Preventing Childhood Obesity - Evidence Policy and Practice.pdf

Chapter 32
and reflect the circumstances of the individuals and
families in their home country. The health status of
a skilled migrant may be very different from a
person who has fled a country affected by famine
and/or war. Their visa status may also determine
their level of access to employment and support
services in their host country.
• Relocation to another country is often a period of
disruption in terms of housing, employment and
secure income . These issues are likely to take precedence
over non - critical health considerations.
• L a ck of health education in home countries and
limited family support and social connectedness
in the host country may reduce the capacity of families
to engage in health promoting practices.
• Acculturation can increase awareness and knowledge
of healthy lifestyle options in the host country.
However, this takes time. In many cases it is the
children who acquire this knowledge first, but
without the benefit of an adult ’ s maturity in decision
making. Therefore, while they are in a position
to inform the family choices, the transfer of knowledge
may not take place. This is supported by recent
research findings in Australia which show that use
of the English language at home is a strong protective
factor against overweight and obesity for boys. 10
This suggests that parents with greater proficiency
in the main language of the host country may have
greater access to nutritional information to support
healthy dietary habits.
These are all likely to be issues affecting minority
groups and their interaction with obesity prevention
research and programs.
Who s hould r epresent
the c ommunity?
Guidelines on culturally competent strategies in
health research and programs consistently call for
participatory approaches based on developed relationships
and partnerships. 11,12 The challenge in
implementing this approach is in knowing who the
appropriate partner is, that is, who represents the
community. This will vary considerably. For new and
emerging communities it may be a gradual process of
getting to know community members and networks
and identifying individuals with capacity and influence
in their community who are interested in sup-
porting the research and program initiatives. Some
minority groups will have established community
organizations or community leaders who are expected
to take that role. However, there may also be competing
interests between different groups within a given
cultural community. In these cases it is very important
to allow an initial period of time to explore these different
roles and to be transparent about who is being
consulted. It is also important to determine if the
community leaders are able to truly represent the
interests of the target community members. For
example, is the male religious leader of a community
able to represent the daily experiences of a mother
trying to provide healthy meals for her family? In these
cases, it is clearly valuable to engage mothers but this
should be negotiated through the community leader
as a trusted and respected community representative.
There are many cultural differences in accepted ways
to communicate between genders and so the gender
of the researcher and the setting of interactions with
research or program participants need to be negotiated
in advance.
As always, it is important to be aware of potential
power differences in research and community
program relationships. This is particularly important
in interactions with minority groups if previous traumatic
experiences or gendered roles have contributed
to a feeling of vulnerability, suspicion of perceived
authority figures, or lack of experience with research.
The benefits of this considered approach to identifying
and engaging community representatives are
self - evident. The time involved in building trusted
relationships will save time and resources as the
research and community program progresses. 13
However, can this culturally competent approach be
supported in a community context with multiple
minority groups? In these circumstances it is extremely
valuable to conduct preliminary pilot work on the
feasibility of the study design and the methodology
to ensure appropriate time and resources have been
allocated to meet the needs of culturally diverse
communities. 11
How c an c ommunity i nvolvement
b e s upported?
Factors likely to impact on the way in which community
groups are engaged in the research and
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