Peprah Prince, Lloyd Jane, Gitau Lydia, Harris Mark
Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia.
Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia.
BMC Public Health. 2025 Jul 11;25(1):2432. doi: 10.1186/s12889-025-23658-4.
There is a growing literature on the influences of cultural knowledge and practices on health literacy, as well as how people's specific communities and backgrounds affect their health literacy in new environments. Although this literature is growing, little is known about how the health knowledge of African refugees influences their experiences with Australian health care, how their health literacy changes as they learn more about Australian systems, and how they use their health literacy to support and improve their health when health systems do not meet their knowledge and needs. This qualitative study explored health literacy among African refugees by highlighting their knowledge, culturally and religiously creative health practices in Australia.
This study draws on 19 semi-structured face-to-face interviews conducted with a culturally and linguistically diverse sample of African refugees from nine countries living in southwestern Sydney, Australia, between March and December 2022. Audio-recorded, semi-structured interviews were transcribed verbatim and coded into QSR NVivo 12. A constant comparative and thematic analysis method-guided data analysis.
Three themes were identified, demonstrating the multifaceted connections between health literacy, culture, religion, experiences, and language. First, African refugees' knowledge of health systems could not be easily used in Australia because systems were different, and Australian health systems were not set up to support other groups/various types of health literacy. The second theme was that health knowledge is multidimensional, with heterogeneous determinants and information sources influencing diverse culturally and religiously conditioned, constructed, and bound health practices. In theme three, African refugees' complex thoughts, decisions, and actions to enhance their health and health literacy after resettling in Australia demonstrated that health information meaning, and knowledge are created and distributed across social networks and relationships.
The findings offer a needed social-cultural re-framing of health literacy to describe and capture health care practices and beliefs of cultural groups such as African refugees in Australia. Expanding health literacy to include social and cultural dimensions could strengthen African refugee patients' knowledge about the health system and empower health care services and providers to adapt their processes, structures and procedures to different health literacy states and levels.
关于文化知识和实践对健康素养的影响，以及人们的特定社区和背景如何在新环境中影响其健康素养的文献越来越多。尽管这类文献在不断增加，但对于非洲难民的健康知识如何影响他们在澳大利亚的医疗经历、随着他们对澳大利亚医疗系统了解的增多其健康素养如何变化，以及当医疗系统不符合他们的知识和需求时他们如何利用健康素养来支持和改善自身健康等方面，人们知之甚少。这项定性研究通过突出非洲难民在澳大利亚的知识、文化和宗教方面富有创造性的健康实践，探讨了他们的健康素养。
本研究采用了19次半结构化面对面访谈，访谈对象是2022年3月至12月期间居住在澳大利亚悉尼西南部的来自9个国家的具有文化和语言多样性的非洲难民样本。对录音的半结构化访谈进行逐字转录，并编码到QSR NVivo 12中。采用持续比较和主题分析方法指导数据分析。
确定了三个主题，展示了健康素养、文化、宗教、经历和语言之间多方面的联系。首先，非洲难民对医疗系统的知识在澳大利亚难以轻易应用，因为系统不同，而且澳大利亚的医疗系统并非为支持其他群体/各种类型的健康素养而设立。第二个主题是，健康知识是多维度的，不同的决定因素和信息来源影响着各种受文化和宗教制约、构建及约束的健康实践。在第三个主题中，非洲难民在澳大利亚定居后为增强自身健康和健康素养而进行的复杂思考、决策和行动表明，健康信息的意义和知识是在社会网络和关系中创造和传播的。
研究结果为健康素养提供了必要的社会文化重新框架，以描述和捕捉澳大利亚非洲难民等文化群体的医疗实践和信念。将健康素养扩展到包括社会和文化维度，可以增强非洲难民患者对医疗系统的了解，并使医疗服务和提供者有能力使其流程、结构和程序适应不同的健康素养状态和水平。
