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Jawad D, Wen LM, Rissel C, Baur L, Mihrshahi S, Taki S. Barriers and enablers to accessing child health resources and services: Findings from qualitative interviews with Arabic and Mongolian immigrant mothers in Australia. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241242674. [PMID: 38561970 PMCID: PMC10989050 DOI: 10.1177/17455057241242674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/10/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Over the past two decades, there has been an increase of immigrants in Australia. Despite this, the availability of culturally responsive resources and services that cater to their needs remains insufficient. OBJECTIVE The aim of this study was to explore the resources used and trusted by Mongolian- and Arabic-speaking migrant mothers in Australia for child health information and examine how they navigate and overcome challenges they encounter accessing this information. DESIGN Semi-structured telephone interview. METHODS A theory informed semi-structured 60-min telephone interview was conducted in Arabic and Mongolian with 20 Arabic- and 20 Mongolian-speaking migrant mothers of children younger than 2 years or currently pregnant and living in Australia. Data were analysed thematically using the framework method. RESULTS The reliance on digital platforms such as google emerged as a common trend among both groups of mothers when seeking child health information. Notably, there were differences in resources selection, with Mongolian mothers showing a preference for Australian-based websites, while Arabic-speaking mothers tended to opt for culturally familiar resources. There were various barriers that hindered their access to health services and resources, including language barriers, cost, and limited knowledge or familiarity with their existence. Negative encounters with healthcare professionals contributed to a perception among many mothers that they were unhelpful. Both groups of mothers employed a cross-checking approach across multiple websites to verify trustworthiness of information. Acculturation was shown only among the Mongolian-speaking mothers who adapted their cultural practices in line with their country of residence. CONCLUSION The findings of this study highlight the importance of addressing the needs of migrant mothers in accessing child health information. Health professionals, government agencies, and researchers have an opportunity to provide culturally responsive support by fostering a culturally inclusive approach to developing and promoting equitable access to services and resources, ultimately enhancing the wellbeing of migrant families.
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Affiliation(s)
- Danielle Jawad
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
| | - Li Ming Wen
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, NSW Health, Camperdown, NSW, Australia
| | - Chris Rissel
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- College of Medicine and Public Health, Rural and Remote Health SA and NT, Flinders University, Darwin, Bedford Park, SA, Australia
| | - Louise Baur
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
- Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sarah Taki
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Health Promotion Unit, Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, NSW, Australia
- Centre of Research Excellence in Translating Early Prevention of Obesity in Childhood (EPOCH-Translate CRE), The University of Sydney, Camperdown, NSW, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, NSW Health, Camperdown, NSW, Australia
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Malek ME, Andermo S, Nyberg G, Elinder LS, Patterson E, Norman Å. Parents' experiences of participating in the Healthy School Start Plus programme - a qualitative study. BMC Public Health 2023; 23:646. [PMID: 37016372 PMCID: PMC10074815 DOI: 10.1186/s12889-023-15552-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND The rise in overweight and obesity among children is a global problem and effective prevention interventions are urgently required. Parents play an important role in children's lifestyle behaviours and body weight development and therefore there is a great need to investigate how to involve parents effectively in health promotion and prevention programmes. The aim of the study was to describe parents' experiences of barriers and facilitators of participating in the Healthy School Start Plus (HSSP) intervention study. METHODS HSSP is a parental support programme, conducted in Sweden, with the aim to promote a healthy diet, physical activity and preventing obesity in 5-7-year-old children starting school. In total 20 parents from 7 schools participated in semi-structured telephone-based interviews. The data was analysed using qualitative content analysis, with a deductive approach based on the Consolidated Framework for Implementation Research (CFIR). RESULTS Parental experiences of barriers and facilitators informing the implementation of the HSSP intervention were identified within all five domains of the CFIR. Two additional constructs, not included in the CFIR were identified: Social factors and Cooperation. The findings of parental experiences of barriers and facilitators related to the importance of (1) adaptation of the intervention to fit the abilities of the parents with different social and cultural backgrounds; (2) the need for continuous delivery of information related to healthy behaviours; (3) the commitment and efforts of the deliverers of the intervention; (4) the need for repetition of information related to healthy behaviours given by the deliverers of the intervention; (5) encouragement and facilitation of the involvement of the family and key people around them through the intervention activities and by the deliverers of the intervention; (6) awareness of unexpected impacts and social and cultural conditions complicating the execution of the intervention and; (7) cooperation and a well-functioning interaction between parents and school staff. CONCLUSIONS Barriers and facilitators indicated by the parents highlighted that interventions like the HSSP need to be adapted to fit the parents' abilities, with reminders, follow-ups and delivery of relevant information. Variations in social and cultural conditions need to be taken into consideration. The commitment of the school and the interaction between the school staff and the family as well as key people around them appears to be important. TRIAL REGISTRATION The Healthy School Start Plus trial was retrospectively registered in the International Standard Randomised Controlled Trial Number Registry on January 4, 2018 and available online at ClinicalTrials.gov: No. NCT03390725.
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Affiliation(s)
- Mahnoush Etminan Malek
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden.
| | - Susanne Andermo
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- The Swedish School of Sport and Health Sciences (GIH), Lidingövägen 1, Stockholm, 114 33, Sweden
| | - Gisela Nyberg
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- The Swedish School of Sport and Health Sciences (GIH), Lidingövägen 1, Stockholm, 114 33, Sweden
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Solnavägen 1E, Stockholm, 113 65, Sweden
| | - Emma Patterson
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Section for Risk and Benefit Assessment, Swedish Food Agency, Box 622, Uppsala, 751 26, Sweden
| | - Åsa Norman
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, 171 77, Sweden
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, 171 77, Sweden
- Department of Psychology, Stockholm University, Stockholm, 106 91, Sweden
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Trends and determinants of organised sports participation in immigrant and Australian children: A nine-year follow-up. J Sci Med Sport 2023; 26:125-131. [PMID: 36774233 DOI: 10.1016/j.jsams.2023.01.007] [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: 04/13/2022] [Revised: 12/27/2022] [Accepted: 01/12/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study aimed to examine trends and determinants of organised sports participation among children of immigrant parents from low-and-middle-income countries, high-income countries, and Australian children. DESIGN Longitudinal (nine-year follow-up). METHODS Data were from the birth-cohort of Australian Children aged 6-15 years with follow-up between 2010 and 2018. Organised sports participation was measured using two items about regular participation in team and individual sports. Multilevel logit modelling was used to assess the determinants of organised sports participation across groups. RESULTS Both team sports participation and individual sports participation increased between 6 and 11 years and declined between 11 and 15 years across the three groups. Children of immigrant parents from low-and-middle-income countries (OR 0.65; 95 % CI 0.57-0.74) and high-income countries (OR 0.82; 95 % CI 0.76-0.89) had lower odds of team sports participation than Australian children. Children of immigrant parents from low-and-middle-income countries had lower odds of team sports participation (OR 0.79; 95 % CI 0.69-0.90) than children of immigrant parents from high-income countries. Female children, high screen time, high psychological difficulties, increased number of siblings and low socio-economic position were identified as determinants of lower team and individual sports participation. CONCLUSIONS The present study identified evidence of disparities in organised sports participation among children of immigrant parents and Australian children. Multilevel and multicomponent interventions to promote children's organised sports participation should be prioritised, with a focus on children of the female sex, older children, children with lower socioeconomic status, and children with higher screen time and higher psychological difficulties.
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Hayba N, Shi Y, Allman-Farinelli M. Enabling Better Nutrition for Adolescents from Middle Eastern Backgrounds: Semi-Structured Interviews with Parents. Nutrients 2021; 13:3918. [PMID: 34836174 PMCID: PMC8624745 DOI: 10.3390/nu13113918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
The unyielding obesity epidemic in adolescents from Middle Eastern (ME) backgrounds warrants culturally-responsive and co-designed prevention measures. This study aimed to capture the opinions of ME parents residing in Australia on the crisis and their enablers and barriers to healthy eating interventions given their influence on adolescent eating behaviors. Twenty-six semi-structured interviews were conducted with ME mothers, aged 35-59 years, and most residing in low socioeconomic areas (n = 19). A reflexive thematic analysis using the Capability, Opportunity, Motivation-Behaviour model and Theoretical Domain Framework was conducted. Parents expressed confidence in knowledge of importance of healthy eating, but were reluctant to believe behaviours were engaged in outside of parental influence. Time management skills are needed to support working mothers and to minimize reliance on nearby fast-food outlets, which was heightened during COVID-19 with home-delivery. Time constraints also meant breakfast skipping was common. A culture of feeding in light of diet acculturation and intergenerational trauma in this diaspora was also acknowledged. Parents pleaded for upstream policy changes across government and school bodies to support parental efforts in the form of increased regulation of fast-food and subsidization of healthy products. Opportunities for weight-inclusive programs including parenting workshops underpinned by culturally-responsive pedagogy were recommended.
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Affiliation(s)
- Nematullah Hayba
- Discipline of Nutrition and Dietetics, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia; (Y.S.); (M.A.-F.)
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Nguyen TH, Götz S, Kreffter K, Lisak-Wahl S, Dragano N, Weyers S. Neighbourhood deprivation and obesity among 5656 pre-school children-findings from mandatory school enrollment examinations. Eur J Pediatr 2021; 180:1947-1954. [PMID: 33576893 PMCID: PMC8105223 DOI: 10.1007/s00431-021-03988-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/29/2021] [Accepted: 02/05/2021] [Indexed: 11/20/2022]
Abstract
The risk of child obesity is strongly related to socioeconomic factors such as individual socioeconomic position (SEP) and neighbourhood deprivation. The present study analyses whether the relationship between neighbourhood deprivation and child obesity differs by child's individual SEP. Data from 5656 children (5-7 years) from the mandatory school enrollment examinations of the pre-school cohorts 2017/2018 in Düsseldorf were analysed. Obesity was determined by the age- and gender-specific body mass index (BMI); neighbourhood deprivation by using the socio-spatial degree of deprivation of the children's residential addresses; and individual SEP by the level of parental education. Using Poisson regression, we estimated prevalence ratios (PR with 95% confidence interval (CI)) of child obesity by neighbourhood deprivation and parental education. Interactions between neighbourhood deprivation and parental education were tested. The prevalence of child obesity increases with the degree of neighbourhood deprivation. Compared to children living in low deprivation neighbourhoods, the proportion of obese children was twice as high in high deprivation neighbourhoods (PR=2.02; CI=1.46-2.78). Likewise, children from families with medium and low education have twice the risk for obesity compared to children with high parental education (PR=2.05; CI=1.46-2.78). The relationship between neighbourhood deprivation and child obesity was significantly moderated by parental education; it was stronger for higher parental education than for medium and low parental education (p<.001).Conclusion: Our findings suggest that children from deprived neighbourhoods and families with lower education have a higher risk for child obesity. The identification of particularly deprived neighbourhoods with structural interventions in combination with the strengthening of parental health literacy seems reasonable. What is Known: • Studies show that children from disadvantaged neighbourhoods are more frequently obese. What is New: • The relationship between neighbourhood deprivation and child obesity is significantly moderated by parental education. It is stronger for children with higher parental education than for children with medium and low parental education.
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Affiliation(s)
- Thuy Ha Nguyen
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Simon Götz
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Katharina Kreffter
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | | | - Nico Dragano
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Simone Weyers
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225, Duesseldorf, Germany.
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Zulfiqar T, Burns RA, D’Este C, Strazdins L. BMI trajectories and risk factors among 2-11-year-old children by their immigrant status: evidence from the Longitudinal Study of Australian Children. BMJ Open 2019; 9:e026845. [PMID: 31289070 PMCID: PMC6615842 DOI: 10.1136/bmjopen-2018-026845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to identify body mass index (BMI) trajectories and their predictors in Australian children by their maternal immigrant status. METHODS Data on 4142 children aged 2-3 years were drawn from the birth cohort of the Longitudinal Study of Australian Children. BMI was calculated according to the International Obesity Task Force cut-off points. Immigrant status was determined by the Australian Bureau of Statistics and the United Nations Development Programme, Human Development Index criteria. Latent class growth analysis estimated distinct BMI trajectories, and multinomial logistic regression analysis examined factors associated with these BMI trajectories. RESULTS Two BMI groups and six BMI trajectories were identified. The stable trajectories group included high-risk (10%, n=375), moderate-risk (5%, n=215) and low-risk (68%, n=2861) BMI trajectories. The changing trajectories group included delayed-risk (6%, n=234), gradual-risk (8%, n=314) and declining-risk (3%, n=143) BMI trajectories. We found some evidence that children of immigrants from low-and middle-income countries were more likely to have moderate-risk and high-risk BMI trajectories compared with low-risk BMI trajectory. However, these associations were insignificant in fully adjusted models. The explanatory risk factors for moderate-risk and high-risk BMI trajectory were birth weight, family socioeconomic position, and organised sports participation. Our results also suggest that 4-7 years of age may be important for the prevention of overweight/obesity in children. DISCUSSION A better understanding of the risk factors associated with distinct BMI trajectories in immigrant children will inform effective preventive strategies. Some of these risk factors such as non-participation in organised sports, and high screen time, may also impede the integration of immigrant children into the host culture. Obesity prevention strategies aimed at increasing physical activities in immigrant children could help deliver a social and health benefit by increasing social integration among children of immigrants and Australians.
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Affiliation(s)
- Tehzeeb Zulfiqar
- National Centre for Epidemiology & Population Health, Research School of Population Health - ANU, Canberra, Australian Capital Territory, Australia
| | - Richard A Burns
- Centre for Research on Ageing, Health & Wellbeing, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Catherine D’Este
- National Centre for Epidemiology & Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Lyndall Strazdins
- National Centre for Epidemiology & Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
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Hardy LL, Jin K, Mihrshahi S, Ding D. Trends in overweight, obesity, and waist-to-height ratio among Australian children from linguistically diverse backgrounds, 1997 to 2015. Int J Obes (Lond) 2019; 43:116-124. [PMID: 29980760 PMCID: PMC6331387 DOI: 10.1038/s41366-018-0139-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 04/10/2018] [Accepted: 05/09/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To report the cross-sectional prevalence and 18-year trends in overweight, obesity and abdominal obesity among Australian children from culturally and linguistically diverse (CALD) backgrounds. SUBJECTS/METHODS Four cross-sectional population health surveys conducted among children (age 4-16 years; n=26, 449) in 1997-2004-2010-2015 in New South Wales, (NSW) Australia. Adiposity outcomes were measured by trained field staff using standard procedures. Binomial regression models with a robust error variance were used to estimate prevalence ratio (PR) and 95% confidence intervals (CI) for overweight and obesity, obesity, and waist-to-height ratio (WHtR) ≥ 0.5 for children from Asian, European, and Middle Eastern language backgrounds compared with children from English-speaking backgrounds, adjusted for sociodemographic characteristics. RESULTS Over time, children from Middle Eastern language backgrounds were consistently more likely to be overweight-obese (PR: 1.29-1.42), obese (PR: 1.49-1.65), and have WHtR ≥ 0.5 (PR: 1.42-1.90), compared with children from English-speaking backgrounds. Children from European language backgrounds generally had higher prevalence and children from Asian language backgrounds had lower prevalence, compared with children from English-speaking backgrounds. Between 1997 and 2015, there were significant trends in the prevalence of overweight and obesity combined among children from English-speaking (PR: 1.06, 95%CI: 1.02, 1.09), Middle Eastern (PR: 1.14, 95%CI: 1.05, 1.24), and Asian language backgrounds (PR: 1.14, 95%CI: 1.05, 1.24). The prevalence of WHtr ≥ 0.5 increased among children from English-speaking (PR: 1.21, 95%CI: 1.13, 1.31) and Middle Eastern (PR: 1.35, 95%CI: 1.16, 1.56) language backgrounds. CONCLUSIONS Overall, the prevalence of overweight and obesity and abdominal obesity is high among NSW children from CALD backgrounds and has increased over time. This suggests that there is a greater scope in understanding, developing, and implementing interventions across the early life-course of children from CALD backgrounds.
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Affiliation(s)
- Louise L Hardy
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
| | - Kai Jin
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
| | - Seema Mihrshahi
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
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