Search

Psychological distress and mental illness have become increasingly pervasive among Chinese university students. However, many university students who need mental health treatment or psychological support do not actively seek help from professional counselors or service providers, which could lead to poor mental health outcomes. To promote help-seeking, we undertook a qualitative study to understand Chinese university students’ perspectives on help-seeking and mental health counseling. We conducted 13 focus group interviews with students in six universities in Jinan, China, and altogether 91 (62%) female students, and 56 (38%) male students participated in the study. Our results indicate that students’ misconception and distrust of on-campus counseling, stigma of mental illness, low mental health literacy, and hard-to-access mental health services are the major barriers that impede students help-seeking behaviors. Internal struggles and systematic and organizational barriers are identified to shed light on future work to promote mental health literacy among Chinese university students.

Gay men and lesbians in contemporary China face multiple forms of marginalisation and discrimination. However, little is known about how heteronormativity works to regulate the everyday lives of se...

The Youth Engagement Project (YEP) is a community-based pilot study in Toronto, Canada that we developed to better understand perspectives about and experiences of sexual health education among socioeconomically marginalized, racialized, and LGBTQ youth. We investigated: 1) what sex-related messages these young people received as they grew up, 2) how those messages affected their perspectives and sexual behaviour, and 3) their recommendations for sexual health education that meets their needs. Engaging youth whose voices are often overlooked due to their low socioeconomic status and their racial, sexual, and religious identities, and using a place-based method, we recruited a total of 47 young people, aged 16–24, and divided them into six groups based on gender and residential neighbourhood. The data was collected through a demographic and sexual practice survey, followed by a series of two focus groups. We conducted thematic analysis, guided by a socio-ecological approach and paying particular attention to participants’ intrapersonal, interpersonal and environmental factors. Our results indicate that participants received inadequate and contradictory sexuality related information from multiple sources. These mixed messages contributed to confusion, misconceptions, distress, and sexual vulnerabilities. Youth expressed their need for more inclusive and relevant sexual health education starting from an early age, more support for parents and teachers to help them talk with children and youth about sexuality, and more youth-driven integrated health promotion programs to allow them to make informed choices. Their voices and perspectives are useful in informing inclusive and youth-centred sexual health education at home, in school and in the community.

Each year Canada approves about 70,000 agricultural temporary foreign worker positions. However, few studies have examined temporary foreign workers' sexual health. In this mixed-methods study, we used surveys and focus groups to explore the knowledge of HIV and sexually transmitted infections (STI), sexual behaviours and the perspectives of sexual health of 100 Thai and Filipino temporary foreign workers in southwestern Ontario, Canada. The findings revealed that transnational migration had opened up social space that workers were not familiar with. Social isolation, stress and prolonged separation from spouses and partners resulted in the formation of new intimate relationships. Close to two-thirds of the 100 participants were sexually active in the twelve months prior to the study and over three-quarters did not use condoms. Many participants had misconceptions about HIV risks and safer sex practices. Few temporary workers accessed sexual health services due to language barriers, time constraints, stigma and lack of transport. As a result, many obtained medical advice and medicine through their families back home and relied on self-treatment in dealing with symptoms of genital infections. Effective sexual health promotion for temporary foreign workers must consider the complex interactive sociocultural and political processes that involve institutional practices in the local and transnational contexts.

Background Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing a high level of stressors consists of health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs is negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and posttraumatic stress symptoms. Objective The aim of this qualitative study was to explore the pandemic stressors experienced by HCPs at work, at home, and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention. Methods Informed by a social ecological approach, we used a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first 2 waves of the COVID-19 pandemic (June 2020 to February 2021) in Canada. Results Informed by a social ecological framework, 5 overarching themes were identified in our thematic analysis: (1) personal level stressors that highlight HCPs’ identities and responsibilities beyond the workplace; (2) interpersonal level stressors from disrupted social relationships; (3) organizational stressors that contributed to unsettled workplaces and moral distress; (4) community and societal stressors attributed to vicarious trauma and emotional labor; and (5) the multilevel and cumulative impacts of COVID-19 stressors on HCPs’ health. Conclusions COVID-19 is not merely a communicable disease but also a social and political phenomenon that intensifies the effects of social inequities. Current understanding of pandemic stressors affecting HCPs is largely partial in nature. Although workplace stressors of HCPs are real and intense, they need to be explored and understood in the context of stressors that exist in other domains of HCPs’ lives such as family and community to ensure these experiences are not being silenced by the “hero” discourses or overshadowed by professional demands.

BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing a high level of stressors consists of health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs is negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and posttraumatic stress symptoms. OBJECTIVE The aim of this qualitative study was to explore the pandemic stressors experienced by HCPs at work, at home, and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention. METHODS Informed by a social ecological approach, we used a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first 2 waves of the COVID-19 pandemic (June 2020 to February 2021) in Canada. RESULTS Informed by a social ecological framework, 5 overarching themes were identified in our thematic analysis: (1) personal level stressors that highlight HCPs’ identities and responsibilities beyond the workplace; (2) interpersonal level stressors from disrupted social relationships; (3) organizational stressors that contributed to unsettled workplaces and moral distress; (4) community and societal stressors attributed to vicarious trauma and emotional labor; and (5) the multilevel and cumulative impacts of COVID-19 stressors on HCPs’ health. CONCLUSIONS COVID-19 is not merely a communicable disease but also a social and political phenomenon that intensifies the effects of social inequities. Current understanding of pandemic stressors affecting HCPs is largely partial in nature. Although workplace stressors of HCPs are real and intense, they need to be explored and understood in the context of stressors that exist in other domains of HCPs’ lives such as family and community to ensure these experiences are not being silenced by the “hero” discourses or overshadowed by professional demands.

Background Chinese students are extremely vulnerable to developing mental illness. The stigma associated with mental illness presents a barrier to seeking help for their mental health. Objective The Linking Hearts—Linking Youth and ‘Xin’ (hearts) project is an implementation science project that seeks to reduce mental illness stigma and promote the mental health of university students in Jinan, China. The Linking Hearts project consists of 3 components. In this paper, we outline the protocol for the first component, that is, the contextual assessment and analysis of the mental health needs of university students as the first step to inform the adaptation of an evidence-based intervention to be implemented in Jinan, China. Methods Six local universities will participate in the Linking Hearts project. A total of 100 students from each university (n=600) will engage in the contextual assessment through self-report surveys on depression, anxiety, stress, mental health knowledge, and mental health stigma. Quantitative data will be analyzed using several descriptive and inferential analyses via SPSS. A small number of participants (144 students and 144 service providers) will also be engaged in focus groups to assess the socio-environmental contexts of university students’ health and availability of mental health resources. Qualitative data will be transcribed verbatim and NVivo will be used for data management. Social network analysis will also be performed using EgoNet. Results Linking Hearts was funded in January 2018 for 5 years. The protocol of Linking Hearts and its 3 components was approved by the research ethics boards of all participating institutions in China in November 2018. Canadian institutions that gave approval were Ryerson University (REB2018-455) in January 2019, University of Alberta (Pro00089364), York University (e2019-162) in May 2019, and University of Toronto (RIS37724) in August 2019. Data collection took place upon ethics approval and was completed in January 2020. A total of 600 students were surveyed. An additional 147 students and 138 service providers took part in focus groups. Data analysis is ongoing. Results will be published in 2021. Conclusions Findings from this contextual assessment and analysis will generate new knowledge on university students’ mental health status, mental health knowledge, and resources available for them. These findings will be used to adapt and refine the Acceptance and Commitment to Empowerment-Linking Youth N’ Xin intervention model. The results of this contextual assessment will be used to inform the adaptation and refinement of the mental health intervention to promote the mental health of Chinese university students in Jinan. International Registered Report Identifier (IRRID) RR1-10.2196/25009

Chinese people are currently the second largest visible minority group living in Canada; however, little is known about the sexual practices of Chinese youth living in Canada. Using a case ...

This study aimed to explore the association between mental health knowledge level and the prevalence of depressive symptoms among Chinese college students. A cross-sectional study was conducted in six universities in Jinan, Shandong Province, China, and a total of 600 college students were recruited to self-complete a series of questionnaires. The Mental Health Knowledge Questionnaire (MHKQ) was used to investigate the level of mental health knowledge. Depressive symptoms were investigated with the depression subscale of the Depression Anxiety Stress Scale (DASS-21). The prevalence rate of depressive symptoms among college students was 31.2%. Compared with MHKQ scoring in the 1st quartile, college students with MHKQ scoring in the 3rd quartile and in the 4th quartile reported lower levels of depressive symptoms after adjusting for potential confounding factors. Since mental health knowledge level was related to depressive symptoms among college students, increased efforts to promote the level of mental health knowledge in Chinese college students are critical.

BACKGROUND Chinese students are extremely vulnerable to developing mental illness. The stigma associated with mental illness presents a barrier to seeking help for their mental health. OBJECTIVE The Linking Hearts—Linking Youth and ‘Xin’ (hearts) project is an implementation science project that seeks to reduce mental illness stigma and promote the mental health of university students in Jinan, China. The Linking Hearts project consists of 3 components. In this paper, we outline the protocol for the first component, that is, the contextual assessment and analysis of the mental health needs of university students as the first step to inform the adaptation of an evidence-based intervention to be implemented in Jinan, China. METHODS Six local universities will participate in the Linking Hearts project. A total of 100 students from each university (n=600) will engage in the contextual assessment through self-report surveys on depression, anxiety, stress, mental health knowledge, and mental health stigma. Quantitative data will be analyzed using several descriptive and inferential analyses via SPSS. A small number of participants (144 students and 144 service providers) will also be engaged in focus groups to assess the socio-environmental contexts of university students’ health and availability of mental health resources. Qualitative data will be transcribed verbatim and NVivo will be used for data management. Social network analysis will also be performed using EgoNet. RESULTS Linking Hearts was funded in January 2018 for 5 years. The protocol of Linking Hearts and its 3 components was approved by the research ethics boards of all participating institutions in China in November 2018. Canadian institutions that gave approval were Ryerson University (REB2018-455) in January 2019, University of Alberta (Pro00089364), York University (e2019-162) in May 2019, and University of Toronto (RIS37724) in August 2019. Data collection took place upon ethics approval and was completed in January 2020. A total of 600 students were surveyed. An additional 147 students and 138 service providers took part in focus groups. Data analysis is ongoing. Results will be published in 2021. CONCLUSIONS Findings from this contextual assessment and analysis will generate new knowledge on university students’ mental health status, mental health knowledge, and resources available for them. These findings will be used to adapt and refine the Acceptance and Commitment to Empowerment-Linking Youth N’ Xin intervention model. The results of this contextual assessment will be used to inform the adaptation and refinement of the mental health intervention to promote the mental health of Chinese university students in Jinan. INTERNATIONAL REGISTERED REPORT RR1-10.2196/25009

Cervical cancer rates are disproportionately high among women living with the human immunodeficiency virus (wlhiv). Cervical cancer is preventable through hpv screening, regular Pap tests, and early cancer detection. Evidence indicates that hpv and cervical cancer screening are suboptimal among wlhiv, who face a myriad of access barriers. Considering that screening is an effective first-line defense to cervical cancer, we conducted a scoping review with the aim of gaining a better understanding about: (1) the knowledge and perceptions of hpv and cervical cancer screening among wlhiv, and (2) the acceptability of self-sampling for hpv among wlhiv. We searched five electronic databases for peer-reviewed articles that were published in English within the last ten years, reported on studies with hiv-positive women who were aged 16 or older, and satisfied the topics of the review. A total of 621 articles were found. After accounting for duplicates and unmet criteria, 17 articles and 1 abstract, reporting on studies in the United States and Africa, were included in this review. The review highlighted that most wlhiv had inadequate knowledge of hpv transmission and cervical cancer prevention, which influenced their perceptions of risk and susceptibility. Screening barriers included misconceptions about Pap tests, fear of diagnosis of serious illness, perceived pain, embarrassment, bodily modesty, and limited access to female health care providers. This review also affirms that self-sampling is an acceptable and promising screening option for wlhiv. Implications for policy, research, and practice are discussed.

In the past decade, the People’s Republic of China has become the leading source country of immigrants to Canada. However, little is known about the experience of Chinese gay immigrants in Canada. Using narratives collected through a qualitative study, we show the way in which Chinese gay men construct their experience of immigration in Canada. Unlike the national discourse that claims Canada is a friendly nation for members of the LGBTTQ community, the experiences of Chinese gay immigration present a different story. As racialised gay men, they continue to be subjected to social violence in Canada – albeit differently from what they experienced in China. The analysis demonstrates the complexity of social marginalisation experienced by these men, the understanding of which is essential for social workers to engage in practice with them that is socially transformative.

Human papillomavirus (HPV) infection is the cause of anal squamous cell cancer (ASCC) in 80% of cases. Available research has also shown high prevalence of anal HPV infection among men who have sex with men (MSM). However, HPV vaccination is low among msm in Canada. In light of this information, we conducted a scoping review with the aim of exploring (1) the knowledge of HPV and anal cancer among HIV-positive msm and (2) the acceptability of HPV and anal cancer self-sampling in this population. In conducting the review, we searched five electronic databases for peer-reviewed articles and abstracts published in English, between 2007 and 2017. A total of 803 articles were retrieved; after accounting for duplicates (n = 40) and unmet criteria (n = 754), a total of 794 articles were excluded. A final total of nine articles were used in this review. Results of this review show that HIV-positive msm have limited knowledge regarding the risks of anal cancer associated with HIV and HPV coinfection. Furthermore, there is limited research on HPV and anal cancer self-sampling in this population. However, the review of available studies suggested that HIV-positive msm were open to anal cancer self-sampling. It also identified potential barriers to self-sampling. In conclusion, we provide suggestions and future directions for policy-makers and educators to develop inclusive and accessible strategies to reach HIV-positive msm regarding anal cancer education and self-screening.

Autoethnography has gained interest among social scientists in recent years. What was once a topic or methodology typically only associated with anthropologists is now increasingly being taken up b...

This study explored sexual practices and sex-seeking behaviours in a sample of 222 East and Southeast Asian men recruited through two gay venues. Over half of the respondents reported having a current regular partner; the rate of unprotected anal sex with their regular partner was high (45.1%). Among all respondents, 74.8% (166) reported having casual sex with an average of 16 partners in the previous six months; 26.5% of these 166 respondents reported unprotected anal sex with their casual partners. Respondents used multiple venues to seek sex, but bathhouses and the internet were most commonly cited. Bivariate analysis demonstrated that respondents who sought men for sex via both bathhouses and the internet in the past six months were most likely to have had a casual partner, to have had unprotected anal sex with a casual partner, and to have had prior HIV and STI testing. In comparison to respondents who used only bathhouses to seek sex, respondents who used only the internet had fewer casual partners but were more likely to have unprotected anal sex with a casual partner. Given these findings, additional research is needed to further explore the individual and structural factors that shape the condom use behaviour of these sub-populations. HIV prevention efforts must include culturally relevant information about HIV and STI transmission to promote condom use. It is also critical to develop culturally and linguistically appropriate online prevention education for Asian MSM who seek sex primarily through the internet.

Purpose – Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the changing populations infected with and affected by HIV. Since 2005 immigrants and refugees from ethno-racial minority communities have comprised close to 20 percent of all new HIV infections in Canada. Anecdotes shared by PLWHAs and service providers indicated that mental health challenges faced by newcomer PLWHAs was a priority concern for HIV prevention, treatment and care. This paper reports on the results of an exploratory study, which examined the complex factors that influence the mental health of immigrants and refugees living with HIV/AIDS (IR-PLWHAs). Design/methodology/approach – This exploratory study is informed by a critical social science paradigm, which acknowledges that the everyday reality is shaped by interlocking systems of social processes and unequal power relations. The paper used a qualitative interpretative design and focus groups to explore the intersecting effects of living with HIV/AIDS, migration and settlement, and HIV stigma and discrimination on the mental health of IR-PLWHAs. Findings – The paper found that in addition to social and economic marginalization, IR-PLWHAs experienced multiple stressors associated with their HIV status: neurocognitive and physical impairments, HIV stigma and discrimination, and fear of deportation. The paper also found that the experiences of stigma and discrimination among IR-PLWHAs were complex and contextual, closely linked to their social positions defined by the intersecting dimensions of race, class, gender, citizenship, sexualities, body norms, and HIV status. The paper concludes that effective HIV prevention, treatment and care, and mental health promotion in newcomer and ethno-racial minority communities must consider the bio-psycho-social connections of different stressors and the interlocking systems of oppression faced by IR-PLWHAs. Research limitations/implications – This study was exploratory in nature with a small number of participants who were recruited through AIDS organizations in Toronto. Consequently, the recruitment strategy may reach only those who were connected to the AIDS organizations. The paper believes that IR-PLWHAs who were not connected to the AIDS organizations might experience even more social exclusion and marginalization. These factors may limit the transferability of this study. Originality/value – This is the first study that explores the bio-psycho-social connections and intersecting determinants of mental health among immigrants and refugees living with HIV and AIDS in Canada. The results of this study contribute to cross-sector dialogue among practitioners and researchers in the HIV/AIDS, mental health, and immigration and settlement services sectors.

Homophobia and heterosexism are ubiquitous in Canadian society. They contribute to significant health and mental health disparities for lesbian, gay and bisexual youth and their families. Anti-homophobia efforts tend to focus on students and teachers at school. While these efforts are important, they do not reach parents, who play an important role in shaping young people's attitudes towards gender and sexuality. To eliminate bullying and victimisation associated with homophobia at school and in the community, concerted efforts are urgently needed to mobilise parents to become champions against homophobia and heterosexism. In this paper, we report on our use of storytelling and critical dialogue to engage a group of Hong Kong Chinese immigrant parents in Toronto to interrogate their values and assumptions about homosexuality. In particular, we illustrate how we use storytelling to create a liminal space whereby the narrators and listeners collaborate to create counter-discourses that challenge social domination and exclusion. We then discuss the implications of using a critical dialogical approach to integrate anti-homophobia efforts in community parenting programmes.

It has long been argued that stereotypes have led many gay Asian men to have negative feelings about themselves and other gay Asians, to the idealization of white men as potential partners, hostility towards other gay Asians, internalization of the stereotypes as passive and submissive, and being sexually objectified by some white men. To counter the effects of the stereotypes, critics and theorists of the gay Asian experience suggest increasing the visibility of Asian role models in the gay community, developing a strong sense of self-identity by choosing Asian men as potential partners, and encouraging involvement with the mainstream gay community. In contrast, we explore resistance to the stereotypes at a personal level, using narratives obtained through a series of interviews to analyze the ways in which gay Asian men negotiate and (re)frame the social stigma associated with their bodies and desire for white men. We argue that gay Asian men do not simply accept the negative stereotypes imposed by the dominant culture; rather, they actively resist and continuously reconstruct meanings about their bodies and desires.

In this article I examine contemporary Asian gay literature and argue that the experience of oppression is the central focus of this writing. Although this focus has helped gay Asians understand their experiences as a minority, the privileging of oppression as the primary site of gay identity also has other ramifications. In particular, it works to exclude experiences that are crucial to gay Asian identity but that are not centered around the experience of oppression. Because language not only describes but also determines and creates our reality, the centering of oppression in contemporary Asian gay literature helps to construct a reality for gay Asians in which oppression becomes the primary locus for identity politics. Consequently other kinds of experiences become, unwittingly, excluded as worthwhile areas of study in gay Asian criticism.

Objectives In recent years we have witnessed an increase in Asian men who use gay Internet chatrooms in Toronto. Previous research has shown that many men who had sex with men (MSM) sought sex partners through the Internet and that meeting sex partners via the Internet increases sexually transmitted infection (STI) and HIV risk. This study aims to (1) explore psychosocial issues relating to Asian men who use gay chatrooms and (2) identify culturally appropriate HIV prevention strategies for this population. Design In-depth interviews were conducted with a total of 21 East and Southeast Asian men who used Internet gay chatrooms. Unstructured, open-ended questions were used to obtain narrative data to help understand their lived, psychosocial experiences of gay chatrooms. Transcripts of the interviews were read to highlight themes and concepts. Results Analysis revealed complex lived, psychosocial experiences of Asian men who use gay chatrooms in Toronto. They tended to be socially isolated and highly margi...

Contemporary gay and lesbian social service literature still heavily focuses on White middle/upper-class issues and uses an isolated and fixed concept of homosexuality. As a result, the discourse has only a limited applicability to people with “dual” or “multiple” identities, accentuating the power of those who control the discourse and the oppression of those with “dual” or “multiple” identities. Using Asians as a case example, I argue that the lack of published articles about Asians in contemporary gay and lesbian social service literature is the result of the different worldviews of Asian and White queers. However, this deficiency is sustained by social structures that are saturated with White middle/upper-class values. Implications of this situation and some directions for social change are discussed.

The study reported here was undertaken to investigate cultural and social barriers that may increase HIV risk among gay, lesbian, and bisexual Asian youth. Interviews and focus groups were used to collect the data because they are well suited for this type of exploratory research. A total of 15 gay, lesbian, and bisexual Asian youth (7 females and 8 males) were recruited. Most of the participants (n = 11) self-identified as lesbian or gay. The mean age was 20.7, ranging from 17 to 24. Twelve participated in one of three focus groups while the remaining three were interviewed. Categories and themes identified include: (1) the lack of sex education at home, (2) homophobia in Asian families, (3) unresponsive health and social service providers, (4) lack of social support, (5) negative stereotypes, (6) ideal standards of beauty, and (7) negative perceptions of safer sex practices among Asian lesbian and bisexual women. HIV prevention strategies are suggested based on the recommendations and needs of ...

Same-sex violence against gay men of Asian descent is a subject frequently neglected by researchers and social workers. However, they may be more vulnerable to intimate violence, especially with a Caucasian partner, due to the accentuated socio-economic differences between them. Lack of culturally and sexually specific services available often leads them to feel helplessness and, therefore, to accept the violence. As a result, their experience of violence will continue. In this article, six risk factors leaving gay Asian men prone to intimate violence in Asian-Caucasian relationships will be explored, which include: (1) homophobia in Asian cultures, (2) issues of professional assistance and social support, (3) the dominant idea of beauty and Asian images in Western countries, (4) age differences, (5) income disparity and its implications in relationships, and (6) cultural values of family. Following that, recommendations and challenges to implementation of them will be outlined.

Translation is an integral component of cross-cultural research that has remained invisible. It is commonly assumed that translation is an objective and neutral process, in which the translators are “technicians” in producing texts in different languages. Drawing from the field of translation studies and the findings of a translation exercise conducted with three bilingual Cantonese-English translators, the authors highlight some of the methodological issues about translation in cross-cultural qualitative research. They argue that only by making translation visible and through open dialogue can researchers uncover the richness embedded in the research data and facilitate multiple ways of knowing.