Bertha Ochieng

Adolescent health promotion: The value of being a peer leader in a health education/ promotion peer education programme

Objective To explore the process of adolescent peer leaders and the benefits of being a peer leader in a sexual health HIV/AIDS peer education programme. Design A qualitative study using the principles of grounded theory method. Setting Individual interviews were carried out by the researcher in a room within the building where training of peer leaders took place. Method Fifteen semi-structured in-depth interviews, followed by grounded theory investigation. Results Findings indicated that the process of peer leadership although complex was largely beneficial. The peer leaders were able to identify areas where the experience had benefited them as individuals. Conclusion The peer leaders that participated in the study highlighted positive changes in attitudes and also discussed the effects on their personal lifestyles. From the findings a correlation framework emerged that could be used for studying the interrelationship of factors that determine the effects of being a peer leader.

Minority Ethnic Families and Family-Centred Care

Family-centred care has generally treated families as though they were all two-parent families. For most minority ethnic families, this treatment is especially inappropriate because a greater percentage of the children are cared/live in non-traditional households, their families are heterogeneous and are primarily oriented towards extended families. However, the involvement of the extended family in family-centred care remains non-existent. This therefore suggests that there currently exists a lack of appreciation in appropriately implementing the concept of family-centred care among minority ethnic families. For this aspect of family-centred care to be explored, this article will provide an overview of the child-rearing styles of minority ethnic families including the role of extended family in child care, before discussing the need to involve the extended family in family-centred care. This analysis should enhance the general awareness of childrens nurses and may facilitate a more comprehensive family-centred care to minority ethnic children and their families.

Black African migrants: the barriers with accessing and utilizing health promotion services in the UK.

BACKGROUND The inequalities for different ethnicities and social classes in accessing health services is well documented, but although a number of recent policy developments have aimed to tackle health inequalities, very little is known about the experiences of Black African migrant communities in accessing health promotion information and services. The aim of the study were to examine the experiences of Black African migrant families in accessing health promotion services. METHODS A convenience sample of 90 Black African migrants in the north of England participated in the study. Quantitative and qualitative data were collected utilizing a self-administered questionnaire in Arabic, English, French and Swahili. The findings were analysed using descriptive analysis and a variation of the constant comparative method. Themes and categories were identified across transcripts and appropriate quotations have been used to illustrate themes. RESULTS Major findings that emerged from the analysis showed that participants were concerned about their insufficient ability to communicate, which appeared to undermine their capacity to access health promotion services. Lack of literacy and proficiency in English was perceived as an underlying problem in seeking health promotion information and support. CONCLUSIONS The findings have a number of implications for health promotion practitioners; in particular, the need to work collaboratively with migrant groups in order to identify and develop appropriate cultural sensitive communication strategies. The study concludes by suggesting the need to explore further the communication needs of migrant families and the implications for the take-up of health promotion services.

The effectiveness of HIV/AIDS school-based sexual health education programmes in Nigeria: A systematic review

HIV/AIDS is one of the most important public health challenges facing Nigeria today. Recent evidence has revealed that the adolescent population make up a large proportion of the 3.7% reported prevalence rate among Nigerians aged 15-49 years. School-based sexual health education has therefore become an important tool towards fighting this problem. This systematic review assesses the efficacy of these educational programmes and examines how future programmes and their evaluations can improve. Primary literature published between January 2002 and May 2012, which measured sexual health outcomes among school-based Nigerians before and after a sexual health education programme was delivered, was identified. All seven studies that met the inclusion and exclusion criteria showed there had been positive changes in outcomes following these educational programmes. These included increased knowledge, healthier attitudes and safer sexual health behaviour. However, these studies each had methodological flaws which highlighted a range of important design, implementation and evaluation challenges that future programmes need to meet.

Black families’ perceptions of barriers to the practice of a healthy lifestyle: a qualitative study in the UK

While studies have focused on tangible indicators of the practice of healthy lifestyles, there remains a dearth of research exploring the inter-relationships between the practice of healthy lifestyles and the prevailing living circumstances of Black and other visible minority ethnic communities in Western societies. This article presents an account of African Caribbean men and womens beliefs and perceptions about the barriers of practising a healthy lifestyle, focusing specifically on the effects of social exclusion, racism and ethnic identity. A total of 18 participants from the north of England participated in the study, with in-depth interviews conducted in their homes. The participants believed that principles of healthy lifestyles were largely not relevant to their lived experiences because they failed to take into account their experiences of racism, social exclusion, ethnic identity, values and beliefs. Indeed, participants argued that, with their emphasis on illness prevention and perceived Eurocentric approaches, the principles of healthy lifestyle were part of the social exclusion paradigm experienced by their community. The study concludes by suggesting that it is essential to place notions of socio-economic disadvantage, discrimination, marginalisation and racism at the centre rather than the periphery when considering strategies to make healthier choices an easier option for Black and other visible minority ethnic communities.

Factors influencing the diet patterns and uptake of physical activity among Black families

Abstract This paper provides insight into the influences of dietary behaviour and physical activity on the experiences of Black families of African Caribbean descent. It draws on data from a community-based qualitative study based in the north of England. Ten African Caribbean families participated in the study. There were several social cultural factors that influenced their decisions about food choices and participation in physical activity. The socio-economic status, values and belief systems of the participants determined their attempts and desires to eat healthily and to participate in physical activities. The findings highlighted the dynamic and interactive nature of the interplay between the structural and cultural factors of the context in which participants formed their attitudes towards experiences of healthy diet and participation in physical activity. It is recommended that to develop effective intervention strategies, it is vital that health promotion practitioners take cognisance of the multidimensional and contextual factors that influence decisions people make about their diet and what physical activity they participate in.

Using mixed methods when researching communities.

AIM To argue for the use of mixed methods when researching communities. BACKGROUND Although research involving minority communities is now advanced, not enough effort has been made to formulate methodological linkages between qualitative and quantitative methods in most studies. For instance, the quantitative approaches used by epidemiologists and others in examining the wellbeing of communities are usually empirical. While the rationale for this is sound, quantitative findings can be expanded with data from in-depth qualitative approaches, such as interviews or observations, which are likely to provide insights into the experiences of people in those communities and their relationships with their wellbeing. DATA SOURCES Academic databases including The Cochrane Library, MEDLINE, CINAHL, AMED, INTERNURSE, Science Direct, Web of Knowledge and PubMed. REVIEW METHODS An iterative process of identifying eligible literature was carried out by comprehensively searching electronic databases. DISCUSSION Using mixed-methods approaches is likely to address any potential drawbacks of individual methods by exploiting the strengths of each at the various stages of research. Combining methods can provide additional ways of looking at a complex problem and improve the understanding of a communitys experiences. However, it is important for researchers to use the different methods interactively during their research. CONCLUSION The use of qualitative and quantitative methods is likely to enrich our understanding of the interrelationship between wellbeing and the experiences of communities. This should help researchers to explore socio-cultural factors and experiences of health and healthcare practice more effectively.

Minority ethnic adolescents’ wellbeing: Child rearing practices and positive family influences

Objective: This paper examines Black adolescents’ experiences and views on the interrelationships between their families’ parenting practices and their wellbeing. Method: The material is drawn from a community-based qualitative study on the health and wellbeing experiences of Black African families and adolescents. A total of 53 adolescents of Black African origin residing in a county in the north of England participated in the study. Data were collected by means of semi-structured in-depth interviews conducted in participants’ homes and youth clubs. Data were subjected to thematic analysis with the aid of a qualitative data analysis software package. Results: While the adolescents acknowledged receiving health-promotion messages from sources such as their peers and the media, they also identified the continued significance of their parents and family network in shaping their behaviours and facilitating their wellbeing. These included specific health-promotion messages such as not to use illegal drugs and cigarettes, and on the dangers and effects of excessive alcohol. In addition, the adolescents believed that their parents’ values, beliefs and child-rearing practices had helped them to cope with social discrimination. Conclusion: Knowledge and understanding of Black families’ child-rearing practices, socio-economic circumstances and life experiences can provide health-promotion practitioners with sound background information for the design and implementation of specific effective health-promotion strategies directed at adolescents.

Black parents speak out: The school environment and interplay with wellbeing

Objective: This article presents an account of the beliefs and perceptions of Black parents and the influence of the education system on the wellbeing of their children. Method: The material is drawn from a large ethnographic study that explored the attitudes and experiences of Black families and adolescents on healthy lifestyle. Setting: Ten Black families of African Caribbean origin were interviewed in their homes. Results: Despite the high value placed on education, a number of key factors were viewed as compromising the wellbeing of African Caribbean adolescents in schools; these were identified as experiences of racism, the delivery of a Euro-centric curriculum, and reliance on suspension and exclusion as a form of discipline at school. Participants also believed that because African Caribbean boys suffered worse educational achievements and the consequences of racism, this led to a significantly poorer wellbeing in comparison with the girls. Conclusion: Findings suggested that for schools to enable the wellbeing and positive self-esteem of young people it is important to promote and provide an educational experience that responds to every child’s need for knowledge, linked to their unique experiences and histories. Though experiences in school are not the only factors that can affect the wellbeing of young people, it remains an important area to consider irrespective of ethnicity. Data from this study provides a conceptual and methodological basis for future large-scale and longitudinal investigations into the educational experiences of children from different ethnic groups and interplay with wellbeing, including health inequalities later in adult life.

Spirituality and the Black Community: Criminality, Victimisation and Well-Being

A growing number of studies have reported fairly consistent positive relationships between religion and spirituality with positive coping strategies for negative life experiences (Hazel and Moffat 2001; Maman et al. 2009). This suggests that the spiritual dimension of an individual needs to be considered in experiences of victimisation and negative life experiences. Although Struve (2001) demonstrated that religious involvement directly influences an individual’s quality of life, other studies have reviewed the close connection between religion and spirituality and positive well-being (see the work of Hylton 1997; Larson et al. 1998). Hill and Butter (1995) argued that religion and spirituality can have beneficial effects on well-being through social networks. Religious and spiritual communities provide opportunities for companionship and involvement in formal social programmes, which can have beneficial effects by reducing both psychological and physical stressors. For people of African descent, Smith (2010) discusses how members of the community who adhere to Kwanza celebrations articulate the strategic benefits of this ceremony in facilitating, more poignantly, their reaffirmation as people of African descents’ unity and culture.