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Sui H, Thomas M, Tial BL, Roose A, McHenry MS. “Understand Us and Acknowledge Our Reasons”: Perspectives from Burmese Refugee Families on Interactions with their Pediatricians. J Migr Health 2023; 7:100186. [PMID: 37082462 PMCID: PMC10112147 DOI: 10.1016/j.jmh.2023.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/02/2023] [Accepted: 03/16/2023] [Indexed: 03/22/2023] Open
Abstract
Introduction Indianapolis is home to one of the largest Burmese communities in the United States; however, little is known of Burmese families' experiences with medical providers. The complex health history of Burmese refugees, coupled with the necessity of quality childhood care for later development, demonstrates a need for medical residents to better understand their diverse patient populations. This study aimed to understand Burmese families' perspectives on their interactions with their pediatric providers. Material and methods Semi-structured interviews were conducted with 15 Burmese refugee families, which were audio-recorded, transcribed, and translated. A patient-centered care framework guided interview questions and directed content analysis. Results Themes that emerged from individual interviews often related with cross-cultural communication, including patient engagement in care, challenges utilizing an interpreter, and concerns about discussing sensitive issues with healthcare workers. Overall, parents had positive perceptions of their child's pediatrician, but some distrusted interpreters and other members of the healthcare staff. Though parents reported a desire to be more involved in their child's care, they felt uncomfortable engaging with sensitive topics. A large barrier to care was lack of time during appointments. Discussion Through understanding the perspectives of Burmese refugee families, pediatricians and training programs for medical professionals may consider ways to enhance the patient-provider relationship and health outcomes for this population.
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Kim EE, Alemi Q, Stempel C, Siddiq H. Health disparities among Burmese diaspora: an integrative review. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 8:100083. [PMID: 37384141 PMCID: PMC10306005 DOI: 10.1016/j.lansea.2022.100083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Tens of thousands of displaced Burmese ethnic minorities have endured various adversities for over six decades but are largely underserved. This study aimed to illuminate the health impacts of their misfortunes and unmet areas of concern. Using a holistic lens, we conducted an integrative review of 47 papers spanning the years 2004 to 2022 from diverse data sources. The results revealed widespread multimorbidity, triggered mainly by displacement. The diaspora's problematic health conditions were worse than their host country's general population. There was a strong indication that the diaspora's unfortunate health trajectory is determined early in life. Ongoing human rights violations and grossly inadequate health care interventions deepened pre-existing health conditions. Noteworthy emerging treatment initiatives, including integrative health care, were underutilized. The persisting health and intervention needs among the diaspora warrant advanced studies to facilitate much-needed resource mobilization and collaboration among stakeholders to promote health equity. Funding There was no financial support for this manuscript.
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Affiliation(s)
- Eunice E. Kim
- Department of Social Work and Social Ecology, Loma Linda University, Loma Linda, USA
| | - Qais Alemi
- Department of Social Work and Social Ecology, Loma Linda University, Loma Linda, USA
| | - Carl Stempel
- Department of Sociology and Social Services, California State University, East Bay, Hayward, USA
| | - Hafifa Siddiq
- Charles R. Drew University of Medicine and Science, Los Angeles, USA
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Chatham RE, Mixer SJ. Cultural Influences on Healthy Weight Care in Karen Children. J Pediatr Nurs 2021; 60:207-214. [PMID: 34246068 DOI: 10.1016/j.pedn.2021.06.020] [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] [Received: 04/20/2021] [Revised: 06/12/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Although the rates of childhood obesity are disproportionately higher in children of racial and ethnic minorities, research rarely addresses possible cultural factors. The purpose of this study was to discover cultural influences that contribute to or prevent childhood obesity from the perspectives of Burmese-American children and adolescents of Karen ethnicity in the southeast U.S. DESIGN AND METHODS The ethnonursing research method was used to seek perspectives of healthy weight care from Karen children between 8 and 15 years-of-age (n = 10). Karen parents (n = 5) and non-Karen community members (n = 13) were also interviewed. Data sources - interviews, fieldnotes, and observation notes - were analyzed using the four phases of the ethnonursing method. RESULTS Four themes important to healthy weight care in Karen children were discovered: views of a healthy child, food and food preparation, physical activity, and mutual support among family and community. These themes revealed both Karen and non-Karen influences. CONCLUSIONS Most Karen cultural influences promote healthy weight care in Karen children and adolescents which may protect them from childhood obesity. Lack of after-school transportation, limited space to play/exercise, and the sedentary tendencies of girls could limit healthy weight care. PRACTICE IMPLICATIONS Pediatric nurses may use knowledge gained from this study for promotion of healthy weight care in Karen families and to advocate for community changes which could benefit all children.
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Affiliation(s)
- Rebecca E Chatham
- College of Nursing, University of Tennessee-Knoxville, United States of America.
| | - Sandra J Mixer
- College of Nursing, University of Tennessee-Knoxville, United States of America
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Carroll D, Wulan N, Swe ZY, Myint AA, Sanda S, Lwin AM, Oo T, Khaing LL, San CC, Tun WPP, Cini K, Win PM, Azzopardi P. Mental health of adolescents in Myanmar: A systematic review of prevalence, determinants and interventions. Asian J Psychiatr 2021; 61:102650. [PMID: 34004460 DOI: 10.1016/j.ajp.2021.102650] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/24/2021] [Accepted: 04/05/2021] [Indexed: 11/16/2022]
Abstract
Adolescence is a developmental phase where mental disorders typically manifest and where platforms for response (including schools and health services) change rapidly. However, data to inform public mental health responses are limited, including in countries like Myanmar which has a large adolescent population and where mental health has been identified as a priority of policy. In this paper we sought to systematically review the peer-reviewed and grey literature to determine (i) the prevalence of mental disorder among adolescents in Myanmar, (ii) determinants of mental disorder and (iii) interventions that have been implemented and evaluated. Nine publications met inclusion criteria (7 peer-reviewed and 2 grey literature) that included 7 publications reporting prevalence, 6 reporting correlates and one an intervention. The available data from the 2016 Global School-based Health Survey highlight that depression (27.2%) and suicidal ideation (9.4%) are prevalent in Myanmar, and these rates are substantially higher than regional averages. The limited available data on correlates identified violence and bullying, alcohol and substance use, and home, family and community security and cohesion as being closely related to mental health for adolescents. Only one study focussed on interventions and this found mindfulness meditation training to be an effective approach for young people whose parents were affected by HIV. These findings underscore the need to address adolescent mental health in Myanmar, but also to invest in better data collection efforts.
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Affiliation(s)
- Dominic Carroll
- Department of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia; Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Nisaa Wulan
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | | | | | - Sanda Sanda
- Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | | | - Tin Oo
- University of Medicine, Yangon, Myanmar
| | | | - Cho Cho San
- Department of Psychology, Yangon University of Distance Education, Yangon, Myanmar
| | - Win Pa Pa Tun
- Department of Psychology, Yangon University of Distance Education, Yangon, Myanmar
| | - Karly Cini
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | | | - Peter Azzopardi
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia; Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute and School of Medicine, University of Adelaide, Adelaide, Australia.
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MacLean SA, Agyeman PO, Singer EK, Baranowski KA, Katz CL. Perspectives on Working with Immigrants Held in Detention Using Photovoice. Psychiatr Q 2021; 92:793-802. [PMID: 33074361 PMCID: PMC7571297 DOI: 10.1007/s11126-020-09853-z] [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] [Accepted: 10/11/2020] [Indexed: 12/04/2022]
Abstract
Those who work with immigrants in detention centers may be at increased risk of secondary trauma. This study used Photovoice to capture reflections on how the lives of volunteers are affected by their work on behalf of immigrant family detainees. Participants were recruited over a two-month period in 2018 from amongst the volunteers of a non-governmental organization that provides legal services to the detainees at one immigration detention center. Participants submitted photos and captions that explored their experiences with their work. Thirteen volunteers consented to participate and submitted 44 photos with captions to the project. Major themes included emotional challenges of the work, frustrations with the U.S. government, comparison of their experiences to those of their clients', and finding uplifting moments. Our findings regarding the significant emotional challenges of this work are of particular importance given the increasing coverage of immigration detention in the media and the increased interest in volunteer opportunities to support this population.
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Affiliation(s)
- Sarah A MacLean
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA.
| | - Priscilla O Agyeman
- Graduate Program of Public Health, Icahn School of Medicine at Mount Sinai, 17 E. 102nd Street, New York, NY, USA
| | - Elizabeth K Singer
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA.,Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA
| | - Kim A Baranowski
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA
| | - Craig L Katz
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA.,Department of Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, USA
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