The relationships between illness and treatment perceptions with adherence to diabetes self-care: A comparison between Arabic-speaking migrants and Caucasian English-speaking patients

Aims
To compare illness and treatment perceptions between Arabic-speaking immigrants and Caucasian English-speaking people with type 2 diabetes, and explore the relationships between these beliefs and adherence to self-care activities.
Methods

A cross-sectional study was conducted in healthcare settings with large Arabic populations in metropolitan and rural Victoria, Australia. Adherence to self-care activities, illness and treatment perceptions, and clinical data were recorded. Bivariate associations for continuous normally distributed variables were tested with Pearson's correlation. Non-parametric data were tested using Spearman's rank correlation coefficient.
Results

701 participants were recruited; 392 Arabic-speaking participants (ASPs) and 309 English-speaking participants (ESPs). There were significant relationships between participants’ illness and treatment perceptions and adherence to diabetes self-care activities. ASPs’ negative beliefs about diabetes were strongly and significantly correlated with poorer adherence to diet recommendations, exercise, blood glucose testing and foot care. ASPs were significantly less adherent to all aspects of diabetes self-care compared with ESPs: dietary behaviours (P = <0.01; 95% confidence interval (CI) = −1.17, −0.84), exercise and physical activity (P = <0.001, 95% CI −1.14, −0.61), blood glucose testing (P = <0.001) and foot-care (P = <0.001). 52.8% of ASPs were sceptical about prescribed diabetes treatment compared with only 11.2% of the ESPs. 88.3% of ASPs were non-adherent to prescribed medication, compared with 45.1% of ESPs.

Conclusions
Arabic-speaking migrants’ illness and treatment perceptions were significantly different from the English-speaking group. There is a pressing need to develop new innovative interventions that deliver much-needed improvements in adherence to self-care activities and key health outcomes.

Native English speaking teachers and Taiwanese English teachers' professional identity

The study found that Native English Speaking Teachers (NESTs) helped Taiwanese English teachers define their weaknesses, strengths, roles and values through relationality. NESTs brought competing discourses to the profession. In addition, team teaching has become a site of tension threatening Taiwanese English teachers in activating their professional agency.

Engaging Deakin's international students in ongoing English language development

Universities in Australia, as with universities in the US and UK, are required more and more to adjust to student cohorts which represent a range of national, cultural and linguistic diversity. Many are concerned about the readiness of these students for study in an English-speaking medium and about their subsequent experiences and success. This presentation reports on the outcomes of “The English Language Growth” project, conducted across five Australian universities. This study, funded by the Australian Learning and Teaching Council (ALTC), represents the largest of its type in Australia. The project investigated the strategies that international students from non-English speaking backgrounds use to continue to improve their English once entering a university in Australia.

Barriers and enablers to healthcare access and use among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes mellitus: a qualitative comparative study

OBJECTIVE: The objective of this study was to explore the decision-making processes and associated barriers and enablers that determine access and use of healthcare services in Arabic-speaking and English-speaking Caucasian patients with diabetes in Australia. STUDY SETTING AND DESIGN: Face-to-face semistructured individual interviews and group interviews were conducted at various healthcare settings-diabetes outpatient clinics in 2 tertiary referral hospitals, 6 primary care practices and 10 community centres in Melbourne, Australia. PARTICIPANTS: A total of 100 participants with type 2 diabetes mellitus were recruited into 2 groups: 60 Arabic-speaking and 40 English-speaking Caucasian. DATA COLLECTION: Interviews were audio-taped, translated into English when necessary, transcribed and coded thematically. Sociodemographic and clinical information was gathered using a self-completed questionnaire and medical records. PRINCIPAL FINDINGS: Only Arabic-speaking migrants intentionally delayed access to healthcare services when obvious signs of diabetes were experienced, missing opportunities to detect diabetes at an early stage. Four major barriers and enablers to healthcare access and use were identified: influence of significant other(s), unique sociocultural and religious beliefs, experiences with healthcare providers and lack of knowledge about healthcare services. Compared with Arabic-speaking migrants, English-speaking participants had no reluctance to access and use medical services when signs of ill-health appeared; their treatment-seeking behaviours were straightforward. CONCLUSIONS: Arabic-speaking migrants appear to intentionally delay access to medical services even when symptomatic. Four barriers to health services access have been identified. Tailored interventions must be developed for Arabic-speaking migrants to improve access to available health services, facilitate timely diagnosis of diabetes and ultimately to improve glycaemic control.

Self-esteem and negative affect as moderators of sociocultural influences on body dissatisfaction, strategies to decrease weight and strategies to increase muscles among adolescent boys and girls

The study was conducted to examine the impact of sociocultural influences and the moderating role of self-esteem and negative affect on body dissatisfaction and body change strategies for both adolescent boys and girls. Surveys designed to assess body dissatisfaction, body change strategies to decrease weight and increase muscles, perceived sociocultural pressures to lose weight and increase muscles, self-esteem and negative affect were administered to 587 boys and 598 girls aged between 11 and 15 years. The majority of respondents were from Anglo-Australian backgrounds (83%) with the remainder being from Asian and European non-English-speaking backgrounds. The sociocultural influences were found to significantly predict body dissatisfaction and body change strategies for both boys and girls. However, in the case of boys, self-esteem was found to moderate the impact of the sociocultural influences in predicting body change strategies. It was primarily the boys with low self-esteem who were more affected by the sociocultural pressures whereas the girls were affected independently of their self-esteem. Negative affect was also found to play a moderating role on some of the sociocultural influences in predicting strategies to increase muscles. Both boys and girls with higher levels of negative affect were more likely to be affected by sociocultural messages directed at increasing muscles. The results from the present study demonstrate that as well as examining the direct influence of sociocultural pressures, it is also important to examine how these may be moderated by self-esteem and negative affect.

A longitudinal analysis of the role of biopsychosocial factors in predicting body change strategies among adolescent boys.

In this study we examined the role of biopsychosocial factors on adolescent boys' body modification strategies over an 8-month period. Participants were 434 adolescent boys aged between 11 and 16 years. The majority of respondents were from Anglo-Australian backgrounds (83%); the others were from Asian and European non-English-speaking backgrounds. The results indicated a consistent relationship between perceived encouragement to engage in body change strategies and increases in adolescents' body modification strategies, including muscle gain, weight gain, and weight loss. In addition, poor parent relations, being younger, and higher scores on the pubertal development scale predicted increased use of food supplements. However, the stability of the body modification strategies and the examined variables over the 8-month period were low. Further studies are needed to examine the stability of adolescent self-perceptions over both longer and shorter periods. Moreover, researchers need to include other factors that may be more relevant for adolescent boys (e.g., involvement in sports).

What women can expect when undertaking expatriate assignments in Australia

Despite a numerical equivalence with men, women in Australia have not experienced parity with males in terms of opportunity. They are continually under-represented among Australia's elite (Higley, Deacon, & Smart, 1979). In general, women employees, particularly those born overseas, face more difficulties in gaining access to, and advancing within, the managerial workforce than are men. Further, obtaining a managerial job in the first place is often the biggest obstacle facing women from a non-English-speaking background (NESS) even when their experience and educational levels are comparable to those of English speaking applicants. This paper sheds light on the experience of women expatriates in Australia and the factors that inhibit and facilitate their entry and advancement into managerial positions. Recommendations for organisations sending women on expatriate assignments to Australia are offered.