Do Thai parents discuss sex and AIDS with young adolescents? A qualitative study.

This qualitative study explored parents' and young adolescents' perceptions of communication related to sex and HIV/AIDS. Focus group discussions and group discussion were conducted among 67 adolescents and 30 parents. For the adolescents, group discussion using participatory activities was conducted, followed by five focus group discussions. Group discussions using participatory activities were conducted among parents. Thematic analysis indicated that the adolescents received inadequate information about sex and AIDS from their parents, whom they feared as providing negative judgment, and this represented a key barrier to such discussions. Their parents, on the other hand, reported that they believed their children were still too young to learn about and engage in sexual activities. The parents perceived barriers to communication included a lack of confidence and feelings of embarrassment. Nevertheless, they also recognized their important role in their child's sexual education. Collectively, these results draw attention to the need for a culturally appropriate program to strengthen parent-child communication skills for the topics of sex and HIV/AIDS.

Perspectives on provider behaviors: a qualitative study of sexual and gender minorities regarding quality of care.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) identified patients report receiving substandard care from healthcare providers. They face the fear and disturbing reality of discrimination when accessing health care. Without culturally sensitive treatment, nursing and other health professions do not properly care for this population. Following the recent trend towards awareness and need for inclusion of LGBTQ populations in healthcare, this paper provides a summary of the current literature on the treatment and needs of LGBTQ people and describes focus groups conducted to explore perceptions regarding provider behaviors. It concludes with a list of behaviors that enhance or impede quality care that can serve as a guide for healthcare professionals.

Health care transitions among youth with disabilities or special health care needs: an ecological approach.

This literature review of 46 articles uses the ecological model as a framework for organizing concepts and themes related to health care transition among youth with disabilities or special health care needs (SHCN). Transition involves interactions in immediate and distal environmental systems. Important interactions in immediate environments include those with family members, health care providers, and peers. Activities in distal systems include policies at the governmental and health system levels. The ecological model can help researchers and practitioners to design experimental interventions in multiple settings that ensure smooth transitions and support the well-being of youth with disabilities or SHCN.

Creating Project Talanoa: a culturally based community health program for U.S. Pacific Islander adolescents.

OBJECTIVE: This is an evaluation of the process and outcome of a research study to determine a culturally targeted health promotion program for U.S. Pacific Islander youth who are at risk for co-occurring problem behaviors, including risky sexual behavior, substance abuse, and interpersonal violence. DESIGN AND SAMPLE: An exploratory design was used and included qualitative interviews (N=54), focus groups (N=16), participant observation (over 3 years), and surveys (N=24) with Pacific Islander adults and youth. After identifying key cultural values and reviewing existing evidence-based prevention interventions, "Project Talanoa" was developed around 4 constructs: (1) cultural identity and pride, (2) teen health, (3) peer relations, and (4) family ties. The program was pilot tested and evaluated by 24 Pacific Islander adolescents (ages 12-15 years). RESULTS: Results indicate it was culturally appropriate, well liked by the participants, supported by parents and others in the community, and found to be feasible. CONCLUSIONS: Additional research is needed to test it for effectiveness. Project Talanoa provides a model for applying cultural concepts in the development of a risk reduction intervention for adolescents.

When family means more (or less) than genetics: the intersection of culture, family and genomics.

There is renewed interest in the use of family history to predict individual disease susceptibility, and as a result, standardized online family history tools are being developed and marketed as a "new genetic test." It is not known how cultural variations in definitions of family influence collection of these data or what is the best format to use. This is significant given that the populations who carry the greatest burden of the target diseases have not been considered in efforts to test these tools. A qualitative study with a convenience sample of 19 Japanese Americans and Samoan Americans, two groups at high risk for type 2 diabetes, was conducted to explore the process of collecting family history. A particularly strong finding was the high degree of acceptance experienced by the participants with the process and their pride in visualizing their family graphically displayed in pedigrees. It was also found that Samoans included those linked by nonbiological ties in their families, which reflects their cultural practices. Further research is needed to assess the most effective and efficient way to gather family history given the complexities surrounding the deceptively simple concept of family.

Gender disparities in health: attending to the particulars.

As we get a feel for this new century, collective creativity is called for while we confront the challenges presented. Globalization, with its flow of ideas, people, and materials is no longer a theoretical concept and its advantages and disadvantages are becoming clear. While the axiom that "all politics are local" remains relevant, world events touch all corners of the globe. In the world of science, there are exciting advances being made,but many of these are accompanied by concerns about unequal access to biomedicine and technology, and misplaced health care priorities. One of the effects of transnationalism is that multiculturalism becomes the norm so that the label "minority" begins to lose its meaning. In the field of women's health, the issues have not changed as much as the conceptualization of them. The fact that biology and society contribute to sex differences is well known, but understanding how these interact at all levels (from the molecular to the community level) requires innovative research strategies. Efforts to describe gender disparities in health status are inadequate unless they are linked with actions that will improve the well being of diverse populations. An approach suggested in this article is to direct research and policy attention to the lifestyles and needs of particular women living in a particular time and place in society. This is the first step before meaningful interventions can be implemented and the women's health paradigm expanded.

A view from the other side: the place of spirits in the Tongan social field.

Spirits are part of everyday life in the Kingdom of Tonga. This study explores beliefs about the supernatural by analyzing discourse on spirits and death and by examining two examples of contemporary cultural practice related to spirits and death. The anthropological concepts of the body and its cultural construction and of thirdspace as a landscape of the Tongan islands that emerges out of the physical and the perceived provide the framework for this investigation. Research findings suggest that spirits participate in the natural order of Tongan society and thus serve to help maintain cultural identity in the face of uncertain social change and a popular but contested prodemocracy movement. Spirits also function as a system of representation, mirroring an image of an ideal self, something that is continually under negotiation. Encounters between spirits of ancestors and their living descendants suggest an uneasy acceptance of death and a sense of irony about its inevitability.