Developing a culturally competent and socially relevant sexual health survey with an urban arctic community

Abstract

Objectives. To develop a culturally competent and socially relevant sexual health survey for people living in Nuuk, Greenland, aged 5 years and older. Study Design. Qualitative study with interviews. Methods. Community and research informants (n=0) were interviewed informally to identify survey topics. A sexual health survey was constructed combining local knowledge from informants with a review of sexual health literature for the Arctic and other Indigenous locations. The draft survey was distributed to community partners for commentary and revision. After translation into Danish and Greenlandic, cognitive interviews were conducted with 11 Nuuk residents, identified through snowball sampling, to both pilot test the survey and exchange social and cultural knowledge relevant to sexual health in Nuuk. The utility of this process was evaluated against implementation of the final survey to Nuuk residents enrolled in Inuulluataarneq (n=149). Results. Theme saturation was reached by the ninth interview. STI risk and self-efficacy, co-occurrence of alcohol use and sex and STI knowledge were identified as most relevant. Questions about community efficacy, culture/community involvement and identity were most sensitive. Upon implementation of the final survey, 146 of 149 participants answered all survey questions. Two Elder participants refused to answer questions about sex. Some questions had low response variability but still added to our contextual understanding and helped to build rapport with participants. Conclusions. Combining an iterative process with community-based participatory research principles and cognitive interview techniques was an effective method for developing a sexual health survey with Nuuk residents.

“Today we are not good at talking about these things”: A mixed methods study of Inuit parent/guardian-youth sexual health communication in Greenland

“…In a previous exploratory study (2007)(2008)(2009), one research participant stated, "Not having sex is like not drinking water or not sleeping. Sex is natural" (Gesink et al, 2010). This statement, recorded in our initial data collection for the design of Inuulluataarneq, supports Greenlanders' pre-colonial perceptions of sex and their cultural belief that sex is natural.…”

“…The second component of Inuulluataarneq involved parent/guardian education regarding sexual health communication with their youth. Prior to the development, design, implementation and evaluation of Inuulluataarneq, we conducted a two-year exploratory study in Greenland (2007Greenland ( -2009, in which Kalaallit youth reported a lack of communication with parents or guardians about topics related to sex, such as STIs (Gesink et al, 2010;Gesink et al, 2012). The results from this study were used to develop Inuulluataarneq's parent/guardian component (Rink et al, 2012).…”

Factors associated with the intake of traditional foods in theEeyou Istchee(Cree) of northern Quebec include age, speaking the Cree language and food sovereignty indicators

“…Blood samples were taken to measure several metabolites from participants who had fasted overnight with methods described elsewhere [13]. For the current study, data on triglycerides [39], high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were used as measures of cardiovascular health.…”

“Taking Care” in Intercultural Research

“…Most qualitative literature about the ever-growing intercultural research focuses mainly on problems encountered rather than strategies for mitigating these complicated issues in translation and interpretation (Björk Brämberg & Dahlberg, 2013;Esposito, 2001, p. 577). Only a few notable exceptions contribute needed practical advice (Gesink et al, 2010;Wong & Poon, 2010).…”

“…Several, mostly qualitative, researchers have attempted to address this gap by showing the crucial interpretive role that translators play and highlighting special considerations in intercultural research (Berman & Tyyskä, 2011;Björk Bräm-berg & Dahlberg, 2013;Easterby-Smith & Malina, 1999;Esposito, 2001;Gesink, Rink, Montgomery-Andersen, Mulvad, & Koch, 2010;Lê, 2008;Shah, 2004;Temple, 2002;Wong & Poon, 2010). They assert that translation is not a neutral technical process, rather it involves meaning-making and is influenced by relative power imbalances (McGloin & Carlson, 2013;Orlove, 2002;Stanner, 2011;Sutton, 2001).…”