Purpose: This DNP project examines the effectiveness of a brief educational presentation to improve cultural competency care for obesity among African Immigrants. This project focused on providers at southwestern urban primary care clinic to become culturally competent in caring for African immigrants with obesity. The findings and recommendations of this project also serve as resource for other providers locally and nation-wide who provide care for African immigrant population. Method: Utilizing a purposeful sampling method, quantitative pre-test and post-test questionnaires were used to evaluate cultural knowledge and intended clinical practices of participants (N =5), feasibility and satisfaction of the educational activity. Aggregate data collected from the pre-and post-test questionnaires were analyzed and discussed through thematic and descriptive analysis. Results: All participants demonstrated significant enhancement in cultural competency in knowledge in regard to nutrition, physical activity and linguistics/communication, body image perception and obesity management in African cultural context. Also, one hundred percent (n=5) of the participants recorded very high level of satisfaction of the intervention content and delivery. Conclusion: The education intervention was successful in enhancing providers’ cultural knowledge and competence in caring for African immigrants with obesity. It also serves as valuable initiative to further develop culturally competent care based on evidence-based practice to enhance the quality of care delivery for African immigrants as well as other vulnerable minority populations. For the over two million African Immigrants in the United States, obesity and its related complications is a constant struggle for this minority population. Health disparities exist for all minority groups suffering from poverty in the US, and the immigrant population is at a higher risk for these disparities due to the slower rate of acculturation. The effort to address obesity among immigrants especially those of African descent is significantly influenced by providers’ cultural knowledge, sensitivity and competency in healthcare delivery. This project outlines the development, implementation and evaluation of a brief PowerPoint presentation aiming to educate healthcare providers on cultural competency and appropriateness in caring for African Immigrants with obesity.

Philosophiae Doctor - PhD / The aim of this study is to develop an understanding of Cape Town's foreign African immigrants by looking at the profile, character and role of immigrant associations and how they shape survival strategies as well as possible paths to the integration of African immigrants. The thesis seeks to develop an understanding of the mediating role played by Cape Town's African foreign immigrant organisations. I also look at the transnational activities of these organizations. I selected Cape Town because it prides itself on liberal values of toleration, diversity and non-racialism while at the same time branding itself as an African City. The City of Cape Town has no comprehensive policy that protects or promotes the immigrants’ interests. The study of the agency and organisations of foreign African immigrants has been singularly neglected by scholars who have been mostly concerned with understanding why South Africans are xenophobic. This study is largely qualitative with life stories interviews that shed light on the context of exit and reception of African immigrants in Cape Town and reveals the hardship immigrants endure and the problems they face in their efforts to integrate into South African society. The thesis shows the different kinds of exclusions African immigrants face in both private and public spaces and highlights also the role of immigrant's organizations in negotiating space and dealing with xenophobic attacks on their community members. My findings concur with the work of key scholars such Alejandro Portes. Immigrant organisations have a variety of activities and sub-organisations that promote both transnational and local collective action. The thesis documents types of immigrant organisations, their characteristics, location, membership, objectives, activities and their efforts in assisting their members in cases of xenophobic attacks. In Cape Town, immigrants have formed organizations that help them to network with one another in order to negotiate space in this hostile environment.

The purpose of this dissertation was to explore the determinants of Pap screening completion among sub-Saharan African immigrant women. Cervical cancer is a public health problem globally. The risk of invasive cervical cancer remains high among sub- Saharan African immigrant women in the US despite being a preventable cancer. Early detection through Pap screening is crucial for prevention, treatment and prognosis. The specific aims of this dissertation were to 1) examine Pap screening practices among African immigrant women and to identify gaps to guide future research; 2) explore barriers and motivators that influence Pap screening decisions among African immigrant women; and 3) explore African immigrant men’s knowledge of Pap screening and attitudes about supporting their wives/female partners to utilize Pap screening, and 4) explore predictors of Pap screening use among sub-Saharan African immigrant women, Specific aim one was addressed by a review and synthesis of literature focused on Pap screening among African immigrant women. Common factors influencing Pap screening completion included immigration status, health care interactions, knowledge deficiency, religiosity, and certain personal characteristics. Specific aim two was addressed by the conduct of a qualitative descriptive study of barriers and motivators contributing to Pap screening decisions in 22 African immigrant women. Women experienced different barriers including low knowledge of screening, cultural beliefs, fear and communication issues. Addressing knowledge gaps and other barriers related to Pap screening may improve Pap screening participation in this group. Specific aim three was addressed by a qualitative descriptive study of men’s attitudes and beliefs regarding Pap screening and support for their wives for Pap screening participation. African immigrant men demonstrated suboptimal knowledge and awareness of cervical cancer screening. Most men had a lack of knowledge regarding HPV and its link with cervical cancer. Despite knowledge deficiency men showed significant interest in supporting their wife/female partners. Specific aim four was addressed by conducting an analysis of cross sectional data collected from 108 sub-Saharan African women. Predictors of Pap screening completion was determined using logistic regression while controlling for age and education. Pap screening awareness and provider’s recommendations were independent predictors of Pap screening. Given the unequitable burden of cervical cancer experienced by this population, the findings from this dissertation point to the need for a multilevel targeted health interventions directed toward African immigrant population are needed to increase the rates of Pap screening among African immigrant women. Prevention efforts should focus on individual level factors and develop culturally relevant strategies that will effectively provide educational outreach interventions and alleviate barriers to Pap screening. Engaging spousal support and addressing social norms related to spouses/partners’ roles that may influence partaking in cervical cancer screening is important among African immigrant women. Cervical cancer is preventable; Pap screening will lead to early detection of cervical cancer in female African immigrants.

This dissertation explores the identity formation of Ethiopian and Nigerian immigrants, their second generation children, and native born African Americans who reside in the Seattle metropolitan area. Using boundary formation theory, I argue that African immigrants and their second generation children are developing a shared sense of Black identity and racial solidarity (linked fate) with native born African Americans. This shared Black identity is illustrated through both Africans and African Americans’ recognition of one another as racial group members, the constraints on their Black identities, and their navigation of similar institutional and political contexts. I argue that this is highly suggestive of an expansion of the Black racial boundary, and the reconstitution of Black identity in the post-Civil Rights Era. Despite some boundary contraction within the Black racial category by some 1st generation Africans, the African 1.5 and second generation are engaging in boundary crossing particularly with African Americans through their bicultural identities. This process appears to be leading to the blurring of boundaries between the children of African immigrants and native born African Americans, especially through the 1.5 and second generations involvement and integration into African American social and professional organizations. Evidence presented in this dissertation suggests that there is a weakening of ethnic identity among the African 1.5 and second generation. This weakening of ethnic identity among the children of Ethiopians and Nigerians suggest subsequent generations of Africans born here in the United States will eventually be absorbed into an undifferentiated African American/Black category. Keywords: Ethiopians, Nigerians, African Americans, linked fate, Black identity, Africans

Magister Artium (Development Studies) - MA(DVS) / Remittances from South Africa to other African countries have been a growing phenomenon over the past few years. A substantial proportion of such flow is informal and yet, the complexity and heterogeneity of migrants mean that relatively very little is known about which migrants remit, what they remit, how much and how, what the challenges are and how their remittance behaviour varies according to nationality. Using the case study of African immigrants in Cape Town, South Africa, this study sets out to explore the nexus between international migration and remittances, in particular the relationship between migrants' characteristics and remittance behaviour. This study is anchored around the international migration system theory, prospect theory and the social capital theory. The methodological approach is both quantitative and qualitative. The information was collected from an extensive literature review, survey questionnaires administered to 83 immigrants from Zimbabwe, DRC, Rwanda and Somalia, selected using purposive and snowballing techniques, a focus group discussion with 12 participants from the case study and observations of two informal remittance sending sites. This study found that African immigrants send cash, goods and social remittances to their respective countries. Furthermore, using nationality, education and income as the key variables of characteristics of immigrants, this study revealed that economic immigrants from Zimbabwe tend to remit cash and goods more frequently, Somalis remit more socially, Rwandese send goods using formal courier companies, while the Congolese remit through buses. In addition, educated and higher income African immigrants tend to remit formally, and more in terms of goods value and cash amount. This study further established that informal remittance systems still dominate. Beside cost, speed, safety, reliability, customer care, friendliness, trustworthiness and convenience; informal remittance operators offer flexibility through loans and the collection of remittances from regular senders at low service charges. Informal remittance systems also provide other services that attract immigrants. Formal remittance systems on the other hand, have no strong appeal for African immigrants, especially the less educated remitting in rural areas due to low coverage. They are also bureaucratic burdens, by requiring proof of income, and address as well as documentations that immigrants are not able to produce. In addition, the challenges related to the South African money transfer policy environment, the registration and licensing of Money Transfer operators drives remittances further underground. Within the context of remittances, the researcher recommended the measures needed to bolster the use of formal systems, this ranged from the government's relaxation of remitting requirements and licensing conditions, formal remittance operators' extension of their reach, provision of better information about their services and reduction in transfer cost, to informal remittance providers pooling their resources together in order to have a strong capital base that can be easily legitimized.

This study was designed to explore how Black African international students develop an understanding of their racial identity within the U.S. context. Although there has been considerable previous theoretical and empirical work examining the process of racial identity development (e.g. Cross, 1971; Sellers et al.1998), which has provided foundation for how we continue to understand how U.S. racial minorities develop their racial identities. However, there is a paucity of research on the racial identity development process of non-U.S. born Black people (Hocoy, 1999; Asante, 2012). Even less is known about the role that intersectionality of other identities plays in the racial identity development of non-U.S. Black groups. Thus, this study was intended to provide information about the racial identity development process within the U.S. context of Black African international students at Southern Illinois University Carbondale. Grounded Theory method was implemented in this study to analyze qualitative data from nine individual interviews. Findings highlight the complexity of navigating racial identity in a different cultural context. The final analysis revealed seven axial coding categories that comprised of 22 open-coding categories and subcategories. A Grounded Theory model emerged from the analysis, racial identity development as a flowing river, which depicts how participants developed their racial identity within the U.S. cultural context. These Black African international students’ racial identity development process was characterized by individual understanding of race, race-related incidents and events, constructivist nature of race, and impact of other group identities. At the center of the theoretical structure was the understanding of racial identity development as a journey, rather than a step-by-step process. Participants typically begun the process with the understanding of race within their home country context, and then gradually navigated how to adjust to the U.S. context of what it means to be Black. The process was like traveling down a flowing river, littered with rocks and ripples, and African identity served as a safe vessel in which to navigate the river’s flow. The study’s conclusions have implications for mental health providers in college counseling centers, international student office personnel, and researchers. Prior to providing services to Black African international students, stakeholders are encouraged to be mindful of the personal and cultural needs of individual students, as well as where they might be in their racial identity development journey.

No description available.

Yes / This study explored the perspectives of Black men, originally from East Africa, living in the United Kingdom and their partners on what it means to live with diagnosed HIV. This article reports on concealment of HIVpositive status as a strategy adopted by the affected participants to manage the flow of information about their HIV-positive status. Analysis of the data, collected using in-depth interviews involving 23 participants, found widespread selective concealment of HIV-positive status. However, a few respondents had ‘come out’ publicly about their condition. HIV prevention initiatives should recognise concealment as a vital strategy in managing communication about one’s HIV-positive status.

HIV/AIDS studies mostly lack distinction between the US-born Blacks and non-US-born Blacks while African Americans (AAs) continues to represent the group with the heaviest burden of AIDS deaths and new diagnosis of HIV. A review of studies on HIV infection in the US, Europe, and other Western countries revealed a knowledge gap on HIV infection with non-refugee African immigrants (NRAIs), especially the Nigerian African Immigrants (NAIs) who are non-US-born Blacks. The purpose of this descriptive phenomenological study is to address this gap by exploring the expressed views of NAIs, a sub-group of the NRAIs living in Houston, Texas, on the issue of HIV infection. In a qualitative research design, 13 NAI individuals aged 18 to 49 were purposively selected for a face-to-face interview. The health belief model provided the conceptual framework for the development of study questions and analysis of the gathered data using the phenomenological approach. The study findings showed that 90% of the participants have knowledge of HIV infection. Even though 100% of the participants acknowledged the severity of unprotected sex and multiple sexual relationships in the acquisition of HIV, 27% engaged in multiple sexual relationships and there was inconsistent use of condoms in 64% of the participants. The participants expressed low levels of perception regarding the threat of contracting HIV in their relationships. Evidence of sexual mixing was found in about 61% of the study participants. This study provided an opportunity for future research with NAIs, an upcoming set of immigrants, in the US. The study also highlighted how knowledge of the NAIs' culture and language can be used in promoting preventative interventions like the use of condoms and HIV testing.

The population of Africans in the United States is growing, yet little is known about the impact of migration on the attitudes of African immigrants toward suicide, mental health, and helpseeking behavior. Migration entails movement from one cultural environment to another, and the process requires adaptation to the host country. According to Ecological Theory, interactions between the societal structures, values, and beliefs of the host country, cultural values from the country of origin, and individual-level characteristics may affect mental health-related attitudes and behaviors. As such, the current study used mixed methods, administered via online survey, to investigate socio-cultural predictors of attitudes toward suicide, mental health, and treatment seeking among African immigrants in the United States. In the current study the responses of 227 participants were used for qualitative analyses, and responses from 168 participants were used for quantitative analyses. Qualitative results indicated overall negative attitudes towards suicide and positive attitudes towards suicide prevention. Perceived culture-specific causes of suicide included acculturation difficulties, immigration stress, social causes such as home sickness discrimination, and racism, financial causes such as responsibility to kin in Africa, spiritual causes, and deportation risk. Results from quantitative analyses indicated that identification with African values and behaviors were related to lower levels of anxiety, depression, stress, and culture oriented psychological distress. Higher levels of spirituality and religiousness were associated with a negative attitude toward suicide. Implications for population based suicide prevention efforts for African immigrants and for mental health professionals working with African immigrants are discussed.