Acculturation of Values and Behavior: A Study of Vietnamese Immigrants

Cultural competence of Australian dental students

BACKGROUND

Australia possesses a highly multicultural demographic, and thus dental practitioners are likely to regularly encounter culturally and linguistically diverse individuals. It is important for dental practitioners to be culturally competent, however, cultural competency education is highly variable in the curricula of dentistry and oral health courses in Australia, and research is largely limited to dentistry students. This study aims to investigate and compare perceived attitudes, beliefs and practices of cultural competence amongst first and final year Doctor of Dental Surgery (DDS) and Bachelor of Oral Health (BOH) students at the University of Melbourne Dental School.

METHODS

Following ethics approval, anonymous questionnaires were completed by 213 participants. The questionnaire was adapted from Schwarz's Healthcare Provider Cultural Competence Instrument and consisted of five scales. Data was analysed using SPSS V 24.0 software.

RESULTS

A total of 213 students participated in this study (response rate = 88%) The majority of participants were female (n = 114, 53.5%) and the mean age of 23.5 years (range 18-40). The majority of participants were Australian born (n = 110) with 74.6% (n = 159) first generation Australians. Participants who identified as Australian represented 35.7% (n = 76) with 66.1% (n = 141) identified as partly Australian. Multivariate analysis indicated that, after controlling for other independent variables in the model, those who had the highest cultural competence score were female, who self-identify as "Australian", who were in the final year. Furthermore, those who were in the final BOH year scored significatively higher than final year DDS students.

CONCLUSION

The findings of this study suggest that there is a significant difference in students self-reported cultural competence at different stages of their education. This may be attributed to differences in cultural competence education, scope of practice and the type of patient encounters and role modelling that students may experience. Future research should involve follow up to create longitudinal data, as well as research at other dental schools in Australia and overseas.

The association between baseline acculturation level and 5-year change in adiposity among Puerto Ricans living on the mainland United States

While it is recognized that acculturation influences adiposity risk, the direction and magnitude of this relationship remain unclear. Previous studies' use of proxy acculturation measures and exclusively cross-sectional study designs have limited understanding of this research question. The aim of this study was to examine associations between acculturation and adiposity among Puerto Ricans (45-75 years) living on the mainland United States. We analyzed data from the longitudinal (baseline, 2-year, 5-year) Boston Puerto Rican Health Study (n = 1114). Language-based and psychological-based acculturations were assessed at baseline using questionnaires. Acculturation scores were divided into tertile categories; higher tertiles indicate greater English- and U.S.-based acculturation. Adiposity was assessed using BMI and waist circumference at baseline and each follow-up. Linear mixed effects regression models were fit with baseline acculturation tertile as the predictor and baseline or change in adiposity as the outcome. When examining baseline associations with language acculturation tertiles, participants in the middle acculturation tertile (bilingual) had 2.48 cm (95%CI: -4.64, -0.31) lower waist circumference compared to the more Spanish-based acculturation tertile. When examining the associations between baseline language acculturation tertiles and change in adiposity, those in the more English-based acculturation tertile had higher annual gains in BMI (0.13 kg/m² (95%CI: 0.01, 0.25)) and waist circumference (0.44 cm (95%CI: 0.01, 0.88)) over 5-years compared to those in the more Spanish-based acculturation tertile. No significant differences in adiposity were found across psychological-based acculturation tertiles. In conclusion, English language-based acculturation at baseline influences long-term adiposity. Psychological-based acculturation may capture distinct acculturation processes from the language-based construct.

Segmentation of Mexican-Heritage Immigrants: Acculturation Typology and Language Preference in Health Information Seeking

With the fast growing number of Mexican immigrants in the United States, more attention is needed to understand the relationship between acculturation and language preference in health information seeking. Latent class analysis provides one useful approach to understanding the diversity in sample of Mexican immigrants (N = 238). Based on 13 linguistic, psychological and behavioral indicators for acculturation, four discrete subgroups were characterized: (1) Less acculturated, (2) Moderately acculturated, (3) Highly acculturated, (4) Selectively bicultural. A Chi-square test revealed that three sub-groups were significantly different in language preference when seeking health information. Less acculturated and moderately acculturated groups sought health information in Spanish, whereas the highly acculturated group preferred English for health information. Selectively bicultural group preferred bilingual health information. Implications for health campaign strategies using audience segmentation are discussed.

Psychological and behavioral acculturation in a social network of Mexican Americans in the United States and use of dental services

OBJECTIVES

We used data from the TalaSurvey study to examine associations between dental health experiences, social network characteristics, and levels of behavioral and psychological acculturation in one location in the American Midwest.

METHODS

Starting in parishes and community organizations, we identified adults of Mexican origin living in Indianapolis, who were 1st- or 2nd-generation immigrants from Tala, Mexico. Using a social networks methodology and following extensive formative research, we created an egocentric social network survey and administered it via face-to-face interviews. We identified the peers (alters) in interviewees' (egos) personal networks. We asked egos about multiple oral health and dental care variables for self and for alters. Acculturation (psychological and behavioral) was measured with a validated tool. Through logistic and negative binomial regression, we examined the effects of acculturation and network composition on ego's dental insurance status, dental office visits, and the reason for most recent dental office visit.

RESULTS

A total of 332 egos (mean age 36; 63% female) were interviewed: 90% were born in Mexico; 45% had completed elementary school or lower; and most had low income. Each ego named 3.9 (SD±1.9) alters in his/her personal network, for a total of 1299 alters (mean age 39; 61% female). Both behavioral acculturation and psychological acculturation were moderately associated with dental insurance coverage, and greater behavioral acculturation predicted more frequent dental care. More psychologically acculturated egos were more likely to seek preventive care. Further, egos with more highly educated networks sought care more frequently and for preventive purposes, net of ego's own education and acculturation.

CONCLUSIONS

This study contextualizes acculturation of Mexican Americans within the personal networks in which oral health discussion takes place. The findings underscore the critical importance of acculturation and social network factors in shaping a subgroup of Latinos' orientation toward dental care.

Biculturalism and Adjustment

Biculturalism (having two cultures) is a growing social phenomenon that has received considerable attention in psychology in the last decade; however, the issue of what impact (if any) biculturalism has on individuals’ adjustment remains empirically unclear. To answer this question, we conducted a meta-analysis that included 83 studies, 322 rs, and 23,197 participants. Results based on the random-effects approach show a significant, strong, and positive association between biculturalism and adjustment (both psychological and sociocultural). This biculturalism- adjustment link is stronger than the association between having one culture (dominant or heritage) and adjustment. Thus, our results clearly invalidate early sociological accounts of this phenomenon, which portrayed bicultural individuals as “marginal” and stumped between two worlds. Analyses also indicate that the association between biculturalism and adjustment is moderated by how acculturation is measured, the adjustment domain, and sample characteristics.

A multidimensional examination of the acculturation and psychological functioning of a sample of immigrant Chinese mothers in the US

The present research used the cluster analysis method to examine the acculturation of immigrant Chinese mothers (ICMs), and the demographic characteristics and psychological functioning associated with each acculturation style. The sample was comprised of 83 first-generation ICMs of preschool children residing in Maryland, Unites States (US). Cluster analysis revealed four acculturation styles: psychologically-behaviorally integrated; psychologically-behaviorally assimilated; psychologically-behaviorally undifferentiated; and psychologically-behaviorally separated. Assimilated mothers were the youngest at immigration and had resided in the US for the longest time. Separated mothers were older at immigration, resided in the US for a shorter time, were less educated, and had lower psychological functioning than mothers in the other clusters. However, there were no differences in demographic characteristics and psychological functioning between psychologically-behaviorally integrated and psychologically-behaviorally undifferentiated clusters. The importance of simultaneously assessing various cultural orientations and components of acculturation was highlighted.

Vignette methodology and culture-relevance: lessons learned through a project on successful aging with Iranian immigrants to Sweden

It is a well-known fact that cultural values play an important role in the construction of aging and old-age related understandings. This is why ethnogerontologists have tried to expand the gerontological imagination by arguing that research needs to become more culturally-relevant. Tapping into the values that people uphold and the understandings of aging that are shaped by them is a challenging endeavor. This is especially the case if one does not share the cultural background of the people whose values one is studying. The same holds true when one wants to shed light on understandings that mainstream social gerontology regards as deviations from the norm. It is after all relatively easy to "impose the Western template" under such circumstances. Vignette methodology has been found to be particularly useful when studying value-laden understandings. This is why it is an appropriate method to consider when designing research that aims to avoid the imposition of the Western template. This article focuses on the pros and cons of this methodology while discussing some of the lessons learned from a project that explored how the construct of successful aging is understood by a group of Iranian immigrants to Sweden. It will be argued that vignettes are particularly useful when trying to shed culturally-relevant light on aging and old age-related understandings.

Longitudinal Changes in Acculturation for Immigrant Women from the Former Soviet Union

Most research on immigrant acculturation has been conducted with cross-sectional samples, using statistical designs that may not capture different trajectories for the components that contribute to this complex concept. The purpose of this study was to examine change over time in acculturation for 226 women from the former Soviet Union who had lived in the US fewer than eight years when recruited. Using self-report data from four annual waves, growth trajectories were examined in four components of acculturation (American behavior, Russian behavior, English language proficiency, and cultural generativity). Results indicate that these components changed at varying rates. Acculturation is a process with multiple distinct components which should be measured separately to obtain a full profile of change over time.

Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among African migrant children to Australia

BACKGROUND

Migrants from developing to developed countries rapidly develop more obesity than the host population. While the effects of socio-economic status on obesity are well established, the influence of cultural factors, including acculturation, is not known.

OBJECTIVE

To examine the association between acculturation and obesity and its risk factors among African migrant children in Australia.

DESIGN AND PARTICIPANTS

A cross-sectional study using a non-probability sample of 3- to 12-year-old sub-Saharan African migrant children. A bidimensional model of strength of affiliation with African and Australian cultures was used to divide the sample into four cultural orientations: traditional (African), assimilated (Australian), integrated (both) and marginalized (neither).

MAIN OUTCOME MEASURES

Body mass index (BMI), leisure-time physical activity (PA) and sedentary behaviours (SBs) and energy density of food.

RESULTS

In all, 18.4% (95% confidence interval (CI): 14-23%) were overweight and 8.6% (95% CI: 6-12%) were obese. After adjustment for confounders, integrated (beta=1.1; P<0.05) and marginalized (beta=1.4; P<0.01) children had higher BMI than traditional children. However, integrated children had significantly higher time engaged in both PA (beta=46.9, P<0.01) and SBs (beta=43.0, P<0.05) than their traditional counterparts. In comparison with traditional children, assimilated children were more sedentary (beta=57.5, P<0.01) while marginalization was associated with increased consumption of energy-dense foods (beta=42.0, P<0.05).

CONCLUSIONS

Maintenance of traditional orientation was associated with lower rates of obesity and SBs. Health promotion programs and frameworks need to be rooted in traditional values and habits to maintain and reinforce traditional dietary and PA habits, as well as identify the marginalized clusters and address their needs.

Different ways of understanding the construct of successful aging: Iranian immigrants speak about what aging well means to them

This article presents the variations in themes and notions of successful aging that were found in a project that aimed to shed light on the value orientations that people prefer and the understandings of successful aging that they uphold. The project, which aimed also to study the way in which the process of migration challenges the notions in question, shed light on the various types of logic that Iranian immigrants to Sweden use when trying to make sense of the construct of successful aging. This article departs from these variations and discusses, among other things, the inevitable decay with which the aging process seems to be associated; the different purpose-related ideologies that people use when trying to explain how the decay in question ought to be handled; the way in which time-related ideas influence the manner in which notions of aging well are framed; the manner in which divergent views regarding activity shape the understandings of successful aging that people uphold; and the way in which ideas regarding autonomy and dependence shape the way in which one defines a good old age. The complexity of logic types utilized by the informants suggests that, if researchers are to further their understanding of the meaning of the construct of successful aging, they need to dismantle people's ideas as well as the way in which they use culture when trying to make sense of what aging well entails. The article finishes with a brief discussion regarding the importance of intracultural variation and suggests that researchers need a better understanding of culture's impact on the manner in which the construct in question is understood if they are to develop the successful aging paradigm in a culturally informed manner.

Measures of psychological acculturation: a review

This article reviews conceptual and methodological issues in the measurement of psychological acculturation. The major issues involve the question of dimensionality and the assessment of specific domains of cultural change. Bidimensional scales that cover both overt and internal domains are more informative for the assessment of general levels of psychological acculturation. The validity of such scales must be examined in terms of the actual exposure of individuals to and involvement in each culture, and the influence of sociocultural factors on the course of acculturation. The parallel application of qualitative and quantitative methods may be useful for validity studies. The complementary use of emic and etic approaches will enhance the psychometric soundness of acculturation scales.

The validity and reliability of the Tertiary Student Values Scale (TSVS)

OBJECTIVE

To explore the factorial composition of an instrument developed to assess value orientations in tertiary students, the Tertiary Student Values Scale (TSVS), using data from culturally diverse undergraduate dental students.

METHODS

A 68-item questionnaire was used to collect the data. The questionnaire included 15 3-item subscales developed in a manner consistent with the Kluckhohn and Strodtbeck value orientation model. The psychometric properties were evaluated using a sample of students from 4 Australian dental schools. The questionnaire was administered to 364 students aged 18-50 years, mean age 21.3 years (SD 3.45 years), using a convenience sampling method. Scores on the 45 items were factor analysed using the maximum-likelihood estimation method for factor extraction with oblique rotation (oblimin). Internal consistency was examined on all of the 3-item subscales, using Cronbach's alpha.

RESULTS

The analysis indicates that the TSVS reflects the hypothesised 15-dimension construct of value orientation. Furthermore, the analysis showed that the identified 15 factors were independent of one another and were sufficiently reliable for group comparisons. With 1 exception, all subscales yielded a Cronbach's alpha > or = 0.55, the exception being 1 subscale with alpha = 0.40 (range 0.40-0.80).

CONCLUSION

Results indicated that value orientation is a complex construct, but that it is quantifiable along multiple dimensions in a psychometrically valid manner. Further refinement of this instrument would increase its value as a tool for policy makers designing educational programmes and services for culturally diverse student groups.

Effect of acculturation on objective measures of oral health in Haitian immigrants in New York City

Acculturation is a complex phenomenon that can serve as a proxy for cultural norms and behaviors affecting care-seeking, prevention behaviors, and, ultimately, health outcomes. The purpose of this study was to assess the effect of acculturation on the oral health of Haitian immigrants in New York City. We hypothesized that acculturation would be a predictor of the oral health status of the participating individuals. An acculturation scale was specifically developed and validated for this study. A sample of 425 adult Haitian immigrants living in NYC was obtained through outreach activities. Oral health examinations were conducted, and a questionnaire was administered to the participants. After adjustment for age, sex, education, income, and marital status, acculturation was negatively associated with measures of decayed teeth, periodontal attachment loss of > or = 4 mm, and the number of missing teeth. Results suggest a positive impact of acculturation on the oral health status of these individuals.