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Shaping interventions to address waterpipe smoking in Arabic-speaking communities in Sydney, Australia: a qualitative study.

ABSTRACT: BACKGROUND:Waterpipe smoking is a traditional method of tobacco smoking that is being increasingly practiced worldwide. However, the research evidence describing the practice and prevalence of waterpipe smoking in Australia is limited. Arabic-speaking communities residing in an area of metropolitan Sydney identified increasing rates of waterpipe smoking as a community health concern during a tobacco intervention project. A qualitative research project was conducted to explore community perceptions about waterpipe smoking and the health promotion interventions that would be acceptable to Arabic speaking communities. METHODS:Participants from Arabic-speaking community groups and networks were recruited by trained bilingual community research assistants (BCRAs). Ten focus groups were conducted, eight by the BCRAs and two by the research team, and included a total of 88 participants. Notes were taken during the focus groups by the BCRAs and provided to the research team. The data was coded and managed using NVivo 11, and examined for themes and subthemes. RESULTS:Eleven themes were identified from the data relating to the perceptions of waterpipe smoking (practices, cultural identity, acceptability, social connectedness, knowledge and perceptions of harm, trend and fashion, availability and access) and possible health promotion interventions (health information and social marketing, health education, policy and legislation, intervention target groups and messages). Waterpipe smoking was reported to be widely practiced and was related to a number of factors including feelings of cultural identity and belonging. The study highlighted the misconceptions of harm that exist in communities about the health effects of waterpipe smoking, as well as the significant role of the family in passing on the practice of waterpipe smoking. These factors should be considered in the development of health promotion interventions. CONCLUSIONS:Our findings suggest that until waterpipe smoking is perceived as a problem, community readiness for accepting health promotion interventions will be limited. Interventions should focus on debunking the myths that contribute toward a reduced perception of harm. A culturally sensitive approach, that considers the cultural connection to waterpipe smoking, should be taken toward the development and implementation of interventions.

SUBMITTER: Kearns R

PROVIDER: S-EPMC6296050 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Project description:BackgroundSchools play a key role in supporting the well-being and resettlement of refugee children, and parental engagement with the school may be a critical factor in the process. Many resettlement countries have policies in place to support refugee parents' engagement with their children's school. However, the impact of these programs lacks systematic evaluation. This study first aimed to validate self-report measures of parental school engagement developed specifically for the refugee context, and second, to identify parent characteristics associated with school engagement, so as to help tailor support to families most in need.Methods and findingsThe report utilises 2016 baseline data of a cohort study of 233 Arabic-speaking parents (77% response rate) of 10- to 12-year-old schoolchildren from refugee backgrounds across 5 schools in Sydney, Australia. Most participants were born in Iraq (81%) or Syria (11%), and only 25% spoke English well to very well. Participants' mean age was 40 years old, and 83% were female. Confirmatory factor analyses were run on provisional item sets identified from a literature review and separate qualitative study. The findings informed the development of 4 self-report tools assessing parent engagement with the school and school community, school belonging, and quality of the relationship with the schools' bilingual cultural broker. Cronbach alpha and Pearson correlations with an established Teacher-Home Communication subscale demonstrated adequate reliability (α = 0.67 to 0.80) and construct and convergent validity of the measures (p < 0.01), respectively. Parent characteristics were entered into respective least absolute shrinkage and selection operator (LASSO) regression analyses. The degree of parents' psychological distress (as measured by the Kessler10 self-report instrument) and postmigration living difficulties (PLMDs) were each associated with lower school engagement and belonging, whereas less time lived in Australia, lower education levels, and an unemployed status were associated with higher ratings in relationship quality with the schools' cultural broker. Study limitations include the cross-sectional design and the modest amount of variance (8% to 22%) accounted for by the regression models.ConclusionsThe study offers preliminary refugee-specific measures of parental school engagement. It is expected they will provide a resource for evaluating efforts to support the integration of refugee families into schools. The findings support the need for initiatives that identify and support parents with school-attending children from refugee backgrounds who are experiencing psychological distress or resettlement stressors. At the school level, the findings suggest that cultural brokers may be effective in targeting newly arrived families.

Project description:BackgroundAustralia is an ethnically diverse nation. Research has demonstrated an elevated risk of developing a mental illness in culturally and linguistically diverse (CaLD) communities yet uptake of mental health services is low. To improve mental health treatment seeking and outcomes for CaLD individuals in Australia there is an urgent need to deeply understand barriers to treatment such as stigma. Using an exploratory qualitative approach, the aim of the study was to explore how CaLD communities' conceptualise and interpret mental illness and associated beliefs and experiences of stigma.MethodsThe study focused on three key CaLD groups: the Congolese, Arabic-speaking and Mandarin-speaking communities residing in Sydney, Australia. A series of eight focus group discussions (n = 51) and 26 key informant interviews were undertaken online using Zoom during the period of November to December 2021. Focus group discussions and key informant interviews were digitally recorded, transcribed, and analysed using NVivo software.ResultsThree major themes were identified. The first theme related to mental illness terminology used in the three communities. Despite variation in the terms used to refer to 'mental illness' all three communities generally distinguished between 'mental illness', a more severe condition and 'mental health problems', considered to arise due to stressors. The second theme centred on beliefs about mental illness; with all three communities identifying migration-related stressors as contributing to mental illness. Culturally related beliefs were noted for the Congolese participants with the perception of a link between mental illness and supernatural factors, whereas Mandarin-speaking participants highlighted lack of inter and intrapersonal harmony and failure to adhere to values such as filial piety as contributing to mental illness. The final theme related to mental illness related stigma and the various ways it manifested in the three communities including presence of collectivist public stigma felt across all three groups and affiliate (family) stigma reported by the Arabic and Mandarin-speaking groups.ConclusionsWe found rich diversity in how these communities view and respond to mental illness. Our findings provide some possible insights on both service provision and the mental health system with a view to building effective engagement and pathways to care.

Project description:ObjectiveTo explore the psychological, social and financial outcomes of COVID-19-and the sociodemographic predictors of those outcomes-among culturally and linguistically diverse communities in Sydney, Australia.DesignCross-sectional survey informed by the Framework for Culturally Competent Health Research conducted between March and July 2021.SettingParticipants who primarily speak a language other than English at home were recruited from Greater Western Sydney, New South Wales.Participants708 community members (mean age: 45.4 years (range 18-91)). 88% (n=622) were born outside of Australia, 31% (n=220) did not speak English well or at all, and 41% (n=290) had inadequate health literacy.Outcome measuresThirteen items regarding COVID-19-related psychological, social and financial outcomes were adapted from validated scales, previous surveys or co-designed in partnership with Multicultural Health and interpreter service staff. Logistic regression models (using poststratification weighted frequencies) were used to identify sociodemographic predictors of outcomes. Surveys were available in English or translated (11 languages).ResultsIn this analysis, conducted prior to the 2021 COVID-19 outbreak in Sydney, 25% of the sample reported feeling nervous or stressed most/all of the time and 22% felt lonely or alone most/all of the time. A quarter of participants reported negative impacts on their spousal relationships as a result of COVID-19 and most parents reported that their children were less active (64%), had more screen time (63%) and were finding school harder (45%). Mean financial burden was 2.9/5 (95% CI 2.8 to 2.9). Regression analyses consistently showed more negative outcomes for those with comorbidities and differences across language groups.ConclusionCulturally and linguistically diverse communities experience significant psychological, social and financial impacts of COVID-19. A whole-of-government approach is needed to support rapid co-design of culturally safe support packages in response to COVID-19 and other national health emergencies, tailored appropriately to specific language groups and accounting for pre-existing health disparities.

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Shaping interventions to address waterpipe smoking in Arabic-speaking communities in Sydney, Australia: a qualitative study.

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