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1.
N Z Med J ; 133(1522): 63-70, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32994617

RESUMO

AIMS: To empower a large whanau (extended family) with a history of severe premature heart disease and familial hypercholesterolemia (FH). METHODS: After broad consultation a Hui was held to discuss how to better manage this issue to ensure present and future generations were appropriately screened and treated. RESULTS: A closed social media page with detailed information on how to manage and screen FH that includes a family tree (for those who consent) has been created. The whanau, facilitated by health professionals, have ownership of their health. This has led to an uptake of screening and treatment for FH with whanau who are now able to inform local health professionals about their disorder. CONCLUSION: FH is the most common dominant genetic disorder in humans and causes premature heart disease and death. Current approaches are dependent on index patients presenting for cascade screening and do not incorporate the needs and views of the extended whanau. Establishing a partnership with the whanau and giving back control of health information is crucial to ensure equity. A national systematic programme is also needed to manage this condition with important health outcomes that can be averted if treated from a young age.


Assuntos
Família/etnologia , Educação em Saúde/métodos , Hiperlipoproteinemia Tipo II , Grupo com Ancestrais Oceânicos/etnologia , Mídias Sociais , Adulto , Criança , Humanos , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/etnologia , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/terapia , Programas de Rastreamento , Nova Zelândia
2.
J Intellect Disabil Res ; 64(10): 739-749, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32808424

RESUMO

BACKGROUND: The COVID-19 pandemic introduced challenges to families with young children with developmental delays. Beyond the widespread concerns surrounding illness, loss of employment and social isolation, caregivers are responsible for overseeing their children's educational and therapeutic programmes at home often without the much needed support of professionals. METHOD: The present study sought to examine the impact of COVID-19 in 77 ethnically, linguistically and socioeconomically diverse families with young children with intellectual and developmental disabilities (IDDs) in California and Oregon, who were participating in larger intervention studies. Parents responded to five interview questions about the impact of the pandemic, services for their child, silver linings or positive aspects, coping and their concerns about the long-term impact of the pandemic. RESULTS: Parents reported that their biggest challenge was being at home caring for their children with the loss of many essential services. Parents reported some positive aspects of the pandemic, especially being together as a family. Although there were positive aspects of the situation, many parents expressed concern about long-term impacts of the pandemic on their children's development, given the loss of services, education and social engagement opportunities. CONCLUSION: Results suggest that parents of young children with IDD report significant challenges at home during the pandemic. Professional support, especially during the reopening phases, will be critical to support family well-being and child developmental outcomes.


Assuntos
Infecções por Coronavirus , Deficiências do Desenvolvimento/enfermagem , Família , Acesso aos Serviços de Saúde , Deficiência Intelectual/enfermagem , Pandemias , Pneumonia Viral , Adulto , California/etnologia , Criança , Pré-Escolar , Família/etnologia , Família/psicologia , Feminino , Humanos , Masculino , Oregon/etnologia , Pais
3.
Medicine (Baltimore) ; 99(28): e20753, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664068

RESUMO

Down syndrome (DS) is the leading cause of intellectual disability. Previous quantitative studies have examined the effects of DS on families of children with DS. This study explored the coping strategies adopted by the families of children with DS. This was a qualitative content analysis study, in which the participants were selected using purposive sampling from the families of children with DS. Semi-structured interviews were performed and collected data were analyzed. A total of 20 family members (10 mothers, 6 fathers, 2 brothers, and 2 sisters) were interviewed. Six categories were extracted in this study, namely "searching for information," "paying attention to children's healthcare needs," "concentration on spirituality," "teaching socially appropriate behavioral skills," "efforts to increase self-reliance in children," and "development of family support circle." The participating families were able to use positive adaptive mechanisms and cope well with the problems associated with having a child with DS. However, they still needed more support from healthcare providers and support organizations. Receiving more support from healthcare providers, such as nurses, can help them in better management of their children.


Assuntos
Adaptação Psicológica , Síndrome de Down , Família/psicologia , Adolescente , Adulto , Família/etnologia , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
4.
J Pain Symptom Manage ; 60(2): e90-e92, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32360238

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic presents unique challenges to Asian countries like Singapore with a predominantly Confucian culture. Palliative care providers play an important role in supporting their patients and family members in these difficult times.


Assuntos
Infecções por Coronavirus/etnologia , Infecções por Coronavirus/psicologia , Pneumonia Viral/etnologia , Pneumonia Viral/psicologia , Infecções por Coronavirus/terapia , Assistência à Saúde Culturalmente Competente , Cultura , Família/etnologia , Família/psicologia , Humanos , Cuidados Paliativos/métodos , Pandemias , Cooperação do Paciente/etnologia , Cooperação do Paciente/psicologia , Pneumonia Viral/terapia , Singapura
6.
Int J Behav Nutr Phys Act ; 17(1): 52, 2020 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316983

RESUMO

BACKGROUND: Healthy Dads Healthy Kids (HDHK) is a unique lifestyle obesity intervention for fathers and children that demonstrated weight loss among the fathers and behavior change among fathers and children in Australia. The program is gender-tailored to specifically target fathers for weight loss and 5-12 year old children for obesity prevention. The aim of this formative study was to examine an Expert Panel's and Hispanic Family Panel's perceptions about the program and suggestions for the cultural adaptation of HDHK for Hispanic families in southwestern US. METHODS: Forty-four Hispanic participants (22 fathers, 13 mothers and 9 children) made up the Family Panel. They participated in 1-5 study contacts (focus groups, online survey, and/or interviews). The scripts and qualitative guides assessed participants' perceptions of the HDHK content and material using the Ecological Validity Model. Studies were conducted in English or Spanish, depending on the preference of the participant. Focus groups and interviews were audio-recorded, transcribed, translated, and thematically coded. Findings were reviewed with the Expert Panel who helped inform the cultural adaptation. RESULTS: 80% of parents were foreign-born, 57% spoke only Spanish at home, and 60% did not graduate from high school. Several themes emerged to inform the cultural adaptation of the program. Parents agreed with the HDHK goals and recommended the program place greater emphasis on parenting and limiting children's screen time. Some mothers and fathers wanted greater mother engagement. Weekly videos and a Facebook group emerged as favorite alternative options to engage mothers. Greater promotion of familism (inclusion and impact on whole family) was recommended for the program goals and activities. Gender roles for mothers and fathers, and differences in how fathers interact with male and female children, emerged and should be considered in program activities. Several barriers to father engagement surfaced, including lack of time due to work schedules, physically demanding jobs, concerns of caring for children without mother, fathers' current fitness/weight, and lack of knowledge of how to eat more healthfully. The reading level of the HDHK materials was too high for some parents. CONCLUSION: Findings from these formative qualitative studies informed the cultural adaptation of HDHK for Hispanic families, to account for literacy level, cultural values, and barriers to participation and engagement.


Assuntos
Família/etnologia , Relações Pai-Filho , Pai/psicologia , Estilo de Vida/etnologia , Obesidade Pediátrica/prevenção & controle , Perda de Peso , Adulto , Criança , Pré-Escolar , Feminino , Grupos Focais , Hispano-Americanos , Humanos , Alfabetização , Masculino , Mães/psicologia , Poder Familiar/etnologia , Desenvolvimento de Programas , Fatores Socioeconômicos , Inquéritos e Questionários , Texas/epidemiologia
7.
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
8.
Australas Psychiatry ; 28(1): 58-60, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31889449

RESUMO

OBJECTIVES: The objectives of this article are to describe a case highlighting challenges in managing an acute psychiatric presentation, the process of mentorship and the significance of cultural matters influencing family engagement in Vanuatu. METHOD: Case description. RESULTS: This case highlights resourcing constraints facing a small mental health team in the Pacific, the clinical significance of the concept of tabu in a ni-Vanuatu context and the importance of family decision making processes in ni-Vanuatu culture. CONCLUSION: A structured mentoring programme to foster mental health capacity development in Vanuatu can support psychiatric decision-making in complex cases, reflection on the role of culture in formulation and family engagement, and mutual learning.


Assuntos
Assistência à Saúde Culturalmente Competente , Tomada de Decisões , Família/etnologia , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Serviços de Saúde Mental , Mentores , Grupo com Ancestrais Oceânicos/etnologia , Adulto , Humanos , Serviços de Saúde Mental/economia , Desenvolvimento de Programas , Psiquiatria/educação , Vanuatu
9.
Proc Natl Acad Sci U S A ; 117(5): 2378-2384, 2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-31964846

RESUMO

The family unit and kinship structures form the basis of social relationships in indigenous societies. Families constitute a cultural group, a so-called clan, within which marriage is prohibited by the incest taboo. The clan attribution governs the mating preference and descent relationships by certain rules. Such rules form various kinship structures, including generalized exchange, an indirect exchange of brides among more than two clans, and restricted exchange, a direct exchange of brides with the flow of children to different clans. These structures are distributed in different areas and show different cultural consequences. However, it is still unknown how they emerge or what conditions determine different structures. Here, we build a model of communities consisting of lineages and family groups and introduce social cooperation among kin and mates and conflict over mating. Each lineage has parameters characterizing the trait and mate preference, which determines the possibility of marriage and the degree of cooperation and conflict among lineages. Lineages can cooperate with those having similar traits to their own or mates', whereas lineages with similar preferences compete for brides. In addition, we introduce community-level selection by eliminating communities with smaller fitness and follow the so-called hierarchical Moran process. We numerically demonstrate that lineages are clustered in the space of traits and preferences, resulting in the emergence of clans with the incest taboo. Generalized exchange emerges when cooperation is strongly needed, whereas restricted exchange emerges when the mating conflict is strict. This may explain the geographical distribution of kinship structures in indigenous societies.


Assuntos
Família , Casamento , Antropologia Cultural , Comportamento Competitivo , Comportamento Cooperativo , Família/etnologia , Características da Família , Feminino , Humanos , Incesto/etnologia , Masculino , Casamento/etnologia , Modelos Teóricos , Grupos Populacionais , Tabu
10.
J Cross Cult Gerontol ; 35(1): 99-109, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31788726

RESUMO

This study investigates the caregiving expectations of a group of nineteen older Spanish speakers living in Australia from the perspective of familism. Speakers participated in audio-recorded interviews about their caregiving expectations late in life and four key themes were identified: (1) tension between value of familism and the self-reliance approach encouraged in Australian society; (2) fear of burdening their "westernized" children, which resulted in shifted care expectations; (3) fear of ending up in an aged care facility; and (4) the importance of religion in coping with uncertainty about future care arrangements.


Assuntos
Envelhecimento/etnologia , Família/etnologia , Migrantes/psicologia , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Austrália/etnologia , Cuidadores/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Masculino , Espanha
11.
Hum Nat ; 30(4): 398-421, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31729693

RESUMO

Fairness is undoubtedly an essential normative concept in humans and promotes cooperation in human societies. The fact that fairness exists is puzzling, however, because it works against the short-term interest of individuals. Theories of genetic evolution, cultural evolution, and gene-culture coevolution identify plausible mechanisms for the evolution of fairness in humans. Such mechanisms include kin selection, the support of group-beneficial moral norms through ethnic markers, free partner choice with equal outside options, and free partner choice with reputation as well as spite in small populations. Here, we present the results of a common-pool resource game experiment on sharing. Based on data from 37 multiethnic villages in a subsistence agricultural population in Foutah Djallon, Guinea, we show that fair behavior in our experiment increased with increasing ethnic homogeneity and market integration. Group size and kinship had the opposite effect. Overall, fair behavior was not conditional on reputation. Instead, the ability of the different village populations to support individuals' fairness in situations lacking the opportunity to build a positive reputation varied significantly. Our results suggest that evolutionary theory provides a useful framework for the analysis of fairness in humans.


Assuntos
Família/etnologia , Processos Grupais , Princípios Morais , Comportamento Social , Percepção Social , Adulto , Guiné/etnologia , Humanos
12.
BMC Palliat Care ; 18(1): 95, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690289

RESUMO

BACKGROUND: Research in Taiwan has indicated that advance care planning is rarely undertaken in long-term care facilities. The purpose of this study was to develop an advance care planning interview guideline and care model to facilitate the process of advance care planning for residents and their families in long-term care facilities. METHODS: This study follows an action research design. Cycles of planning, action, observation, and reflection were planned and modified based on the results of interviews with residents and their families as well as meetings with staff. To establish the interview guideline and care model through this action research study, residents and their families were interviewed separately. The researcher subsequently held meetings with staff members to evaluate the results and identify problems during each advance care planning process. This information was synthesised and used to modify the care model for implementation with the next resident-family pair. This process was performed a total of ten times. RESULTS: This study included residents (N = 10), their families (N = 20), and medical staff (N = 4) at a long-term care facility. The interviews and meetings were audio recorded, transcribed, and subjected to a simple thematic analysis together with the field notes and reflection logs. Four themes emerged from the data related to: opening the conversation with the interview guidelines about the life story of residents; continuing life stories to the quality of remaining years of the residents; gradually changing the topic to the end-of-life care issues; and concluding the conversation by explaining the content of advance directives and hospice care. CONCLUSIONS: The advance care planning care model was implemented following logical thinking from a Chinese perspective. This consisted of opening, developing, changing, and concluding through the views of Confucianism, Buddhism, and Taoism. The research findings indicate that the model successfully facilitated the process of advance care planning for residents and their families.


Assuntos
Planejamento Antecipado de Cuidados/organização & administração , Diretivas Antecipadas/etnologia , Assistência de Longa Duração/organização & administração , Casas de Saúde/organização & administração , Planejamento Antecipado de Cuidados/normas , China , Família/etnologia , Guias como Assunto , Pessoal de Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Taiwan , Assistência Terminal/organização & administração
13.
BMC Public Health ; 19(1): 1452, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31690307

RESUMO

BACKGROUND: Physical inactivity is a crucial risk factor for the development of chronic health issues, which have a high incidence among Arabs living in the Gulf Cooperation Council (GCC) countries. The Qatar Stepwise Survey 2012 reported that approximately 44% of young adults 18-44 years of age had insufficient levels of physical activity. Family is a powerful source of information and socialization for adolescents and has a strong influence on their attitudes, decision-making, and behaviors. METHODS: The purpose of this study is to understand how university students' physical activity can be influenced by sociocultural factors, particularly family health values and Muslim Arab culture. Using the criterion sampling strategy, 20 undergraduate Muslim students (Female students =10, Male students = 10) aged from 18 to 23 years who were Qatari or born and also raised in Qatar were recruited and interviewed. Participants were asked if they consider themselves active or not, about their perception of family health values regarding physical activity and the factors shaping these values, and the influence of family values on their physical activity behavior. The interviews were transcribed verbatim, coded, and analyzed following inductive analysis. RESULTS: The majority of the participants were influenced by their family health values, which were shaped by Qatari culture and the culture of origin for non-Qatari and were implicitly shaped by Islam. Participants reported that their role models of physical activity were males (fathers and male siblings), a health condition will motivate their families to be physically active, and families give priority to work and academic achievement over physical activity. A few participants showed that there was explicit influence of Islam on their physical activity, because culture's influence was veiling religion's. Culture was seen as a facilitator for physical activity from the males' perspectives, which was not the case for female participants who reported the negative influence of culture on their physical activity because of the limited choices available for them. Non-Qatari students revealed that their culture of origin (such as Syria, Palestine, Egypt, Somalia, Bangladesh, Sudan, Pakistan and India) was the dominant factor in shaping their family health values. CONCLUSIONS: The findings address gaps in the literature about families' health values regarding physical activity in Qatar, the influence of the different ecologies surrounding these values, and the physical activity behaviors of university students. Knowledge about these factors can aid in the development of family-based interventions designed to motivate adolescents to be physically active, which should be religion- and culture-tailored.


Assuntos
Exercício Físico/psicologia , Islamismo/psicologia , Estudantes/psicologia , Adolescente , Características Culturais , Família/etnologia , Família/psicologia , Feminino , Identidade de Gênero , Humanos , Masculino , Catar , Pesquisa Qualitativa , Estudantes/estatística & dados numéricos , Universidades , Adulto Jovem
14.
Am J Community Psychol ; 64(1-2): 21-33, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31486101

RESUMO

In this study, we respond to calls for strengths-based Indigenous research by highlighting American Indian and First Nations (Anishinaabe) perspectives on wellness. We engaged with Anishinaabe community members by using an iterative, collaborative Group Concept Mapping methodology to define strengths from a within-culture lens. Participants (n = 13) shared what it means to live a good way of life/have wellness for Anishinaabe young adults, ranked/sorted their ideas, and shared their understanding of the map. Results were represented by nine clusters of wellness, which addressed aspects of self-care, self-determination, actualization, community connectedness, traditional knowledge, responsibility to family, compassionate respect toward others, enculturation, and connectedness with earth/ancestors. The clusters were interrelated, primarily in the relationship between self-care and focus on others. The results are interpreted by the authors and Anishinaabe community members though the use of the Seven Grandfather Teachings, which provide a framework for understanding Anishinaabe wellness. The Seven Grandfather Teachings include Honesty (Gwayakwaadiziwin), Respect (Manaadendamowin), Humility (Dabaadendiziwin), Love (Zaagi'idiwin), Wisdom (Nibwaakaawin), Bravery/Courage (Aakode'ewin), and Truth (Debwewin).


Assuntos
Índios Norte-Americanos/psicologia , Povos Indígenas/psicologia , Adulto , Cultura , Família/etnologia , Família/psicologia , Feminino , Humanos , Índios Norte-Americanos/etnologia , Masculino , Autonomia Pessoal , Satisfação Pessoal , Autocuidado , Participação Social , Responsabilidade Social , Adulto Jovem
15.
BMC Public Health ; 19(1): 981, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337379

RESUMO

BACKGROUND: The goal of adaptation is to maintain the effectiveness of the original intervention by preserving the core elements that account for its success while delivering an intervention that is tailored to the new community and/or cultural context. The current study describes the process of adapting an evidence-based smoke-free homes (SFH) intervention for use in American Indian/Alaska Native (AI/AN) households. METHODS: We followed a systematic adaptation process. We first assessed the community through focus groups coordinated in collaboration with tribal partners. Because our team included the original developers of the intervention, the steps of understanding the intervention, selecting the intervention and consulting with experts were simplified. Additional steps included consulting with stakeholders through a national work group and collaboratively deciding what needed adaptation. RESULTS: A number of key themes pertinent to the adaptation of the SFH intervention were identified in the focus groups. These included the gravity of messaging about commercial tobacco use; respect, familialism, and intergenerationalism; imagery, including significant symbolism, colors, and representative role models; whether and how to address traditional tobacco; and, barriers to a SFH not adequately addressed in the original materials. CONCLUSIONS: Adaptation of an intervention to create smoke-free homes in AI/AN families necessitated both surface structure changes such as appearance of role models and deep structure changes that addressed core values, and beliefs and traditions.


Assuntos
Nativos do Alasca/psicologia , Família/etnologia , Habitação , Índios Norte-Americanos/psicologia , Política Antifumo , Grupos Focais , Humanos
16.
Patient Educ Couns ; 102(12): 2199-2207, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31272799

RESUMO

OBJECTIVE: During critical care, physicians are frequently confronted with bad-news communication because of patients' frail conditions. Delivering bad news is not easy, certainly not when patients from ethnic minority groups are involved. In this study we investigate the delivery of bad news in a multi-ethnic critical care context. METHODS: Ethnographic fieldwork in one intensive care unit of a multi-ethnic urban hospital in Belgium. Data were collected through negotiated interactive observation, in-depth interviews and from reading patients' medical records. Data were thematically analysed. RESULTS: Bad-news communication was primarily dominated by physicians. Patients' and relatives' input and other professionals' involvement in the communication was limited. Staff encountered ethno-cultural related difficulties, firstly, in choosing suitable conversation partner(s); secondly, in choosing the place of conversations and thirdly, in the information exchange. Staff usually tried to address these problems themselves on the spot in a quick, pragmatic way. Sometimes their approaches seemed to be more emotion-driven than well thought-out. CONCLUSION: Delivering bad news in a multi-ethnic intensive care unit has a number of specific difficulties. These can have negative consequences for parties involved. PRACTICE IMPLICATIONS: The challenges of an adequate delivery of bad news need a team-approach and a well thought-out protocol.


Assuntos
Barreiras de Comunicação , Comunicação , Competência Cultural , Diversidade Cultural , Família/etnologia , Unidades de Terapia Intensiva , Relações Médico-Paciente , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisões , Grupos Étnicos , Família/psicologia , Feminino , Pessoal de Saúde/psicologia , Humanos , Unidades de Terapia Intensiva/organização & administração , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Assistência Terminal
17.
Am J Health Behav ; 43(4): 680-690, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31239012

RESUMO

Objectives: The purpose of this study is to explore the motivations that encourage Asian Americans to use ENDS. In addition, it seeks to evaluate the underlying implications of Asian cultural beliefs and values that influence the use of ENDS. Methods: We conducted 12 semi-structured in-depth interviews among Asian Americans. Data were analyzed using thematic analysis. Results: Participants were influenced by Asian cultural values of filial piety and saving face which allowed them to either de-stigmatize or conceal the use of ENDS among their family members and peers. They also reported preferences for e-juice flavors reflective of food and products prominent in the Asian culture. Moreover, respondents also believed that ENDS use is less harmful than combustible cigarettes and reported experiencing perceived health benefits. Conclusion: Asian Americans who use ENDS are encouraged by the perception of their family members and value a sense of comfortability and familiarity when choosing their e-juice flavors. These results can help inform public health educators and researchers create culturally-specific health campaigns and interventions targeting the Asian-American population.


Assuntos
Americanos Asiáticos/estatística & dados numéricos , Sistemas Eletrônicos de Liberação de Nicotina , Família/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Motivação , Vaping/etnologia , Adulto , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Estados Unidos/etnologia
18.
BMC Public Health ; 19(1): 759, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200685

RESUMO

BACKGROUND: Due to multiple and interacting factors, Latino children are disproportionately at risk for overweight and obesity in the United States. Childhood obesity increases the risk for adverse physical and psychosocial outcomes throughout the lifespan. Intensive behavioral interventions recommended in primary care settings may not conform to current practices, and the most vulnerable populations are often unable to access these services. Community Health Workers (CHWs) offer a promising approach to bridging the gap between vulnerable communities and culturally competent services. La Vida Buena (The Good Life) is an 8-week family-focused intervention for Latino children 5-8 years old and their parents or caregivers who are patients at a Federally-Qualified Community Health Center (FQHC). It is a culturally and linguistically appropriate curriculum, facilitated by CHWs, that targets family behaviors to foster a healthy lifestyle in order to prevent and mitigate childhood overweight and obesity. METHODS: The primary objective is to test the effectiveness of the La Vida Buena (LVB) childhood obesity program among Latino children 5-8 years old and their families as compared with a single educational session. This study uses a parallel two-arm quasi-experimental design. The intervention group receives the 8-week La Vida Buena intervention and the comparison group receives a single educational session. The primary outcome is the change in the child's BMI z-score from baseline to 6 months. DISCUSSION: The implementation and evaluation of La Vida Buena may inform research and practice for linking Latino patients in FQHCs to culturally responsive community-based childhood obesity interventions. It will also contribute to the literature about CHWs as facilitators of behavior change for families underserved by health services and preventive programs. La Vida Buena can serve as a culturally and linguistically appropriate early intervention curriculum that will foster a healthy home environment for childhood obesity mitigation and prevention. TRIAL REGISTRATION: The trial was retrospectively registered on December 18, 2018. The ClinicalTrials.gov Identifier is NCT03781856.


Assuntos
Agentes Comunitários de Saúde , Família/etnologia , Hispano-Americanos/psicologia , Obesidade Pediátrica/etnologia , Programas de Redução de Peso/organização & administração , Criança , Pré-Escolar , Família/psicologia , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , México , Obesidade Pediátrica/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Estados Unidos
19.
J Child Sex Abus ; 28(7): 860-884, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31211664

RESUMO

Intrafamilial child sexual abuse is the commonest, though the under-reported, form of child sexual abuse in Marondera District and Zimbabwe generally. However, little is known about what drives it and what practitioners know about it. This study explored the factors associated with the incidence of intrafamilial child sexual abuse in Marondera based on perceptions of Victim-Friendly Court professionals in the district. A semi-structured questionnaire was administered to twenty-five professionals from thirteen agencies implementing the Victim-Friendly Court initiative in Marondera. Relevant court records of intrafamilial child sexual abuse cases were also reviewed. Data were analyzed using thematic analysis, descriptive statistics and document analysis. The study revealed that intrafamilial child sexual abuse in Marondera is associated with very subtle structural factors which put children at risk of abuse, prevent children, families, and communities from reporting, and reduce the accessibility of formal systems of social control. There are 'conflicts' between normative/legal and traditional socio-cultural value systems such that there is no shared understanding of the fundamental issues driving this phenomenon. Policy/practice responses need to take cognizance of these peculiarities. As a basic first step, a comprehensive national prevalence study is required. Further in-depth research of the socio-cultural determinants of intrafamilial child sexual abuse is also recommended.


Assuntos
Abuso Sexual na Infância , Serviços de Proteção Infantil , Família , Jurisprudência , Adulto , Criança , Abuso Sexual na Infância/etnologia , Abuso Sexual na Infância/legislação & jurisprudência , Família/etnologia , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Zimbábue/etnologia
20.
BMC Public Health ; 19(1): 652, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31138165

RESUMO

BACKGROUND: Colorectal cancer (CRC) screening, such as fecal occult blood test (FOBT), is an effective way to prevent CRC, one of the most common cancers worldwide. However, studies found that South Asian ethnic minorities tend not to utilize CRC screening, whose importance on CRC prevention shall be educated among those from ethnic minorities, especially older adults. The purpose of this study is to develop and implement a family-based, multimedia intervention to augment the knowledge of CRC prevention among older South Asian adults in Hong Kong and enhance their motivation for undergoing FOBT. The acceptability and effectiveness of the intervention will be assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. METHODS: A cluster randomized controlled trial will be carried out. Three hundred and twenty South Asian dyads, comprising an older adult aged between 50 and 75 and a younger family member aged between 18 and 49, will be recruited in ten districts in Hong Kong through community organizations that provide support services for South Asians in local communities. Dyads will be randomly allocated to either the intervention or wait-list control group. Intervention dyads will receive intervention, whose contents are based on the health belief model, via multiple forms of media including PowerPoint presentation, video clip and health information booklet. Control dyads will receive intervention after post-intervention data are collected. For dyads in both groups, an appointment with a family doctor will be arranged for those willing to undergo FOBT. Outcomes will be assessed at baseline and post-intervention. Data will be analysed using the Generalised Linear Models Procedure in an intention-to-treat manner. DISCUSSION: Findings of this study will provide evidence of the benefits of utilizing multimedia and family-based approaches in intervention development to enhance the effectiveness of health promotion interventions for ethnic minorities. Further, the findings would provide reference to the potential incorporation of the intervention in the existing support services for South Asian ethnic minorities in local communities. TRIAL REGISTRATION: This trial is registered at the ISRCTN Registry ( ISRCTN72829325 ) on 19th July 2018.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Neoplasias Colorretais/etnologia , Detecção Precoce de Câncer/estatística & dados numéricos , Família/etnologia , Promoção da Saúde/métodos , Grupos Minoritários/psicologia , Multimídia , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Protocolos Clínicos , Neoplasias Colorretais/prevenção & controle , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Sangue Oculto , Adulto Jovem
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