The contribution of psychosocial factors to socioeconomic differences in food purchasing

In developed countries the relationship between socioeconomic position (SEP) and health is unequivocal. Those who are socioeconomically disadvantaged are known to experience higher morbidity and mortality from a range of chronic diet-related conditions compared to those of higher SEP. Socioeconomic inequalities in diet are well established. Compared to their more advantaged counterparts, those of low SEP are consistently found to consume diets less consistent with dietary guidelines (i.e. higher in fat, salt and sugar and lower in fibre, fruit and vegetables). Although the reasons for dietary inequalities remain unclear, understanding how such differences arise is important for the development of strategies to reduce health inequalities. Both environmental (e.g. proximity of supermarkets, price, and availability of foods) and psychosocial (e.g. taste preference, nutrition knowledge) influences are proposed to account for inequalities in food choices. Although in the United States (US), United Kingdom (UK), and parts of Australia, environmental factors are associated with socioeconomic differences in food choices, these factors do not completely account for the observed inequalities. Internationally, this context has prompted calls for further exploration of the role of psychological and social factors in relation to inequalities in food choices. It is this task that forms the primary goal of this PhD research. In the small body of research examining the contribution of psychosocial factors to inequalities in food choices, studies have focussed on food cost concerns, nutrition knowledge or health concerns. These factors are generally found to be influential. However, since a range of psychosocial factors are known determinants of food choices in the general population, it is likely that a range of factors also contribute to inequalities in food choices. Identification of additional psychosocial factors of relevance to inequalities in food choices would provide new opportunities for health promotion, including the adaption of existing strategies. The methodological features of previous research have also hindered the advancement of knowledge in this area and a lack of qualitative studies has resulted in a dearth of descriptive information on this topic. This PhD investigation extends previous research by assessing a range of psychosocial factors in relation to inequalities in food choices using both quantitative and qualitative techniques. Secondary data analyses were undertaken using data obtained from two Brisbane-based studies, the Brisbane Food Study (N=1003, conducted in 2000), and the Sixty Families Study (N=60, conducted in 1998). Both studies involved main household food purchasers completing an interviewer-administered survey within their own home. Data pertaining to food-purchasing, and psychosocial, socioeconomic and demographic characteristics were collected in each study. The mutual goals of both the qualitative and quantitative phases of this investigation were to assess socioeconomic differences in food purchasing and to identify psychosocial factors relevant to any observed differences. The quantitative methods then additionally considered whether the associations examined differed according to the socioeconomic indicator used (i.e. income or education). The qualitative analyses made a unique contribution to this project by generating detailed descriptions of socioeconomic differences in psychosocial factors. Those with lower levels of income and education were found to make food purchasing choices less consistent with dietary guidelines compared to those of high SEP. The psychosocial factors identified as relevant to food-purchasing inequalities were: taste preferences, health concerns, health beliefs, nutrition knowledge, nutrition concerns, weight concerns, nutrition label use, and several other values and beliefs unique to particular socioeconomic groups. Factors more tenuously or inconsistently related to socioeconomic differences in food purchasing were cost concerns, and perceived adequacy of the family diet. Evidence was displayed in both the quantitative and qualitative analyses to suggest that psychosocial factors contribute to inequalities in food purchasing in a collective manner. The quantitative analyses revealed that considerable overlap in the socioeconomic variation in food purchasing was accounted for by key psychosocial factors of importance, including taste preference, nutrition concerns, nutrition knowledge, and health concerns. Consistent with these findings, the qualitative transcripts demonstrated the interplay between such influential psychosocial factors in determining food-purchasing choices. The qualitative analyses found socioeconomic differences in the prioritisation of psychosocial factors in relation to food choices. This is suggestive of complex cultural factors that distinguish advantaged and disadvantaged groups and result in socioeconomically distinct schemas related to health and food choices. Compared to those of high SEP, those of lower SEP were less likely to indicate that health concerns, nutrition concerns, or food labels influenced food choices, and exhibited lower levels of nutrition knowledge. In the absence of health or nutrition-related concerns, taste preferences tended to dominate the food purchasing choices of those of low SEP. Overall, while cost concerns did not appear to be a main determinant of socioeconomic differences in food purchasing, this factor had a dominant influence on the food choices of some of the most disadvantaged respondents included in this research. The findings of this study have several implications for health promotion. The integrated operation of psychosocial factors on food purchasing inequalities indicates that multiple psychosocial factors may be appropriate to target in health promotion. It also seems possible that the inter-relatedness of psychosocial factors would allow health promotion targeting a single psychosocial factor to have a flow-on affect in terms of altering other influential psychosocial factors. This research also suggests that current mass marketing approaches to health promotion may not be effective across all socioeconomic groups due to differences in the priorities and main factors of influence in food purchasing decisions across groups. In addition to the practical recommendations for health promotion, this investigation, through the critique of previous research, and through the substantive study findings, has highlighted important methodological considerations for future research. Of particular note are the recommendations pertaining to the selection of socioeconomic indicators, measurement of relevant constructs, consideration of confounders, and development of an analytical approach. Addressing inequalities in health has been noted as a main objective by many health authorities and governments internationally. It is envisaged that the substantive and methodological findings of this thesis will make a useful contribution towards this important goal.

Factors affecting new project delays in Saudi Arabian manufacturing organisations

Delay in the delivery of manufacturing projects is a major problem in manufacturing industries. This research investigates the factors that influence the lead time of new projects in manufacturing organisations. Employing a questionnaire survey and interview methodologies, this study collected data from five leading manufacturing organisations as well as their suppliers and contractors in Saudi Arabia to examine what, how and why the new project implementation delay occurs. Results show that the main factors contributing to manufacturing delays are related to people and material. On the other hand, social, political and cultural factors were the least significant factors as per the outcome of this study. Views of manufacturers, suppliers and contractors regarding causes of delays have also been analysed.

The regional differences between countries in traffic safety: A cross-cultural study and Turkish Case

Road traffic accidents are a large problem everywhere in the world. However, regional differences in traffic safety between countries are considerable. For example, traffic safety records are much worse in Southern Europe and the Middle East than in Northern and Western Europe. Despite the large regional differences in traffic safety, factors contributing to different accident risk figures in different countries and regions have remained largely unstudied. The general aim of this study was to investigate regional differences in traffic safety between Southern European/Middle Eastern (i.e., Greece, Iran, Turkey) and Northern/Western European (i.e., Finland, Great Britain, The Netherlands) countries and to identify factors related to these differences. We conducted seven sub-studies in which I applied a traffic culture framework, including a multi-level approach, to traffic safety. We used aggregated level data (national statistics), surveys among drivers, and data on traffic accidents and fatalities in the analyses. In the first study, we investigated the influence of macro level factors (i.e., economic, societal, and cultural) on traffic safety across countries. The results showed that a high GNP per capita and conservatism correlated with a low number of traffic fatalities, whereas a high degree of uncertainty avoidance, neuroticism, and egalitarianism correlated with a high number of traffic fatalities. In the second, third, and fourth studies, we examined whether the conceptualisation of road user characteristics (i.e., driver behaviour and performance) varied across traffic cultures and how these factors determined overall safety, and the differences between countries in traffic safety. The results showed that the factorial agreement for driver behaviour (i.e., aggressive driving) and performance (i.e., safety skills) was unsatisfactory in Greece, Iran, and Turkey, where the lack of social tolerance and interpersonal aggressive violations seem to be important characteristics of driving. In addition, we found that driver behaviour (i.e., aggressive violations and errors) mediated the relationship between culture/country and accidents. Besides, drivers from "dangerous" Southern European countries and Iran scored higher on aggressive violations and errors than did drivers from "safe" Northern European countries. However, "speeding" appeared to be a "pan-cultural" problem in traffic. Similarly, aggressive driving seems largely depend on road users' interactions and drivers' interpretation (i.e., cognitive biases) of the behaviour of others in every country involved in the study. Moreover, in all countries, a risky general driving style was mostly related to being young and male. The results of the fifth and sixth studies showed that among young Turkish drivers, gender stereotypes (i.e., masculinity and femininity) greatly influence driver behaviour and performance. Feminine drivers were safety-oriented whereas masculine drivers were skill-oriented and risky drivers. Since everyday driving tasks involve not only erroneous (i.e., risky or dangerous driving) or correct performance (i.e., normal habitual driving), but also "positive" driver behaviours, we developed a reliable scale for measuring "positive" driver behaviours among Turkish drivers in the seventh study. Consequently, I revised Reason's model [Reason, J. T., 1990. Human error. Cambridge University Press: New York] of aberrant driver behaviour to represent a general driving style, including all possible intentional behaviours in traffic while evaluating the differences between countries in traffic safety. The results emphasise the importance of economic, societal and cultural factors, general driving style and skills, which are related to exposure, cognitive biases as well as age, sex, and gender, in differences between countries in traffic safety.

Social Influence and Blood Donation: Cultural Differences Between Scotland and Australia

People can be motivated to carryout behaviours which contribute to improvement of quality of life for reasons driven by cultural norms. There is a common perception that people within a cultural cluster, particularly one with a common language such as English, will exhibit similar consumer behaviours. However there is an emerging field of research investigating intra-cultural differences in marketing that challenges this perception. In particular, the role of peers and norms as drivers of altruistic behaviours that benefit society may differ between these countries. Altruism is an important motivation for pro-social behaviours such as blood donation, water conservation and peer counselling for health problems. Understanding the social influences for these behaviours assists marketers to develop programs that meet the needs of donors and potential donors. An ongoing foundation of altruistic consumers is essential for delivering services that improve quality of life for people. Without blood donors, there would be no blood products for cancer sufferers or accident victims, without a sufficient water supply the quality of life for residents would be compromised and without breastfeeding peer counselling, new mothers and their babies would have reduced quality of life. This chapter reports the findings of two online surveys with Scottish and Australian blood donors and demonstrates differences in the way social norms influence donation behaviour, and importantly different impacts of cultural factors in the two populations.

Environmental factors and product adaptation in Middle Eastern markets : the experience of Australian companies

This paper examines the impact that environmental factors have on the decision of Australian companies to adapt products for Middle Eastern markets. It  concludes that of all product aspects, labeling requires the greatest amount of adaptation and that socio-cultural factors have the greatest influence on overall product adaptation. Furthermore, environmental factors impact on product   adaptation in different ways, reflected in the adaptation of different aspects of the overall product.

The effects of cultural barriers on market entry strategies

The increasing interests worldwide urge researchers to examine the strategies used specifically for tackling the Chinese market. This urgency is brought forward by the fact of a low success rate of international businesses operating in China in the past twenty years. This paper identifies the fundamental barrier - cultural difference and its impact on Australia China business practices. It identifies the differences which impinge on basic decision making processes. It raises the issue of where cultural factors should be placed in organizations. It stresses that consideration of cultural differences plays an important role in the success of entering the Chinese market. Through a single case study of an Australian organisations operation in China, it is demonstrated that cultural differences should be considered at a strategic level rather than an operational level. This will allow appropriate strategies to be implemented rather than constant acijustments to strategies.

Accommodating culture and cultural diversity in online teaching

The term 'culture' has been in common use for a long time. However there is no universally accepted definition and hence it is important to define clearly what culture means in a particular research context. The research reported here is part of a project undertaken at a large Australian university in late 2005. The overall aim of the project was to identify the characteristics of culture and cultural diversity, and to consider how these manifested themselves when teaching and learning in an online environment. The article reports on particular outcomes from the second stage of the project. This involved conducting focus groups with experienced academics and educational developers of online units. The aim was to gain an understanding of culture and cultural difference in the online environment and to consider what strategies were effective in teaching a culturally diverse cohort of online students. The findings from the focus group sessions were benchmarked with other external faculty. The cultural factors of ethnicity and language, attitudes to educational learning, education and prior learning, learning styles and socio-economic background were well supported by the external faculty. However the factors of religion and gender were not supported. Practices for accommodating such cultural differences amongst students within the online class are presented.

Student characteristics and approaches to learning: a cross-cultural study

The principal aim of this study is to examine the relationship between the cultural background of students and their learning approaches in a tertiary accounting program. While prior research in this area has more generally focused on the investigation of the learning approaches of accounting students, there appears to have been little investigation into the learning approaches of students from different cultures who are studying together at the same institution. The paper presents the results of a study of 550 students enrolled in an undergraduate accounting program at a multi-campus Victorian university where learning approaches and cultural background variables were investigated together with other background variables such as gender and age.

The findings extend prior research on the impact cultural factors may have on the learning approaches of accounting students and also assists in clarifying the relationship between memorisation in the process of learning given the diverse ways that students from different cultures study accounting.

Families as carers-information needs in a cultural context

While the important role of family as a carer has been increasingly recognised in healthcare service provision, particularly for patients with acute or chronic illnesses, the carer’s information needs have not been well understood and adequately supported by current health information systems. In order to effectively provide continuous and home-based care for the patient, a family relative as the primary carer needs sufficient access to medical knowledge and patient’s health information. There are two challenges. First, being a family relative, the primary carer is often a non-medical practitioner. Second, in Australia, many primary carers are family relatives of patients from a non-English speaking background. They are often seen as interpreters in clinical consultation sessions. Their roles and responsibilities as an interpreter and a carer are often mixed and blurry.
Therefore, their information needs are often seen as secondary to the patient or neglected. The primary carer’s information needs are currently not yet well understood.

This paper reports finding from a case study which examines an on-line diary of a husband-carer who provided support and care for his wife, who at the time of care was a lung cancer patient. The case study examines an ongoing learning process that the husband went through, identifies information needs by the carer and cultural factors which played an important role in the husband’s interpretation of information, decision making and provision of care. The finding extends a current model of the user’s information needs in the literature and suggests implications for further research into developing health information systems to meet information needs by the family carer.

Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among African migrant children to Australia

Background: Migrants from developing to developed countries rapidly develop more obesity than the host population. While the effects of socio-economic status on obesity are well established, the influence of cultural factors, including acculturation, is not known.

Objective: To examine the association between acculturation and obesity and its risk factors among African migrant children in Australia.

Design and participants: A cross-sectional study using a non-probability sample of 3- to 12-year-old sub-Saharan African migrant children. A bidimensional model of strength of affiliation with African and Australian cultures was used to divide the sample into four cultural orientations: traditional (African), assimilated (Australian), integrated (both) and marginalized (neither).

Main outcome measures: Body mass index (BMI), leisure-time physical activity (PA) and sedentary behaviours (SBs) and energy density of food.

Results: In all, 18.4% (95% confidence interval (CI): 14–23%) were overweight and 8.6% (95% CI: 6–12%) were obese. After adjustment for confounders, integrated (ß=1.1; P<0.05) and marginalized ß(=1.4; P<0.01) children had higher BMI than traditional children. However, integrated children had significantly higher time engaged in both PA (ß=46.9, P<0.01) and SBs (ß=43.0, P<0.05) than their traditional counterparts. In comparison with traditional children, assimilated children were more sedentary (ß=57.5, P<0.01) while marginalization was associated with increased consumption of energy-dense foods (ß=42.0, P<0.05).

Conclusions: Maintenance of traditional orientation was associated with lower rates of obesity and SBs. Health promotion programs and frameworks need to be rooted in traditional values and habits to maintain and reinforce traditional dietary and PA habits, as well as identify the marginalized clusters and address their needs.

Migrant youth, cultural identity and media representation

The current social climate of heightened intercultural tensions in culturally pluralist societies such as Australia highlights the need to develop a more nuanced understanding of the complex cultural adjustment processes  encountered by migrant youth in developing and articulating a sense of  national belonging, To this end, this chapter examines migrant settlement experiences as a 'process by which individuals and groups ... maintain their cultural identity while actively participating in the larger societal framework' (Karac 2001). Research into these critical aspects of integration and  acculturation examines identity formation as a cultural process of  renegotiating individual and group identity, and focuses on concepts of belonging, recognition and self-respect (Berry '997). While cultural factors are considered critical indicators of successful integration into the host community, insufficient research has been conducted into the particular processes of group and individual identity formation that take place amongst migrant youth. In the case of Australia, this process has been made  particularly difficult for some cultural groups due to the contemporary resurgence of populist and exclusionary discourses of national identity. In such a context, the construction of identity amongst migrant youth is all the more challenging, especially when this process exhibits notions of dual attachment, hybridity and difference. For migrant youth, the engagement with different social institutions such as family, school and wider societal networks often affects the processes of identity 'formation that are inherently  dynamic and 'necessarily multiple and fluid' (Noble & Tabar 2002, pp.I28). Negotiating life in-between cultures, youths from migrant backgrounds experience identity construction as a highly contested territory.

Cultural identity is a central issue for immigrants, regardless of how much time has elapsed since leaving their country of origin. This issue is particularly salient for first- and second-generation1 migrant youth, who negotiate identity space comfortably alongside, in opposition to, or more commonly, somewhere in between, their immigrant parents' conceptions of culture and the receiving culture in which they live. Unlike their native peers,  the children of immigrants arc exposed to intra-ethnic and inter- ethnic   dynamics and experiences in their journey towards cultural identity formation. These experiences are complex and diverse, and are navigated within multi- layered ethnic, racial, familial, gendered, socioeconomic and educational  contexts.

The chapter begins by providing theoretical frameworks for conceptualising  cultural diversity and cultural identity. It then examines how migrant youth  negotiate cultural identity in the public realms of family networks and school  environments and how these translate into key educational and behavioural  outcomes. It will draw on some qualitative snapshots as a way of illustrating  shifting migrant youth attitudes towards society, school and culture.

The effects of cultural barriers on market entry strategy

The increasing interests worldwide urge researchers to examine the strategies used specifically for tackling the Chinese market. This urgency is brought forward by the fact of a low success rate of international businesses operating in China in the past twenty years. This paper identifies the fundamental barrier — cultural difference and its impact on Australia-China business practices. It identifies the differences which impinge on basic decision making processes. It raises the issue of where cultural factors should be placed in organizations. It stresses that consideration of cultural differences plays an important role in the success of entering the Chinese market. Through a single case study of an Australian organisation's operation in China, it is demonstrated that cultural differences are to be considered at a strategic level rather than an operational level. In this method, appropriate implementations will be able to be carried out.

Who will be an entrepreneur? How cultural mechanisms and social network structure together influence entrepreneurial participation

Using data collected from 35 countries over five years, this study provides an investigation of the combined influence of cultural factors and social network structure on whether or not an individual, anywhere in the world, becomes an entrepreneur. Results show that knowing someone who has started a business recently, across the world, has a significant impact on entrepreneurship participation. Regarding the potential cultural influences, it seems that importance attached to personally knowing entrepreneurs differs significantly between individuals operating in different cultures. In cultures with high power distance, personally knowing a person who recently started a business is relatively less important as a driver of entrepreneurship participation compared to cultures with low power distance. On the other hand, in cultures where the Hofstede’s ‘masculinity’construct predominates, it is more important than in cultures characterised by ‘femininity’.

Cultural issues in understanding and treating obsessive compulsive and spectrum disorders

This chapter discusses the cross-cultural understanding of the obsessive compulsive and spectrum disorders. Epidemiological studies suggest a reasonably consistent prevalence of OCD around the world. The role of other culturally influenced factors in the presentation of OCD is also considered (i.e., religiosity, superstition, and beliefs), with religion considered particularly important in the presentation of OCD, although not in its prevalence per se. Treatment effect sizes across countries and within minority cultures from Western countries are outlined. The influence of cultural factors on help-seeking behaviors, assessment, misdiagnosis, and treatment are considered. Limitations of the literature base are discussed, particularly the lack of non-Western studies of treatment effects, and the low evidence base for the spectrum disorders.

The effect of African Americans' ethnographic paradigms and cultural explanatory model of breast cancer in framing the male partner's attitudes and behaviors about the woman's breast cancer diagnosis

The disparate burden of breast cancer-related morbidity and mortality experienced by African American women compared with women of other races is a topic of intense debate in the medical and public health arenas. The anomaly is consistently attributed to the fact that at diagnosis, a large proportion of African American women have advanced-stage disease. Extensive research has documented the impacts of cultural factors and of socioeconomic factors in shaping African American women's breast-health practices; however, there is another factor of a more subtle influence that might have some role in establishing these women's vulnerability to this disease: the lack of or perceived lack of partner support. Themes expressed in the research literature reflect that many African American breast cancer patients and survivors consider their male partners as being apathetic and nonsupportive. ^ The purpose of this study was to learn how African American couples' ethnographic paradigms and cultural explanatory model of breast cancer frame the male partners' responses to the women's diagnosis and to assess his ability to cope and willingness to adapt to the subsequent challenges. The goal of the study was to determine whether these men's coping and adaptation skills positively or negatively affect the women's self-care attitudes and behaviors. ^ This study involved 4 African American couples in which the woman was a breast cancer survivor. Participants were recruited through a community-based cancer support group and a church-based cancer support group. Recruitment sessions were held at regular meetings of these organizations. Accrual took 2 months. In separate sessions, each male partner and each survivor completed a demographic survey and a questionnaire and were interviewed. Additionally, the couples were asked to participate in a communications activity (Adinkra). This activity was not done to fulfill any part of the study purpose and was not included in the data analysis; rather, it was done to assess its potential use as an intervention to promote dialogue between African American partners about the experience of breast cancer. ^ The questionnaire was analyzed on the basis of a coding schema and the interview responses were analyzed on the principles of hermeneutic phenomenology. In both cases, the instruments were used to determine whether the partner's coping skills reflected a compassionate attitude (positive response) versus an apathetic attitude (negative response) and whether his adaptation skills reflected supportive behaviors (the positive response) versus nonsupportive behaviors (the negative response). Overall, the women's responses showed that they perceived of their partners as being compassionate, yet nonsupportive, and the partner's perceived of themselves likewise. Only half of the women said that their partners' coping and adaptation abilities enabled them to relinquish traditional concepts of control and focus on their own well-being. ^ The themes that emerged indicate that African American men's attitudes and behaviors regarding his female partner's diagnosis of breast cancer and his ability to cope and willingness to adapt are influenced by their ritualistic mantras, folk beliefs, religious teachings/spiritual values, existential ideologies, socioeconomic status, and environmental factors and by their established perceptions of what causes breast cancer, what the treatments and outcomes are, and how the disease affects the entire family, particularly him. These findings imply that a culturally specific intervention might be useful in educating African American men about breast cancer and their roles in supporting their female partners, physically and psychologically, during diagnosis, treatment, and recovery. ^