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Dutta MJ, Kaur-Gill S, Metuamate S. Decolonizing Impact Through the Culture-Centered Approach to Health Communication: Mobilizing Communities to Transform the Structural Determinants of Health. HEALTH COMMUNICATION 2024:1-9. [PMID: 38632707 DOI: 10.1080/10410236.2024.2343466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
In this issue, we outline the central tenets of the culture-centered approach to health communication. What does the culture-centered approach address when suggesting the co-creation of voice infrastructures? What is the theory's methodological emphasis for mobilizing and transforming structures that shape health inequalities for communities at the margins? Drawing on examples of culture-centered interventions in over fifty communities spread across 17 countries and three continents, a large number of them housed under the umbrella of the Center for Culture-centered Approach to Research and Evaluation (CARE) at Massey University in Aotearoa, New Zealand, we articulate the communicative processes (referring to actionable sources and targets of communicative action) that shape the building of voice infrastructures mobilizing toward structural transformation. For instance, African American communities organizing under the framework of the culture-centered approach, documented in Dutta, Collins, and colleagues study in 2019, discuss the building of voice infrastructures where community members participate in co-creating heart health information based on comparative effectiveness research, building an African American media ecosystem disseminating the information alongside community-led initiatives growing healthy food, community-led youth activities, and activism addressing the racist structural drivers that adversely impact African American heart health. In this essay, we describe the impact of culture-centered interventions reflected in the voice infrastructures within communities that witness and articulate the oppressions that threaten human health at the margins and in the transformations of these structures that organize various facets of life and livelihood at the global margins linked to health.
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Affiliation(s)
- Mohan J Dutta
- Center for Culture-Centered Approach to Research and Evaluation (CARE), School of Communication, Journalism and Marketing, Massey University
| | | | - Selina Metuamate
- Center for Culture-Centered Approach to Research and Evaluation (CARE), School of Communication, Journalism and Marketing, Massey University
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Ward A, Andrews L, Black A, Williamson AE. Communicating effectively with inclusion health populations: 2022 ICCH symposium. PATIENT EDUCATION AND COUNSELING 2023; 117:107977. [PMID: 37708698 DOI: 10.1016/j.pec.2023.107977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/24/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To describe communication strategies for clinical practice that allow practitioners to work more effectively with marginalised population groups and to discuss how to incorporate these into medical practice. METHODS Active practitioners working in inclusion health and people with lived experience of homelessness and the asylum-seeking process shared their perspectives in the symposium at the 2022 International Conference on Communication in Healthcare (ICCH) and a subsequent conference on empathy in healthcare. The views of attendees were sought. SYMPOSIUM DISCUSSION We describe the perspectives shared at the symposia under two main themes: communication needs in people experiencing homelessness and migrant populations, and trauma-informed practice. CONCLUSIONS People experiencing homelessness have more communication challenges compared to the general adult population. Migrant, refugee, and asylum-seeking populations also face the complexity of negotiating unfamiliar healthcare, legal and social systems with the added burden of language barriers. Trauma-informed practice provides a useful framework that can improve communication with these groups.
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Affiliation(s)
- Andy Ward
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester, Leicester, UK.
| | | | - Anna Black
- Department of General Practice and Primary Care, University of Glasgow, UK
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Rahman MM, Dutta MJ. The United Nations (UN) Card, Identity, and Negotiations of Health among Rohingya Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3385. [PMID: 36834082 PMCID: PMC9965439 DOI: 10.3390/ijerph20043385] [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: 11/12/2022] [Revised: 01/28/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Being persecuted and expelled from Myanmar, Rohingya refugees are now distributed throughout the world. The Southeast Asian nation of Malaysia has been a preferred destination for Rohingyas fleeing Myanmar's state-sponsored genocide and more recently in a bid to change their fates from the refugee camps in Bangladesh. Refugees are one of the most vulnerable groups in Malaysia and often face dire circumstances, in which their health and wellbeing are compromised. Amidst a plethora of structural challenges, Rohingya refugees try to claim some of their rights with the aid of the UN card (UNHCR ID cards) in Malaysia. Guided by the culture-centered approach (CCA), this study examined the perspectives and experiences of healthcare among Rohingya refugees while living in Malaysia, now resettled in Aotearoa, New Zealand. The participants' narratives showed that the UN card not only materialized their refugee status in Malaysia but also offered them a way of living in a world where documents anchor the materiality of health.
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Affiliation(s)
| | - Mohan J. Dutta
- Center for Culture-Centered Approach to Research and Evaluation (CARE), School of Communication, Journalism and Marketing, Massey University, Manawatu Campus, Palmerston North 4442, New Zealand
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Peng B, Ling L. Health service behaviors of migrants: A conceptual framework. Front Public Health 2023; 11:1043135. [PMID: 37124818 PMCID: PMC10140430 DOI: 10.3389/fpubh.2023.1043135] [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: 09/13/2022] [Accepted: 03/14/2023] [Indexed: 05/02/2023] Open
Abstract
Universal health coverage is vital to the World Health Organization's (WHO's) efforts to ensure access to health as a human right. However, it has been reported that migrants, including both international immigrants and internal migrants, underuse health services. Establishing a conceptual framework to facilitate research on the health service behaviors (HSB) of migrants is particularly important. Many theoretical frameworks explaining the general population's HSB have been published; however, most theoretical frameworks on migrants' HSB only focus on international immigrants without the inclusion of internal migrants. Of note, internal migrants are much more abundant than immigrants, and this group faces similar barriers to HSB as immigrants do. Based on theoretical frameworks of immigrants' HSB and Anderson's behavior model, the author proposes a new conceptual framework of migrants' HSB that includes both immigrants and internal migrants. The new conceptual framework divides the determinants into macro-structural or contextual factors, health delivery system characteristics, and characteristics of the population at risk and describes subgroup-specific factors. The author added some variables and reclassified variables in some dimensions, including characteristics of health delivery systems and access to healthcare. The characteristics of health delivery systems comprise the volume, organization, quality, and cost of the health delivery system, while the characteristics of access to healthcare include time accessibility, geographic accessibility, and information accessibility. The outcomes of HSB have been expanded, and relationships between them have been reported. The mediating effects of some variables have also been described. This conceptual framework can facilitate a deep and comprehensive understanding of the HSB determination process for migrants, including internal migrants.
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Affiliation(s)
- Boli Peng
- Department of Actuarial Science, School of Insurance, Guangdong University of Finance, Guangzhou, China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Li Ling,
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Griffin G, Ali M, Nau SZ, Riggs E, Dantas JAR. Accessing and navigating healthcare: A scoping review of the experiences of women of refugee background from Myanmar. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3459-e3476. [PMID: 35915878 PMCID: PMC10087957 DOI: 10.1111/hsc.13955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/20/2022] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
Despite well-documented health problems, healthcare access by women of refugee background in resettlement countries is typically poor. Suggested reasons include inadequate health literacy and resettlement challenges. A scoping review to explore the experiences of women of refugee background from Myanmar accessing and navigating healthcare was conducted following Arksey and O'Malley's framework, with an intersectional lens. Studies were analysed thematically following Braun and Clark's approach; four themes (eight subthemes) were constructed: Culture (Constructions of health; Navigating cultural tensions); Gender (Shifting gender roles; Sexual and reproductive health); Survivorship (Past health experiences; Strength in collectivism); and Language (The language barrier; Masked communication barriers). Intersectional factors of culture, gender, survivorship and language influenced women's experiences, shaping barriers and facilitators to healthcare. Community networks and bicultural peers are resources which may be enhanced. Research into trauma-informed cultural competency programs, community education and bicultural health navigators is recommended to support women of refugee background from Myanmar.
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Affiliation(s)
- Georgia Griffin
- Curtin School of Population HealthCurtin UniversityBentleyWestern AustraliaAustralia
| | - Mohammed Ali
- Curtin School of Population HealthCurtin UniversityBentleyWestern AustraliaAustralia
| | - S. Zaung Nau
- School of Management and MarketingCurtin UniversityBentleyWestern AustraliaAustralia
| | - Elisha Riggs
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department of General PracticeUniversity of MelbourneMelbourneVictoriaAustralia
| | - Jaya A. R. Dantas
- Curtin School of Population HealthCurtin UniversityBentleyWestern AustraliaAustralia
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Lai M. Communicating National Disability Insurance Scheme - Exploring Interpreters' Perspective. HEALTH COMMUNICATION 2022; 37:1661-1670. [PMID: 33840314 DOI: 10.1080/10410236.2021.1912891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article reports of a study on 19 Australian community interpreters and their experience in facilitating mediated communication in the National Disability Insurance Scheme (NDIS), which was introduced in Australia in 2016. These interpreters were among those who attended a training workshop comprising of a pedagogical segment explaining this new scheme in detail, and a hands-on segment to translate a selection of NDIS terms into their target language to highlight possible linguistic and cultural challenges they may encounter. The training aimed to enable the interpreters to facilitate NDIS communication with clients from linguistically and culturally diverse backgrounds in ways that make sense to their culture and experience. The purpose of the current study is to understand the extent the participant interpreters applied their learning in NDIS communication, and their perspective about specific challenges in this new contextual area, where certain concepts and terms may be hard to translate, and the understanding of disability may be culturally bound. The aim of the study is to deepen the understanding of multicultural communication in disability services, and to inform similar future professional development during major changes to systems in the disability sector, and more broadly in health and welfare.
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Affiliation(s)
- Miranda Lai
- Royal Melbourne Institute of Technology, Royal Melbourne Institute of Technology (RMIT University)
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Griffin G, Nau SZ, Ali M, Riggs E, Dantas JAR. Seeking Health Information: A Qualitative Study of the Experiences of Women of Refugee Background from Myanmar in Perth, Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063289. [PMID: 35328976 PMCID: PMC8951186 DOI: 10.3390/ijerph19063289] [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] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 12/23/2022]
Abstract
Women of refugee background are subject to significant health inequity. Access to health information and a good level of health literacy are integral components to manage one’s health needs. The aim of this study isto understand the experiences of women of refugee background from Myanmar seeking and accessing health information. Semi-structured interviews were conducted with 14 women of refugee background from Myanmar resettled in Western Australia. Interpretative phenomenological analysis underpinned the study and was conducted on the interview data. Three superordinate themes and nine subordinate themes emerged from the analysis: (1) Seeking health information (Motivation and Sources), (2) Facilitators and Barriers (Communication, Navigating the system and Community) and (3) Seeking health information in the context of past experiences (Health information as a by-product of healthcare, Health professionals’ provision of health information, Accessibility of healthcare and Expectations on resettlement). These themes provide insight into the challenges of accessing understandable and actionable health information and of promoting the health literacy of women of refugee background from Myanmar. Co-designed community-based and health service interventions should be trialled, including trauma-informed training for health professionals, health information apps and community health promotion programs. Community engagement, participation and evaluation are critical for determining the effective interventions to address the inequalities experienced by this population.
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Affiliation(s)
- Georgia Griffin
- Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia; (M.A.); (J.A.R.D.)
- Correspondence:
| | - S. Zaung Nau
- School of Management and Marketing, Curtin University, Bentley, WA 6102, Australia;
| | - Mohammed Ali
- Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia; (M.A.); (J.A.R.D.)
| | - Elisha Riggs
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia;
- Department of General Practice, University of Melbourne, Parkville, VIC 3000, Australia
| | - Jaya A. R. Dantas
- Curtin School of Population Health, Curtin University, Bentley, WA 6102, Australia; (M.A.); (J.A.R.D.)
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Streuli S, Ibrahim N, Mohamed A, Sharma M, Esmailian M, Sezan I, Farrell C, Sawyer M, Meyer D, El-Maleh K, Thamman R, Marchetti A, Lincoln A, Courchesne E, Sahid A, Bhavnani SP. Development of a culturally and linguistically sensitive virtual reality educational platform to improve vaccine acceptance within a refugee population: the SHIFA community engagement-public health innovation programme. BMJ Open 2021; 11:e051184. [PMID: 34521673 PMCID: PMC8442061 DOI: 10.1136/bmjopen-2021-051184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To combat misinformation, engender trust and increase health literacy, we developed a culturally and linguistically appropriate virtual reality (VR) vaccination education platform using community-engaged approaches within a Somali refugee community. DESIGN Community-based participatory research (CBPR) methods including focus group discussions, interviews, and surveys were conducted with Somali community members and expert advisors to design the educational content. Co-design approaches with community input were employed in a phased approach to develop the VR storyline. PARTICIPANTS 60 adult Somali refugees and seven expert advisors who specialise in healthcare, autism research, technology development and community engagement. SETTING Somali refugees participated at the offices of a community-based organisation, Somali Family Service, in San Diego, California and online. Expert advisors responded to surveys virtually. RESULTS We find that a CBPR approach can be effectively used for the co-design of a VR educational programme. Additionally, cultural and linguistic sensitivities can be incorporated within a VR educational programme and are essential factors for effective community engagement. Finally, effective VR utilisation requires flexibility so that it can be used among community members with varying levels of health and technology literacy. CONCLUSION We describe using community co-design to create a culturally and linguistically sensitive VR experience promoting vaccination within a refugee community. Our approach to VR development incorporated community members at each step of the process. Our methodology is potentially applicable to other populations where cultural sensitivities and language are common health education barriers.
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Affiliation(s)
- Samantha Streuli
- Department of Anthropology, University of California San Diego, La Jolla, California, USA
| | - Najla Ibrahim
- Department of Health and Wellness, Somali Family Service of San Diego, San Diego, CA, USA
| | - Alia Mohamed
- Department of Biology, San Diego State University, San Diego, CA, USA
| | - Manupriya Sharma
- Department of Physics and Engineering, Palomar College, San Marcos, California, USA
| | | | | | - Carrie Farrell
- School of Public Affairs, San Diego State University, San Diego, California, USA
| | - Mark Sawyer
- Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Dan Meyer
- Department of Cardiovascular & Thoracic Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Ritu Thamman
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alex Marchetti
- Farmer School of Business, Miami University, Oxford, Ohio, USA
| | - Alan Lincoln
- Deparment of Clinical Psychology, Alliant International University-San Diego, San Diego, California, USA
| | - Eric Courchesne
- Department of Neurosciences, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Ahmed Sahid
- Somali Family Service of San Diego, San Diego, California, USA
| | - Sanjeev P Bhavnani
- Healthcare Innovation and Practice Transformation Laboratory, Scripps Clinic La Jolla-Genesee Executive Plaza, San Diego, California, USA
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Kaur-Gill S, Qin-Liang Y, Hassan S. Negotiating Mental Health During the COVID-19 Pandemic: Performing Migrant Domestic Work in Contentious Conditions. THE AMERICAN BEHAVIORAL SCIENTIST 2021; 65:1406-1425. [PMID: 38603066 PMCID: PMC7992093 DOI: 10.1177/00027642211000394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Migrant domestic work is performed in precariously (im)mobile working conditions that mark the subaltern body in a state of constant lived experience with and in strife. In Singapore, the structural context of hire amplifies conditions of servitude, indebtedness, and subalternity that have implications for mental health. This study documents mental health narratives by migrant domestic workers during the COVID-19 pandemic, registering how mental health is negotiated amid dissension in the performance of precarious labor. While functional employment structures enabled and empowered well-being, dysfunctional structures disrupted mental health meanings, creating layers of constant contention for domestic workers to broker, limiting opportunities for mental health and well-being. Narratives gathered indicate systemic mental health precarities tied to workplace dysfunctions.
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