Cultural Considerations Research Articles

Identifying the Minimal Clinically Important Difference in Emotion Regulation Among Youth Using the JoyPop App: Survey Study.

The minimal clinically important difference (MCID) is an important threshold to consider when evaluating the meaningfulness of improvement following an intervention. The JoyPop app is an evidence-based smartphone app designed to improve resilience and emotion regulation. Information is needed regarding the JoyPop app's MCID among culturally diverse youth. This study aims to calculate the MCID for youth using the JoyPop app and to explore how the MCID may differ for a subset of Indigenous youth. Youth (N=36; aged 12-18 years) were recruited to use the JoyPop app for up to 4 weeks as part of a larger pilot evaluation. Results were based on measures completed after 2 weeks of app use. The MCID was calculated using emotion regulation change scores (Difficulties in Emotion Regulation-Short Form [DERS-SF]) and subjective ratings on the Global Rating of Change Scale (GRCS). This MCID calculation was completed for youth overall and separately for Indigenous youth only. A significant correlation between GRCS scores and change scores on the DERS-SF supported face validity (r=-0.37; P=.04). The MCID in emotion regulation following the use of the JoyPop app for youth overall was 2.80 on the DERS-SF. The MCID for Indigenous youth was 4.29 on the DERS-SF. In addition, most youth reported improved emotion regulation after using the JoyPop app. These MCID findings provide a meaningful threshold for improvement in emotion regulation for the JoyPop app. They provide potential effect sizes and can aid in sample size estimations for future research with the JoyPop app or e-mental health technologies in general. The difference between overall youth and Indigenous youth MCID values also highlights the importance of patient-oriented ratings of symptom improvement as well as cultural considerations when conducting intervention research and monitoring new interventions in clinical practice.

Establishing oncofertility care in limited resource settings: a narrative review.

While the literature has addressed the implementation of oncofertility care at developed institutions, minimal advice exists for those seeking to build oncofertility programs in limited resource settings (LRS). Our research offers a promising conversation on establishing oncofertility care in such settings from the perspective of a practitioner working to establish care in Latin America. We propose practices that have the potential to significantly improve access to and quality of care in these challenging settings. PubMed was used to identify articles on fertility preservation (FP) in LRS for this narrative review. Eligible articles were published between January 2010 and May 2023, available in English and include two or more key phrases: "oncofertility care," "limited resources," "low-income settings," "limiting access," and "fertility preservation." As each institution faces a unique profile of medical, financial, geographical, cultural, and legal considerations, it is difficult to generalize an approach to optimizing care. However, the success of many programs is underpinned by collaborative efforts to educate and support healthcare specialists across the globe. National and international clinical guidelines, an unparalleled opportunity to promote the maintenance of a high level of care, do not exist for many Oncofertility practices. It is necessary that future guidelines consider barriers unique to implementing care in LRS as historically, guidelines have not done so, leaving LRS practitioners to deviate from the standard of care without consensus on how to best do so. It is crucial to consider the unique challenges in low-resource settings when strategizing the expansion of oncofertility efforts, optimizing care, and developing clinical guidelines. Addressing the diverse barriers to care requires multifaceted initiatives at local, national, and international levels.

“You wished the ground would open and swallow you up”: Expert opinions on shame, the collective, and other cultural considerations for suicide prevention among Asian American and Pacific Islander veterans

BackgroundRates of suicide remain elevated among U.S. Veterans and have increased disproportionately among Asian American and Pacific Islander (AAPI) Veterans. Knowledge is limited regarding suicide prevention considerations for clinicians working with AAPI Veterans, yet culturally responsive strategies tend to be most effective. To address this gap, we sought to elucidate subject matter experts’ perspectives regarding suicide prevention considerations for AAPI Veterans.MethodsQualitative interviews were conducted with 14 key informants (e.g., clinicians, researchers) in 2023 to understand their experiences with, and recommendations for, preventing suicide among AAPI Veterans in the Continental U.S. Interview transcripts were analyzed through thematic analysis, with an inductive approach.ResultsKey informants discussed the heterogeneity of the AAPI population and emphasized the need to balance cultural sensitivity and cultural humility in suicide prevention with AAPI Veterans. Fear of bringing shame and dishonor upon one’s family was described as a factor which may prevent AAPI Veterans from disclosing mental health concerns and suicide risk and which may prevent them from accessing healthcare services for mental health and suicidality. Suicide risk among AAPI Veterans was viewed as being shaped by shame and the centrality of the family-collective, with family conferring both protection against and risk for suicide. Cultural norms and beliefs regarding suicide were considered pertinent to suicide among AAPI Veterans and included beliefs about perseverance in coping with distress to permittance of suicide in specific circumstances. Somatic idioms were described as a means by which AAPI Veterans may communicate distress and suicidality, with key informants discussing how this may impact treatment and outreach.ConclusionKey informant interviews provided crucial insights into cultural factors salient to conceptualizing and addressing AAPI Veterans’ risk for suicide. These findings can be utilized to inform tailored suicide prevention for this population, with emphasis on addressing mental health stigma, considering somatic idioms of distress, and considering the role of family in suicide risk and prevention.

Balancing Cybersecurity Policies and Institutional Ethics: A Legal and Cultural Perspective on Higher Education Frameworks

Objective: The objective of this study is to investigate the intersection of cybersecurity policies with legal and cultural considerations within higher education institutions (HEIs), with the aim of addressing key challenges and proposing a balanced framework that ensures institutional control while respecting ethical and cultural diversity. Theoretical Framework: This research is grounded in theories of ethical governance, legal compliance, and cultural sensitivity. Established frameworks such as ISO 27001 and NIST Cybersecurity Framework provide a foundational basis but are examined critically for their limitations in addressing the unique needs of HEIs. Method: The study employs a qualitative methodology, combining a systematic literature review and semi-structured expert interviews. Data collection was conducted through a comprehensive review of academic and institutional sources (2015–2024) and in-depth interviews with ten experts from the fields of cybersecurity, legal studies, and higher education policy. Results and Discussion: The results revealed that existing cybersecurity frameworks lack alignment with cultural and ethical considerations, leading to resistance and limited effectiveness in HEIs. Key challenges include insufficient stakeholder engagement, tensions between institutional control and individual rights, and inadequate resources. The discussion contextualizes these findings within the theoretical framework, emphasizing the importance of inclusive policy development and ethical audits. Limitations of the study include its focus on specific institutional contexts, which may not fully generalize to other educational systems. Research Implications: The research has practical and theoretical implications for the development of more robust and inclusive cybersecurity policies. The findings provide actionable insights for improving stakeholder engagement, balancing legal and ethical imperatives, and fostering cultural sensitivity. These implications are particularly relevant for HEIs, policymakers, and cybersecurity professionals. Originality/Value: This study contributes to the literature by highlighting the necessity of integrating cultural and ethical dimensions into cybersecurity frameworks. Its innovative approach bridges gaps in existing models, providing practical solutions for HEIs to create secure, equitable, and culturally responsive digital environments.

Consideration of culture in Canadian courtrooms: Before and after the Divorce Act amendments

Consideration of culture in Canadian courtrooms: Before and after the Divorce Act amendments

Introduction: Family court review special issue on the importance of cultural considerations in parental access matters

Introduction: Family court review special issue on the importance of cultural considerations in parental access matters

Reflections on using Talanoa methodology to engage with Pacific youth in Aotearoa New Zealand about their sexual and reproductive health

Pacific understandings of sexual and reproductive health (SRH) encompass beliefs and practices reflective of Pacific values systems. These are integral to cultural understandings of safety, relationships, and intimacy. Research processes and practices that appropriately address these values and sensitives are scarcely available in the literature, leading to limited use and understanding of culturally appropriate methods and procedures. Pacific methodologies like Talanoa are useful in ensuring that cultural perspectives unique to Pacific youth are addressed and appropriately represented in the research. This paper describes how cultural factors associated with sexual and reproductive health influenced the Talanoa research processes in a study of Pacific youth and SRH education. Key cultural considerations are discussed focussing on the positionality of the researchers, cultural sensitivities and protocols, communication strategies and the role of flexibility in privileging Pacific youth voices.

Navigating the Discussion of Mental Illness With Korean Americans.

Korean Americans have one of the highest rates of depression of the Asian subgroups in the United States, and they have culture-related factors that affect their mental health. It is important for health care providers to understand the cultural considerations of Korean Americans to better address their mental health. This review article delves into the pertinent cultural practices of Korean Americans for navigating discussions of mental health. We note the cultural views, language barriers, historical traumas, and immigration challenges of Korean Americans, and we consider the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision's discussion of Koreans. We also include a table of Korean mental health terms with cultural significance and a list of online resources tailored for Korean Americans. In addition, we discuss the unique experiences of North Korean refugees that affect their mental health. Overall, this review informs health care providers about cultural considerations for navigating discussions of mental health with Korean Americans.

Alcohol in Daily Products: Health Risks, Cultural Considerations, and Economic Impacts

Alcohol in Daily Products: Health Risks, Cultural Considerations, and Economic Impacts

Large language models for the mental health community: framework for translating code to care.

Large language models (LLMs) offer promising applications in mental health care to address gaps in treatment and research. By leveraging clinical notes and transcripts as data, LLMs could improve diagnostics, monitoring, prevention, and treatment of mental health conditions. However, several challenges persist, including technical costs, literacy gaps, risk of biases, and inequalities in data representation. In this Viewpoint, we propose a sociocultural-technical approach to address these challenges. We highlight five key areas for development: (1) building a global clinical repository to support LLMs training and testing, (2) designing ethical usage settings, (3) refining diagnostic categories, (4) integrating cultural considerations during development and deployment, and (5) promoting digital inclusivity to ensure equitable access. We emphasise the need for developing representative datasets, interpretable clinical decision support systems, and new roles such as digital navigators. Only through collaborative efforts across all stakeholders, unified by a sociocultural-technical framework, can we clinically deploy LLMs while ensuring equitable access and mitigating risks.

A Bibliometric Analysis of Economic Inclusiveness in Developing Countries

This study presents a bibliometric analysis aimed at mapping the academic landscape of economic inclusiveness in developing countries from 2000 to 2024. Through a comprehensive review of the literature, this analysis identifies core themes including governance, sustainability, financial inclusion, and education, emphasizing their roles in fostering equitable economic growth. Using data sourced from Scopus, the study employs VOSviewer software for visualization of co-authorship and co-citation networks, revealing prominent authors, pivotal publications, and thematic clusters. The results highlight an interdisciplinary approach in the research with significant contributions from various global regions, showcasing the complexity of implementing economic inclusiveness across different socio-economic and environmental contexts. The findings underline the necessity of integrating sustainable practices and robust governance to ensure inclusiveness and suggest directions for future research to fill the existing gaps in empirical data and cultural considerations.

IMPLEMENTING ISUPPORT IN UGANDA: A PILOT RCT FOR REDUCING CAREGIVER STRESS

Abstract Background: Dementia is a significant public health issue in low- and middle-income countries, and Uganda has seen a notable increase in cases. The iSUPPORT program, adapted into AiSUPPORT, provides tailored interventions that address the sociocultural and economic context of Uganda, aiming to alleviate psychological distress among caregivers of patients with AD and dementia. Methods: This pilot randomized controlled trial (RCT) was conducted in the Wakiso District, enrolling 65 caregivers of Alzheimer’s disease and related dementia (ADRD) patients. Participants were randomly assigned to either an intervention group that received AiSUPPORT sessions, or a control group that received standard care. This study aimed to assess the feasibility, fidelity, acceptability, and impact of the intervention on caregivers’ psychological distress, quality of life, and depression severity, as measured using the Kessler Psychological Distress Scale and other tools. Results: In the intervention group, psychological distress scores reduced significantly, averaging 29.2 to 23.7 (p< 0.001), and depression severity scores dropped from 33.4 to 25.6 (p< 0.001). Quality of life scores improved substantially, from an average of 81.1 to 89.4 (p< 0.001), compared with the control group. The AiSUPPORT program demonstrated effectiveness and cultural appropriateness, with a 95% retention rate and high engagement. Conclusion: The AiSUPPORT program for dementia caregivers in Uganda’s successful implementation in low-resource settings demonstrates its potential. The program’s effectiveness, feasibility, and cultural sensitivity underscore the importance of cultural considerations in intervention design, supporting the integration of culturally adapted evidence-based interventions in national health systems to address the complex needs of dementia caregivers.

ASSISTING DEMENTIA FAMILY CAREGIVERS WITH INTERACTIVE AI TECHNOLOGY

Abstract The escalating prevalence of Alzheimer’s and related dementias (ADRD) presents a global health crisis, straining family caregivers. This study, guided by the Unified Theory of Acceptance and Use of Technology (UTAUT), examines the role of artificial intelligence (AI) in assisting ADRD family caregivers through a mixed-methods approach. It involves qualitative analysis of marginalized dementia caregivers’ experiences in the technology era and a systematic review of interactive AI evidence in dementia care. Qualitative insights from six focus groups and 24 individual interviews highlight the need for adaptable AI solutions, particularly for emotional and social support. Systematic review results underscore various AI applications, their acceptance, benefits, and challenges, including technological literacy, trust issues, limited access, and cultural considerations. The discussion emphasizes interdisciplinary collaboration and caregiver involvement in AI development. The study concludes by emphasizing AI’s transformative potential in dementia care, advocating for collaborative research efforts and innovative services to support diverse caregiver groups and their ADRD care recipients.

THE EMOTIONAL AND SOCIAL IMPACTS OF UNIFORMS ON COLLEGE STUDENTS: EVIDENCE FROM SAUDI ARABIA

Purpose: The study's purpose is to assess how wearing uniforms affects college students psychologically and socially, with an emphasis on comfort, productivity, self-worth, and social relationships. It specifically looks at Saudi male college students' inclination for traditional clothing over uniforms and considers the policy and practice consequences. Methodology: Purposive sampling was used to gather survey data from 249 Saudi male college students as part of the study's quantitative methodology. Respondents answered questions about uniform comfort, price, usefulness, and social integration. Three hypotheses about uniforms' psychological, social, and academic implications were tested through data analysis using SPSS. Findings: The results show that uniforms significantly negatively impact students' academic achievement (H3), social perception (H2), and emotional wellness (H1). Uniforms were seen as constrictive and unpleasant, which negatively affected self-esteem and output. Where traditional clothing were favored because of their utility and cultural value. The findings highlight the necessity of ergonomic and culturally aware uniform designs to balance student welfare and institutional goals. Practical & SocialImplications: The study gives educational leaders practical advice on updating uniform regulations while including cultural considerations and adaptability to students' preferences. Future studies should investigate the long-term psychological effects of uniforms across genders and cultures, building on various samples. Value and Originality: This study fills a knowledge gap by investigating the cultural and psychological impacts of uniforms on Saudi Arabian college students. It advances knowledge of how uniforms affect students' social and academic experiences and aids in creating culturally inclusive policies.

Prevalence of Hepatitis B Virus and Associated Factors Among Pregnant Mothers Attending Antenatal Care in Public Hospitals, Afar Region, North Eastern Ethiopia

Background:Hepatitis B kills a large number of individuals every year all over the world. Despite the critical nature of this issue, the extent of hepatitis B virus infection among pregnant women in the Afar Region remains unknown. Therefore, this study aimed to assess the Prevalence of the Hepatitis B Virus and its associated factors among pregnant women Attending Antenatal Care in Public Hospitals in Afar, Ethiopia. Method:A hospital-based cross-sectional study was conducted from August 1, 2023, to August 2, 2024, involving 442 pregnant women attending antenatal care at five public hospitals in the Afar Region. Structured and pretested questionnaires were used to collect socio-demographic data and associated factors. Blood samples were collected from each consenting participant after the interviews to assess their HBV status. The data was analyzed using SPSS, applying bivariate and multivariable logistic regression methods to identify associations and determine statistical significance, with a p-value threshold of less than 0.05. Result:The overall Prevalence of hepatitis B virus infection was 12.7% (95% CI: 9.7-16.1). Hepatitis B virus infection had a significant association with a family history of the virus (AOR=3.92; 95% CI [1.26-12.14]), sharing sharp objects (AOR=3.83; 95% CI [1.16-12.6]), female genital mutilation (AOR=4.77; 95% CI [1.02-22.3]), extraction of teeth (AOR=5.22; 95% CI [2.54-10.7]), and hospital admissions (AOR=2.48; 95% CI [1.15-5.35]). Conclusion:This study revealed a high prevalence of HBV in specific public hospitals in Ethiopia's Afar regional state. The study found that a history of Hepatitis B virus in the family, sharing of sharp objects, having teeth extraction, hospital admission, and female genital mutilation are important risk factors that lead to the high viral Prevalence in the Afar Region. Establishing comprehensive prenatal screening programs, educating the public, and considering cultural considerations are essential to solving this public health issue. Keywords: hepatitis B prevalence; pregnant women; antenatal care; public hospitals, Ethiopia

Transnational Healthcare Practices Among Migrants: A Concept Analysis.

To present a conceptual definition of transnational healthcare in the context of migrant older adults. This article follows the Walker and Avant concept analysis framework to conduct an in-depth analysis of transnational healthcare. Databases were searched for scholarly articles using keywords associated with transnational healthcare. The DistillerSR software was employed to screen articles for inclusion in the concept analysis. Titles and abstracts of 390 articles were screened with 50 identified for full-text screening. Thirty-seven articles were included to inform the concept analysis. Social Science Citation Index (Clarivate), PsycInfo and CINAHL databases. Search dates: March-May 2024. Defining attributes of the concept include cultural comfort and alignment, perceived quality and trust, integration barriers and experiences of discrimination, use of digital platforms and informal networks, challenges navigating host country health systems. Cases, antecedents, consequences, empirical referents and cultural considerations were used to shape a conceptual definition of transnational healthcare. Transnational healthcare is defined as a practice involving those living outside of their country of origin seeking healthcare from that country of origin through physical or other means. This conceptual definition highlights the importance of understanding healthcare access, quality and continuity of care across national borders. This study addresses gaps in available literature regarding transnational healthcare and its impacts on treatment outcomes, healthcare satisfaction and continuity of care in migrant communities. This article adheres to the PRISMA (2020) reporting guidelines for systematic reviews. No patient or public contribution.

Behavioral Insights Informing the Pandemic Response in the City of Moscow

Background. The public response to the coronavirus pandemic, including their uptake of protective measures, was critical for containing the virus, and this required effective interventions, policy decisions, and public communication that took into account the perspectives of the population. The main goal of the study was to explore public perceptions, behaviors, and well-being of the population of Moscow, Russian Federation, to inform the pandemic response.Methods. A survey tool originally developed by the WHO Regional Office for Europe with support from the University of Erfurt, Germany, was adapted to the Moscow (Russian Federation) context. Computer-assisted telephone interviews (CATI) were conducted using a stratified, two-core sample of landline and mobile phones. Three waves of data collection took place from mid-May 2020 to mid-June 2020: 1) May 13–18, 2020, n = 1019 people; 2) May 26, 2020 – June 1, n = 1000 people; 3) June 16–24, 2020, n = 993 people.Findings. The study identified the awareness of Moscow residents about the coronavirus, their perceptions, understanding of the pandemic situation and behavioral responses to measures taken by the authorities to reduce the spread of COVID-19.Interpretation. Monitoring of public perceptions, behaviors, and well-being allowed a people-centered approach, which took into account population perspectives alongside epidemiological data and economic, cultural, ethical, and structural-political considerations, to become the basis for an effective coronavirus response.

Behavioral Insights Informing the Pandemic Response in the City of Moscow

Background. The public response to the coronavirus pandemic, including their uptake of protective measures, was critical for containing the virus, and this required effective interventions, policy decisions, and public communication that took into account the perspectives of the population. The main goal of the study was to explore public perceptions, behaviors, and well-being of the population of Moscow, Russian Federation, to inform the pandemic response.Methods. A survey tool originally developed by the WHO Regional Office for Europe with support from the University of Erfurt, Germany, was adapted to the Moscow (Russian Federation) context. Computer-assisted telephone interviews (CATI) were conducted using a stratified, two-core sample of landline and mobile phones. Three waves of data collection took place from mid-May 2020 to mid-June 2020: 1) May 13–18, 2020, n = 1019 people; 2) May 26, 2020 – June 1, n = 1000 people; 3) June 16–24, 2020, n = 993 people.Findings. The study identified the awareness of Moscow residents about the coronavirus, their perceptions, understanding of the pandemic situation and behavioral responses to measures taken by the authorities to reduce the spread of COVID-19.Interpretation. Monitoring of public perceptions, behaviors, and well-being allowed a people-centered approach, which took into account population perspectives alongside epidemiological data and economic, cultural, ethical, and structural-political considerations, to become the basis for an effective coronavirus response.

Caribbean Narratives of Terminal Illness: Theoretical, Practical, and Ethical Considerations for Medical Education

First-person accounts of grieving from Caribbean perspectives provide important narrative knowledge; however, they are seldom categorized as narratives of illness and remain underrepresented in medical humanities curricula. This paper analyses two autobiographical works by Caribbean writers caring for dying family members, My Brother by Jamaica Kincaid, and The Zea Mexican Diary by Kamau Brathwaite. Both narratives reveal literary elements characteristic of pathographies (Hawkins, 1999). A distinctive Caribbean aesthetic sensibility, an elegiac dimension rooted in African heritage, underlies both narratives. Drawing from narrative theory, I demonstrate how Kincaid and Brathwaite illustrate myths that depart from Western cultural models. Medical students who develop skills in interpreting Caribbean stories should be better able to appreciate the experiences of patients and their families, identify cultural considerations, and anticipate communication problems encountered in clinical practice. Uniquely positioned to stimulate ethical reflection on patient care, Caribbean narratives about dying warrant inclusion in medical education.

A Comprehensive Review of Food Safety Culture in the Food Industry: Leadership, Organizational Commitment, and Multicultural Dynamics.

Food safety culture (FSC) has transitioned from a narrow compliance-based concept to a comprehensive organisational value that is essential for ensuring food safety. This review explores the pivotal roles of leadership, organisational commitment, and cultural diversity in shaping an effective FSC. It highlights how leadership style, particularly transformational leadership, can enhance employee engagement and foster a proactive safety culture. Additionally, the impact of national and organisational cultures on FSC is analysed, emphasising the challenges posed by a multicultural workforce in standardising food safety practices. This article also provides a comparative analysis of FSC across various sectors, such as meat and dairy processing, identifying sector-specific challenges and best practices. In particular, high-risk sectors tend to exhibit a stronger FSC due to regulatory pressure, while other sectors struggle with issues like communication and employee ownership. The importance of integrating behavioural training with cultural considerations is underscored as a key strategy for sustaining a positive FSC. For maintaining a strong FSC, tailored approaches, which account for cultural and operational differences, are necessary for improving food safety outcomes. This comprehensive analysis provides valuable insights for industry professionals and policymakers, offering a foundation for future research and the development of more effective food safety management practices.