Culturally And Linguistically Diverse Communities Research Articles

Applying a Participatory Action Research Approach to Engage an Australian Culturally and Linguistically Diverse Community around Human Papillomavirus Vaccination: Lessons Learned

Globally, migrant and culturally and linguistically diverse (CALD) communities are known to have inequitable access to HPV vaccination. One participatory research approach used to engage CALD communities around vaccination is participatory action research (PAR), but we know little about the use of PAR to engage priority migrant and CALD communities around school and HPV vaccination. To address this gap, we partnered with our local Multicultural Health Service to understand how the largest CALD group in our region of New South Wales, Australia, engages with their local school and HPV vaccination program. Through a long-standing PAR relationship, we used a participatory research method (World Café) approach to explore the level of awareness and engagement a multi-generational community member had concerning HPV vaccination. We acted by sharing a co-designed information website to answer the community’s questions about HPV vaccination. We then evaluated these engagements with surveys, focus groups and online analytic platforms. Last, we reflected with project partners and health service stakeholders on the overall project outcomes and shared our learnings. In our discussion, we shared our lessons learned and contributed to a wider conversation about the benefits, challenges, and practicalities of using PAR to engage a priority CALD community around HPV vaccination.

Family member and service provider experiences and perspectives of a digital surveillance and service navigation approach in multicultural context: a qualitative study in identifying the barriers and enablers to Watch Me Grow-Electronic (WMG-E) program with a culturally diverse community

BackgroundChildren and families from priority populations experienced significant psychosocial and mental health issues to the COVID-19 pandemic. Yet they also faced significant barriers to service access, particularly families from culturally and linguistically diverse (CALD) backgrounds. With most child and family health nurse clinics ceasing in-person consultations due to the pandemic, many children missed out on health and developmental checks. The aim of this study was to investigate the perspectives and experiences of family members and service providers from an urban, CALD community regarding the implementation of a digital, developmental surveillance, Watch Me Grow-Electronic (WMG-E) program.MethodsSemi-structured interviews were conducted with 17 family members, service navigators, and service providers in a multicultural community in South Western Sydney, Australia. This qualitative study is an implementation evaluation which formed as part of a larger, two-site, randomised controlled trial of the WMG-E program. A reflexive thematic analysis approach, using inductive coding, was adopted to analyse the data.ResultsParticipants highlighted the comprehensive and personalised support offered by existing child and family health services. The WMG-E was deemed beneficial because the weblink was easy and quick to use and it enabled access to a service navigator who support family access to relevant services. However, the WMG-E was problematic because of technology or language barriers, and it did not facilitate immediate clinician involvement when families completed the weblink.ConclusionsFamilies and service providers in this qualitative study found that using WMG-E empowered parents and caregivers to access developmental screening and learn more about their child’s development and engage with relevant services. This beds down a new and innovative solution to the current service delivery gap and create mechanisms that can engage families currently not accessing services, and increases knowledge around navigating the health and social care services. Notwithstanding the issues that were raised by families and service providers, which include accessibility challenges for CALD communities, absence of clinical oversight during screening, and narrow scope of engagement with available services being offered, it is worth noting that improvements regarding these implementation factors must be considered and addressed in order to have longevity and sustainability of the program.Trial registration.The study is part of a large randomised controlled trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.

Starting conversations about mental health and wellbeing in Australian culturally and linguistically diverse communities.

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.

Tailoring emergency and disaster preparedness engagement approaches for culturally and linguistically diverse communities

The effects of emergencies and disasters pose greater challenges for people within culturally and linguistically diverse (CALD) communities. Several barriers can prevent people in CALD communities from adequately preparing for such events and this contributes to an increased vulnerability. Queensland experiences heightened natural hazard risks, therefore it is crucial to ensure that preparedness information is accessible and relevant to all communities, including CALD communities. This paper describes a qualitative study that examined the emergency and disaster preparedness information needs of people in CALD communities in Queensland. The aim was to identify better ways of delivering preparedness initiatives through tailored engagement approaches. Three focus groups were conducted with 16 CALD community leaders from the Gold Coast, Logan and Ipswich local government areas. The data gathered showed that CALD communities in these areas possessed low levels of awareness of emergencies and disasters and low levels of preparedness for such events. This study highlights the need for tailored and strengths- based engagement approaches. Disseminating information in suitable formats through preferred communication channels and partnering with trusted sources, including community leaders and places of worship, were found to be effective ways to engaging CALD communities in disaster preparedness.

Migrant and refugee communities strengthening disaster resilience

This paper presents insights from a community-led initiative in South Australia aimed at enhancing disaster resilience in culturally and linguistically diverse (CALD) migrant and refugee communities. Anchored in the principles of community cohesion, empowerment and informed action, the project addresses socio-cultural dynamics and communication barriers. A series of workshops and forums, tailored to account for cultural sensitivity, showed strengthened community collaboration, skills development and increased awareness of the psychosocial effects of disasters, prompting proactive strategies that consider the unique vulnerabilities and strengths of CALD communities. Participant testimonials noted increased community spirit and practical application of acquired knowledge, including understanding local hazard risk profiles and trust-building with emergency services organisations. The findings demonstrate the importance of mitigating access challenges, integrating diverse community perspectives into resilience- building activities and ensuring the inclusivity of management policies. Highlighting the significance of strengths-based community-driven approaches in emergency and disaster management, particularly for marginalised groups, this initiative found that engaging communities as active contributors enables more resilient and self-efficacious populations that effectively bridge cultural and linguistic gaps in preparedness.

Co-designing strategies to improve advance care planning among people from culturally and linguistically diverse backgrounds with cancer: iCanCarePlan study protocol

BackgroundAdvance care planning (ACP) describes the process of supporting individuals at any age or stage of health to consider and share their personal values, life goals, and preferences regarding future health care. Engaging in ACP is associated with better-quality of care in which people receive care in lines with their wishes, values and preferences. Direct translations of ACP guides and resources do not attend to the considerable inter- and intra-ethnic variations in cultural and religious or spiritual beliefs that shape preferences among people from culturally and linguistically diverse (CALD) backgrounds. ICanCarePlan is a three-year project that aims to determine the prevalence of ACP documentation among people from CALD backgrounds with cancer, identify resources available and their use to support ACP among CALD communities, identify barriers and facilitators of person-centred ACP, and to develop, through co-design with consumers and clinicians, approaches that enhance the process ACP for people from CALD backgrounds.MethodA mixed-method sequential approach will be used comprising of four studies. Study one is retrospective medical record review of approximately 1500 medical records to establish the prevalence of ACP documentation among CALD patient records in cancer services. Study two is a document analysis synthesising the resources available in the Australian health system to support ACP. Study three is a qualitative study with healthcare staff and consumers to explore barriers and enablers of person-centred ACP. Evidence generated from studies one to three will inform the conduct of co-design with stakeholders to develop approaches to improve ACP processes among CALD communities. Language, technical and financial support for meaningful involvement with consumers from CALD backgrounds throughout this project is outlined. A plan for distress management is also made due to sensitive nature of the topic. The research project has also established a project steering group consisting of three consumer members who are from CALD backgrounds.DiscussionThe project will address a national priority issue for a growing population of CALD communities in Australia. The project will provide novel evidence of ACP among CALD communities and novel strategies developed with stakeholders to enhance uptake and experiences of ACP.

Trust to test translation practices

Abstract Trust is important in public health communication to culturally and linguistically diverse (CALD) communities during pandemics. This empirical research, using quantitative data from 107 foreign nationals at a university in Shanghai, probes into how trust varied in official translation services (OTS) and non-official translation services (NOTS) during COVID-19. Statistical analysis was carried out by IBM SPSS Statistics 26 and it was found that (1) NOTS which are more frequently used are more trusted compared with OTS; (2) NOTS are uncorrelated with demographics while OTS are correlated with demographics, among which education and trust in OTS suggest a linear positive relationship (Sig. = 0.003, β = 0.467), whereas age and trust in OTS suggest a linear negative relationship (Sig. = 0.027, β = −0.348); (3) there is a positive relationship between the frequency of using services and trust, i.e., higher frequency implies higher trust. The findings of this case study can have implications for policy makers and the representatives of CALD communities.

Liminality, Situated Digital Tales, and the Pandemic: Three Cases of Radical Placemaking in Australia

AbstractSettlers of colour occupy a liminal space in the settler colony of Australia, and this liminality was exacerbated during the COVID‐19 pandemic. Through the literature on digital activism, technological immersion, and placemaking, this paper explores Radical Placemaking as a route for culturally and linguistically diverse (CALD) people based in Brisbane to stake their right to the city through alternative digitised modalities. Three projects using situated digital stories were created: (i) the Chatty Bench Project; (ii) the TransHuman Saunter Project; and (iii) Chatty Bench Festival Community Media Visual Projections. We analysed the experiences of study participants creating the digital stories and eventual user experiences of the stories for their ability to provoke self‐reflection, immersiveness, and belonging through evocation and representation of lived experiences. The paper suggests that radical placemaking offers CALD communities subversive tactics of occupying space through emerging technologies without engaging in erasure of existing histories of place.

The role of social support among caregivers of people with cancer from Chinese and Arabic communities: a qualitative study

PurposeCancer caregivers from culturally and linguistically diverse (CALD) communities have reported significant unmet emotional support needs. This study aimed explore the role of social support to manage emotional wellbeing among cancer caregivers from Arabic and Chinese communities in Australia.MethodsSemi-structured interviews were conducted with Chinese (n = 12) and Arabic (n = 12) speaking cancer caregivers. Participants’ mean age was 40.6 years; majority were female (83%) and providing care to a parent (41.67%).ResultsUsing thematic analysis to analyse interview data, five overarching themes emerged describing caregivers’ perspectives on social support. Themes were related to the following: (1) receiving emotional support from social networks, (2) barriers to accessing emotional support from social networks, (3) isolation and loss of connection following the cancer diagnosis, (4) faith as a source of support, and (5) utility of support groups and caregiver advocates. Several caregivers relied on social networks for emotional support; however, caregivers identified key cultural and generational barriers to seeking support from their social networks which prevented caregivers from disclosing their emotions and caregiving situation. Caregivers also reported being isolated from their support system.ConclusionEmpirical testing of culturally appropriate strategies that improve social support seeking among caregivers from CALD communities is recommended.

‘We Were an Afterthought’: Corona Virus Disease 2019 (COVID-19) Pandemic in Culturally and Linguistically Diverse (CALD) Communities in New South Wales, Australia

ABSTRACT This paper investigates the impact on Culturally and Linguistically Diverse (CALD) communities in Australia of government and community responses to the coronavirus pandemic of 2019 in the domains of education, employment, housing, social connectedness, and public health communication. Most of the examples are drawn from the state of New South Wales. In Australia, CALD refers to people from countries not classified as main English speaking. Most CALD communities reported in this article are from refugee backgrounds, are recently arrived migrants or do not use English in most of their communication. Inadequate, and in some instances, inappropriate or absent support, adversely impacts CALD communities. We used a multidisciplinary bricolage approach that draws on media, government, and community support publications and concluded that CALD communities experienced heightened pressures due to lower resource availability and poor communication. This led to disruption of support services, exposing gaps and vulnerability. The results reported here challenge Australian government, schools, community agencies, researchers to include proactively CALD community perspectives when planning and responding to such crises in future. Improving communication, pandemic response planning, addressing needs and ensuring participation are key considerations.

Knowledge, attitudes, and behaviors related to dietary salt intake and the acceptability of salt substitute among the Australian culturally and linguistically diverse community: An online survey.

The Australian culturally and linguistically diverse (CALD) communities may be at higher risk of salt intake than recommended given the use of a combination of discretionary sources and exposure to processed foods within a western country. This survey aimed to understand the knowledge, attitudes, and behaviors toward dietary salt and the acceptability of salt substitutes in the CALD communities. An online cross-sectional survey was conducted among adults who self-reported being a part of a CALD community, which was defined as non-Indigenous cultural groups in Australia having cultural or linguistic connections with their overseas place of birth, ancestry or ethnic origin, religion, preferred language or language spoken at home. A total of 218 respondents opened the survey link. A total of 196 completed the entire survey. The majority of respondents (162, 83%) were aware that high salt intake causes serious health problems. Altogether 134 (69%) respondents were aware that there is a recommended amount for daily salt consumption although only 59 (44%) knew precise recommendations as<5 g salt per day. Around one quarter of the respondents rarely or never looked for ‟low in salt'' or ‟reduced salt'' messages on food labels when shopping. Over half specified they always or often added salt during cooking or preparing foods in the household. Almost 4 in 5 CALD respondents were willing to reduce their salt intake for health and 3 in 4 were open to trying a salt substitute. Further research into the utility of a salt substitute intervention in the Australian CALD community is warranted.

Older women's experience with COVID-19 pandemic: A study of risk perception and coping among culturally and linguistically diverse population in South Australia.

A global catastrophe-the COVID-19 pandemic-appears to have two-dimensional health consequences for older adults: high risk of being infected and psychological distress. There is limited evidence on how the pandemic has impacted the life and coping of older adults who are culturally and linguistically diverse (CALD), women in particular. This study explored the COVID-19 risk perception and coping strategies of older CALD women in South Australia. A mixed-methods research design was employed, involving a 31-items coping and emergency preparation scale for survey and semi-structured interviews with participants. The older CALD women were approached through 11 multicultural NGOs. One hundred and nine women participants from 28 CALD communities completed the online surveys; 25 of them agreed to a telephone interview and provided their contact details. 15 older CALD women ultimately participated in interviews. Mean sum-score of dread risk, unknown risk, and fear (M: 43.5; SD: 4.9) indicated that the participants were somewhat anxious and worried. Mean sum-score of coping (M: 79.8; SD: 9.3) reported their compliance with expert advice and disinfection practices but accessing health information (M: 2.8; SD 1.4) and tendency to minimize anxiety (M: 2.1; SD: 1.2) were below neutral. Significant variations were found in coping in terms of age, meaning that the women aged 75 years and older were less likely to cope with the pandemic (P = 0.01). Emergency preparation differed based on the participants' residence and occupation status. The deductive-inductive thematic analysis of interview data was framed around three priori themes: risks of being affected, emotional and behavioral coping, and emergency preparation and access to services. Evidence shows a fear among the older CALD women with an endeavor to cope and prepare for emergency situations. This suggests the requirements for interventions that improve coping and reduce the risk of stress among them.

Exploring the Role of Migration Status in Pregnancy Loss Attributions, Experiences, and Support in Australia.

While previous research has explored the impact of migration status on experiences and attributions about pregnancy loss, less common is comparative research examining similarities and differences between migrants and non-migrants. This paper reports on a cross sectional comparative study of 623 culturally and linguistically diverse (CALD) or non-CALD people living in Australia. Participants completed a survey that asked about experiences of pregnancy loss, support, and attributions about pregnancy loss. There were no differences between the two groups in terms of rates of pregnancy loss, though CALD participants reported greater distress following a loss. CALD participants reported greater reliance on partners and faith communities, and found healthcare professionals to be less supportive. CALD participants were more likely to attribute pregnancy loss to spiritual reasons (among others), and non-CALD participants to fetal abnormalities. The paper concludes by calling for awareness campaigns and professional upskilling to better ensure the needs of CALD communities.

Experiences with health information among caregivers of people with cancer from culturally and linguistically diverse backgrounds: A qualitative study.

Although some research suggests that caregivers from culturally and linguistically diverse (CALD) communities have higher unmet information needs compared to their English-speaking counterparts, few studies have examined determinants of information needs among CALD cancer caregivers and their satisfaction with received information. This study aimed to explore experiences with cancer-related information among caregivers of people with cancer from CALD communities. Semi-structured interviews were conducted with 24 caregivers from Arabic and Chinese backgrounds (12 in each group). Thematic analysis was used to analyze data. Participants' mean age was 40.6 years, and most were female (83%). Six themes were identified: (a) lack of information to meet their needs; (b) challenges understanding cancer- and care-related information; (c) proactivity to make sense of, and understand information; (d) interpreting information: the role formal and informal services; and (e) engaging with health providers to access information. Caregivers identified significant language and communication barriers impacting their capacity to understand cancer-related information given by providers and they invested personal effort clarifying information. The importance of access to formal interpreter services, even when caregivers and care recipients seem proficient in English, was highlighted. Cultural sensitivity of providers when discussing a cancer diagnosis and treatment was also identified as an important consideration. Culturally tailored outreach programs designed to provide key cancer-related information which are accessible to CALD caregivers have the potential to improve the health outcomes of both caregivers and care recipients.

“Women are capable too!” Exploring intersectionality and challenging CaLD gender stereotypes at Australian universities

AbstractWith a focus on Culturally and Linguistically Diverse (CaLD) women, this article will discuss the underlying gender inequalities and stereotypes these women experience in Australian tertiary institutions through reflections of translingual discrimination. Translingual discrimination refers to the ideologies and practices that produce unequal linguistic power relationships between CaLD communities and dominant communities of the host society, focusing on the central role that language plays in the enduring relevance of discrimination disparity. Because of CaLD women's translingual identities, these groups experience such aspects of translingual discrimination as accentism, naming practices, linguistic subordination, deskilling, and stereotyping, which eventually affect their well‐being and economic security. CaLD women need a linguistically and culturally “safe space” where they will be supported and appreciated based on their capabilities and skills and not subjected to objectification, femininity evaluations, and derogatory actions. Opportunities for women should persist because, unfortunately, in men‐dominated fields, these opportunities are still necessary to support and include women.

Barriers and enablers of women carers from culturally and linguistically diverse communities participating in physical activities.

This research article presents a phenomenological evaluation of an organization working within disability and with CALD communities of a project that was supporting women carers who are newly arrived to Australia to be happier and healthier. The initiative aimed to alleviate social isolation, enhance wellbeing, and boost confidence among women from Culturally and Linguistically Diverse (CALD) backgrounds in Metropolitan Melbourne, Victoria. Through a qualitative exploration of the lived experiences of participants, findings were categorized into enablers and barriers, shedding light on the outcomes of physical activity participation for these women. Enablers included improvements in health, skill development, achievement, and enhanced social interaction and support, while barriers encompassed challenges related to access, socio-cultural factors, resource availability, interpersonal dynamics, and physiological constraints. Based on these findings, recommendations are proposed to empower CALD community members in the co-development and co-delivery of future programs, fostering sustainability and community-driven engagement.

Co-designing a nature play program for culturally and linguistically diverse children and primary carers: Implications for practice

Nature play can significantly benefit children's development, health and well-being, however, limited literature on the considerations needed to deliver such programs for culturally and linguistically diverse (CALD) communities exists. Co-design methods in health promotion program design are gaining popularity, yet practical guidance is lacking. Using a synthesised operational co-design framework, engaging industry experts and CALD children's primary carers, a series of workshops were undertaken to develop a population-acceptable nature play program. The findings highlight the importance of providing culturally appropriate information and messaging, promoting social connectedness and cultural awareness, incorporating learning and education and addressing fears and judgments. This research contributes to varying bodies of literature and offers practical insights for programs aiming to improve the health and well-being of CALD communities through nature play, warranting further research to evaluate their impacts and long-term effects.

Breaking the barriers: overcoming dementia-related stigma in minority communities.

Dementia is a global health concern that affects individuals irrespective of their cultural or linguistic backgrounds. However, research has long recognized the pronounced stigma associated with dementia, particularly within Culturally and Linguistically Diverse (CALD) communities. This article seeks to summarize the underlying factors contributing to the heightened levels of dementia stigma within CALD communities, through a review of the literature. Our examination shows that cultural beliefs, language barriers, limited awareness, and the impact of migration on perceptions of aging and cognitive decline are contributing factors. Consequently, our analysis highlights the need for tailored, culturally appropriate interventions aimed at mitigating stigma and enhancing dementia care within CALD populations. Our proposed solutions, built on a social-ecological approach, highlights the critical role of collaborative efforts involving policymakers, healthcare providers, community organizations, and CALD community members in fostering a more dementia-inclusive society. This perspective piece aims to shed light on the distinct challenges faced by CALD communities, while advocating for a holistic approach to redefine perceptions and care strategies tailored to these populations.

Quantitative analysis on dental utilisation in culturally and linguistically diverse mothers.

Culturally and linguistically diverse (CALD) mothers are influential in children's behaviours, yet little is known about this population. Furthermore, insufficient quantitative and context-based studies are available with CALD mothers and their access to oral health care. To address this gap, the study investigates oral health behaviours, psychological factors and remoteness area with dental utilisation in CALD mothers, within the NSW context. Informed by middle-range theory and a CALD-specific rainbow model, the 2013 and 2015 NSW Adult Population Health Survey was analysed. Variables for CALD mothers included household structure, age and language spoken. Multivariable analysis was conducted with oral health behaviours, psychological and remoteness variables, with dental utilisation as the outcome. The sample was weighted (n =190,283). In total, 39.8% did not have a dental visit, and older mothers (aged 36-55 years) sought more dental services than younger mothers (aged 18-35 years). Higher odds for treatment dental care (aOR 2.21, 95% CI 1.12-4.37) than prevention-oriented care were found. Mothers experiencing moderate levels of psychological distress (aOR 0.49, 95% CI 0.31-0.77), or residing in outer regional and remote regions (aOR 0.19, 95% CI 0.04-0.85) were less likely to utilise dental care. Findings underline geographical issues in dental care utilisationand the need for integrated care for CALD mothers experiencing psychological distress, and to encourage uptake of preventive oral health care. Addressing cost barriers necessitates for universal health coverage. Multidisciplinary integration of healthcare services with improved primary sector collaboration between governments and healthcare providers, and the expansion to regional services are required for equity in CALD communities.

Development of Moving Pictures GENIE‐an online gateway to dementia resources to support Culturally and Linguistically Diverse (CALD) communities

AbstractBackgroundOver the past decades the use of technology in healthcare has increased exponentially, and the recent pandemic further accelerated the dependence on technology, both to access health and care services but also digital resources and information for health care consumers. Carers of people living with dementia from culturally and linguistically diverse (CALD) backgrounds have been disproportionately impacted as in‐language resources are scarce and locating them can be difficult. Thus, there is need to centralize digital resources to improve access for carers of persons living with dementia who speak languages other than English. Responding to this, our project co‐produced the GENIE (Global dEmeNtIa rEsources): a comprehensive, global online gateway to culturally and linguistically appropriate digital dementia resources.MethodMethods comprised an environmental scan (academic literature and systematic online search) and online consultations with key stakeholders to identify resources. Resources were included if developed by healthcare organizations, dementia or aged care peak bodies, dementia advocacy groups, government departments, or academic organizations. The GENIE site was coproduced with CALD carers and providers in Australia. Data analytics are being collected via the website.ResultThe environmental scan highlighted the dearth of resources developed for CALD communities, and gaps in availability of digital dementia resources across many languages. Further, dementia resources identified via the literature search were often not available for public access, required payment, or were no longer available. More than 400 resources in 68 languages were identified and included in the gateway, and the site was made publicly available in November 2022. Data analytics show that the uptake of the resource has been good with &gt; 700 new users and &gt;3500 page views in the first two months.ConclusionThe Moving Pictures Genie project has produced one of the most comprehensive gateways to digital dementia resources to support carers and families who speak languages other than English currently available. In addition to the production of the resource, the project provides insights into the gaps in existing resources across languages and geographical regions. These findings will be useful to guide the direction of resource development to avoid duplication and enhance equity and benefit to CALD communities.