Barriers to mental health service utilization among Arab society in Israel: Perspectives from service providers.

This study attempted to identify the barriers to the utilization of mental health services among the Arab society in Israel, as perceived by professionals working with this population. Twenty-seven therapists from community mental health services participated in structured in-depth interviews with at least 5 years of experience. Five main types of barriers to the utilization of mental health services were discovered: barriers related to attitudes and perceptions regarding mental disorders and their treatment, low literacy in the field of mental health, exposure and stigma, family characteristics and cultural values, and instrumental barriers. Flexibility and sensitivity to the socio-cultural context of the target population while allocating resources to create equality in access to mental health care may increase the utilization of mental health services in a traditional society such as the Arab society in Israel.

Prostitution in the shadow of life-long sexual abuse: Arab women's retrospective experiences.

The present study uses the life-course and intersectionality perspectives to explore the meaning that aging Arab women attribute to their lived experiences of life-long sexual abuse in the shadow of engaging in prostitution. Interpretive phenomenological analysis was used to analyze the narratives of 10 older Arab women in Israel who were engaged in prostitution. Four themes emerged: experiencing childhood in the shadow of sexual abuse, becoming a prostitute, being entrapped in prostitution, and settling accounts with the native culture. Women aging in prostitution experience a harsh reality of abuse and loss. The present study points to multiple channels of abuse throughout the life course, from childhood until old age.

From a humble identity to an identity of respect: lifetime abuse among Arab Israeli older women.

This study addresses the retrospective experiences of older Arab Israeli women after a lifetime of living in the shadow of intimate partner violence. Qualitative research was conducted, using in-depth, semi-structured interviews of 15 Arab Israeli older women. Underlying this study is a feminist perspective and a life course perspective. Two main themes emerged: (1) socially endorsed violence against Arab Israeli women. This took several forms: men's dominant position and women's dependence, sources of violence used against women before and after marriage, and the social education of women to accept their fate. (2) The construction of a multifaceted survival identity throughout Arab Israeli women's life and old age. This identity has a variety of dimensions, including: a submissive victim identity, a rehabilitative identity of respect in old age, and a form of split identity that combines both the rehabilitative social identity and the marginal identity still experienced within the home.

Uterine Transplantation: Ethical Considerations within Middle Eastern Perspectives.

The field of reproductive medicine witnessed a breakthrough in September 2014 with the first successful live birth post uterine transplantation. This success represents the culmination of decades' worth of research on infertility and reproductive medicine. This subject of infertility gathers special attention in the Middle East, as childbearing is given paramount importance in the family unit. And as with any new medical advancement, Middle Eastern people look to their religious authorities for guidance. This paper describes the various ethical quandaries related to uterine transplantation, from a perspective of the religious and societal factors that are unique to the Middle East, and embeds them within the conversation of its alternative solutions.

SCAPER-Related Autosomal Recessive Retinitis Pigmentosa with Intellectual Disability: Confirming and Extending the Phenotypic Spectrum and Bioinformatics Analyses.

Mutations in the gene SCAPER (S phase Cyclin A-Associated Protein residing in the Endoplasmic Reticulum) have recently been associated with retinitis pigmentosa (RP) and intellectual disability (ID). In 2011, a possible involvement of SCAPER in human diseases was discovered for the first time due to the identification of a homozygous mutation causing ID in an Iranian family. Later, five studies were published in 2019 that described patients with autosomal recessive syndromic retinitis pigmentosa (arRP) accompanied by ID and attention-deficit/hyperactivity disorder (ADHD). This present study describes three patients from an Arab consanguineous family in Israel with similar clinical features of the SCAPER syndrome. In addition, new manifestations of ocular symptoms, nystagmus, glaucoma, and elevator palsy, were observed. Genetic testing of the patients and both parents via whole-exome sequencing revealed the homozygous mutation c.2023-2A>G in SCAPER. Phenotypic and genotypic descriptions for all available cases described in the literature including our current three cases (37 cases) were carried out, in addition to a bioinformatics analysis for all the genetic variants that was undertaken. Our study confirms and extends the clinical manifestations of SCAPER-related disorders.

Childhood exposure to parental violence, attachment insecurities, and intimate partner violence perpetration among Arab adults in Israel.

BACKGROUND: Extensive research supports the existence of a "cycle of violence" that links exposure to parental violence during childhood (i.e., witnessing interparental violence and child maltreatment) with intimate partner violence (IPV) perpetration. However, there is still a need to explore the mechanisms through which early exposure to parental violence may foster IPV perpetration during adulthood. OBJECTIVE: In this study, we examine the mediating role of attachment insecurities and gender differences in the relationship between exposure to parental violence during childhood and IPV perpetration during adulthood. METHOD, PARTICIPANTS, AND SETTING: We conducted a cross-sectional survey among a representative sample of 604 married Arab adults (M age = 33.5, SD = 6.52; 50.1 % women) in Israel using a self-administered questionnaire. RESULTS: Exposure to physical violence, both as a victim and indirectly as a witness in childhood, was found positively correlated with adulthood IPV perpetration, with effect sizes ranging from weak (f2 = 0.01) to moderate (f2 = 0.15). Further, attachment-related avoidance was found to mediate the association between witnessing interparental physical violence and IPV perpetration. Gender differences were found in this relationship, with a stronger association indicated among male participants than among females. CONCLUSION: Exposure to physical violence may be understood as a risk factor for IPV perpetration directly and indirectly through the development of attachment-related avoidance.

Exposure to Parental Violence During Childhood and Later Psychological Distress Among Arab Adults in Israel: The Role of Gender and Sense of Coherence.

Exposure to parental violence in childhood is a significant predictor of psychological distress in adulthood. Factors at the individual level may explain the variance in psychological distress among adults exposed to parental violence. The current study examined the effect of exposure to different forms (i.e., physical violence and psychological aggression) and different patterns of parental violence (i.e., witnessing interparental violence, experiencing parental violence) on later psychological distress. The mediating role of sense of coherence (SOC) and the moderating role of gender in this relationship were also examined. A cross-sectional survey was conducted among 604 married Arab adults in Israel (age = 20-60, M = 33.5, SD = 6.52) using a retrospective, self-administered questionnaire. Results indicate a significant positive relationship between all forms and types of parental violence explored in the current study with levels of psychological distress. Furthermore, exposure to parental violence correlated negatively with SOC, and low levels of SOC predicted higher levels of psychological distress. SOC was found to partially mediate the relationship between exposure to parental violence and psychological distress. Gender differences were found only with regard to experiencing physical violence as a predictor of psychological distress, indicating that the relationship between these variables is stronger in females. These results highlight the importance of SOC as a personal resource and its role in promoting psychological wellbeing. Healthcare practitioners should be aware of possible gender differences in psychological distress among Arab adults exposed to parental violence.

Cultural Adaptation of the Illness Management and Recovery Intervention Among Israeli Arabs.

Awareness of the need for culturally adapted mental health interventions is growing. The authors describe the cultural adaptation of an evidence-based practice (EBP), illness management and recovery (IMR), to the Arab population in Israel. The process included reviewing the literature on cultural adaptations of EBPs and interviewing Arab and IMR professionals, which helped inform modifications that reflected the norms of Arab society in Israel related to family, religion, and beliefs about mental health. The process yielded a culturally adapted IMR intervention, which was translated into Arabic and used to train Arab practitioners on implementation with Arab clients in Israel.

Institution efficiency satisfaction and emotional responses to the COVID-19 pandemic in Arab citizens of Israel: An exploratory cross-sectional study.

The COVID-19 pandemic has led to the emergence of various stressors among people around the world. However, rare are the studies that investigate stressors by employing institution evaluations as their predictors in ethnic minorities. The goal of the current study was to examine the association between satisfaction with the efficiency of institutions' work on mitigation of the COVID-19 spread, and stressors - emotional responses to the pandemic: worry of the COVID-19 spread, and fear of being hurt by its spread. The study was conducted among Israeli Arab citizens (N = 697), who participated in an annual personal security index survey. Multinomial logistic regression was used for the multivariate analysis. The main finding suggests that satisfaction with efficiency of the emergency institutions performance was associated with a lower likelihood of being highly worried of COVID-19 spread, as well as with a lower likelihood of having a great fear of being hurt by its spread. Satisfaction with efficiency of societal institutions performance was associated only with lower likelihood of being moderately worried of the COVID-19 spread. The results imply that the institutions have an ability to reduce the stressors in population by means of efficient performance in mitigating the consequences of the pandemic. The results also imply that institutions differ in this ability. The main policy implication is that institutions, which efficiency satisfaction was unrelated to the stressors, should significantly improve such performance in order to reduce the magnitude of negative emotional responses in ethnic minorities.

Effective Ways to Encourage Health-Care Practices among Cultural Minorities in Israel during the COVID-19 Pandemic.

Following the worldwide outbreak of COVID-19, policymakers have been occupied with the questions of whether and how to specially address unique cultural groups coping with the pandemic. This study aimed to evaluate the potential for a culturally tailored approach to the transmission of health messages in a time of crisis among two minority populations within Israeli society: the Ultra-Orthodox population and the Arab population. To that end, 380 individuals from Israeli Ultra-Orthodox society and 360 individuals from Israeli Arab society completed a self-reported questionnaire in early April 2020, in the midst of the COVID-19 pandemic. The findings of this study reveal differences between these groups in terms of the effectiveness of different channels for conveying messages and the channels that were preferred, as well as significant relationships between community sense of coherence and the study variables. We found that advocacy and motivation based on values, on the one hand, and recognition of the effectiveness of a culturally tailored approach, on the other, may be the best approach for persuading members of minority populations, who belong to collectivist societies, to comply with epidemic-control instructions.

The Current and Forecasted Status of Type 2 Diabetes in the Arab Society of Israel.

BACKGROUND: Diabetes mellitus (DM) is considered one of the main causes of mortality, morbidity, and health care expenditures. Effectively treating this disease is of crucial importance and imposes a global challenge. The incidence of Type 2 DM (T2DM) is rapidly rising in both developing and developed countries. The Arab community in Israel is a distinct ethnic group with unique characteristics. Recently, this community has undergone major changes in its lifestyle, adopting the Westernized one, which could have caused an increase in the T2DM incidence rate. OBJECTIVE: This review aims to shed light on various studies undertaken to explore the prevalence of diabetes and determine its current status in the Arab society of Israel, resting on previous and current data. It is presented to highlight the status of diabetes globally and to focus on its current situation in the Arab society of Israel, attempting to forecast its direction in the upcoming decade. METHODS: Data were obtained from our previous comprehensive socio-economic and health crosssectional surveys for successive periods from 2004 to 2017. These surveys were conducted on the Arab society of Israel by the Galilee Society. RESULTS: Our results showed a progressive increase in the prevalence of T2DM from 3.4% to 7.6% in the Arab society of Israel. This trend is expected to continue rising in the coming decade, and based on our predictions, may exceed 12% in 2030. CONCLUSION: Substantial and practical health-related actions must be initiated to prevent an increasing number of adults from developing diabetes and its complications.

Caregiving of offspring with intellectual developmental disabilities in Israeli Jewish and Arab households: Financial and psychosocial differences.

BACKGROUND: This research responds to the lack of evidence-based knowledge regarding the psychosocial and financial gaps among caregivers of children with intellectual disabilities living in Jewish and Arab households. It examines the financial gaps and explores whether caregivers' social economic status and households' affiliation (Jewish vs. Arab) can explain the psychosocial variables such as levels of stress, social participation types and rates, and use of public services. METHOD: One hundred and twenty-five Jewish and Arab caregivers completed an income and expenditure survey, including out-of-pocket expenditures, a services use survey, a questionnaire regarding resources and stress levels, and a social participation scale. RESULTS: Arab households are more likely to have a low socioeconomic status (SES) than Jewish ones, characterized by lower per capita income, less spending, fewer out-of-pocket expenditures, and less ability to deal with an unexpected expense. In respect to psychosocial measures, Arab caregivers report lower use of public services than Jewish caregivers and lean more toward contact with relatives and religious participation than do Jewish caregivers. Caregivers' social economic status and households' affiliation do not have any interaction effect on psychosocial variables. CONCLUSIONS: Findings are discussed regarding research and practice.