Arab American Women's Health Study: Correlational and Experimental Examination of a Sexual Health Interview
[Thesis]
Holmes, Hannah J.
Lumley, Mark A.
Wayne State University
2019
134 p.
Ph.D.
Wayne State University
2019
Arab Americans are a diverse group of Americans of Arab heritage or identity. Given the underrepresentation of Arab Americans in research and a taboo surrounding sexuality in Arab culture, it is not surprising that Arab American sexual health is understudied, even though sexuality is an important aspect of health. Arab American women face the challenging task of negotiating both their heritage and American culture, which may have implications for sexual health due to the two cultures' disparate views on sexuality. Given the conflict and taboo likely to surround the topic of sexuality among Arab American women, confidential discussion of these sensitive topics with a knowledgeable and empathic interviewer may yield beneficial effects. This correlational and experimental study aimed to fill the gap in the literature on Arab American sexual health by examining: a) how sexual health is associated with physical and psychological health and b) whether engaging in an interview about sexuality improves participants' sexual health. In this study, 134 Arab American women ages 18-35 (M = 20.6) were recruited from the university and community. Participants completed measures assessing sexual health and attitudes, somatic and psychological symptoms, and cultural identity, and then were randomized to an interview or control (delayed interview) condition. The 60-minute interviews, conducted by female clinical psychology graduate students, inquired about sexual health, particularly relatively private attitudes and experiences. Five weeks later, all participants completed follow-up measures, and the control participants then completed the interview. Multiple regression analyses indicated that sexual self-esteem and unwanted sexual experiences were positively associated with somatic, depressive, and anxious symptoms, even after accounting for sociocultural variables and sexual experiences. Additionally, sexual satisfaction was inversely associated with psychological symptoms, and sexual self-schema was positively associated with somatic symptoms, also after accounting for those covariates. Bicultural identity integration moderated some of these relationships. These correlational findings suggest that sexual health is a key aspect of health and well-being and should be assessed among Arab American women. Analysis of covariance indicated that the interview condition led to significantly greater sexual satisfaction and marginally less discomfort with sexual self-disclosure at follow-up (adjusting for baseline), compared to controls. Moderation analyses revealed that these benefits extended to women with varying degrees of discomfort with sexual self-disclosure and extent of past sexual self-disclosure. These experimental findings suggest the value - rather than the risk - of openly discussing sexuality-related topics in a confidential, empathic setting with Arab American women.