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1.
Nephrol Nurs J ; 47(1): 53-65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32083437

RESUMO

Understanding African-American families' experiences with treatment for kidney failure is necessary for informing the delivery of family-centered care and the design of appropriate interventions. This qualitative study explored treatment-related questions, concerns, and family impacts among African-American family members of patients with pre-kidney failure and kidney failure. Thirty-five family members participated in focus groups stratified by patients' treatment experiences (pre-kidney failure, in-center hemodialysis, peritoneal dialysis, awaiting living-donor kidney transplantation, or post-transplantation). Family members raised questions and concerns about the psychological, lifestyle, and practical aspects of treatment. Similarly, discussions about family impacts emphasized psychosocial effects, lifestyle consequences, and the provision and receipt of support. Efforts to address these questions, concerns, and perceived family impacts through additional research, early and tailored education, and supportive interventions are needed.


Assuntos
Afro-Americanos/psicologia , Atitude Frente a Saúde/etnologia , Família/etnologia , Insuficiência Renal/etnologia , Insuficiência Renal/terapia , Família/psicologia , Humanos
2.
BMC Health Serv Res ; 20(1): 24, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914997

RESUMO

BACKGROUND: Community Health Representatives (CHRs) overcome health disparities in Native communities by delivering home care, health education, and community health promotion. The Navajo CHR Program partners with the non-profit Community Outreach and Patient Empowerment (COPE), to provide home-based outreach to Navajo clients living with diabetes. COPE has created an intervention (COPE intervention) focusing on multiple levels of improved care including trainings for CHRs on Motivational Interviewing and providing CHRs with culturally-appropriate education materials. The objective of this research is to understand the participant perspective of the CHR-COPE collaborative outreach through exploring patient-reported outcomes (PROs) of clients who consent to receiving the COPE intervention (COPE clients) using a qualitative methods evaluation. METHODS: Seven COPE clients were selected to participate in semi-structured interviews one year after finishing COPE to explore their perspective and experiences. Qualitative interviews were recorded, transcribed, and coded to identify themes. RESULTS: Clients revealed that health education delivered by CHRs facilitated lifestyle changes by helping them understand key health indicators and setting achievable goals through the use of accessible material and encouragement. Clients felt comfortable with CHRs who respected traditional practices and made regular visits. Clients also appreciated when CHRs educated their family members, who in turn were better able to support the client in their health management. Finally, CHRs who implemented the COPE intervention helped patients who were unable to regularly see a primary care doctor for critical care and support in their disease management. CONCLUSION: The COPE-CHR collaboration facilitated trusting client-CHR relationships and allowed clients to better understand their diagnoses. Further investment in materials that respect traditional practices and aim to educate clients' families may foster these relationships and improve health outcomes. TRIAL REGISTRATION: clinicaltrials.gov: NCT03326206. Registered 9/26/2017 (retrospectively registered).


Assuntos
Nativos do Alasca/psicologia , Atitude Frente a Saúde/etnologia , Serviços de Saúde Comunitária/organização & administração , Diabetes Mellitus/etnologia , Índios Norte-Americanos/psicologia , Nativos do Alasca/estatística & dados numéricos , Agentes Comunitários de Saúde/psicologia , Relações Comunidade-Instituição , Comportamento Cooperativo , Diabetes Mellitus/terapia , Feminino , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Organizações sem Fins Lucrativos/organização & administração , Participação do Paciente , Relações Profissional-Paciente , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Estados Unidos
4.
BMC Public Health ; 19(1): 1429, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31672141

RESUMO

BACKGROUND: The feminization and ethnic diversification of HIV infection, has resulted in a call for gender- and culture-specific prevention strategies for at-risk groups including Latinos in the United States. The steadily changing demographic profile of the AIDS epidemic challenges prevention strategies to remain relevant and up-to-date, particularly in populations of women midlife and older where an understanding of risk remains under explored. As the CDC requests country-specific HIV risk profiles for Latino communities in the US, understanding the socio-economic, behavioral and personal risk reasons of HIV risk for older Dominican women is critical for prevention. METHODS: We conducted focus group discussions informed by the Theory of Gender and Power (TGP). The three constructs of the TGP: 1) Affective influences/social norms; 2) Gender-specific norms and. 3) Power and Authority guided the thematic analysis and identified themes that described the socio-cultural and contextual reasons that that contribute to perceptions of HIV risk. RESULTS: Sixty Dominican American women ages 57-73 participated in our focus group discussions. Sexual Division of Labour: 1) Economic Dependence; 2) Financial Need and 3) Education and Empowerment. Sexual Division of Power: 4) HIV Risk and 5) Relationship Dynamics. Cathexis: Affective Influences/Social Norms: 6) HIV/AIDS Knowledge and 7) Prevention and Testing. Importantly, participants were concerned about partner fidelity when visiting the Dominican Republic, as the country accounts for the second highest HIV rates in the Caribbean. CONCLUSIONS: Our results confirm previous findings about perceptions of HIV risk and provide additional insight into aging-related aspects of HIV risk for Latino women midlife and older.


Assuntos
Atitude Frente a Saúde/etnologia , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Hispano-Americanos/psicologia , Idoso , República Dominicana/etnologia , Feminino , Grupos Focais , Hispano-Americanos/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Medição de Risco , Comportamento Sexual/etnologia , Parceiros Sexuais/psicologia , Estados Unidos
5.
N Z Med J ; 132(1503): 66-74, 2019 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581183

RESUMO

AIM: To investigate Maori (Indigenous people of Aotearoa New Zealand) understandings of dementia, its causes, and ways to manage a whanau (extended family) member with dementia. METHOD: We undertook kaupapa Maori research (Maori informed research) with 223 kaumatua (Maori elders) who participated in 17 focus groups across seven study regions throughout Aotearoa New Zealand and eight whanau from the Waikato region. We audio recorded all interviews, transcribed them and then coded and categorised the data into themes. RESULTS: Mate wareware (becoming forgetful and unwell) ('dementia') affects the wairua (spiritual dimension) of Maori. The findings elucidate Maori understandings of the causes of mate wareware, and the role of aroha (love, compassion) and manaakitanga (hospitality, kindness, generosity, support, caring) involved in caregiving for whanau living with mate wareware. Participants perceived cultural activities acted as protective factors that optimised a person's functioning within their whanau and community. CONCLUSION: Whanau are crucial for the care of a kaumatua with mate wareware, along with promoting healthy wairua for all. Whanau urgently need information to assist with their knowledge building and empowerment to meet the needs of a member affected by mate wareware. This requires collaborative healthcare practice and practitioners accessing the necessary matauranga Maori (Maori knowledge) to provide culturally appropriate and comprehensive care for whanau.


Assuntos
Envelhecimento/psicologia , Atitude Frente a Saúde/etnologia , Demência , Etnopsicologia/métodos , Grupo com Ancestrais Oceânicos , Adulto , Idoso , Cultura , Demência/diagnóstico , Demência/etnologia , Demência/psicologia , Feminino , Grupos Focais , Transição Epidemiológica , Humanos , Incidência , Entrevistas como Assunto/métodos , Masculino , Nova Zelândia/epidemiologia , Grupo com Ancestrais Oceânicos/psicologia , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Técnicas Psicológicas
6.
AIDS Behav ; 23(9): 2600-2609, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31367967

RESUMO

Men diagnosed with HIV face gender-related barriers to initiating and adhering to antiretroviral therapy (ART). This qualitative study (73 in-depth interviews; 28 focus group discussions), conducted with men in three urban sites in Côte d'Ivoire in 2016, examined perceptions of ART, including benefits and challenges, to explore how ART mitigates HIV's threats to men's sexuality, economic success, family roles, social status, and health. Participants perceived that adhering to ART would reduce risk of transmitting HIV to others, minimize job loss and lost productivity, and help maintain men's roles as decision makers and providers. ART adherence was thought to help reduce the threat of HIV-related stigma, despite concerns about unintentional disclosure. While ART was perceived to improve health directly, it restricted men's schedules. Side effects were also a major challenge. Social and behavior change approaches building on these insights may improve male engagement across the HIV care continuum.


Assuntos
Terapia Antirretroviral de Alta Atividade , Atitude Frente a Saúde/etnologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Adesão à Medicação , Homens/psicologia , Adulto , Costa do Marfim , Relações Familiares , Feminino , Grupos Focais , Identidade de Gênero , Infecções por HIV/etnologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pesquisa Qualitativa , Comportamento Sexual , Estigma Social
7.
J Drugs Dermatol ; 18(7): 623-632, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31329400

RESUMO

Background: Among the growing aesthetic patient population, Hispanic/Latinos represent the largest proportion of non-Caucasians patients. While treatment of Caucasian facial aging patterns are well documented, far less information describes the aesthetic needs of the Hispanic/Latino patient. Objective: An online study was designed to survey facial aesthetic concerns, treatment priorities, and future treatment considerations among a US-based population of Hispanic/Latino American women. Materials and Methods: A total of 401 participants ages 30 to 65 years reported their attitudes toward facial aging, current facial conditions, most bothersome facial areas, areas most/least likely to be treated first, awareness of treatment options and their consideration rates, and motives and barriers that factor into consideration of injectable treatments. Results: Most participants wanted to look good for their age and treatment interests reflected predominant conditions: facial wrinkles, periorbital signs of aging, and uneven skin tone. Most bothersome facial areas included the submental area, periorbital area, and forehead, which were also among the areas most-likely to treat first. The majority of participants would consider injectables. Cost and safety/side effects were cited as frequent concerns. Conclusion: An understanding of the facial aesthetic concerns and treatment priorities specific to Hispanic/Latino women will enhance the practitioner's patient-centric treatment approach. J Drugs Dermatol. 2019;18(7):623-632.


Assuntos
Atitude Frente a Saúde/etnologia , Técnicas Cosméticas/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Envelhecimento da Pele/etnologia , Adulto , Idoso , Técnicas Cosméticas/economia , Estética , Face , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Pigmentação da Pele , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
8.
J Drugs Dermatol ; 18(7): 633-641, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31329401

RESUMO

Background: As facial aesthetic procedures have become more widely accepted, the racial and ethnic diversity of aesthetic patient populations has increased. Asian Americans represent a growing segment of this population and have specific aesthetic concerns that should be differentiated from the broader Caucasian population. Objective: An online study was designed to survey facial aesthetic concerns, treatment priorities, and future treatment considerations among a US-based population of Asian American women. Materials and Methods: A total of 403 participants ages 30 to 65 years reported perspectives on facial aging, current facial conditions, most bothersome facial areas, most/least likely to be treated first, awareness of treatment options and consideration rates, and motives/barriers impacting the consideration rate of injectable treatments. Results: Treatment interests reflected predominant issues; uneven skin tone, wrinkles, and sun damage. Most bothersome facial areas included the periorbital area, forehead, and submental area, and also among areas designated as most likely to treat first. The majority of participants would consider injectables. However, safety/side effects, cost, and concerns about not looking natural were primary barriers. Conclusion: Understanding the aesthetic concerns and priorities specific to Asian American women may help guide treatment plans more aligned with the goals and expectations of this patient population. J Drugs Dermatol. 2019;18(7):633-641.


Assuntos
Americanos Asiáticos/psicologia , Atitude Frente a Saúde/etnologia , Técnicas Cosméticas/efeitos adversos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Envelhecimento da Pele/etnologia , Adulto , Idoso , Americanos Asiáticos/estatística & dados numéricos , Técnicas Cosméticas/economia , Estética , Face , Feminino , Humanos , Pessoa de Meia-Idade , Pigmentação da Pele , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos
10.
J Gambl Stud ; 35(4): 1331-1345, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31111295

RESUMO

Reflecting international patterns, Aboriginal people in Victoria are more likely to gamble and to experience gambling harm than non-Indigenous Victorians. This paper describes experiences of gambling reported by 50 Aboriginal people interviewed in regional Victoria in 2016 and 2017 as part of studies initiated by two Aboriginal community-controlled organisations. Data were analysed using social practice theory (SPT) and coded to the elements of 'meaning', 'material', 'competence', and 'temporality'. Across each element we identified highly contradictory experiences. Gambling held meaning as an opportunity for community gatherings but was also regarded as a cause of domestic violence, conflict, isolation and shame. Materially, the venues that offered gambling were experienced by many Aboriginal people as safe and welcoming, but at the same time gambling produced a damaging affective sense of addiction for some. Gambling was a competency that some people valued and taught to children, but it was also seen as undermining cultural practices. While Aboriginal people were historically denied access to licensed venues offering commercial gambling, many participants now found opportunities to gamble inescapable. The intermingling of benefits and harms described above supports the need for a multi-faceted response to gambling in Aboriginal communities, which includes harm reduction as well as supply restriction and treatment. Some experiences of gambling related by our participants reflected those reported also by non-Indigenous Australians, while others were differently nuanced. Because SPT is used to understand collectively-shared practices, it facilitates the identification of gambling interventions at the level of the community, as recommended by our research participants.


Assuntos
Jogo de Azar/etnologia , Jogo de Azar/psicologia , Grupo com Ancestrais Oceânicos/psicologia , Valores Sociais/etnologia , Adulto , Atitude Frente a Saúde/etnologia , Austrália , Comportamento de Escolha , Feminino , Redução do Dano , Humanos , Controle Interno-Externo
11.
Health Care Women Int ; 40(6): 665-681, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31084466

RESUMO

Sub-Saharan African immigrant (SSAI) men have significant influence on the health-seeking behavior including cervical cancer screening uptake by their female partners/wives. We conducted a qualitative descriptive study with 21 SSAI men to explore knowledge, perceptions, and support related to cervical screening. Participants were aged 36 ± 9 years, college educated (88%), and 53% have lived in the U.S. > 5 years. Three themes emerged; inadequate cervical cancer knowledge, willingness and strategies for support, and shared versus autonomous decision making for screening. Social structure with emphasis on male leadership could be leveraged in cervical cancer screening promotion for SSAI women.


Assuntos
Atitude Frente a Saúde/etnologia , Emigrantes e Imigrantes , Conhecimentos, Atitudes e Prática em Saúde , Cônjuges/psicologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal , Adulto , África ao Sul do Saara/etnologia , Tomada de Decisões , Detecção Precoce de Câncer , Feminino , Humanos , Masculino , Homens/psicologia , Pessoa de Meia-Idade , Apoio Social , Estados Unidos/epidemiologia
12.
Rural Remote Health ; 19(2): 4789, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31137938

RESUMO

INTRODUCTION: Disparities in cancer outcomes between Indigenous and non-Indigenous people are well reported. Some Australian Indigenous communities' beliefs about cancer may influence health behaviours, support for those with cancer and ,ultimately, treatment outcomes. This project was instigated by request of a cultural adviser from a regional Queensland community and aims to make community perceptions of cancer visible, facilitate development of resources representing these perceptions and briefly evaluate the project from the community's perspective. METHODS: The project was guided by qualitative, participatory and visual research methodology. Community participation was engaged by identifying community champions who helped recruit interested community members and continued project momentum. The project was defined and driven by community, and a consensus decision making approach was used to select resources or activities to represent community perceptions of cancer and raise cancer awareness. Qualitative data were collected from yarning groups at two community forums and subsequent group sessions to explore and define community perceptions of cancer. Informed consent was obtained prior to audio-taped yarning groups. Data were also included from publicly available interviews broadcast on radio and television. All data about community perceptions of cancer and of the project were thematically analysed. Photovoice using cameras was the visual method chosen to capture images and stories representing community cancer beliefs. RESULTS: Three main themes were derived from thematic analysis of data collected about community perceptions of cancer, identified by participants as important to improving cancer outcomes: (1) silence in the community, (2) support is important for survivorship and (3) awareness of cancer and the importance of sharing positive stories. A consensus decision-making approach resulted in the community choosing two resources to stimulate community discussion about cancer, raise awareness and reduce stigma. These were creating a community quilt, with each quilt square representing community perceptions of cancer, and producing a community calendar, with messages promoting healthy behaviours and cancer screening. The overall project was viewed as valuable for facilitating and improving the conversation about cancer with family, friends, the broader community and health professionals. Group sessions were considered important for providing a shared, safe space for support, for asking health related questions and as an instigator to share cancer related knowledge and stories with others. CONCLUSION: Silence around cancer may influence awareness and discussion about cancer, screening participation and help-seeking behaviour in this community. In this project, engaging with the community created a safe space for conversation around a previously taboo topic, which could lead to improved screening and help seeking behaviour. The role of primary health care in reducing health disparities by partnering with community to conduct awareness and prevention activities and by providing culturally appropriate care for Indigenous people is emphasised.


Assuntos
Atitude Frente a Saúde/etnologia , Serviços de Saúde do Indígena/organização & administração , Neoplasias/etnologia , Neoplasias/psicologia , Grupo com Ancestrais Oceânicos/psicologia , Adulto , Informação de Saúde ao Consumidor/organização & administração , Feminino , Humanos , Masculino , Queensland , Percepção Social
13.
BMC Womens Health ; 19(1): 66, 2019 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-31096978

RESUMO

BACKGROUND: Female genital mutilation (FGM) is prevalent in Iraqi Kurdistan Region, but there is a lack of adequate knowledge about how the practice is perceived by the women population who are the direct victims of the practice. This study aimed to assess the knowledge, beliefs, and attitude of a sample of Kurdish women of FGM and identify the main enabling factors for performing this practice and the barriers to ending it. METHODS: This qualitative study was based on six focus groups involving a sample of 51 women. We used a topic guide to lead discussions, which included questions on women's perspectives of different aspects of FGM such as the reasons for practicing it, the positive and negative consequences, the continuation of the practice and tackling this problem in the community. Content analysis was used for the qualitative analysis of the data. RESULTS: The women had poor knowledge about different aspects of FGM particularly concerning the procedure and the consequences. The mutilated participants revealed the devastating experience of the pain and the psychological effects they have experienced. Reducing sexual desire, having halal (permissible by Allah) hands, and religious requirement were the main reasons for practicing FGM. Reduction in women's sexual desire and the related social problems with the husband were the main problems identified to be associated with FGM. Most women did not support the continuation of FGM practice, but some women still think that FGM should be left to the people's preference. The participants identified raising people's awareness, active involvement of religious leaders in prevention efforts and the issuance and enforcement of legislation against FGM as the primary measures to reduce FGM practice. CONCLUSION: Passing through FGM at childhood is an overwhelming experience with long-term effects for women. There is still a significant segment among the women population that do not oppose the continuations of FGM and need religious and scientific evidence against FGM. Some reasons for practicing FGM are deeply embedded in the culture and traditions, and there is a need for extensive efforts to raise the awareness of the population and change their thoughts and behavior about FGM.


Assuntos
Atitude Frente a Saúde/etnologia , Circuncisão Feminina/etnologia , Circuncisão Feminina/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Circuncisão Feminina/legislação & jurisprudência , Feminino , Humanos , Iraque , Prevalência , Pesquisa Qualitativa , Fatores Socioeconômicos , Adulto Jovem
14.
Am J Public Health ; 109(5): 774-780, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30969834

RESUMO

OBJECTIVES: To test whether indicators of despair are rising among US adults as they age toward midlife and whether this rise is concentrated among low-educated Whites and in rural areas. METHODS: We used data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of US adolescents in 1994. Our sample was restricted to individuals who participated in 1 or more of 5 waves (1994-2017) and self-identified as non-Hispanic White, non-Hispanic Black, or Hispanic (n = 18 446). We examined change in indicators of despair from adolescence to adulthood using multilevel regression analysis, testing for differences by race/ethnicity, education, and rurality. RESULTS: We found evidence of rising despair among this cohort over the past decade. This increase was not restricted to low-educated Whites or to rural areas. CONCLUSIONS: Results suggest that generally rising despair among the young adult cohort now reaching midlife that cuts across racial/ethnic, educational, and geographic groups may presage rising midlife mortality for these subgroups in the next decade.


Assuntos
Atitude Frente a Saúde/etnologia , Depressão/etnologia , Grupos Étnicos/estatística & dados numéricos , Adaptação Psicológica , Adulto , Estudos de Coortes , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
15.
Int Nurs Rev ; 66(3): 329-337, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30843192

RESUMO

AIM: This study explored self-management practices in relation to traditional methods for managing illness in newborns and infants and the implications of these practices on infant health. BACKGROUND: Self-medication with folk remedies is believed to have short- and long-term impacts on well-being. Little is known about how mothers in Arab societies used their traditional beliefs and practices in self-managing their newborns' and infants' health. METHODS: Data were collected from five focus groups using open-ended questions with 37 mothers. Participants were selected using snowball sampling and were recruited from four different cities in Jordan between June 2016 and August 2016. ETHICAL APPROVAL: All identifying information regarding the study participants has been omitted, and this study was approved by the Academic Research Committee at the University of Jordan. FINDINGS: Mothers were more willing to try herbal remedies, traditional massage and certain foods to self-manage their infants' health. Folk remedies were not restricted to traditions handed down through generations, but included a representation of newly emerged trends towards 'safety' or 'nature'. CONCLUSIONS: While the use of folk remedies have been handed down generations as customs, today, virtual support groups and social media provide modern resources for folk remedies' promotion in care and self-management. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing and health policymakers can use our findings for planning and developing strategies and health policies that increase public awareness about adverse health effects associated with herbal remedies. Such strategies are likely to be facilitated through partnerships between nursing and midwifery education institutions, antenatal clinics and social media in the region.


Assuntos
Atitude Frente a Saúde/etnologia , Cuidado do Lactente/métodos , Medicina Tradicional/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Adulto , Árabes , Feminino , Humanos , Recém-Nascido , Jordânia , Masculino , Medicina Tradicional/métodos , Percepção Social
16.
Can J Public Health ; 110(4): 404-413, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30868415

RESUMO

BACKGROUND: Urban Indigenous populations in Canada are steadily growing and represent diverse and culturally vibrant communities. Disparities between Indigenous and non-Indigenous peoples' experiences of the social determinants of health are a growing concern. Under the guidance of the West End Aboriginal Advisory Council (WEAAC), Parkdale Queen West Community Health Centre (PQWCHC) launched the Niiwin Wendaanimak Four Winds Wellness Program that seeks to enhance health and community services for homeless and at-risk Indigenous populations in Toronto. OBJECTIVES: A process evaluation was carried out to (1) assess the collaborative service delivery model; (2) identify service gaps and issues for homeless and at-risk Indigenous populations; and (3) develop recommendations for how non-Indigenous organizations can provide culturally responsive services for Indigenous populations. METHODS: In consultation with the WEAAC, a thematic analysis of qualitative data collected from 2 focus groups with community members who access the Niiwin Wendaanimak program and 17 key informant interviews with staff and peers was conducted. RESULTS: The Niiwin Wendaanimak program bridges teachings of inclusivity and the practice of harm reduction to create a non-judgemental space where community members' dignity and autonomy is respected. Strengths of the program include Indigenous leadership and access to activities that promote wellness and community building. CONCLUSIONS: As a non-Indigenous service provider, PQWCHC is meeting the needs of homeless and at-risk Indigenous populations in Toronto. Program strengths, system gaps, and challenges including policy recommendations were identified.


Assuntos
Atitude Frente a Saúde/etnologia , Serviços de Saúde Comunitária , Promoção da Saúde , Grupos Populacionais/psicologia , Canadá , Feminino , Pessoas em Situação de Rua , Humanos , Masculino , Grupos Populacionais/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Medição de Risco , População Urbana
17.
Aust N Z J Public Health ; 43(3): 294-299, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30908804

RESUMO

OBJECTIVE: Rheumatic fever (RF) recurrence prevention requires secondary prophylaxis for at least ten years. However, recurrences of rheumatic fever (RRF) persist disproportionately affecting Maori and Pacific youth. Reasons for recurrence rates are not well understood and commonly attributed to patient non-adherence. This research explored Maori and Pacific family experiences of RRF to better understand barriers to accessing secondary prophylaxis to inform health service improvements. METHODS: Participants were Maori and Pacific patients who had RRF or unexpected rheumatic heart disease and their family; and health professionals working in RF contexts. Kaupapa Maori, Talanga and Kakala Pacific qualitative methodologies were employed. Data were thematically analysed using a general inductive approach. RESULTS: Data collection included 38 interviews with patients and families (n=80), six focus group interviews and nine interviews with health providers (n=33) from seven geographic regions. Three key themes were identified where mismatches occurred between services and community needs: 1. Model of delivery; 2. Interpersonal approaches to care; and 3. Adolescent care. Conclusions and Public health implications: Successful RRF prevention requires interventions to address structural causes of inequity, appropriate clinical guidelines and quality health services. Service-delivery models should provide regular prophylaxis in an accessible manner through culturally-safe, community-based, age-appropriate care.


Assuntos
Atitude Frente a Saúde/etnologia , Assistência à Saúde/métodos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde do Indígena/organização & administração , Grupo com Ancestrais Oceânicos/psicologia , Febre Reumática/prevenção & controle , Cardiopatia Reumática/prevenção & controle , Prevenção Secundária , Adolescente , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Nova Zelândia/epidemiologia , Pesquisa Qualitativa , Febre Reumática/diagnóstico , Febre Reumática/etnologia , Cardiopatia Reumática/diagnóstico
18.
Nurs Res ; 68(3): 218-226, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30829835

RESUMO

BACKGROUND: Minority blood donations have historically been low in the United States; however, increasing the proportion of minority blood donations is essential to reducing blood transfusion complications-particularly in African Americans with sickle cell disease and thalassemia. OBJECTIVES: The research question was as follows: What are the facilitators and barriers to blood donation in minority populations? METHODS: Beginning August 2017, we conducted a literature search using the following electronic databases: CINAHL Plus with Full Text, Academic Search Complete, MEDLINE, PsycINFO, Sociological Collection, Cochrane Library, ProQuest Dissertation and Theses, and PubMed, which continued through December 2017. Based on primarily descriptive data in the articles (n = 15), the systematic review proceeded as a meta-synthesis. An inductive approach was used to analyze commonalities, differences, patterns, and themes in the study findings; interpret the findings; and synthesize the findings to generate new knowledge about the phenomena of study. RESULTS: The themes included (a) knowing a blood recipient; (b) identifying with culture, race/ethnicity, and religious affiliation; and (c) medical mistrust and misunderstanding. All were prominent in the descriptions of minorities on blood donation and exist as facilitators and barriers. DISCUSSION: The reviewed studies demonstrated that facilitators and barriers to minority blood donations are complex and exist concurrently. Community education and communication about blood donation have a positive effect on fellow community members, including friends and family, in racial and ethnic minorities that are underrepresented among blood donors. Findings further suggest the need to rebuild trust among minority communities.


Assuntos
Atitude Frente a Saúde/etnologia , Doadores de Sangue/estatística & dados numéricos , Barreiras de Comunicação , Características Culturais , Grupos Minoritários/estatística & dados numéricos , Doadores de Sangue/psicologia , Humanos , Grupos Minoritários/psicologia , Fatores Socioeconômicos , Estados Unidos
19.
Qual Health Res ; 29(10): 1419-1432, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30741092

RESUMO

How do minorities differ from Whites in their interactions with the broader consumeristic health culture in the United States? We explore this question by investigating the role that acculturation plays in minority and White patients' views of prescription drugs and the direct-to-consumer advertising (DTCA) of prescription drugs. Drawing on data from six race-based focus groups, we find that patients' views of prescription drugs affect their responses to DTCA. While both minorities and Whites value the information they receive from DTCA, level of acculturation predicts how minorities use the information they receive from DTCA. Less acculturated minorities have healthworlds and cultural health toolkits that are not narrowly focused on prescription drugs. This results in skepticism on the part of less acculturated minorities toward pharmaceuticals as treatment options. In this article, we argue that researchers must consider the role acculturation plays in explaining patients' health dispositions and their consumeristic health orientations.


Assuntos
Aculturação , Atitude Frente a Saúde/etnologia , Cultura , Medicamentos sob Prescrição/uso terapêutico , Adulto , Idoso , Grupos de Populações Continentais/etnologia , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
20.
J Community Health Nurs ; 36(1): 19-30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30793961

RESUMO

Given the significantly higher cervical cancer risks faced by Korea Americans (KA), the aim of this study was to explore cultural influences and barriers affecting human papillomavirus (HPV) vaccination decisions and preferred educational methods to effectively deliver HPV information. Focus groups included 20 KA parents. This study found a lack of knowledge about HPV and the vaccine, along with negative perceptions about the vaccine, affects HPV vaccination decision-making. Ineffective conversations and a lack of HPV vaccine recommendations by health care providers influenced by cultural beliefs were found to be another major barrier. These findings reveal new insights to guide the development of HPV education programs.


Assuntos
Americanos Asiáticos/educação , Necessidades e Demandas de Serviços de Saúde , Vacinas contra Papillomavirus/uso terapêutico , Educação de Pacientes como Assunto , Adulto , Atitude Frente a Saúde/etnologia , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/etnologia , Infecções por Papillomavirus/prevenção & controle , República da Coreia/etnologia , Estados Unidos
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