1
|
Lirios A, Mullens AB, Daken K, Moran C, Gu Z, Assefa Y, Dean JA. Sexual and reproductive health literacy of culturally and linguistically diverse young people in Australia: a systematic review. CULTURE, HEALTH & SEXUALITY 2024; 26:790-807. [PMID: 37755697 DOI: 10.1080/13691058.2023.2256376] [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: 12/07/2022] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Young people from culturally and linguistically diverse backgrounds experience barriers accessing sexual and reproductive health (SRH) information and care. This systematic review, utilising a pre-determined protocol, performed according to PRISMA guidelines, explored SRH knowledge, attitudes and information sources for young (16-24 years) culturally and linguistically diverse background people living in Australia, to gain understanding of their sexual health literacy. CINAHL, Embase, MEDLINE, PubMed and Scopus were systematically searched with inclusion criteria applied to 216 articles. After title and abstract screening, backward/forward searching, and full-text review of 58 articles, 13 articles from eight studies were identified. Thematic analysis, guided by core constructs from cultural care theory, identified three themes: (1) SRH knowledge varied by topic but was generally low; (2) young people's attitudes and beliefs were influenced by family and culture; however, 'silence' was the main barrier to sexual health literacy; and (3) Access to SRH information was limited. To attain sexual health literacy and equitable access to culturally-congruent and responsive SRH information and care, there is a need for theory-informed strategies and policies that address the diverse social, cultural and structural factors affecting young culturally and linguistically diverse background people, especially the 'silence' or lack of open SRH communication they experience.
Collapse
Affiliation(s)
- Alison Lirios
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Kirstie Daken
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Claire Moran
- True Relationships and Reproductive Health (True), Windsor, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland (ECCQ), West End, Queensland, Australia
| | - Yibeltal Assefa
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Judith A Dean
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| |
Collapse
|
2
|
Kim M, Vingan P, Boe LA, Tadros AB, Nelson JA, Stern CS. Nonresponse data in sexual well-being among breast reconstruction patients-who are we overlooking? J Surg Oncol 2024; 129:1192-1201. [PMID: 38583135 DOI: 10.1002/jso.27639] [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] [Received: 02/12/2024] [Accepted: 02/17/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Missing data can affect the representativeness and accuracy of survey results, and sexual health-related surveys are especially at a higher risk of nonresponse due to their sensitive nature and stigma. The purpose of this study was to evaluate the proportion of patients who do not complete the BREAST-Q Sexual Well-being relative to other BREAST-Q modules and compare responders versus nonresponders of Sexual Well-being. We secondarily examined variables associated with Sexual Well-being at 1-year. METHODS A retrospective analysis of patients who underwent breast reconstruction from January 2018 to December 2021 and completed any of the BREAST-Q modules postoperatively at 1-year was performed. RESULTS The 2941 patients were included. Of the four BREAST-Q domains, Sexual Well-being had the highest rate of nonresponse (47%). Patients who were separated (vs. married, OR = 0.69), whose primary language was not English (vs. English, OR = 0.60), and had Medicaid insurance (vs. commercial, OR = 0.67) were significantly less likely to complete the Sexual Well-being. Postmenopausal patients were significantly more likely to complete the survey than premenopausal patients. Lastly, autologous reconstruction patients were 2.93 times more likely to respond than implant-based reconstruction patients (p < 0.001) while delayed (vs. immediate, OR = 0.70, p = 0.022) and unilateral (vs. bilateral, OR = 0.80, p = 0.008) reconstruction patients were less likely to respond. History of psychiatric diagnosis, aromatase inhibitors, and immediate breast reconstruction were significantly associated with lower Sexual Well-being at 1-year. CONCLUSION Sexual Well-being is the least frequently completed BREAST-Q domain, and there are demographic and clinical differences between responders and nonresponders. We encourage providers to recognize patterns in nonresponse data for Sexual-Well-being to ensure that certain patient population's sexual health concerns are not overlooked.
Collapse
Affiliation(s)
- Minji Kim
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Perri Vingan
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lillian A Boe
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Audree B Tadros
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jonas A Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carrie S Stern
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
3
|
Gray C, Crawford G, Roberts M, Vujcich D. 'You are making it sound like you are talking to a child': exploring community sentiment on developing and disseminating tailored sexual health education resources for migrants. HEALTH EDUCATION RESEARCH 2024:cyae014. [PMID: 38568929 DOI: 10.1093/her/cyae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024]
Abstract
Health communication is a critical component of public health, which includes health education resources. Resource effectiveness is improved where health literacy demands, including the cultural appropriateness of resources, match the intended audience. International guidelines support the tailoring of resources for migrants from culturally and linguistically diverse backgrounds (CaLD). Five focus groups (n = 18) and interviews (n = 9) with people from CaLD migrant backgrounds explored community perspectives on sexual health resources developed by a state department of health, specifically clarity, comprehensiveness, cultural appropriateness and strategies for dissemination. We identified three major thematic areas relating to simplicity, cultural norms and beliefs and dissemination. Participants recommended resource delivery in different formats as part of a broader intervention. Generally, sexual health information was deemed appropriate and easily understood. However, the resources used simplified language that participants reported was vague and inaccurate at times, potentially contributing to misinformation and reinforcing stigma relating both to the status of being a migrant and sexual health. Findings suggest the need for more nuanced health resource development beyond translation and language simplification. Resources developed in different formats, including different health literacy demands, using approaches that engage the target group in design and dissemination and contextualized within a comprehensive health promotion project, are likely to be more effective.
Collapse
Affiliation(s)
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Meagan Roberts
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Daniel Vujcich
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| |
Collapse
|
4
|
Coulibaly K, Bousmah MAQ, Ravalihasy A, Taéron C, Mbiribindi R, Senne JN, Gubert F, Gosselin A, Desgrées du Loû A. Bridging the knowledge gap of biomedical HIV prevention tools among sub-saharan african immigrants in France. Results from an empowerment-based intervention. SSM Popul Health 2023; 23:101468. [PMID: 37560089 PMCID: PMC10407280 DOI: 10.1016/j.ssmph.2023.101468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Biomedical HIV prevention tools are available in France to prevent new infections. However, evidence suggests a lack of knowledge of these tools among sub-Saharan African immigrants, who are particularly affected by HIV due to social hardship, an indirect factor of HIV acquisition. We analysed the impact of an empowerment-based intervention on the knowledge of treatment as prevention (TasP), pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) in a population of precarious sub-Saharan African immigrants. METHODS Data were collected throughout the MAKASI project. Following an outreach approach, participants were recruited in public places based on their precarious situations and followed for six months (0, 3, 6 months) between 2018 and 2021. Participants were randomized into two groups and received an empowerment intervention sequentially (stepped wedge design). We used random-effects logistic regression models to evaluate the intervention effect on the knowledge of biomedical HIV prevention tools. ClinicalTrials.gov Identifier: NCT04468724. RESULTS The majority of the participants were men (77.5%), and almost half of them had arrived in France within 2 years prior to inclusion (49.3%). At baseline, 56% of participants knew about TasP, 6% knew about PEP and 4% knew about PrEP. Receiving the intervention increased the odds of knowing about PEP (aOR = 2.02 [1.09-3.75]; p < 0.026). Intervention effects were observed for TasP and PrEP only after 6 months. We found significant time effects for PEP (at 3 months, aOR = 4.26 [2.33-7.80]; p < 0.001; at 6 months, aOR = 18.28 [7.39-45.24]; p < 0.001) and PrEP (at 3 months, aOR = 4.02 [2.10-7.72]; p < 0.001; at 6 months, aOR = 28.33 [11.16-71.91]; p < 0.001). CONCLUSIONS We showed that the intervention increased the knowledge of biomedical HIV prevention tools. The effect of the intervention was coupled with an important time effect. This suggested that exposure to the intervention together with other sources of information contributed to increased knowledge of biomedical HIV prevention tools among precarious sub-Saharan African immigrants.
Collapse
Affiliation(s)
- Karna Coulibaly
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | - Marwân-al-Qays Bousmah
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | - Andrainolo Ravalihasy
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | | | | | | | - Flore Gubert
- IRD, UMR LEDa-DIAL, PSL, Université Paris-Dauphine, CNRS, Paris, France
| | - Anne Gosselin
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
- Institut National D’Études Démographiques, Aubervilliers, France
| | - Annabel Desgrées du Loû
- Université Paris Cité, IRD, Inserm, Ceped, F-75006, Paris, France
- French Collaborative Institute on Migrations, CNRS, Aubervilliers, France
| | | |
Collapse
|
5
|
Vujcich D, Reid A, Brown G, Durham J, Guy R, Hartley L, Mao L, Mullens AB, Roberts M, Lobo R. HIV-Related Knowledge and Practices among Asian and African Migrants Living in Australia: Results from a Cross-Sectional Survey and Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4347. [PMID: 36901357 PMCID: PMC10002009 DOI: 10.3390/ijerph20054347] [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: 02/07/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
Australian HIV notification rates are higher for people born in Northeast Asia, Southeast Asia and sub-Saharan Africa compared to Australian-born people. The Migrant Blood-Borne Virus and Sexual Health Survey represents the first attempt to build the national evidence base regarding HIV knowledge, risk behaviors and testing among migrants in Australia. To inform survey development, preliminary qualitative research was conducted with a convenience sample of n = 23 migrants. A survey was developed with reference to the qualitative data and existing survey instruments. Non-probability sampling of adults born in Northeast Asia, Southeast Asia and sub-Saharan Africa was undertaken (n = 1489), and descriptive and bivariate analyses of data were conducted. Knowledge of pre-exposure prophylaxis was low (15.59%), and condom use at last sexual encounter was reported by 56.63% of respondents engaging in casual sex, and 51.80% of respondents reported multiple sexual partners. Less than one-third (31.33%) of respondents reported testing for any sexually transmitted infection or blood-borne virus in the previous two years and, of these, less than half (45.95%) tested for HIV. Confusion surrounding HIV testing practices was reported. These findings identify policy interventions and service improvements critically needed to reduce widening disparities regarding HIV in Australia.
Collapse
Affiliation(s)
- Daniel Vujcich
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Alison Reid
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Graham Brown
- Centre for Social Impact, UNSW, Sydney, NSW 2052, Australia
| | - Jo Durham
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Rebecca Guy
- Kirby Institute, UNSW, Sydney, NSW 2052, Australia
| | - Lisa Hartley
- Centre for Human Rights Education, Curtin University, Bentley, WA 6102, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia
| | - Amy B. Mullens
- School of Psychology & Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Qld, Ipswich, QLD 4305, Australia
| | - Meagan Roberts
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| |
Collapse
|
6
|
Okeke SR. "It was protected, except, it wasn't [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia. BMC Public Health 2022; 22:2168. [PMID: 36434571 PMCID: PMC9700902 DOI: 10.1186/s12889-022-14512-y] [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: 08/02/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities around sex-related experiences are lost or, at most, tangentially investigated. To address this research problem, this study used a mixed-methods design to examine protective practices against blood-borne viruses and sexually transmissible infections (BBVs/STIs) among Sydney-based East Asian and sub-Saharan African international students. METHODS This mixed-methods study generated quantitative data using anonymous online survey (n = 149), and qualitative data through in-depth interviews (n = 20). The main recruitment strategy involved advertising the study through paper and electronic flyers. Quantitative data were analysed using logistic regression, while interviews data were analysed using reflexive thematic analysis. RESULTS Self-reported BBVs/STIs protective practices in the last 12 months include abstinence (28.7%), consistent condom use (19.9%), occasional condom use (18.7%), single partner fidelity (25.1%), other strategies (1.8%), and nothing (5.8%). Further, findings from the bivariate analysis showed higher BBVs/STIs prevention knowledge, lower acculturation into Australian sexual culture, greater access to sexual health information, less conservative sexual norms, greater emotional social support and older age were significantly associated with increased protective practices. Variables significant at bivariate level were entered into a logistic regression. The model was statistically significant, (X2(6) = 31.33, p < 0.01) and explained 33.1% of the variance in BBVs/STIs protective practices. However, only acculturation to sexual norms in Australia (OR = 0.883, 95% CI = 0.820-0.952) was found to be independent predictor of BBVs/STIs protective practices. The results of the study based on the quantitative data, indicated condom use (consistent and occasional) was the most reported BBVs/STIs protective behaviour among sexually active participants. Therefore, interviews data was used to explore condom-use motives and practices. The interviews results showed participants primary concern as regards condom use was around pregnancy and not BBVs/STIs. Thus, some participants described safe sex largely as contraception, with BBVs/STIs constituting a secondary concern or no concern at all. CONCLUSIONS Based on the results of this study, tailored sexual health interventions for international students; which incorporate strategies for modifying perceived sexual norms in Australia, are advocated. In addition, this study recommends sexual health interventions that promote dual protection of condoms for both contraception and BBVs/STIs.
Collapse
Affiliation(s)
- Sylvester Reuben Okeke
- grid.1005.40000 0004 4902 0432Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| |
Collapse
|
7
|
Vujcich D, Brown G, Durham J, Gu Z, Hartley L, Lobo R, Mao L, Moro P, Pillay V, Mullens AB, Oudih E, Roberts M, Wilshin C, Reid A. Strategies for Recruiting Migrants to Participate in a Sexual Health Survey: Methods, Results, and Lessons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12213. [PMID: 36231514 PMCID: PMC9564521 DOI: 10.3390/ijerph191912213] [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: 06/01/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 06/16/2023]
Abstract
In this article, we describe the approaches taken to recruit adult migrants living in Australia for a sexual health and blood-borne virus survey (paper and online) and present data detailing the outcomes of these approaches. The purpose was to offer guidance to redress the under-representation of migrants in public health research. Methods of recruitment included directly contacting people in individual/organizational networks, social media posts/advertising, promotion on websites, and face-to-face recruitment at public events/venues. Search query strings were used to provide information about an online referral source, and project officers kept records of activities and outcomes. Descriptive statistical analyses were used to determine respondent demographic characteristics, proportions recruited to complete the paper and online surveys, and sources of referral. Logistic regression analyses were run to predict online participation according to demographic characteristics. The total sample comprised 1454 African and Asian migrants, with 59% identifying as female. Most respondents (72%) were recruited to complete the paper version of the survey. Face-to-face invitations resulted in the highest number of completions. Facebook advertising did not recruit large numbers of respondents. Same-sex attraction and age (40-49 years) were statistically significant predictors of online completion. We encourage more researchers to build the evidence base on ways to produce research that reflects the needs and perspectives of minority populations who often bear the greatest burden of disease.
Collapse
Affiliation(s)
- Daniel Vujcich
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Graham Brown
- Centre for Social Impact, UNSW, Sydney, NSW 2052, Australia
| | - Jo Durham
- Centre for Healthcare Transformation, Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, West End, QLD 4101, Australia
| | - Lisa Hartley
- Centre for Human Rights Education, Curtin University, Bentley, WA 6102, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW, Sydney, NSW 2052, Australia
| | - Piergiorgio Moro
- Multicultural Health Support Service, Centre for Culture, Ethnicity and Health, Richmond, VIC 3121, Australia
| | - Vivienne Pillay
- Ethnic Communities Council of WA, North Perth, WA 6006, Australia
| | - Amy B. Mullens
- Centre for Health Research, School of Psychology & Wellbeing, University of Southern Queensland, Ipswich, QLD 4305, Australia
| | - Enaam Oudih
- Relationships Australia South Australia, Hindmarsh, SA 5007, Australia
| | - Meagan Roberts
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Caitlin Wilshin
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Alison Reid
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| |
Collapse
|
8
|
Translating best practice into real practice: Methods, results and lessons from a project to translate an English sexual health survey into four Asian languages. PLoS One 2021; 16:e0261074. [PMID: 34919577 PMCID: PMC8682877 DOI: 10.1371/journal.pone.0261074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background Migrants are underrepresented in population health surveys. Offering translated survey instruments has been shown to increase migrant representation. While ‘team translation’ represents current best practice, there are relatively few published examples describing how it has been implemented. The purpose of this paper is to document the process, results and lessons from a project to translate an English-language sexual health and blood-borne virus survey into Khmer, Karen, Vietnamese and Traditional Chinese. Methods The approach to translation was based on the TRAPD (Translation, Review, Adjudication, Pretesting, and Documentation) model. The English-language survey was sent to two accredited, independent translators. At least one bilingual person was chosen to review and compare the translations and preferred translations were selected through consensus. Agreed translations were pretested with small samples of individuals fluent in the survey language and further revisions made. Results Of the 51 survey questions, only nine resulted in identical independent translations in at least one language. Material differences between the translations related to: (1) the translation of technical terms and medical terminology (e.g. HIV); (2) variations in dialect; and (3) differences in cultural understandings of survey concepts (e.g. committed relationships). Conclusion Survey translation is time-consuming and costly and, as a result, deviations from TRAPD ‘best practice’ occurred. It is not possible to determine whether closer adherence to TRAPD ‘best practice’ would have improved the quality of the resulting translations. However, our study does demonstrate that even adaptations of the TRAPD method can identify issues that may not have been apparent had non-team-based or single-round translation approaches been adopted. Given the dearth of clear empirical evidence about the most accurate and feasible method of undertaking translations, we encourage future researchers to follow our example of making translation data publicly available to enhance transparency and enable critical appraisal.
Collapse
|