Canada's growing ethnocultural diversity challenges health professionals to develop culturally sensitive cancer prevention strategies. Little is known about the ethnocultural specificity of cancer risk beliefs. This qualitative pilot study examined cancer risk beliefs, focusing on diet, among adults from Toronto's Somali, Chinese, Russian, and Spanish-speaking communities.
Group interviews (n = 4) were conducted with convenience samples of adults (total n = 45) from four ethnocultural communities (total 45 participants).
The constant comparison method of data analysis identified three common themes: knowledge of cancer risk factors, concern about the food supply, and the roles of spiritual and emotional well-being. Two areas of contrasting belief concerning specific mediators of cancer risk were identified.
Findings support the investigation of cultural-specific health promotion strategies emphasizing both the maintenance of traditional cancer protective eating practices and the adoption of additional healthy eating practices among new Canadians. More research is needed to enhance our understanding of ethnoculturally specific cancer risk beliefs and practices to ensure the cultural relevance of programming.
Like most indigenous populations throughout the world who have undergone innumerable cultural changes, the mental health care needs of American Indians are great. Some surveys conducted by the Indian Health Service show high rates of suicide, mortality, depression and substance abuse. Little is known about effective mental health care among American Indians due, in part, to the lack of culturally appropriate models of mental health in American Indians. This article presents a cultural framework in order to understand the mental health care needs of American Indians and discusses barriers to providing effective mental health services to American Indians.
We examined culture-related influences on willingness to seek treatment for social anxiety in first- and second-generation students of Chinese heritage (Ns=65, 47, respectively), and their European-heritage counterparts (N=60). Participants completed measures that assessed their willingness to seek treatment for various levels of social anxiety. Results showed that participants were similar on willingness to seek treatment at low- and high-severity levels of social anxiety; however, at moderate levels, first-generation Chinese participants were significantly less willing to seek treatment compared to their European-heritage counterparts. The reluctance of first-generation Chinese participants to seek treatment was associated with greater Chinese-heritage acculturation, and was not related to perceiving symptoms of social anxiety as less impairing. The findings support the general contention that Asians in North America tend to delay treatment for mental health problems.
There is some concern that ordered responses on health questions may differ across populations or even across subgroups of a population. This reporting heterogeneity may invalidate group comparisons and measures of health inequality. This paper proposes a test for differential reporting in ordered response models which enables to distinguish between cut-point shift and index shift. The method is illustrated using Canadian National Population Health Survey data. The McMaster Health Utility Index Mark 3 (HUI3) is used as a more objective health measure than the simple five-point scale of self-assessed health. We find clear evidence of index shifting and cut-point shifting for age and gender, but not for income, education or language.
The current studies examined if cultural and self-construal differences in self-enhancement extended to defensive responses to health threats.
Responses to fictitious medical diagnoses were compared between Asian-Americans and European-North Americans in experiment 1 and between Canadians primed with an interdependent versus an independent self-construal in experiment 3. In experiment 2, the responses of Chinese and Canadians who were either heavy or light soft drink consumers were assessed after reading an article linking soft drink consumption to insulin resistance.
The primary-dependent measure reflected participants' defensiveness about threatening versus nonthreatening health information.
In experiment 1, all participants responded more defensively to an unfavourable than a favourable diagnosis; however, Asian-Americans responded less defensively than did European-North Americans. In experiment 2, all high soft drink consumers were less convinced by the threatening information than were low soft drink consumers; however, among high consumers, Chinese changed their self-reported consumption levels less than did European-Canadians. In experiment 3, interdependence-primed participants responded less defensively to an unfavourable diagnosis than did independence-primed participants.
Defensive reactions to threatening health information were found consistently; however, self-enhancement was more pronounced in individuals with Western cultural backgrounds or independent self-construals.
In many European countries, the last decade has been marked by an increasing debate about the acceptability and regulation of euthanasia and other end-of-life decisions in medical practice. Growing public sensibility to a 'right to die' for terminally ill patients has been one of the main constituents of these debates. Within this context, we sought to describe and compare acceptance of euthanasia among the general public in 33 European countries. We used the European Values Study data of 1999-2000 with a total of 41125 respondents (63% response rate) in 33 European countries. The main outcome measure concerned the acceptance of euthanasia (defined as 'terminating the life of the incurably sick', rated on a scale from 1 to 10). Results showed that the acceptance of euthanasia tended to be high in some countries (e.g. the Netherlands, Denmark, France, Sweden), while a markedly low acceptance was found in others (e.g. Romania, Malta and Turkey). A multivariate ordinal regression showed that weaker religious belief was the most important factor associated with a higher acceptance; however, there were also socio-demographic differences: younger cohorts, people from non-manual social classes, and people with a higher educational level tended to have a higher acceptance of euthanasia. While religious belief, socio-demographic factors, and also moral values (i.e. the belief in the right to self-determination) could largely explain the differences between countries, our findings suggest that perceptions regarding euthanasia are probably also influenced by national traditions and history (e.g. Germany). Thus, we demonstrated clear cross-national differences with regard to the acceptance of euthanasia, which can serve as an important basis for further debate and research in the specific countries.
The realities of doing field research with high-risk, minority, or indigenous populations may be quite different than the guidelines presented in research training. There are overlapping and competing demands created by cultural and research imperatives. A National Institute on Drug Abuse (NIDA)-funded study of American Indian youth illustrates competing pressures between research objectives and cultural sensitivity. This account of the problems that were confronted and the attempts made to resolve them will hopefully fill a needed gap in the research literature and serve as a thought-provoking example for other researchers. This study built cross-cultural bridges. Researchers worked as a team with stakeholders to modify the instruments and methods to achieve cultural appropriateness. The researchers agreed to the communities' demands for increased service access and rights of refusal for all publications and presentations. Data indicate that these compromises did not substantially harm the first year of data collection completeness or the well-being of the youth. To the contrary, it enhanced the ability to disseminate results to those community leaders with the most vested interests. The conflicts between ideal research requirements and cultural demands confronted by the researchers and interviewers in the American Indian community were not necessarily different from issues faced by researchers in other communities. Of major import is the recognition that there are no easy answers to such issues within research.
Cites: J Am Acad Child Adolesc Psychiatry. 2000 Aug;39(8):1032-910939232
First Nations peoples bring a particular history and cultural perspective to healing and well-being that significantly influences their health behaviors. The authors used grounded theory methods to describe and explain how ethnocultural affiliation and gender influence the process that 22 First Nations people underwent when making lifestyle changes related to their coronary artery disease (CAD) risk. The transcribed interviews revealed a core variable, meeting the challenge. Meeting the challenge of CAD risk management was influenced by intrapersonal, interpersonal (relationships with others), extrapersonal (i.e., the community and government), sociodemographic, and gendered factors. Salient elements for the participants included their beliefs about origins of illness, the role of family, challenges to accessing information, financial and resource management, and the gendered element of body image. Health care providers need to understand the historical, social, and culturally embedded factors that influence First Nations people's appraisal of their CAD.
OBJECTIVES: This article is part of an ethnographic study that aims to describe and understand health as a phenomenon of the Sami culture. STUDY DESIGN: The article is based on literature concerning the northern environment and the Sami culture, which is analysed from the point of view of health culture. RESULTS: From the point of view of health culture, life in the northern regions requires adaptation to certain special features of the climate and the natural environment. Nature is also a versatile source of health care, healing and traditions. Particularly in the late 1990's, the northern environment and the Sami lifestyle were profoundly affected by changes in the sources of income caused by modernisation and the adaptation of traditional Sami livelihoods to governmental regulations. The current Sami values and beliefs are multilayered factors affecting health culture. The social growth milieu of Sami children as a source of health culture has changed over the generations. The key elements affecting the growth milieu have changed over time, due to the attitude of the government towards the Sami culture and the consequent changes and actions of society.
The Sami people have historically been exposed to severe assimilation processes. The objective of this study was to explore elderly Samis' experiences of health. A total of 19 elderly Sami individuals in Norway were interviewed.This article is a dialogical narrative analysis of the life stories of 3 Sami women. The life stories are perceived as narratives of health and resistance. Postcolonial theory provides a framework for understanding the impact of historical and socioeconomic factors in people's lives and health. Narratives of resistance demonstrate that people are not passive victims of the legacy of colonialism. Resistance is not a passive state but an active process, as is health. Resistance is a resource that should be appreciated by health services, both at a systemic level--for example, through partnership with Indigenous elderly in the planning and shaping of services--and in individual encounters between patients and healthcare providers.