During the COVID-19 pandemic, people in the UK with a new continuous cough, high temperature or loss of smell/taste were urged to take steps including testing and self-isolating to prevent the spread ...of disease.1 The proportion of symptomatic people who engaged in these behaviours was low (42.5%).2 In part, this was driven by low recognition of symptoms that required testing or isolation (51.5%)2 and by perceptions that single or mild symptoms were unlikely to signify COVID-19.3,4 Low levels of knowledge may indicate that insufficient attention was paid to communicating these essential facts.In this study, we assessed whether official spokespeople made speeches to the public about COVID-19 in which they reinforced specific symptoms that required public action.
Issues addressed: Mental health services are under-utilised by the Macedonian community in south-east Sydney. This project investigated attitudes and beliefs towards mental illness in this community ...and used the findings to inform a multifaceted community intervention to reduce stigma and improve mental health literacy. Methods: The study was conducted in two phases. In Phase 1, 100 people from the Macedonian community - 24 clients of the mental health service, 23 carers and 53 community members - participated in a telephone interview about mental illness. These results were used in Phase 2 to deliver targeted education programs to key individuals and groups within the community. Results: In Phase 1, participants cited negative views about mental illness, negative attitudes and discrimination towards people with mental illness, and concerns about confidentiality as the main reasons for failing to seek care early. In Phase 2, more than 90% of those who provided written feedback indicated that the community and workplace education sessions had given them a better understanding of mental illness and its impact. Conclusions: Considerable progress was made towards the long-term aims of raising awareness, positively changing attitudes and behaviours and encouraging the utilisation of mental health services in the target community.
The cultural, linguistic, and religious diversity of Australia's population presents challenges for mental health service delivery. Arabic-speaking communities in Australia underutilise mental health ...services despite high levels of trauma and psychological distress. Clinicians who work with this population lack linguistically and culturally appropriate clinical resources. The aim of this study was to explore the acceptability and clinical utility of a Mindfulness Skills CD translated into formal Arabic. The 70 participants were Arabic-speaking adults, mostly Lebanese-born Muslim women, who enrolled in a 5-week mindfulness program using the CD and agreed to follow-up at 12 weeks. Both recruitment and data collection were undertaken by a female project officer who is a widely respected member of the Arabic community in south-east Sydney. Compliance with the program protocol was high and all but 4 participants continued to use the CD beyond the 5 weeks. Overall, participants reported that mindfulness techniques fitted well with their way of life and were compatible with their cultural and religious practices. Most found mindfulness complementary to their regular reflective prayer. Using the Mindfulness Skills CD was associated with statistically significant reductions in psychological distress as measured by the Kessler Scale (K10) and the Depression, Anxiety, and Stress Scale (DASS21) postprogram (K10; DASS21 Depression and Stress subscales) and at follow-up (all measures). The evaluation showed that the Arabic Mindfulness Skills CD is an effective and culturally appropriate mental health resource for this population group. This low-cost, easily distributed resource is suitable for use in individual self-management and as an adjunct to primary and specialist mental health care.
Issues addressed: Previous research has revealed low levels of mental health service utilisation and widespread discrimination towards people with mental illness in Sydney's Macedonian community. As ...an extension to a multifaceted community intervention to improve mental health literacy and reduce stigma, a Macedonian-language play was produced. Methods: Qualitative data from earlier studies and professional experience were used to craft a script that was performed by actors from the Macedonian community. Eight performances at three venues were attended by approximately 1,600 people. Telephone interviews with 236 audience members (including 76 with personal or family experience of mental illness) and 25 key informants were conducted 1-10 months later. Data were analysed and compared with data collected pre-intervention. Results: Compared with the earlier data, the audience sample was significantly more likely to report positive community attitudes toward people with mental illness and their families, and to favour disclosure to extended family and friends. They also indicated greater willingness to seek help from health services. Key informants reported greater service utilisation since the play was staged. Conclusions: Building on previous work, theatre was an effective means of disseminating information and reducing stigma around mental illness in the target community.
Aim
This study aimed to describe refugee children, their families and settlement characteristics, and how their development and social‐emotional well‐being change over time.
Methods
We conducted a ...longitudinal study of 61 refugee children (6 months to 15 years) in an Australian setting, over 2009–2013 and measured child, family and settlement factors as well as physical health, development and social‐emotional well‐being (Strengths and Difficulties Questionnaire, SDQ).
Results
Questionnaires were completed with parents of 54 (89%) children at year 2 and 52 (100%) at year 3. Forty percent of parents had low levels of education, 30% of fathers were absent on arrival, 13% of children were born in refugee camps and 11% of parents self‐disclosed previous trauma. Over time, there was increased parental employment (P = 0.001), improved English proficiency for partners (P = 0.02) and reduced stressful life events in the last 12 months (P = 0.003). At years 2 and 3, parents were studying English (96%; 76%), accessing government financial support (96%; 100%) and primary health care (98%; 87%), and feeling supported by their own (78%; 73%) or the general (69%; 63%) community. Fifteen percent of children had a chronic disease, and 13% were obese and overweight. In pre‐school children, 27% had mild developmental problems in year 2; all were normal by year 3. Abnormal SDQ total difficulties scores reduced over time from 13 to 6% of children but this did not reach significance.
Conclusion
Most refugee children have developmental and well‐being outcomes within the normal range by year 3. However, a minority of children have persistently poor social‐emotional outcomes.
The need for Australian health care organisations to deliver culturally competent and safe care to its increasingly diverse population provided the impetus for the development of an interactive ...eSimulation module “Communicating with Patients from Culturally and Linguistically Diverse Backgrounds, Case Study: Ms Shu Fen Chen”. This article discusses the rationale, development and implementation of the module. Feedback from sixty nurses and allied health professionals indicated the module was highly engaging and had a positive impact on learners' confidence, knowledge and clinical practice. It is concluded that eSimulation modules can contribute to the uptake of cultural competency training and create a foundation for further initiatives to enhance the provision of culturally competent health care.
•An interactive eSimulation module was designed to enhance cultural competence.•The module was implemented within a large health care organisation.•The module incorporated the critical attributes of effective simulation.•Learners reported positive impacts on confidence, knowledge and clinical practice.
The ability of families to adhere to public health guidance is critical to controlling a pandemic. We conducted qualitative interviews with 30 parents of children aged 18 and under, between 16 and 21 ...April 2020 when schools in England were closed due to the COVID-19 pandemic. Using the Theoretical Domains Framework, we classified the factors that influenced adherence to seven non-pharmaceutical interventions. We found 40 factors that influenced a family’s ability to adhere. Parents generally indicated they could adhere and reported how their family had changed their behaviour to comply with the guidance. Parents primarily reported they were motivated to adhere out of concern for the health consequences of COVID-19, and because the guidance was delivered by the government. However, we found that reduced access to resources (e.g., technology, transport, and outside space) and social influences that encouraged non-adherent behaviour, decreased adherence. Furthermore, we suggest that families with low psychological and physical ability may face additional challenges to adherence and need to be supported. During future school closures, public health agencies should account for these factors when developing guidance.
An extensive body of scholarship focuses on cultural diversity in health care, and this has resulted in a plethora of strategies to “manage” cultural difference. This work has often been ...patient-oriented (i.e., focused on the differences of the person being cared for), rather than relational in character. In this study, we aimed to explore how the difference was relational and coproduced in the accounts of cancer care professionals and patients with cancer who were from migrant backgrounds. Drawing on eight focus groups with 57 cancer care professionals and one-on-one interviews with 43 cancer patients from migrant backgrounds, we explore social relations, including intrusion and feelings of discomfort, moral logics of rights and obligation, and the practice of defaulting to difference. We argue, on the basis of these accounts, for the importance of approaching difference as relational and that this could lead to a more reflexive means for overcoming “differences” in therapeutic settings.
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