The influence of socio-cultural factors on breast cancer screening behaviors in Lagos, Nigeria.

Culture has been shown to influence health beliefs and health-related behaviors by influencing the type of health information to which women have been exposed and shapes health and illness perceptions and practices. To increase screening rates, cultural influences should be considered as important correlates of screening behaviors for breast cancer. This study used semi-structured interviews of women attending a cancer screening facility in Lagos, Nigeria guided by the PEN-3 model to describe culturally relevant factors that shape attitudes toward breast cancer and breast cancer screening. Religion was the most prominent theme and was shown to have positive, negative and existential effect on breast cancer perceptions. Other major themes observed were related to family and traditional beliefs. The results from this study could be used to develop and implement culturally relevant cancer prevention interventions, strategies, and recommendations to overcome screening barriers in an effort to increase breast cancer participation and awareness among Nigerian women.

Barriers in general practitioners' dementia diagnostics among people with a migration background in Germany (BaDeMi) - study protocol for a cross-sectional survey.

BACKGROUND: Considering the targeted general practitioner-centred healthcare in Germany, general practitioners (GPs) are in the best possible position to increase awareness of all sorts of dementia, an age-related syndrome with rising relevance in the future. In Germany, a doubling of the number of cases from 1.55 million up to 3 million in 2050 is predicted. Diagnostics can be challenging, especially among patients with a migration background. Complicating factors include: Language-based diagnostic tools, cultural differences in handling the syndrome and its underlying diseases as well as a differing use of the healthcare system. Because of missing research in this field in Germany, the type, frequency and intensity of barriers as well as the way GPs cope with them is unknown. That is why it's crucial to focus research on diagnostics in total and especially among this population group. METHODS: A cross-sectional study among a random sample of 1000 general practitioners in Germany is conducted in October 2017. A self-administered standardized questionnaire was developed, evaluated and send to the GP practices. A response rate of 30% is expected with one reminder letter. Descriptive statistics as well as, depending on the results, multivariable analyses will be executed. Based on these results and the stated needs, a cluster-randomized intervention study will be constructed to improve healthcare. DISCUSSION: This study is the first in Germany focusing on how dementia diagnostics in general practice is performed, what problems occur, especially because of a migration background of patients, and how GPs cope with them. Depending on the results, it should emphasize the necessity of dementia diagnostics to be adjusted to the needs of the rising amount of people with a migration background (22.5% in Germany, 2016) like concluded from international studies. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00012503 , date of registration: 05.09.2017. Clinical register of the study coordination office of the University hospital of Bonn: ID530 , date of registration: 05.09.2017.

Investigating acculturation orientations of patients with an immigration background and doctors in Canada: implications for medical advice adherence.

BACKGROUND: Increased immigration requires successful interaction of different cultures in various life domains, such as health. This study investigates acculturation orientation (AO) of immigrant patients and doctors native to the country, as a potential factor related to perceived medical advice adherence. DATA AND METHODS: N = 171 immigrant patients (M = 54.38 years, SD = 17.94, range = 23-96, 74.3 % female) and their N = 12 doctors (M = 38.88 years, SD = 13.42, range = 27-66, 83 % female) from a hospital in Montreal, Canada, participated in a paper-based survey to assess AOs, patients' perceived expectations of their doctor (regarding adopting the new culture or keeping their previous culture), doctors' actual expectations, perceived quality of care and perceived adherence. RESULTS: AO of patients significantly related to perceived adherence, via a path model involving perceptions of doctors' expectations and perceived quality of care. Integration was positively related to perceived adherence, while Marginalization was negatively related to it. Doctors' AOs were not significant. CONCLUSION: Patient perceptions seem to be a significant factor to be considered when striving to improve immigrant medical advice adherence.

Envisioning Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital, Northwest Territories.

Background: To improve the quality of care for Indigenous patients, local Indigenous leaders in the Northwest Territories, Canada have called for more culturally responsive models for Indigenous and biomedical healthcare collaboration at Stanton Territorial Hospital.Objective: This study examined how Indigenous patients and biomedical healthcare providers envision Indigenous healing practices working successfully with biomedical hospital care at Stanton Territorial Hospital.Methods: We carried out a qualitative study from May 2018 - June 2022. The study was overseen by an Indigenous Community Advisory Committee and was made up of two methods: (1) interviews (n = 41) with Indigenous Elders, patient advocates, and healthcare providers, and (2) sharing circles with four Indigenous Elders.Results: Participants' responses revealed three conceptual models for Indigenous and biomedical healthcare collaboration: the (1) integration; (2) independence; and (2) revisioning relationship models. In this article, we describe participants' proposed models and examine the extent to which each model is likely to improve care for Indigenous patients at Stanton Territorial Hospital. By surfacing new models for Indigenous and biomedical healthcare collaboration, the study findings deepen and extend understandings of hospital-based Indigenous wellness services and illuminate directions for future research.

Implementing a singing-based intervention for postpartum depression in Denmark and Romania: a brief research report.

Background: There is a burgeoning evidence-base that demonstrates the positive impact of the arts on our health, wellbeing, and health behaviors. However, very few studies have focused on how to optimize the implementation of these activities for different sociocultural contexts. Due to the increasing interest in scaling effective arts interventions as part of public health strategies, and in line with global goals of achieving health equity, this is an essential focus. Aim: Using the case study of a singing for post-partum depression (PPD) intervention with empirically-demonstrated clinical effects, this brief research report explores implementation of an arts and health intervention that has been successful in the United Kingdom ("Music and Motherhood") for the new contexts of Silkeborg (Denmark) and Cluj-Napoca (Romania). Methods: Data was collected from participants at all levels of the implementation structure including at local and management levels. The study draws on qualitative implementation data to explore participant experiences, including one-to-one interviews, written testimonies, meeting minutes, ethnographic researcher reflections and focus groups, including data from 46 participants in total. Results and conclusion: We explore implementation and adaptation across five key themes: (1) acceptability and feasibility; (2) practical and structural barriers and enablers; (3) adoption and sustainability; (4) broader contextual factors affecting implementation and sustainability; and (5) project structure and processes. Taken together, the themes demonstrate that arts interventions need to be adapted in culturally sensitive ways by stakeholders who have local knowledge of their environments. This research serves as an informative foundation for use by other researchers that aim to expand the reach and impact of arts-based interventions.

"We Don't Do Any of These Things Because We are a Death-Denying Culture": Sociocultural Perspectives of Black and Latinx Cancer Caregivers.

This qualitative study explored the unique challenges and experiences faced by Black and Latinx cancer survivors through the lens of their caregivers, including the specific cultural, social, and systemic factors that influence cancer survivorship experience within these communities in the United States. We conducted six focus group discussions (three Latinx and three Black groups) with a total of 33 caregivers of cancer survivors, (Mean age = 63 years). Data were analyzed using inductive content analysis; The sociocultural stress and coping model was used as a framework to interpret the findings. We identified three main themes: 1) families as (un)stressors in survivorship such as the vitality of social connections and families as unintended burden; 2) responses after diagnosis specifically whether to conceal or accept a diagnosis, and 3) experiencing health care barriers including communication gaps, biased prioritizing of care, and issues of power, trust, and need for stewardship. This study's findings align with previous research, highlighting the complex interplay between cultural, familial, and healthcare factors in cancer survivorship experiences within underserved communities. The study reiterates the need for culturally tailored emotional, physical, financial, and informational support for survivors and their caregivers. Also, the study highlights a need to strengthen mental health and coping strategies, to help address psychological distress and improve resilience among survivors and their caregivers.

Seeing Context through Metaphor: Using Communications Research to Bring a Social Determinants Perspective to Public Thinking about Child Abuse and Neglect.

Human beings think in metaphor and reason through analogy. The metaphors through which we think influence how we understand and feel about social issues as well as the actions that we see as appropriate and important. Metaphors can be used to increase understanding of how issues work and increase the salience of a given issue, build support for programs and policies necessary to address the issue, and instigate demand for change and civic action. In this paper, we use a mixed methods research design, including brief qualitative interviews, experimental surveys, and focus groups, to test the ability of different metaphors to influence public understanding of the social determinants of child abuse and neglect in the UK. We find one metaphor in particular that improves people's understanding of the social causes of child maltreatment and increases support for structural solutions. This metaphor can be used to build support for preventative public health solutions.

Culture: The missing link in health research.

Culture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research. This paper describes a multidisciplinary effort to find consensus on essential elements of a definition of culture to guide researchers in studying how cultural processes influence health and health behaviors. We first highlight the lack of progress made in the health sciences to explain differences between population groups, and then identify 10 key barriers in research impeding progress in more effectively and rapidly realizing equity in health outcomes. Second, we highlight the primarily mono-cultural lens through which health behavior is currently conceptualized, third, we present a consensus definition of culture as an integrating framework, and last, we provide guidelines to more effectively operationalize the concept of culture for health research. We hope this effort will be useful to researchers, reviewers, and funders alike.

From bench to bedside: the realities of reducing global prostate cancer disparity in black men.

Prostate cancer in black men of African descent has a different tumour biology compared to those of other races. Its clinical manifestations depict a more aggressive disease with higher morbidity and mortality. This study proposes, through a literature search, identifying applied laboratory and clinical research in prostate cancer directed to improve outcomes and decrease global disparities of prostate cancer in black men of African descent. This review identified five categories pertinent for research: prostate-specific antigen (PSA) testing for early detection and screening, the potential of epigenetics, cultural determinants and health-seeking behaviours, other biomarkers for prostate cancers, and the economics of treating advanced prostate cancer. The analysis revealed that in developed countries, men of African descent are underrepresented in the sampling pools in both laboratory and clinical research, and thus the applicability and relevance of these results to men of African descent are circumspect. However, developing countries with high populations of black males have limited laboratory and clinical research publications. This is due to limited funding to support research programmes and basic clinical services for early detection and treatment. The study concludes that for the involvement of developing countries in bench research, they should do it in collaboration, like fostering partnerships with credible academic-based institutions and organisations. This requires a realm of transparency, respect, protection of the rights and dignity of the patients, and an equity in participation and sharing of the benefits to be accrued. The current transatlantic and Caribbean collaborations in research, education, and health service delivery in prostate cancer care for men of African descent exemplify the successes of such partnerships.

Saúde e antropologia: contribuições à interpretação da condição humana em ciências da saúde / Health and anthropology: contributions to the interpretation of the human condition in the health sciences / Salud y antropología: contribuciones a la interpretación de la condición humana en ciencias de la salud

A interpretação do processo saúde/doença tem sido marcada pelo positivismo e pelas ciências naturais. A medicina/saúde ocidental concentrou uma atenção quase exclusiva às dimensões biológicas das patologias, demarcando sucessos cognitivos e operacionais, a biologia representando a verdadeira prova de rigor e objetividade. A função moduladora em relação às defesas orgânicas era atuada pelas dinâmicas psíquicas, a dimensão da subjetividade como lugar da ativa intermediação, em cada indivíduo, entre as esferas relacional e biológica. O reconhecimento dos fatores comportamentais e socioculturais desenvolveu-se fora do campo médico-institucional, seguindo linhas de investigação das disciplinas psicológicas e antropológicas. O texto tenta esboçar que um efetivo delineamento científico dos estudos sobre o homem somente pode fundar-se em uma abordagem sistêmica, em que os níveis biológico e histórico-social, que organizam a condição humana e realizam sua relação com o contexto, precisam ser examinados e interpretados em suas relações de integração, em sua recíproca autonomia e especificidade.

The interpretation of the health/disease process has been marked by positivism and by the natural sciences. Western medicine/health has focused almost exclusively on the biological dimensions of pathologies, delimiting cognitive and operational successes, biology representing the true proof of rigor and objectivity. The modulating function in relation to the organic defenses used to be enacted by the psychic dimensions, the dimension of subjectivity being the place of the active intermediation, in each individual, between the relational and biological spheres. The recognition of the behavioral and sociocultural factors was developed outside the medical-institutional field, following lines of investigation of the psychological and anthropological disciplines. The text tries to outline that an effective scientific design of the studies about man can only be founded on a systemic approach, in which the biological and historical-social levels, which organize the human condition and realize its relation to the context, need to be examined and interpreted in their relations of integration, in their reciprocal autonomy and specificity.

La interpretación del proceso salud/enfermedad ha sido marcada por el positivismo y por las ciencias naturales. La medicina/salud occidental concentró atención casi exclusiva a las dimensiones biológicas de las patologías, demarcando sucesos cognitivos y operacionales, representando la biología una verdadera prueba de rigor y objetividad. La función moduladora en relación a las defensas orgánicas era actuada por las dinámicas psíquicas, la dimensión de la subjetividad como lugar de activa intermediación en cada individuo, entre las esferas relacional y biológica. El reconocimiento de los factores comportamentales y socio-culturales se ha desarrollado fuera del campo médico-institucional, siguiendo líneas de investigación de las disciplinas psicológicas y antropológicas. El texto intenta esbozar que un efectivo delineamiento científico de los estudios sobre el hombre sólo se puede apoyar en un enfoque sistémico en que los niveles biológicos e histórico-sociales que organizan la condición humana y realizan su relación con el contexto necesitan examinarse e interpretarse en sus relaciones de integración, en su recíproca autonomía y especificidad.