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Chen Q, Maher CG, Rogan E, Machado G. Management of low back pain in Australian emergency departments for culturally and linguistically diverse populations from 2016 to 2021. Emerg Med J 2023:emermed-2022-212718. [PMID: 37085180 DOI: 10.1136/emermed-2022-212718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/12/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Disparate care in the ED for minority populations with low back pain is a long-standing issue reported in the USA. Our objective was to compare care delivery for low back pain in Australian EDs between culturally and linguistically diverse (CALD) and non-CALD patients. METHODS This is a retrospective review of medical records of the ED of three public hospitals in Sydney, New South Wales, Australia from January 2016 to October 2021. We included adult patients diagnosed with non-serious low back pain at ED discharge. CALD status was defined by country of birth, preferred language and use of interpreter service. The main outcome measures were ambulance transport, lumbar imaging, opioid administration and hospital admission. RESULTS Of the 14 642 included presentations, 7656 patients (52.7%) were born overseas, 3695 (25.2%) preferred communicating in a non-English language and 1224 (8.4%) required an interpreter. Patients born overseas were less likely to arrive by ambulance (adjusted OR (aOR) 0.68, 95% CI 0.63 to 0.73) than Australian-born patients. Patients who preferred a non-English language were also less likely to arrive by ambulance (aOR 0.82, 95% CI 0.75 to 0.90), yet more likely to be imaged (aOR 1.12, 95% CI 1.01 to 1.23) or be admitted to hospital (aOR 1.16, 95% CI 1.04 to 1.29) than Native-English-speaking patients. Patients who required an interpreter were more likely to receive imaging (aOR 1.43, 95% CI 1.25 to 1.64) or be admitted (aOR 1.49, 95% CI 1.29 to 1.73) compared with those who communicated independently. CALD patients were generally less likely to receive weak opioids than non-CALD patients (aOR range 0.76-0.87), yet no difference was found in the use of any opioid or strong opioids. CONCLUSION Patients with low back pain from a CALD background, especially those lacking English proficiency, are significantly more likely to be imaged and admitted in Australian EDs. Future interventions improving the quality of ED care for low back pain should give special consideration to CALD patients.
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Affiliation(s)
- Qiuzhe Chen
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris G Maher
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Eileen Rogan
- Canterbury Hospital, Campsie, New South Wales, Australia
| | - Gustavo Machado
- Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Lambert E, Strickland K, Gibson J. Cultural considerations at end-of-life for people of culturally and linguistically diverse backgrounds: A critical interpretative synthesis. J Clin Nurs 2023. [PMID: 37024426 DOI: 10.1111/jocn.16710] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 05/13/2022] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE/AIM To establish cultural considerations for people from culturally or linguistically diverse backgrounds at the end-of-life in Australia. BACKGROUND Globally, there is a rapidly increasing proportion of the ageing population, and high levels of migration to Australia, the Australian healthcare community must recognise individualised and cultural needs when approaching death and end-of-life care. Many people from culturally and linguistically diverse backgrounds do not traditionally practice the palliative care approaches that have been developed and practised in Australia. DESIGN A Critical Interpretive Synthesis. METHODS A review protocol was established using PRISMA 2020 guidelines and the literature searched using CINAHL, PubMed, Psych INFO and Medline from January 2011 to 27th February 2021. This search protocol results in 19 peer-reviewed results for inclusion in critical analysis. RESULTS Included studies were qualitative (14), quantitative (4) and mixed methods (1). Four themes were identified from the literature: (i) communication and health literacy; (ii) access to end-of-life care services; (iii) cultural norms, traditions and rituals; and (iv) cultural competence of healthcare workers. CONCLUSIONS Healthcare workers have an essential role in providing care to people with life-limiting illnesses. Cultural considerations during end-of-life care are imperative for the advancement of nursing practice. To achieve effective care for people of culturally and linguistically diverse backgrounds during end-of-life care, healthcare workers need to increase their education and cultural competency. There is inadequate research conducted within specific cultural groups, rural and remote Australian communities and individual cultural competence of healthcare workers. IMPLICATIONS FOR PRACTICE Continuing advancement within nursing practice relies on health professionals adopting a person-centred and culturally appropriate approach to care. To ensure individualised person-centred care is provided in a culturally appropriate way, healthcare workers must learn to reflect on their practice and actively advocate for people with culturally and linguistically diverse backgrounds during end-of-life care.
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Affiliation(s)
| | | | - Jo Gibson
- University of Canberra, Canberra, Australia
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Abdul Rahim R, Pilkington R, Procter AM, Montgomerie A, Mittinty MN, D'Onise K, Lynch J. Child protection contact among children of culturally and linguistically diverse backgrounds: A South Australian linked data study. J Paediatr Child Health 2023; 59:644-652. [PMID: 36744551 PMCID: PMC10946611 DOI: 10.1111/jpc.16364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 01/10/2023] [Accepted: 01/23/2023] [Indexed: 02/07/2023]
Abstract
AIM To describe the cumulative incidence of child protection (CP) system contact, maltreatment type, source of reports to age 7 years, and socio-demographic characteristics for culturally and linguistically diverse (CALD) Australian children. METHODS We used CP, education, health, and birth registrations data for children followed from birth up to age 7 from the South Australian Better Evidence, Better Outcomes, Linked Data (SA BEBOLD) platform. PARTICIPANTS SA born children enrolled in their first year of school from 2009 to 2015 (n = 76 563). CALD defined as non-Aboriginal or Torres Strait Islander, spoken language other than English, Indigenous or Sign, or had at least one parent born in a non-English speaking country. OUTCOMES MEASURES For CALD and non-CALD children, we estimated the cumulative incidence (risk) of CP contacts up to age 7, relative risk and risk differences for all levels of CP contact from notification to out-of-home care (OOHC), primary maltreatment type, reporter type, and socio-economic characteristics. Sensitivity analyses explored different population selection criteria and CALD definitions. RESULTS By age 7, 11.2% of CALD children had 'screened-in' notifications compared to 18.8% of non-CALD (risk difference [RD] 7.6 percentage points (95% confidence interval: 6.9-8.3)), and 0.6% of CALD children experienced OOHC compared to 2.2% of non-CALD (RD 1.6 percentage points (95% confidence interval: 1.3-1.8)). Emotional abuse was the most common substantiated maltreatment type for CALD and neglect for non-CALD. Among both groups, the most common reporter sources were police and education sector. Socio-economic characteristics were broadly similar. Sensitivity analyses results were consistent with primary analyses. CONCLUSION By age 7, CALD children had lower risk of contact with all levels of CP. Estimates based on primary and sensitivity analyses suggested CALD children were 5-9 percentage points less likely to have a report screened-in, and from 1.0 to 1.7 percentage points less likely to have experienced OOHC.
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Affiliation(s)
- Razlyn Abdul Rahim
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Rhiannon Pilkington
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
- Robinson Research InstituteThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Alexandra M Procter
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
- Robinson Research InstituteThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Alicia Montgomerie
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
- Robinson Research InstituteThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Murthy N Mittinty
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Katina D'Onise
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
- Prevention and Population HealthWellbeing SAAdelaideSouth AustraliaAustralia
| | - John Lynch
- School of Public HealthThe University of AdelaideAdelaideSouth AustraliaAustralia
- Robinson Research InstituteThe University of AdelaideAdelaideSouth AustraliaAustralia
- Bristol Medical School, Population Health SciencesUniversity of BristolBristolUK
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Marcus K, Balasubramanian M, Short S, Sohn W. Barriers and facilitators to dental care among culturally and linguistically diverse carers: A mixed-methods systematic review. Community Dent Oral Epidemiol 2023; 51:327-344. [PMID: 35342972 DOI: 10.1111/cdoe.12745] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Culturally and linguistically diverse (CALD) communities experience widespread inequalities in dental care utilization. While, several studies have reported factors contributing to such inequalities, a synthesis of evidence is lacking for CALD carers. This review examined the barriers and facilitators to dental care utilization among CALD carers. METHODS Medline, CINAHL, ProQuest, Scopus and Web of Science were searched for dental utilization and related factors, without geographic limitations. An integrated mixed-method design was adopted, where both qualitative and quantitative findings were combined into a single synthesis. Critical appraisal was conducted using JBI tools, and a Universal Health Coverage (UHC) framework guided the synthesis approach. Reliability and researcher triangulation occurred throughout the conduct of this review. RESULTS A total of 20 papers were included: qualitative (n = 8), quantitative (n = 8) and mixed method (n = 4). Studies were from Australia, Canada, South Korea, Trinidad and Tobago, United Kingdom and the United States. Three studies insufficiently reported confounding variables and nine qualitative papers lacked philosophical perspectives. Affordability was the foremost barrier at the system level, followed by psychosocial negative provider experiences and language/communication issues at the provider level. Cultural, knowledge, attitudes and beliefs were individual-family level factors. Utilizing a UHC framework, the barriers and facilitators were aggregated at three levels; financial-system, provider and individual-family levels and illustrated in the rainbow model of CALD oral health. CONCLUSION The review strengthens evidence for multilayered, system-related policies and culturally sensitive provision of services for reducing oral healthcare inequalities in CALD carers.
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Affiliation(s)
- Kanchan Marcus
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Surry Hills, New South Wales, Australia
| | - Madhan Balasubramanian
- Health Care Management, College of Business, Government and Law, Flinders University, Adelaide, South Australia, Australia
- Faculty of Medicine and Health, Menzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Short
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Woosung Sohn
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Surry Hills, New South Wales, Australia
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Lemoh C, Xiao Y, Tran L, Yussf N, Moro P, Dutertre S, Wallace J. An Intersectional Approach to Hepatitis B. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4879. [PMID: 36981797 PMCID: PMC10049575 DOI: 10.3390/ijerph20064879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
Hepatitis B is a chronic condition, primarily associated with hepatitis B viral infection in early life. The failure of prevention and appropriate management can lead to subsequent liver cirrhosis and cancer. Hepatitis B most commonly affects people born in Asia and Sub-Saharan Africa and their global diasporas. The physical, psychological, and social impacts of hepatitis B are strongly influenced by sex and gender. Inequities in access to timely, sensitive diagnosis and effective management arise from interactions between structural inequalities related to race, ethnicity, Indigenous/settler status, class, and geography. The biomedical response to hepatitis B has led to advances in prevention, diagnosis, and treatment, but many affected communities have explanatory health belief models that differ from that of biomedicine. We argue that an intersectional approach, led by affected people and communities, can integrate biomedicine with the lived experience and social context that give purpose to and shape all personal, communal, clinical, and public health responses to hepatitis B. This approach has the potential to enable a consciously equitable, effective response to the biopsychosocial complexities of hepatitis B, improve the health and wellbeing of people living with hepatitis B, and reduce hepatitis B-associated mortality.
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Affiliation(s)
- Christopher Lemoh
- Department of Medicine, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Yinzong Xiao
- Burnet Institute, Melbourne, VIC 3004, Australia
| | - Lien Tran
- Department of Medicine, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia
- WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Parkville, VIC 3010, Australia
| | - Nafisa Yussf
- WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Parkville, VIC 3010, Australia
- Department of Infectious Diseases, The University of Melbourne, Melbourne, VIC 3004, Australia
| | - Piergiorgio Moro
- Centre for Culture, Ethnicity and Health, North Richmond Community Health, Richmond, VIC 3121, Australia
| | - Sophie Dutertre
- Centre for Culture, Ethnicity and Health, North Richmond Community Health, Richmond, VIC 3121, Australia
| | - Jack Wallace
- Burnet Institute, Melbourne, VIC 3004, Australia
- Centre for Social Research in Health, University of New South Wales, Kensington, NSW 2052, Australia
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Brijnath B, Navarro Medel C, Antoniades J, Gilbert AS. Culturally Adapting Evidence on Dementia Prevention for Ethnically Diverse Communities: Lessons Learnt from co-design. Clin Gerontol 2023; 46:155-167. [PMID: 35894749 DOI: 10.1080/07317115.2022.2101968] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES 40% of dementia cases can be prevented by addressing 12 lifestyle factors. These risk factors have increased presence in ethnic minorities, yet dementia prevention messages have not reached these communities. This article investigates the experience of co-designing a dementia prevention animated film with 9 ethnic groups in Australia. METHODS Evidence-based recommendations were adapted through an iterative process involving workshops with a stakeholder advisory committee and nine focus groups with 104 participants from the Arabic-, Hindi-, Tamil-, Cantonese-, Mandarin-, Greek-, Italian-, Spanish-, and Vietnamese-speaking communities. Data were analyzed using the Normalization Process Theory. RESULTS Cultural adaptation involves consideration of the mode of delivery, imagery and tone of the resource being developed; ensuring cultural adequacy; anticipating the need of the end-users; and managing linguistic challenges associated with working across multiple languages. CONCLUSIONS Learnings from this co-design process offer valuable insights for researchers and program developers who work with ethnic minority groups. CLINICAL IMPLICATIONS • Adaptation across cultures and languages is a negotiation not a consensus building exercise• Linguistic adaptation requires consideration of the education levels, and linguistic and intergenerational preferences of community members• Co-designing across multiple languages and cultures risks "flattening out" key aspects of cultural specificity.
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Affiliation(s)
- Bianca Brijnath
- Division of Social Gerontology, National Ageing Research Institute
- School of Social Sciences, University of Western Australia
| | | | - Josefine Antoniades
- Division of Social Gerontology, National Ageing Research Institute
- School of Public Health and Preventive Medicine, Monash University
| | - Andrew S Gilbert
- Division of Social Gerontology, National Ageing Research Institute
- Department of Social Inquiry, La Trobe University
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Whitehead L, Talevski J, Fatehi F, Beauchamp A. Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review. J Med Internet Res 2023; 25:e42719. [PMID: 36853742 PMCID: PMC10015358 DOI: 10.2196/42719] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/09/2022] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Health care systems have become increasingly more reliant on patients' ability to navigate the digital world. However, little research has been conducted on why some communities are less able or less likely to successfully engage with digital health technologies (DHTs), particularly among culturally and linguistically diverse (CaLD) populations. OBJECTIVE This systematic review aimed to determine the barriers to and facilitators of interacting with DHTs from the perspectives of CaLD population groups, including racial or ethnic minority groups, immigrants and refugees, and Indigenous or First Nations people. METHODS A systematic review and thematic synthesis of qualitative studies was conducted. Peer-reviewed literature published between January 2011 and June 2022 was searched across 3 electronic databases. Terms for digital health were combined with terms for cultural or linguistic diversity, ethnic minority groups, or Indigenous and First Nations people and terms related to barriers to accessing digital technologies. A qualitative thematic synthesis was conducted to identify descriptive and analytical themes of barriers to and facilitators of interacting with DHTs. Quality appraisal was performed using the Mixed Methods Appraisal Tool. RESULTS Of the 1418 studies identified in the electronic search, a total of 34 (2.4%) were included in this review. Half of the included studies (17/34, 50%) were conducted in the United States. There was considerable variation in terms of the CaLD backgrounds of the participants. In total, 26% (9/34) of the studies focused on Indigenous or First Nations communities, 41% (14/34) were conducted among ethnic minority populations, 15% (5/34) of the studies were conducted among immigrants, and 18% (6/34) were conducted in refugee communities. Of the 34 studies, 21 (62%) described the development or evaluation of a digital health intervention, whereas 13 (38%) studies did not include an intervention but instead focused on elucidating participants' views and behaviors in relation to digital health. From the 34 studies analyzed, 18 descriptive themes were identified, each describing barriers to and facilitators of interacting with DHTs, which were grouped into 7 overarching analytical themes: using technology, design components, language, culture, health and medical, trustworthiness, and interaction with others. CONCLUSIONS This study identified several analytic and descriptive themes influencing access to and uptake of DHTs among CaLD populations, including Indigenous and First Nations groups. We found that cultural factors affected all identified themes to some degree and that cultural and linguistic perspectives should be considered in the design and delivery of DHTs, with this best served through the inclusion of the target communities at all stages of development. This may improve the potential of DHTs to be more acceptable, appropriate, and accessible to population groups currently at risk of not obtaining the full benefits of digital health.
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Affiliation(s)
- Lara Whitehead
- School of Rural Health, Faculty of Medicine, Nursing and Health Science, Monash University, Warragul, Australia
| | - Jason Talevski
- School of Rural Health, Faculty of Medicine, Nursing and Health Science, Monash University, Warragul, Australia.,Institute for Physical Activity and Nutrition Research (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.,Australian Institute for Musculoskeletal Science, The University of Melbourne and Western Health, Melbourne, Australia
| | - Farhad Fatehi
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia.,School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Alison Beauchamp
- School of Rural Health, Faculty of Medicine, Nursing and Health Science, Monash University, Warragul, Australia
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Kamau S, Koskenranta M, Isakov TM, Kuivila H, Oikarainen A, Tomietto M, Mikkonen K. Culturally and linguistically diverse registered nurses' experiences of integration into nursing workforce - A qualitative descriptive study. NURSE EDUCATION TODAY 2023; 121:105700. [PMID: 36566646 DOI: 10.1016/j.nedt.2022.105700] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The nursing shortage is a global and ongoing phenomenon that is expected to worsen. In many countries, imbalances in the nursing workforce will require international recruitment and plans to increase domestic and international nursing graduates. Nurses from culturally and linguistically diverse backgrounds have been reported to experience challenges while integrating into the workforce. AIM To describe culturally and linguistically diverse registered nurses' experiences of their integration into the Finnish nursing workforce. METHODS The study adopted a qualitative descriptive design. Data were collected during the spring of 2021 from 24 culturally and linguistically diverse registered nurses working in various healthcare settings in Finland. Data were analyzed using content analysis, which resulted in 596 open codes, 21 sub-categories, and 8 categories. RESULTS According to the performed analysis, culturally and linguistically diverse nurses in Finland face cultural, ethnic and linguistic challenges. Organizational acceptance and acknowledgement of culturally and linguistically diverse nurses' competence can help decrease the practice of deskilling and the perception that foreign nurses have purely opportunistic goals. Cultural and language learning support, tailored orientation programs, and mentorship are the most common organizational strategies for supporting integration and competence development. The role of the nurse manager and organizational strategies were also identified as essential components of smooth integration, work wellbeing and retention. CONCLUSIONS Finnish healthcare organizations need to implement strategies that support culturally and linguistically diverse nurses' integration into the workforce. Nurse managers are important leaders that can foster culturally and linguistically diverse nurses' competence development, ensure the efficient use of their specialized skills, promote work wellbeing, and improve nurse retention.
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Affiliation(s)
- Suleiman Kamau
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Department of Healthcare and Social Services, Jyvaskyla University of Applied Sciences, Jyvaskyla, Finland.
| | - Miro Koskenranta
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Terhi-Maija Isakov
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Heli Kuivila
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Ashlee Oikarainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - Marco Tomietto
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Department of Nursing, Midwifery and Healthcare, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK.
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
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Smout S, Gardner LA, Newton N, Champion KE. Dose-response associations between modifiable lifestyle behaviours and anxiety, depression and psychological distress symptoms in early adolescence. Aust N Z J Public Health 2023; 47:100010. [PMID: 36645951 DOI: 10.1016/j.anzjph.2022.100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To investigate associations between key modifiable lifestyle behaviours (sleep; physical activity; fruit, vegetable and sugar-sweetened beverage consumption; screen time; alcohol use and tobacco use) and mental health among early adolescents in Australia. METHODS Cross-sectional self-report data from 6,640 Year 7 students (Mage:12.7[0.5]; 50.6% male, 48.9% female, 0.5% non-binary) from 71 schools in New South Wales, Queensland and Western Australia were analysed using multivariate linear regression adjusting for sociodemographic factors and school-level clustering. RESULTS All examined behaviours were associated with anxiety, depression and psychological distress (p≤0.001), with the lowest mental health symptom scores observed in participants who slept 9.5-10.5 hours per night; consumed three serves of fruit daily; consumed two serves of vegetables daily; never or rarely drank sugar-sweetened beverages; engaged in six days of moderate-to-vigorous physical activity per week; kept daily recreational screen time to 31-60 minutes; had not consumed a full standard alcoholic drink (past six months); or smoked a cigarette (past six months). CONCLUSIONS Targeting modifiable risk behaviours offers promising prevention potential to improve adolescent mental health; however, further longitudinal research to determine directionality and behavioural interactions is needed. IMPLICATIONS FOR PUBLIC HEALTH While Australian Dietary, Movement and Alcohol Guidelines target physical health, findings indicate similar behaviour thresholds may offer mental health benefits.
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Affiliation(s)
- Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Isakov T, Kamau S, Koskenranta M, Kuivila H, Oikarainen A, Ropponen P, Mikkonen K. Culturally and linguistically diverse nurses' experiences of how competence facilitates integration into the working environment: A qualitative study. Nurse Educ Pract 2023; 67:103553. [PMID: 36657318 DOI: 10.1016/j.nepr.2023.103553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
AIM This study aims to describe culturally and linguistically diverse nurses' experiences of how they transferred their competence to meet professional competence requirements in non-English speaking environment. BACKGROUND Competence is one factor that affects culturally and linguistically diverse nurses' integration into the working environment. In this study, knowledge, skills, values and personal traits are included in the holistic competence concept. DESIGN Qualitative. METHODS A total of 24 culturally and linguistically diverse nurses involved in Finnish health care participated in this qualitative study. Data were collected through snowball sampling during the summer of 2021 using semi-structured interviews. The collected data were analysed using inductive content analysis. RESULTS The data analysis revealed a total of five main categories describing culturally and linguistically diverse nurses' experiences: 1) before immigration; 2) competence requirements in the country of immigration; 3) assessment of competencies; 4) support factors; and 5) hardships. CONCLUSION Degree recognition, colleagues' tolerance towards culturally and linguistically diverse nurses at the workplace and continuous education focusing on local language could improve culturally and linguistically diverse nurses' integration into the working environment.
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Affiliation(s)
- T Isakov
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu. Attendo Finland/Silkroad, Espoo, Finland.
| | - S Kamau
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Department of healthcare and social services, Jyvaskyla university of applied sciences, Jyvaskyla, Finland.
| | - M Koskenranta
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - H Kuivila
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - A Oikarainen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.
| | - P Ropponen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Diaconia University of Applied Sciences, Helsinki, Finland.
| | - K Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
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Pearson T, Due C, Obst K. Culturally and Linguistically Diverse Men's Grief Experiences Following Perinatal Death in Australia. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231153545. [PMID: 36689624 DOI: 10.1177/00302228231153545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
To explore the grief experiences of men from culturally and linguistically diverse (CALD) backgrounds following perinatal death in Australia. Qualitative analysis of interview data using thematic analysis. Participants were health service providers (n = 6), and CALD community members (n = 10) who were either community leaders with experience working with CALD men following perinatal death in Australia (n = 6), or were CALD men who had lived experience of perinatal death (n = 4). Thematic analysis identified four themes related to CALD men's grief. These included the role of religion and rituals, grief as stoic, the partner- and family-centred nature of men's grief, and finally grief as ensuring and changeable over time. This research points to the strong need for CALD men's specific needs to be included in the development of policy and practice surrounding perinatal death.
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Affiliation(s)
- Thomas Pearson
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Clemence Due
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Kate Obst
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
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Cardona M, Fien S, Myooran J, Hunter C, Dillon A, Lewis E, Browning M, Lewis L, Ní Chróinín D. Clinical and cost-effectiveness of telehealth for Indigenous and culturally and linguistically diverse (CALD) people: a scoping review. ETHNICITY & HEALTH 2023; 28:114-135. [PMID: 34983256 DOI: 10.1080/13557858.2021.2023111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To examine the modalities and clinical and non-clinical effectiveness of telehealth services available to people from Indigenous and culturally and linguistically diverse backgrounds (CALD). MATERIALS AND METHODS A scoping review of peer-reviewed publications (2000-2021) on the effectiveness of telehealth interventions for Indigenous and CALD groups based on searches of Medline, CINAHL, and PsycInfo and manual searches from reference lists of captured literature reviews. RESULTS Of the initial 601 articles, 10 met the inclusion criteria (seven of clinical effectiveness and three of non-clinical effectiveness), with participants from the USA, Australia, New Zealand, and Canada, with sample sizes ranging from 19 to 1,665 participants (overall 327 Indigenous and 2,030 CALD patients). Telehealth was delivered via telephone or by videoconference-with or without data uploads-and follow-up ranging from 6 months to 5 years. DISCUSSION The findings suggest that telehealth shows some promise in: diabetes, depression, neuro/cognitive assessment, and health program adherence/service utilisation/cost. However, our confidence in the accuracy of the results is undermined by the mixed quality of designs and outcome measurements, and the high risk of bias derived from not proper random selections and small sample sizes. CONCLUSIONS The available literature suggests acceptable clinical and non-clinical effectiveness of telehealth against usual care in Indigenous and/or CALD groups but methodological limitations diminish their value in informing practice. Therefore, we consider it is premature to use the findings of these primary studies to draw conclusive recommendations about clinical or other effectiveness of telehealth for the two target groups. Further randomised trials with adequate sampling frames and objective outcome assessments are warranted.
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Affiliation(s)
- Magnolia Cardona
- Evidence-Based Practice Professorial Unit, Gold Coast University Hospital, Southport, Australia
- Institute for Evidence-Based Healthcare, Bond University, Robina, Australia
| | - Samantha Fien
- Faculty of Health, Medical and Applied Sciences, Central Queensland University, Mackay, Australia
| | - Jananee Myooran
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
| | - Carol Hunter
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
- UNSW Medicine, University of New South Wales, Kensington, Australia
- South Western Sydney Clinical School, UNSW Medicine, Kensington, Australia
| | - Anne Dillon
- UNSW Medicine, University of New South Wales, Kensington, Australia
| | - Ebony Lewis
- School of Psychology, Faculty of Science, University of New South Wales, Kensington, Australia
- School of Population Health, Faculty of Medicine & Health, University of New South Wales Kensington, Sydney, Australia
| | - Melissa Browning
- Aboriginal and Torres Strait Islander Health Service, Gold Coast Hospital and Health Service, Southport, Australia
| | - Lou Lewis
- Matraville Medical Centre, Sydney, Australia
| | - Danielle Ní Chróinín
- Department of Geriatric Medicine, Liverpool Hospital, Liverpool, Australia
- South Western Sydney Clinical School, UNSW Medicine, Kensington, Australia
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Poirier BF, Ribeiro Santiago PH, Kapellas K, Jamieson L, Neadley KE, Boyd M. Development of Social Determinants of Health Screening Tool (SDoHST): qualitative validation with stakeholders and patients in South Australia. Curr Med Res Opin 2023; 39:131-140. [PMID: 36346396 DOI: 10.1080/03007995.2022.2144053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND It is well-established that social determinants of health contribute to health and well-being. Among the social determinants of health, health-related social needs (HRSNs) are unmet needs that can be identified by the health care system and addressed through referral to community services. Despite the importance of identifying patients with HRSNs, none of the few screening tools for HRSNs available internationally have received a comprehensive psychometric validation. This study aims to conduct a qualitative validation of the Social Determinants of Health Screening Tool (SDoHST). METHODS This study took place at Lyell McEwin Hospital, a major tertiary hospital located in Adelaide, South Australia. Patient (n = 5) and stakeholder (n = 9) focus groups were conducted face to face, audio recorded, and transcribed verbatim. Inductive content analysis of focus group transcripts was performed to inform tool modifications (e.g. item rewording). RESULTS The patient focus group recommended the addition of an explanatory paragraph to improve face validity, and highlighted the importance of reliable transport and internet access. The stakeholder focus group recommended using language that carries less stigma to this particular community and incorporating questions surrounding cultural, linguistic, and spiritual needs. The final version of the SDoHST included 12 items (four original items were removed and seven new items were added during the validation process). CONCLUSION The SDoHST is the first validated tool to measure social determinants of health (and specifically HRSNs) in Australia, receiving a comprehensive qualitative validation. The instrument is readily available and future studies will further investigate its psychometric properties with quantitative methods.
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Affiliation(s)
- Brianna Faye Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | | | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | | | - Mark Boyd
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Northern Adelaide Local Health Network, Adelaide, Australia
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Pham TTL, O’Brien KS, Berecki-Gisolf J, Liu S, Gibson K, Clapperton A. Intentional self-harm in culturally and linguistically diverse communities: A study of hospital admissions in Victoria, Australia. Aust N Z J Psychiatry 2023; 57:69-81. [PMID: 34881672 PMCID: PMC9791328 DOI: 10.1177/00048674211063421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To examine the rates and profiles of intentional self-harm hospital admissions among people from culturally and linguistically diverse and non-culturally and linguistically diverse backgrounds. METHODS A retrospective analysis of 29,213 hospital admissions for self-harm among people aged 15 years or older in Victoria, Australia, was conducted using data from the Victorian Admitted Episodes Dataset between 2014/2015 and 2018/2019. The Victorian Admitted Episodes Dataset records all hospital admissions in public and private hospitals in Victoria (population 6.5 million). Population-based incidence of self-harm, logistic regression and percentages (95% confidence intervals) were calculated to compare between culturally and linguistically diverse groups by birthplaces and the non-culturally and linguistically diverse groups of self-harm admissions. RESULTS When grouped together culturally and linguistically diverse individuals had lower rates of (hospital-treated) self-harm compared with the non-culturally and linguistically diverse individuals. However, some culturally and linguistically diverse groups such as those originating from Sudan and Iran had higher rates than non-culturally and linguistically diverse groups. Among self-harm hospitalised patients, those in the culturally and linguistically diverse group (vs non-culturally and linguistically diverse group) were more likely to be older, Metropolitan Victorian residents, from the lowest socioeconomic status, and being ever or currently married. Self-harm admissions by persons born in Southern and Eastern Europe were the oldest of all groups; in all other groups number of admissions tended to decrease as age increased whereas in this group the number of admissions increased as age increased. CONCLUSION There was considerable heterogeneity in rates of hospital-treated self-harm in culturally and linguistically diverse communities, with some countries of origin (e.g. Sudan, Iran) having significantly higher rates. Some of this variation may be due to factors relating to the mode of entry into Australia (refugee vs planned migration), and future research needs to examine this possibility and others, to better plan for support needs in the culturally and linguistically diverse communities most affected by self-harm. Combining all culturally and linguistically diverse people into one group may obscure important differences in self-harm. Different self-harm prevention strategies are likely to be needed for different culturally and linguistically diverse populations.
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Affiliation(s)
- Thi Thu Le Pham
- Monash University Accident Research Centre, Monash University, Clayton, VIC, Australia,Thi Thu Le Pham, Monash University Accident Research Centre, Monash University, Clayton, VIC 3800, Australia. ;
| | - Kerry S O’Brien
- School of Social Sciences, Monash University, Melbourne, VIC, Australia
| | | | - Sara Liu
- Monash University Accident Research Centre, Monash University, Clayton, VIC, Australia
| | - Katharine Gibson
- Prevention and Population Health Branch, Public Health Division, The Victorian Department of Health, Melbourne, VIC, Australia
| | - Angela Clapperton
- Centre for Mental Health, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Integration strategies and models to support transition and adaptation of culturally and linguistically diverse nursing staff into healthcare environments: An umbrella review. Int J Nurs Stud 2022; 136:104377. [DOI: 10.1016/j.ijnurstu.2022.104377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/18/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022]
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Cordell B, Nguyen K, Shahir AK, Lord SJ, Gallego G. Prevalence and characteristics of frequent presenters to Auburn Hospital emergency department. Emerg Med Australas 2022; 34:898-906. [PMID: 35582890 PMCID: PMC9790270 DOI: 10.1111/1742-6723.14011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/10/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Frequent presenters (FPs) to the ED are common and contribute to ED overcrowding. Our aim was to identify the proportion of FPs over a 12-month period and to investigate the sociodemographic, clinical and attendance characteristics of FPs. METHODS A retrospective cohort study of adult patients (≥18 years) presenting to Auburn Hospital ED between 1 January 2018 to 31 December 2018. Patients with ≥4 presentations in 12 months were classified as FP. Multivariable logistic regression was used to assess associations between sociodemographic characteristics and FP. RESULTS During the study period, there were 22 679 presentations to the ED from 16 624 adult patients. FPs represented 5.1% (95% confidence interval [CI] 4.8-5.5) of the total population, but 15.8% of the total ED visits. Median age of FPs was 46 years (interquartile range 29-72), 51.9% were males. Age over 65 was the strongest determinant of FP (odds ratio [OR] 2.33; 95% CI 2.01-2.72 adjusted for sex). FP was more likely for Arabic speakers compared to English speakers (OR 1.54; 95% CI 1.28-1.86 adjusted for age and sex) and least likely for Mandarin speakers (adjusted OR 0.40; 95% CI 0.27-0.59). CONCLUSIONS FPs represent a significant proportion of ED visits, yet a small proportion of ED patients. Our findings suggest that identifying ways to provide targeted services to older FPs may reduce the overall rates. The differences between language groups and FP highlights the importance of social context and culture when developing targeted interventions.
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Affiliation(s)
- Billie Cordell
- Auburn Clinical School, The School of MedicineThe University of Notre Dame AustraliaSydneyNew South WalesAustralia
| | - Khanh Nguyen
- Auburn Clinical School, The School of MedicineThe University of Notre Dame AustraliaSydneyNew South WalesAustralia,Emergency DepartmentAuburn HospitalSydneyNew South WalesAustralia
| | - Ahmed K Shahir
- Auburn Clinical School, The School of MedicineThe University of Notre Dame AustraliaSydneyNew South WalesAustralia,Medicine DepartmentAuburn HospitalSydneyNew South WalesAustralia
| | - Sarah J Lord
- Auburn Clinical School, The School of MedicineThe University of Notre Dame AustraliaSydneyNew South WalesAustralia,National Health and Medical Research Council Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia
| | - Gisselle Gallego
- Auburn Clinical School, The School of MedicineThe University of Notre Dame AustraliaSydneyNew South WalesAustralia
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Marcus K, Balasubramanian M, Short SD, Sohn W. Dental hesitancy: a qualitative study of culturally and linguistically diverse mothers. BMC Public Health 2022; 22:2199. [PMID: 36443774 PMCID: PMC9703727 DOI: 10.1186/s12889-022-14513-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/01/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Oral healthcare is paramount and inextricably linked to well-being. Yet, the evidence indicates that culturally and linguistically diverse (CALD) migrant communities have unequal access to mainstream dental services due to several barriers. The purpose of this study was to investigate the oral healthcare experiences, attitudes and barriers to oral healthcare utilisation in CALD mothers. METHODS A qualitative study with semi-structured interviews was conducted within a social constructivism epistemology. CALD mothers who identified as non-English speaking, foreign country born, with a child under 12, were recruited though purposive snowball sampling. Questions probed oral healthcare experiences, barriers, enablers, and attitudes. Verbatim typed transcripts were thematically analysed using grounded methodology. RESULTS Thirty-three CALD mothers participated; twenty from India, five from Fiji, four from China, two from Nepal and one each from Israel and Macedonia. Languages included Cantonese, Fiji-Hindi, Gujrati, Hebrew, Hindi, Kannada, Mandarin, Maharashtrian, Macedonian, Nepalese, Punjabi, Sanskrit, Telegu and Urdu. Cost was the foremost barrier to oral healthcare services, followed by Confidence in quality care for the provision of services and treatment. Confusion in navigating a public and private healthcare system was highlighted and Competing priorities took precedence. Complacency referred to 'no need' or lack of urgency in dental care. Subsequently, dental hesitancy (superordinate theme) described the patterning of data as comprising the five 'C' factors and was theorised as the dental hesitancy phenomenon to explain the occurrence of delay or avoidance in utilising dental care. CONCLUSION Findings highlight the utility of the dental hesitancy phenomenon unearthed within this study. CALD mothers explained five 'C' dimensions: cost, confidence, confusion, competing priorities and complacency as barriers to accessing timely dental care. Multisectoral collaboration between healthcare systems, universal health coverage and primary sector support is required to address dental hesitancy in CALD mothers. Further, this study contributes to the field of behavioural and social sciences in oral health and augments the literature on dental avoidance.
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Affiliation(s)
- Kanchan Marcus
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, NSW Australia ,grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Madhan Balasubramanian
- grid.1014.40000 0004 0367 2697Health Care Management, College of Business, Government and Law, Flinders University, Adelaide, Australia ,grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Stephanie D. Short
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Woosung Sohn
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Faculty of Medicine and Health, The University of Sydney School of Dentistry, Surry Hills, NSW Australia ,grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
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Marcus K, Balasubramanian M, Short SD, Sohn W. Dental diaspora: oral health care attitudes and experiences in culturally and linguistically diverse mothers in Australia. BMC Health Serv Res 2022; 22:1314. [PMID: 36329526 PMCID: PMC9632598 DOI: 10.1186/s12913-022-08708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background Globally oral health care is unequally accessible or utilised within culturally and linguistically diverse (CALD) migrant communities. Yet much remains unknown about CALD mothers and their oral healthcare experiences in Australia. Hence, this paper explores the oral health care attitudes and experiences of CALD mothers within the Australian context with the broader objective to reduce oral health inequalities. Methods Qualitative semi-structured interviews were conducted from a social constructivism paradigm. Participants were foreign country born, spoke language/s other than English and have a child. Purposive snowball sampling and recruitment was conducted through CALD organisations and social media. Participants were interviewed for their attitudes and experiences to dental care and frequency of utilisation in Australia and the home country. Interviews were transcribed verbatim and grounded analysis (Strauss and Corbin) performed. Researcher bias was reduced through reflexivity and triangulation. Results The participants (n = 33) included 20 CALD mothers born in India and 13 from either China, Fiji, Nepal, Macedonia and Israel. The theme, experiences with health workforce personnel revealed positive attitudes toward CALD providers from similar cultural and/or linguistic backgrounds. We coin these CALD providers as the ‘dental diaspora’. The dental diaspora facilitated CALD mothers through culture and/or language factors, alleviating cost barriers and flexibility in appointments. Dental travel to the home country was affirmed, however family visitation was the foremost reason for travel. Conclusion The findings suggest that the dental diaspora plays a significant role in promoting oral health care utilisation for first generation CALD mothers in Australia. This paper brings to light the phenomenon of the ‘dental diaspora’ as an essential health workforce that contributes to addressing inequities in oral healthcare utilisation within CALD migrant communities. Universal health coverage in oral health is further affirmed, as aligned to the WHO policy context.
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Affiliation(s)
- Kanchan Marcus
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Faculty of Medicine and Health, The University of Sydney Dental School, Surry Hills, NSW Australia ,grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Madhan Balasubramanian
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia ,grid.1014.40000 0004 0367 2697Health Care Management, College of Business, Government and Law, Flinders University, Bedford Park, SA Australia
| | - Stephanie D Short
- grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Woosung Sohn
- grid.1013.30000 0004 1936 834XPopulation Oral Health, Faculty of Medicine and Health, The University of Sydney Dental School, Surry Hills, NSW Australia ,grid.1013.30000 0004 1936 834XMenzies Centre for Health Policy and Economics, School of Public Health, The University of Sydney, Camperdown, NSW Australia
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Neven ACH, Lake AJ, Williams A, O'Reilly SL, Hendrieckx C, Morrison M, Dunbar JA, Speight J, Teede H, Boyle JA. Barriers to and enablers of postpartum health behaviours among women from diverse cultural backgrounds with prior gestational diabetes: A systematic review and qualitative synthesis applying the theoretical domains framework. Diabet Med 2022; 39:e14945. [PMID: 36004677 PMCID: PMC9826483 DOI: 10.1111/dme.14945] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
AIMS Racial and ethnic disparities exist in gestational diabetes prevalence and risk of subsequent type 2 diabetes mellitus (T2DM). Postpartum engagement in healthy behaviours is recommended for prevention and early detection of T2DM, yet uptake is low among women from diverse cultural backgrounds. Greater understanding of factors impacting postpartum health behaviours is needed. Applying the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation-Behaviour (COM-B) model, our aim was to synthesise barriers to and enablers of postpartum health behaviours among women from diverse cultural backgrounds with prior GDM and identify relevant intervention components. METHODS Databases, reference lists and grey literature were searched from September 2017 to April 2021. Two reviewers screened articles independently against inclusion criteria and extracted data. Using an inductive-deductive model, themes were mapped to the TDF and COM-B model. RESULTS After screening 5148 citations and 139 full texts, we included 35 studies (N = 787 participants). The main ethnicities included Asian (43%), Indigenous (15%) and African (11%). Barriers and enablers focused on Capability (e.g. knowledge), Opportunity (e.g. competing demands, social support from family, friends and healthcare professionals, culturally appropriate education and resources) and Motivation (e.g. negative emotions, perceived consequences and necessity of health behaviours, social/cultural identity). Five relevant intervention functions are identified to link the barriers and enablers to evidence-based recommendations for communications to support behaviour change. CONCLUSIONS We provide a conceptual model to inform recommendations regarding the development of messaging and interventions to support women from diverse cultural backgrounds in engaging in healthy behaviours to reduce risk of T2DM.
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Affiliation(s)
- Adriana C. H. Neven
- Monash Centre for Health Research and Implementation, Monash Public Health and Preventive MedicineMonash UniversityClaytonVictoriaAustralia
| | - Amelia J. Lake
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes VictoriaMelbourneVictoriaAustralia
| | - Amelia Williams
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes VictoriaMelbourneVictoriaAustralia
| | - Sharleen L. O'Reilly
- Centre for Physical Activity and Nutrition ResearchDeakin UniversityBurwoodVictoriaAustralia
- UCD Institute of Food and Health, School of Agriculture and Food Science, University CollegeDublin 4Ireland
| | - Christel Hendrieckx
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes VictoriaMelbourneVictoriaAustralia
| | | | - James A. Dunbar
- Deakin Rural Health, School of MedicineDeakin UniversityWarrnamboolVictoriaAustralia
| | - Jane Speight
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes VictoriaMelbourneVictoriaAustralia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash Public Health and Preventive MedicineMonash UniversityClaytonVictoriaAustralia
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Gilbert AS, Antoniades J, Croy S, Thodis A, Adams J, Goeman D, Browning C, Kent M, Ellis K, Brijnath B. The experience of structural burden for culturally and linguistically diverse family carers of people living with dementia in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4492-e4503. [PMID: 35599431 PMCID: PMC10083988 DOI: 10.1111/hsc.13853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/27/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of 'structural burden' to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi-structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo-centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno-specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer-directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno-specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.
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Affiliation(s)
- Andrew Simon Gilbert
- National Ageing Research InstituteParkvilleVictoriaAustralia
- La Trobe UniversityBundooraVictoriaAustralia
| | - Josefine Antoniades
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Curtin UniversityBentleyWestern AustraliaAustralia
| | - Samantha Croy
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Antonia Thodis
- National Ageing Research InstituteParkvilleVictoriaAustralia
- Swinburne University of TechnologyHawthornVictoriaAustralia
| | - Jon Adams
- University of Technology SydneyUltimoNew South WalesAustralia
| | - Dianne Goeman
- University of NewcastleCallaghanNew South WalesAustralia
- Monash UniversityClaytonVictoriaAustralia
| | - Colette Browning
- Federation UniversityMount HelenVictoriaAustralia
- Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Mike Kent
- Curtin UniversityBentleyWestern AustraliaAustralia
| | - Katie Ellis
- Curtin UniversityBentleyWestern AustraliaAustralia
| | - Bianca Brijnath
- National Ageing Research InstituteParkvilleVictoriaAustralia
- University of Western AustraliaCrawleyWestern AustraliaAustralia
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Albin M, Micsinszki S, Phoenix M. Cultural Adaptation of Parent-Implemented Early Communication Interventions: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2229-2247. [PMID: 35926193 DOI: 10.1044/2022_ajslp-21-00286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Parent-implemented early communication interventions are commonly delivered to culturally and linguistically diverse families. Although there is evidence from fields such as public health or psychology, there is little guidance regarding what elements to culturally adapt for parent-implemented speech-language pathology interventions. This scoping review addresses this gap by identifying parent-implemented early communication interventions that have been culturally adapted and describing which intervention components were adapted. Definitions of culture, use of adaptation frameworks, and adaptation guidelines, policies, and recommendations are also reported. METHOD The databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PsycINFO, and Embase via OVID were searched. Supplementary search methods, including hand-searching of references and a gray literature search, were also conducted. Covidence software was used to deduplicate, collate, and review articles. Population, intervention, study, and cultural adaptation data were extracted and synthesized using the Ecological Validity Framework. RESULTS Twenty-one articles were included from the database and supplementary searches. No studies defined culture, and only three used cultural adaptation models or frameworks to guide adaptation. Studies varied greatly in what they adapted; language adaptations, such as translation, were conducted most frequently, and intervention goals were rarely adapted. Only three studies obtained parent feedback to inform cultural adaptation for future recommendations. CONCLUSIONS More clarity in the reporting of cultural adaptation for communication interventions is required. Cultural adaptation frameworks are useful tools to guide adaptation but can be difficult to operationalize. Additional research in this area is necessary to help clinicians provide culturally responsive, parent-implemented communication interventions. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20416107.
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Affiliation(s)
- Maya Albin
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, Canada
| | - Samantha Micsinszki
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
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Hamiduzzaman M, Siddiquee N, McLaren H, Tareque MI. The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study. Infect Dis Health 2022; 27:149-158. [PMID: 35527217 PMCID: PMC9015960 DOI: 10.1016/j.idh.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND In Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults' risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia. METHODS A cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0. RESULTS Mean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian β 3.40; 95% CI 1.21, 5.59; African β 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [β 1.82; 95% CI 0.65, 2.99]; and fear [β 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants' responses, on average, did not prevent them from buying large quantities and storing essential goods. CONCLUSION A pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.
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Affiliation(s)
- Mohammad Hamiduzzaman
- The University of Newcastle Department of Rural Health, University of Newcastle, Taree, 2430 Australia; Faculty of Health, Southern Cross University, Gold Coast, NSW, 4225, Australia.
| | - Noore Siddiquee
- College of Business, Government & Law, Flinders University, Adelaide, South Australia, 5042, Australia.
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, 5042, Australia.
| | - Md Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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Chen M, Lim S, Harrison CL. Limiting Postpartum Weight Retention in Culturally and Linguistically Diverse Women: Secondary Analysis of the HeLP-her Randomized Controlled Trial. Nutrients 2022; 14:2988. [PMID: 35889944 PMCID: PMC9316445 DOI: 10.3390/nu14142988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023] Open
Abstract
Postpartum weight retention (PPWR) contributes to maternal obesity development and is more pronounced in culturally and linguistically diverse (CALD) women. Our antenatal healthy lifestyle intervention (HeLP-her) demonstrated efficacy in reducing PPWR in non-Australian-born CALD women compared with Australian-born women. In this secondary analysis, we aimed to examine differences in the intervention effect on behavioral and psychosocial outcomes between Australian-born and non-Australian-born women and explore factors associated with the differential intervention effect on PPWR. Pregnant women at risk of gestational diabetes (Australian-born n = 86, non-Australian-born n = 142) were randomized to intervention (four lifestyle sessions) or control (standard antenatal care). PPWR was defined as the difference in measured weight between 6 weeks postpartum and baseline (12-15 weeks gestation). Behavioral (self-weighing, physical activity (pedometer), diet (fat-related dietary habits questionnaire), self-perceived behavior changes), and psychosocial (weight control confidence, exercise self-efficacy, eating self-efficacy) outcomes were examined by country of birth. Multivariable linear regression analysis was conducted to assess factors associated with PPWR. The intervention significantly increased self-weighing, eating self-efficacy, and self-perceived changes to diet and physical activity at 6 weeks postpartum in non-Australian-born women, compared with no significant changes observed among Australian-born women. Intervention allocation and decreased intake of snack foods were predictors of lower PPWR in non-Australian-born women. Results indicate that the HeLP-her intervention improved dietary behaviors, contributing to the reduction of PPWR in CALD women. Future translations could prioritize targeting diet while developing more effective strategies to increase exercise engagement during pregnancy in this population.
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Affiliation(s)
- Mingling Chen
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia;
| | - Siew Lim
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia;
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia;
- Diabetes and Endocrine Unit, Monash Health, Clayton, VIC 3168, Australia
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74
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Pearson T, Obst K, Due C. Culturally and linguistically diverse men's experiences of support following perinatal death: A qualitative study. J Clin Nurs 2022. [PMID: 35864732 DOI: 10.1111/jocn.16465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore culturally and linguistically diverse men's experiences of support after perinatal death, including barriers and facilitators to support and how healthcare providers, systems and policies can best support families. BACKGROUND Many groups of culturally and linguistically diverse families in Australia are at higher risk of experiencing perinatal death. Culturally sensitive bereavement services are essential; however, there has been no previous research specifically examining culturally and linguistically diverse men's experiences of support following perinatal death. DESIGN Individual semi-structured interviews were completed with healthcare providers, community leaders and culturally and linguistically diverse men who had experienced a perinatal death in Australia (n = 16). Data were analysed using Thematic Analysis and COREQ guidelines were followed. RESULTS Men's need for support following perinatal death was associated with stigma, and shaped by culturally-relevant religion and ritual, and connection to community and family. Significant barriers to men seeking and gaining support included challenges with self-advocacy and navigating the woman-centred nature of perinatal care in Australia. CONCLUSIONS Culturally and linguistically diverse men's specific needs should be included in the development of policy and practice surrounding perinatal death. While perinatal bereavement care guidelines acknowledge the importance of culturally informed care following perinatal death, there remains a lack of culturally specific supports available, particularly for culturally and linguistically diverse men. RELEVANCE TO CLINICAL PRACTICE Specific recommendations from this research include increasing community liaison officers or cultural consultants in hospitals and support organisations; providing culturally and linguistically diverse support groups; adopting family-centred and father-inclusive language in all perinatal death support services and ensuring clear communication and targeted assistance for culturally and linguistically diverse men to self-advocate for their baby and access to support. PATIENT OR PUBLIC CONTRIBUTION This study came out of consultation with community members and member checking of results was conducted to ensure adequate representation of participants' views.
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Affiliation(s)
- Thomas Pearson
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Kate Obst
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Clemence Due
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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75
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Vergani M, Mansouri F, Weng E, Rajkobal P. The effectiveness of ethno-specific and mainstream health services: an evidence gap map. BMC Health Serv Res 2022; 22:879. [PMID: 35799175 PMCID: PMC9263048 DOI: 10.1186/s12913-022-08238-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People of culturally and linguistically diverse (CALD) background face significant barriers in accessing effective health services in multicultural countries such as the United States, Canada, Europe and Australia. To address these barriers, government and nongovernment organisations globally have taken the approach of creating ethno-specific services, which cater to the specific needs of CALD clients. These services are often complementary to mainstream services, which cater to the general population including CALD communities. METHODS This systematic review uses the Evidence Gap Map (EGM) approach to map the available evidence on the effectiveness of ethno-specific and mainstream services in the Australian context. We reviewed Scopus, Web of Science and PubMed databases for articles published from 1996 to 2021 that assessed the impact of health services for Australian CALD communities. Two independent reviewers extracted and coded all the documents, and discussed discrepancies until reaching a 100% agreement. The main inclusion criteria were: 1) time (published after 1996); 2) geography (data collected in Australia); 3) document type (presents results of empirical research in a peer-reviewed outlet); 4) scope (assesses the effectiveness of a health service on CALD communities). We identified 97 articles relevant for review. RESULTS Ninety-six percent of ethno-specific services (i.e. specifically targeting CALD groups) were effective in achieving their aims across various outcomes. Eighteen percent of mainstream services (i.e. targeting the general population) were effective for CALD communities. When disaggregating our sample by outcomes (i.e. access, satisfaction with the service, health and literacy), we found that 50 % of studies looking at mainstream services' impact on CALD communities found that they were effective in achieving health outcomes. The use of sub-optimal methodologies that increase the risk of biased findings is widespread in the research field that we mapped. CONCLUSIONS Our findings provide partial support to the claims of advocacy stakeholders that mainstream services have limitations in the provision of effective health services for CALD communities. Although focusing on the Australian case study, this review highlights an under-researched policy area, proposes a viable methodology to conduct further research on this topic, and points to the need to disaggregate the data by outcome (i.e. access, satisfaction with the service, health and literacy) when assessing the comparative effectiveness of ethno-specific and mainstream services for multicultural communities.
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Affiliation(s)
- Matteo Vergani
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, Australia.
| | - Fethi Mansouri
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, Australia
| | - Enqi Weng
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, Australia
| | - Praveena Rajkobal
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, Australia
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76
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Stavert BM, Monaro S, Tienstra L, Naganathan V, Aitken SJ. Protocol for a qualitative study exploring haemodialysis dependent patients' arteriovenous fistula experience, values and concerns in Sydney, Australia. BMJ Open 2022; 12:e058152. [PMID: 36691241 PMCID: PMC9171227 DOI: 10.1136/bmjopen-2021-058152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 05/11/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The experiences of patients from culturally and linguistically diverse backgrounds, with chronic mental illness, disabilities or who identify as sexual or religious minorities are under-represented in clinical research on arteriovenous fistula (AVF) for haemodialysis access. A greater understanding of the experiences, values and concerns of these diverse patient groups are needed to provide haemodialysis access care that addresses the needs of all haemodialysis-dependent patients. This study seeks to describe a broad range of patient experiences related to the creation, care and surveillance of AVFs, including interactions with healthcare teams. METHODS AND ANALYSIS This qualitative study will use semistructured interviews with individual patients purposefully selected to provide a diverse patient population. A deliberate strategy will be used to recruit a demographically broad range of participants. Thematic analysis of interview transcripts, using a constant comparative methodology, will generate themes that describe patient experiences, values and concerns. Findings from this study will give a nuanced insight into the experiences of patients on haemodialysis with respect to their AVF. ETHICS AND DISSEMINATION Ethical approval for this study was provided by the Sydney Local Health District Human Research Ethics Committee (REGIS identifier: 2021/ETH00362, CH reference number: CH62/6/2021-033). Results will be made available to the participants, local health district, funders and other researchers through various hospital and academic forums. Data will also be published in peer-reviewed journals and be part of a larger body of work looking into patient-reported outcome measures for patients with AVF.
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Affiliation(s)
- Bethany Miriam Stavert
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Vascular Surgery Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Susan Monaro
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Vascular Surgery Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Lisa Tienstra
- Renal Medicine Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Vasi Naganathan
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Education and Research on Ageing, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Sarah Joy Aitken
- Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Vascular Surgery Department, Concord Repatriation General Hospital, Concord, New South Wales, Australia
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77
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Khatri RB, Assefa Y. Access to health services among culturally and linguistically diverse populations in the Australian universal health care system: issues and challenges. BMC Public Health 2022; 22:880. [PMID: 35505307 PMCID: PMC9063872 DOI: 10.1186/s12889-022-13256-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background About half of first- or second-generation Australians are born overseas, and one-in-five speak English as their second language at home which often are referred to as Culturally and Linguistically Diverse (CALD) populations. These people have varied health needs and face several barriers in accessing health services. Nevertheless, there are limited studies that synthesised these challenges. This study aimed to explore issues and challenges in accessing health services among CALD populations in Australia. Methods We conducted a scoping review of the literature published from 1st January 1970 to 30th October 2021 in four databases: PubMed, Scopus, Embase, and the Web of Science. The search strategy was developed around CALD populations and the health services within the Australian context. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for selection and Arksey and O’Malley framework for analysis of relevant articles. A narrative synthesis of data was conducted using inductive thematic analysis approach. Identified issues and challenges were described using an adapted socioecological model. Results A total of 64 studies were included in the final review. Several challenges at various levels were identified to influence access to health services utilisation. Individual and family level challenges were related to interacting social and health conditions, poor health literacy, multimorbidity, diminishing healthy migrants’ effect. Community and organisational level challenges were acculturation leading to unhealthy food behaviours and lifestyles, language and communication problems, inadequate interpretation services, and poor cultural competency of providers. Finally, challenges at systems and policy levels included multiple structural disadvantages and vulnerabilities, inadequate health systems and services to address the needs of CALD populations. Conclusions People from CALD backgrounds have multiple interacting social factors and diseases, low access to health services, and face challenges in the multilevel health and social systems. Health systems and services need to focus on treating multimorbidity through culturally appropriate health interventions that can effectively prevent and control diseases. Existing health services can be strengthened by ensuring multilingual health resources and onsite interpreters. Addressing structural challenges needs a holistic policy intervention such as improving social determinants of health (e.g., improving living and working conditions and reducing socioeconomic disparities) of CALD populations, which requires a high level political commitment. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13256-z.
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Affiliation(s)
- Resham B Khatri
- School of Public Health, the University of Queensland, Brisbane, Australia.
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
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McCulloch K, Murray K, Cassidy E. Bridging Across the Digital Divide: Identifying the Extent to Which LGBTIQ+ Health Service Websites Engage Culturally and Linguistically Diverse (CALD) Users. JOURNAL OF HOMOSEXUALITY 2022:1-23. [PMID: 35452366 DOI: 10.1080/00918369.2022.2060057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
eHealth is promoted as a viable platform for health service provision, as it can deliver relevant information instantaneously and anonymously, whilst circumventing geographical and discriminatory barriers that can occur in face-to-face settings. Lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) communities stand to benefit greatly from eHealth services, however, the way in which culturally and linguistically diverse (CALD) LGBTIQ+ users are included within eHealth service provision is currently unknown. The current study observed the way in which Australian LGBTIQ+ health service websites are inclusive of CALD users. Quantitative content analysis was performed on 19 Australian LGBTIQ+ health service websites, with a focus on translation of services and materials, English and digital literacy, and CALD specific resources. Results showed limited translated information across all websites, an absence of translation tools embedded in the home page, as well as moderate to high levels of digital and English literacy required, and largely absent CALD specific resources. These results suggest that Australian LGBTIQ+ health service websites are not currently meeting the unique needs of their CALD constituents. Increased availability of translation services, navigation tools, and CALD LGBTIQ+ stakeholder inclusion during website development is recommended to ensure more equitable access for CALD LGBTIQ+ communities.
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Affiliation(s)
- Katherine McCulloch
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kate Murray
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Elija Cassidy
- School of Communication, Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
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Valeriani G, Sarajlic Vukovic I, Bersani FS, Sadeghzadeh Diman A, Ghorbani A, Mollica R. Tackling Ethnic Health Disparities Through Community Health Worker Programs: A Scoping Review on Their Utilization During the COVID-19 Outbreak. Popul Health Manag 2022; 25:517-526. [PMID: 35417223 DOI: 10.1089/pop.2021.0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The coronavirus disease (COVID-19) outbreak has magnified existing health inequities linked to social determinants of health, with racial and ethnic minorities being disproportionately affected by the pandemic. A proposed strategy to address these inequities is based on the implementation of community health worker (CHW) programs able to bridge the gaps between marginalized communities and the formal health care systems. A scoping review was conducted through searching 4 databases: PubMed, Scopus, Web of Science, and Science Direct. Inclusion criteria focused on studies defining any kind of adopted CHW intervention to address inequities related to racial/ethnic groups during the COVID-19 crisis, published from December 31, 2019, to October 31, 2021. Narrative synthesis was undertaken to summarize the findings. In total, 23 studies met the inclusion out of the 107 search results. Data converged on the relevant potential of CHWs on engaging with community leaders, addressing social determinants of health, and issues related to structural racism, promoting culturally tailored health information, and encouraging institutions to policy change in favor of people left behind. Although vulnerability of racial and ethnic minorities was already present before the COVID-19 outbreak, the pandemic has represented a wakeup call to address it more efficiently. In recent years, CHWs have increasingly been acknowledged as valuable members of the health care workforce. As health disparities may increase after our multicultural societies begin to recover from COVID-19, CHWs may play a crucial role in addressing system-level changes to have broad and lasting effects on health outcomes.
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Affiliation(s)
| | - Iris Sarajlic Vukovic
- Department for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | | | - Richard Mollica
- Harvard Program in Refugee Trauma, Massachusetts General Hospital, Harvard Medical School, Cambridge, Massachusetts, USA
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Hamiduzzaman M, Siddiquee N, McLaren H, Tareque MI, Smith A. Risk Perception and Health Precautions Towards COVID-19 Among Older Culturally and Linguistically Diverse Adults in South Australia: A Cross-Sectional Survey. J Multidiscip Healthc 2022; 15:497-514. [PMID: 35313620 PMCID: PMC8934113 DOI: 10.2147/jmdh.s343985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/09/2022] [Indexed: 01/22/2023] Open
Abstract
Background Risk perceptions and precaution-taking against COVID-19 are affected by individuals' health status, psychosocial vulnerabilities and cultural dimensions. This cross-sectional study investigates risk perceptions associated with COVID-19 and specifically the problem- and emotion-focused health precautions of older, culturally and linguistically diverse (CALD) South Australians. Methods Cross-sectional research involving self-administration of an online survey. Participants were CALD adults living in South Australia, aged 60 years and above (n = 155). Multi-indicator surveys were analyzed using Stata/MP version 13.0 and multiple linear regression models fitted to examine associations between risk perceptions and problem- and emotion-focused health precautions. Results Dread risk returned the highest mean score; COVID-19 was perceived as a catastrophe. Mean scores for fear showed that participants were worried about COVID-19 and scared of becoming infected. Participants followed health advice as they were worried [β 0.15; 95% CI 0.07, 0.23] and realized the effect of COVID-19 on them [β 0.15; 95% CI 0.02, 0.28], or worried and had trust in experts' knowledge and managing capacity [β 0.17; 95% CI 0.06, 0.28]. Age was negatively associated with sum-score of problem-focused coping: compared to participants aged 60-69 years, 80+ years revealed a decrease in problem-focused health precautions. Variables like education (primary schooling [β 2.80; 95% CI 0.05, 5.55] and bachelor degree [β 3.16; 95% CI 0.07, 6.25] versus no formal education), self-confidence in reducing risk, and fear [β 0.84; 95% CI 0.31, 1.36] significantly affected emotional-focused health precautions. Conclusion This local study has global implications. It showed that COVID-19 has psychosocial and environmental implications for older CALD adults. When many CALD populations have existing vulnerabilities to intersecting disadvantage, cultural-tailoring of interventions and pandemic response plans may buffer the effects of compounding disaster. Larger studies are needed to compare risk perception and health response patterns across countries and cultural groupings.
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Affiliation(s)
- Mohammad Hamiduzzaman
- The University of Newcastle Department of Rural Health, University of Newcastle, Taree, Australia
| | - Noore Siddiquee
- College of Business, Government & Law Flinders University, South Australia, Australia
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Md Ismail Tareque
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Anthony Smith
- The University of Newcastle Department of Rural Health, University of Newcastle, Taree, Australia
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Eatt J, Watson SJ, Ball HL, Sevar K, Galbally M. Maternal Depression and Early Parenting: A Comparison Between Culturally and Linguistically Diverse and Australian born Mothers. Australas Psychiatry 2022; 30:119-125. [PMID: 34991358 DOI: 10.1177/10398562211052886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the risk of perinatal depression, parenting stress and infant sleep practices in Australian culturally and linguistically diverse (CaLD) women. METHOD Within the Mercy Pregnancy and Emotional Wellbeing Study, we examined 487 pregnant women of whom 52 were CaLD and 435 non-CaLD. Depression was measured using the Structured Clinical Interview for DSM-IV and the Edinburgh Postnatal Depression Scale. In addition, Parenting Stress Index and infant sleep measures were collected. RESULTS Fewer CaLD women had a depression diagnosis but there were no differences between CaLD and non-CaLD women for perinatal mental health symptoms. More mothers in the CaLD group were bed sharing with their infant during the night at six months; however, bedsharing was only associated with higher parenting stress for non-CaLD mothers. CONCLUSIONS Findings suggest both differences in infant sleep parenting practices and in parenting stress but not general emotional wellbeing. Future research is required to replicate these findings.
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Affiliation(s)
- Jodi Eatt
- Psychiatry Training, Post Graduate Training in Psychiatry, Graylands Hospital, Graylands, WA, Australia
| | - Stuart J Watson
- Psychology, Murdoch University, Murdoch, WA, Australia; and School of Medicine, University of Notre Dame, Fremantle, WA, Australia
| | - Helen L Ball
- Durham Infancy & Sleep Centre, Department of Anthropology, Durham University, Durham, UK
| | | | - Megan Galbally
- Psychology, Murdoch University, Murdoch, WA, Australia; School of Medicine, University of Notre Dame, Fremantle, WA, Australia; and King Edward Memorial Hospital, Subiaco, WA, Australia
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82
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The complexity of disparities in pain. Pain 2022; 163:1651-1652. [DOI: 10.1097/j.pain.0000000000002575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022]
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Hamiduzzaman M, Siddiquee N, McLaren H. COVID-19 risk perceptions and precautions among the elderly: A study of CALD adults in South Australia. F1000Res 2022; 11:43. [PMID: 35356314 PMCID: PMC8933644 DOI: 10.12688/f1000research.74631.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians' demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation. The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from Harvard Dataverse.
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Affiliation(s)
- Mohammad Hamiduzzaman
- College of Health, Medicine & Wellbeing, The University of Newcastle, Department of Rural Health, Taree, New South Wales, 2430, Australia
| | - Noore Siddiquee
- College of Business, Government & Law, Flinders University, Adelaide, South Australia, Australia
| | - Helen McLaren
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
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Doolan BJ, Saikal SL, Scaria A, Gupta M. Patient factors associated with dermatology outpatient non-attendance: An analysis of racial and ethnic diversity. Clin Dermatol 2022; 40:405-410. [PMID: 34983001 DOI: 10.1016/j.clindermatol.2021.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Non-attendance to dermatology outpatient appointments is a risk factor for poorer patient outcomes. The culturally and linguistically diverse (CALD) communities in Australia have been identified as at risk of poorer health outcomes, but there is a paucity of data assessing patient factors that may increase outpatient non-attendance. To investigate this, we performed a retrospective cross-sectional study of dermatology appointments from patients attending a tertiary, referral public hospital located in one of Australia's most racially and ethnically diverse communities. Patients within the 18-45 years age bracket were 61% more likely to not attend compared to older age groups. Those born in Oceania, Middle East Asia, and surprisingly Australia were more likely to miss an appointment, whilst those born in East and Southeast Asia were more likely to attend. Those who spoke Arabic at home were more likely to not attend, whilst those who spoke Vietnamese at home were more likely to attend. This study sheds further light on health disparities in non-attendance and emphasizes the importance of not collectively amalgamating all groups of the CALD community.
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Affiliation(s)
- Brent J Doolan
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia.
| | - Samra L Saikal
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia; The University of Newcastle, Sydney, New South Wales, Australia
| | - Anish Scaria
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Monisha Gupta
- Department of Dermatology, Liverpool Hospital, Sydney, New South Wales, Australia; Faculty of Medicine, University of New South Wales, Western Sydney University, New South Wales, Australia
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"The mind may go, but the heart knows": Emotional care by ethnic minority carers of people living with dementia. Soc Sci Med 2021; 285:114294. [PMID: 34365072 DOI: 10.1016/j.socscimed.2021.114294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 11/21/2022]
Abstract
Drawing on the sociology of emotions, this article investigates the socially and culturally mediated nature of emotions and emotional care within 93 ethnic minority carers' narratives of dementia care. Adding to the cross-cultural literatures on the sociology of emotions and dementia care respectively, our analysis showed that 'signals' of dementia to family carers were often emotional outbursts of anger by the person with dementia. These displays, in turn, created conflict, and aroused emotions such as shame, anger, and depression among carers. To mitigate these tendencies, carers enacted emotional management, which centered on reducing the gravity of negative emotions felt by the person with dementia, and affording them the social space to maintain a positive disposition. To create this positive emotional space, carers deployed different strategies. Some mobilized medical discourses to diffuse the emotional and moral significance of their relative's behavior and enable emotional distantiation. Others conceived of people with dementia as 'childlike' and requiring their protection from emotional negativity. Although, such efforts work took a toll on carers' emotional energies, it was considered enabling, therapeutic, and integral to care. Such emotional work departs from academic and advocacy efforts that see such behavior as patronizing and infantilizing, and underscores the need for more nuanced discussion around emotions and dementia care in ethnic minority families.
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