American Indian and Alaska Native men experience poorer sexual health than white men. Barriers related to their sex and racial identity may prevent them from seeking care; however, little is known about this population's use of sexual health services.
Sexual health service usage was examined among 923 American Indian and Alaska Native men and 5,322 white men aged 15-44 who participated in the 2006-2010 National Survey of Family Growth. Logistic regression models explored differences in service use by race and examined correlates of use among American Indians and Alaska Natives.
Among men aged 15-19 and those aged 35-44, men with incomes greater than 133% of the federal poverty level, men with private insurance, those living in the Northeast and those living in rural areas, American Indians and Alaska Natives were more likely than whites to use STD or HIV services (odds ratios, 1.5-3.2). The odds of birth control service use did not differ by race. Differences in service use were found among American Indian and Alaska Native men: For example, those with a usual source of care had elevated odds of using sexual health services (1.9-3.4), while those reporting no recent testicular exam had reduced odds of using these services (0.3-0.4).
This study provides baseline data on American Indian and Alaska Native men's use of sexual health services. Research exploring these men's views on these services is needed to help develop programs that better serve them.
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.
In this study, a series of focus groups were conducted to gain an understanding of the nature of stress among Canadian Aboriginal women and men living with diabetes. Specifically, attention was given to the meanings Aboriginal peoples with diabetes attach to their lived experiences of stress, and the major sources or causes of stress in their lives. The key common themes identified are concerned not only with health-related issues (i.e. physical stress of managing diabetes, psychological stress of managing diabetes, fears about the future, suffering the complications of diabetes, and financial aspects of living with diabetes), but also with marginal economic conditions (e.g. poverty, unemployment); trauma and violence (e.g. abuse, murder, suicide, missing children, bereavement); and cultural, historical, and political aspects linked to the identity of being Aboriginal (e.g. 'deep-rooted racism', identity problems). These themes are, in fact, acknowledged not as mutually exclusive, but as intertwined. Furthermore, the findings suggest that it is important to give attention to diversity in the Aboriginal population. Specifically, Métis-specific stressors, as well as female-specific stressors, were identified. An understanding of stress experienced by Aboriginal women and men with diabetes has important implications for policy and programme planning to help eliminate or reduce at-risk stress factors, prevent stress-related illnesses, and enhance their health and life quality.
PURPOSE: The aim of the present investigation was to perform an international multicenter comparison of dental appearance as evaluated by dentists, dental technicians, and nondental subjects. MATERIALS AND METHODS: The participants were drawn from three groups: 203 dentists, 197 dental technicians and 254 nondental subjects. The methods developed in a previous study in Sweden were applied again in seven centers located in six countries. A questionnaire, accompanied by five sets of computer-manipulated images portraying one man and one woman, was used to prompt and record responses to different aspects of dental appearance and function. RESULTS: The questionnaire revealed that both the dental appearance and function of teeth were important to most of the participants, but three quarters of the participants did indicate that good dental function was more important that esthetics. More women (30%) than men (18%), however, placed greater importance on appearance. Age or gender did not influence judgments of the computer-manipulated images, although judgments did vary greatly within the three groups and between the centers. Nonetheless, highly colored teeth were preferred more often by nondental subjects than by dentists or dental technicians. CONCLUSION: Computer-aided image manipulation shows promise as a method for investigating the significance of dental-related beliefs, especially those relating to esthetics, in different population groups. The evaluation of dental appearance and function in this study indicated that dental function is held in greater regard, and that the significance of dental appearance varies widely among dentists, dental technicians, and nondental subjects.
In a phenomenological research study with a purposeful sample, 6 Ojibwa and Cree indigenous women healers from Canada and the United States shared their experience of being a traditional healer. Using stories obtained during open-ended, unstructured interviews, in this article I depict the lives, backgrounds, and traditional healing practices of women who, in the past, have not been afforded an opportunity to dialogue about their healing art and abilities. The methods of these women healers, their arts and their gifts, are different from those of Western conventional medicine because of dissimilar world views related to health and illness. An increased awareness of health care providers related to the ancient art of traditional healing currently practiced in communities by gifted women who provide culturally specific holistic healing and health care is essential.
Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources. This study investigated attitudes toward and perceptions of the BCHG program, as well as use patterns and satisfaction levels, within the Iranian community of the Greater Vancouver Area (GVA)--among BC's largest and fastest-growing Middle Eastern immigrant communities--and explored a model for introducing the BCHG program to ethnic communities in the GVA and BC.
In a 2-stage quasi-experimental design, with a combination of quantitative and qualitative research methods, data obtained from structured telephone surveys, in-person interviews, and focus groups involving a randomly selected sample of the target population were analyzed before and after intervention with audiovisual health information: a series of culturally relevant informative video clips developed by direct participation of the community and aired on local television channels in the fall of 2004.
There was low awareness and low utilization of the BCHG program among participants at the beginning of this study. Furthermore, many participants in the initial stage of this study cautioned that self-care resources in general are unsuited to Iranian culture, due to widespread distrust of health advice received via telephone or the Internet, and due to the strong value placed on health advice received directly from a professional medical doctor. Nonetheless, attitudes, perceptions, and self-reported utilization rates of the BCHG program improved substantially among the participants of this study following the screening of culturally appropriate, targeted promotional videos. Participants almost unanimously reported that watching the videos had encouraged them to use the BCHG program, and that they intended to promote the resources to others. In addition, the majority of participants who had accessed at least one of the BCHG program resources reported being satisfied with the services that they had received, and improved utilization rates were maintained at the follow-up focus group stage. At the same time, participants cautioned that gaining the confidence of the wider Iranian community in BC and increasing service utilization will require considerable time and effort. In particular, they suggested using a variety of media and communication channels, carefully selecting the health messengers, and targeting messages to specific community subgroups.
The findings of this study strongly suggest that Iranians living in the GVA are open to alternatives to routine healthcare services, including the use of preventive and self-care resources. However, awareness levels and utilization rates of the BCHG program among the GVA's Iranian immigrant population have until now been low. The noticeable and sustained improvement to attitudes, perceptions, and self-reported utilization rates of the BCHG program among Iranian participants in this study after watching culturally appropriate promotional videos indicates the potential to modify cultural beliefs in regard to the delivery of preventive health information if the relevant messages are delivered appropriately. By carefully considering the demographic and cultural characteristics of the various ethnic communities living in BC, and by targeting promotional activities and services directly to these individual communities, the BCHG program could improve awareness and utilization rates within these communities.
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To describe the attitudes and subjective norms of female adolescents toward breastfeeding, and to determine whether these are influenced by age, education level, mother tongue, place of birth, exposure to breastfeeding and intention to breastfeed their children.
236 female adolescents, from four schools randomly selected among those offering education levels from secondary 1 to V 4, answered a questionnaire based on the theory of reasoned action.
Female adolescents showed overall positive attitudes towards breastfeeding, but negative subjective norms. Older girls who were breastfed as infants and who originated from foreign countries showed the most positive attitudes towards breastfeeding.
Even though adolescent girls showed overall positive attitudes, several were unable to make up their mind. This result could be attributed to a lack of knowledge and low exposure to breastfeeding mothers. The school system plays an important role in health promotion and should expose all students to the art of breastfeeding through its health classes.
SETTING: A study carried out in 1996 in four districts representing south and north as well as urban and rural areas of Vietnam. OBJECTIVE: To explore gender differences in knowledge, beliefs and attitudes towards tuberculosis and its treatment, and how these factors influence patients' compliance with treatment. DESIGN: Sixteen focus group discussions were performed by a multi-disciplinary research team from Vietnam and Sweden. Analysis was performed using modified Grounded Theory technique, specifically evaluating gender differences. RESULTS: Women were believed to be more compliant than men. Insufficient knowledge and individual cost during treatment were reported as main obstacles to compliance among men (poor patient compliance), while sensitivity to interaction with health staff and stigma in society (poor health staff and system compliance) were reported as the main obstacles among women. CONCLUSIONS: It is time to adopt a more comprehensive and gender-sensitive approach to compliance, which incorporates patient compliance, doctor compliance and system compliance, in order to fully support individual patients in their efforts to comply with treatment.