Date on Master's Thesis/Doctoral Dissertation

12-2025

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Nursing

Degree Program

Nursing, PhD

Committee Chair

Anderson, Debra

Committee Co-Chair (if applicable)

Hines-Martin, Vicki

Committee Member

Huntington-Moskos, Luz

Committee Member

Carrico, Ruth

Author's Keywords

Congolese; mothers; preventive healthcare; perceptions; infants

Abstract

In 2024, approximately 100,000 refugees were admitted to the United States, with 20% coming from the DRC, while Kentucky continues to rank fourth in the country for refugee resettlement. The increasing number of Congolese refugee children in the United States and Kentucky necessitates a greater understanding of these beliefs and practices to ensure equitable, quality, and culturally informed health services. The purpose of this study was to explore Congolese refugee mothers’ culturally and socially situated beliefs, perceptions, practices, and resources related to health care that may influence their views and practices of preventive well-child health care for their infants in urban Kentucky. The PEN-3 cultural model was used to analyze cultural beliefs and practices, as well as societal structures and influential individuals that may impact health behaviors. This study employed a focused ethnography design, incorporating semi-structured interviews and field observations conducted in participants' homes. Data from 13 informants were collected and analyzed to better understand influencing factors. Four themes emerged from the data: The embodiment of Congolese motherhood, being in two different worlds, valuing healthcare, and the capacity to influence and shape outcomes. The embodiment of Congolese motherhood encompassed the various elements and characteristics that defined what it meant to be a mother in Congolese culture, as lived in the United States. This includes traditions, feelings, responsibilities, practices, and perceptions. The theme of being in two different worlds encapsulated their previous experiences in Africa as well as their current life in the United States. Valuing healthcare reflected individuals' perceptions, beliefs, and barriers concerning healthcare in this country. The capacity to influence and shape outcomes refers to their ability to affect or control aspects of their lives. This study highlighted beliefs such as witchcraft, practices including co-sleeping, societal influences like transportation, and key individuals, such as husbands, who influence health care decisions for Congolese infants. Implications for the future encompass determining appropriate sleeping arrangements for infants, comprehending cultural practices related to the prevention and treatment of illnesses, identifying indicators of domestic abuse and providing suitable resources, and investigating alternative methods to corporal punishment for children.

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