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Horwitz R, Brener L, Prankumar SK, de Jesus T, Jaworski A, Jadran A, Bryant J. Understanding cultural inclusion in alcohol and other drug services in New South Wales, Australia and assessing the acceptability of a cultural inclusion audit. Drug Alcohol Rev 2024. [PMID: 38825730 DOI: 10.1111/dar.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/27/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024]
Abstract
INTRODUCTION Cultural inclusion and competence are understood at the most basic level to be the practice of considering culture so as to provide effective services to people of different cultural backgrounds. In order to work better with clients from diverse backgrounds, alcohol and other drug (AOD) services need to offer a service that is designed to be accessible to all people, where systems in place operate in a way that considers different cultural needs. This research aimed to assess the extent to which non-government AOD services in New South Wales are positioned to support cultural inclusion as well as to evaluate the acceptability of a cultural inclusion audit across four AOD sites. METHODS The research adopted a mixed methods approach comprising of a pre-audit online survey (n = 85) designed to assess AOD services' attitudes and practices towards cultural inclusion, and in-depth interviews that were conducted with nine AOD service staff and four cultural auditors to explore the acceptability of a cultural inclusion audit process. RESULTS Findings from the survey indicate cultural inclusion practices are limited. Interview data highlight that while staff are not fully aware of what appropriate cultural inclusions entails, they are receptive to and want a cultural inclusion program. DISCUSSION AND CONCLUSIONS The study illustrates the benefits of implementing a cultural inclusion audit process aimed at raising awareness of what cultural inclusion entails. Including a cultural inclusion service audit is likely to enhance AOD service provision to culturally and linguistically diverse groups and thereby improve treatment outcomes.
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Affiliation(s)
- Robyn Horwitz
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | - Tata de Jesus
- The Network of Alcohol and other Drugs Agencies, Sydney, Australia
| | - Alison Jaworski
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Ahmad Jadran
- Drug and Alcohol Multicultural Education Centre, Sydney, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
- School of Social Sciences, UNSW Sydney, Sydney, Australia
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Douglass CH, Block K, Eghrari D, Horyniak D, Hellard ME, Lim MSC. "You have to drink with a little bit of shame": Alcohol and other drug use among young people from migrant and ethnic minority backgrounds in Melbourne, Australia. J Ethn Subst Abuse 2024; 23:340-364. [PMID: 35758222 DOI: 10.1080/15332640.2022.2091703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Migrant and ethnic minority groups are underrepresented in alcohol and other drug (AOD) research. This qualitative study explored AOD use among young people from migrant and ethnic minority backgrounds in Melbourne, Australia. We conducted one focus group and 16 interviews and thematically analyzed data drawing on the social-ecological model of health. Theme one showed AOD use was considered a "normal" part of youth identity, particularly for participants who had grown up with peer groups in Australia. Theme two highlighted participant's sense of responsibility to meet expectations and make informed decisions about AOD use to protect themselves and their friends. Theme three highlighted participant's risk of experiencing AOD-related stigma through negative stereotypes and fear of consequences within families and communities, particularly among female participants. Participants' perceptions and experiences differed by individual factors, interpersonal relationships, AOD accessibility across settings and broader gender, cultural and religious norms. Interventions developed with young people from migrant and ethnic minority backgrounds are needed to target the social-ecological factors underpinning AOD use, particularly stigma.
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Affiliation(s)
- Caitlin H Douglass
- Burnet Institute, Melbourne, Victoria, Australia
- University of Melbourne, Carlton, Victoria, Australia
| | - Karen Block
- University of Melbourne, Carlton, Victoria, Australia
| | - Donya Eghrari
- University of Melbourne, Carlton, Victoria, Australia
| | - Danielle Horyniak
- Burnet Institute, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Margaret E Hellard
- Burnet Institute, Melbourne, Victoria, Australia
- University of Melbourne, Carlton, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Megan S C Lim
- Burnet Institute, Melbourne, Victoria, Australia
- University of Melbourne, Carlton, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
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Douglass CH, Win TM, Goutzamanis S, Lim MSC, Block K, Onsando G, Hellard M, Higgs P, Livingstone C, Horyniak D. Stigma Associated with Alcohol and Other Drug Use Among People from Migrant and Ethnic Minority Groups: Results from a Systematic Review of Qualitative Studies. J Immigr Minor Health 2023; 25:1402-1425. [PMID: 36976449 PMCID: PMC10632266 DOI: 10.1007/s10903-023-01468-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/29/2023]
Abstract
Stigma reduces access to alcohol and other drug (AOD) support. This systematic review explored perceptions and experiences of stigma associated with AOD use among migrant and ethnic minority groups. Qualitative studies published in English were identified using six databases. Two reviewers screened and critically appraised articles using the Joanna Briggs Institute Critical Appraisal Checklist for qualitative studies. Data were synthesised using best fit framework synthesis. Twenty-three studies were included. Stigma drivers and facilitators included stereotypes, socio-cultural norms, legal responses and precarious lived experiences. Stigma intersected with gender, citizenship, race and ethnicity and manifested though shame, exclusion, secondary stigma and discrimination in treatment. Outcomes and impacts included avoidance of services, emotional distress, isolation and loneliness. This review identified similar stigma experiences to other populations, however outcomes were complicated by precarious lived experiences and multiple stigmatised identities. Multi-level interventions are required to reduce AOD-related stigma for migrant and ethnic minority groups.
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Affiliation(s)
- Caitlin H Douglass
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Thin Mar Win
- Burnet Institute Myanmar, 226 Wizaya Plaza, U Wisara Road, Yangon, Myanmar
| | | | - Megan S C Lim
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Karen Block
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Gerald Onsando
- Melbourne School of Social and Political Sciences, University of Melbourne, 420 John Medley Building, Parkville, VIC, 3010, Australia
| | - Margaret Hellard
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Peter Higgs
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Public Health Department, La Trobe University, Plenty Road, Bundoora, VIC, 3086, Australia
| | - Charles Livingstone
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danielle Horyniak
- Burnet Institute Australia, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Who are Australia's young heavy drinkers? a cross-sectional population study. Aust N Z J Public Health 2023; 47:100020. [PMID: 36907002 DOI: 10.1016/j.anzjph.2023.100020] [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: 06/07/2022] [Revised: 10/31/2022] [Accepted: 11/27/2022] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE In light of the recent declines in youth drinking, the socio-demographic correlates of (1) annual total alcohol consumption (volume) and (2) monthly single occasion risky drinking among underage young people (14-17-year-olds) and young adults (18-24-year-olds) were examined. METHODS Cross-sectional data were drawn from the 2019 National Drug Strategy Household Survey (n=1,547). Multivariable negative binomial regression analyses identified the socio-demographic correlates of total annual volume and monthly risky drinking. RESULTS Those who spoke English as first language reported higher total volume and rates of monthly risky drinking. Not being in school predicted total volume for 14-17-year-olds, as did having a certificate/diploma for 18-24-year-olds. Living in affluent areas predicted a greater total volume for both age groups, and risky drinking for 18-24-year-olds. Young men in regional areas and working in labour and logistics reported higher total volume than young women in the same groups. CONCLUSIONS There are important differences among young heavy drinkers related to gender, cultural background, socio-economic status, education, regionality and work industry. IMPLICATIONS FOR PUBLIC HEALTH Prevention strategies that are sensitively tailored towards high risk groups (e.g. young men in regional areas and working in trade and logistics) may be of public health benefit.
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Hamrah MS, Bartlett L, Jang S, Roccati E, Vickers JC. Modifiable Risk Factors for Dementia Among Migrants, Refugees and Asylum Seekers in Australia: A Systematic Review. J Immigr Minor Health 2023; 25:692-711. [PMID: 36652152 DOI: 10.1007/s10903-022-01445-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/19/2023]
Abstract
While the prevalence of non-communicable disease risk factors is understood to be higher among migrants than for people born in host nations, little is known about the dementia risk profile of migrants, refugees and asylum seekers. This systematic review examines published literature to understand what is currently reported about 12 identified modifiable risk factors for dementia among migrants, refugees, and asylum seekers residing in Australia. Three literature databases (PubMed/CINAHL/MEDLINE) were systematically searched to find articles reporting excessive alcohol consumption, traumatic brain injury, air pollution, lack of education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and limited social contact in Australia's migrant, refugee and asylum seeker population samples. Papers were systematically reviewed following PRISMA guidelines. A total of 763 studies were found, of which 676 articles were excluded, and 79 articles remained. Despite wide variability in study design, size and purpose, the prevalence and correlates of modifiable risk factors of dementia appears markedly different among the studied samples. Compared with Australian-born participants, migrant samples had a higher prevalence of depression, social isolation, physical inactivity and diabetes mellitus. Insufficient information or conflicting evidence prevented inference about prevalence and correlates for the remaining dementia risk factors. A better understanding of the prevalence and correlates of modifiable dementia risk factors is needed in Australia's migrant, refugee and asylum seeker populations. This information, together with a deeper understanding of the contextual and cultural contributing factors affecting people who arrive in Australia through differing pathways is needed before preventive interventions can be realistically targeted and sensitively implemented.
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Affiliation(s)
- Mohammad Shoaib Hamrah
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 143, Hobart, TAS, 7001, Australia
| | - Larissa Bartlett
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 143, Hobart, TAS, 7001, Australia
| | - Sunny Jang
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 143, Hobart, TAS, 7001, Australia
| | - Eddy Roccati
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 143, Hobart, TAS, 7001, Australia.
| | - James C Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 143, Hobart, TAS, 7001, Australia
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Douglass CH, Block K, Horyniak D, Hellard ME, Lim MSC. Addressing alcohol and other drug use among young people from migrant and ethnic minority backgrounds: Perspectives of service providers in Melbourne, Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e308-e317. [PMID: 33825228 DOI: 10.1111/hsc.13355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/24/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
Young people from migrant and ethnic minority backgrounds are recognised as emerging priority populations for reducing alcohol and other drug (AOD)-related harms in Australia. Limited research has investigated how service providers address AOD challenges in migrant communities. In this qualitative study, we interviewed 15 service providers from AOD, migrant support, community and other health services in a diverse region of Melbourne. Interviews explored the challenges that service providers faced and the strategies they implemented to engage with young migrants in relation to AOD use. Thematic analysis was used to generate four themes: stigma as a barrier to service delivery, intergenerational differences between young people and parents, the need for outreach and establishing trust and understanding over time. Service providers believed that stigma prevented many young people from migrant backgrounds having open conversations about their AOD use with family members and professionals. Participants perceived that some parents had less AOD-related knowledge and lower English language proficiency than their children creating challenges for effective communication. Service providers recognised the importance of engaging with young people in settings where they felt comfortable rather than expecting them to approach their service. Participants also acknowledged the need to invest time in establishing trust and understanding with young migrants so they could facilitate conversations about AOD use as relationships evolved. Although service providers had a strong understanding of young people's needs, they found it challenging to build relationships in the context of funding and time constraints. Our results indicate the need for long-term funding and timelines that enable service providers to build strong relationships with young migrants, their families and their broader cultural communities to facilitate access to AOD support.
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Affiliation(s)
- Caitlin H Douglass
- The Burnet Institute, Melbourne, VIC, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Karen Block
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Danielle Horyniak
- The Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Margaret E Hellard
- The Burnet Institute, Melbourne, VIC, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Megan S C Lim
- The Burnet Institute, Melbourne, VIC, Australia
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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No One Smiles at Me: The Double Displacement of Iranian Migrant Men as Refugees Who Use Drugs in Australia. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10030085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Drawing on relevant sociological and feminist theories namely a social constructivist and intersectional framework, this article explores ways in which migrant Iranian men as ‘refugees’ ‘who use drugs’ navigate the complex terrain of ‘double displacement’ in the Australian contemporary context. It presents findings from a series of community based participatory and culturally responsive focus groups and in-depth interviews of twenty-seven participants in Sydney, Australia. Results highlight the ways in which social categories of gender, language, class, ethnicity, race, migration status and their relationship to intersubjective hierarchies and exclusion in Australia circumnavigate and intervene with participants’ alcohol and other drugs’ (AOD) use and related harms. The article argues that there is a need to pay greater attention to the implications of masculinities, power relations and the resultant material, social and affective emotional impacts of displacement for refugee men within Australian health care responses.
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Manoharan A, Jones J, Jiang Z, Singal M. Career optimism of culturally and linguistically diverse hotel workers in the pandemic age. INTERNATIONAL JOURNAL OF HOSPITALITY MANAGEMENT 2021; 93:102796. [PMID: 36919181 PMCID: PMC9998180 DOI: 10.1016/j.ijhm.2020.102796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 05/21/2023]
Abstract
The impact of COVID-19 on workers in accommodation and food services-which account for a large proportion of the hospitality sector-is severe, with more than one third of these workers losing their jobs. Against this backdrop, there is heightened interest in the concept of career optimism, yet a dearth of empirical research. Our study addresses this gap by investigating the factors that influence the career optimism of culturally and linguistically diverse (CALD) hotel workers. Using a qualitative study, we found a temporal facet of career optimism for CALD workers, and developed a model to show the individual and contextual factors that enabled and inhibited the career optimism of this group. We thus advance hospitality literature on the careers of CALD workers in hotels and offer practical implications to help CALD hospitality workers stay vocationally optimistic during crisis events such as COVID-19.
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Affiliation(s)
- Ashokkumar Manoharan
- College of Business, Government and Law, Flinders University, Adelaide, SA, 5001, Australia
| | - Janice Jones
- College of Business, Government and Law, Flinders University, Adelaide, SA, 5001, Australia
| | - Zhou Jiang
- College of Business, Government and Law, Flinders University, Adelaide, SA, 5001, Australia
| | - Manisha Singal
- Pamplin College of Business, Virginia Tech, 295 West Campus Drive, Blacksburg, VA, 24061, United States
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Definitions of Culturally and Linguistically Diverse (CALD): A Literature Review of Epidemiological Research in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020737. [PMID: 33467144 PMCID: PMC7830035 DOI: 10.3390/ijerph18020737] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 01/04/2023]
Abstract
Objective: To identify how Culturally and Linguistically Diverse (CALD) communities are defined in epidemiological research in Australia and provide a definition of CALD status that aids the consistency and interpretability of epidemiological studies. Methods: Peer-reviewed literature from January 2015 to May 2020 was searched via four databases (Ovid Medline combined with PubMed, Embase, Emcare, and CINAHL) to identify quantitative studies of CALD people in Australia. Results: A total of 108 studies met the criteria for inclusion in the review. Country of birth was the most commonly used CALD definition (n = 33, 30.6%), with combinations of two or more components also frequently used (n = 31, 28.7%). No studies used all the components suggested as core to defining CALD status. including country of birth, languages other than English spoken at home, English proficiency, and indigenous status. Conclusions: There was considerable inconsistency in how CALD status was defined. The review suggests that CALD status would best be defined as people born in non-English speaking countries, and/or who do not speak English at home. Additionally, indigenous peoples should be considered separately. This recommended definition will support the better identification of potential health disparity and needs in CALD and indigenous communities.
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