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Background Overseas Filipino workers (OFWs) comprise one of the largest populations of migrant workers globally. Within China, they represent the largest group of imported domestic workers. Little is known about their working conditions or how this might affect their health and wellbeing. Methods This qualitative study explored the working conditions and risk factors for poor health in a sample of temporary female Filipino domestic workers in Macao, China. Focus group discussions with female domestic workers ( n = 22) and in-depth interviews with key informants ( n = 7) were conducted. Results Domestic workers reported physical (e.g., hypertension, chronic pain, diabetes, poor sleep), and mental health problems (depression, anxiety), and addictive behaviors (gambling, alcohol misuse), along with significant structural, linguistic, financial, and cultural barriers to healthcare access to address these concerns. Adverse working conditions including poor treatment and abuse by employers, lack of privacy and inadequate sleeping areas in employers’ homes or in crowded boarding houses, language barriers, inadequate and poor enforcement of labor protections, and discrimination. Domestic workers also cited exorbitant agency fees and remittances causing significant financial stress. Kinship network ties with family members back home were fraught with infidelity, difficulty parenting, misuse of remittances, and family misconceptions of domestic workers’ situation abroad. Lack of quality social support and peer social networks exacerbated these conditions. Conclusions In this sample of Filipino migrant domestic workers, stressors experienced within the host country were commonly reported. Indebtedness and low salaries limits social mobility. Psychosocial and policy-level interventions are needed to improve the health and wellbeing of this population of migrant women.

Many Filipinos experience poverty and poor employment opportunities. In order to alleviate poverty and provide sufficient resources for their families, numerous mothers leave the Philippines to become domestic workers. The present study aimed to build a model of family resilience for transnational families. A total of 33 participants consisting of Filipino transnational families, domestic workers, and key informants participated in a series of focus group discussions and interviews. A new model of resilience among transnational families of Filipina domestic helpers was created using a constructivist grounded theory approach. The model highlighted how temporal and spatial elements are embedded in collective migration experiences. Family narratives begin with the sacrifice of separation, where mothers leave their families for a chance to solve economic problems. To successfully adapt to their separation, the families undergo five relational processes. First, families communicate across space using technology to bridge relational distance. Second, families restructure across space through role sharing and the validation of each other’s efforts in their family roles. Third, families rebuild ties through temporary family reunification that bridge physical and relational distance. Fourth, families have the collective goal of permanent family reunification by ending migration to become complete again. Fifth, they strive to commit to their families by prioritizing them instead of succumbing to difficulties. Family resilience for transnational migrants is a collectivistic process, negotiated by each family member.

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Background Electronic mental (e-mental) health interventions can address mental health needs of different populations. Cultural adaptation of these interventions is crucial to establish a better fit with the cultural group and to achieve better treatment outcomes. Objective This study aimed to describe the cultural adaptation of the World Health Organization’s e-mental health program Step-by-Step for overseas Filipino workers. We used a framework which posits that cultural adaptation should enhance (1) relevance, wherein the cultural group can relate with the content; (2) acceptability, where the cultural group will not find any element offensive; (3) comprehensibility, where the program is understandable; and (4) completeness, wherein the adapted version covers the same concepts and constructs as the original program. We aimed to have English and Filipino and male and female versions. Methods Overall, 3 experienced Filipino psychologists provided their perspectives on the program and how it might be adapted for overseas Filipino workers. We then adapted the program and obtained feedback from 28 overseas Filipino workers from diverse industries through focus group discussions. We conducted 7 and 9 focus group discussions with male and female participants, respectively. Per discussion, cognitive interviewing was used to probe for relevance, acceptability, comprehensibility, and completeness of illustrations and text. Participant feedback guided iterative program adaptations, which were again shown to participants for validation and improvement. Results Several issues were raised by participants about the generic version of Step-by-Step. There were elements deemed irrelevant, like unfitting characters, lack of Filipino values, and unsuitable problems and activities. There were unacceptable components that were stigmatizing, political, inappropriate to context or subgroups, and too feminine for male users. Some elements were incomprehensible, unclear, or complicated. To address these issues, we made key adaptations. To enhance relevance, we adapted the narrative to match the experiences of overseas Filipino workers, incorporated Filipino values, and illustrated familiar problems and activities. To increase acceptability, our main characters were changed to wise elders rather than health professionals (reducing mental health and help-seeking stigma), political or unacceptable content was removed, and the program was made suitable for overseas Filipino workers from different sectors. To increase comprehension, we used English and Filipino languages, simplified the text to ease interpretation of abstract terms, and ensured that text and illustrations matched. We also used Taglish (ie, merged English and Filipino) when participants deemed pure Filipino translations sounded odd or incomprehensible. Finally, we retained the core elements and concepts included in the original Step-by-Step program to maintain completenes...