Migration-related Factors and Settlement Service Literacy: Findings from the Multi-site Migrants' Settlement Study

Migrants' access and effective utilisation of settlement services depend on their level of settlement service literacy (SSL). However, SSL is multi-dimensional in nature and has many facets that are influenced by demographic and migration-related factors. Identifying factors that drive various components of SSL, and thus allowing for more focused development of specific dimensions, is critical. The aim of this study was to examine the relationship between components of SSL and migration-related and migrants' demographic factors. Using a snowball sampling approach, trained multilingual research assistants collected data on 653 participants. Data were collected using face-to-face or online (phone and via video platforms such as Zoom and Skype) surveys. Our findings suggest that demographic and migration-related factors explained 32% of the variance in overall SSL; and 17%, 23%, 44%, 8%, 10% of the variance in knowledge, empowerment, competence, community influence, and political components of SSL respectively. SSL was positively associated with pre-migration and post-migration educational attainment, being employed in Australia, being a refugee, coming from the sub-Saharan region but negatively associated with age and coming from the East Asia and Pacific region. Across SSL dimensions, post-migration education was the only factor positively associated with the overall SSL and all SSL dimensions (except the political dimension). Employment status in Australia was also positively associated with competency and empowerment, but not other dimensions. Affiliating with a religion other than Christianity or Islam was negatively associated with knowledge and empowerment whilst being a refugee was positively associated with knowledge. Age was negatively associated with the empowerment and competency dimensions. The study provides evidence of the importance of some pre- and post-migration factors that can assist in developing targeted initiatives to enhance migrants' SSL. Identifying factors that drive various components of SSL will allow for more focused development of specific dimensions and therefore is critical.

Pro-environmental purchase intentions in a low-involvement context: the role of myopia and apathy

Purpose

To achieve the UN’s 2030 agenda, consumers will need to behave more responsibly and make less environmentally harmful purchases. This study aims to investigate the antecedents of consumers’ pro-environmental purchase intentions based on a range of motivating (i.e. attitudes, locus of control) and inhibiting factors (i.e. apathy and myopia) for a low-involvement product. It also tests the moderating effect of the greenness of a low-involvement product (green vs nongreen) on the consumer’s pro-environmental purchase intentions.

Design/methodology/approach

An online panel survey of 679 Turkish consumers was used. Structural equation modeling was used to test the hypothesized relationships.

Findings

The results suggest that while inhibiting factors (i.e. apathy and myopia) may not directly impede such purchase intentions, they could prevent consumers from considering the environmental characteristics of low-involvement products.

Practical implications

The insights are expected to assist marketers and policymakers to understand consumer psychological mechanisms when encouraging and promoting pro-environmental behavior in the context of low-involvement purchases, enhancing consumers contributing to the 2030 objectives.

Originality/value

This study examines the role of inhibiting factors behind the purchase of low-involvement goods. It also tests the moderating effect of the greenness of a low-involvement product on pro-environmental purchase intentions.

Exploring Factors Influencing Childhood Obesity Prevention Among Migrant Communities in Victoria, Australia: A Qualitative Study

Despite the availability of numerous obesity prevention initiatives in developed countries including Australia, rising childhood obesity levels have been found among migrant communities which contribute to widening obesity-related disparities in these countries. We sought to understand the factors influencing the participation of migrant communities in childhood obesity prevention initiatives. We conducted a qualitative study using semi-structured interviews among 48 migrant parents from African, Middle Eastern, Indian and Vietnamese origins living in disadvantaged areas of Victoria, Australia to explore their views on childhood obesity and its prevention. Thematic analysis showed low obesity literacy among migrant communities, cultural influences negatively impacting their healthy lifestyle behaviours and cultural, family-level and community-level barriers impacting their participation in childhood obesity prevention initiatives. There is an urgent need to improve obesity literacy among migrant communities using bicultural workers in order to improve their responsiveness to childhood obesity prevention initiatives. Health interventionists are urged to incorporate culturally-mediated influences in the design of obesity prevention programs to achieve energy balance and maintain healthy weight among migrants. Such culturally appropriate approaches have the potential of reducing the widening ethnic-related obesity disparities in Australia.

Readiness of communities to engage with childhood obesity prevention initiatives in disadvantaged areas of Victoria, Australia

Objective Disadvantaged communities bear a disproportionate burden of childhood obesity and show low participation in childhood obesity prevention initiatives. This study aims to examine the level of readiness of disadvantaged communities to engage with childhood obesity prevention initiatives. Methods Using the community readiness model, 95 semi-structured interviews were conducted among communities in four disadvantaged areas of Victoria, Australia. Community readiness analysis and paired t-tests were performed to assess the readiness levels of disadvantaged communities to engage with childhood obesity prevention initiatives. Results The results showed that disadvantaged communities demonstrated low levels of readiness (readiness score=4/9, 44%) to engage with the existing childhood obesity prevention initiatives, lacked knowledge of childhood obesity and its prevention, and reported facing challenges in initiating and sustaining participation in obesity prevention initiatives. Conclusion This study highlights the need to improve community readiness by addressing low obesity-related literacy levels among disadvantaged communities and by facilitating the capacity-building of bicultural workers to deliver obesity prevention messages to these communities. Integrating these needs into existing Australian health policy and practice is of paramount importance for reducing obesity-related disparities currently prevailing in Australia. What is known about the topic? Childhood obesity prevalence is plateauing in developed countries including Australia; however, obesity-related inequalities continue to exist in Australia especially among communities living in disadvantaged areas, which experience poor engagement in childhood obesity prevention initiatives. Studies in the USA have found that assessing disadvantaged communities' readiness to participate in health programs is a critical initial step in reducing the disproportionate obesity burden among these communities. However, no studies in Australia have assessed disadvantaged communities' readiness to engage in obesity prevention initiatives. What does this paper add? This paper addresses the current gap in the knowledge of disadvantaged communities' level of readiness to engage in childhood obesity prevention initiatives in Australia. The study also identified the key factors responsible for low readiness of disadvantaged communities to participate in current childhood obesity prevention services. By using the Community Readiness model this study shows the readiness levels specific to the various dimensions of the model; Understanding dimension-specific readiness allows us to identify strategies that are tailored to each dimension, as guided by the model. What are the implications for practitioners? With the increasing burden of childhood obesity on disadvantaged communities, policymakers and health practitioners are facing a crisis in obesity prevention and management. Almost every year, new interventions are being planned and implemented. However if the target communities are not ready to participate in the available interventions these efforts are futile. This study exposes the key factors responsible for low readiness to participate in current obesity prevention services by disadvantaged communities. Addressing these key factors and improving readiness before designing new interventions will improve the participation of disadvantaged communities in those interventions. The study findings ultimately have the potential of reducing obesity-related disparities in Australia.

Barriers and facilitators to childhood obesity prevention among culturally and linguistically diverse (CALD) communities in Victoria, Australia

OBJECTIVE

Childhood obesity is rising among culturally and linguistically diverse (CALD) groups who show poor engagement in obesity prevention initiatives. We examined the barriers and facilitators to the engagement of CALD communities in obesity prevention initiatives.

METHODS

We used the nominal group technique to collect data from 39 participants from Vietnamese, Burmese, African, Afghani and Indian origins living in disadvantaged areas of Victoria, Australia. Data analysis revealed ranked priorities for barriers and facilitators for CALD community engagement in obesity prevention initiatives.

RESULTS

CALD parents identified key barriers as being: competing priorities in the post-migration settlement phase; language, cultural and program accessibility barriers; low levels of food and health literacy; junk food advertisement targeting children; and lack of mandatory weight checks for schoolchildren. Key facilitators emerged as: bicultural playgroup leaders; ethnic community groups; and school-based healthy lunch box initiatives.

CONCLUSION

This study has identified several policy recommendations including: the implementation of robust food taxation policies; consistent control of food advertising targeting children; improving CALD health literacy using bicultural workers; and matching health promotional materials with CALD community literacy levels. Implications for Public Health: These recommendations can directly influence public health policy to improve the engagement of CALD communities in obesity prevention services and ultimately reduce the widening obesity disparities in Australia.

Addressing migration-related social and health inequalities in Australia: call for research funding priorities to recognise the needs of migrant populations

OBJECTIVE

Migrants constitute 26% of the total Australian population and, although disproportionately affected by chronic diseases, they are under-represented in health research. The aim of the present study was to describe trends in Australian Research Council (ARC)- and National Health and Medical Research Council (NHMRC)-funded initiatives from 2002 to 2011 with a key focus on migration-related research funding.

METHODS

Data on all NHMRC- and ARC-funded initiatives between 2002 and 2011 were collected from the research funding statistics and national competitive grants program data systems, respectively. The research funding expenditures within these two schemes were categorised into two major groups: (1) people focused (migrant-related and mainstream-related); and (2) basic science focused. Descriptive statistics were used to summarise the data and report the trends in NHMRC and ARC funding over the 10-year period.

RESULTS

Over 10 years, the ARC funded 15 354 initiatives worth A$5.5 billion, with 897 (5.8%) people-focused projects funded, worth A$254.4 million. Migrant-related research constituted 7.8% of all people-focused research. The NHMRC funded 12399 initiatives worth A$5.6 billion, with 447 (3.6%) people-focused projects funded, worth A$207.2 million. Migrant-related research accounted for 6.2% of all people-focused initiatives.

CONCLUSIONS

Although migrant groups are disproportionately affected by social and health inequalities, the findings of the present study show that migrant-related research is inadequately funded compared with mainstream-related research. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce these inequalities among migrants.

Should blood donors be routinely screened for glucose-6-phosphate dehydrogenase deficiency? A systematic review of clinical studies focusing on patients transfused with glucose-6-phosphate dehydrogenase-deficient red cells

The risk factors associated with the use of glucose-6-phosphate dehydrogenase (G6PD)-deficient blood in transfusion have not yet been well established. Therefore, the aim of this review was to evaluate whether whole blood from healthy G6PD-deficient donors is safe to use for transfusion. The study undertook a systematic review of English articles indexed in COCHRANE, MEDLINE, EMBASE, and CINHAL, with no date restriction up to March 2013, as well as those included in articles' reference lists and those included in Google Scholar. Inclusion criteria required that studies be randomized controlled trials, case controls, case reports, or prospective clinical series. Data were extracted following the Preferred Reporting Items for Systematic Reviews using a previously piloted form, which included fields for study design, population under study, sample size, study results, limitations, conclusions, and recommendations. The initial search identified 663 potentially relevant articles, of which only 13 studies met the inclusion criteria. The reported effects of G6PD-deficient transfused blood on neonates and children appear to be more deleterious than effects reported on adult patients. In most cases, the rise of total serum bilirubin was abnormal in infants transfused with G6PD-deficient blood from 6 hours up to 60 hours after transfusion. All studies on neonates and children, except one, recommended a routine screening for G6PD deficiency for this at-risk subpopulation because their immature hepatic function potentially makes them less able to handle any excess bilirubin load. It is difficult to make firm clinical conclusions and recommendations given the equivocal results, the lack of standardized evaluation methods to categorize red blood cell units as G6PD deficient (some of which are questionable), and the limited methodological quality and low quality of evidence. Notwithstanding these limitations, based on our review of the available literature, there is little to suggest that G6PD-deficient individuals should be excluded from donating red blood cells, although transfusions of such blood may potentially have negative impacts on premature neonates or patients who need repeated transfusions, and thus, for this group, screening for G6PD deficiency may be appropriate.