Cultural sensitivity in perinatal mental health care for ethnic minority women

Gardener, Angelene (2024) Cultural sensitivity in perinatal mental health care for ethnic minority women. Doctoral thesis, University of East Anglia.

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Abstract

Background: Prior research has identified disparities in perinatal health outcomes for ethnic minority women, and qualitative studies highlighted how ethnic minority women perceive perinatal services as lacking cultural sensitivity. Findings suggest embedding culture into mental health interventions and services can positively influence outcomes. This thesis portfolio comprises a systematic review and meta-analysis of culturally adapted interventions (CAIs) for ethnic minority women with perinatal mental health difficulties. Followed by a qualitative exploration to understand ethnic minority women’s experiences of perinatal services in the East of England.

Methods: A systematic review identified studies evaluating perinatal mental health CAIs for ethnic minority women, and CAI components were synthesised. A meta-analysis compared the efficacy of interventions to controls. For the empirical paper, semi-structured interviews were conducted with ethnic minority women who had accessed NHS perinatal teams and analysed using an Interpretive Phenomenological Analysis Framework. Results: 17 studies (n= 1,923) were synthesised, encompassing the following CAIs; cognitive behavioural therapy (n=9), interpersonal therapy (n=6), problem-solving (n=1) and psychoeducation (n=1), incorporating various surface-level and deep-level adaptations. The meta-analysis included 13 RCTs (n= 1,456) with depression as the primary outcome. The overall effect size was small to moderate and significant (g = -0.33; 95% CI -0.57 to -0.09;
p= 0.007). From the qualitative analysis, four themes emerged: 1) Strengthening community networks and peer support; 2) Valuing cultural curiosity; 3) Making sense of how culture, ethnicity, race, and racism impact mental health; and 4) Tailoring interventions to ethnic minority women and their families.

Conclusions: Findings suggest that CAIs for perinatal depression are more efficacious than controls and that professionals should support ethnic minority women in community resources and peer support, explore cultural dynamics and apply cultural and practical adaptations to interventions. Further research should compare CAIs against active controls and explore how specific ethnic minority groups experience different aspects of perinatal services.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Kitty Laine
Date Deposited:	11 Nov 2024 14:59
Last Modified:	11 Nov 2024 14:59
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97610
DOI:

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