Acculturation and health status among African-Caribbean, Bangladeshi and White British adolescents - Validation and findings from the RELACHS study

Objective This paper reports the validation process for research questions that measure cultural identity in a survey of adolescents from a multi-ethnic urban area. Method Four questions that tapped preferred cultural origins of friends and clothing were used to classify subjects into categories for cultural identity described by Berry (1980). We assessed face, content and construct validity of these questions by: i) investigating the meaning of cultural identity from an African-Caribbean, Bangladeshi, and White British perspective in three focus groups; ii) asking participants to comment on the questions and their suitability for studies of cultural identity; and iii) using data from the Research with East London Adolescents: Community Health Survey (RELACHS) study of adolescents to test hypotheses about associations of acculturation with health outcomes (physical and mental) in order to assess whether these trends are consistent with previous research, and are in accord with trends predicted by the Berry model. Results Questions about the cultural origins of friends and clothing showed good face and content validity. However, only the questions on friendship choices showed some associations in the predicted directions, with some associations that were unexpected. The most significant findings were that, in comparison with marginalised pupils, for African-Caribbean pupils assimilation was associated with more tiredness (OR = 40.7, 3.8-432.8, p < 0.001) and traditionalism with less obesity (OR = 0.1, 0.02-0.5, p < 0.001). For Bangladeshi pupils integration was associated with a lower risk of depression (OR = 0.4, 0.2-0.8, p < 0.001). Conclusion Questions on friendship choices can be used to assess cultural identity, but associations with health and health risk behaviours are different for each ethnic group.