The problem addressed in this project is the high attrition rate among English as Second Language (ESL) students in a local community college associate degree nursing program. If the retention problem is addressed, the increase in the number of ESL nursing student graduates could result in a more diverse nursing workforce, reflecting the diversity of the community. The purpose of this study was to examine student and faculty views regarding factors that contribute to the academic success and retention of ESL students. To that end, a qualitative case study approach was used, guided by the theoretical frameworks of Cummins's contextual interaction theory and Freire's and Mezirow's transformational learning theory. By using purposeful sampling, 8 ESL students and 5 faculty members were interviewed in both structured and unstructured interviews. The data were decoded using Nvivo computer software to establish themes and categories for analysis. The themes pointed to faculty lacking: (a) cultural awareness and sensitivity, (b) knowledge of the academic needs of ESL students, (c) knowledge of teaching strategies to accommodate the learning of ESL students, and (d) skills to prepare ESL students for what to expect. The findings led to creating a professional development workshop for faculty and led to recommending that the director and dean of the nursing program make it mandatory for faculty to continue their education on skills to improve academic success of ESL students. The findings suggest administrators should make cultural awareness competency compulsory. These efforts and faculty training may result in broader positive social change for ESL students and faculty, administrators, and the community, improving the number of graduating nurses to serve a diverse patient population.

Under-utilisation of mental health services is widespread globally and within Australia, especially among culturally and linguistically diverse (CALD) communities. Improving service access is a priority, as is the need to deliver culturally competent services to the CALD communities. Having migrated to Australia in waves for approximately 150 years from China and South East Asia for various social, political and economic reasons, the Chinese population in Sydney is now the fastest growing non-English speaking ethnic group. There is a need to better understand the impact of culture on the emotional experiences of these Chinese in Australia. How do Chinese make sense of their depressive episodes? To address this question, this study explored the ways participants reach out for medical and/or non-medical help. Lay concepts of illness underpin these decisions and were thus unveiled. Mixed-method research design provided the opportunity to bring together multiple vantage points of investigation: population mental health, transcultural psychiatry and medical anthropology. A study combining quantitative survey and qualitative focus groups was undertaken in metropolitan Sydney. Narratives on symptoms, explanatory models and help-seeking strategies were articulated by focus group informants. Surveys covered demographics, symptom-recognition, previous depressive experiences and professional help sought. Depression measurement tools were cross-culturally validated. Self-ratings of ethnic identities and the Suinn-Lew Self-Identity Acculturation Scale were used to quantify Chinese participants' acculturation level. This allowed comparisons between 'low-acculturated' Chinese', highly-acculturated' Chinese and Australians. Survey results showed comparable levels of symptom-recognition in all subgroups. Focus group discussions provided rich data on informants' help-seeking strategies. Highly acculturated Chinese closely resembled the Australians in many study variables, yet qualitative data suggested cultural gaps beyond language barriers in influencing service use. Participants believed that trustful relationships could work as the bridge to link services with those in need. The implications for Australia's mental health policy include recognising the importance of rapport-building and the existence of cultural gaps. The study indicated professionals can benefit from acquiring information about the mental health beliefs both of individual clients and the wider ethnic communities in which they belong, and respecting the cultural differences between helper and helped as the first step towards cultural competency.

In this Master's of Public Issues Anthropology thesis I examine the perceptions of health and healthcare services within a small rural subsistence farming community in South-Western Paraguay from a political ecology of health perspective. Qualitative research data was collected from May to September of 2010 in Lindo Manantial, a subsistence farming village, and Piribebuy, the closest town to Lindo Manantial and the location of the nearest health centre, the Piribebuy Centro de Salud. The primary goals of this research project were to gain an ethnographic understanding of current local health perspectives and concerns, as well as the local frameworks for health provision in Piribebuy. I argue that the introduction of culturally competent healthcare services could greatly improve individual and community health statuses and outcomes in Lindo Manantial and other similar rural subsistence farming communities in Paraguay. / Social Sciences and Humanities Research Council of Canada (SSHRC)

Under-utilisation of mental health services is widespread globally and within Australia, especially among culturally and linguistically diverse (CALD) communities. Improving service access is a priority, as is the need to deliver culturally competent services to the CALD communities. Having migrated to Australia in waves for approximately 150 years from China and South East Asia for various social, political and economic reasons, the Chinese population in Sydney is now the fastest growing non-English speaking ethnic group. There is a need to better understand the impact of culture on the emotional experiences of these Chinese in Australia. How do Chinese make sense of their depressive episodes? To address this question, this study explored the ways participants reach out for medical and/or non-medical help. Lay concepts of illness underpin these decisions and were thus unveiled. Mixed-method research design provided the opportunity to bring together multiple vantage points of investigation: population mental health, transcultural psychiatry and medical anthropology. A study combining quantitative survey and qualitative focus groups was undertaken in metropolitan Sydney. Narratives on symptoms, explanatory models and help-seeking strategies were articulated by focus group informants. Surveys covered demographics, symptom-recognition, previous depressive experiences and professional help sought. Depression measurement tools were cross-culturally validated. Self-ratings of ethnic identities and the Suinn-Lew Self-Identity Acculturation Scale were used to quantify Chinese participants' acculturation level. This allowed comparisons between 'low-acculturated' Chinese', highly-acculturated' Chinese and Australians. Survey results showed comparable levels of symptom-recognition in all subgroups. Focus group discussions provided rich data on informants' help-seeking strategies. Highly acculturated Chinese closely resembled the Australians in many study variables, yet qualitative data suggested cultural gaps beyond language barriers in influencing service use. Participants believed that trustful relationships could work as the bridge to link services with those in need. The implications for Australia's mental health policy include recognising the importance of rapport-building and the existence of cultural gaps. The study indicated professionals can benefit from acquiring information about the mental health beliefs both of individual clients and the wider ethnic communities in which they belong, and respecting the cultural differences between helper and helped as the first step towards cultural competency.

O presente estudo qualitativo teve como objetivo descrever e compreender o cuidado das crianças no processo saúde-doença sob a perspectiva das famílias de uma comunidade nativa do Peru. O Modelo para Competência Cultural de Purnell foi a base teórica que deu sustentação ao estudo. O método etnográfico com ênfase na etnoenfermagem, utilizando as técnicas da observação participante e da entrevista etnográfica, com cinco famílias durante um período de convivência de quatro meses em uma comunidade nativa; permitiu a compreensão da perspectiva dos informantes sobre o cuidado das crianças. Emergiram três temas culturais do conjunto dos dados: A estrutura sociocultural da comunidade Kabano e seu cotidiano, na qual a função desempenhada por cada membro representa um papel preponderante na estrutura sociocultural e no cotidiano da cultura. A promoção e preservação da saúde na comunidade Kabano é caracterizada por um cotidiano de limitações e dificuldades. Os papéis dos membros da família nuclear, da família ampliada, e do curandeiro e da parteira, referentes às atividades de cuidado cotidianas, visam à promoção da saúde e a vida do coletivo. As práticas no adoecimento das crianças são permeadas por grandes dificuldades apesar do suporte da rede social. As dificuldades são de natureza econômica e provêm das falhas no relacionamento e na comunicação do profissional de saúde com os membros da cultura e os déficits estruturais do estabelecimento de saúde. A assistência à saúde na cultura Kabano se encontra nas etapas iniciais do Modelo para Competência Cultural de Purnell, ou seja, um cuidado caracterizado pela inconsciência incompetente. Os resultados descritos neste estudo, se considerados, podem levar os profissionais a se aproximarem da competência inconsciente para o cuidado cultural da pessoa, da família e da comunidade. / This qualitative study aimed to describe and understand the care of children in the health-illness process from the perspective of the families of a native community in Peru. The Purnell Model for Cultural Competence was the theoretical framework that had supported the study. The ethnographic method with emphasis in the ethnonursing using the participant observation and ethnographic interview techniques with five families, during four months of coexistence in a native community; allowed to understand the informants perspective about the care of children. Three cultural themes emerged from the data set: The socio-cultural structure of Kabano\'s community and their everyday, in which the role played by each member represents a preponderant role in the socio-cultural structure and in the everyday of the culture. The promotion and preservation of health in Kabanos community is characterized by daily limitations and difficulties. The roles of the members of the nuclear family, extended family, and the healer and midwife, regarding the daily care activities, aim at promoting health and life of the collective. Practices in childrens illness are permeated by great difficulties despite the support of social network. The difficulties are of economic kind and come from failures in the relationship and communication between the health professional and the members of the culture and from the structural deficits of the health center. The health care in the Kabano culture is in the early stages of the Purnell Model for Cultural Competence, and characterized by a careful unconscious incompetent. The results described in this study, if they can bring to the professional approach the unconscious competence for cultural care of the person, family and community.

The topic of the present thesis is the accessibility and the quality of mental health care for foreigners in Prague. The theoretical part presents some of the principle topics from intercultural psychology that are related to mental health. Further, the phenomena associated with living abroad and with mental health of foreigners are discussed. Then follows a summary of the principle findings about a good practice in psychological and psychotherapeutic work with culturally and linguistically different clients. The theoretical part concludes with an overview of the present situation of the mental health care in the Czech Republic along with information about the regulations and options of mental health care for the foreign population. The empirical part presents a qualitative research which explores what experience have English and Russian-speaking foreigners with mental health services in Prague, and what are the main barriers that hinder their access to a good quality care. The sample was composed of two groups - clinical group (n=27) and non-clinical group (n=74). The data collection was mostly done via questionnaires and semi-structured interviews. The main findings from both groups identified eight principal barriers that adversely impact the accessibility and the quality of mental health care...

African American women (AAW) suffer from disproportionately high death rates due to coronary heart disease (CHD) compared to Caucasian women. Although there have been a number of studies targeting African American adults with CHD in clinical interventions, very few studies have addressed the social determinants of health and the influence of AAW's perceptions of health factors on health outcomes. The purpose of this phenomenological study was to fill the gap in the existing knowledge base by examining the lived experiences of 10 AAW diagnosed with CHD with a focus on the perceptions of environmental, socioeconomic, and cultural factors related to their disease. The framework for this study was Stokol's socioecological theory. Data were collected through individual semi structured interviews that were audio recorded, transcribed, inductively coded, and organized into themes. Results confirmed an expected connection between CHD and key external factors such as smoking, poor nutrition, and low exercise. The findings also indicated that financial considerations were a factor, including the affordability of healthy foods, although the historical cultural connections to cooking and eating were a greater impediment. The financial burden of medical treatment was less troublesome for the participants of this study, as all had access to private or public insurance plans. Other significant barriers included the inability to schedule appointments with physicians due to work and home commitments. The findings from this study contribute to social change by providing insight into the need for public policy that encourages a more culturally-competent health care system to better educate people about CHD, amend AAW's perceptions on CHD, and aid in the possible reduction of CHD.

Student demographic data in today’s elementary and secondary schools have shown an increase in the numbers of diverse students in classrooms across the United States. This change in classroom demographics has established the need for changes to both the classroom educational environment and the preparation of our teachers. Research supports a few documented ways teachers can support both their student experiences and academic performance. Culturally competent teachers, cultural humility, and culturally relevant pedagogy are a few of the ways educators can adapt to the change in student demographics. Linking the literature to these findings will help provide an overview of several factors associated with teacher cultural competency and student academic performance. Included in the research are classroom demographics, cultural bias, teacher education and experience, relational capacity, and culturally relevant pedagogy. The research suggests that the more teachers are aware of their own bias through culturally competent teacher education, the more successful teachers are at reaching diverse students in the classroom. The goal is to provide information on the importance of teacher cultural competency and how it relates to student success. This action research, case study analyzed the relationship between teachers’ cultural competency and their students’ academic performance through a post-positive research study. Data were collected from various resources: classroom observations; teacher, parent, and student focus groups; academic data; and observations of classroom instruction. This study was a 9-week, two-intervention cycle of action research. The purpose of this action research, case study was to gain insight into teacher, student, and parent experiences and perceptions of classrooms where teachers were of Slavic descent and classrooms where teachers were of non-Slavic descent. This action research, case study aimed to answer multiple research questions to investigate why there were discrepancies between classrooms led by Slavic and non-Slavic teachers with regard to the classroom pedagogy and the academic success of Slavic students. Past research has supported a wide array of culturally responsive teaching techniques for a variety of ethnic and linguistic subgroups. The past research did not specifically look at, or study, the Slavic cultural needs in the classroom. This action research, case study specifically looked at the Slavic cultural needs at one particular school. This is the first study to provide information on the importance of culturally responsive teaching for the Slavic community and how teacher cultural humility with Slavic students can potentially improve perceptions, experiences, and academic success. This study can help fill the gap and potentially lead to further inquiry into Slavic cultural humility.

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