Engaging Migrant and Refugee Young People with Sexual Health Care: Does Generation Matter More Than Culture?
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Abstract
Young people from migrant and refugee backgrounds in Australia are recognised as under-utilising mainstream sexual and reproductive health care. A qualitative study was undertaken in Sydney, Australia, to explore the complexities and opportunities for engaging young people from migrant and refugee backgrounds with sexual and reproductive health information and care. Several rounds of interviews were undertaken with 27 migrant and refugee young people aged 16–24 years. These included an initial semi-structured interview (n = 27) and a follow-up and/or walking interview with a sub-set of participants (n = 9 and n = 15 respectively). A theme of ‘generational difference’ recurred throughout the interviews. Particular ways of talking about age-related differences, including the ‘young generation’ and ‘older generations’, appeared to be deployed as a mechanism for explaining a perceived disjunction between service providers and young people. This group, from a very diverse range of cultural and linguistic backgrounds, appeared to be more similar than different when talking about sexual health. They saw themselves as generationally distinct, and commonly positioned ‘older people’ as judgemental and less accepting in relation to sexual health. Migrant and refugee young people may not be fully engaged with, or benefitting from, sexual and reproductive health services, despite a number of service options being available. It is likely that their perceptions and previous experiences, as well as stated preferences for services and service providers, would affect their willingness to engage with services. To enable information and services to better reach young people across the many cultural and linguistic groups living in contemporary Australia, attention must be paid to ensuring they feel included as a member of a ‘young generation’, and ensuring services are inclusive and welcoming.
Keywords
Cultural diversity Young people Sexual and reproductive health Generations Health services AustraliaNotes
Acknowledgements
We are grateful for the contributions of the young people interviewed, who so willingly shared their views and experiences, as well as for the young people who contributed as part of the Youth Advisory Group convened for the study. Thanks also to the co-investigators (Dr. Alison Rutherford, Dr. Christopher Carmody, Dr. Catriona Ooi, Dr. Melissa Kang, Dr. Mitchell Smith, Dr. Deborah Bateson, Mr. Brendan Crozier and Ms. Katherine Bennett) and partner organisations (High St Youth Health Service, Family Planning NSW, NSW Refugee Health Service, South Western Sydney Sexual Health Service, Sydney Sexual Health Centre, and Western Sydney Sexual Health Centre) who contributed to this research. Lastly, we acknowledge UNSW Arts and Social Sciences who contributed some funding towards the fieldwork for this research, as well as the support of an Australian Government Research Training Program Scholarship.
Compliance with Ethical Standards
Conflict of Interest
Author 1 is a doctoral candidate at UNSW Sydney and an employee of the Family Planning NSW Research Centre. Family Planning NSW is a partner organisation for this research. Authors 2 and 3 declare no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
References
- Australian Bureau of Statistics. (2017). 2016 Census: Multicultural. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/lookup/Media%20Release3.
- Bearinger, L. H., Sieving, R. E., Ferguson, J., & Sharma, V. (2007). Global perspectives on the sexual and reproductive health of adolescents: Patterns, prevention, and potential. Lancet, 369(9568), 1220–1231.CrossRefGoogle Scholar
- Berne, L. A., Patton, W., Milton, J., Hunt, L. Y. A., Wright, S., Peppard, J., & Dodd, J. (2000). A qualitative assessment of Australian parents’ perceptions of sexuality education and communication. Journal of Sex Education and Therapy, 25(2–3), 161–168.CrossRefGoogle Scholar
- Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302.CrossRefGoogle Scholar
- Booth, M. L., Bernard, D., Quine, S., Kang, M. S., Usherwood, T., Alperstein, G., & Bennett, D. L. (2004). Access to health care among Australian adolescents young people’s perspectives and their sociodemographic distribution. The Journal of Adolescent Health, 34, 97–103.CrossRefGoogle Scholar
- Botfield, J. R., Newman, C. E., & Zwi, A. B. (2015). Young people from culturally diverse backgrounds and their use of services for sexual and reproductive health needs: A structured scoping review. Sexual Health, 13(1), 1–9.Google Scholar
- Botfield, J. R., Newman, C. E., & Zwi, A. B. (2017). Drawing them in: Professional perspectives on the complexities of engaging ‘culturally diverse’ young people with sexual and reproductive health promotion and care in Sydney, Australia. Culture, Health & Sexuality, 19(4), 438–452.CrossRefGoogle Scholar
- Botfield, J. R., Zwi, A. B., & Newman, C. E. (2016). Young migrants and sexual and reproductive health care. In F. Thomas (Ed.), Handbook of migration and health (pp. 438–458). Cheltenham: Edward Elgar Publishing.CrossRefGoogle Scholar
- Bradley, E. H., Curry, L. A., & Devers, K. J. (2007). Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Services Research, 42(4), 1758–1772.CrossRefGoogle Scholar
- Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.CrossRefGoogle Scholar
- Bryman, A. (2016). Social research methods (5th ed.). Oxford: Oxford University Press.Google Scholar
- Charmaraman, L., & McKamey, C. (2011). Urban early adolescent narratives on sexuality: Accidental and intentional influences of family, peers, and the media. Sexuality Research & Social Policy, 8(4), 253–266.CrossRefGoogle Scholar
- Chown, P., Kang, M., Sanci, L., Newnham, V., & Bennett, D. L. (2008). Adolescent health: Enhancing the skills of general practitioners in caring for young people from culturally diverse backgrounds, GP Resource Kit 2nd Edition. In. Sydney: NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre.Google Scholar
- Dadich, A., Jarrett, C., Sanci, L., Kang, M., & Bennett, D. (2013). The promise of primary health reform for youth health. Journal of Paediatrics and Child Health, 49, 887–890.CrossRefGoogle Scholar
- Davis, K. (2008). Intersectionality as buzzword: A sociology of science perspective on what makes a feminist theory successful. Feminist Theory, 9(1), 67–85.CrossRefGoogle Scholar
- Department of Human Services. (1998). Youth assessment of mainstream health services. Victoria: Department of Human Services.Google Scholar
- Dubbin, L. A., Chang, J. S., & Shim, J. K. (2013). Cultural health capital and the interactional dynamics of patient-centered care. Social Science & Medicine, 93(10), 1–16.Google Scholar
- Edmunds, J., & Turner, B. S. (2002). Generations, culture and society. Buckingham: Open University Press.Google Scholar
- Evans, J., & Jones, P. (2011). The walking interview: Methodology, mobility and place. Applied Geography, 31, 849e858.CrossRefGoogle Scholar
- Foster, K. (2013). Generation and discourse in working life stories. The British Journal of Sociology, 64(2), 195–215.CrossRefGoogle Scholar
- Garcia, C. M., Eisenberg, M. E., Frerich, E. A., Lechner, K. E., & Lust, K. (2012). Conducting go-along interviews to understand context and promote health. Qualitative Health Research, 22(10), 1395–1403.CrossRefGoogle Scholar
- Hach, M. (2012). Common threads: The sexual and reproductive health experiences of immigrant and refugee women in Australia. Melbourne: Multicultural Centre for Women’s Health.Google Scholar
- Hankivsky, O., & Cormier, R. (2009). Intersectionality: Moving women’s health research and policy forward. In. Vancouver: Women’s Health Research Network.Google Scholar
- Health, N. S. W. (2011). Refugee health plan 2011–2016. North Sydney: Ministry of Health, NSW.Google Scholar
- Health, N., & Medical Research Council. (2006). Cultural competency in health: A guide for policy, partnerships and participation. National Health and Medical Research Council: Canberra.Google Scholar
- Henderson, S., & Kendall, E. (2011). Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: Exploring the need for improvement in health service delivery. Australian Journal of Primary Health, 17(2), 195–201.CrossRefGoogle Scholar
- Iqbal, N., Joyce, A., Russo, A., & Earnest, J. (2012). Resettlement experiences of Afghan Hazara female adolescents: A case study from Melbourne. International Journal of Population Research: Australia.Google Scholar
- Lamb, C. F., & Smith, M. (2002). Problems refugees face when accessing health services. NSW Public Health Bulletin, 13(7), 161–163.CrossRefGoogle Scholar
- Liamputtong, P. (2009). Qualitative research methods (3rd ed.). South Melbourne: Oxford.Google Scholar
- Madden, E. F. (2017). Healthcare workers mobilising cultural health capital to assist socially marginalised patients. Health Sociology Review, 1–15. https://doi.org/10.1080/14461242.2017.1387069.CrossRefGoogle Scholar
- Manderson, L., Kelaher, M., Woelz-Stirling, N., Kaplan, J., & Greene, K. (2002). Sex, contraception and contradiction among young Filipinas in Australia. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 4(4), 381–391.CrossRefGoogle Scholar
- Mannheim, K. (1997 [1952]). The problem of generations. London: Routledge.Google Scholar
- Mason, J. (2002). Qualitative researching (2nd ed.). London: Sage Publications.Google Scholar
- McDaniel, S. A. (2004). Generationing gender: Justice and the division of welfare. Journal of Aging Studies, 18, 27–44.CrossRefGoogle Scholar
- McMichael, C. (2008). Promoting sexual health amongst resettled youth with refugee backgrounds. In. Melbourne: Refugee Health Research Centre.Google Scholar
- McMichael, C., & Gifford, S. (2009). It is good to know now...before it’s too late: Promoting sexual health literacy amongst resettled young people with refugee backgrounds. Sexuality and Culture, 13(4), 218–236.CrossRefGoogle Scholar
- Mitchell, A., Patrick, K., Heywood, W., Blackman, P., & Pitts, M. (2014). 5th National Survey of Australian Secondary Students and Sexual Health 2013. In. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.Google Scholar
- National Health and Medical Research Council, Australian Research Council, & Australian Vice-Chancellors’ Committee. (2007 (Updated May 2015)). National Statement on Ethical Conduct in Human Research 2007 (Updated May 2015). Retrieved from Canberra.Google Scholar
- Neale, J. (2016). Iterative categorization (IC): A systematic technique for analysing qualitative data. Addiction, 111, 1096–1106.CrossRefGoogle Scholar
- Newman, C. E., Persson, A., Paquette, D. M., & Kidd, M. R. (2013). The new cultural politics of the waiting room: Straight men, gay-friendly clinics and ‘inclusive’ HIV care. Sexuality Research & Social Policy, 10(2), 87–96. https://doi.org/10.1007/s13178-013-0111-z.CrossRefGoogle Scholar
- Ngum Chi Watts, M. C., Liamputtong, P., & Carolan, M. (2014). Contraception knowledge and attitudes: Truths and myths among African Australian teenage mothers in Greater Melbourne, Australia. Journal of Clinical Nursing, 23(15–16), 2131–2141.CrossRefGoogle Scholar
- Pariera, K. L., & Brody, E. (2017). Talk more about it: Emerging adults’ attitudes about how and when parents should talk about sex. Sexuality Research and Social Policy. https://doi.org/10.1007/s13178-017-0314-9 CrossRefGoogle Scholar
- Patton, M. (2002). Qualitative research and evaluation methods (3rd ed.). Thousand Oaks: Sage Publications.Google Scholar
- Poljski, C. (2011). On your own: Sexual and reproductive health of female international students in Australia. Melbourne: Multicultural Centre for Women’s Health.Google Scholar
- QSR International. (2012). NVivo Qualitative Data Analysis Software: Version 10. Melbourne: QSR International Pty Ltd.Google Scholar
- Ransome, P. (2013). Ethics and values in social research. London: Palgrave Macmillan.CrossRefGoogle Scholar
- Rawson, H., & Liamputtong, P. (2009). Influence of traditional Vietnamese culture on the utilisation of mainstream health services for sexual health issues by second-generation Vietnamese Australian young women. Sexual Health, 6(1), 75–81.CrossRefGoogle Scholar
- Rawson, H., & Liamputtong, P. (2010). Culture and sex education: The acquisition of sexual knowledge for a group of Vietnamese Australian young women. Ethnicity & Health, 15(4), 343–364.CrossRefGoogle Scholar
- Reeders, D. (2011). Responding to diversity: Meeting the sexual and reproductive health needs of international students. In: Melbourne: Centre for Culture, Ethnicity & Health.Google Scholar
- Rogers, C., & Earnest, J. (2014). A cross-generational study of contraception and reproductive health among Sudanese and Eritrean women in Brisbane, Australia. Health Care for Women International, 35(3), 334–356.CrossRefGoogle Scholar
- Rose, N. (1996). Governing ‘advanced’ liberal democracies. In N. B. Rose & A. T. Osborne (Eds.), Foucault and political reason. London: UCL Press.Google Scholar
- Shim, J. K. (2010). Cultural health capital: A theoretical approach to understanding health care interactions and the dynamics of unequal treatment. Journal of Health and Social Behavior, 51(1), 1–15.CrossRefGoogle Scholar
- South Eastern Sydney Local Health District. (2011). Implementation plan for the NSW refugee health plan 2011–2016. Sydney: South Eastern Sydney Local Health District.Google Scholar
- Tylee, A., Haller, D. M., Graham, T., Churchill, R., & Sanci, L. A. (2007). Youth-friendly primary-care services: How are we doing and what more needs to be done? Lancet, 369, 1565–1573.CrossRefGoogle Scholar
- Ussher, J. M., Rhyder-Obid, M., Perz, J., Rae, M., Wong, T. W. K., & Newman, P. (2012). Purity, privacy and procreation: Constructions and experiences of sexual and reproductive health in Assyrian and Karen women living in Australia. Sexuality and Culture, 16, 467–485.CrossRefGoogle Scholar
- Vincent, J. A. (2005). Understanding generations: Political economy and culture in an ageing society. The British Journal of Sociology, 56(4), 579–599.CrossRefGoogle Scholar
- White, J. (2013). Thinking generations. The British Journal of Sociology, 64(2), 216–247.CrossRefGoogle Scholar
- White, R., & Wyn, J. (2013). Youth and society (3rd ed.). South Melbourne: Oxford University Press.Google Scholar
- World Health Organization. (2002). Adolescent friendly health services: An agenda for change. In. Geneva: World Health Organization.Google Scholar
- Wray, A., Ussher, J. M., & Perz, J. (2014). Constructions and experiences of sexual health among young, heterosexual, unmarried Muslim women immigrants in Australia. Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 16(1), 76–89.CrossRefGoogle Scholar
- Wyn, J., & White, R. (2015). Complex worlds, complex identities: Complexity in youth studies. In D. B. Woodman & A. (Eds.), Youth cultures, transitions, and generations: Bridging the gap in youth research (pp. 28–41). Palgrave Macmillan UK: United Kingdom.CrossRefGoogle Scholar
- Wyn, J., & Woodman, D. (2006). Generation, youth and social change in Australia. Journal of Youth Studies, 9(5), 495–514.CrossRefGoogle Scholar