproductive Health, Family and Population Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Jonas Preposi Cruz
- Department of Medicine, School of Medicine, Nazarbayev University, Astana, Kazakhstan
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Parter C, Gwynn J, Wilson S, Skinner JC, Rix E, Hartz D. Putting Indigenous Cultures and Indigenous Knowledges Front and Centre to Clinical Practice: Katherine Hospital Case Example. Int J Environ Res Public Health 2023; 21:3. [PMID: 38276792 PMCID: PMC10815878 DOI: 10.3390/ijerph21010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
The inclusion of Indigenous cultures, known as the cultural determinants of health, in healthcare policy and health professional education accreditation and registration requirements, is increasingly being recognised as imperative for improving the appalling health and well-being of Indigenous Australians. These inclusions are a strengths-based response to tackling the inequities in Indigenous Australians' health relative to the general population. However, conceptualising the cultural determinants of health in healthcare practice has its contextual challenges, and gaps in implementation evidence are apparent. In this paper, we provide a case example, namely the Katherine Hospital, of how healthcare services can implement the cultural determinants of health into clinical practice. However, to be effective, health professionals must concede that Australia's Indigenous peoples' knowledges involving cultural ways of being, knowing and doing must co-exist with western and biomedical knowledges of health practice. We use the Katherine Hospital ABC Radio National Background Briefing interview, which was mentioned by two research participants in a 2020 study, as an example of good practice that we can learn from. Additionally, the six Aboriginal and Torres Strait Islander Health actions contained in the 2nd Edition of the Australian National Safety and Quality Health Service Standards provide governance and accountability examples of how to enable Indigenous people's cultures and their knowledges in the provision of services. The role of non-Indigenous clinical allies and accomplices is imperative when embedding and enacting Indigenous Australians' cultures in service systems of health. When Indigenous Peoples access mainstream hospitals, deep self-reflection by allies and accomplices is necessary to enable safe, quality care, and treatment that is culturally safe and free from racism. Doing so can increase cultural responsiveness free of racism, thereby reducing the inherent power imbalances embedded within mainstream health services.
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Affiliation(s)
- Carmen Parter
- Djurali Centre for Aboriginal & Torres Strait Islander Education and Health Research, Heart Research Institute, Newtown, NSW 2042, Australia;
| | - Josephine Gwynn
- Charles Perkins Centre, Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia;
| | - Shawn Wilson
- Department of Community, Culture and Global Studies, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - John C. Skinner
- Djurali Centre for Aboriginal & Torres Strait Islander Education and Health Research, Heart Research Institute, Newtown, NSW 2042, Australia;
| | - Elizabeth Rix
- Adelaide Nursing School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Donna Hartz
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia;
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Ogunlana MO, Oyewole OO, Aderonmu JA, Onyeso OK, Faloye AY, Govender P. Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals. BMC Med Educ 2023; 23:933. [PMID: 38066501 PMCID: PMC10709888 DOI: 10.1186/s12909-023-04910-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Being culturally competent would enhance the quality of care in multicultural healthcare settings like Nigeria, with over 200 million people, 500 languages, and 250 ethnic groups. This study investigated the levels of training and practice of cultural competence among clinical healthcare professionals in two purposively selected Nigerian tertiary hospitals. METHODS The research was a cross-sectional study. A multi-stage sampling technique was used to recruit participants who completed the adapted version of Cultural Competence Assessment Instrument (CCAI-UIC). Data were analysed using descriptive statistics, Pearson's correlation, ANOVA, and multivariate linear regression. RESULTS The participants were mainly women (66.4%), aged 34.98 ± 10.18 years, with ≤ 5 years of practice (64.6%). Personal competence had a positive weak correlation with age (p < 0.001), practice years (p = 0.01), training (p = 0.001), practice (p < 0.001), and organisational competence (p < 0.001). There were significant professional differences in the level of training (p = 0.005), and differences in training (p = 0.005), and personal competence (p = 0.015) across levels of educational qualifications. Increasing practise years (p = 0.05), medical/dental profession relative to nursing (p = 0.029), higher personal (p = 0.013), and organisational (p < 0.001) cultural competences were significant predictors of the level of training. Male gender (p = 0.005), higher years in practice (p = 0.05), local language ability (p = 0.037), rehabilitation professionals relative to nursing (p = 0.05), high culturally competent practice (p < 0.001), higher training opportunities (p = 0.013), and higher organisational competence (p = 0.001) were significant predictors of higher personal competence. CONCLUSION About a third of the participants had no formal training in cultural competence. Incorporating cultural competence in the Nigerian healthcare professionals' education curricula may enhance the quality of care in the multicultural setting.
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Affiliation(s)
- Michael O Ogunlana
- Department of Physiotherapy, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria.
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa.
| | - Olufemi O Oyewole
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
- Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
| | - Joseph A Aderonmu
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Ogochukwu Kelechi Onyeso
- Population Studies in Health, Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Ayobamigbe Y Faloye
- Unit of Planning Research and Statistics, Federal Medical Centre Abeokuta, Abeokuta, Ogun State, Nigeria
| | - Pragashnie Govender
- College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban, South Africa
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Potiki J, Tawaroa D, Casey H, Thom K, O'Brien A, Lenagh-Glue J, Glue P. Cultural Influences on the Creation and Use of Psychiatric Advance Directives. Psychiatr Serv 2023; 74:1299-1302. [PMID: 37312506 DOI: 10.1176/appi.ps.20220565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Little published research exists on how culture influences mental health service users when they create or use psychiatric advance directives (PADs). This column reports the results of a study (N=38 participants) of cultural factors that might encourage New Zealand Māori who engage in mental health services to make greater use of PADs in their care. The most important factor identified was the inclusion of family and friends in decision making during PAD creation and use. Discussions revealed multiple culturally important themes that were synthesized into a conceptual model, pou herenga (mooring place), which focuses on the importance of reassessing all aspects of one's life journey when creating a PAD.
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Affiliation(s)
- Johnnie Potiki
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
| | - Daniel Tawaroa
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
| | - Heather Casey
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
| | - Katey Thom
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
| | - Anthony O'Brien
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
| | - Jessie Lenagh-Glue
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
| | - Paul Glue
- Southern District Health Board (Potiki, Casey) and Te Āti Haunui-ā-Pāpārangi, Ngā Paerangi, Ngāti Pikiao, Ngāti Paruaharanui (Tawaroa), Dunedin, New Zealand; Centre for Non-Adversarial Justice, Auckland University of Technology, Auckland, New Zealand (Thom); Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand (O'Brien); Faculty of Law (Lenagh-Glue) and Department of Psychological Medicine (Glue), University of Otago, Dunedin, New Zealand
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Quintiliani LM, Kamaka M, Henault L, Antonio MCK, Sentell T, Spencer K, Akaka G, Honda LKL, Hanakeawe D, Dillard A, Kekauoha BP, Davis AD, Seitz R, Cabral HJ, Volandes A, Leimomi Mala Mau MK, Paasche-Orlow MK. I kua na'u "Let me carry out your last wishes" Clinical trial protocol to promote advance care planning among native Hawaiian populations. Contemp Clin Trials 2023; 135:107365. [PMID: 37884121 PMCID: PMC10814879 DOI: 10.1016/j.cct.2023.107365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/06/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
Advance Care Planning (ACP) is a communication process about serious illness decision making designed to inform patients of possible medical options. Native Hawaiians consistently have low rates of ACP and low use of palliative and hospice care services. Our multidisciplinary community and research group partnered to create I kua na'u "Let Me Carry Out Your Last Wishes," an ACP intervention featuring culturally tailored videos and are now testing its efficacy. Focus groups and informant interviews were conducted with Native Hawaiian community members to ensure the curriculum honored the history, opinions, and culture of Native Hawaiians. Native Hawaiian culture has traditionally been an oral culture; the spoken word transmitted the mo'olelo, stories, traditions, histories and genealogies, which merges seamlessly with video media. The I kua na'u intervention included multiple educational sessions enhanced with videos (informational and personal). The specific aims are to compare ACP knowledge (primary outcome) and readiness for ACP engagement, ACP preferences, decisional conflict, and ACP completion rates via electronic medical record review (secondary outcomes) in 220 Native Hawaiians over age 55 in: (a) a randomized controlled trial of 110 people recruited from ambulatory clinics, and (b) a pre-post study design among 110 people living on Hawaiian Homestead communities located on lands set aside for Native Hawaiians or assisted living. Our protocol aims to evaluate the efficacy of our video-based educational intervention for Native Hawaiians to support decision making in this community and decrease disparities in serious illness care. Clinical Trial Registration Number: NCT04771208.
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Affiliation(s)
- Lisa M Quintiliani
- Department of Medicine, Tufts University School of Medicine, Tufts Medical Center, USA.
| | - Martina Kamaka
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA
| | | | - Mapuana C K Antonio
- Native Hawaiian and Indigenous Health, Thompson School of Social Work & Public Health, University of Hawaii, USA
| | - Tetine Sentell
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA
| | - Kimberley Spencer
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA
| | | | | | | | - Adrienne Dillard
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, USA; Kula No Na Po'e Hawaii o Papakolea, Kewalo, Kalawahine, USA
| | | | | | | | - Howard J Cabral
- Department of Biostatistics, Boston University School of Public Health, USA
| | - Angelo Volandes
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, USA
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Britt-Thomas JY, Kridel M, Velez J, Kouame G, Tharrington S, Barrett T, Casanova T. A scoping review of institutional policies and recommendations for trans inpatient mental health care. J Psychiatr Ment Health Nurs 2023; 30:1043-1053. [PMID: 37202857 DOI: 10.1111/jpm.12933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/30/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: International guidelines for trans-and-gender-non-conforming (TGNC) exists in outpatient settings. Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States. ABSTRACT INTRODUCTION: Access to culturally sensitive care is critical for addressing known mental health disparities among trans-and gender-non-conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings. AIM To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change. METHOD A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis. RESULTS Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender. DISCUSSION The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings. IMPLICATIONS FOR PRACTICE To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings.
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Affiliation(s)
- Jessica Y Britt-Thomas
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Matthew Kridel
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Janina Velez
- Clinical Psychology, The Chicago School of Professional Psychology, Washington, DC, USA
| | - Gail Kouame
- Charles M. Baugh Biomedical Library, University of South Alabama, Mobile, Alabama, USA
| | - Shafer Tharrington
- Robert B. Greenblatt, M.D. Library, Augusta University, Augusta, Georgia, USA
| | - Thomas Barrett
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Tracy Casanova
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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27
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Blattner K, Rogers-Koroheke M, Clay L. Te Paatu o Te Ao Hurihuri - pandemic-related virtual adaptation of an established marae-based workshop for rural doctors: a qualitative study. J Prim Health Care 2023; 15:343-349. [PMID: 38112704 DOI: 10.1071/hc23089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 09/20/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Due to COVID-19 pandemic restrictions in Aotearoa New Zealand, an established remote community marae-based workshop (a component of a postgraduate rural medical programme) was converted into a virtual platform. Aim The aim of this study was to explore student and teacher experiences of this virtual adaptation with focus on cultural aspects. Methods A qualitative exploratory study was undertaken that involved document review and qualitative interviews. Students and teachers were invited to participate. Semi-structured interviews were conducted. Thematic analysis was undertaken using a framework-guided rapid analysis method. The two participant groups' data were analysed concurrently but separately. Results Students found the virtual workshop valuable in furthering their knowledge of Māori culture, cross-cultural communication skills and health inequities in rural clinical practice. Through the innovative efforts of their teachers, they felt some sense of connection with the remote locality and its people. Teachers were able to impart knowledge, connect and keep everyone culturally safe through their commitment and adaptability. However, moving to a virtual platform meant compromise to the cultural experience for students and loss of sharing the learning and experience with their place and their people. Discussion In the event of a further pandemic or other emergency situation, where strong established relationships exist, replacing an in-person remote marae-based workshop with a virtual workshop, while limited, is achievable and has value. When urban tertiary institutions partner with remote Māori communities to deliver virtual teaching, caution is needed in ensuring sustained transparency in priorities and expectations to avoid further exacerbations of power imbalance and resulting loss of value.
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Affiliation(s)
- Katharina Blattner
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand; and Hokianga Health Enterprise Trust, Rawene, New Zealand
| | | | - Lynne Clay
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
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Irfan B, Yasin I, Yaqoob A. Tele-ID Politesse: Recognizing Cross-Culturally Sensitive Care With Hijab and Niqab. Clin Infect Dis 2023; 77:1614-1615. [PMID: 37463312 DOI: 10.1093/cid/ciad426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/24/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
- Bilal Irfan
- University of Michigan Ann-Arbor, Ann Arbor, MI, USA
| | - Ihsaan Yasin
- University of Michigan Ann-Arbor, Ann Arbor, MI, USA
| | - Aneela Yaqoob
- Corewell Health Beaumont Hospital Wayne, Wayne, MI, USA
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29
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Raigal-Aran L, Roldán-Merino J, Martins T, Sequeira C, Ferré-Grau C, Belzunegui-Eraso A, Sampaio F. Translation, Adaptation, and Validation of the Cultural Competence Assessment in Portuguese Nurses. J Nurs Meas 2023; 31:510-521. [PMID: 37848230 DOI: 10.1891/jnm-2022-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Background and Purpose: Previous research shows significant benefits resulting from improving culturally competent nursing care. Thus, the purpose of this study was to translate, adapt, and validate the Cultural Competence Assessment (CCA) in a sample of Portuguese nurses. Methods: A psychometric study of the CCA, after translation into European Portuguese, was performed with a snowball sample of 284 nurses. Participants were asked to fill in a sociodemographic questionnaire and the CCA. Results: The four-factor model of the CCA (Portuguese version) exhibited satisfactory indices of fitness without item nine. Cronbach's alpha was 0.85. Correlations between subscales and the total score scale were strong and statistically significant. Conclusions: These data add to the cultural competence knowledge of nurses to promote better practices and culturally competent care.
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Affiliation(s)
| | | | - Teresa Martins
- Nursing School of Porto, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, Portugal
| | - Carlos Sequeira
- Nursing School of Porto, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, Portugal
| | | | - Angel Belzunegui-Eraso
- History and Art Department, Faculty of Arts, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
| | - Francisco Sampaio
- Nursing School of Porto, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, Portugal
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Hirchak KA, Echo-Hawk H, Parent S, Peavy KM, Webb K, Bajet K, Richardson M, Granbois A, Herron JL, Catron K, King K, Parsells E, Freese TE, Thomas LR, Rawson R, Clark HW, Roll J, McDonell MG. The urgent need for contingency management among Tribal communities in the United States: Considerations for implementation, policy, and sovereignty. Prev Med 2023; 176:107662. [PMID: 37573952 PMCID: PMC10840817 DOI: 10.1016/j.ypmed.2023.107662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/28/2023] [Accepted: 08/10/2023] [Indexed: 08/15/2023]
Abstract
In two randomized controlled trials, culturally adapted contingency management (i.e., incentives provided for substance-negative urine samples) was associated with reduced alcohol and drug use among geographically diverse American Indian and Alaska Native (AI/AN) adults. In response to interest in contingency management from other Tribal and AI/AN communities, our research team in collaboration with AI/AN behavioral health experts, translated the research into practice with new AI/AN community partners. Tenets of community-based participatory research were applied to develop, pilot, and refine contingency management training and implementation tools, and identify implementation challenges. In partnership with the AI/AN communities, four members of the university team developed tools and identified implementation and policy strategies to increase the successful uptake of contingency management in each location. Through our collaborative work, we identified policy barriers including inadequate federal funding of contingency management incentives and a need for further clarity regarding federal anti-kickback regulations. Adoption of contingency management is feasible and can strengthen Tribal communities' capacity to deliver evidence-based substance use disorder treatments to AI/AN people. Unfortunately, non-evidence-based limits to the use of federal funding for contingency management incentives discriminate against AI/AN communities. We recommend specific federal policy reforms, as well as other practical solutions for Tribal communities interested in contingency management.
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Affiliation(s)
- Katherine A Hirchak
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA.
| | | | - Sara Parent
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA
| | - K Michelle Peavy
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA
| | - Kellie Webb
- Doya Natsu Healing Center, Fort Washakie, WY, USA
| | - Kelsey Bajet
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA
| | - Meenakshi Richardson
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA
| | - Alexandria Granbois
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA
| | - Jalene L Herron
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | | | - Keli King
- Kauffman and Associates, Inc., Spokane, WA, USA
| | - Ed Parsells
- Kauffman and Associates, Inc., Spokane, WA, USA
| | | | - Lisa Rey Thomas
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Richard Rawson
- University of Vermont, Burlington, VT, USA; Motivational Incentives Policy Group, USA
| | | | - John Roll
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Michael G McDonell
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA; Promoting Research Initiatives in Substance Use and Mental Health Collaborative, Washington State University, Spokane, WA, USA
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31
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DiMeo A, Karlage A, Schoenherr K, Spigel L, Chakraborty S, Bazan M, Molina RL. Cultural brokering in pregnancy care: A critical review. Int J Gynaecol Obstet 2023; 163:357-366. [PMID: 37681939 DOI: 10.1002/ijgo.15063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
People who speak languages other than English face structural barriers in accessing the US healthcare system. With a growing number of people living in countries other than their countries of birth, the impact of language and cultural differences between patients and care teams on quality care is global. Cultural brokering presents a unique opportunity to enhance communication and trust between patients and clinicians from different cultural backgrounds during pregnancy care-a critical window for engaging families in the healthcare system. This critical review aims to synthesize literature describing cultural brokering in pregnancy care. We searched keywords relating to cultural brokering, pregnancy, and language in PubMed, Embase, and CINAHL and traced references of screened articles. Our search identified 33 articles. We found that cultural brokering is not clearly defined in the current literature. Few of the articles provided information about language concordance between cultural brokers and patients or clinicians. No article described the impact of cultural brokering on health outcomes. Facilitators of cultural brokering included: interprofessional collaboration within the care team, feeling a family connection between the cultural broker and patients, and cultivating trust between the cultural broker and clinicians. Barriers to cultural brokering included: misunderstanding the responsibilities, difficulty maintaining personal boundaries, and limited availability and accessibility of cultural brokers. We propose cultural brokering as interactions that cover four key aims: (1) language support; (2) bridging cultural differences; (3) social support and advocacy; and (4) navigation of the healthcare system. Clinicians, researchers, and policymakers should develop consistent language around cultural brokering in pregnancy care and examine the impact of cultural brokers on health outcomes.
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Affiliation(s)
- Amanda DiMeo
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ami Karlage
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karen Schoenherr
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lauren Spigel
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Saugata Chakraborty
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maria Bazan
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Universidad Cientifica del Sur, Lima, Peru
| | - Rose L Molina
- Ariadne Labs at Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Gillis LJ, Blackwell LM, Taylor-Garza A. Virtual Poverty Simulation: Effect on Attitudes Toward Poverty in Nursing Students. J Nurs Educ 2023; 62:642-646. [PMID: 37934685 DOI: 10.3928/01484834-20230906-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Simulation has been shown to be an effective teaching strategy for increasing nursing students' knowledge and empathy toward individuals with low income. Virtual simulation is effective in teaching critical thinking, situational awareness, and empathy. METHOD This mixed-method study examined three virtual poverty simulation programs. The study sample included senior baccalaureate nursing students (n = 99) in a Community Health course. RESULTS Fifteen of the 21 items on the Attitudes Toward Poverty-Short Form (ATP-SF) scale showed a statistically significant increase in knowledge and understanding of people living in poverty. Qualitative data analysis revealed four themes: (1) empathy; (2) sacrifice; (3) stress; and (4) moral struggle. CONCLUSION Virtual poverty simulation is a teaching strategy for increasing nursing students' empathy, knowledge, and understanding of those living in poverty to provide compassionate, culturally competent care for individuals with low income. The simulation can be implemented in a variety of settings. [J Nurs Educ. 2023;62(11):642-646.].
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Germain M. President's Message: Enhancing Culturally Competent Care in Creating Global Partnerships in Health. J Transcult Nurs 2023; 34:402. [PMID: 37724829 DOI: 10.1177/10436596231202790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
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Johnston J, McKenna L, Malik G, Reisenhofer S. Recognizing and Adapting to Cultural Differences: Influence of International Educational Programs on Future Nursing and Midwifery Practice. J Transcult Nurs 2023; 34:423-430. [PMID: 37740536 PMCID: PMC10637073 DOI: 10.1177/10436596231198276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
INTRODUCTION International educational programs build cultural humility and safety skills in nursing and midwifery students; however, long-term outcomes of these programs are unclear. The purpose of this study was to explore the impact of international educational programs on nurses' and midwives' future professional practice. METHOD Using grounded theory informed by Charmaz, 13 general nurses, two mental health nurses, three midwives, and four dual-qualified nurse/midwives across eight different countries were interviewed. Three categories evolved from the analysis. This article reports on the category Recognizing and adapting to cultural differences. FINDINGS Participants developed cultural safety and awareness from participation in programs extending into future practice. Experiencing and adapting to cultural similarities and differences, they developed culturally congruent practices many years after program completion. DISCUSSION International programs contributed to participants' professional practice. Positive and ongoing influences are important for employers to promote patient safety and culturally congruent quality care. Findings are also relevant for education providers to inform quality cultural learning.
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Affiliation(s)
| | - Lisa McKenna
- La Trobe University, Melbourne, Victoria, Australia
| | - Gulzar Malik
- La Trobe University, Melbourne, Victoria, Australia
| | - Sonia Reisenhofer
- La Trobe University, Melbourne, Victoria, Australia
- Bairnsdale Regional Health Service, Victoria, Australia
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35
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Öner M, Kalanlar B, Demir S, Özyurt N, Erul A, Şenel E. Challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers: A qualitative study. Burns 2023; 49:1706-1713. [PMID: 36890056 DOI: 10.1016/j.burns.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/13/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Burn injuries in childhood create serious trauma for both children and their caregivers. Burn injuries require extensive nursing care to reduce complications and to restore optimal functional health conditions. When children receive burn treatment and their caregivers are migrants with different languages, religions, and habits, nurses must adopt a cultural approach while caring for such patients. AIM This descriptive qualitative study aimed to reveal the challenges, expectations, and cultural care experiences of nurses regarding migrant children receiving burn treatment and their caregivers. METHOD Purposive sampling was used to recruit the nurses (n = 12). Semi-structured face-to-face interviews were conducted with nurses using an interview guide, and the interviews were recorded. Thematic analysis was used to create themes in the study. RESULTS The data were gathered around three main themes: "challenges" with the subcategories "communication," "trust relationship," and "care burden"; "expectations for better care" with the subcategories "translator support" and "hospital environment"; and "intercultural care" with the subcategories "cultural-religious differences" and "intercultural sensitivity." CONCLUSIONS The results of this study provide a novel insight into nurses' experiences with migrant child patients and their caregivers, and can be used to develop action plans to provide effective cultural care for patients receiving burn treatment and their caregivers.
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Affiliation(s)
- Mücahide Öner
- Department of Public Health Nursing. Hacettepe University Faculty of Nursing Ankara, Turkey.
| | - Bilge Kalanlar
- Department of Public Health Nursing. Hacettepe University Faculty of Nursing Ankara, Turkey.
| | - Sabri Demir
- Department of Pediatric Surgery, and Pediatric Burn Center Children Hospital, Ankara City Hospital, Bilkent, 06800 Ankara, Turkey.
| | - Neşe Özyurt
- Department of Pediatric Surgery, and Pediatric Burn Center Children Hospital, Ankara City Hospital, Bilkent, 06800 Ankara, Turkey.
| | - Abdurrahman Erul
- Department of Pediatric Surgery, and Pediatric Burn Center Children Hospital, Ankara City Hospital, Bilkent, 06800 Ankara, Turkey.
| | - Emrah Şenel
- Department of Pediatric Surgery, Medical Faculty, Ankara Yildirim Beyazit Universty, 06800 Ankara, Turkey.
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Wilson DH, German D, Ricker A, Gourneau H, Hanson GC, Mayhew J, Brockie TN, Sarche M. Feasibility, acceptability and effectiveness of a culturally informed intervention to decrease stress and promote well-being in reservation-based Native American Head Start teachers. BMC Public Health 2023; 23:2088. [PMID: 37880677 PMCID: PMC10599064 DOI: 10.1186/s12889-023-16913-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND While benefiting from strong cultural ties to family, land and culture Native Americans residing on reservations experience psychological distress at rates 2.5 times that of the general population. Treatment utilization for psychological health in reservation-based communities is low with access to culturally appropriate care lacking. Evidence suggests that for mental health treatment, Native Americans prefer culturally informed care that respects Native perspectives on health and well-being. METHODS To decrease stress and promote well-being in tribal Head Start teachers we adapted and implemented a culturally focused intervention within a community-based participatory research framework using mixed methods. Feasibility and acceptability of the adapted 5-session curriculum was tested in a single arm intervention study with a sample of 18 teachers on the Fort Peck Reservation. Participants completed surveys at baseline and upon completion of the intervention. Within session observations and two post-intervention focus groups (n = 8, n = 10) were conducted to elaborate and explain the quantitative results eliciting participant experience of intervention effectiveness and feasibility, acceptably and appropriateness. Implementation outcomes were assessed quantitatively using the Acceptability of Intervention, Intervention Appropriateness, and Feasibility of Intervention measures. RESULTS Quantitively, attendance rate overall was 93% with no dropouts. Pretest/posttest surveys were analyzed using t-tests and Hedges g to measure effect size. Contrary to our hypothesis, self-perceived stress showed a small positive effect size, indicating that participants were more stressed post intervention. However, depression decreased, with tribal identity and resilience showing positive effect sizes. Content analysis for the qualitative data collected within session observations and post intervention focus groups revealed how lifetime traumas were affecting participants, providing some explanation for the increase in stress. Teachers reported that the sessions helped their psychological health and well-being, supporting feasibility of future interventions. Acceptability scored highest with a mean (SD) of 4.25 (.84) out of 5, appropriateness 4.18 (.86) and feasibility 4.06 (.96) supporting intervention to be acceptable, appropriate, and feasible. CONCLUSION Utilizing a culturally based intervention to buffer stress and support the well-being of reservation-based teachers showed promise in helping them recognize their cultural strengths, stress, and need for ongoing support. Implementation outcomes show that intervention scale-out is feasible.
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Affiliation(s)
- Deborah H Wilson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA.
- Auckland University of Technology School of Clinical Sciences, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
| | - Danielle German
- Department of Health Behavior and Society, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Adrian Ricker
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Hilary Gourneau
- Fort Peck Tribes Head Start, 409 G St, W Poplar, MT, 59255, USA
| | - Ginger C Hanson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Justin Mayhew
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington Street, Baltimore, MD, 21231, USA
| | - Teresa N Brockie
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD, 21205, USA
| | - Michelle Sarche
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Mail Stop, 13001 E 17th Pl B119, Aurora, CO, 80045, USA
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Henson C, Chapman F, Shepherd G, Carlson B, Rambaldini B, Gwynne K. Amplifying Older Aboriginal and Torres Strait Islander Women's Perspectives to Promote Digital Health Equity: Co-Designed Qualitative Study. J Med Internet Res 2023; 25:e50584. [PMID: 37847550 PMCID: PMC10618878 DOI: 10.2196/50584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/14/2023] [Accepted: 09/17/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Digital health is becoming ubiquitous, and we must ensure equity in access. Indigenous people across most high-income countries typically have not benefited as much as other citizens from usual health care systems and technologies. Despite Aboriginal and Torres Strait Islander people's clear interest in, and enthusiastic use of, new technologies, little research has examined the needs or interests of older Aboriginal and Torres Strait Islander women. OBJECTIVE This study prioritizes the perspectives of older Aboriginal and Torres Strait Islander women, tapping into their expertise associated with Indigenous ways of knowing, being, and doing, as well as their unique position within their families and communities, to design a model for using digital technologies to improve health for themselves and their families as well as their communities. METHODS Older Aboriginal and Torres Strait Islander women from 4 partner organizations were recruited for this study. This co-designed qualitative research included citizen scientists in shaping the protocol as well as collecting, analyzing, and interpreting data. We used yarning, an Indigenous research method validated for use in health research with Indigenous people and seen as respectful and culturally safe, as a primary research tool. The use of Indigenous methodologies and our iterative process enabled us to deeply explore and incorporate perspectives from all participants and ensure that the perspectives of Indigenous citizen scientists with lived experience were privileged. The data-checking methods also used a yarning methodology, which ensured that the findings and translational model derived from the findings were validated by the participants. RESULTS Participants comprised 24 Aboriginal and Torres Strait Islander women aged ≥41 years and including 3 generations that did not grow up with the internet: seniors, baby boomers, and Generation X. The key findings in this research were that older women use various digital technologies to improve health and well-being for themselves and their families as well as their communities. Older Aboriginal women want a culturally sensitive cyberspace that caters specifically to their needs and includes relevant content and functionality that are accessible and efficient. Our translational model highlights the conditions necessary for anyone to use digital health technologies, summarizes the essential elements needed to promote equity in digital health, and illuminates the unmet needs and requirements for older Aboriginal and Torres Strait Islander women to fully benefit from digital health technologies. CONCLUSIONS Health is a fundamental right. As we move toward greater reliance on digital health solutions, we must recognize and address the concerns of the smaller populations of people who differ in their needs. We must urgently address the financial, connectivity, and other limiting factors highlighted by older Aboriginal and Torres Strait Islander women in this study that limit equitable access to digital health tools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1177/20552076221084469.
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Affiliation(s)
- Connie Henson
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie University, Australia
| | - Felicity Chapman
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie University, Australia
| | - Gina Shepherd
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie University, Australia
| | - Bronwyn Carlson
- Centre for Global Indigenous Futures, Macquarie University, Macquarie University, Australia
- Department of Indigenous Studies, Faculty of Arts, Macquarie University, Macquarie University, Australia
| | - Boe Rambaldini
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie University, Australia
| | - Kylie Gwynne
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Macquarie University, Australia
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie University, Australia
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Im EO, Chee W, Paul S, Choi MY, Kim SY, Deatrick JA, Inouye J, Ma G, Meghani S, Nguyen GT, Schapira MM, Ulrich CM, Yeo S, Bao T, Shin D, Mao JJ. A randomized controlled trial testing a virtual program for Asian American women breast cancer survivors. Nat Commun 2023; 14:6475. [PMID: 37838727 PMCID: PMC10576740 DOI: 10.1038/s41467-023-42132-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023] Open
Abstract
A culturally tailored virtual program could meet the survivorship needs of Asian American women breast cancer survivors (AABC). This study aims to determine the efficacy of a culturally tailored virtual information and coaching/support program (TICAA) in improving AABC's survivorship experience. A randomized clinical trial (NCT02803593) was conducted from January 2017 to June 2020 among 199 AABC. The intervention group utilized TICAA and the American Cancer Society [ACS] website while the control group used only ACS website for 12 weeks. The outcomes were measured using the SCNS-34SF (needs; primary), the MSAS-SF (symptoms; secondary), and the FACT-B (quality of life; secondary). The data were analyzed using an intent-to-treat approach. The intervention group showed significant reductions in their needs from the baseline (T0) to post 4 weeks (T1) and to post 12 weeks (T2). Although the changes were not statistically significant, the intervention group had decreased symptoms from T0 to T2 while the control group had an increase in their symptoms. The intervention group had a significant increase in their quality of life from T0 to T2. A culturally tailored virtual program could therefore improve quality of life in AABC patients. Trial Registration: To Enhance Breast Cancer Survivorship of Asian Americans (TICAA), NCT02803593, https://clinicaltrials.gov/ct2/show/NCT02803593?titles=TICAA&draw=2&rank=1.
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Affiliation(s)
- Eun-Ok Im
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA.
| | - Wonshik Chee
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA
| | - Sudeshna Paul
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Mi-Young Choi
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
- Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Seo Yun Kim
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Janet A Deatrick
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Jillian Inouye
- University of Hawaii, 2528 McCarthy Mall, Webster Hall 402, Honolulu, HI, 96822, USA
| | - Grace Ma
- Temple University, 1801 N Broad St, Philadelphia, PA, 19122, USA
| | - Salimah Meghani
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Giang T Nguyen
- Harvard University Health Services, 75 Mt. Auburn Street, Cambridge, MA, 02138, USA
| | - Marilyn M Schapira
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Connie M Ulrich
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - SeonAe Yeo
- University of North Carolina, Carrington Hall, S Columbia St, Chapel Hill, NC, 27599, USA
| | - Ting Bao
- Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 456, New York, NY, 10065, USA
| | - David Shin
- University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, 90024, USA
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 456, New York, NY, 10065, USA
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Heng TJT, Shorey S. Experiences of moral distress in nursing students - A qualitative systematic review. Nurse Educ Today 2023; 129:105912. [PMID: 37480673 DOI: 10.1016/j.nedt.2023.105912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/29/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVES The review aims to synthesize and consolidate the factors and situations in which student nurses experience moral distress during their clinical practice and its potential implications for patient care and outcomes. DESIGN A qualitative systematic review. DATA SOURCES The articles were sourced from PubMed, Embase, CINAHL, Scopus, PsycInfo, Web of Science, ERIC (ProQuest), and ProQuest Dissertations and Theses Global Database between their inception dates to December 2022. Reference lists of included studies were also screened for additional studies. REVIEW METHODS Published and unpublished primary studies of any qualitative research methods focused on student nurses' experiences of moral distress regardless of their education level were included in this review. Two reviewers independently screened titles and abstracts, assessed full-text articles for eligibility, extracted data, and appraised the quality of included studies. Sandelowski and Barroso's (2007) two-step meta-synthesis approach and Braun and Clarke's (2006) thematic analysis framework were used to analyze and interpret findings from included studies. RESULTS Seven studies met the inclusion criteria and were included in the review. The meta-synthesis revealed an overarching theme, "Moral Distress and its Intertwined Roots". This was supported by the four main themes: 1) Inadequacy and lack of autonomy, 2) Unprofessionalism of healthcare professionals, 3) Differing cultural views and values of patients and their relatives, and 4) Healthcare needs versus resource constraints. CONCLUSION This review highlights the experiences of student nurses in situations of moral distress, including feelings of inadequacy and powerlessness when faced with ethical challenges, and the negative impact of resource constraints, unprofessional behavior, and cultural differences. Collaborative efforts between healthcare professionals and student nurses are needed to promote shared decision-making, prioritize ethical training, and provide culturally sensitive care to address these challenges and ultimately improve patient care.
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Affiliation(s)
- Tonya Jing Ting Heng
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Dimopoulos-Bick T, Follent D, Kostovski C, Middleton V, Paulson C, Sutherland S, Cawley M, Files M, Follent S, Osten R, Trevena L. Finding Your Way - A shared decision making resource developed by and for Aboriginal people in Australia: Perceived acceptability, usability, and feasibility. Patient Educ Couns 2023; 115:107920. [PMID: 37531789 DOI: 10.1016/j.pec.2023.107920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Finding Your Way is a culturally adapted shared decision making (SDM) resource for Aboriginal (First Nations) people of Australia. It integrates the Eight Ways of Aboriginal Learning (8 Ways) and was created by Aboriginal health workers and community members in New South Wales (NSW), Australia. OBJECTIVE To explore the perceived acceptability, usability, and feasibility of Finding Your Way as a SDM resource for Aboriginal people making health and wellbeing decisions. METHODS The web-based resources were disseminated using social media, professional networks, publications, and the 'Koori grapevine'. Thirteen 'champions' also promoted the resources. An online questionnaire was available on the website for three months. Framework analysis determined early indications of its acceptability, usability, and feasibility. Web and social media analytics were also analysed. Partnership with and leadership by Aboriginal people was integrated at all phases of the project. RESULTS The main landing page was accessed 5219 times by 4259 users. 132 users completed the questionnaire. The non-linear and visual aspects of the resources 'speak to mob' and identified with Aboriginal culture. The inclusion of social and emotional well-being, and the holistic approach were well received by the small number of users who opted to provide feedback. They suggested that non-digital formats and guidance on the resources are required to support use in clinical practice. CONCLUSION The 8 Ways enabled the development of a culturally safe SDM resource for Aboriginal people, which was well received by users who took the time to provide feedback after a brief dissemination process. Additional accessible formats, practice guides and training are required to support uptake in clinical practice. PRACTICE IMPLICATIONS Finding Your Way could be used to help improve experiences, health literacy, decision making quality and outcomes of healthcare for Aboriginal Australians.
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Affiliation(s)
| | | | | | | | - Cory Paulson
- Royal Flying Doctor Service, South Eastern Section, NSW, Australia
| | - Stewart Sutherland
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Melissa Cawley
- South Eastern Sydney Local Health District, NSW, Australia
| | - Marsha Files
- Katungul Aboriginal Corporation Regional Health and Community Services, NSW, Australia
| | | | | | - Lyndal Trevena
- School of Public Health, University of Sydney, NSW, Australia
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Meade CD, Stanley NB, Arevalo M, Tyson DM, Chavarria EA, Aguado Loi CX, Rivera M, Gutierrez L, Abdulla R, Christy SM, Gwede CK. Transcreation matters: A learner centric participatory approach for adapting cancer prevention messages for Latinos. Patient Educ Couns 2023; 115:107888. [PMID: 37463555 DOI: 10.1016/j.pec.2023.107888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Advancing health equity requires innovative patient education approaches for adapting English-language evidence-based interventions (EBIs) to resonate with multicultural, multilingual audiences. OBJECTIVE Examine the benefit, functionality, and practical considerations of transcreation (translation + cultural adaptation) as a critical and salient learner-centric process for developing a Spanish-language intervention (photonovella + video): Un examen sencillo para un colon saludable (A simple test for a healthy colon). PATIENT/COMMUNITY INVOLVEMENT We involved patients/community members in a participatory reflective process, from problem identification to intervention design, development, delivery, and impact measurement. METHODS A community-based participatory research (CBPR) approach involving formative research plus systematic iterative pretesting and learner verification checks augmented by a community advisory board guided the transcreation processes. RESULTS Data collected using a learner-centric approach effectively produced a new Spanish-language EBI and substantiated the value of co-learner/co-design methods. Learner-centric methods identified cultural nuances that were treated as knowledge and integrated into the intervention materials and study design. Pilot testing of the intervention among Latinos receiving care at community clinics demonstrated improved initial colorectal cancer screening uptake, awareness, and perceived susceptibility. DISCUSSION Inherent in the transcreation process was learner involvement that informed essential modification and adaptation of the materials. The transcreation methods led to the development of a culturally salient intervention that maintained theoretical integrity and message intent as well as behavioral activation. Findings have broad implications for the creation and transfer of EBIs to new audiences for greater adoption, engagement, and 'reach' of interventions. PRACTICAL VALUE Transcreation aligns with a growing paradigm shift in health communication science that brings to light the beneficial effect that construction and application of cultural knowledge has on patient education toward health equity.
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Affiliation(s)
- Cathy D Meade
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA.
| | - Nathanael B Stanley
- Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA
| | - Mariana Arevalo
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Office of Community Outreach, Engagement & Equity. Moffitt Cancer Center, Tampa, FL, USA
| | | | - Enmanuel A Chavarria
- Behavioral, Social, and Health Education Sciences Department, Emory University, Atlanta, GA, USA
| | - Claudia X Aguado Loi
- Department of Health Science and Human Performance, University of Tampa, Tampa, FL, USA
| | | | | | - Rania Abdulla
- NTRO Non-Therapeutic Research Office, Moffitt Cancer Center, Tampa, USA
| | - Shannon M Christy
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA; Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, USA
| | - Clement K Gwede
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, USA; Department of Oncological Sciences, University of South Florida, Tampa, USA; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, USA; Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, USA
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Macdonald S. ACEM adding its voice to the Voice hits the wrong note. Emerg Med Australas 2023; 35:E1-E2. [PMID: 37437924 DOI: 10.1111/1742-6723.14279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023]
Abstract
ACEM has endorsed the proposal for an Aboriginal Voice to Parliament in Australia as a means of delivering its objectives to provide culturally safe care in EDs and to improve health outcomes for Aboriginal and Torres Strait Islander people. Unfortunately the Voice proposal has become a politically conentious issue. There is currently insufficient detail about how the Voice would operate and whether it will achieve the outcomes its proponents intend. This article argues that the claims in the ACEM statement are speculative rather than based on facts. In addition, by taking a position on this complex and controversial political matter ACEM is operating beyond its remit and risks distracting attention from its core mission.
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Affiliation(s)
- Stephen Macdonald
- Emergency Department, Royal Perth Hospital, Perth, Western Australia, Australia
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Komro KA, D'Amico EJ, Dickerson DL, Skinner JR, Johnson CL, Kominsky TK, Etz K. Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: a Comparison of Reservation- and Urban-Based Approaches. Prev Sci 2023; 24:88-98. [PMID: 35750937 PMCID: PMC9244356 DOI: 10.1007/s11121-022-01396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
There are few substance use treatment and prevention programs for AI/AN people that integrate culturally based practices with evidence-based treatment and prevention. The National Institutes of Health's (NIH's) Helping to End Addiction Long-term (HEAL) Prevention Cooperative supports two projects focused on AI/AN populations. One focuses on youth ages 15 to 20 years living within the Cherokee Nation reservation, a multicultural rural area in northeastern Oklahoma, and the second focuses on emerging adults ages 18 to 25 years living in diverse urban areas. We provide a brief overview of the two prevention trials and a case comparison across approaches using the framework of promising practices for intervention science with Indigenous communities (Whitesell et al., 2020) related to (1) integration of Indigenous and academic perspectives to respond to community needs, (2) community partnership and engagement, (3) alignment with Indigenous cultural values and practices, (4) capacity building and empowerment, (5) implementation within complex cultural contexts, and (6) tribal oversight. Overall, these two projects highlight the importance of long-standing relationships with community partners, engaging the community at all levels to ensure that programming is culturally and developmentally appropriate, and having tribal and elder oversight. These practices are key to establishing trust and building confidence in research in these communities and ensuring that research can benefit AI/AN people. These studies showcase how strong partnerships can advance health and support the conduct of rigorous science to help pinpoint optimal health solutions by identifying efficacious, culturally grounded intervention strategies. Although the sovereign status of tribes demands this type of partnership, this research serves as a model for all community research that has a goal of improving health.
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Affiliation(s)
- Kelli A Komro
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | | | - Daniel L Dickerson
- Integrated Substance Abuse Programs (ISAP), University of California Los Angeles, Los Angeles, CA, USA
| | | | | | | | - Kathy Etz
- Epidemiology Research Branch, National Institute On Drug Abuse, North Bethesda, USA
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Barbour V. The MJA supports an Aboriginal and Torres Strait Islander Voice to Parliament. Med J Aust 2023; 219:257-258. [PMID: 37634242 DOI: 10.5694/mja2.52074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 08/29/2023]
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Buhagiar R, Lu A, Liu S, Sahadevan S, Schulz LM, Ghosh J, Yeoh A. A pilot study to assess the impact of aboriginal and torres strait islander cultural humility webinars on australian medical school students. BMC Med Educ 2023; 23:626. [PMID: 37661272 PMCID: PMC10476379 DOI: 10.1186/s12909-023-04612-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The Aboriginal and Torres Strait Islander Health Curriculum Framework helps higher education providers to deliver safe and well-informed cultural humility education. However, there is currently a scarcity of evidence surrounding the efficacy and impact of cultural humility education. This study will use qualitative and quantitative research methods to evaluate learning outcomes from an Indigenous health educational webinar aimed at Australian medical students. METHODS A pilot study was conducted following a group of Australian medical students who attended an educational Indigenous health (IH) culturally responsive webinar. Recruitment was conducted via the webinar hosts' social media pages. Quantitative methods involved sending one pre- and two post-webinar questionnaires to attendees. To assess participants' retention of information, one post-webinar survey was sent out immediately after the webinar and another three months after the webinar. These questionnaires were designed to reflect pre-determined learning objectives for the webinar. Qualitative methods involved a focus group discussion to identify common themes from participant feedback. RESULTS Twenty-six participants were included in the final quantitative analysis. Most of the participants were clinical students between 18 and 24 years old who did not identify as Aboriginal and/or Torres Strait Islander. There was a significant increase (p = 0.007) between pre-intervention (M = 0.35, SD = 0.26) and post-webinar knowledge for the learning outcome exploring the links between health and education (M = 047, SD = 0.25). No results were obtained from the three months post-intervention questionnaire. The qualitative analysis synthesized feedback from three participants and identified presenter delivery style as an important mediator of webinar effectiveness. CONCLUSIONS There was a significant increase in knowledge and understanding for the learning outcome that explored the links between health and education. We attribute this partly to the engaging and conversational delivery style of the webinar presenters. The importance of Indigenous facilitators that encourage reflective teaching should not be understated. Our results suggest that cultural humility webinars can have a positive impact on medical students' understanding of the Aboriginal and/or Torres Strait Islander health landscape. This pilot study warrants further research on a larger population.
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Affiliation(s)
- R Buhagiar
- School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, VIC, 3216, Australia.
| | - A Lu
- School of Medicine, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - S Liu
- School of Medicine, Monash University, Wellington Road, Clayton, VIC, 3800, Australia
| | - S Sahadevan
- School of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia
| | - L M Schulz
- School of Medicine, Western Sydney University, 255 Elizabeth Street, Sydney, NSW, 2000, Australia
| | - J Ghosh
- School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, 3216, VIC, Australia
| | - A Yeoh
- Institute of Evidence-Based Healthcare, Bond University, 14 University Drive, Robina, QLD, 4226, Australia
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Shaw AR, Key MN, Fikru S, Lofton S, Sullivan DK, Berkley-Patton J, Glover CM, Burns JM, Vidoni ED. Development of a Culturally Adapted Dietary Intervention to Reduce Alzheimer's Disease Risk among Older Black Adults. Int J Environ Res Public Health 2023; 20:6705. [PMID: 37681845 PMCID: PMC10488073 DOI: 10.3390/ijerph20176705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/18/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
The objective of this study is to identify and understand knowledge and attitudes that influence dietary practices among older Black adults using a community-engaged approach. This is a non-interventional mixed methods study designed to inform the development of an adapted brain-healthy soul food diet intervention. A purposive sampling approach was used to conduct seven semi-structured focus group discussions and an online quantitative survey. In total, 39 participants who self-identified as Black, aged 55 years and older, English speaking, and who were cognitively normal with an AD8 < 2; (25.6% men; 74.4% women) participated in the online survey and one of the seven 60 min virtual focus group discussions (5-7 per focus group). Quantitative frequency data from the online surveys were analyzed using descriptive statistics. Qualitative focus group data were analyzed using a 6-step thematic analysis process. Five themes emerged: dementia awareness; practices shaping food choices and consumption; barriers to eating healthy; instrumental support; and elements of a culturally adapted brain-healthy dietary intervention. Older Black adults perceived an adapted MIND dietary model as the most acceptable with the incorporation of salient cultural characteristics and strategies within both the design and delivery phases.
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Affiliation(s)
- Ashley R. Shaw
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Mickeal N. Key
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Samantha Fikru
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Saria Lofton
- College of Nursing, University of Illinois Chicago, Chicago, IL 60612, USA;
| | - Debra K. Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Jannette Berkley-Patton
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City, Kansas City, MO 64108, USA;
| | - Crystal M. Glover
- Department of Psychiatry and Behavioral Sciences, Division of Behavioral Sciences, Rush Medical College, Chicago, IL 60612, USA;
- Department of Neurological Sciences, Rush Medical College, Chicago, IL 60612, USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - Jeffrey M. Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
| | - Eric D. Vidoni
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS 66160, USA; (M.N.K.); (S.F.); (J.M.B.); (E.D.V.)
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Ishikawa SI, Kishida K, Takahashi T, Fujisato H, Urao Y, Matsubara K, Sasagawa S. Cultural Adaptation and Implementation of Cognitive-Behavioral Psychosocial Interventions for Anxiety and Depression in Japanese Youth. Clin Child Fam Psychol Rev 2023; 26:727-750. [PMID: 37500948 DOI: 10.1007/s10567-023-00446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
The present article reviews the current status of cognitive-behavioral therapy (CBT) interventions for anxiety and depression in Japanese youth. First, a literature review of youth CBT programs for anxiety and depression is provided. Through this process, we identify which program/protocol has been most researched within Japan. Second, through a systematic interview to the authors, the development process of four predominant programs is outlined. The programs included were a family CBT program for anxiety disorders (the Japanese Anxiety Children/Adolescents Cognitive Behavior Therapy program), two school-based prevention programs for anxiety and depression (Journey of the Brave and Phoenix Time), and a transdiagnostic protocol for anxiety and depression (Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents). Third, cultural adaptation and modification of the programs are discussed from the scope of user-centered design principles as described by Lyon and Koerner (Sci Pract 23:180-200, 2016). As a result, changes in program content and material, as represented by the use of culture-friendly program names, acronyms, illustrations, and characters were endorsed in all of the programs. Structured but flexible session formats helped increase learnability and efficiency while keeping the cognitive load of providers and consumers low. A careful selection of providers, as well as quality training and consultation are important factors to maximize competency and ensure appropriate implementation. Application of existing time frames and staff who work in each setting were effective ways to increase scalability. Overall, it was shown that many of the modifications adopted overlap among successful programs; these represent the most basic and essential requirements for a program to be applicable to a wide range of contexts. Implications and further directions are explored.
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Affiliation(s)
- Shin-Ichi Ishikawa
- Faculty of Psychology, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, 610-0394, Japan.
| | - Kohei Kishida
- Japan Society for the Promotion of Science, Tokyo, Japan
- Kwansei Gakuin University, Hyogo, Japan
| | | | | | | | - Kohei Matsubara
- Faculty of Psychology, Doshisha University, 1-3 Tatara Miyakodani, Kyotanabe, Kyoto, 610-0394, Japan
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Johnston B, Dönmez CF, Julião M. Effectiveness of dignity therapy in the context of culturally competent care in people with palliative care needs: a systematic review of systematic reviews. Curr Opin Support Palliat Care 2023; 17:186-192. [PMID: 37428208 DOI: 10.1097/spc.0000000000000664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
PURPOSE OF REVIEW This review aims to synthesise the evidence from systematic reviews and meta-analyses on the efficacy of dignity therapy (DT) in relation to psychosocial and spiritual outcomes in the context of person-centred and culturally competent care for people with supportive and palliative care needs. RECENT FINDINGS Thirteen reviews were found, including seven conducted by nurses. Most reviews were of high quality, including various study populations such as cancer, motor neurone disease and non-malignant conditions. Six psychosocial and spiritual outcomes were identified: quality of life, anxiety, depression, hopefulness, meaning and purpose in life, and suffering based on the cultural variations in the implementation of DT. SUMMARY DT has a positive impact on anxiety, depression, suffering, and meaning and purpose in life for people with palliative care needs, but the evidence is somewhat conflicted as to whether DT is effective in improving hope, quality of life and spiritual outcomes in the context of culturally competent care. Nurse-led DT seems desirable given its pivotal role when caring for people with palliative care needs. More randomised controlled trials should be conducted for people with different cultural backgrounds to provide person-centred, culturally competent supportive and palliative care.
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Affiliation(s)
- Bridget Johnston
- School of Medicine, Dentistry and Nursing, University of Glasgow
- NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - C Fulya Dönmez
- School of Medicine, Dentistry and Nursing, University of Glasgow
- Fethiye Faculty of Health Sciences, Mugla University, Fethiye, Turkey
| | - Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
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Cammock R, Lovell S, Vaka S. Cultural values influencing iTaukei women's discussion of family planning in the home. Cult Health Sex 2023; 25:1198-1213. [PMID: 36409764 DOI: 10.1080/13691058.2022.2146204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Pacific Sexual and reproductive health is influenced by cultural taboos and sensitivities. Although Pacific values are integral to family planning, open communication in the home is often difficult in the face of changing socio-cultural norms. This study explores the experiences of iTaukei Pacific women living in Fiji and Aotearoa New Zealand, and their discussion of family planning within the family setting. The study utilises talanoa methodology to understand women's realities and their navigation through shifting sexual and reproductive norms in both countries. The study found that although family may be seen as a place of 'truth' in which appropriate, culturally sensitive family planning communication should be available, this was challenged by cultural taboos or tabu which were persistent in family planning discussions. The study calls for greater reliance on holistic approaches to Pacific family planning perspectives and a greater examination of vā or the spaces within which Pacific women's experiences are negotiated and informed.
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Affiliation(s)
- Radilaite Cammock
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Sarah Lovell
- School of Health Sciences, Faculty of Health, University of Canterbury, Christchurch, New Zealand
| | - Sione Vaka
- School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Arya N. How do South Asian seniors in a large Canadian city perceive long-term care? Can Fam Physician 2023; 69:e181-e188. [PMID: 37704237 PMCID: PMC10498910 DOI: 10.46747/cfp.6909e181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To understand how community-dwelling South Asian older adults understand and envision long-term care (LTC). DESIGN Descriptive qualitative study. SETTING The Region of Waterloo in Ontario. PARTICIPANTS Participants included 3 key informants (geriatrician, social worker, and medical translator, all South Asian), 1 family caregiver, and 15 community-dwelling South Asian adults aged 65 and older. METHODS In-depth interviews and focus groups were recorded, transcribed verbatim, and analyzed using a framework analysis approach. MAIN FINDINGS High-level themes included the emotional impacts of failure to provide culturally competent care, such as fear and isolation; a desire for a model of culturally competent care with an emphasis on food and language; and the need for LTC to be more integrated with the broader community and connected to families. CONCLUSION As the delivery of LTC is rethought in this country, there is the potential to deliver on the promise of culturally competent care for this growing population. These findings are among the first to communicate the LTC care needs of South Asian older adults in their own words.
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Affiliation(s)
- Neil Arya
- Assistant Clinical Professor at McMaster University in Hamilton, Ont; Fellow at the Balsillie School of International Affairs in Waterloo, Ont; and Director of the Centre for Family Medicine Refugee Health Clinic in Kitchener, Ont
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