title: Negotiating health and chronic illness in Filipino-Australians: a qualitative study with implications for health promotion.
abstract: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country.
  
  
  
  This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants' experiences .
  
  
  
  Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable.
  
  
  
  This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing social support are likely important strategies in promoting chronic disease self-management among the elderly. These interventions have the potential to empower and encourage individuals to take control and better manage their chronic disease.
authors.affiliation: a South Western Sydney Local Health District (SWSLHD) , Ingleburn , Australia.|b Centre for Applied Nursing Research (CANR) , Ingham Institute for Applied Medical Research , Liverpool , Australia.|c School of Nursing and Midwifery , Western Sydney University , Penrith , Australia.
authors.forename: Della
authors.identifier: 0000-0001-6475-8804
authors.initials: D
authors.lastname: Maneze
authors.affiliation: b Centre for Applied Nursing Research (CANR) , Ingham Institute for Applied Medical Research , Liverpool , Australia.|c School of Nursing and Midwifery , Western Sydney University , Penrith , Australia.
authors.forename: Lucie
authors.identifier: 0000-0001-7815-3005
authors.initials: L
authors.lastname: Ramjan
authors.affiliation: d Centre for Cardiovascular and Chronic Care, Faculty of Health , University of Technology Sydney , Ultimo , Australia.
authors.forename: Michelle
authors.identifier: 0000-0001-5484-8224
authors.initials: M
authors.lastname: DiGiacomo
authors.affiliation: b Centre for Applied Nursing Research (CANR) , Ingham Institute for Applied Medical Research , Liverpool , Australia.|c School of Nursing and Midwifery , Western Sydney University , Penrith , Australia.|e South Western Sydney Local Health District (SWSLHD) , Liverpool , Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Everett
authors.affiliation: d Centre for Cardiovascular and Chronic Care, Faculty of Health , University of Technology Sydney , Ultimo , Australia.|f School of Nursing , Johns Hopkins University , Baltimore , USA.
authors.forename: Patricia Mary
authors.initials: PM
authors.lastname: Davidson
authors.affiliation: b Centre for Applied Nursing Research (CANR) , Ingham Institute for Applied Medical Research , Liverpool , Australia.|c School of Nursing and Midwifery , Western Sydney University , Penrith , Australia.
authors.forename: Yenna
authors.identifier: 0000-0002-7429-4086
authors.initials: Y
authors.lastname: Salamonson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease / Q000208:ethnology*; D003469:Culture; D054242:Emigrants and Immigrants; D005260:Female; D017144:Focus Groups; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D010679:Philippines / Q000208:ethnology; D036301:Qualitative Research; D012944:Social Support
keywords: Acculturation; culturally competent health care; culture; language; migrants; self-management; social isolation