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Developing culturally-responsive health promotion: insights from cultural experts.

ABSTRACT: Culturally-responsive health promotion initiatives are important to the creation of health equity for Indigenous and minority populations and these initiatives are complex and time-intensive to establish. The knowledge and resources of cultural experts are often pivotal in programs, yet there is minimal research on effective collaborations. The KāHOLO Project demonstrated strong success in the management of uncontrolled hypertension in the high-risk Indigenous population through a 6-month program based on the Hawaiian cultural dance of hula. This program was developed utilizing a community-based participatory research approach and implemented by cultural experts. To better understand the effectiveness of the research endeavor and program, six experienced hula experts and educators who delivered the community-based program were interviewed. As skilled and trusted cultural experts they set a safe supportive learning environment that promoted health and cultural goals. They articulated it was important that the program maintained cultural priorities and integrity. Through the methodical establishment of mutual respect, cooperation on research protocols and requirements was achieved. The development of cultural experts as health allies offers important inroads to the inclusion of minority and Indigenous cultures in health programming.

SUBMITTER: Look MA

PROVIDER: S-EPMC10108309 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Developing culturally-responsive health promotion: insights from cultural experts.

Look Mele A MA Maskarinec Gregory G GG de Silva Māpuana M Werner Kamuela K Mabellos Tricia T Palakiko Donna-Marie DM Haumea Stacy L SL Gonsalves Joseph J Seabury Aukahi A AA Vegas Jetney Kahaulahilahi JK Solatorio Cappy C Kaholokula Joseph Keaweʻaimoku JK

Health promotion international 20230401 2

Culturally-responsive health promotion initiatives are important to the creation of health equity for Indigenous and minority populations and these initiatives are complex and time-intensive to establish. The knowledge and resources of cultural experts are often pivotal in programs, yet there is minimal research on effective collaborations. The KāHOLO Project demonstrated strong success in the management of uncontrolled hypertension in the high-risk Indigenous population through a 6-month progra ...[more]

PMID: 37067166

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Project description:BackgroundA culturally responsive health workforce is essential to ensure the delivery of culturally safe health services that meet Aboriginal and Torres Strait Islander Peoples needs. In partnership with universities, placement providers play an essential role in creating opportunities for immersive experiences that enable students to develop their cultural responsiveness. This study evaluated students' experiences of an innovative student placement model embedded within an urban Aboriginal and Torres Strait Islander Community-Controlled Health Organisation.MethodsStudents completed pre and post placement surveys administered using a web-based interface. The surveys involved five-point Likert and open-ended response items exploring students' perceptions of their knowledge, skills development, awareness and self-development, and overall placement experience. Frequencies were calculated for the variables of interest and compared between pre and post surveys. The sign test for matched pairs was used to calculate differences between pre and post surveys, and a one-sided hypothesis test was utilised to determine if the level of agreement increased from pre to post survey. Qualitative data obtained for seven questions were thematically analysed using Groundwater Method, an Indigenous data analysis technique.ResultsBetween January 1, 2017, and June 30, 2019, 938 students from 32 disciplines were placed within the organisation and its Member services. Survey responses were received from 338 participants pre-placement, and 158 participants post-placement. The matched pre-post group contained 81 students. The results indicate significant positive changes in cultural responsiveness, skills development, awareness, and self-development when comparing pre- and post-placement responses. Students' overall satisfaction with the quality of their placement was positively associated with their intention to work in Aboriginal and Torres Strait Islander health contexts in the future. Key pre-placement themes included competence, cultural skills, support and fear, and key post-placement themes included expertise, cultural responsiveness, learning environment and challenges.ConclusionsIndigenous-led, regionally coordinated placements in urban Indigenous health contexts can support transformative learning and the development of a culturally responsive workforce. Universities should aim to develop reciprocal relationships with Indigenous-led organisations to support students to develop their cultural responsiveness and improve the provision of culturally safe care for Aboriginal and Torres Strait Islander Peoples. Future research should explore the longer-term impacts of student placements on cultural responsiveness, attitudes, values, and behaviours, as well as the experiences of Aboriginal and Torres Strait Islander Peoples interfacing with university students on placement in urban settings. NOTE: We will predominantly use the term 'Aboriginal and Torres Strait Islander Peoples', as opposed to 'Indigenous' or 'First Nations'. When the term 'Indigenous' is used, it largely relates to government policy - except when referring to Indigenisation of curriculum and Indigenous Knowledges - and where 'First Nations' is used, it is in a global context. In addition, we use the term 'Peoples' to signify that Aboriginal and Torres Strait Islander Peoples are not one People or Nation, but a collective of Peoples and Nations.

Project description:BackgroundBlack young adults suffer from psychological distress at either similar or greater rates than that of White Americans, yet they are seven times less likely to have access to or receive effective treatments. Fortunately, mobile-health (mHealth) technology may transform mental health services and address disparities in mental healthcare. The current study utilized focus groups of Black young adults to inform the development of culturally-adapted mHealth using quantitative and qualitative approaches.MethodsThe study utilized a mixed-methods approach, in that qualitative (i.e., mini focus groups, n=11) and quantitative methods (i.e., self-report surveys) were used to explore the research questions. Participants included African American young adults (n=38, Mage =21). Participants completed self-report questionnaires prior to focus group facilitation. Correlational analyses were used to answer the quantitative research questions, and thematic analysis was used to answer the qualitative research questions.ResultsThe qualitative findings highlighted that sociocultural experiences impact mental health and treatment seeking attitudes. Despite these findings, participants highlighted a variety of desired features and content that should be incorporated into future culturally-adapted mHealth interventions. Participants also highlighted both positive and negative aspects of current mHealth technologies for mental health. Finally, the study found that on average, participants had positive attitudes towards mental health, mental health treatments, and utilizing mHealth for mental health. Participants also had strong desires for culturally-adapted mHealth interventions. Bivariate correlations also revealed significant associations between vicarious online racial discrimination and mHealth attitudes, as well as racial identity and mHealth attitudes.ConclusionsIn summary, the current study highlights that there is an urgent need for mHealth technology for mental health symptoms for African American young adults and presents a variety of features, content, and design/development considerations for future researchers.

Project description:The increasing focus of healthcare systems worldwide on long-term care highlights the need for culturally sensitive Health-Related Quality of Life instruments to accurately capture perceived health of various populations. Such instruments require a contextualized conceptual framework of health domains, which is lacking in some socio-cultural contexts. We developed a comprehensive and culturally sensitive conceptual framework of health domains relevant to the Singaporean population. We recruited Singaporeans/ permanent residents, English/ Chinese-speaking, with/ without chronic illnesses to participate in focus group discussions (FGDs) and in-depth interviews (IDIs). We elicited health areas participants perceived to be important for them to be happy and satisfied with life. To encourage spontaneous emergence of themes, we did not specify any aspect beyond the broad domains of Physical, Mental, and Social health so as not to limit the emergence of new themes. Themes from the transcripts were distilled through open coding (two independent coders), then classified into more abstract domains (each transcript coded independently by two coders from a pool of six coders). From October 2013 to August 2014, 121 members of the general public participated in 18 FGDs and 13 IDIs (44.6% males, mean age: 53.3 years 77% Chinese, 9% Malay, 12% Indian, 63% with chronic illness) while 13 healthcare workers participated as patient-proxies in three FGDs. Thematic analysis identified 27 domains. The 15 physical domains included physical appearance, energy, physical fitness, and health and resistance to illness. The nine mental domains included emotions, self-esteem, and personal freedom. The three social domains were social contact, social relationships, and social roles. This conceptual framework reflected physical, mental, and social dimensions of well-being, suggesting that the Singapore population's views on health support the World Health Organization's definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

Project description:ObjectivesImmigrant and sexually/gender-diverse women (henceforth, women) face inequities in access to and quality of care. As a result, many seek health information from community agencies perceived as culturally safe. We aimed to generate knowledge on capacity needed for culturally safe community agency health promotion.DesignTheoretical rapid review.Data sourcesStudies identified in MEDLINE, EMBASE, CINAHL, PsycINFO, Sociological Abstracts, Cochrane Library and the Joanna Briggs Institute Database of Systematic Reviews.Eligibility criteriaStudies published in 2013 or later on health promotion for ethnoculturally, sexually and gender-diverse women led by community agencies (eg, settlement, cultural, support and faith).Data extraction/synthesisWe extracted data on study characteristics, cultural tailoring, implementation with the Reach Effectiveness Adoption Implementation framework and health promotion capacity with the New South Wales framework.ResultsWe included 19 studies published from 2017 to 2023. Most focused on health promotion to African or Latin American persons in faith-based organisations. Few studies focused solely on women, and no studies focused on or included 2SLGBTQ women. Few studies described cultural tailoring beyond the use of participants' first language. Training of community health workers (CHWs) to deliver health promotion education, and CHW in-person group training of health promotion participants on a wide range of topics resulted in improved knowledge, self-efficacy, intention to modify behaviour, behaviour change and health outcomes. A few studies yielded some insight into what community agencies need to enable health promotion: dedicated funding and personnel, training in healthcare issues, space and partnerships with academic and healthcare organisations.ConclusionsThis study confirmed and enhanced our understanding of the health promotion role of community agencies and identified gaps that can inform future research on how to achieve culturally safe community agency health promotion for diverse women.

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Developing culturally-responsive health promotion: insights from cultural experts.

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Developing culturally-responsive health promotion: insights from cultural experts.

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