A sociocultural approach to voting: Construing voting as a duty to others predicts political interest and engagement.

A representative democracy requires citizens to be politically engaged; however, a substantial portion of eligible United States voters do not vote. While structural (e.g., ease or difficulty of voting) and individual (e.g., political efficacy, civic knowledge) factors contribute to (a lack of) turnout, the present work adopts a sociocultural perspective to investigate an additional contributor: how people construe-or make sense of-the duty to vote. We examine whether, and for whom, construing voting as interdependent (i.e., voting as a duty to others), compared to independent (i.e., voting as a duty to self), is associated with increased perceived duty and political engagement. Archival analysis (n[Formula: see text] 10,185) documents how perceived duty to vote relates to voter turnout in a nationally representative sample of Americans (Study 1). Two preregistered studies (total n[Formula: see text] 1,256) provide evidence that naturalistically construing one's duty to vote as interdependent (Study 2) and experimentally reflecting on interdependence (Study 3) both predict increases in perceived voting duty. Perceived duty to vote, in turn, is associated with heightened political engagement intentions. Taken together, the present work suggests that how voting is construed-as an independent duty to the self or an interdependent duty to others-may meaningfully influence political engagement, with implications for voter turnout interventions.

Utilization of treated municipal effluent for irrigating agricultural land in Palestine: The driving factors and existing practices.

This article investigates the motivations and practices of using treated wastewater (TWW) to irrigate crop fields in Jenin, Palestine. Around 40 farmers were surveyed for data collection. The results showed that 66% of the farmers grew alfalfa crops while 30% grew fruit trees. The main obstacles the farmers faced before starting to use TWW were disgust (68.2%), worries about the quality of TWW (68.2%), health concerns (63.6%), and concerns about adverse effects on the soil (63.6%). All interviewed farmers considered the establishing and funding of an irrigation project to be the cornerstone for any reuse project. The second most important driving factor was the price of TWW that is 10-25% of the fresh water prices. After reusing TWW for irrigation, 59% of the farmers did not use any fertilizer, but they were not sufficiently aware of the crops' water needs, nor the nutrients in the TWW. All the fodder-growing farmers abstained from selling their crops before drying. The farmers used the TWW for five to nine months annually. After the TWW was reused, the main positive impacts of the TWW reuse were increased crop yields (77.3%), crops quality (50.0%), and crops marketing (47.7%). On the other hand, the main negative impacts were blocking of the irrigation systems (77.3%) and release of odors (54.5%). After practicing TWW use in crops irrigation, the key factors contributed to the "no difference" index were the effects on human health (100%), soil quality (56.8%), and insects spread (54.5%). Therefore, the results of the study support the decision makers to implement TWW reuse policies for crop irrigation in arid regions with scarce water resources. Monitoring TWW reuse and training farmers and helping them overcome obstacles is essential.

A multisystem model for understanding stress and adaptation in ethnically and racially diverse youth.

Contemporary biological and contextually based theoretical frameworks have conceptualized how stress exposure may influence adaptation in youth. However, nearly all of this scholarship neglects the role of specific contextual features and/or biological processes that are involved in ethnic-racial minority youth's responses and adaptation to sociocultural stressors. Drawing on the theoretical principles of the developmental psychopathology framework and contemporary models of stress and adaptation, this article proposes a new multisystem model that explains how multiple levels and systems within and outside of individual youth influence their sociocultural adaptation. We provide empirical evidence to support components of this multisystem model. We propose that research based on our new theoretical framework will capture the sociocultural experiences of ethnic-racial minority youth by centering processes that are relevant to their lived experiences, coping, and adjustment. In doing so, this model will inform psychosocial interventions focused on promoting healthy adaptation among ethnic and racial diverse youth. Finally, we offer recommendations to guide future research on stress and adaptation among ethnic and racial diverse youth, in particular, and developmental psychopathology more broadly.

"An obedient wife never says "no" to her virtual god." High fertility conceptions and barriers to contraceptive use among mothers of Southern Pakistan: a qualitative study.

ISSUE: Biomedical approaches want to change locals' behaviors without understanding the sociocultural rationales and contextualizing the cultural and structural backdrop of women's agency. OBJECTIVES: This study explored the perceptions and practices of rural mothers about fertility and reproductive health and further examine the lack of preference for contraception and birth spacing in Southern Pakistan. METHODOLOGY: Using purposive sampling we recruited 15 healthcare providers and 20 mothers from Southern Punjab. Key informants and in-depth interviews were used for data collection. We extracted themes and sub themes to analyse qualitative data. FINDINGS: Five major themes identified preventing birth spacing and contraceptive use: (1) cultural barriers (2) economic difficulties and demographic factors; (3) gender-related hurdles; (4) spiritual and religious obstacles, and (5) medico-ethical complications. Nearly, ten sub-themes contributing to these major themes were: custom of girls' early marriages, in-laws' permission for contraception, women's concern for medical complications and preference for safer methods, misuse of contraceptive methods by the medical community, mothers' perception of contraception as sinful act and controlling birth is against faith, economic and rural-ethnic factors for high fertility, masculine disapproval of condom use, and wishing to give birth to male children. SUGGESTIONS: We advocate for understanding the sociocultural explanations for low contraceptive use and urge practice of more natural methods of birth spacing over commercial solutions. The study suggests socio-economic development of less developed communities and empowerment of poor, illiterate, and rural women along with behavior change communication strategies.

Experiences of family caregivers in dealing with cases of advanced breast cancer: a qualitative study of the sociocultural context in Punjab, Pakistan.

BACKGROUND: Patients with advanced breast cancer require consistent help and support from family caregivers. These caregivers often endure financial burdens and psychological stress, with their experiences significantly influenced by sociocultural factors. This study aims to explore the experiences of family caregivers of advanced breast cancer patients in Punjab province, Pakistan. METHODS: Data was collected through in-depth interviews with fifteen family caregivers of advanced breast cancer patients in three major cities of Punjab, Pakistan. Caregivers, who had been in close contact with the patient for the last two years, were purposively sampled from five major hospitals. The data was analyzed using thematic analysis. RESULTS: The study revealed that the experiences of family caregivers are deeply rooted in the sociocultural context. Key themes identified include social responsibility and cultural reciprocity norms; limited awareness and mobility options for caregivers; financial responsibility and strain; impacts of beauty myths and shyness on caregiving attitudes and decisions; the stressful and emotional nature of caregiving; treatment perspectives influenced by social groups; challenges in consulting male physicians and associated stigma; the role of religious beliefs in caregiving; and stress management, with religion often being a coping mechanism. These factors can contribute to delayed treatment decisions for patients. CONCLUSIONS: Family caregivers are crucial in facilitating timely treatment decisions for advanced breast cancer patients in the Pakistani context. To minimize treatment delays and alleviate caregiver stress, addressing sociocultural barriers in care-seeking is essential. A tailored approach, considering sociocultural and religious factors, is imperative for the management and early diagnosis of breast cancer, necessitating appropriate policymaking and implementation.

Cultural foundations of a mathematician's thinking: a Psychobiographical exploration of Zoltán Paul Dienes and his cognitive development.

This psychobiographical study utilises Lev Vygotsky's sociocultural theory to explore the impact of diverse cultural experiences on the intellectual growth of Zoltán Paul Dienes, a prominent mathematician and theorist of mathematical education. Vygotsky's sociocultural theory is particularly relevant for understanding the impact of culture on intellectual development. According to Vygotsky, cognitive development is shaped by social and cultural interactions, and the tools and practices of a given culture. The study employs a taxonomy of cognitive tools to categorise the influences young Dienes encountered in Hungary, Austria, France, United Kingdom and elsewhere. By examining the presence and frequency of these tools in his formative years, the research sheds light on the origins of Dienes's principles in mathematical education. The research enriches psychobiography by integrating sociocultural theory, providing valuable insights into the relationship between culture, cognitive tools, and intellectual growth in knowledgeable individuals. Ultimately, this study contributes to a better comprehension of the origins and principles behind Dienes's theory of mathematical education.

Guiding psychologists through inner and outer worlds: reflections from an academic Levinsonian psychobiography of Joe Slovo.

Psychobiography has become valuable within the context of professional psychology training. A recent psychobiography purposively sampled Joe Slovo to uncover, reconstruct and illustrate significant trajectories of his development. Slovo's (1926-1995) lifelong dedication to the struggle against Apartheid has been widely acknowledged, and he held longstanding leadership positions in various South African liberation movements. Levinson's theory of lifespan development served as the study's psychological lens. Alexander's approaches to data identification and extraction were used, followed by a psycho-historical matrix for data categorisation based on the life cycle theory and significant historical periods throughout Slovo's life. To fully embrace the Levinsonian understanding that an individual cannot be separated from their social world, consideration was given to significant historical and sociocultural forces and events during the data analysis. Therefore, this study's findings extend beyond Slovo's individual development to illuminate the complex ways external forces, such as family dynamics, historical events, political movements, community concerns and cultural and language considerations, influence developmental trajectories, life structures and tasks. The authors reflect on the value of sociocultural and contextual sensitivity in psychobiography to help trainee psychologists venture beyond the subject's inner psychological life, including understanding their outer worlds.

The sociocultural influences in Lawrence Kohlberg's life: a psychobiography.

Lawrence Kohlberg (1927-1987) was a moral development specialist and moral teacher. He is considered an exceptional individual due to the success he obtained from developing his Theory of Moral Development. Throughout Kohlberg's life, there was a reciprocal influence between Kohlberg's development and the sociocultural influences of his time, guiding his life story. This psychobiography used a longitudinal, single-case research design from the qualitative paradigm, utilising the descriptive-interpretive approach to explore the influences which shaped major life events in Kohlberg's life. This research design enabled the illumination of how sociocultural circumstances shaped various spheres in Kohlberg's life, such as his identity, education, career path and vocational success. This was done through using Bronfenbrenner's Bioecological Theory of Human Development Framework, by including its enmeshed, most up-to-date scientific research design, the Proximal-Person-Context-Time Model.

A "Self-Milieux" perspective on help-seeking: examining the impact of a person's sociocultural background on help-seeking in people with untreated depressive symptoms.

BACKGROUND: Mental illness is a global concern and the leading cause of years lived with disability. Research on help-seeking behaviour has focused on individual factors, but there is still much unexplained variance. Suggesting complex interactions between determinants of human behaviour a new framework called Self-Milieux is proposed to represent a person's sociocultural background. The article introduces a statistical approach to determine Self-Milieux and exemplarily examines its predictive validity for health-related research. METHODS: Self-Milieux are determined through a two-stage clustering method based on the determinants socioeconomic status and self-construal profile. Descriptive analyses are used to compare Self-Milieux characteristics. Hierarchical binary logistic regression models test the association between Self-Milieux and help-seeking behaviour, while controlling for socioeconomic status as an established predictor. RESULTS: The sample size was N = 1535 (Mage = 43.17 and 64.89% female participants). Average depression severity was M = 12.22, indicating mild to moderate symptoms. Six Self-Milieux were determined and named. Participants from privileged (aOR = 0.38) and self-sufficient (aOR = 0.37) milieux were less likely to seek help from a general practitioner than those from the entitled milieu. Participants from privileged (aOR = 0.30), collaborators (aOR = 0.50), disadvantaged (aOR = 0.33), and self-sufficient (aOR = 0.21) milieux were less likely to seek help from family members than those from the entitled and family-bound milieux. DISCUSSION: The study's strengths and limitations, as well as the cluster methodology, are discussed. The comparative results for the six Self-Milieux are interpreted based on current research. For example, participants from some milieux follow a help-seeking process proposed in previous research, while participants from other milieux seem to show a different process, one that ends in informal help-seeking.

Standing together at the helm - how employees experience employee-driven innovation in primary care.

Primary care needs to find strategies to deal with today's societal challenges and continue to deliver efficient and high-quality care. Employee-driven innovation is increasingly gaining ground as an accessible pathway to developing successful and sustainable organisations. This type of innovation is characterised by employees being engaged in the innovation process, based on a bottom-up approach. This qualitative study explores employees' experiences of employee-driven innovation at a primary care centre in Sweden. Data are collected by focus group interviews and analysed by inductive qualitative content analysis. The result is presented with the overarching theme "Standing together at the helm" followed by three categories: "Motivating factors for practising employee-driven innovation", "Challenges in practising employee-driven innovation" and "Benefits of employee-driven innovation", including nine subcategories. The study found that employee-driven innovation fosters organisational innovation, empowers employees, and enhances adaptability at personal and organisational levels. This enables individual and collective learning, and facilitates the shaping, development, and adaptation of working methods to meet internal and external requirements. However, new employees encountered difficulty grasping the concept of employee-driven innovation and recognising its long-term advantages. Additionally, the demanding and task-focused environment within primary care posed challenges in sustaining efforts in innovation work. The employees also experienced a lack of external support to drive and implement some innovative ideas.

"I don't want my marriage to end": a qualitative investigation of the sociocultural factors influencing contraceptive use among married Rohingya women residing in refugee camps in Bangladesh.

BACKGROUND: The timely provision of comprehensive contraceptive services to Rohingya women is impeded due to a lack of clarity and understanding of their traditional beliefs and cultural frameworks. Recognizing this challenge, our paper aims to explore the socio-cultural factors influencing the utilization of contraceptives among married Rohingya women living in the refugee camps of Cox's Bazar, Bangladesh. METHOD: A qualitative study was conducted in two unregistered Rohingya camps (Camp 7&14) located in Ukhiya Upazila, Cox's Bazar from January 10th to 20th, 2022. A total of 14 In-Depth Interviews (IDIs) were conducted among married Rohingya women of reproductive age (15-49 years), along with 16 Key Informant Interviews (KIIs) involving stakeholders engaged in reproductive healthcare provision. Participants were selected using purposive sampling. All interviews were conducted in the local language, recorded, transcribed verbatim, and subsequently translated into English. The data were analyzed using NVivo (Version 11), and the analysis process followed Neuman's three-phase coding system. RESULTS: Five broad themes were identified: Sociocultural expectations and values attached to births, power imbalances within marital relationships, the role of religious beliefs, fear of side effects, and misperceptions about contraception. Having a larger number of children is viewed positively as it is believed that children play a crucial role in preserving the lineage and contributing to the growth of the Islamic population. Despite expressing an inclination towards contraception, the disapproval of husbands becomes a significant barrier for women. Defying their husbands' wishes can result in instances of Intimate Partner Violence (IPV) and even marriage dissolution within the camps. Moreover, the fear of side effects, such as a particular method would cause infertility, discourages women from using contraception. Many of these fears stem from myths, misconceptions, and mistrust in the existing medical system. CONCLUSION: Addressing the socio-cultural barriers that prevent women from using modern contraception will have important public health implications. These findings can support in crafting culturally sensitive programs and educational interventions. These initiatives can assist Rohingya refugee women in planning their pregnancies and reducing high-risk pregnancies, ultimately leading to a decrease in maternal mortality rates within the community.

The timely provision of comprehensive contraceptive services to Rohingya women is impeded due to a lack of clarity and understanding of their traditional beliefs and cultural frameworks. Taking this into account, our objective is to investigate the socio-cultural factors that influence the utilization of contraceptives among married Rohingya women living in the refugee camps of Cox's Bazar, Bangladesh. A total of 14 IDIs and 16 KIIs were conducted in two unregistered Rohingya camps. We found that contraceptive use among Rohingya refugees was constrained by various socio-cultural and religious beliefs. The desire for a larger number of children to ensure the continuity of the lineage and to be able to contribute to the growth of the Islamic population serves as a major barrier. Lack of decision-making power regarding reproductive life not only stops participation but also makes women vulnerable to IPV and marriage dissolution within the camps. Moreover, the fear of side effects, such as a particular method would cause infertility, discourages women from using contraception. Many of these fears stem from myths, misconceptions, and mistrust in the existing medical system. Young women often acquire information about both true side effects and myths from their social networks. Therefore, developing culturally sensitive programs and educational interventions targeting the women, their peers, and other related communities is indispensable to assist Rohingya refugee women in overcoming the identified barriers to contraception.

Examining contraceptive utilization behavior in Pakistani women.

BACKGROUND: There is a dearth of research examining the couple characteristics in determining contractive utilization behavior in developing countries. This study fills the gap by analyzing the roles of women's intra-household bargaining power and spousal age differentials in predicting contraceptive utilization behavior in Pakistani women. METHODS: A sample of 13,331, excluding pregnant and sexually inactive married women aged 15-49, was extracted from the Pakistan Demographic and Health Survey 2017-18. The dataset is cross-sectional. Exploratory analysis was used to examine the pattern of contraceptive knowledge, types of contraceptive utilization, and intention to use contraceptives among women. Furthermore, binary regressions were employed to examine the association of women's intrahousehold bargaining power and spousal age difference with contraceptive utilization without and after accounting for all potential covariates. RESULTS: Only 33% of women use contraceptives, while 30% express an intention to use contraceptives in the future. Almost all women (98%) knew about modern contraceptives. Compared to same-age couples, higher odds of current contraceptive use are observed among women whose husbands are at least 20 years older than them or whose husbands are young to them. The odds of the intention to use contraceptives tend to increase with the increase in spousal age difference. Women's intra-household bargaining is a significant predictor of current contraceptive utilization and intention to use contraceptives. CONCLUSION: Findings underscore the importance of considering the couple's characteristics in reproductive healthcare programming and policies. RECOMMENDATION: Greater women's intra-household bargaining power and smaller spousal age differences are associated with higher contraceptive usage. Empowering women and promoting their decision-making authority within households can enhance reproductive health outcomes.

School teachers' menstrual experiences and practices: reflections from rural Rajasthan, India.

Menstruation is considered an off-limits subject in India where menstruating woman continue to face silence, discrimination and isolation. A mesh of patriarchal cultural practices surrounding the subject of menstruation places restrictions on girls and women who are menstruating. This paper explores the menstrual experiences and challenges experienced by teachers from a village located in a Kishangarh block in rural Rajasthan. Informed by qualitative research, the study reveals the irony in thrust to distribute disposable menstrual pads to adolescent girls in school while ignoring the needs of teachers. The study calls for the inclusion of teachers as key stakeholders in the design of school based menstrual hygiene management and awareness initiatives and programmes.

'Parents are gudlists!' Experiences of puberty and parent-child sexual communication in rural KwaZulu-Natal, South Africa.

This paper explores young people's experiences of puberty and their perspectives on parent-child sexual communication in rural northern KwaZulu-Natal. In-depth individual interviews, focus group discussions, and participatory visual research methodology were employed with 18 and 19-year-old young women (n = 30) and young men (n = 16) attending three primary health care facilities and a local high school in Jozini municipality. The findings suggest a complex interplay between unequal gender and socio-cultural norms that results in divergent puberty experiences and ambiguous and inconsistent patterns of parent-child sexual communication. Young people referred to their parents as gudlists, a local colloquialism for someone who is evasive, vague, ambiguous and indirect. Lack of open parent-child sexual communication hinders discussion of healthy sexuality, neglecting the sexual and reproductive health education and needs of young people. Reflective of their desire for change, young women in particular contest current parenting norms and suggest returning to cultural practices linked to traditional forms of courtship and sexual communication among young Zulu people.

Delineating dengue risk zones in Jaipur: An interdisciplinary approach to inform public health strategies.

Dengue fever (DF) is a pervasive public health concern in tropical climates, with densely populated regions, such as India, disproportionately affected. Addressing this issue requires a multifaceted understanding of the environmental and sociocultural factors that contribute to the risk of dengue infection. This study aimed to identify high-risk zones for DF in Jaipur, Rajasthan, India, by integrating physical, demographic, and epidemiological data in a comprehensive risk analysis framework. We investigated environmental variables, such as soil type and plant cover, to characterize the potential habitats of Aedes aegypti, the primary dengue vector. Concurrently, demographic metrics were evaluated to assess the population's susceptibility to dengue outbreaks. High-risk areas were systematically identified through a comparative analysis that integrated population density and incidence rates per ward. The results revealed a significant correlation between high population density and an increased risk of dengue, predominantly facilitated by vertical transmission. Spatially, these high-risk zones are concentrated in the northern and southern sectors of Jaipur, with the northern and southwestern wards exhibiting the most acute risk profiles. This study underscores the importance of targeted public health interventions and vaccination campaigns in vulnerable areas. It further lays the groundwork for future research to evaluate the effectiveness of such interventions, thereby contributing to the development of robust evidence-based strategies for dengue risk mitigation.

Sociocultural Responsive Frameworks to Increase Engagement in Service Systems Through a Peer-to-Peer Model.

Service engagement is critical when working with children and families experiencing chronic adversities because of their socially marginalized status. Further, sociodemographic disparities exist in service engagement within service systems including Community-Based Behavioral Health; likely in part, a result of structural issues driving unresponsive service systems. Despite this knowledge, a large proportion of the family engagement literature continues to be approached through a deficit-based and family-centric lens leaving out important systemic considerations and furthering health inequities. Drawing from a Socio-Ecological Framework (Stokols, 1996), this study focuses on exploring the value of peer support providers (PSPs) to understand how sociocultural responsiveness functions under this service model. Individual interviews and focus group data were collected from both families and PSPs. Thematic analysis (Braun & Clarke in Qualitative Research in Psychology, 3(2), 77-101, 2006) was utilized to code and synthetize the data collected. Findings highlight the importance of capitalizing on meaningful and trusting relationships to foster family engagement in services. These findings solidify the understanding that family engagement is a function of crucial relationships between family, provider, and systems. This work also illustrates how PSPs organic embodiment of sociocultural responsiveness through cultural humility is an avenue through which family engagement can be sustained.

Longitudinal relationships among sociocultural pressure for body image, self-concept clarity, and emotional well-being in adolescents.

INTRODUCTION: This study examined the longitudinal relationships among sociocultural pressure for body image (SPBI), self-concept clarity (SCC), and emotional well-being (EWB) at both the between- and within-person levels. METHODS: The participants were 2001 Chinese adolescents (age range 11-24, 42.9% males). Recruitment of participants occurred for 1 year across three waves (i.e., 6 months apart across three cohorts). The baseline and follow-up questionnaire surveys were utilized to assess SPBI, SCC, EWB, and background variables. Longitudinal associations between the above main variables were tested using a cross-lagged panel model (CLPM) and multilevel regression analysis. RESULTS: The CLPM and multilevel-model analysis showed that SCC longitudinally mediated the relationships between SPBI and EWB. Besides, gender and age were considered moderators in the associations among SPBI, SCC, and EWB. CONCLUSIONS: SCC could be an underlying mechanism for the longitudinal relationship between SPBI and EWB among Chinese adolescents, which provides a potential intervention target for improving adolescents' well-being from a sociocultural framework.

Exploring men's struggles with infertility: A qualitative content analysis.

AIM: To investigate the experiences of men struggling with infertility. DESIGN: This is a qualitative study, and the report follows the COREQ checklist. METHODS: A team of nurse researchers conducted this research in Iran to examine the experiences of 11 men with primary infertility. The participants were selected through targeted sampling and underwent in-depth semi-structured interviews. The data collected was analysed using the conventional content analysis method outlined by Krippendorff. To ensure the study's accuracy, it followed the criteria proposed by Lincoln and Guba. RESULTS: The central theme, "the threat to masculinity," was identified upon analysis. It comprises six categories: psychological pressure of confronting reality, frustration, discomfort with others, holding out against ridicule, tolerating unwanted opinions and advice and concealment of infertility and therapy. CONCLUSION: This study brings attention to the challenge to masculinity that men with primary infertility face as their central struggle. It highlights the importance of culturally sensitive care from healthcare professionals, emotional support, counselling services and public awareness to reduce the stigma surrounding male infertility. It can be valuable to evaluate and enhance infertility care in various settings. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: To provide the best possible care for infertile men, it would be beneficial for nurses to pay more attention to sociocultural factors. Fertility care should be respectful of patients' beliefs and backgrounds. IMPACT: WHAT PROBLEM DID THE STUDY ADDRESS?: Infertility care has been the subject of recent research, focusing on the impact of sociocultural factors. Male-factor infertility is often overlooked in clinical care literature. There is a correlation between cultural background and men's acceptance of reproductive healthcare. WHAT WERE THE MAIN FINDINGS?: Male infertility is often avoided in discussions due to its perceived threat to masculinity. Multiple factors, including societal norms, cultural expectations and personal experiences, influence the nature of men's struggles with infertility. Providing emotional support and counselling services is crucial so that men can openly discuss their fertility challenges and seek treatment without feeling ashamed or judged. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: Raising public awareness and providing education about male infertility is crucial. Nurses must exhibit cultural sensitivity while caring for men experiencing infertility. Policymakers need to implement strategies to reduce the stigma surrounding male infertility. REPORTING METHOD: The study is reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: No public or patient involvement.

Measuring sociocultural engagement of health professions education students: a psychometric study.

BACKGROUND: Sociocultural engagement of students refers to broadening viewpoints and providing awareness of, and respect for, diverse backgrounds and perspectives. However, there are no existing validated instruments in the literature for measuring sociocultural engagement of health professions education (HPE) students. Therefore, the aim of this study is to develop and validate a questionnaire designed to assess sociocultural engagement among HPE students. METHODS: The study included undergraduate HPE students (n = 683) at Gulf Medical University. The initial version of the sociocultural engagement of students' questionnaire (SESQ) was developed after extensive literature review and guided by the Global Learning Qualifications Framework. We then tested the content validity of the questionnaire by using focus group discussion with subject experts (n = 16) and pilot testing with students (n = 20). We distributed the content-validated version of the SESQ (16 items) to undergraduate students in six HPE colleges. To examine the construct validity and construct reliability of the questionnaire, we conducted exploratory factor analysis, followed by confirmatory factor analysis. RESULTS: Confirmatory factor analysis supported the two-factor structure which consists of 13 items with good fitness indices (χ2 = 214.35, df = 61, χ 2/df = 3.51, CFI = 0.98, RMSEA = 0.06, SRMR = 0.025, and AIC = 208.00). The two factors were sociocultural interactions (8 items) and sociocultural adaptation (5 items). The construct reliability of the total questionnaire is 0.97 and the two factors were 0.93 and 0.92 for sociocultural interactions and sociocultural adaptation, respectively. In addition, there were significant weak correlations between both factors of sociocultural engagement scores and student satisfaction with the university experience (r = .19 for each, P = .01). CONCLUSIONS: The sociocultural engagement of students' questionnaire exhibits good evidence of construct validity and reliability. Further studies will be required to test the validity of this questionnaire in other contexts.

Sociocultural adjustment and social support as predictors for international medical sciences students' anxiety during COVID-19.

BACKGROUND: The prevalence of anxiety is high among international medical sciences students and it increased even more during the COVID-19 pandemic due to different restrictions and social isolation. Successful sociocultural adjustment and social support could be important factors in overcoming those challenges, however, there is a lack of studies which would investigate the role of those factors among inter- national medical students. This study aimed to assess the role of sociocultural adjustment and social support as predictors for international medical students' anxiety during COVID-19. METHODS: Two measurements were conducted via self-reported questionnaires which consisted of three scales - SCAS, MSPSS and GAD-7. In total, 82 international medical students participated in both measurements in this longitudinal study. RESULTS: The findings indicated that 37% of international students had symptoms of moderate or severe anxiety during their first year of studies at university. In the second year, during the COVID-19 pandemic and an official lockdown, 35% of international students had symptoms of moderate or severe anxiety. In addition, this study showed that gender and sociocultural adjustment did not play a role as predictors of students' anxiety during the second year of studies. However, this study revealed that social support provided by family during the first year of studies, as well as having friends or family members who had been ill with COVID-19 predicted higher levels of anxiety at second measurement, while sociocultural adjustment was an even stronger predictor of anxiety in the second year of studies of international medical students. CONCLUSIONS: This knowledge can help to better understand how international medical students felt during the COVID-19 pandemic and what role the above- mentioned factors played in the students' anxiety. As the anxiety level is quite high among international medical students, universities and mental health service providers should take it into consideration and help them to overcome those challenges.