Skip to main content

Identification of Cultural and Transcultural Health Assets Among Moroccan, Romanian and Spanish Adolescents Through Photovoice

Abstract

The health assets model focuses on recognizing the strengths, capacities and resources of individuals and their communities to improve health control processes. This study focuses on identifying and comparing the transcultural and cultural assets in health as accounted for by 45 young Romanians, Moroccans and Spaniards living in southern Spain. The research uses a photovoice method to understand what young people consider to boost their health. Of all the photographs taken, each young person selected the six most relevant images, and individual interviews were carried out. Both images and interviews were analysed qualitatively using Atlas Ti. We identified 40 transcultural assets in health that were common among the 3 cultural groups and 7 cultural assets that were specific to cultural groups. The seven assets include religion and spirituality, cultural symbols, medicine, traditional food, thinness, freedom/autonomy and plants. The definition of transcultural and cultural health assets facilitates the development of educational health interventions that reinforce the strengths of others in a culturally sensitive manner.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Data Availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Eriksson M, Lindström B. A salutogenic interpretation of the Ottawa Charter. Health Promot Int. 2008;23(2):190–9.

    PubMed  Google Scholar 

  2. WHO. Ottawa charter for health promotion: an International Conference on Health Promotion, the move towards a new public health. Ottawa, Geneva, Canada: World Health Organization; 1986.

  3. Suárez-Orozco C, Suárez-Orozco MM. Children of immigration. Harvard: Harvard University Press; 2009.

    Google Scholar 

  4. Phalet K, Fleischmann F, Hillekens J. Religious identity and acculturation of immigrant minority youth: toward a contextual and developmental approach. Eur Psychol. 2018;23(1):32–43.

    Google Scholar 

  5. Hernández-Girón C, Orozco-Núñez E, Arredondo-López A. Public health conceptual models and paradigms. Revista de Salud Pública. 2012;14(2):315–24.

    PubMed  Google Scholar 

  6. Rivera de los Santos F, Ramos Valverde P, Moreno Rodríguez C, Hernán García M. Análisis del modelo salutogénico en España: aplicación en salud pública e implicaciones para el modelo de activos en salud. Revista española de salud pública. 2011;85(2):129–39.

    PubMed  Google Scholar 

  7. Vaandrager L, Kennedy L. The application of salutogenesis in communities and neighborhoods. In: Mittelmark M, et al., editors. The handbook of salutogenesis. Cham: Springer; 2017. p. 159–70.

    Google Scholar 

  8. Morgan A, Ziglio E. Revitalising the evidence base for public health: an assets model. Promot Educ. 2007;14(2):17–22.

    Google Scholar 

  9. Rotegård A, Moore S, Fagermoen M, Ruland C. Health assets: a concept analysis. Int J Nurs Stud. 2010;47(4):513–25.

    PubMed  Google Scholar 

  10. Lindström B, Eriksson M. Un enfoque salutogénico para abordar las desigualdades sanitarias. In: Hernán M, Antony M, Mena Á, editors. Formación en salutogénesis y activos para la salud, vol. 16. Consejería de salud y bienestar social. Sevilla: Junta de Andalucía; 2010. pp. 67–102.

  11. Ickovics JR, Carroll-Scott A, Peters SM, Schwartz M, Gilstad-Hayden K, McCaslin C. Health and academic achievement: cumulative effects of health assets on standardized test scores among urban youth in the United States. J Sch Health. 2014;84(1):40–8.

    PubMed  PubMed Central  Google Scholar 

  12. Morgan A, Davies M, Ziglio E. Health assets in a global context: theory, methods, action. New York: Springer; 2010.

    Google Scholar 

  13. Cubilla-Batista I, Andrade EL, Cleary SD, Edberg MC, Evans WD, Simmons LK, Sojo-Lara G. Picturing adelante: Latino youth participate in CBPR using place-based PhotoVoice. Soc Market Q. 2017;23(1):18–35.

    Google Scholar 

  14. Bonmatí-Tomás A, del Carmen Malagón-Aguilera M, Bosch-Farré C, Gelabert-Vilella S, Juvinyà-Canal D, Gil MDMG. Reducing health inequities affecting immigrant women: a qualitative study of their available assets. Glob Health. 2016;12(1):37.

    Google Scholar 

  15. Baquero B, Goldman S, Simán F, Muqueeth S, Villa-Torres L, Eng E, Rhodes SD. Mi Cuerpo, Nuestra Responsabilidad: using Photovoice to describe the assets and barriers to sexual and reproductive health among Latinos in North Carolina. J Health Dispar Res Pract. 2014;7(1):7–27.

    Google Scholar 

  16. Downey L, Anyaegbunam C. Your lives through your eyes: rural Appalachian youth identify community needs and assets through the use of photovoice. J Appalach Stud. 2010;1:42–60.

    Google Scholar 

  17. Lightfoot E, Blevins J, Lum T, Lum T. Cultural health assets of Somali and Oromo refugees and immigrants in Minnesota: findings from a community-based participatory research project. J Health Care Poor Underserved. 2016;27(1):252–60.

    PubMed  Google Scholar 

  18. Airhihenbuwa CO. Health and culture: beyond the western paradigm. Thousand Oaks: Sage; 1995.

    Google Scholar 

  19. Menéndez EL. Poder, estratificación y salud: Análisis de las condiciones sociales y económicas de la enfermedad en Yucatán, vol. 15. Editorial Universitat Roviri i Virgili-, 2018.

  20. Leininger M. Transcultural nursing: concepts, theories and practices. New York: Wiley; 1978.

    Google Scholar 

  21. Welsch W. Transculturality: the changing form of cultures today. Filozofski Vestnik. 2001;22(2):59–86.

    Google Scholar 

  22. Hammer MR. The developmental paradigm for intercultural competence research. Int J Intercult Relat. 2015;48(1):12–3.

    Google Scholar 

  23. Albarran J, Rosser E, Bach S, Uhrenfeldt L, Lundberg P, Law K. Exploring the development of a cultural care framework for European caring science. Int J Qual Stud Health Well-being. 2011;6(4):1145–57.

    Google Scholar 

  24. Pies C, Parthasarathy P, Posner SF. Integrating the life course perspective into a local maternal and child health program. Matern Child Health J. 2012;16(3):649–55.

    PubMed  Google Scholar 

  25. Royce SW, Parra-Medina D, Messias DH. Using photovoice to examine and initiate youth empowerment in community-based programs: a picture of process and lessons learned. Calif J Health Promot. 2006;4(3):80–91.

    Google Scholar 

  26. Walker A, Early J. “We have to do something for ourselves”: using photovoice and participatory action research to assess the barriers to caregiving for abandoned and orphaned children in Sierra Leone. Int Electron J Health Educ. 2010;13(1):33–48.

    Google Scholar 

  27. Wang C, Burris MA. Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav. 1997;24(3):369–87.

    CAS  PubMed  Google Scholar 

  28. Wang CC, Pies CA. Family, maternal, and child health through photovoice. Matern Child Health J. 2004;8(2):95–102.

    PubMed  Google Scholar 

  29. Hergenrather KC, Rhodes SD, Cowan CA, Bardhoshi G, Pula S. Photovoice as community-based participatory research: a qualitative review. Am J Health Behav. 2009;33(6):686–98.

    PubMed  Google Scholar 

  30. Wang C. Photovoice: a participatory action research strategy applied to women’s health. J Women’s Health. 1999;8:185–92.

    CAS  Google Scholar 

  31. Wang CC, Redwood-Jones YA. Photovoice ethics: perspectives from Flint photovoice. Health Educ Behav. 2001;28(5):560–72.

    CAS  PubMed  Google Scholar 

  32. Wang C, Burris MA. Empowerment through photo novella: portraits of participation. Health Educ Q. 1994;21(2):171–86.

    CAS  PubMed  Google Scholar 

  33. Castleden H, Garvin T. Modifying photovoice for community-based participatory Indigenous research. Soc Sci Med. 2008;66(6):1393–405.

    PubMed  Google Scholar 

  34. Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S. A children’s global assessment scale (CGAS). Arch Gen Psychiatry. 1983;40(11):1228–31.

    CAS  Google Scholar 

  35. Evans-Agnew RA, Boutain DM, Rosemberg MAS. Advancing nursing research in the visual era: reenvisioning the photovoice process across phenomenological, grounded theory, and critical theory methodologies. Adv Nurs Sci. 2017;40(1):E1–15.

    Google Scholar 

  36. Hansen-Ketchum P, Myrick F. Photo methods for qualitative research in nursing: an ontological and epistemological perspective. Nurs Philos. 2008;9(3):205–13.

    PubMed  Google Scholar 

  37. Salmon J, Buetow S. Transcendental phenomenology and classic grounded theory as mixed data collection methods in a study exploring foetal alcohol spectrum disorder in New Zealand. J Popul Ther Clin Pharmacol. 2013;20(2):e82–90.

    PubMed  Google Scholar 

  38. Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. Thousand Oaks: Sage Publications; 2008.

    Google Scholar 

  39. Morgan A, Haglund BJ. Social capital does matter for adolescent health: evidence from the English HBSC study. Health Promot Int. 2009;24(4):363–72.

    PubMed  Google Scholar 

  40. Fenton C, Brooks F, Spencer NH, Morgan A. Sustaining a positive body image in adolescence: an assets-based analysis. Health Soc Care Community. 2010;18(2):189–98.

    PubMed  Google Scholar 

  41. García-Moya I, Brooks F, Morgan A, Moreno C. Subjective well-being in adolescence and teacher connectedness: a health asset analysis. Health Educ J. 2014;74(6):641–54.

    Google Scholar 

  42. Kia-Keating M, Dowdy E, Morgan M, Noam G. Protecting and promoting: an integrative conceptual model for healthy development of adolescents. J Adolesc Health. 2011;48(3):220–8.

    PubMed  Google Scholar 

  43. Hornby-Turner Y, Peel N, Hubbard R. Health assets in older age: a systematic review. BMJ Open. 2017;7(5):e013226.

    PubMed  PubMed Central  Google Scholar 

  44. Pfarrwaller E, Suris J. Determinants of health in recently arrived young migrants and refugees: a review of the literature. Ital J Public Health. 2012. https://doi.org/10.2427/7529.

    Article  Google Scholar 

  45. Luque-Morales L, Castien-Maestro JI. Apuntes sobre la vivencia de la sexualidad entre la juventud marroquí: investigaciones en Marruecos y en España. Prisma Soc. 2014;13:492–541.

    Google Scholar 

  46. Pàmies J. Las identidades escolares y sociales de los jóvenes marroquíes en Cataluña (España). Psicoperspectivas. 2011;10(1):144–68.

    Google Scholar 

  47. Cotton S, Zebracki K, Rosenthal S, Tsevat J, Drotar D. Religion/spirituality and adolescent health outcomes: a review. J Adolesc Health. 2006;38(4):472–80.

    PubMed  Google Scholar 

  48. Wilkin A, Liamputtong P. The photovoice method: researching the experiences of Aboriginal health workers through photographs. Aust J Prim Health. 2010;16(3):231–9.

    PubMed  Google Scholar 

  49. Pérez-Wilson P, Hernán M, Morgan AR, Mena A. Health assets for adolescents: opinions from a neighbourhood in Spain. Health Promot Int. 2013;30(3):552–62.

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the participant educational centres and the adolescents for their support.

Funding

This study was funded by a grant from Ministry of Economy and Competitiviness of Spain (Grant/Award No. EDU2011-26887).

Author information

Affiliations

Authors

Contributions

ES conceived and design the presented project. ES, VC and DR contributed to the implementation of the research, to the analysis of the results and to the writing of the final report. VC and ES authors wrote this version of the manuscript.

Corresponding author

Correspondence to Verónica C. Cala.

Ethics declarations

Competing interests

The authors declare that they have no competing interests.

Ethical Approval

The Ministry of Economy and Competitiveness of Spain evaluated the ethical dimension of the study and approved the project. In addition the Bioethics Commission from the University of Almeria accepted and approved the study.

Consent to Participate

To guarantee the information, voluntary and conscious participation of all the participants, a written informed consent was provided, explaining the anonymous and confidential nature of the extracted data, which had to be signed by the parents or legal guardians and. In addition, a verbal consent was recorded in all the interviews. Likewise, to reduce the socioeconomic bias, cameras were made available to the participants who did not have cameras or mobile phones.

Consent for Publication

Written informed consent was obtained from the participants for publication of their individual details and accompanying images in this manuscript. The consent form is held by the authors and is available for review by the Editor-in-Chief.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Soriano-Ayala, E., Cala, V.C. & Ruiz-Salvador, D. Identification of Cultural and Transcultural Health Assets Among Moroccan, Romanian and Spanish Adolescents Through Photovoice. J Immigrant Minority Health 22, 255–265 (2020). https://doi.org/10.1007/s10903-019-00934-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10903-019-00934-1

Keywords

  • Transcultural health
  • Photovoice
  • Health assets
  • Immigrant
  • Adolescents
  • Romanian
  • Moroccan
  • Spanish