Culturally And Linguistically Diverse Research Articles

Cerebrovascular Disease Profiles of Culturally and Linguistically Diverse Communities in South Western Sydney and New South Wales

Introduction: Culturally and linguistically diverse (CALD) communities are growing globally. Understanding patterns of cerebrovascular disease in CALD communities may improve health outcomes through culturally specific interventions. We compared rates of transient ischaemic attack (TIA)/stroke (ischaemic stroke, intracerebral haemorrhage) and stroke risk factor prevalence in overseas and Australian-born people in South Western Sydney (SWS) and New South Wales (NSW). Methods: This was a 10-year retrospective analysis (2011–2020) of SWS and NSW age-standardized rates per 100,000 person-years of TIA/stroke. Data were extracted from Health Information Exchange and Secure Analytics for Population Health Research and Intelligence systems. Rates of hypertension, type 2 diabetes mellitus (T2DM), atrial fibrillation (AF), smoking, and obesity were also calculated. Results: The SWS and NSW age-standardized rate of TIA/stroke for people born in Australia was 100 per 100,000 person-years (100/100,000/year). In SWS, 56.6% of people were overseas-born compared to 29.8% for NSW. The age-standardized rate of TIA/stroke for Polynesian-born people was more than double that of Australian-born people (p < 0.001). Hypertension (33 [SWS] vs. 27/100,000/year [NSW]) and T2DM (36 [SWS] vs. 26/100,000/year [NSW]) were the most common risk factors with rates >50/100,000/year (hypertension) and >80/100,000/year (T2DM) for people born in Polynesia, Melanesia, and Central America. Rates of T2DM, AF, and obesity for Polynesian-born people were over threefold greater than people born in Australia. Discussion/Conclusion: Greater rates of TIA/stroke were observed in specific CALD communities, with increased rates of cerebrovascular risk factors. Culturally specific, targeted interventions may bridge health inequalities in cerebrovascular disease.

Developing Pre-Service Teachers: A Social Justice Approach for Educating Culturally and Linguistically Diverse Students

In this article, we describe a dissertation in practice (DiP) conducted by the first author. The DiP focused on a social justice issue—providing pre-service teachers with highly effective preparation for working with culturally and linguistically diverse (CLD) students. As part of the article, interludes have been inserted prior to each major section of the article. These interludes have been used to discuss the thinking and research processes that were considered as the DiP unfolded in a program that employed an action research approach. The intervention was multi-faceted including teaching about orientations toward CLD students, providing pre-service teachers with pedagogical knowledge and skills, and employing a Community of Practice-based, service-learning approach. Quantitative and qualitative results from the study indicated pre-service teachers increased their knowledge, self-efficacy, and projected use of culturally responsive pedagogy. Discussion focused on connecting results to the literature, implications for practice and research, and extensions to current work.

Access to health services among culturally and linguistically diverse populations in the Australian universal health care system: issues and challenges

BackgroundAbout half of first- or second-generation Australians are born overseas, and one-in-five speak English as their second language at home which often are referred to as Culturally and Linguistically Diverse (CALD) populations. These people have varied health needs and face several barriers in accessing health services. Nevertheless, there are limited studies that synthesised these challenges. This study aimed to explore issues and challenges in accessing health services among CALD populations in Australia.MethodsWe conducted a scoping review of the literature published from 1st January 1970 to 30th October 2021 in four databases: PubMed, Scopus, Embase, and the Web of Science. The search strategy was developed around CALD populations and the health services within the Australian context. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines for selection and Arksey and O’Malley framework for analysis of relevant articles. A narrative synthesis of data was conducted using inductive thematic analysis approach. Identified issues and challenges were described using an adapted socioecological model.ResultsA total of 64 studies were included in the final review. Several challenges at various levels were identified to influence access to health services utilisation. Individual and family level challenges were related to interacting social and health conditions, poor health literacy, multimorbidity, diminishing healthy migrants’ effect. Community and organisational level challenges were acculturation leading to unhealthy food behaviours and lifestyles, language and communication problems, inadequate interpretation services, and poor cultural competency of providers. Finally, challenges at systems and policy levels included multiple structural disadvantages and vulnerabilities, inadequate health systems and services to address the needs of CALD populations.ConclusionsPeople from CALD backgrounds have multiple interacting social factors and diseases, low access to health services, and face challenges in the multilevel health and social systems. Health systems and services need to focus on treating multimorbidity through culturally appropriate health interventions that can effectively prevent and control diseases. Existing health services can be strengthened by ensuring multilingual health resources and onsite interpreters. Addressing structural challenges needs a holistic policy intervention such as improving social determinants of health (e.g., improving living and working conditions and reducing socioeconomic disparities) of CALD populations, which requires a high level political commitment.

Unpacking the ‘anti-diet movement’: domination and strategies of resistance in the broad anti-diet community

ABSTRACT This paper explores how those who adopt an ‘anti-diet’ stance use strategies to challenge weight-loss dieting norms. We used a qualitative survey to examine how a heterogenous collective of feminists, fat activists and health professionals (and those on the margins of these groups) define the source(s) of power underlying diet culture and discuss the strategies they use to challenge it. One hundred and eighteen people (Mage = 36.67, SD = 10.50) took part. Most were female (n = 112), heterosexual (69%), and residing in Australia (59%). A small proportion (13%) had a culturally and linguistically diverse (CALD) background. Thirty-seven per cent were health professionals, and over half identified as non-diet activists (52%). We generated three themes in our thematic analysis: ‘Describing diet culture: Unpacking cultural and material forms of power,’ ‘Self-care as a political strategy: Refusals and ambivalence in the anti-diet community,’ and ‘Relational strategies: Challenging diet culture in work and everyday interactions.’ Participants viewed diet culture as being reinforced through internalized multi-institutional patriarchal, Eurocentric and capitalist systems. They challenged cultural norms and institutions that reinforce diet culture by being critical of gender norms and rejecting consumerist dieting practices. We argue that the self-care and relational strategies used by participants across communities signify an awkward but unified ‘anti-diet movement.’ Future research should recruit a more culturally and ethnically diverse sample and examine the ‘anti-diet’ movement beyond the Global North context.

‘Without technology we’d be very stuck’: Ageing migrants’ differential (im)mobile practices during a lockdown

Ubiquitous mobile communication technologies have played an integral role in the way people navigated forced physical immobilities produced through restrictive measures during a pandemic. This paper critically investigates how 15 ageing people from Culturally and Linguistically Diverse (CALD) backgrounds in Victoria, Australia used a range of digital communication technologies and online platforms to cope during the 2020 lockdown. The study deploys the mobilities lens (Urry, 2007) in analysing a data set based on conducting remote and in-depth interviewing. It foregrounds how everyday and multi-scalar digital behaviours afford cultural and social connectedness, reflecting diverse forms of care practices. However, forced immobile practices emerged as shaped by disproportionate network capital. In sum, this study puts forward a nuanced perspective in understanding the scales and textures of (im)mobile practices of ageing migrants during a lockdown in Australia.

Bridging Across the Digital Divide: Identifying the Extent to Which LGBTIQ+ Health Service Websites Engage Culturally and Linguistically Diverse (CALD) Users

ABSTRACT eHealth is promoted as a viable platform for health service provision, as it can deliver relevant information instantaneously and anonymously, whilst circumventing geographical and discriminatory barriers that can occur in face-to-face settings. Lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) communities stand to benefit greatly from eHealth services, however, the way in which culturally and linguistically diverse (CALD) LGBTIQ+ users are included within eHealth service provision is currently unknown. The current study observed the way in which Australian LGBTIQ+ health service websites are inclusive of CALD users. Quantitative content analysis was performed on 19 Australian LGBTIQ+ health service websites, with a focus on translation of services and materials, English and digital literacy, and CALD specific resources. Results showed limited translated information across all websites, an absence of translation tools embedded in the home page, as well as moderate to high levels of digital and English literacy required, and largely absent CALD specific resources. These results suggest that Australian LGBTIQ+ health service websites are not currently meeting the unique needs of their CALD constituents. Increased availability of translation services, navigation tools, and CALD LGBTIQ+ stakeholder inclusion during website development is recommended to ensure more equitable access for CALD LGBTIQ+ communities.

From the World to Western: A Community-Engaged Teaching Strategy to Enhance Students' Learning of Cultural Issues Relevant to Healthcare.

Using the transformational learning theory and action research method, this study captured the experiences of students from health-related disciplines in the cultural immersion program From the World to Western. A total of nine students participated in the pilot program with four host families from Culturally and Linguistically Diverse (CALD) backgrounds, and four cultural facilitators who connected the host families and students. The findings of this research showed that it was beneficial for students in health-related disciplines to engage in the cultural immersion program to further prepare them for culturally competent care in their future roles as healthcare professionals. In addition, the students indicated the need for the cultural immersion program to be part of the curriculum for future students to develop cultural skills, awareness and encounters with diverse populations.

“Come On, Put Viber, We Can Drink Coffee Together”: Performing (Im)mobile Intimacy in Turbulent Times Among Aging Migrants

Abstract This paper critically examines how elderly people from Culturally and Linguistically Diverse(CALD) backgrounds in Victoria, Australia use visual-based platforms in navigating the lockdown in Melbourne, Australia. Based on conducting remote interviews among 15 participants in 2020, the findings show digital practices as integral to forge and maintain cultural identities and social connectedness. Using the mobilities perspective to interrogate digital behaviours, I coin the term ‘(im)mobile intimacy’ to articulate a sense of closeness enabled, felt and negotiated through modes of movements and stasis in and with online platforms. I contend that differential mediated mobilities and immobilities are informed by social, contextual, and technological factors, revealing the textures of affective and relational dimensions of enacting mobile intimacy. In sum, by locating both movements and stasis in digital environments, this paper sheds light on the (re)production of exclusion during the COVID-19 pandemic.

The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study.

BackgroundIn Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults’ risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia.MethodsA cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0.ResultsMean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian β 3.40; 95% CI 1.21, 5.59; African β 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [β 1.82; 95% CI 0.65, 2.99]; and fear [β 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants’ responses, on average, did not prevent them from buying large quantities and storing essential goods.ConclusionA pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.

Exploring emotional and social competencies in undergraduate students: Perspectives from CALD and non-CALD students

With the internationalisation of higher education, students from culturally and linguistically diverse (CALD) backgrounds represent a significant proportion of the university student body in Australia. Research literature indicates that the unique cultural and linguistic challenges experienced by these students may adversely impact their academic performance and social integration in university settings. However, less is known about how the socio-emotional competencies of undergraduate CALD and non-CALD domestic English-speaking students compare. This cross-sectional quantitative study compares the emotional and social competencies in a cohort of CALD and non-CALD occupational therapy undergraduates. Data were collected at one Australian university from a group of 360 students enrolled in the Bachelor of Occupational Therapy (Honours) course. Participants completed the Emotional and Social Competency Inventory– University edition (ESCI-U). Multivariate regression analyses were used to compare between CALD and non-CALD students, controlling for students’ year level of study, age, and gender. Key findings from the regression analysis included the observation of indicate that non-CALD students having significant higher scores than CALD students on all the ESCI-U socio-emotional subscales, especially the Emotional Self-control, Achievement Orientation, Empathy and Teamwork from western perspectives. No difference was found between CALD and non-CALD student on two cognitive competencies- systems thinking and pattern recognition. These findings should be interpreted with caution considering CALD students may interpret the questions differently and demonstrate the competencies in different ways. Specific emotional and social competencies that need to be strengthened in students are discussed and recommendations are made to inform the preparation of evidence-based curricula.

Learning from a codesign exercise aimed at developing a navigation intervention in the general practice setting.

In this study, we aimed to describe and evaluate the codesign of an intervention in general practice setting to help address navigation problems faced by the patients from the culturally and linguistically diverse (CALD) community in Australia. An experience-based codesign (EBCD) methodology was adopted using the Double Diamond design process. Two codesign workshops were conducted online with 13 participants including patients, their caregivers, health service providers, researchers, and other stakeholders. Workshops were audio-recorded, transcribed, and thematically analyzed. The codesign participants identified several navigation problems among CALD patients such as inadequate health literacy, cultural and language barriers, and difficulties with navigating health and social services. They believed that bilingual community navigators (BCNs; lay health workers from the same language or cultural background) could help them address these problems. However, this depended on BCNs being trained and supervised, with a clear role definition and manageable workloads, and not used as an interpreter. In undertaking the codesign process, we found that pre-workshop consultations were useful to ensure engagement, especially for consumers who participated more actively in group activities with service providers after these and their own separate small group discussions during the workshop. Overall, participants identified that BCNs could offer help in addressing the problems faced by the CALD patients in accessing care in general practice setting. The codesign process provided new insights into the navigation problems faced by CALD patients in accessing care and collaboratively developed a strategy for further testing and evaluation.

Access to pulmonary rehabilitation for people from culturally and linguistically diverse communities: A cohort study.

Little is known about the extent of cultural and linguistic diversity among people with chronic obstructive pulmonary disease (COPD) in Australia and if ethno-cultural factors influence engagement in pulmonary rehabilitation (PR). We conducted a prospective cohort study to evaluate the extent of cultural and linguistic diversity among people with COPD and identify variables that influence engagement in PR. Patients with COPD attending the respiratory outpatient clinic at a metropolitan health service completed a study-specific questionnaire with results descriptively analysed. Access issues of awareness, referrals, attendance and completion of PR were examined. A multiple regression analysis was conducted to identify variables that influenced engagement in PR. Ninety-seven participants were recruited, of whom 36 (37%) self-identified a culturally and linguistically diverse (CALD) community. While participants from CALD communities had less awareness of PR as compared with the English Australian group (χ2 (df)=5.3 (1), p=0.02), there were no significant between-group differences in number of observed referrals (p=0.30), attendance (p=0.50) and completions of PR (p=0.90). Only 11 (11%) out of 97 participants completed PR. Age (p=0.006) and being from a CALD community (p=0.03) were independent factors impacting on the awareness of PR while English proficiency (p=0.04) was an independent factor impacting on referrals to PR. While older age and being from a CALD community were associated with having less awareness in PR, referrals to, attendance and completion rates of PR were similar regardless of ethnicity.

What is known about the types of supports used by culturally and linguistically diverse students and their professional placement educators that facilitate successful learning experiences: A scoping review

Purpose: Students from culturally and linguistically diverse (CALD) backgrounds can find professional placements challenging. This review aimed to identify evidence regarding how professional placement educators successfully support CALD students during professional placements and to identify research gaps in this area. Methods: Literature searches were conducted in CINAHL, ERIC, SCOPUS, PubMed, PsychNet, Emerald Insight, IEEE and ABI Inform Global databases from 1990 to October 2020 and reference lists of identified papers were also scanned. Data analysis occurred through quantitative (frequency of methodology types) and qualitative analysis methods. This review included a consultation phase with professional placement educators and managers. Results: A total of 109 papers were selected for review. The majority of papers investigated the perceptions of CALD students and placement educators with some papers focussing on support programs undertaken prior to or during placement. Conclusion: It is evident that many gaps exist in the literature regarding the supports placement educators and CALD students use during professional placements. Where programs have been described, they have not measured outcomes robustly. Furthermore, where papers have reported supports, they were often not sufficiently reported to facilitate implementation or replication. Further research is warranted to fully understand how CALD students are successfully supported on placement.

Risk Perception and Health Precautions Towards COVID-19 Among Older Culturally and Linguistically Diverse Adults in South Australia: A Cross-Sectional Survey.

BackgroundRisk perceptions and precaution-taking against COVID-19 are affected by individuals’ health status, psychosocial vulnerabilities and cultural dimensions. This cross-sectional study investigates risk perceptions associated with COVID-19 and specifically the problem- and emotion-focused health precautions of older, culturally and linguistically diverse (CALD) South Australians.MethodsCross-sectional research involving self-administration of an online survey. Participants were CALD adults living in South Australia, aged 60 years and above (n = 155). Multi-indicator surveys were analyzed using Stata/MP version 13.0 and multiple linear regression models fitted to examine associations between risk perceptions and problem- and emotion-focused health precautions.ResultsDread risk returned the highest mean score; COVID-19 was perceived as a catastrophe. Mean scores for fear showed that participants were worried about COVID-19 and scared of becoming infected. Participants followed health advice as they were worried [β 0.15; 95% CI 0.07, 0.23] and realized the effect of COVID-19 on them [β 0.15; 95% CI 0.02, 0.28], or worried and had trust in experts’ knowledge and managing capacity [β 0.17; 95% CI 0.06, 0.28]. Age was negatively associated with sum-score of problem-focused coping: compared to participants aged 60–69 years, 80+ years revealed a decrease in problem-focused health precautions. Variables like education (primary schooling [β 2.80; 95% CI 0.05, 5.55] and bachelor degree [β 3.16; 95% CI 0.07, 6.25] versus no formal education), self-confidence in reducing risk, and fear [β 0.84; 95% CI 0.31, 1.36] significantly affected emotional-focused health precautions.ConclusionThis local study has global implications. It showed that COVID-19 has psychosocial and environmental implications for older CALD adults. When many CALD populations have existing vulnerabilities to intersecting disadvantage, cultural-tailoring of interventions and pandemic response plans may buffer the effects of compounding disaster. Larger studies are needed to compare risk perception and health response patterns across countries and cultural groupings.

Building a Social Justice Framework for Cultural and Linguistic Diversity in ABA.

ABA may be uniquely positioned to have broader impacts with culturally and linguistically diverse (CLD) client populations, not only due to its growth and increased social acceptability, but also because a segment of the field practices within the education system. Decades of misinformation have potentially reduced the widespread reliance on learning pedagogies derived from behavior analytic research. Disseminating ABA technologies depends on an advocacy-based approach to close gaps from research-to-practice. Social justice is both an approach and a framework that can be integrated into our strategic planning for the field. This article describes how to apply social justice guidelines when working with CLD students and families. There are culturally relevant considerations that can be included in our research, training, and service delivery, in particular if we want the field to grow in a sustainable fashion. Behavior analysts must consider it an ongoing long-term objective to engage in culturally informed assessment, culturally and linguistically relevant intervention, culturally focused advocacy and collaboration with families, and use self-assessment of their cultural competence.

Professional support for teachers and children in diverse classrooms

ABSTRACT In recent decades, Iceland has become a more diverse nation, as witnessed, for example, in the increasing diversity of the school population. While recognising these changes, teachers have reported feeling unprepared to respond as they engage with students with culturally and linguistically diverse backgrounds. The interview study presented in this article aimed at identifying professional support available to teachers working with children of diverse backgrounds, as well as the support provided to students. Interviews were conducted with two preschool- and two primary school teachers, two principals and multiple professionals working within the municipality in matters related to education and CALD (Culturally and Linguistically Diverse) children. Findings indicate that the participating teachers seldom sought assistance or guidance from the municipality for their own professional development. Standardised reading tests seem influential in the primary school, even as early as in the first grade, somewhat contradicting the characteristics of the official inclusive school policy in Iceland. In some primary schools, the education of CALD children coincides with special needs education. A more direct link between expertise at the municipality level and the teachers seems relevant, as the principals’ communication with the municipality professionals does not necessarily benefit the teachers.

Exploring alternative perspectives on millennial teachers’ beliefs of and engagement with cultural and linguistic diversity: the use of reflective practice

ABSTRACT Reflective narrative is an essential practice that teachers and preservice teachers can use to: identify issues from their teaching; actively seek and reflect on solutions; and gain professional growth. Teachers’ reflective practice regarding diversity has been widely researched in recent decades. However, as the new mainstream teaching force in schools with increasing culturally and linguistically diverse (CLD) children, millennial teachers (MTs) have been underrepresented in the body of research. In this multi-case study of millennial teachers (MTs), systematic and purposeful reflective practice has been employed as a pedagogical tool in preparing and supporting teachers of multilingual learners (MLs). The reflective narratives in the MTs’ journals, interviews, and advocacy plans for CLD students were examined to explore the MTs’ self-reflexive inquiries, discovery, and self-transformation. The MTs were found to hold an asset-based perspective of CLD students and see them as leaders, language brokers, and figures in their families and communities. Furthermore, the findings revealed MTs’ improved engagement in diversity issues as advocates through expanded communication, understanding, connection, and collaboration with CLD students, families, ESOL teachers, mentors, and community members. This article concludes with the importance and affordances of using reflective practices in preparing teachers of and for CLD students.

Culturally and linguistically diverse (CALD): terminology and standards in reducing healthcare inequalities

Culturally and linguistically diverse (CALD): terminology and standards in reducing healthcare inequalities

Introducing an integrated model of cross-cultural assessment

Objective With increasing levels of cultural diversity, it is important that mental health services are relevant and accessible to new migrant populations. Efforts have been made to bring attention to the unique experiences and needs of culturally and linguistically diverse (CALD) sub-groups in clinical settings, resulting in various frameworks and professional development workshops. While some of these strategies have raised awareness and persuaded service providers to accommodate different populations, few are effective and genuinely impact consumer outcomes. Conclusion This paper proposes an integrated cross-cultural assessment framework comprising both clinical and organisational components to improve cross-cultural clinical encounters and consumer satisfaction. The framework underscores the importance of the therapeutic alliance through the building of rapport and trust. Moreover, the framework is designed to be organisationally feasible, and locally and practically oriented.

Reasons behind Low Cervical Screening Uptake among South Asian Immigrant Women: A Qualitative Exploration.

Despite advancements in prevention strategies, cervical cancer remains a leading cause of death among underprivileged women. Although Australia has low age-standardized cervical cancer incidence rates compared with other countries, disparities exist in cervical screening uptake among certain population subgroups, especially those from culturally and linguistically diverse (CALD) backgrounds. South Asian immigrant women have been reported to have lower cervical screening uptake than Australian-born women and those from other immigrant backgrounds. The objective of this study was to gain insight into the reasons and barriers for low cervical screening participation among South Asian immigrant women, through qualitative exploration. Semi-structured, in-depth interviews were conducted with 20 women, aged 26–50 years, living in Queensland, Australia, who were recruited via purposive sampling. After translation and transcription of recorded interviews, data was analysed via inductive thematic approach. Resulting themes, illustrating barriers towards screening, included: lack of cervical cancer and screening knowledge, especially of the changes in the revised screening program; effect of preventive, health-seeking behaviours; health care system factors; role of practical constraints and influence of sociocultural beliefs. Results suggest that culturally informed interventions, that involve relevant information provision and behavioural change strategies, to clarify women’s misconceptions, are required.