Health Care Providers\u27 Intention to Provide Culturally Competent Health Care to Somali Based Upon the Indirect Measures of the Integrated Behavioral Model

The purpose of this cross-sectional study was to assess health care providers\u27 intention to provide culturally competent health care to Somali based upon the constructs of the Integrated Behavioral Model by indirect measures. Using ZoomerangTM data collection systems, data were collected on a non-random and purposive sample. Every physician, nurse practitioner, and physician assistant in a non-administrative role at a rural primary care clinic located in Minnesota was recruited by email. A sample of thirty-one health care providers was used in this study. The survey was divided into four main scales based on the constructs of the Integrated Behavioral Model. These constructs included intention, attitudes, subjective norms, and perceived behavioral control. Each main scale, with the exception of intention, was further divided into subscales measuring construct components. The subscales included instrumental attitudes, experiential attitudes, injunctive norms, descriptive norms, motivation to comply with injunctive norms, motivation to comply with descriptive norms, self-efficacy and perceived control. Data analysis showed that overall intention of participants\u27 to provide Somali with culturally competent health care was high. The constructs of the Integrated Behavioral Model, as each related to intention, showed mixed results. Only the relationship between intention and overall subjective norms was statistically significant. More specific correlations were identified when each construct was further divided into construct components. Significant positive correlations between behavioral intention and instrumental attitudes, subjective norms, injunctive norms, descriptive norms and self-efficacy were found. Correlational analysis between demographic characteristics and overall intention did not reveal any significant relationships. Further investigation into gender and years of experience using independent samples t-tests did show some significant findings. Female participants responded to survey items pertaining to experiential attitudes and motivation to comply with injunctive norms more favorably than males. Health care workers with 11 years or more experience were found to have lower overall intention, experiential attitudes, instrumental attitudes, and motivation to comply with injunctive norms scores than those with 10 years of experience or less

Somali American female refugees discuss their attitudes toward homosexuality and the gay and lesbian community

Minnesota is home to the largest population of Somalis in the USA – most arriving as refugees from the civil war in Somalia. As Somali Americans adjust to life in the USA, they are likely to undergo shifts in their belief systems – including changes in their attitudes toward gays and lesbians. We examined the attitudes of 29 Somali American women in the Minneapolis-St. Paul metropolitan area toward homosexuality via face-to-face, semi-structured interviews. Transcripts were translated, transcribed and analysed using an approach informed by grounded theory. Three major themes were identified: (1) Islamic prohibitions against homosexuality; (2) homosexuals exiled to a hidden community; and (3) community members exploring tolerance. Participants’ attitudes toward homosexuality were heavily influenced by religious doctrines and cultural contexts. This is the first known study in the USA of Somali American attitudes toward gays and lesbians. As people mass migrate from nations with negative attitudes toward homosexuality to countries with more progressive attitudes toward varied sexual orientations, refugee attitudes about homosexuality will undergo change. Through research and education, we can better understand how to increase tolerance toward and opportunities for visibility among gay and lesbian refugees throughout the diaspora.Le Minnesota abrite la population la plus importante de Somaliens aux États-Unis – la plupart étant arrivés en tant que réfugiés de la guerre civile en Somalie. Alors que les Somaliens-Américains s’adaptent à la vie aux États-Unis, leurs systèmes de croyances sont susceptibles de changer – ces changements concernant aussi leurs attitudes vis-à-vis des gays et des lesbiennes. Nous avons exploré les attitudes de 29 femmes Somaliennes-Américaines, vivant dans la métropole de Minneapolis-St. Paul, vis-à-vis de l’homosexualité, en ayant des entretiens semi-structurés en face à face avec elles. Les transcriptions ont été traduites, transcrites et analysées dans une approche orientée par la théorie ancrée. Trois thèmes majeurs ont été identifiés : (1) interdiction islamique de l’homosexualité ; (2) exil d’homosexuel(le)s dans une communauté cachée ; et (3) exploration de la tolérance par des membres de la communauté. Les attitudes des participantes vis-à-vis de l’homosexualité étaient lourdement influencées par les doctrines religieuses et les contextes culturels. Cette étude est la première à être connue aux États-Unis pour avoir exploré les attitudes des Somaliens-Américains à l’endroit des gays et des lesbiennes. Alors que se produit une migration en masse depuis des pays hostiles à l’homosexualité vers d’autres, où les attitudes sont plus progressistes vis-à-vis des diverses orientations sexuelles, l’attitude des réfugiés vis-à-vis de l’homosexualité sera amenée à changer. La recherche et l’éducation peuvent nous aider à mieux comprendre comment accroître la tolérance vis-à-vis des réfugiés gays et lesbiennes dans la diaspora, ainsi que les opportunités de visibilité pour ces derniers.La población más grande de somalíes en EE.UU. vive en Minnesota, y la mayoría son refugiados de la guerra civil en Somalia. Cuando estos americanos somalíes se adaptan a la vida estadounidense suelen experimentar cambios en sus sistemas de creencias, por ejemplo en lo que respecta a su actitud con respecto a homosexuales y lesbianas. Mediante entrevistas personales y semiestructuradas, en este artículo analizamos la opinión de 29 mujeres americanas de origen somalí en el área metropolitana de Minneapolis-St. Paul con respecto a la homosexualidad. Las transcripciones fueron traducidas, transcritas y analizadas con ayuda de un enfoque informado de teoría fundamentada. Se identificaron tres temas principales: (1) prohibiciones islámicas contra la homosexualidad; (2) homosexuales exiliados en una comunidad oculta; y (3) el modo en que los miembros de la comunidad exploran la tolerancia. Las actitudes de los participantes hacia la homosexualidad estaban muy influidas por doctrinas religiosas y contextos culturales. Este es el primer estudio conocido en los Estados Unidos sobre las actitudes de americanos somalíes con respecto a los homosexuales y las lesbianas. Cuando ocurren migraciones masivas de países con una mentalidad negativa hacia la homosexualidad a países con actitudes más progresistas sobre las diversas orientaciones sexuales, suelen cambiar las actitudes de los refugiados hacia la homosexualidad. A través de investigaciones y educación, podemos entender mejor cómo se pueden mejorar la tolerancia y las oportunidades de percepción entre refugiados homosexuales y lesbianas en la diáspora.UCare Fund of the Minnesota Medical Foundation [grant number 2010-02R]; The New Researcher Award, St. Cloud State University; The IDEA Multicultural Research Award, University of Minnesota; The Planning Grant in Health Disparities Research [grant number PHDR-2009-301].http://www.tandfonline.com/loi/tchs202018-08-30hj2017Sociolog

The East African HIV prevention model: Perspectives from HIV-positive male immigrants living in the USA

African-born immigrants have been identified as a high risk population for contracting HIV/AIDS. We used Community Identification processes to interview three types of respondents: 11 HIV-seropositive East African-born men; 11 professionals working with HIV-seropositive East African-born men; and 11 individuals interacting with HIV-seropositive East African-born men. Using grounded theory methodology, we developed the East African HIV Prevention Model which displays four components (demographic factors, stigma, disclosure, education) contributing to high risk behaviors and HIV testing. Our model suggests interventions for targeting community demographic factors, pervasive stigma leading to lack of disclosure, and education in the East African community