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1.
BMC Health Serv Res ; 19(1): 477, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299950

RESUMO

BACKGROUND: Attention to culture and its impact on health care can improve the quality of care given, add to our understanding of health care among culturally diverse populations, and encourage a more holistic approach to health care within general care. Connection to culture is important to Aboriginal peoples, and integrating Aboriginal culture into general care in residential aged care facilities may contribute to improving care delivery and outcomes for residents. The literature to date revealed a lack of understanding of the capacity of residential aged care and the health practices of carers in relation to providing cultural care for Aboriginal people. This study aimed to explore how cultural care needs are maintained for Aboriginal residents from their own and their carers' perspectives. METHODS: Applying an Aboriginal centered research method, an Interpretive Descriptive Approach was used as a theoretical framework to explore data in this study. Semi structured audio-recorded interviews were conducted. An additional file provides a complete description of the interview questions used as a guide for the study [see Additional file 1]. Three Residential Aged Care Centres, in South Australia were used i.e., two rural from centres and one urban metropolitan centre. Seven Aboriginal residents and 19 carers participated in interviews. Data was transcribed and an interpretive analysis was employed to code the transcribed data for themes and sub-themes. The study was guided by an Aboriginal community advisory group with an aim to work under the principle of reciprocity; giving back to the communities, participants and those where the research results may have been relevant. RESULTS: Three themes emerged from the views of the residents and carers: (i) lack of resources and funding; (ii) care practice; and (iii) marginalisation of Aboriginal culture within aged care facilities. CONCLUSION: The findings suggest that carers and residents believe cultural inclusion in general care practices may enrich Aboriginal residents' daily life, health and well-being in residential aged care facilities. This study may provide carers, aged care centre managers and policy makers with information on the need of resources, funding, organised care plan and management, and cultural competency of carers to be considered to improve Aboriginal aged care protocols for integrating cultural care into practice.


Assuntos
Assistência à Saúde Culturalmente Competente/etnologia , Instituição de Longa Permanência para Idosos , Determinação de Necessidades de Cuidados de Saúde , Grupo com Ancestrais Oceânicos , Espiritualidade , Idoso , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/psicologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Pesquisa Qualitativa , Austrália do Sul
2.
Plast Surg Nurs ; 39(2): 35-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31136555

RESUMO

Orofacial clefts are one of the most common global birth defects. Orofacial clefts may be part of a syndrome or an isolated birth defect, and affect approximately 1-1.5 per 1,000 live births worldwide with noted inequalities across geographical areas and cultures. In the United States, Asian American populations have a substantially higher incidence of cleft lip with or without cleft palate (2/1,000 live births). Orofacial clefts are a key health issue with substantial health care costs, and associated medical, psychological, and social ramifications. It has been estimated that the health care costs within the United States are approximately $697 million over a child's lifetime. In disorders like orofacial clefts, because of the complexity of the condition and subsequent medical interventions, as well as the cultural intricacies of the Asian culture, it requires significant knowledge and understanding by the health care providers. In order to provide optimal and safe cleft care, reduce health care costs, and improve the outcomes for the Asian American population, a culturally sensitive, multidisciplinary, and coordinated approach is needed. Increased culturally specific education, early access to prenatal care, and ongoing infant and pediatric health care are essential.


Assuntos
Americanos Asiáticos/psicologia , Fenda Labial/cirurgia , Fenda Labial/epidemiologia , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/métodos , Humanos , Fatores de Risco , Estados Unidos/epidemiologia , Estados Unidos/etnologia
4.
Trials ; 20(1): 158, 2019 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-30832708

RESUMO

BACKGROUND: Difficulties with delaying gratification, coping with frustration, and regulating emotions are significant predictors of aggression and behavioural and interpersonal problems early in life and mental health disorders during childhood, adolescence, and adulthood. Mental health problems generate a high burden of disease in society in general, and there is a significant treatment gap, especially among economically vulnerable populations. Prevention strategies appear to be the more recommendable options, mainly if these interventions can be implemented early in life and at low cost. Few preventive interventions aiming to increase resilience in the face of adversity have been rigorously evaluated among Chilean preschoolers. Substantial international evidence indicates that strengthening basic psychological skills, such as emotion regulation and social problem-solving, can reduce the incidence of mental pathology and improve various academic indicators. The curriculum of the Interpersonal Cognitive Problem-Solving Programme, also known as I Can Problem Solve (ICPS), is focussed on the development of the cognitive process and children's social problem-solving skills. ICPS is effective at increasing prosocial behaviours and reducing aggressive behaviour among preschoolers. ICPS provides children with the skills to think about how to solve problems using sequenced games, discussion, and group-interaction techniques focussed on listening to, and observing, others, promoting empathy and alternative and consequential thinking. The aims of this study are (1) to develop a culturally appropriate version of the ICPS programme and (2) to evaluate the acceptability and feasibility of the adapted version of ICPS among vulnerable schools in Santiago, Chile, conducting a pilot randomised controlled trial with three arms: (1) the ICPS programme delivered by an internal early teacher, (2) the ICPS programme delivered by an external early teacher, and (3) a control group. METHODS AND DESIGN: This is a pilot, three-armed randomised controlled trial of the adapted version of ICPS with an enrolment target of 80 preschoolers attending four schools per arm. Children in both intervention groups will receive the ICPS programme: 59 sessions of 20 min each delivered three times a week by trained internal or external early teachers over 5-6 months. Internal teachers are part of the school staff, and external teachers are facilitators hired by the research team to go to schools and deliver the intervention during a normal school day, working together with the early teacher present in the classroom. The intervention consists of games using pictures, puppets, and simple role-playing techniques to facilitate the learning process. Cognitive regulation, emotion recognition, social-problem-solving skills, and psychological functioning will be measured at baseline and after the intervention. DISCUSSION: No previous studies in Spanish-speaking Latin American countries have been conducted to explore the acceptability and feasibility of ICPS to provide information to evaluate the effectiveness of this intervention on a larger scale. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03383172 . Registered on 26 December 2017.


Assuntos
Comportamento Infantil , Terapia Cognitivo-Comportamental , Assistência à Saúde Culturalmente Competente , Transtornos do Neurodesenvolvimento/prevenção & controle , Adaptação Psicológica , Fatores Etários , Comportamento Infantil/etnologia , Pré-Escolar , Chile/epidemiologia , Cognição , Características Culturais , Assistência à Saúde Culturalmente Competente/etnologia , Emoções , Estudos de Viabilidade , Feminino , Humanos , Masculino , Saúde Mental , Transtornos do Neurodesenvolvimento/diagnóstico , Transtornos do Neurodesenvolvimento/etnologia , Transtornos do Neurodesenvolvimento/psicologia , Projetos Piloto , Resolução de Problemas , Ensaios Clínicos Controlados Aleatórios como Assunto , Resiliência Psicológica , Método Simples-Cego , Comportamento Social , Fatores de Tempo , Resultado do Tratamento
5.
Acad Psychiatry ; 43(3): 300-305, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30617998

RESUMO

OBJECTIVE: Promoting awareness in residency training about the influence of religion on the doctor's and patient's ability to negotiate a patient-centered treatment plan is challenging and yet important for improving the quality of mental health care for religious individuals. This paper aims to explore the use of community partners and non-psychiatry faculty to provide this education within psychiatry residency programs. METHODS: Fifty-one psychiatry residents at an academic psychiatric hospital took part in a 4-h interdisciplinary workshop aimed at improving doctors' overall approach to treating African-American Christian patients. Community-based African-American clergy and mental health professionals, hospital-based psychiatrists, and primary care physicians facilitated educational sessions. A majority of the facilitators were African-American. A pre- and post-workshop survey was administered to measure change in participant attitudes and comfort levels associated with exposure to the workshop. Paired t tests on three subscales were used to calculate change in attitudes on pre- to post-workshop surveys. RESULTS: Resident scores on each of the three factor subscales increased significantly between pre- and post-workshop assessments: comfort in discussions with patients about spirituality [t [17] = 2.758; p = 0.013]; willingness to collaborate with clergy [t [16] = 3.776; p = 0.002]; and importance of religion to mental health [t [17] = 3.645; p = 0.002]. CONCLUSION: Findings suggest that collaboration between academic and community-based clergy, physicians, and other mental health providers may be a feasible method of improving psychiatry trainees' comfort in addressing religion in psychiatric care to ultimately provide more culturally competent care.


Assuntos
Afro-Americanos , Assistência à Saúde Culturalmente Competente , Assistência Centrada no Paciente , Psiquiatria/educação , Adulto , Atitude do Pessoal de Saúde , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/normas , Feminino , Humanos , Internato e Residência , Masculino , Saúde Mental/etnologia , Pessoa de Meia-Idade , Assistência Centrada no Paciente/normas , Religião e Psicologia , Adulto Jovem
6.
Australas J Ageing ; 38(1): 39-46, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30632245

RESUMO

OBJECTIVE: To examine the prevalence and context of racism self-reported by older Aboriginal and Torres Strait Islander people. METHODS: The 2015 National Aboriginal and Torres Strait Islander Survey was used to measure the prevalence, contexts and demographic differences in reports of racism. Multivariable logistic regression was used to examine the association of age with racism in later life. RESULTS: A sizeable minority of older Aboriginal people reported experiences of unfair treatment (31%) and avoidance (15%), oftentimes occurring in contexts critical to human capital investments. Specific demographic groups, including those with higher levels of education, were more likely to report experiences of unfair treatment. The prevalence of unfair treatment and avoidance remains relatively high in later life (albeit lower than younger ages), with a significant reduction from age 65. CONCLUSION: Addressing racism, particularly in contexts crucial to human capital, is important for the health and well-being of older Aboriginal people.


Assuntos
Envelhecimento/psicologia , Aprendizagem da Esquiva , Grupo com Ancestrais Oceânicos/psicologia , Racismo/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Envelhecimento/etnologia , Atitude do Pessoal de Saúde/etnologia , Austrália , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde/etnologia , Escolaridade , Feminino , Empregados do Governo/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Opinião Pública , Racismo/etnologia , Fatores de Risco , Autorrelato , Fatores de Tempo , Adulto Jovem
7.
Asian J Psychiatr ; 39: 53-57, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30572272

RESUMO

Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by social, communication, and behavioral deficits. Fortunately, early intervention has proved to be of significant benefit in the lives of children with ASD. However, timely access to health services and support requires equitable access, which is often a challenge for immigrant families. Barriers to equal access and support for immigrant families of children with ASD include cultural beliefs about child development and ASD, delayed diagnosis, access to services, and negative perceptions of services. There is a shortage of studies that explore how to increase understanding and collaboration among the immigrant population and health care practitioners to address these barriers. The barriers can indeed be appropriately addressed with structured programs and cultural models. The objectives of this article are to shed light on how barriers impact outcomes of immigrant children with ASD and to describe a culturally sensitive program model to address the barriers and provide awareness, education, and interventions for these immigrant families. The South Asian Autism Awareness Center in Toronto, Canada is presented as an example of such a model.


Assuntos
Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Assistência à Saúde Culturalmente Competente/métodos , Emigrantes e Imigrantes , Acesso aos Serviços de Saúde/estatística & dados numéricos , Transtorno Autístico/etnologia , Criança , Assistência à Saúde Culturalmente Competente/etnologia , Humanos
8.
Reprod Health ; 15(1): 48, 2018 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-29540225

RESUMO

BACKGROUND: Iron deficiency remains a prevalent adolescent health problem in low income countries. Iron supplementation is recommended but improvement of iron status requires good adherence. OBJECTIVES: We explored factors affecting adolescent adherence to weekly iron and/or folic acid supplements in a setting of low secondary school attendance. METHODS: Taped in-depth interviews were conducted with participants in a randomised, controlled, periconceptional iron supplementation trial for young nulliparous women living in a rural, malaria endemic region of Burkina Faso. Participants with good, medium or poor adherence were selected. Interviews were transcribed and analysed thematically. RESULTS: Thirty-nine interviews were conducted. The community initially thought supplements were contraceptives. The potential benefits of giving iron supplementation to unmarried "girls" ahead of pregnancy were not recognised. Trial participation, which required parental consent, remained high but was not openly admitted because iron supplements were thought to be contraceptives. Unmarried non-school attenders, being mobile, were often sent to provide domestic labour in varied locations. This interrupted adherence - as did movement of school girls during vacations and at marriage. Field workers tracked participants and trial provision of free treatment encouraged adherence. Most interviewees did not identify health benefits from taking supplements. CONCLUSIONS: For success, communities must be convinced of the value of an adolescent intervention. During this safety trial, benefits not routinely available in iron supplementation programmes were important to this low income community, ensuring adolescent participation. Nevertheless, adolescents were obliged to fulfil cultural duties and roles that interfered with regular adherence to the iron supplementation regime. TRIAL REGISTRATION: Trial Registration at clinicaltrials.gov : NCT01210040.


Assuntos
Fenômenos Fisiológicos da Nutrição do Adolescente , Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Ferro na Dieta/administração & dosagem , Cooperação do Paciente , Cuidado Pré-Concepcional , Saúde da População Rural , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente/etnologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etnologia , Anemia Ferropriva/prevenção & controle , Burkina Faso/epidemiologia , Estudos de Coortes , Assistência à Saúde Culturalmente Competente/etnologia , Países em Desenvolvimento , Feminino , Grupos Focais , Ácido Fólico/uso terapêutico , Seguimentos , Humanos , Ferro na Dieta/uso terapêutico , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/etnologia , Defeitos do Tubo Neural/prevenção & controle , Cooperação do Paciente/etnologia , Prevalência , Sistemas de Apoio Psicossocial , Pesquisa Qualitativa , Características de Residência , Saúde da População Rural/etnologia
9.
Reprod Health ; 15(1): 51, 2018 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-29559000

RESUMO

BACKGROUND: South Sudan has one of the worst health and maternal health situations in the world. Across South Sudan, while maternal health services at the primary care level are not well developed, even where they exist, many women do not use them. Developing location specific understanding of what hinders women from using services is key to developing and implementing locally appropriate public health interventions. METHODS: A qualitative study was conducted to gain insight into what hinders women from using maternal health services. Focus group discussions (5) and interviews (44) were conducted with purposefully selected community members and health personnel. A thematic analysis was done to identify key themes. RESULTS: While accessibility, affordability, and perceptions (need and quality of care) related barriers to the use of maternal health services exist and are important, women's decisions to use services are also shaped by a variety of social fears. Societal interactions entailed in the process of going to a health facility, interactions with other people, particularly other women on the facility premises, and the care encounters with health workers, are moments where women are afraid of experiencing dignity violations. Women's decisions to step out of their homes to seek maternal health care are the results of a complex trade-off they make or are willing to make between potential threats to their dignity in the various social spaces they need to traverse in the process of seeking care, their views on ownership of and responsibility for the unborn, and the benefits they ascribe to the care available to them. CONCLUSIONS: Geographical accessibility, affordability, and perceptions related barriers to the use of maternal health services in South Sudan remain; they need to be addressed. Explicit attention also needs to be paid to address social accessibility related barriers; among others, to identify, address and allay the various social fears and fears of dignity violations that may hold women back from using services. Health services should work towards transforming health facilities into social spaces where all women's and citizen's dignity is protected and upheld.


Assuntos
Violações dos Direitos Humanos/prevenção & controle , Serviços de Saúde Materna , Aceitação pelo Paciente de Cuidados de Saúde , Pessoalidade , Saúde da População Rural , Estresse Psicológico/etiologia , Adolescente , Adulto , Assistência à Saúde Culturalmente Competente/etnologia , Países em Desenvolvimento , Medo/psicologia , Feminino , Grupos Focais , Violações dos Direitos Humanos/etnologia , Violações dos Direitos Humanos/psicologia , Humanos , Determinação de Necessidades de Cuidados de Saúde , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gravidez , Sistemas de Apoio Psicossocial , Pesquisa Qualitativa , Saúde da População Rural/etnologia , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia , Sudão , Adulto Jovem
10.
S D Med ; 71(11): 489-493, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30742747

RESUMO

As the U.S. becomes more diverse, so does the population presenting to healthcare providers. As a result, cultural competency has become a vital aspect of healthcare in the U.S. Providers need to understand not only how their treatments are appropriate for a specific cultural group, but also how they can most effectively communicate with and establish relationships with these patients. One of the distinct cultural groups living in South Dakota are the Hutterites. While members of the Hutterite colonies use mainstream medical facilities for their health care, there is little information about the preparation of mainstream healthcare providers for the culture of this group and how this preparation may impact the services they provide to Hutterites. The purpose of this phenomenological study was to understand Hutterites' experiences with healthcare providers. Individual interviews were conducted with eight adults from a local Hutterite colony who had experience with mainstream healthcare providers. The qualitative analysis of these interviews resulted in two major themes: issues of healthcare culture and use of medical services only when needed. Certain aspects of Hutterite culture should be acknowledged when they present for medical treatment.


Assuntos
Assistência à Saúde Culturalmente Competente/etnologia , Grupos Étnicos , Pessoal de Saúde , Adulto , Humanos , Pesquisa Qualitativa , South Dakota/etnologia
11.
Australas Emerg Care ; 21(3): 93-98, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30998884

RESUMO

Lack of awareness about cultural and religious values and beliefs of patients presenting to Emergency Departments (ED) can compromise patient care and safety. Muslim Australians represent the fastest growing religious demographic group, with over a 77% growth in the last decade. The changing face of the Australian population requires that Australian health care carefully consider the dominant Western cultural paradigm currently influencing health care delivery. This predominance is particularly critical in the ED, as it is a common gateway into health care services. This scoping review explores the evidence of key components and impacts of culturally safe care (CSC) in the ED for staff and care consumers who identify as Muslim. A systematic search using electronic (five databases) and heading searching methods for primary research was undertaken; followed by a rigorous screening and quality appraisal process. Included articles were assessed for similarities and differences, and the subsequent content was grouped, synthesized and tested for clinical salience using the six stages of the Arksey and O'Malley methodological framework. The Mixed Method Assessment Tool was used to appraise the quality of included literature. Three studies were included in the analysis. Religious beliefs and practices are common among the individuals who identify as Muslim. Such beliefs and practices could influence patients' understanding of their conditions, their acceptance of care delivery, their processes of decision-making, and their commitment to treatment regimens and coping strategies. These ideals could also impact on a patient's care seeking behaviors and on family and community acceptance of care delivery. There is a serious lack of evidence around the delivery of culturally safe care in the ED locally and internationally. While many EDs may have procedure documents or staff care guidelines, it is unclear as to how these guides were derived, as there is minimal published evidence exploring any issues around provision of CSC to Muslim ED care consumers.


Assuntos
Assistência à Saúde Culturalmente Competente/normas , Serviço Hospitalar de Emergência/normas , Islamismo/psicologia , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/métodos , Serviço Hospitalar de Emergência/organização & administração , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente/etnologia , Queensland/etnologia , Religião e Medicina
12.
Transcult Psychiatry ; 54(5-6): 626-652, 2017 Oct-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29226793

RESUMO

Westernized approaches to mental health care often place limited emphasis on refugees' own experiences and cultural explanations of symptoms and distress. In order to effectively assess community mental health needs and develop interventions grounded in local needs, mental health programs need to be informed by an understanding of cultural features of mental health, including cultural idioms of distress (CIDs). The current study aims to explore CIDs among Somali refugees displaced in Kenya to understand mental health needs in cultural context and serve the community in a culturally responsive and sensitive manner. This research was conducted as a two-phase qualitative study. First, key informant interviews with Somali mental health stakeholders generated a list of 7 common Somali CIDs: buufis, buqsanaan, welwel, murug, qaracan, jinn, and waali. Typologies of each CID were further explored through four focus group interviews with Somali community members. The findings from a template analysis revealed Somali lay beliefs on how trauma and daily stressors are experienced and discussed in the form of CIDs and how each term is utilized and understood in attributing symptoms to associated causes. This study highlights the need to incorporate colloquial terms in mental health assessment and to adopt a culturally relevant framework to encourage wider utilization of services and religious/spiritual support systems.


Assuntos
Características Culturais , Assistência à Saúde Culturalmente Competente/etnologia , Trauma Psicológico/etnologia , Refugiados/psicologia , Estresse Psicológico/etnologia , Adulto , Feminino , Humanos , Quênia/etnologia , Masculino , Somália/etnologia , Terminologia como Assunto
13.
Medisan ; 21(10)oct.2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-996172

RESUMO

Se presenta un proyecto de investigación que pretende promover la colaboración intercultural entre la atención sanitaria (estudiantes, enfermeros y médicos) y los curanderos y parteras tradicionales en los centros de salud rurales, a fin de examinar las necesidades y las circunstancias propias del contexto para elaborar medidas concretas que permitan integrar este contenido al currículo de las carreras de medicina y enfermería de la Universidad Técnica Particular de Loja, de la Universidad de Cuenca y de otros centros de ese tipo en Ecuador. El proyecto tiene como finalidad vincular a los proveedores de atención sanitaria ya activos en las áreas rurales, tanto académicos como tradicionales, para intercambiar entre ellos.


An investigation project is presented aimed at promoting the intercultural collaboration between the health care staff (students, nurses and doctors) and the folk healers and traditional midwives in the rural health centers from Ecuador, in order to examine the necessities and the circumstances of the context to elaborate concrete measures that allow to integrate this content to the curriculum of the medicine and nursing careers of the Technical Particular University in Loja, from Cuenca University and from other centers of that type in the country. The project has as purpose to link the suppliers of health care who are already active in the rural areas, either as academic or as traditional, to exchange experiences among them.


Assuntos
Humanos , Masculino , Feminino , Religião e Medicina , Diversidade Cultural , Assistência à Saúde Culturalmente Competente/etnologia , Medicina Tradicional/métodos , Universidades , Comunicação , Comportamento Cooperativo , Características Culturais , Grupo com Ancestrais Nativos do Continente Americano
14.
Diabetes Educ ; 43(5): 441-448, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28793835

RESUMO

Purpose The African American church has long been recognized as a valuable partner for health interventions in the community. While an extensive literature exists documenting the potential efficacy of diabetes education programs in church settings, there has yet to be an effort to leverage spiritual beliefs and practices to promote diabetes self-management and shared decision making within a faith-based framework that is culturally tailored to the African American church. The purpose of this article is to describe the translation of a clinic-based diabetes education program into faith-based education curriculum tailored for use in the African American church. Conclusions Themes extracted from focus groups and input from a faith-based community partner provided a methodical and patient-informed foundation for culturally tailoring and piloting a diabetes self-management curriculum for the African American church setting. This study illustrates how spirituality can be incorporated into interventions to enhance health promotion and behavioral change among African Americans with diabetes. Participants in our study described how religious beliefs play an active role in many aspects of diabetes care, including self-management behaviors, coping strategies, and patient/provider communication. In addition, this intervention can serve as a model for the development of patient-centered health interventions.


Assuntos
Afro-Americanos/educação , Assistência à Saúde Culturalmente Competente/etnologia , Diabetes Mellitus , Educação de Pacientes como Assunto/métodos , Participação do Paciente , Protestantismo , Adulto , Idoso , Currículo , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Qualitativa , Autogestão/educação
15.
Prim Care Diabetes ; 11(6): 522-528, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28779981

RESUMO

AIMS: This study sought to determine and compare the metabolic control of type 2 diabetes mellitus (T2DM) in non-Nordic immigrants and native Nordics. The aim was also to describe and compare the request of supportive care between these two groups. METHODS: One hundred and eighty-four patients (n=184) coming to a routine check-up in a primary healthcare setting (PHC), were consecutively enrolled to the study during a period of one year. Data on therapeutic interventions, clinical measurements, healthcare consumption, and adherence to standard diabetes healthcare program were extracted from the patients medical record. Structured interviews on supportive care were conducted by diabetes trained nurses. If needed, a qualified interpreter was used. Comparisons were made between Nordic patients (n=151) and non-Nordic patients (n=33). RESULTS: Among T2DM patients in a setting of PHC, there was a difference in meeting the metabolic target HbA1c, between native Nordics and non-Nordic immigrants. There was also a difference in request on supportive care. The non-Nordic group significantly requested more and different supportive care. They also attended the standard diabetes program to a lesser degree. CONCLUSIONS: Culturally/individually adapted prevention is not only medically warranted but also requested by the patients themselves.


Assuntos
Assistência à Saúde Culturalmente Competente/etnologia , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/terapia , Emigrantes e Imigrantes , Necessidades e Demandas de Serviços de Saúde , Determinação de Necessidades de Cuidados de Saúde , Pacientes , Fatores Socioeconômicos , Populações Vulneráveis/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/psicologia , Feminino , Hemoglobina A Glicada/metabolismo , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/etnologia , Pacientes/psicologia , Atenção Primária à Saúde , Suécia/epidemiologia , Populações Vulneráveis/psicologia
16.
Public Health Nutr ; 20(16): 3019-3028, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28803580

RESUMO

OBJECTIVE: The present study aimed to explore how Australian local governments prioritise the health and well-being of Aboriginal populations and the extent to which nutrition is addressed by local government health policy. DESIGN: In the state of Victoria, Australia, all seventy-nine local governments' public health policy documents were retrieved. Inclusion of Aboriginal health and nutrition in policy documents was analysed using quantitative content analysis. Representation of Aboriginal nutrition 'problems' and 'solutions' was examined using qualitative framing analysis. The socio-ecological framework was used to classify the types of Aboriginal nutrition issues and strategies within policy documents. SETTING: Victoria, Australia. SUBJECTS: Local governments' public health policy documents (n 79). RESULTS: A small proportion (14 %, n 11) of local governments addressed Aboriginal health and well-being in terms of nutrition. Where strategies aimed at nutrition existed, they mostly focused on individual factors rather than the broader macroenvironment. CONCLUSIONS: A limited number of Victorian local governments address nutrition as a health issue for their Aboriginal populations in policy documents. Nutrition needs to be addressed as a community and social responsibility rather than merely an individual 'behaviour'. Partnerships are required to ensure Aboriginal people lead government policy development.


Assuntos
Prioridades em Saúde , Disparidades nos Níveis de Saúde , Governo Local , Saúde das Minorias , Modelos Organizacionais , Política Nutricional , Estado Nutricional , Assistência à Saúde Culturalmente Competente/ética , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/legislação & jurisprudência , Prioridades em Saúde/ética , Prioridades em Saúde/legislação & jurisprudência , Humanos , Saúde das Minorias/etnologia , Saúde das Minorias/legislação & jurisprudência , Determinação de Necessidades de Cuidados de Saúde , Política Nutricional/legislação & jurisprudência , Estado Nutricional/etnologia , Grupo com Ancestrais Oceânicos , Formulação de Políticas , Vitória
17.
Hawaii J Med Public Health ; 76(7): 190-198, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28721313

RESUMO

To help community health workers (CHW) meet increased demand for their services, it is essential to have data supported strategies for approaches to their training and capacity development. The objective of this paper is to report on the development, implementation, and evaluation of "Heart 101," a cardiovascular disease (CVD) training program, conducted among CHW in Hawai'i who serve Native Hawaiians and other Pacific Peoples (NHPP). Principles from Community-Based Participatory Research provided a framework to develop and implement the 5-hour training curriculum. Developers incorporated teaching strategies shown to be effective among learners that represent the majority of CHW, and included principles of adult learning theory and culture-based education. Training participants completed pre-, post-, and 6-months post-training knowledge tests, as well as demographic and participant satisfaction surveys. Data analysis based on pre- and post-training knowledge tests (n=30) indicated that Heart 101 significantly increased CVD knowledge by 32% (P < .001, t test). Long-term CVD competency measured at six-months post-training (n = 20) was also shown to be significant (P < .001, t test). Analysis of knowledge by subtopic suggested CHW strengths in clinical aspects of CVD and weaknesses in medical terminology and basic science aspects. These results, along with positive participant satisfaction, suggest that a culturally relevant and interactive course is a strong approach for CVD information dissemination to CHW serving NHPP communities, and provides insight on potential areas for special focus in their training. The demonstrated success of Heart 101 has positive implications for the standardization of CHW education and for their professional development.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Agentes Comunitários de Saúde/educação , Grupo com Ancestrais Oceânicos/educação , Ensino/normas , Adulto , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Agentes Comunitários de Saúde/estatística & dados numéricos , Pesquisa Participativa Baseada na Comunidade/estatística & dados numéricos , Assistência à Saúde Culturalmente Competente/etnologia , Currículo/normas , Currículo/estatística & dados numéricos , Feminino , Hawaii/etnologia , Educação em Saúde/métodos , Educação em Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos/etnologia , Desenvolvimento de Programas/métodos , Desenvolvimento de Programas/normas , Ensino/estatística & dados numéricos
18.
Am J Geriatr Psychiatry ; 25(9): 1029-1032, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28545833

RESUMO

OBJECTIVE: This study aims to culturally adapt, translate, and test the feasibility and acceptability of delivering cognitive stimulation therapy (CST) for persons with mild to moderate dementia in Chennai, India. METHODS: The adaptation followed a five-stage process in accordance with the formative method for adapting psychotherapy. Focus-group discussions with experts and feedback from participants, carers, and facilitators after two consecutive pilot studies provided the basis for adaptation. RESULTS: Substantial modifications were required. The adapted program was found to be an acceptable, enjoyable, and constructive by participants and carers alike. CONCLUSION: CST was successfully adapted for use in South India. Translations into other Indian languages using the adapted manual are required for nation-wide implementation. Large-scale clinical trials are required to replicate global reports on the efficacy and cost-effectiveness of CST in India across different settings.


Assuntos
Remediação Cognitiva/métodos , Assistência à Saúde Culturalmente Competente/etnologia , Demência/etnologia , Demência/reabilitação , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Estudos de Viabilidade , Feminino , Humanos , Índia , Masculino , Projetos Piloto
19.
Ann Behav Med ; 51(6): 868-878, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28432578

RESUMO

BACKGROUND: Evidence-based HIV treatment adherence interventions have typically shown medium-sized effects on adherence. Prior evidence-based HIV treatment adherence interventions have not been culturally adapted specifically for Black/African Americans, the population most affected by HIV disparities in the USA, who exhibit lower adherence than do members of other racial/ethnic groups. PURPOSE: We conducted a randomized controlled trial of Rise, a 6-month culturally congruent adherence counseling intervention for HIV-positive Black men and women. METHODS: Rise was delivered by a trained peer counselor who used a problem-solving approach to address culturally congruent adherence barriers (e.g., medical mistrust, HIV stigma) and assisted with linkage to supportive services. A total of 215 participants were randomized to the intervention group (n = 107) or a wait-list control group (n = 108). Adherence was assessed daily via electronic monitoring. RESULTS: In a repeated measures multivariate logistic regression model of dichotomous adherence (using a clinically significant cutoff of 85% of doses taken), adjusted for sociodemographic and medical covariates, adherence in the intervention group improved over time relative to the control group, (OR = 1.30 per month (95% CI = 1.12-1.51), p < 0.001), representing a large cumulative effect after 6 months (OR = 4.76, Cohen's d = 0.86). CONCLUSIONS: Rise showed a larger effect on adherence than prior HIV adherence intervention studies. For greater effectiveness, interventions to improve adherence among Black people living with HIV may need to be customized to address culturally relevant barriers to adherence. ( ClinicalTrials.gov #NCT01350544).


Assuntos
Afro-Americanos/etnologia , Aconselhamento/métodos , Assistência à Saúde Culturalmente Competente/etnologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/etnologia , Adesão à Medicação , Adulto , Idoso , Feminino , Humanos , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade
20.
Diabetes Educ ; 43(3): 272-285, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28447545

RESUMO

Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.


Assuntos
Assistência à Saúde Culturalmente Competente/métodos , Diabetes Mellitus Tipo 2/terapia , Terapia Familiar/métodos , Americanos Mexicanos/psicologia , Autogestão/métodos , Adulto , Assistência à Saúde Culturalmente Competente/etnologia , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/psicologia , Dieta para Diabéticos/etnologia , Dieta para Diabéticos/psicologia , Feminino , Humanos , Masculino , Projetos de Pesquisa , Autoeficácia , Autogestão/psicologia , Apoio Social , Estresse Psicológico/etnologia , Estresse Psicológico/psicologia
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