Sample and study participants
A total of 533 respondents from four immigrant groups in Norway took part in the study. In addition, data from Norwegian students (N = 250) were used as a native comparison in parts of the analyses. In total, 81 respondents had more than 30 missing data points (out of 783 responses; 10%) and were excluded from all statistical analyses. Hence, the final sample consisted of 702 participants. The age of the respondents ranged from 19 to 64 years with a mean of 30.8 (SD = 9.3). Table 1 shows the demographic characteristics of the different subsamples.
Table 1. Descriptive statistics for the samples
|
Country of origin
|
Norway (n = 225)
|
Russia
(n = 151)
|
Poland
(n = 109)
|
Pakistan
(n = 117)
|
Somalia
(n = 100)
|
|
M (SD)
|
M (SD)
|
M (SD)
|
M (SD)
|
M (SD)
|
Age
|
27.3 (7.0)
|
34,8 (8.5)
|
34.4 (9.6)
|
28.5 (10.2)
|
28.9 (8.3)
|
Years in Norway
|
Not relevant
|
7.9 (5.2)
|
6.1 (5.8)
|
16.7 (8.8)
|
9.3 (7.1)
|
Born in Norway (N)
|
Not relevant
|
11
|
2
|
86
|
0
|
Higher education*
|
100%
|
6%
|
23%
|
20%
|
69%
|
Females
|
69%
|
87%
|
77%
|
69%
|
44%
|
Note.* Includes those who have started, are undertaking or have completed studies at university level.
|
Procedure
Immigrant samples: The survey was distributed and collected on paper (n = 33) or online (n = 500). The possibility of answering the survey on paper was only offered to the Somali respondents. Some of the data on Somali immigrants have been presented in a previous paper(26). As for the online survey, the respondents were recruited through social network sites (e.g., Facebook). Respondents of Somali and Pakistani origin could choose to answer the survey in English or Norwegian, while respondents of Russian and Polish origin could also choose to answer in Russian or Polish, respectively. The instruments were translated using a translation-back-translation procedure, comparing versions to maximize technical, semantic, content, and conceptual equivalence. The Norwegian sample: The survey was distributed online. A research assistant invited respondents via a private message on Facebook or by email. The students were mainly recruited from higher education institutions in Bergen, Norway, from different academic disciplines: 30% humanities (e.g., pedagogy), 30% social sciences (e.g., psychology), 11% natural sciences (e.g., chemistry), 16% medicine (e.g., nursing) and 13% from formal science disciplines and professions (e.g., law and real estate management).
Instruments
The first part of the survey consisted of questions about demographics, including age, gender, years of formal education, and length of residence in Norway. Respondents were then asked to read a vignette (Table 2), describing a person with symptoms of depression consistent with the criteria for a depressive episode in the International Classification of Diseases-10(27). The gender of the vignette character was matched to the respondent to facilitate identification.
Table 2. Vignette used in the survey
|
“John/Ann is a 27-year-old waiter in a restaurant in Bergen. He/she was born in Oslo to parents who were restaurant owners, but has made Bergen his/her home for 5 years. In the last few weeks, he/she has been experiencing feelings of sadness every day. John/Ann's sadness has been continuous, and he/she cannot attribute it to any specific event or to the season of the year. It is hard for him/her to go to work every day; he/she used to enjoy the company of his/her co-workers and working at the restaurant, but now he/she cannot find any pleasure in this. In fact, John/Ann has little interest in most activities that he/she once enjoyed. He/she is not married and lives alone, near his/her brother/sister. Usually, they enjoy going out together and with friends. But now he/she does not enjoy this anymore. John/Ann feels very guilty about feeling so sad, and feels that he/she has let down his/her brother/sister and friends. He/she has tried to change his/her work habits and start new hobbies to become motivated again, but he/she cannot concentrate on these tasks. Even his/her brother/sister has now commented that John/Ann gets distracted too easily and cannot make decisions. Since these problems began, John/Ann has been sleeping poorly every night; he/she has trouble falling asleep and often wakes up during the night. A few nights ago, as he/she lay awake, trying to fall asleep, John/Ann began to cry because he/she felt so helpless.”
|
Note. In the Russian version, the male name John was changed to the more typical Russian name Zenia.
|
After reading the vignette, the respondents answered questionnaires about help-seeking preferences and acculturation orientation.
The General Help-Seeking Questionnaire (26, 28) (GHSQ) consists of 19 items describing different sources from whom help can be sought (e.g., friends, traditional healer, and telephone helpline). Each item was rated on a six-point Likert scale (1 = “very unlikely” to 6 = “very likely”). The standard instruction: “If you were having [problem-type], how likely is it that you would seek help from the following people?”(28), was modified to: “If you were feeling like Ann/John (gender-matched), how likely is it that you would seek help from the following sources?”. In line with the recommendations of Wilson et al.(28), relevant items were added to fit the target group. Specifically, we included items referring to help-seeking sources in the immigrant community (e.g., traditional healers, elders in my community, leaders in my ethnic community or from the same country as me, other people in my ethnic community or from the same country as me) and alternative medicine (e.g., acupuncture, homeopathy). One source (the Norwegian Labour and Welfare Administration, abbreviated to Social Worker/NAV in the survey) was added to adapt the questionnaire to the Norwegian context.
The Vancouver Index of Acculturation(29) (VIA) measures acculturation orientation. It consists of 20 statements assessing interest and participation in one`s heritage culture (10 items) and the mainstream (Norwegian) culture in the country of residence (10 items). Each item was rated on a nine-point Likert scale (1 = “strongly disagree” to 9 = “strongly agree”). The average of the 10 items in each subscale was computed, resulting in a score for each participant on the heritage subscale and on the mainstream subscale. These scales will in the following be referred to as “Maintenance” and “Adoption”.
Data analysis
SPSS 24.0 was used for all statistical analysis. A parallel principal component analysis (with Varimax rotation) of all items in the GHSQ was conducted of help-seeking sources that tend to be used simultaneously. Items with cross-loadings of .40 or higher on two or more factors were removed(30). Based on the results, composite scores for the subscales were computed for each factor. Secondly, differences in means between all immigrant groups were assessed using a multivariate analysis of variance (MANOVA) and Tukey post-hoc tests. Thirdly, a correlation analysis was conducted to explore the relationship between preferred help-seeking sources, acculturation orientation (only immigrants) and background variables. Finally, a hierarchical multiple regression analysis was conducted to investigate whether the acculturation subscales explained help-seeking preferences when controlling for gender, age, and years of higher education in the immigrant sample. Age was controlled for by a partial correlation analysis and an analysis of covariance (ANCOVA), and no significant differences were observed (results not shown).