Applying Community-Based Participatory Approaches to Addressing Health Disparities and Promoting Health Equity

This special issue highlights work that contributes to our understanding of health disparities and community-based participatory research (CBPR) approaches to promoting health equity across diverse populations and issues that matter to communities. We take on a global perspective, and thus, various efforts across international contexts are illustrated. Articles elucidate a variety of CBPR approaches designed to empower and build capacity among individuals and communities in order to seek changes at the level of community practices, programs, and systems. These articles span across diverse populations—children, youth, and families; adults and older adults; immigrants; refugees; Black people; Latinx people; Native Americans/Indigenous people, the Roma community; Muslim women, and women with disabilities—experiencing inequities of interest to community psychologists and other researchers and practitioners.     

Caught Between Two Worlds: Sexuality and Young Muslim Women in Melbourne,Australia

Existing research suggests that culture has a significant influence on the sexuality of culturally and linguistically diverse communities in Australia. However, few studies have explored the influence of both religion and culture on sexuality of young Muslim women. This paper qualitatively examines the influence of Islam, Muslim culture and Australian culture on the sexuality of young Muslim women in Melbourne, Australia. This research employed an in-depth interview technique to gather data on the lived experiences of 11 young Muslim women. The findings revealed a marked influence of religion and culture on the sexuality of young Muslim women. Additionally, this study highlights the challenges that young Muslim women face in regards to balancing Muslim culture, Australian culture and Islamic religion. This study contributes to knowledge about the lived experiences of young Muslim women in Australia regarding meanings of sexuality and the difficulties they have in balancing the influences of religion and culture. This knowledge can be useful for the provision of sexual health care that reflects a culturally and religiously sensitive approach for young Muslim women in Australia and elsewhere.     

The Effect of Religiosity on Life Satisfaction in a Secularized Context: Assessing the Relevance of Believing and Belonging

The positive relationship between religiosity and life satisfaction is well-established. This relationship is, however, likely to vary across cultural contexts and different religious affiliations. Furthermore, research is needed to uncover why religion is relevant for life satisfaction. Addressing these issues, we investigate what dimensions of being religious play a role in the life satisfaction of individuals with different religious affiliations, including the understudied Muslim category, in the highly secularized Dutch context. We examine ‘believing’, which captures how religion provides meaning and a coherent worldview, and ‘belonging’, which comprises both cultural benefits of being embedded in a congregation with a shared framework of meaning and structural benefits due to more social ties. Analyses of the NEtherlands Longitudinal Lifecourse Study (n = 5312) first indicate that Muslims display significantly lower life satisfaction than the non-religious, which appears to be due to their underprivileged social position rather than intra-religious factors of believing and belonging. Second, we find that Catholics experience significant life satisfaction benefits compared to those who are not religious, and that only belonging plays a role in this association. Next to the beneficial effect of the structural aspect of belonging, which revolves around social ties, a cultural aspect of religious belonging appears to be salient, suggesting that an important life satisfaction advantage of religious communities lies in their ability to foster a sense of solidarity and commitment through a shared framework of meaning. We make several recommendations for further research based on these findings.     

Mental health disparities impacting Christian Korean Americans: a qualitative examination of pastors’ perspectives

Mental health disparities impacting Korean Americans are multifaceted. Although encouraging developments have been made in the knowledge of mental health prevalence and professional help-seeking behaviours of Asian Americans, Korean Americans continue to experience many challenges and unique needs that require more ethnic- and culture-specific knowledge. Given the prominent role that religion, particularly Christianity, plays in the Korean American context, we conducted exploratory interviews with 10 Korean American pastors regarding their perspectives on mental health issues impacting the Korean American community. Using consensual qualitative research, we found four salient domains: (a) Barriers to seeking mental health services, (b) Challenges that pastors experience, (c) Pastor’s assessment of church’s current climate in approaches to mental health issues, and (d) What is needed. Implications for research and practice in addressing mental health disparities are discussed.     

Everyday lived Islam: religiosities and identities of Muslim women in the Republic of Macedonia

In the Republic of Macedonia, most Muslim women belong to the Albanian minority. Particularly due to the current fractured nature of the Macedonian societal body and the diverse historical developments that have led to this, the importance of ethnic identities is emphasised and religious identities, especially Orthodox Christian and Muslim identities, fortify them. Everyday lived religion, its active enacting, and the values Islam represents can be important to Muslim women in the Republic of Macedonia and manifest themselves, for instance, in the human relationships within Muslim communities. Everyday lived Islam may also be an important factor when women’s roles in the larger societal context are examined. The 19 Albanian women whom I interviewed during the period 2008–2009 described in a relatively detailed manner their everyday lived Islam and religiosities, how these affected their lives and how these were localised in everyday situations. This also gave an insight into the way the Muslim women negotiated their identities in different contexts. In this article I examine, drawing on the concepts of everyday lived religion, religiosity, and identity, how Islamic values and traditions could be localised through women’s narratives in relationships within the Muslim communities, between men and women, between different Muslim communities, and in the wider societal context.     

People Awakening: Collaborative Research to Develop Cultural Strategies for Prevention in Community Intervention

The consequences of alcohol use disorder (AUD) and suicide create immense health disparities among Alaska Native people. The People Awakening project is a long-term collaboration between Alaska Native (AN) communities and university researchers seeking to foster health equity through development of positive solutions to these disparities. These efforts initiated a research relationship that identified individual, family, and community protective factors from AUD and suicide. AN co-researchers next expressed interest in translating these findings into intervention. This led to development of a strengths-based community intervention that is the focus of the special issue. The intervention builds these protective factors to prevent AUD and suicide risk within AN youth, and their families and communities. This review provides a critical examination of existing literature and a brief history of work leading to the intervention research. These work efforts portray a shared commitment of university researchers and community members to function as co-researchers, and to conduct research in accord with local Yup’ik cultural values. This imperative allowed the team to navigate several tensions we locate in a convergence of historical and contemporary ecological contextual factors inherent in AN tribal communities with countervailing constraints imposed by Western science.     

Promoting Healthy Behavior from the Pulpit: Clergy Share Their Perspectives on Effective Health Communication in the African American Church

African Americans continue to suffer disproportionately from health disparities when compared to other ethnicities (ACS 2010; CDC 2007). Research indicates that the church and the pastor in the African American community could be enlisted to increase effectiveness of health programs (Campbell et al. in Health Edu Behav 34(6):864–880, 2007; DeHaven et al. in Am J Public Health 94(6):1030–1036, 2004). The objective of this study was to investigate African American pastors’ perceptions about health promotion in the church and how these perceptions could serve as a guide for improving health communication targeting African Americans. Semi-structured interviews with African American clergy revealed that pastors feel strongly about the intersection of health, religion and spirituality; they also believe that discussing health screening and other health issues more frequently from the pulpit and their own personal experiences will ultimately impact health behavior among congregants. This study suggests that African American clergy see themselves as health promoters in the church and believe this communication (i.e., pastor-endorsed health information materials) will impact health behavior among underserved and minority populations.     

Asians as the model minority: Implications for US Government's policies

Asian Americans are often perceived as a 'model minority'– an ethnic minority that are high achieving, hardworking, self-reliant, law-abiding, as well as having few social and mental health problems. Although the impact of the model minority image on the US government's redistributive policies is a widely contested topic in public discourses, there has been little research on the association between the model minority image, people's worldviews, and attitudes towards the US government's redistributive policies. In an experiment that measured American participants' worldviews and manipulated the salience of the model minority image, we have demonstrated that those who believed in a malleable social reality were relatively unsupportive of government policies that help the Asian American ( vs African American) communities. Theoretical and practical implications of this finding are discussed.     

Creating a Space for Spiritual Practice: Pastoral Possibilities with Sexual Minorities

Is a religious gay person an oxymoron? It appears possible, given that the research on religion and spirituality among sexual minority individuals is so limited. While books written on the intersection of religion and psychotherapy may include a chapter addressing the religious and spiritual lives of lesbian, gay, and bisexual (LGB) individuals, there are no critical texts focusing solely on this issue. In this paper, we review some of the most recent research on homosexuality, religion, and spirituality, and discuss how LGB individuals may integrate these two identities. A case presentation is offered and implications for pastoral counselors and methods of supporting the integration of the spiritual/religious identity in tandem with a LGB identity are also discussed.     

Feelings toward refugees and non‐Muslims in Turkey: The roles of national and religious identifications,and multiculturalism

The current study, conducted in Turkey, examined feelings toward Muslim refugees among Turkish participants (n = 605) in comparison to feelings toward established non‐Muslim national minority groups. Using the social identity perspective, these feelings were examined in relation to national and religious group identifications, and the endorsement of multicultural beliefs. The feelings toward both refugees and minority communities were similarly negative, yet the processes behind these feelings were somewhat different. While stronger national identification was associated with more negative feelings toward Muslim refugees, stronger religious group identification was associated with more negative feelings toward non‐Muslim minority communities. Further, higher endorsement of multiculturalism was associated with less negative feelings toward both refugees and minority communities, but only for relatively low national identifiers.     

Religion insulates ingroup evaluations: the development of intergroup attitudes in India

Research on the development of implicit intergroup attitudes has placed heavy emphasis on race, leaving open how social categories that are prominent in other cultures might operate. We investigate two of India's primary means of social distinction, caste and religion, and explore the development of implicit and explicit attitudes towards these groups in minority‐status Muslim children and majority‐status Hindu children, the latter drawn from various positions in the Hindu caste system. Results from two tests of implicit attitudes find that caste attitudes parallel previous findings for race: higher‐caste children as well as lower‐caste children have robust high‐caste preferences. However, results for religion were strikingly different: both lower‐status Muslim children and higher‐status Hindu children show strong implicit ingroup preferences. We suggest that religion may play a protective role in insulating children from the internalization of stigma.     

Gathering Diverse Perspectives to Tackle “Wicked Problems”: Racial/Ethnic Disproportionality in Educational Placement

Among students receiving behavioral health and special education services, racial/ethnic minority students are consistently overrepresented in settings separate from general classrooms. Once separated, many young people struggle to improve academically and face significant difficulty upon trying to return to a general education setting. Given the complex, ongoing, and multifaceted nature of this challenge, racial/ethnic disproportionality can be identified as a “wicked problem,” for which solutions are not easily identified. Here, we describe our community-engaged research efforts, eliciting perspectives from relevant partners in an ongoing dialogue, to better integrate diverse stakeholders’ perspectives when attempting to address such disparities. We conducted focus groups and qualitative interviews with members of three stakeholder groups: community-serving organizations, individuals with lived experience of behavioral health conditions, and state-level policymakers, with a shared interest in addressing racial and ethnic disparities. Participant responses illustrated the “wickedness” of this problem and highlighted the need for additional supports for students, families, and school personnel, increased collaboration across relevant systems and agencies, and reduced barriers related to funding. Overall, this methodology bridged differing perspectives to develop, in concert with our partners, a shared language of the problem and a core set of issues to consider when seeking to effect change.     

A WAY FORWARD FOR SOCIOLOGICAL RESEARCH ON SCIENCE AND RELIGION: A REVIEW AND A RIFF

John Evans’s new book Morals Not Knowledge pushes scholars to rethink contemporary debates about religion and science by moving past the rhetoric of societal elites to examine the perspectives of everyday Americans, identifying the moral conflicts at the heart of debates. We review Evans’s key contributions while also extending and challenging his arguments, urging consideration of how renewed moral debates might be informed by a broader set of U.S. “publics.” Drawing on empirical research, we highlight four sets of voices that are missing from Evans’s analysis. Specifically, we highlight the voices of racial and ethnic minorities, religious communities (as opposed to individuals), members of minority religious traditions, and everyday religious scientists. Through doing so we offer avenues for future research on these diverse publics that will help facilitate a broader set of better and more informed debates about moral conflict between religious and scientific communities.     

Diverse Perceptions of the Informed Consent Process: Implications for the Recruitment and Participation of Diverse Communities in the National Children’s Study

We examined the experiences, perceptions, and values that are brought to bear when individuals from different ethnic and cultural backgrounds consider participating in health research. Fifty-three women from Latino, Asian American, Middle Eastern, or Non-Latino, White backgrounds participated in seven English or Spanish focus groups facilitated by trained investigators using a standard protocol. Investigators described the National Children’s Study (NCS) and then asked questions to elicit potential concerns, expectations, and informational needs. Group sessions were audio-recorded, transcribed verbatim, and analyzed using qualitative thematic methods. A major theme that emerged during focus groups was participant self-identification as a member of a cultural group or community when raising issues that would influence their decision to participate in research. A related theme was the belief by some that communities may differ in the ease of participation in the NCS. Identified themes related to the informed consent process included perceived risks, anticipated burden, perceived benefits, informational needs, and decision-making strategies. Although themes were shared across groups, there were cultural differences within themes. Findings indicated that individuals from diverse backgrounds may have different perspectives on and expectations for the research process. To effectively recruit representative samples, it will be important to address a range of issues relevant for informed consent and to consider the impact of participation on both individuals and communities.     

A Muslim President? Misperceptions of Barack Obama's Faith in the 2008 Presidential Campaign

Rumors that President Barack Obama is a Muslim were rampant during the 2008 presidential campaign and continued well into his presidency. These rumors were widely believed, were electorally consequential, and are part of a growing trend of politically motivated misconceptions. Thus, relying principally on the theory of motivated reasoning, we examine the factors that shaped citizens’ beliefs about and responses to messages about Obama's faith. Using an original survey experiment and data from the 2008–2009 American National Election Study panel, we show that citizens’ responses to rumors about Obama's religion were shaped by political predispositions, political awareness, and their interactions. Identification of Obama with Islam was most widespread, and the cues encouraging such identification were most successful, among individuals with low levels of political awareness, conservative and Republican identifications, and negative views of cultural out‐groups. Viewing Obama as Muslim was significantly less prevalent among people with high levels of awareness and with the opposite set of predispositions.     

Racial healthcare disparities: A social psychological analysis

Around the world, members of racial/ethnic minority groups typically experience poorer health than members of racial/ethnic majority groups. The core premise of this chapter is that thoughts, feelings, and behaviours related to race and ethnicity play a critical role in healthcare disparities. Social psychological theories of the origins and consequences of these thoughts, feelings, and behaviours offer critical insights into the processes responsible for these disparities and suggest interventions to address them. We present a multilevel model that explains how societal, intrapersonal, and interpersonal factors can influence ethnic/racial health disparities. We focus our literature review, including our own research, and conceptual analysis at the intrapersonal (the race-related thoughts and feelings of minority patients and non-minority physicians) and interpersonal levels (intergroup processes that affect medical interactions between minority patients and non-minority physicians). At both levels of analysis, we use theories of social categorisation, social identity, contemporary forms of racial bias, stereotype activation, stigma, and other social psychological processes to identify and understand potential causes and processes of health and healthcare disparities. In the final section, we identify theory-based interventions that might reduce ethnic/racial disparities in health and healthcare.     

An investigation of African American and European American students' perception of teaching behavior

Teaching behaviors are associated with a range of student academic and mental health outcomes. Substantial academic, school disciplinary, and mental health disparities across African American and European American students suggest that diverse students may view and interpret teaching behaviors differently. The Teaching Behavior Questionnaire measures students' perceptions of teaching behaviors. The purpose of the current study was to examine the scale's factor structure among European American high school students using exploratory factor analysis and, subsequently, cross-validate using confirmatory factor analysis based on African American student data. Results supported reconceptualizing the scale according to a three-factor model in both groups. Implications related to the interpretation and use of scores are discussed.