Abstract
People from refugee backgrounds generally have long and stressful journeys that involve involuntarily fleeing their homes and often include dislocation from family and friends. Food is integral to settlement when arriving in a destination country, as it is entwined with self-identity, culture, and connectedness to family and community. The aim of this study was to understand the facilitators and barriers of accessing cultural foods during the settlement journey for families with a refugee background, from the perspectives of workers who support the settlement journey. The study used participatory action research methodology to conduct focus groups with settlement and other workers who regularly interacted with people from refugee backgrounds, spoke English, and preferably self-identified with a refugee background. Participants were recruited through community organisations in Brisbane, Australia, and focus groups were held at workplaces or online. Eight focus groups (n = 32) were conducted between June and October 2021. The main theme was that food security, culture, and mental health were interrelated. When cultural food access, culture, or mental health were maintained or adversely impacted, all three factors were likewise affected. The behaviours around purchasing cultural foods were motivated by the desire to express and validate culture, which in turn improved mental health. It was also found that individual and community support systems sustained access to cultural foods, while social, environmental, institutional, and political structures impacted this access, sometimes detrimentally. This study highlights the need for interventions that foster social capital for families with refugee backgrounds and consider food security, culture, and mental health collectively. In addition, there is a need for increased awareness of the settlement journey, and for cultural inclusivity to be integrated into government policies, by working with communities and providing opportunities for people to express their culture, improve access to cultural foods, and maintain mental health.
1. Introduction
Food security (FS) has been defined by the Food and Agriculture Organisation as having “physical, social, and economic access to sufficient, safe, and nutritious food to meet their dietary needs and food preferences for an active and healthy life.” [1] The terms “social” and “food preferences” in the FS definition implies FS includes access to culturally appropriate foods or “cultural foods.” Foods for “an active and healthy life” also imply that these foods need to support holistic health encompassing physical, mental, and social wellbeing.
On arrival in a destination country, people from refugee backgrounds move beyond the stress and anxiety of seeking asylum, to settlement, where they aim to form a livelihood in the new society. Settlement is a journey which can take many years or decades, and this period is often governed by striving for a sense of belonging, reestablishing identity, and reconnecting with culture [2]. These can be reinforced by, among other things, sharing particular foods and music, cultural traditions, and religious practices [2]. FS is tied, not only to successful settlement [3], but also to culture and mental health (MH).
To date, much of the research on FS has focused on the availability of and access to enough food as well as the nutritional and biological aspects of food [3]. Eating habits are driven by cultural customs, religious practices, and society, among other things, which are passed on through generations; as such, food is intrinsically linked to identity and the maintenance of culture [3–6]. Therefore, the cultural and spiritual aspects of food (and their relationship to health) are also important when exploring FS, however, these aspects have been inadequately explored in research [3].
In Australia, settlement service providers support the settlement of newly arrived refugee and humanitarian entrants through the Federal Government-funded Humanitarian Settlement Program (up to 6 to 18 months after arrival). This program focuses on English skills, employment, education, and training and access to health and social services to help people from refugee backgrounds to become self-sufficient active members of the community [7]. The Settlement Engagement and Transition Support Program provides settlement support to people on a longer-term basis. This program aims to continue supporting people towards self-sufficiency, independence, and economic well-being and incorporates other aspects of settlement, including social participation, personal well-being, and community connectedness [8]. Community service providers, such as community hubs, neighbourhood centres, and education centres, also support the settlement journey through more generalised services in the community. Therefore, service providers may have unique perspectives of the role of cultural foods in settlement and the factors which impact on food security and experiences navigating new food pathways.
The current research examines the facilitators and barriers of accessing cultural foods during the settlement journey for people from refugee backgrounds living in Greater Brisbane, Australia. Through participatory and mixed methods research, the perspectives of workers who support the settlement journey for communities from refugee backgrounds were solicited on key issues surrounding FS and access to cultural foods.
2. Materials and Methods
2.1. Methodology
This research is nested within a larger project called Connecting with Cultural Foods [4], which aims to identify best practice evidence for improving access to food for people with a lived refugee experience. The Connecting with Cultural Foods project is underpinned by Participatory Action Research methodology (PAR) [9]. PAR is a social justice methodology which explores the lived experience of participants to generate new knowledge and awareness about the political and social structures which oppress people and leads to collaborative action for social change [9]. In this study, the research team held focus groups with people supporting the settlement journey, to explore stories about their clients’ experiences accessing food. The research team then reflexively examined and discussed these stories to generate a new understanding of the social and political structures that impact FS for people from refugee backgrounds in the greater Brisbane area. The findings from this study were used to inform subsequent research activities that involved people from refugee backgrounds.
2.2. Governance
This project is run by a steering committee of seven members from a range of diverse backgrounds that have a refugee background themselves and/or significant experience working closely with people that do. The steering committee collaboratively designed the overarching research plan and the aims of the focus groups, utilised their networks with community organisations for recruitment, arranged focus group times and dates, and co-facilitated the groups. A subset of the steering committee analysed the data and are authors (TG, NE, and EP).
This project was approved by the QUT Human Research Ethics Committee (#2021000211/4025).
2.3. Participants and Recruitment
Existing relationships among steering committee members were leveraged to recruit participants from organisations, neighbourhood centres, and community hubs that service communities from refugee backgrounds in the greater Brisbane area. The focus groups were advertised by e-mail and on staff notice boards by relevant organisations. A gift card (valued at AUD$30) was offered to participants.
Participants were aged 18 and over, had a job which required them to regularly interact with people from refugee backgrounds (e.g., caseworkers, support workers, and English as second language teachers) and were proficient in English. It was desirable (but not essential) that they had personal lived refugee experiences. These participants were purposively recruited as they have a unique understanding of the factors which impact on the experiences of accessing food across cultures and throughout settlement. In addition, connecting with organisations that support settlement for people from refugee backgrounds provided an opportunity to build relationships that could support access to community members for future project endeavours.
2.4. Data Collection
Focus groups were chosen for data collection, as they allow participants to delve into shared lived experiences through group interaction, realign power and voice to participants, and allow group dynamics to establish priorities, concepts, and frameworks for shared perceptions [10]. Focus groups were held at organisations, neighbourhood centres, community hubs, and online. The lead investigator (TG) facilitated all focus groups and was supported by steering committee members from refugee backgrounds as co-facilitators of some focus groups. One focus group was held in Burmese and was translated to English during the focus group by a steering committee member (EP). All other focus groups were held in English.
Participants were invited to attend focus groups which, for convenience, were often held at their workplace and therefore may have been known to other participants. They may have also been known to facilitators through prior work relationships. This created a relaxed and somewhat informal environment where stories and discussion were held among participants and may have resulted in richer data being collected. Care was taken to ensure participants did not feel coerced into participation or answering questions by making it clear participation was voluntary and, if preferred, they could attend a focus group held at a different location with another facilitator.
Focus groups lasted approximately 60 minutes and were audio-recorded. Semi-structured open-ended questions (see Supplementary Material 1) were used to collect information on the facilitators and barriers to accessing foods, including information about the social, environmental, and political structures which impact on food access. Characteristics of participants were collected via an anonymous short survey at the start of the focus groups.
2.5. Data Analysis
Audio recordings were transcribed using computer assisted technology [11, 12] and checked and corrected by the lead investigator (TG). NVivo [12] and Word [13] were used for data management, coding, and analysis. Data were analysed using thematic analysis [14], which aligns to PAR methodology. Analysis was collaborative and reflexive, drawing on experiences to explore meaning in the data and generate themes. Three steering committee members (TG, NE, and EP) who worked closely with people from refugee backgrounds were co-authors and other authors (KM, ICV, and DG) were from culturally diverse backgrounds with significant experience working in the areas of FS and/or with people from refugee backgrounds.
In brief, the following analysis steps were undertaken: (1) a codebook was created by three researchers (TG, NE, and EP) collaboratively reading one focus group and inductively defining codes from the data; (2) the first author coded the transcripts and confirmed new identified codes; (3) all authors independently read codes and reflected on the meaning underlying the data using their experiences and a constructionist framework to understand the social and structural impacts in the data; (4) three authors (TG, NE, and EP) collaboratively and iteratively discussed the codes to latently interpret the data; (5) codes were utilised to map the relationships between the codes and explore underlying themes; (6) themes developed previously using the socio-ecological model and a postcolonial lens during a systematic review [15] were deductively applied to the codes to assess these themes for gaps and appropriateness; and (7) all authors collaboratively agreed on the findings.
3. Results
Eight focus groups were held between June and October 2021 and 32 participants attended. Participants who completed the survey (n = 30) were from a range of jobs, with between one month and 11 years of experience; 31% (n = 9) identified as having a refugee background. To maintain anonymity, it was not possible to nuance the data between people with and without a lived refugee experience. Therefore, the following findings report on a thematic analysis of the perspectives of community members and people with close ties to community members. Table 1 provides an overview of the characteristics of participants completing the survey.
Three main themes (and eight subthemes) were identified: FS, culture, and MH are interlinked; individual and community support systems sustain access to cultural foods; and higher-level structures impact cultural food access. Figure 1 provides a graphical representation of the themes and subthemes.
3.1. Theme 1: FS, Culture, and MH Are Interlinked
During discussions with participants, it became apparent that FS, MH, and culture were interlinked and underpinned all aspects of health and wellbeing. This theme was fundamental to most discussions, and when FS was supported or adversely impacted, culture, and MH were likewise affected, and vice-versa. This theme is shown in Figure 1 in the centre of the diagram and represents being at the core, and influenced by, all other themes and subthemes.
Participants reported that access to cultural foods enabled people to express and validate their culture and improve their MH. These foods were synonymous with culture, and as such, sharing food was an important part of culture and celebrations, and a way to maintain identity. During these occasions, food gave comfort, memories of home, a sense of belonging, and was a source of great pleasure. In addition, expressing culture created a time and place where people ate cultural foods and bonded with community, thereby increasing access to these foods and reducing isolation. When people continued to experience trauma, food provided a safe way to express culture and come together to improve the MH of the whole community.
“Food is like such a cultural practice and it is something that people do use to bring that sense of home back to themselves. I know when like at [my organisation] they started that cultural cooking class, and that was really great. Started mostly for the Zomi mums from Myanmar and while the kind of crisis in Myanmar was really at its peak and at the start of this year, and that was like a really fantastic way in which they were able to kind of do something as a community and involve other people from other communities and like have that sense of family and that sense of belonging back.”
Participant, focus group 7
The interrelated effects of cultural foods, culture, and MH are especially notable during life course milestones. Participants described cultural rituals and beliefs, and particular cultural foods which should be consumed during these significant life events. When these foods were not consumed, it meant cultural practices were not followed, and consequently MH could be negatively impacted. The following quote describes this connection for pregnant or breastfeeding women, and how not consuming cultural foods or practicing cultural customs may worsen the MH of the mother and infant:
“Yeah, so there’s a lot of postnatal depression … and those cultural rituals that come with pregnancy and birth that are so important around the women in your life and your mothers and your sisters and your aunts that are just not there. And so we see a lot of mums really struggle when they’ve had their children here in Australia versus even in refugee camps, although that’s got lots of its own trauma, they are often surrounded by people that understand the cultural, the rituals that come with pregnancy. But also, the food they should be eating, really particular foods that [in] a lot of countries would buy and eat when pregnant.”
Participant, focus group 6
Participants reported that when cultural foods were unavailable, inaccessible, or unable to be utilised, it impacted on MH and the ability to express culture. The lack of access to cultural foods may mean individuals were unable to participate in or contribute to cultural events, which may have led to feelings of shame and embarrassment. Cultural obligations may exacerbate these feelings, for example, community members may become offended when someone does not attend a cultural celebration or provide food when it was culturally required to do so. At the community level, when cultural foods were unavailable, the whole community was unable to celebrate cultural events. This may have led to isolation from cultural community for individuals, and over time, contributed to loss of culture for the whole community.
“[not] having access to cultural foods means that you can’t participate in cultural traditions. For example, you know when we have weddings or funerals and there’s an exchanging of gifts to you know, usually for a funeral, for example, you will go to the family’s house who have lost a loved one to show your support, by giving certain things to help them through that mourning period and part of that process is usually … key foods that you would give. … So, if you don’t have access to those things, and if you would replace them with other foods, it may not make sense, so you wouldn’t really be able to participate in that exchange, and so naturally then also not be connected to community.”
Participant, focus group 2
Cultural foods grown, purchased, prepared, cooked, and eaten in specific ways created an environment that had meaning, and which also had improved MH. Growing foods in the backyard or in community gardens using cultural methods and organic soil ensured the food embodied the energy of these practices and held the flavour of the food. Stores where cultural foods could be purchased provided an environment which was comforting and familiar, allowing people to speak their own language and feel accepted and provided access to cultural foods that brought back memories of home.
“So yeah, it allows people to then purchase food that’s familiar, and tastes like home.”
Participant, focus group 7
Furthermore, food prepared in a cultural way, such as over an open fire or coals using specially designed cultural equipment and utensils, imparted specific smells and taste into the food. Consuming foods in a cultural way, for example, eating together off one plate and using hands, was important for bonding and sharing culture together. Where any of these cultural practices were missing, it may have meant the food did not have the same meaning, which diminished their ability to fully experience their culture and those cultural benefits.
“My other learning from not being with people I mean, if you have an Eritrean background the sharing of coffee, for example in the tradition of grinding the beans and creating a multi-sensory experience with the smell and the conviviality of sitting together and preparing and drinking coffee that they recognise that it’s something they don’t want to lose and it’s a big part of their culture to create community and to address MH issues, as well as to enjoy the taste and flavour of coffee.”
Participant, focus group 8
MH facilitated culture and FS, as it provided capacity for people to celebrate their culture, and cultural foods were a way of sharing this with others. The first few months or years of arrival was described as a period when people were under considerable stress, and culture shock was significant. People were described as being in “survival mode,” as they dealt with an overwhelming amount of information and undertook tasks required by service providers, government departments, and institutional organisations. There was an expectation that they would acculturate into an unfamiliar society quickly. During this time, these tasks contributed to competing priorities which impacted people’s capability to celebrate their culture and connect to their community and therefore were less likely to share cultural foods. Over time, as people became familiar with the new country, there was less time and some stressors eased, MH improved, and people began to participate in cultural celebrations and share food.
“I remember the Syrian refugees starting to come … like when they first came out were really kind of very reserved and really quiet, and you could tell incredibly overwhelmed and probably quite traumatised by the experience of getting to Australia, and it was just about getting them the basics. … now when you see them, it is things like about food and establishing their cultural food, but also their music and then you know their religion and all those other things that are really important that go with it.”
Participant, focus group 6
3.2. Theme 2: Individual and Community Support Systems Sustain Access to Cultural Food
Access to cultural foods was facilitated by support systems that exist at the individual and community level. The “cultural and food literacy” subtheme was revealed at the individual level, and the three subthemes at the community level were: social capital; sharing of cultural foods; and trust and respect. These four subthemes were interconnected and affected FS, culture, and MH. Therefore, this theme is illustrated in Figure 1 as the middle circle, which impacts theme 1.
Social capital describes the networks, social connections and ties between people, that are relied upon for mutual benefit to overcome barriers and generate collective action. These can include: bonding capital, social networks within a group or community (in-group ties); bridging capital, connections across communities (between-group ties); and linking capital across levels of authority and hierarchy [12]. For people with lived refugee experiences, bonding capital could be described as connections to cultural community and bridging capital as connections with people outside of their cultural community.
Participants indicated one of the main barriers to accessing cultural foods was not knowing where to find them. This information was often not available through service providers or community organisations involved in the settlement journey. Bonding social capital overcame this barrier to support FS through increased food literacy, as community members shared essential knowledge on where and how to access cultural foods.
“You know, in my experience clients are far smarter at knowing where you can get cheaper food than what I am, purely out of survival. Yeah, so I think that’s where the kind of bonding capital really comes in, because people do link up with one another and often it’s a sense of relief when someone shows them “Ah, this is where you can get food from you know our culture.””
Participant, focus group 7
Exchanging information about food also helped people form connections with new friends and provided opportunities to share food and culture, as people explored the history and preparation of similar dishes across cultures, creating bridging capital. This occurred at workplaces, places of education and worship, and other places where multiple diverse cultural groups congregated. This created cultural cohesion, unity, and reduced isolation.
“Yeah, for example, I will go with Ethiopians and the Eritreans wherever they are, they see injera [a cultural food] as something that is connecting them together as one people. There are people from Burundi and Congo and Rwanda and Tanzania whenever they think oh golly is it kind of connecting trait. Yeah so they the food is somehow a traditional food or cultural food is somehow kind of uniting or brings people together as some feel as isolated, but when they come out as in their community or anywhere they feel connected together again. So food is has got a lot of significance, especially in these minorities.”
Participant, focus group 2
Sharing food also helped build trust and respect across cultural boundaries. The giving of food was described as a cultural responsibility and included in the unwritten rules of many cultures: to nourish the community and ensure everyone is fed and healthy. This may have led to stronger connections between people of different cultures and an overall sense of belonging, inclusivity, and cultural pride.
“Yeah, and I think food, food is yeah connection I think, you know, in any way doesn’t matter any background, you’re from or any religion I think everywhere in the world food is number one to everyone and I think that most people enjoy as well.”
Participant, focus group 1
Opposingly, when proffered food was not accepted by people or negative comments were made about aspects of cultural foods, such as their appearance or smell, people often felt their entire culture was being vilified or rejected. It may have led to a disconnection between cultures, and feelings of isolation and disrespect. This lack of trust then created a reluctance to share food and an unwillingness to try other cultural foods, thus further impacting on culture and MH.
Participant 1: “The other thing I noticed, say like Caucasians is reluctance to try other food. I have my workmates, I have Burmese [food] there, they quite reluctant to try other food. Meanwhile other people, Africans or Asians, we try, we like to try. That’s what I see.”
Participant 2: “Respect, yeah. We respect other food, we never judge food.”
Conversation between 2 participants, focus group 4
Sharing of food provided pathways to increase cultural and food literacy across generations, again facilitating the connections between culture and MH. Parents taught children about culture during food exchanges and ensured the family had ongoing connections to a shared cultural history, and therefore, food was the past, present, and future of cultural identity.
“Your connection to your culture, it’s your connection to your family it’s the recipes that’ve been passed down from generation to generation that, you know, if you didn’t learn them, if you didn’t cook them, they would end with you. Your kids wouldn’t then know what foods you eat, how to cook it, how to prepare it, and you know the rest of the generations then would lose it as well.“
Participant, focus group 3
3.3. Theme 3: Higher-Level Structures Impact Cultural Food Access
Higher-level structures at the political, institutional, social, and environmental levels were found to impact access to cultural foods. This then impinged on community and individual factors to ultimately affect FS, culture, and MH. Theme 3 is found as the outermost circle in Figure 1, representing its influencing effect on all other themes and subthemes.
Foods provided for newly arrived people from refugee backgrounds were regulated by political and institutional structures, impacting on access to cultural foods during the initial settlement period. On arrival, people were placed in temporary accommodation, organised by settlement service providers and were supplied with essentials for the first few days, including a box of food. However, although participants working in these organisations described efforts to ensure the food was culturally appropriate, they were limited to types of foods that were aligned with government requirements. In addition, small and local businesses run by community members were often an important source of cultural foods in the community. However, settlement service providers were not always able to purchase from them when providing food for new arrivals, as the organisations were unable to provide the required documentation, such as official tax invoices. This may have led to service providers supplying culturally inappropriate or unrecognisable food to new arrivals:
“Trying to find the appropriate food for someone will hopefully enjoy and be familiar with when they arrive means you have to go to smaller shops, … and maybe don’t have the appropriate tax invoicing system to then be able to show your funding body that it was an appropriate purchase. So you try to support local business, if there is a local business, but they need to also give you the right tax invoice so that you can prove that was an actual purchase. Because the department prefer we just go through the big suppliers, like Woolies and Coles.”
Participant, focus group 1
Environment structures also have a significant impact, as people may not have previously used cooking facilities that are standard in Australian homes, such as an oven, stove, and refrigerator. The cooking equipment and utensils provided by the service providers as part of the arrival package may also not be appropriate to prepare cultural meals. Cultural meals were often prepared using specially designed pots and pans, which were cared for in a particular way and imparted flavour and meaning to the food.
“I know in Rwanda they use open fires to cook and use pans that have been seasoned for years and are cared for in a particular way, you know and we move somebody and they come to Australia, and we settle them into a lovely home with a nice stove and it’s just so foreign to them, they’re like “no, we don’t cook like this, we cook on an open fire with all our food around us and the pots and the ladles and all the things that are kind of familiar to us, and yes, you give us shiny new pots for my lovely oven, but that’s actually not what we want.””
Participant, focus group 6
The way food is procured, prepared, and consumed is determined by social constructs. In home countries, people may have shopped daily, spent many hours preparing cultural dishes, and cooked over open fires, and women may have been predominantly responsible for these food practices. Education and workplaces in Australia often structure work hours around cultural norms of mealtimes, for example, by providing students and employees a break for morning/afternoon tea and lunch. When foods were not consumed in this manner, it may lead to misunderstandings with serious consequences and significant distress.
“A few years ago, we had a conversation around a student who child safety was called to their house because their kid never had lunch at school. And what they didn’t know was in that particular culture they have a very big breakfast. And that’s their main meal of the day. So they fill up on that, and then dinner is the other main, other meal they have. They don’t actually have lunch.”
Participant, focus group 3
In workplaces and other institutions which were less culturally diverse, social norms and unspoken rules around food may have impacted on inclusivity. This may have led to feelings of shame and embarrassment when these rules were inadvertently broken, adversely impacting on the ability to express culture. The following describes a conversation one participant had with her husband after he broke one such rule, to not heat fish in the work microwave oven:”
“He’s afraid that even sometime to warm it up. Because they start “Oh, what kind of smell come from this.” He hiding. So he said “I can’t do it because of they will tell me,” I say “why, you have to take it” “No, no, no, no, I can’t take this food because of my workmate.”
Participant, focus group 4
These smells were considered discourteous by those making the complaint, and the comments were considered disrespectful to culture by those receiving the criticism.
In culturally diverse workplaces, there was a deeper understanding of the meaning of food, and cultural foods were often shared, discussed, and respected. In culturally diverse schools, there was evidence that school canteens (where Australian children predominantly purchase food when not brought from home) were progressively offering more culturally sensitive dishes, such as halal meals. This indicates workplace and education institutions simultaneously fostered or hindered connections between multicultural groups, depending on social norms and cultural diversity within the local environment.
4. Discussion
This study found that FS (specifically access to cultural foods), culture, and MH were mutually dependent. This was fundamental to all findings, and when cultural food access, culture, or MH were maintained or adversely impacted, all three factors were likewise affected. The interconnectedness of FS and MH have previously been identified [15, 17]. This was also found to be the case for other migrant groups that have experienced displacement [18]. Economic constraints may lead to worry over accessing sufficient food for the family, thereby worsening MH, while poor MH may adversely affect FS. In addition, it has been recognised that cultural foods are an essential component of identity and culture [3, 4]. However, to the authors’ knowledge, this is the first study to identify that all three factors (FS, culture, and MH) reinforce each other.
This study also highlighted that individual and community support systems were found to sustain access to cultural foods. Bonding capital was used to share vital information about access to cultural foods to support FS, and the sharing of cultural foods with people reinforced culture, MH, and community networks. Sharing food with people outside the cultural community offered opportunities to create bridging capital, foster trust and respect, and share culture, which was essential for FS and MH. The role of community in sharing food sources, combining resources, and providing knowledge about the food environment has been described previously [19–23]. In addition, it has also been identified that bonding capital is important for MH [16]. This study adds further insight that social capital is vital when considering FS, culture, and MH collectively.
Finally, this study also found that higher level structures impacted access to cultural foods, sometimes detrimentally. Similar to other studies, it was found the environment, social, institutional, and political structures which were not culturally inclusive imposed barriers that affected access to cultural foods [15, 23–25]. Likewise, interventions that aim to improve FS for people from refugee backgrounds have generally failed to account for the role that food plays in identity and culture, and instead focus on the biological and nutritional aspects of FS [3, 26]. Given the definition, it could be argued that FS has not been adequately addressed in these programs. This study expands this knowledge to highlight that structures existing within culturally diverse communities, such as schools and organisations, facilitated access to cultural foods through culturally inclusive social practices, which created new bridging capital, and supported culture and MH.
The strength of this study is the PAR methodology, which has involved people with lived refugee experience in all aspects of the research to ensure it was conducted in a culturally appropriate manner. The participants had a detailed understanding of a wide variety of aspects of the settlement journey, coming from a range of organisations and geographical locations, working with people from a diverse range of backgrounds, with 20% working in their roles for over 5 years. Limitations revolved around recruitment and data collection. Some participants were recruited using existing relationships among steering committee members with organisations, which may have biased the sample towards people with similar perspectives to those of the steering committee. This was mitigated by the lead investigator (TG) liaising with supervisors and team leaders within those organisations, and a pre-prepared recruitment e-mail and flyer used for advertising the focus groups. Moderator bias may have influenced the discussion; however, this was mitigated by codesigning the focus group guide and cofacilitating the focus groups with steering committee members where possible. A statement that participation was voluntary was made at the commencement of all focus groups to ensure participants understood participation was not connected to their employment.
5. Conclusion
Food security is not simply being able to access enough food. It is also about accessing foods that optimise cultural identity and mental health, and as such is important for holistic wellbeing. For people with lived refugee experience, cultural foods are essential for successful settlement. These findings have been used to inform further project activities that involved codesigning research and outcomes with community members. Interventions need to consider food security, culture, and mental health, collectively, foster the development of bridging and bonding social capital, and remove structural barriers that limit access to, and celebration of, cultural foods. In addition, there is a need for greater awareness of the lived experience of the settlement journey and policy makers should incorporate cultural inclusivity into policies by working with communities and providing opportunities for people to express their culture, improve access to cultural foods, and maintain MH.
6. Additional Points
What Is Known about the Topic? (1) Food security and mental health are related, as economic constraints may lead to worry over accessing sufficient food for the family, thereby worsening mental health, while poor mental health may adversely affect food security. Additionally, cultural foods are an essential component of identity and culture. (2) Community plays an important role in sharing food sources, combining resources, and providing knowledge about food. Additionally, connections to community are important for mental health. (3) Environment, social, institutional, and political structures which are not culturally inclusive impose barriers that affect access to cultural foods. What This Paper Adds? (1) Food security (specifically access to cultural foods), culture, and mental health are interrelated. When cultural food access, culture, or mental health are maintained or adversely impacted, all three factors are likewise affected. (2) Individual and community support systems sustain access to cultural foods. Communities share vital information about access to cultural foods to support food security, and the sharing of cultural foods with people reinforces culture, mental health, and community networks. Additionally, sharing food with people outside the cultural community offers opportunities to create new social connections, foster trust and respect, and share culture, which are essential for food security and mental health. (3) Structures existing within multicultural communities, such as schools and organisations, facilitate access to cultural foods through culturally inclusive social practices, which create new social connections and support culture and mental health.
Data Availability
The coding framework data used to support the findings of this study have been deposited in the QUT Research Data Finder repository (https://researchdatafinder.qut.edu.au/display/n19615).
Disclosure
This project was conducted as part of a PhD for Tina Gingell. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflicts of Interest
Danielle Gallegos has received research support from the Children’s Hospital Foundation via a philanthropic donation from the commercial funder Woolworths. Danielle Gallegos declares she has no other conflicts of interest. Tina Gingell, Nehal Eltahir, Evelyn Pe, Kate Murray, and Ignacio Correa-Velez declare they have no conflicts of interest.
Acknowledgments
The authors would like to acknowledge the steering committee members of the Connecting with Cultural Foods Project for their guidance throughout this study, and organising and co-facilitating focus group sessions. The authors would like to thank the communities in the Brisbane region for their ongoing support of the project. Danielle Gallegos has received research support from the Children’s Hospital Foundation via a philanthropic donation from the commercial funder Woolworths, and Tina Gingell received funding from Queensland University of Technology. The authors acknowledge the open access publishing facilitated by Queensland University of Technology, as part of the Wiley–Queensland University of Technology agreement via the Council of Australian University Librarians.
Supplementary Materials
Supplementary Material 1: indicative list of questions used during focus groups. (Supplementary Materials)