Tag Archives: Cultural translation

Talanoa approach supports long-term change for Pasifika women with diabetes

Type 2 Diabetes is a significant public health problem and Australian Pacific Islander women and their communities are experiencing a higher burden of morbidity and mortality from the disease. Despite the higher burden, there are few initiatives that are culturally tailored to improve prevention and management.

We spoke to Women’s Wellness Research Collaborative member Dr Heena Akbar from the University of Queensland about using talanoa, a community-based research methodology, to build capacity with Australian Pacific Islander women in Queensland to develop culturally relevant methods of information sharing and knowledge building to improve health outcomes for women with Type 2 Diabetes.

Can you tell us more about this project and how it came about?

The Pasifika Women’s Diabetes Wellness Program was borne out of wanting to look at diabetes in the Pasifika (Pacific) context because, as a person from Fiji, we are often faced with an increased risk of type 2 diabetes in our communities, both in the islands but also in Australia. Here in Australia, we don’t have recent data, which makes it challenging for our communities to address this important issue.

I started my PhD in 2013 after talking to our community elders and members about how we might address this problem in a culturally appropriate and strength-based way. My PhD looked at “Socio-Cultural Context of Managing Type 2 Diabetes in Australian Pacific Islander Women Living in Queensland” where through participatory action research and embedding the Talanoa Pacific methods – story telling – we aimed to understand how our women who already have type 2 diabetes were looking after themselves and managing their diabetes within their family and community context.

The focus of this research was about working together with our women in the Māori and Pasifika community to develop awareness around diabetes and to promote diabetes prevention and management for our Pasifika community. We worked closely with our Pasifika communities to host three diabetes health forums (during my PhD) that provided diabetes education, promoted awareness around chronic conditions and undertook health screening for our people within a culturally safe community space.

Community led initiatives have a far more powerful impact on change. This is partly because we frame our work through cultural safety principles and cultural values such as identity, respect, reciprocity, spirituality, family and community, which are pertinent to Māori and Pasifika communities and our ways of knowing, being and doing.

Can you tell us more about the community-academic partnership and the value of this to the project?

Community-academia partnership is really important, particularly when we want to build a culturally responsive research path for academia and community collaboration.

Strong partnerships are also very important if we want to make a positive contribution towards influencing long-term health behaviours.

Our work is largely a partnership with the Pasifika Women’s Alliance Inc. (PWA), a culturally diverse network of women from across Oceania that seeks to build and strengthen a Queensland sisterhood of Pacific Islander women and to raise awareness of members as to their rights and responsibilities as citizens and encourages their participation in all aspects of community life. A large part of this is ensuring that our women are aware of their health and includes promoting healthier and stronger families through projects like the Pasifika Women’s Diabetes Wellness Program.

What is the Talanoa Framework and how was it used in your approach?

‘Talanoa’ frames how we talk to each other. Talanoa – is a Pasifika way of having conversations and dialogues between people and relies heavily on building and maintaining relationships. Talanoa with elders and members of the Pasifika communities are critical in community engagement and in the development of diabetes research protocols to ensure long-term benefits and change in health inequities.

In the Pasifika Diabetes Wellness context, it is important for us to build personal connections with our women and communities – using our Pasifika way – ‘Talanoa’ – which means that our women own the process of collecting the information that is meaningful to them.

It is also about acknowledging our ancestors, our culture, where we come from and giving that respect to our people. Trust, reciprocity, spirituality, nurturing is all part of our collective Pacific culture. Embracing these in the research processes is imperative to working respectfully with Pacific peoples and is very important in our understanding of our health and wellbeing.

We have approached this research using talanoa as a cultural framework and taking this approach has certainly made the research and collecting information more meaningful for our women and community.

What have been some of the notable outcomes of this project to date – for the community and academia?

Our research and this project have built strong partnerships with key stakeholders, including Griffith University, Diabetes Queensland, The Good Start Program for Māori and Pacific Islander Communities, and many community groups who are represented by our PWA members. PWA have been pivotal in creating a safe space for our women to engage in this research process and also to ensuring that the research mutually benefited our Pacific communities.

Through these partnerships, we have led three very significant community summits – the Pacific women’s diabetes health forums, in 2013 and 2014, and community-led Pasifika diabetes health from in 2016.

We have also worked very closely with our Pasifika communities and PWA to provide a culturally-safe community space to run diabetes education sessions, undertake health screening for our people and conduct Talanoa discussions to collect information with our people. More than 90 Queensland University of Technology students have also conducted community placements in these health forums.

This framework has been used worldwide amongst Indigenous peoples and is notably a very successful model because it is driven by the people and for the people using their own cultural frameworks.

We have also been instrumental in building individual as well as organisational capacity for our women to address health in the community. We developed a teaching module which is currently being used by the Federal Government to train and educate health providers in how to work with culturally and linguistically diverse and Indigenous communities such as ours.

We have presented in several national and international Health conferences including NZ, Hawaii, Canada, Cairns and here in Brisbane and were awarded two grants to run the Diabetes health forums and carry out the research (through Diabetes Queensland and QUT Engagement and Innovation grant).

Future grants have allowed us to develop the Pasifika Women’s Diabetes Wellness Program and the most recent funding will allow us to trial this program.

For more information about the Pasifika Women’s Diabetes Program, visit www.dawncomplete.org.au.

Dr Heena Akbar is a Lecturer in Public Health within the Faculty of Medicine at the University of Queensland and an Adjunct Fellow at the Queensland University of Technology.

WWAGBP program

Grant recognises need to develop wellness program for Vietnamese women after giving birth

A team of researchers from VinUniversity in Vietnam and the University of Technology Sydney in Australia have been awarded a grant to develop a 12-week wellness program for Vietnamese women after giving birth. We spoke to Dr. Nguyen Thi Thanh Huong, Assistant Professor, Senior Lecturer at College of Health Sciences, VinUniversity – Principal Investigator of this project, about what this program will mean for women in Vietnam.

Q. What was the impetus for developing a women’s wellness after giving birth program for Vietnamese women?

The transition to parenthood is a potentially vulnerable time for mothers’ mental health. Baby blues are expected to happen during the first couple of weeks. However, for approximately 20% of Vietnamese mothers, it goes beyond that, resulting in postpartum depression in the first year after birth. Complications of this condition involve both the mothers – lower life quality, or even suicidal/self-harming behaviours; and their children – impaired physical as well as mental development.

Vulnerable groups of women in less socio-economically developed areas with economic constraints, lack of family support, and/or insufficient access to information regarding mental wellness are less likely to seek mental health services and even if they do reach out, mothers tend to seek help from fortune-tellers or “word-of-mouth” medicine rather than modern and evidence-based methods.

Q. How will the Program be developed?

The VinUniversity women research team, in collaboration with the University of Technology Sydney research team led by Professor Debra Anderson, aims to explore the current situation of mental wellness of Vietnamese women after birth and associated factors. After that, a Vietnamese version of the Women’s Wellness Program (WWP), named Women’s Wellness After Giving Birth Program (WWAGBP), with a package of booklets, a website, and delivery guidelines will be adapted and piloted to confirm the degree to which the package adequately reflects the Vietnamese cultural context and effectively promotes Vietnamese women’s wellness after giving birth.

Q. How long do you anticipate it will take to develop and launch the Program?

The Program is anticipated to take nine months to develop before being piloted. In this phase, a baseline survey will be conducted to explore the prevalence of postpartum depression among women after giving birth and associated factors. Then, the WWAGBP will be culturally adapted from the WWP and be confirmed on its validity and reliability by health experts in related areas and by key stakeholders.

We hope to launch the program to the first round of participants in mid-2023.

Q. What will the Program look like for Vietnamese women?

Women who have delivered their babies within one year (or even pregnant women willing to join) will be invited to participate in a 12-week wellness program that will help mothers handle the special changes or prepare them to be ready for women’s issues after giving birth. The topics that might be included in the wellness program include; nutrition, sleep, stress and relaxation and psychosocial support.

Two milestone evaluations will be set for weeks 1, 6 and 12 week and 12. A wrap-up workshop with experts from WWP international network (Australia, New Zealand, United Kingdom, China, Hong Kong, and Vietnam) will be organised to review the outcomes of the WWAGBP in the pilot and develop an action plan for future implementation of the WWAGBP in a larger-scale project.

Q. What do you hope to achieve with the development of this Program?

We hope the WWAGBP will be an innovation that uniquely contributes to current efforts to support Vietnamese women after giving birth as a non-pharmacologically virtual support for women’s wellness, a culturally adapted WWP aligning with the Vietnamese context, and a pioneering and novel program for women after giving birth.

This program will contribute to the body of knowledge in Vietnam and the world about postpartum depression, mental wellness for women after giving birth, and effective coping strategies delivered with an e-health intervention package.

For more information about the Women’s Wellness after Giving Birth Program in Vietnam, please contact:

Dr. Nguyen Thi Thanh Huong – Principal Investigator
College of Health Sciences, VinUniversity, Hanoi 100000, Vietnam
Email: huong.ntt@vinuni.edu.vn

Ms. Hoang Phuong Anh – Project Coordinator
College of Health Sciences, VinUniversity, Hanoi 100000, Vietnam
Email: anh.hp@vinuni.edu.vn

One program doesn’t suit all – translating the WWACP in New Zealand and Hong Kong

Following the success of the Women’s Wellness after Cancer Program (WWACP) trials in Australia, Professor Sandie McCarthy had the opportunity to take Women’s Wellness outside of Australia when she took up a position at the University of Auckland back in 2017. We talked to Professor McCarthy about why there was a need for Women’s Wellness programs overseas and how the programs have been translated to be culturally appropriate and successful in different countries and regions.

What was the impetus for translating the programs for different cultures?

In 2017 I took up the role as Head of the School of Nursing at the University of Auckland. Given my background as a chemotherapy nurse in Australia and many years in research developing the Women’s Wellness after Cancer Program, it soon became very clear that there was no cancer research happening in supportive care in New Zealand.

The system was similar in terms of acute cancer treatment but, like Australia, it lacked the aftercare that women were crying out for. And the more I embedded myself in the system and heard from clinicians and patients, the more I realised the critical need for a program like the Women’s Wellness after Cancer Program in New Zealand.

How did you adapt the program for New Zealand and, in particular, Māori women?

I started talking to Cancer Trials NZ, who traditionally dealt with acute treatment, but who were very interested in exploring the development of a supportive cancer recovery program for women in New Zealand. At the same time, we identified that Hong Kong women were also hungry for a program. We successfully secured a grant to support New Zealand and Hong Kong to work together to build up the Women’s Wellness after Cancer Programs to be culturally appropriate and address specific needs in each country.

We worked with community leaders, health practitioners and academics to tailor the programs. In New Zealand, the program we run looks very different to the one we run in Australia. For example, in New Zealand our sessions are run in a Māori cultural space in groups, rather than individual sessions, to recognise that illness is shared by the whole family rather than just tackled by the individual who is unwell.

In Hong Kong, where alcohol is not really a health concern, we stripped that out of the program and the approach we’ve taken is much more direct to suit the learning culture. The Hong Kong program also focuses mainly on gynecological cancer with a strong emphasis on sexuality.

And what’s next?

The trials in New Zealand and Hong Kong have been hugely successful and we’ve since secured two grants to develop Hong Kong and Cantonese versions of the program. We also secured a grant from the Health Research Council of New Zealand to develop a culturally appropriate program for younger women in New Zealand with breast cancer. This trial has just been completed and was a huge success, finishing 12 months earlier than expected, even though it started 9 months late.

We are also really excited to announce that we will be implementing our Women’s Wellness after Cancer Program across a major health service in Queensland and will start to train more than 200 clinicians across their public and private services.

For more information about the Women’s Wellness Programs, visit www.dawncomplete.org.au