The Complex Roles of Acculturation and Religious Coping in Shaping Recovery Experiences After Cardiac Events Among Arab Individuals in Ottawa
Creators: name: Ba Haroon, Hussein
Publisher: name: Université d'Ottawa / University of Ottawa
Year: 2022
Subjects: Acculturation
Arab Immigrants
Cardiac Events
Cardiac Rehabilitation
Cardiovascular Diseases
Lifestyle Behaviours
Mixed Methods
Religiosity
Religious Coping
Stress Management

description: Background: People from ethnic minority immigrant groups living in host countries are known to have higher risk factors for cardiovascular diseases. The role of acculturation, or assimilation into a different and dominant culture, is often studied from social and medical views when focusing on individuals diagnosed with cardiovascular diseases and their recovery after cardiac events. However, the effects of the complex roles of acculturation and religious coping on these individuals are rarely considered in the research. There is limited knowledge regarding the complex roles of acculturation and religious coping in adopting healthy lifestyle behaviours and managing stress among individuals with cardiovascular diseases from Arab communities in the Ottawa region. This research project’s general purpose was to explore and understand the complex roles of acculturation and religious coping through the experiences of individuals diagnosed with CVD from Arab communities in the Ottawa region. Objectives: The specific objectives were to 1) identify and understand the challenges among Arab immigrants related to acculturation and religiosity in adopting healthy lifestyle behaviours and managing stress; 2) measure and describe the levels of religious beliefs as well as religious coping strategies, acculturation, perceived stress, and healthy lifestyle behaviours among Arab individuals living in the region of Ottawa, Ontario, Canada who have been diagnosed with cardiac events or who are at high risk for cardiovascular diseases; and 3) explore the role of acculturation and religious coping in shaping male Arab individuals’ lived experiences after a cardiac event and to explore their ways of understanding lifestyle behaviours and cardiac rehabilitation during recovery. Methods: A mixed-method approach was adopted in this research, which included three separate studies: Study 1 was a qualitative study (views of key informants with first-hand knowledge) in which three face-to-face focus groups were conducted with 17 Arab health promoters; Study 2 was a cross-sectional survey study was conducted with 63 individuals from local Arab communities who had been diagnosed with cardiac events or who were at high risk for cardiovascular diseases; and Study 3 consisted of a phenomenographic qualitative study, semi-structured in-depth interviews with male Arab individuals (N=10), selected from Study 2, who identified themselves as having had cardiac events while living in Canada. Results: From the perspective of Arab health promoters, there was an overlapping between various aspects of acculturation and religious beliefs that may have impacted the healthy lifestyle of Arab immigrants. These challenges were coded in four themes: “Culture first!”: dominant influence of home country culture; “Religiosity alone does not make you healthy!”: limited religious influence; “It is not easy!”: difficulties adapting to the Canadian lifestyle; and “We are not young!”: generational differences in adopting a healthy lifestyle. Findings from the survey study indicated that most participants were oriented more toward their Arabic culture than Canadian culture. Participants tended to be religious, and their nutritional behaviours were healthier than physical activity behaviours. However, age, gender, and interestingly, length of time living in Canada did not affect the participants’ results in any of the questionnaires. Based on lived experiences of 10 participants in the interview study, five core themes were identified: “Stressful events or cardiac events!”: acculturative stress effects; “It was a dreamlike event!”: dismissing perceptions of cardiac events; “recognizing risk factors is not enough to avoid them”: perceived threat; religious coping outcomes: satisfaction and fatalism; Cardiac Rehabilitation programs: who refers and who participates. Conclusion: This dissertation showed that acculturation level plays an essential role in Arab immigrants’ beliefs and behaviours regarding their health status and their experiences in preventing cardiovascular diseases risk factors or in recovery after cardiac events. Religious coping seems to be a way for less acculturated Arab immigrants to manage stress and mental burdens and find internal peace and satisfaction. From the perspective of Arab health promoters, some religious or cultural beliefs may be barriers to engaging in physical activity, especially for women and older people, and these barriers may be exacerbated by acculturative stress. Religiosity may also play an essential indirect role in managing stress through socialization, family support, and the adoption of coping strategies. Arab individuals living in the region of Ottawa, Ontario, Canada, who have been diagnosed with cardiac events or who are at high risk for cardiovascular diseases may have been more religious and less acculturated in Canadian society. Their lifestyle health behaviours related to physical activity and nutrition may have been influenced by their health status, religious beliefs, and the practices or traditions of their culture of origin. Stress and mental burdens while living in Canada reflected negatively on Arab male individuals’ experiences with cardiac events. Stress was perceived as a potential cause of cardiac events and a factor leading to low self-efficacy in changing lifestyle behaviours. There is a need to promote healthy lifestyle messages and raise awareness about cardiovascular diseases risk factors among Arab communities. Future research is needed to design culturally adapted cardiac rehabilitation programs for Arab individuals and to evaluate the effectiveness of interventions with both physical and mental health components.