CULTURAL AND SOCIETAL BARRIERS AND OBSTACLES TO

SERVICES AND BEST PRACTICES

NOVEMBER 15, 2016

Lillian Agbeyegbe, DrPH, CHES, CPHExecutive Director

LEARNING OBJECTIVE

• Discuss cultural reflections on faith and community values, and their impact on seeking services.

• Societal obstacles to seeking services.

• Discussion on best practices – both academic and intuitively.

OUTLINE

• Understanding the African Immigrant

• Cultural and Faith Perspective on Community Services

• Societal obstacles to Seeking Services

• Best Practices – Academic and Intuitive

WHO IS AN AFRICAN IMMIGRANT?

WHO IS AN AFRICAN IMMIGRANT?

A NON-MONOLITHIC GROUP

African Immigrant

Faith

LanguageCulture/Patriarchal

Education

A NON-MONOLITHIC GROUP

African Immigrant

Immigration Status

EmploymentAcculturation/Isolation

Strong Family Values

African Immigrant

Marriage

Intimate Partner Violence Services

MARRIAGE

Non-African Immigrant

Perspective: Two partners Involved

Priority:Individuals

Practice: Respond to individual discontentment

MARRIAGE

African Immigrant (Culture)

Perspective:Two families/ communities

Priority:Community/family harmony

Practice: Protect family image

MARRIAGE

African Immigrant (Faith)

Perspective: An everlasting union

Priority: Save marriage at all cost

Practice: Overlook and endure

INTIMATE PARTNER VIOLENCE – NON-AFRICAN IMMIGRANT

Perspective •Physical and Non-Physical•Unacceptable

Priority •Remove self and children•Seek help as necessary

Practice •Law enforcement•Legal

INTIMATE PARTNER VIOLENCE – AFRICAN IMMIGRANT

Perspective •Mainly physical•Should be tolerated

Priority •No “dirty linen” in public•Maintain “all is well” image

Practice •Non-disclosure•Seek faith family intervention

SERVICES

Food Stamps

A means to an endPERSPEC

TIVE

• Not culturally acceptable• For those “suffering”

Ensure continuity in ability to functionPRIORITY

• Maintain appearances

Seek services as necessaryPRACTIC

E

• Do not seek services• Do not accept when offered

SOCIETAL OBSTACLES - AWARENESS

Individual Perception

•Perceived Susceptability•Perceived Severity

Modifying Factors

• Demographic variables

• Knowledge• Cues to Action

Likelihood of Action

•Perceived Benefits•Perceived Barrier

Health Belief Model – 1950 by Hochbaum, Rosenstock and Kegels

SOCIETAL OBSTACLES - AWARENESS

Behavior

Environmental Factors

Personal Factors

• Social Cognitive Theory – Albert Bandura (1986, 1997)

• Reciprocal Determinism

• Self-Efficacy

SOCIETAL OBSTACLES – LAW ENFORCEMENT

Amadou Diallo, Tamir Rice, Eric Garner, Aaron Sterling, Rumain Brisbon, Akai Gurley, Sean Bell

SOCIETAL OBSTACLES – LAW ENFORCEMENT

• Trust

• Gender

• Training

SOCIETAL OBSTACLES – LEGAL

Intimidating

Overwhelming

Unaffordable

SOCIETAL OBSTACLES – IMMIGRATION

Spousal VisaNo Documents

VAWAU-Visa

BEST PRACTICES– ACADEMIC

• Awareness of their values, beliefs and biases

• Knowledge of their clients’ values, belief and cultural practices

• Skills to use culturally appropriate and sensitive intervention strategies

BEST PRACTICES– ACADEMIC

• Greater value for “Risk to others”

• “Barriers” more important than “Risk”

BEST PRACTICES– ACADEMIC

• Value on Spirituality

• Lack of trust in system

• Encourage greater collaboration and community participation

BEST PRACTICES– ACADEMIC

• Go to family; Go to cultural/social leaders; Go outside community

• Ally with “Progressive” leaders; Engage Women and leaders; Community Outreach

BEST PRACTICE – RISK COMMUNICATION

Risk communication is an interactive process of exchange of information and opinion among individuals, groups, and institutions. It involves multiple messages about the nature of risk and other messages, not strictly about risk, that express concerns, opinions, or reactions to risk messages or to legal and institutional arrangements for risk management.”

- National Research Council Committee (1989)

Professional Knowledge

African Immigrant Fear

BEST PRACTICES– INTUITION

Building Survivor Trust•Beyond “Statistics”

•Reality outside “Domestic Violence” Industry

BEST PRACTICES– INTUITION

SurvivorEducated

Embraces “Foreign” Culture

“Rejects” Own Culture

Not-EducatedMaintains Own Culture

Embraces Foreign Culture

Building Community Trust

ENGAGING RESEARCHERS

African –born Immigrants Not African-American

Study as distinct population

CALL TO ACTION

•Two-way communicationC•Incorporate information into programsI•Community-wide educationE•Research to document population-specific knowledgeR

ContactLillian Agbeyegbe, DrPH, CHES, CPH

lilagbeyegbe@gmail.comwww.therestofalife.com

Tel: 469-878-6834