1 Western Michigan University, Kalamazoo, MI, USA.
2 University of Indianapolis, Indianapolis, IN, USA.
Health Educ Behav. 2017 Oct;44(5):769-780. doi: 10.1177/1090198117726572. Epub 2017 Sep 4.
Refugees have recently been thrust into the spotlight worldwide. The strikingly negative rhetoric currently surrounding refugees calls for increased action from public health educators. In 2016, the largest proportion of refugees to the United States came from the Democratic Republic of Congo. This presents the opportunity to explore health needs as Congolese refugees resettle in the United States, with women taking priority due to health disparities linked to gender-based discrimination, trauma, sexual and gender-based violence, lower literacy rates, and less access to learning English. Insight into experiences of Congolese women in the United States is critical for the proactive development of socioculturally relevant health promotion rather than reaction interventions once health inequities are exacerbated. Therefore, to better understand perceptions and experiences of Congolese women in Indianapolis related to health and health care, a community-based participatory research study with an anthropological approach was conducted in collaboration with a refugee resettlement agency utilizing photovoice and semistructured interviews. Sixteen women participated in six photovoice sessions and home-based interviews. Selected photos, photo stories, and interview transcripts were analyzed using ethnographic content analysis. Major themes were health care system issues, social support, and daily experiences of health. Findings provide needed insight into the sociocultural context of health for Congolese refugees in the United States for both health educators and resettlement agencies. Findings also revealed specific priority areas for culturally tailoring health education and assets on which to build when promoting health for this population. Additionally, lessons were learned about the power of an anthropological, community-based participatory research approach to qualitative research for promoting health equity.
难民最近成为全球关注的焦点。当前，对难民的负面言论甚嚣尘上，呼吁公共卫生教育工作者采取更多行动。2016 年，美国接收的难民中，来自刚果民主共和国的比例最大。这为探索刚果难民在美国重新定居后的健康需求提供了机会，由于性别歧视、创伤、性暴力和基于性别的暴力、文化程度较低以及学习英语的机会较少等因素导致的健康差距，妇女应优先考虑。深入了解美国刚果妇女的经历，对于积极制定与社会文化相关的健康促进措施至关重要，而不是在健康不平等加剧后采取应对干预措施。因此，为了更好地了解印第安纳波利斯市刚果妇女对健康和医疗保健的看法和体验，本研究与一家难民重新安置机构合作，采用参与式社区研究方法（结合人类学方法），利用影像叙事和半结构化访谈进行了一项社区研究。16 名妇女参加了 6 次影像叙事活动和家访访谈。选取照片、影像故事和访谈记录，采用民族志内容分析法进行分析。主要主题包括医疗保健系统问题、社会支持和日常健康体验。研究结果为美国的刚果难民的健康提供了社会文化背景的深入了解，这对健康教育工作者和重新安置机构都具有重要意义。研究结果还揭示了针对这一人群进行文化上调整健康教育和资产建设的具体优先领域，此外，还了解到了采用人类学、参与式社区研究方法进行定性研究促进健康公平的力量。
