A culturally appropriate diet and lifestyle intervention can successfully treat the components of metabolic syndrome in female Pakistani immigrants residing in Melbourne, Australia

This study was designed to test the effectiveness of a culturally appropriate diet and lifestyle intervention to treat metabolic syndrome in female Pakistani immigrants residing in Melbourne, Australia. Forty Pakistani women with metabolic syndrome (aged 20-50 years) completed a 12-week culturally appropriate diet and exercise program. Results indicate that, before intervention, participants were sedentary, taking 4000 ± 22.6 steps per day, and had an obese-classified body mass index (BMI) of 29.2 ± 0.46 kg/m2 (BMI was categorized in accordance with guidelines specifically designed for Asians) and high waist circumference of 132 ± 25.95 cm. Participants were hypertensive (systolic, 135 ± 1.3 mm Hg; diastolic, 86 ± 0.68 mm Hg), were dyslipidemic (total cholesterol, 6.8 ± 0.15 mmol/L; triglycerides, 2.9 ± 0.09 mmol/L), and had elevated blood glucose (6.4 ± 0.33 mmol/L) and fasting blood insulin (45 ± 6.3 μU/mL) levels. After the 12-week culturally appropriate intervention, activity increased (8600 ± 596.7 steps per day, P < .05); and BMI (27.8 ± 0.45 kg/m2), blood pressure (systolic, 125 ± 1.4 mm Hg; diastolic, 80 ± 0.6 mm Hg), cholesterol (5.5 ± 0.1 mmol/L), blood glucose (5.9 ± 0.33 mmol/L), and blood insulin (24.14 ± 1.8 μU/mL) levels were all significantly reduced (P < .05). This study revealed that the Pakistani female migrants who had metabolic syndrome and its components can successfully be treated via a culturally appropriate diet and lifestyle intervention. The success of the current program raises the possibility that other high-risk ethnic groups can also be treated with a culturally appropriate program.

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

BACKGROUND: It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness.

METHODS: A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey.

RESULTS: From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists.

CONCLUSION: Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a mental health crisis.

The influence of mindfulness meditation on angry emotions and violent behavior on Thai technical college students

Introduction: Violence among technical college students is a significant issue in Thailand, South East Asia, and yet few interventions are available for use with this group. In this study the outcomes of a culturally appropriate intervention, mindfulness meditation (MM), on anger and violent behavior are reported. The MM intervention was delivered over three consecutive weeks to technical college students (n = 40) and the effects compared to a comparison group (n = 56) who attend classes as usual. Methods: Both the intervention and comparison group completed a series of validated self-report measures on aggressive and violent behavior perpetration and victimization on three occasions (pre-intervention, 1 month and 3 month post-intervention). Results: Program participants reported lower levels of anger expression at one month follow-up, but there were no observed group. ×. time interactions for self-reported violent behavior. Rates of victimization changed over time, with one interaction effect observed for reports of being threatened. Conclusions: MM may have the potential to improve emotional self-control, but is likely to only impact on violent behavior when this is anger mediated.

Effective anger intervention for indigenous prisoners : research and development in a South Australian study

Although the need for the development and provision of culturally appropriate rehabilitation programs for offenders is widely acknowledged, there is a lack of empirical data that can be used as the basis for the development of new programs. This paper reports the findings of two studies - first a qualitiative study exploring the meaning of anger for Indigenous men in prison; and second a comparison of Indigenous and non-Indigenous male prisoners on a range of measures relevant to the experience of anger by indigenous prisoners in Australia. The results suggest that Indigenous participants are more likely to experience symptoms of early trauma, have greater difficulties identifying and describing feelings and perceive higher levels of discrimination than non-Indigenous prisoners. The implications of this work for the development of culturally appropriate and effective anger management programs for indigenous male prisoners and those from other imnoirty cultural groups are discussed.

Cultural diversity and mental health : the relationship between leisure experiences and wellbeing in an ageing Italian community in Australia

One of the population health implications for Australia’s ageing population is that a larger proportion of the Australian community will be retired and have more time for leisure pursuits. Meaningful leisure activities for this group are thought to be a factor in promoting positive mental health. However, a search of health literature revealed a paucity of research on how older adults make use of their leisure time, what meaning these pursuits have to them, and whether their chosen leisure activities are health enhancing and promote wellbeing. Australia’s population is diverse with many cultures represented. As the population ages, mental health workers will be called upon to provide culturally-appropriate mental health services to clients from a range of ethnic groups. Literature on how people of culturally diverse backgrounds understand leisure activities is also limited. This paper reports on a study carried out in an Italian community in a large regional centre. The participants were selected based on the following criteria; aged 65 years and over, born in Italy, independently living in the community, ambulant, and retired from paid workforce. This study explored how a well-elderly group from an ethnic community derived meaning from their leisure activities and how this impacted on their mental health. Establishing the relationship between leisure and mental health in an ageing ethnic community is important because it sheds light on potential intervention strategies that can be used to maintain the mental health of people living independently in the community. Participants were interviewed using semi-structured questions about their perceptions of leisure, the meanings they derived from these activities, and their perceived impact of these activities on their health. Participant observation was also used to add trustworthiness to the data. Themes arising from the interviews and participant observation will be related to the participants’ sense of health. Results also revealed how older Italians engaged in leisure activities. Implications of the research findings will be directed towards mental health practice with older ethnic clients in community settings. The promotion of healthy lifestyles and positive mental health for Australia’s ageing population will also be discussed.

Anger and indigenous men : understanding and responding to violent behaviour

This book is for social work and criminal justice practitioners who wish to develop culturally appropriate and effective programs for reducing anger-related violence perpetrated by Indigenous men. It places cultural context at the heart of any intervention, broadening the focus from problematic behaviour to a more holistic notion of well-being.

A randomised controlled trial of a social support intervention

Background: Much evidence has accumulated over the last three decades that low social support is related to both mental and physical health. Despite this large and convincing literature, reviewers have noted that there exists remarkably little evidence that social support can be increased by an appropriate intervention. This study reports on the development and evaluation of a new intervention for social support which takes account of the stress-buffering and direct effect models.

Method: Eighty-one individuals scoring low on social support were randomly allocated to the intervention or a waiting-list control condition. Treatment consisted of 10 weekly sessions administered in a group format, and 49 participants (nine males) completed assessments at the beginning and end of a 10-week period, and at 10-week follow-up (intervention condition only).

Results: The intervention proved to be successful at increasing functional support but not structural support. The intervention was also successful in increasing the social skill of self-disclosure, and decreasing depression. Gains made between pre- and post-treatment were maintained at 10-week follow-up.

Conclusions: Based on published analyses of the effects of social support on health, the results imply that the intervention would be useful for stress-buffering purposes, but not for the general health-promoting effects that are associated with good social integration.

A review of evidence-based evaluation of measures for assessing social and emotional well-being in indigenous Australians

Addressing low levels of social and emotional well-being (SEWB) in Indigenous communities has been a national strategic priority for over 10 years and yet progress in assessing the impact of interventions has been slow. One of the key factors limiting the development of evidence-based practice has been the lack of well-validated instruments to assess SEWB and how it changes over time as a result of intervention. This article systematically reviews available measures, classifying them in terms of the evidence base that exists to support their use. It is concluded that there is an ongoing need to develop psychometrically sound, comprehensive, culturally appropriate measures to operationalise Indigenous SEWB at a population health, programme evaluation, and clinical level. It is suggested that seven pathways be followed to achieve this goal, including the need to recognise that the gold standard status for Indigenous measurement tools cannot be ascribed based on evidence-based assessment criteria alone.

A longitudinal study of children's disordered eating and muscle preoccupation

Recent research has demonstrated high levels of dieting, food preoccupation and muscle preoccupation in preadolescent children. In children, these attitudes and behaviours can constitute health risks. The design of appropriate intervention programs relies on empirical identification of the relevant risk factors. The current study was designed to investigate low self-esteem, perceived parental relations, perceived peer relations, negative affect, perfectionism and BMI as predictors of dieting, food preoccupation and muscle preoccupation in 8 to 10 year old children, over a 10 month period. The results demonstrate the importance of perfectionism as a predictor of dieting and muscle preoccupation in preadolescent boys.

Motorcycle ownership and injury in China

Background. China has made tremendous progress in its economic development in the past two decades. Accompanying this economic development has been an evident shift in the modes of transport, from walking and cycling to the use of motorcycles and, increasingly, four-wheel vehicles. Such changes are likely to have also produced changes in the patterns and numbers of road traffic injuries, including increases in motorcycle injuries. However, such changes have not been well documented. The work described in this paper sought, therefore, to document the changes in motorcycle ownership, motorcyclist mortality and injury rates in China since 1987.
Methods. National traffic ownership and injury data from 1987 to 2001 were obtained from the National Bureau for Traffic Administration. Additionally, traffic ownership and injury records from 1997 to 2001 were collected from local police offices from 20 counties in Guangxi Region. Population data were obtained from the national and county statistics bureaus. Motorcycle ownership, fatality and injury trends over time were calculated.
Results. Nationally, motorcycles accounted for 23.4% of all registered motor vehicles in 1987, increasing to 63.2% in 2001. Motorcyclist fatalities and injuries increased 5.5-fold and 9.3-fold, respectively, between 1987 and 2001. In 1987, 7.5% of all traffic fatalities and 8.8% of all traffic injuries were sustained by motorcyclists, with the corresponding proportions increasing to 18.9% and 22.8%, respectively, in 2001. The changing proportions of both traffic fatalities and injuries sustained by motorcyclists were positively correlated with the change in the proportion of motorcycles among all motor vehicles. In the 20 counties in Guangxi, motorcyclist fatality and injury rates also increased between 1997 and 2001. Moreover, these rates were considerably higher than the national rates.
Conclusions. Motorcyclist injury in China is a serious public health problem. Motorcyclist fatalities and injuries are likely to continue to increase unless appropriate intervention programmes are implemented.

Sociocultural factors relating to Tongans' and Indigenous Fijians' patterns of eating, physical activity and body size

This paper reviews literature between 1974 and 2007 that addresses the impact of sociocultural factors on reported patterns of eating, physical activity (activity) and body size of Tongans and indigenous Fijians (Fijians) in their countries of origin. There have been changes in diet (more imported and fewer traditional foods), activity (reduced, especially in urban settings), residence (rural-urban shift) and body size (increased obesity and at a younger age). The prevalence of overweight/obesity in Tongans and Fijians has increased rapidly over the last two decades and remains among the highest in the world (>80% in Tonga; >40% in Fiji), with more females reported to be obese than males. The few studies that investigated sociocultural influences on patterns of eating, activity and/or body size in this population have examined the impact of hierarchical organisation, rank and status (sex, seniority), values (respect, care, co-operation) and/or role expectations. It is important to examine how sociocultural factors influence eating, activity and body size in order to i) establish factors that promote or protect against obesity, ii) inform culturally-appropriate interventions to promote healthy lifestyles and body size, and iii) halt the obesity epidemic, especially in cultural groups with a high prevalence of obesity. There is an urgent need for more systematic investigations of key sociocultural factors, whilst taking into account the complex interplay between sociocultural factors, behaviours and other influences (historical; socioeconomic; policy; external global influences; physical environment).

A cross-cultural examination of barriers to social inclusion for children : a qualitative study using child-centred methods

Social exclusion is a risk factor for mental health problems. This study aims to identify the factors that contribute to social exclusion for children from several cultural backgrounds, living in low-socioeconomic status (SES) areas. Children from English, Chinese and Arabic speaking backgrounds participated in semi-structured interviews. They were asked questions around three prominent themes of social exclusion: exclusion from school, social activities and social networks. Children from English and Chinese speaking backgrounds experienced exclusion at school, from social activities or in social networks. The major barriers to social inclusion, which differed across cultural groups, included bullying, time constraints, economic resources and parental permission. Although money is a barrier to social inclusion, there are several other barriers that need to be considered, such as bullying, time and parental permission, and they may differ by culture. Mental health promotion programmes in schools and communities need to address these barriers in a culturally appropriate manner.