Perceptions, Knowledge, and Practices Concerning Indoor Environmental Pollution of Parents or Future Parents.

Indoor pollutants can have short- and long-term health effects, especially if exposure occurs during prenatal life or early childhood. This study describe the perceptions, knowledge, and practices of adults concerning indoor environmental pollution. Adults of 18 to 45 years of age were recruited in the department of Ille-et-Vilaine (Brittany-France) in 2019 through a stratified random draw in the waiting rooms of general practitioners (GPs) (n = 554) who completed a self-questionnaire. The 71% who had already heard of this type of pollution were older (p = 0.001), predominantly women (p = 0.007), not expecting a baby (p = 0.005), and had a higher knowledge score (p < 0.001). The average knowledge score was 6.6 ± 6.6 out of 11, which was higher for participants living in a couple and with a higher level of education (p < 0.001). Some practices were well implemented (>80% of participants) (aeration during renovation) whereas others were insufficiently practiced (<60% of participants) (paying attention to the composition of cosmetic products). Factors associated differed depending on the frequency of integration: living in a couple and having a child for well implemented practices and educational level, knowledge level, and perception for those under implemented. Knowledge must be improved to modify perceptions and certain practices, making sure not to increase social inequalities in health.

Mixed and misunderstandings: An exploration of the meaning of racism with maternal, child, and family health nurses in South Australia.

AIMS: The aim of this study was to explore child and family health nurses' (CaFHNs) understanding of racism. BACKGROUND: Despite a growing literature examining racism in health care, few studies have explored health professionals' understanding of racism and how they manage it in practice. DESIGN: A qualitative descriptive design was employed. METHODS: Five focus group discussions were held from January-June 2013 with 31 maternal, CaFHNs working across metropolitan South Australia. Data were analysed using thematic analysis with discourse analytic techniques. FINDINGS: Focus group discussions identified three major themes: the relationship between racism and children's health care; perception of racist health system structures that have an impact on choice and relationship building; and the need for professionals to manage the tensions arising in everyday healthcare practice. CONCLUSIONS: Limited understandings of individual, structural, and ideological racism and racist practice were found. These were underpinned by discourses of multiculturalism and individualism within a framework of democratic racism. There is urgent need for nursing practice and pedagogy to centralize race and racialization to address inequities in health care.

Applying ecological modeling to parenting for Australian refugee families.

Children in families with parents from refugee backgrounds are often viewed as a vulnerable group with increased risks of developing physical or psychological problems. However, there is very little research regarding the strategies that parents might use to parent their children in a new country while they also manage the interrelated challenges of poverty, social isolation, maternal stress, and mental ill health that often go along with resettlement. We explore the application of ecological modeling, specifically at individual, institutional, and policy levels, within an Australian context to critique the factors that shape the development of parenting capacity within refugee families settling in a new Western country. Ecological modeling enables examination of how public policy at local state and national levels influences the individual and family directly and through the organizations that are given the task of implementing many of the policy recommendations. Recommendations for health practice and research are made.

An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition.

OBJECTIVE: This research explored how the concept of cultural competence was represented and expressed through health policies that were intended to improve the quality and efficacy of healthcare provided to families from culturally marginalised communities, particularly women and children with refugee backgrounds. METHOD: A critical document analysis was conducted of policies that inform healthcare for families from culturally marginalised communities in two local government areas in South Australia. RESULTS: The analysis identified two major themes: lack of, or inconsistent, definitions of 'culture' and 'cultural competency' and related terms; and the paradoxical use of language to determine care. CONCLUSIONS: Cultural competence within health services has been identified as an important factor that can improve the health outcomes for families from marginalised communities. However, inconsistency in definitions, understanding and implementation of cultural competence in health practice makes it difficult to implement care using these frameworks. IMPLICATIONS: Clearly defined pathways are necessary from health policy to inform culturally competent service delivery. The capacity for policy directives to effectively circumvent the potential deleterious outcomes of culturally incompetent services is only possible when that policy provides clear definitions and instructions. Consultation and partnership are necessary to develop effective definitions and processes relating to cultural competence.

Enterprising social wellbeing: social entrepreneurial and strengths based approaches to mental health and wellbeing in "remote" Indigenous community contexts.

OBJECTIVE: Social enterprises are market-based activities that provide social benefits through the direct engagement of people in productive activities. Participation in social enterprise development brings psychosocial wellbeing benefits, by strengthening family networks, enhancing trust, increasing self-reliance and social esteem and promoting cultural safety. Our objective is to explore how social enterprise activities can meet community needs and foster self-sustainability while generating profits for redistribution as social investment into other ventures that aid social functioning and emotional well-being. CONCLUSIONS: Social entrepreneurship enhances both interdependence and independence. Concomitant mental health and social wellbeing dividends accrue overtime to communities engaged in self-determined enterprise activities. Social entrepreneurship builds social capital that supports social wellbeing. Strengths-based approaches to social entrepreneurship can assuage disempowering effects of the "welfare economy" through shifting the focus onto productive activities generated on people's own terms.

How can country, spirituality, music and arts contribute to Indigenous mental health and wellbeing?

OBJECTIVE: Mental health and social and emotional wellbeing (SEWB) have been linked as outcomes of attachment to country, spirituality, and engagement in music and arts, particularly for Indigenous Australians. It is not clear how this occurs, even though the links seem substantial. METHOD: We explore how mental health and SEWB may be linked to attachment to country, spirituality, and engagement in music and arts by reviewing literature and presenting examples from our research with Indigenous communities. Rather than abstracting, our goal is to describe specific examples encompassing the rich contextual details needed to understand the factors contributing to mental health and SEWB. RESULTS: While engagement in music is often seen as benefiting mental health because thoughts and feelings can be expressed in less public ways, it can also lead to employment and access to economic and social resources. Attachment to country also shows a plethora of positive outcomes which can contribute to mental health and SEWB even when not explicitly aimed at doing so, such as reducing conflictual situations. CONCLUSIONS: We conclude that more detailed, contextual research is required to fully explore the links between creative enterprises and mental health and SEWB outcomes.

Body composition and cardiorespiratory fitness among refugee Somali women living in New Zealand.

The purpose of this study was to compare the body composition and cardiorespiratory fitness levels of a sample of refugee Somali women living in New Zealand with normative data. Refugee Somali women were invited to participate in sessions to assess physical fitness and body measurements. Height, bodyweight and waist and hip circumference were measured. The Rockport Fitness Walk Test was used to estimate the women's cardiorespiratory fitness levels. Thirty-one women between 12 and 66 years old participated in this study. There was a significantly greater proportion (71.4%) of participants with a BMI in the overweight or obese range (>or=25 kg/m2) compared to normative New Zealand women's data (49.3%; p = 0.015). The proportion of Somali women (42%) with a waist-to-hip ratio in excess of 0.8 was higher than that of New Zealand women (35.6%), but not statistically so. All women over 30 years of age (n = 12) had an estimated VO2max below the 50th percentile with eight participants below the 10th percentile. The extent of overweight and obesity and low fitness levels, particularly among the older Somali women in this study, suggests that Somali women are at increased risk of developing lifestyle related diseases.

Advocacy as a means to an end: assisting refugee women to take control of their reproductive health needs.

Negotiating reproductive rights is particularly complex for resettling migrant women from refugee backgrounds. In our ongoing work with women who have fled from countries in Africa and the Middle East, and have resettled in Australia and New Zealand, subtleties of discrimination and perceptions of human rights discriminations were revealed through the complex interplay between research and advocacy. Community Based Participatory Research (CBPR) has therefore been critical in assisting women to identify their needs and negotiate acceptable solutions with health services. This paper presents qualitative and quantitative findings of research with women from refugee backgrounds in Australia (n = 255) and New Zealand (n = 64). The research questions were a combination of community-driven and researcher initiated issues and the projects developed through a continuous iterative process involving feedback from women in the community. We highlight the essential role of advocacy in CBPR and how that can enhance research quality. We argue for the justification of this approach as not only valid and credible but essential in research with these and other communities.

Physical activity programs for refugee Somali women: working out in a new country.

Islamic refugee women from non-westernized countries face a number of challenges in adapting to their new country, especially when that new country is westernized and is not Islamic. Refugees are primarily women and children, so it is important that women be in their best health because they usually bear the responsibility of caring for each other and children, often in very difficult situations. Maintaining or obtaining good levels of physical activity contributes to good health: mentally, physically and socially. At the request of women in the local Somali community, a number of initiatives were taken to increase their opportunities for physical activity. Through interviews, observations and conversations we explored barriers to fitness and exercise, the social, physical, and cultural effects of physical activity, and solutions to facilitate Somali women's access to fitness and exercise opportunities. Physical activity interventions included exercise classes in a community center used by the Somali community, trial memberships at a local women-only fitness center, and walking and sports groups. We discuss the procedural issues relating to setting-up these physical activity opportunities, the results of interviews with 37 of the women about their health and perceptions and issues relating to the physical activity options, and our recommendations for setting up similar classes with other Somali or Islamic communities.