Saudi Arabian Women - Research Proposal Example

Veiled Womenin Saudi Arabia Have Vitamin D Deficiencyas a Result ofLess Exposureto Sunlight Literature Review A considerablenumber of Saudi Arabian women spend most of their lives indoors. Whenever these womenleave their houses, they do so while covering their entire bodies with black clothes and wearing veils. Previous studies have revealed that human bodies produce vitamin D when the skin is exposed to the sun’s ultraviolet rays;as a result of theirblack garments, which cover their bodies completely,many Saudi Arabian women lack the opportunity to get sufficient exposure to sunlight. Culture is a major obstacle to these women’s chance of being exposed to the sun over the course oftheir entire lives (O’Shea 2006).There are three major classifications of vitamin D. One of these classifications entails exposure of the skin to direct radiation from the sun. The sun activates the vitamin, which the skin produces, because of a metabolic process that occurs in the kidneys and liver. Exposing the skin to sufficient sunlight assists in the synthesis of vitamin D. Vitamin D synthesis is also facilitated by nutrients present in certain foods. Vitamin D deposits present in food are, however, in relatively small amounts when compared to the amount of vitamin D produced as a result of exposure to the sun. Vitamin D3 is acquired from foods such asmackerel, herring, tuna, and North Sea salmon, butmany foods do not contain any vitamin D deposits. Lack of sunlight incapacitates the skin, making it difficult to synthesise vitamin D properly and thus ensure a healthy body.A research report by Mohammed Ardawi, alongside his colleagues from King Abdulaziz University in Jeddah, found specific concentrations of vitamin D that are commonly termed as serum 25-hydroxyvitamin D, the chemical name of which is written as (25[OH]D). Quantities of this serum were recorded below 50 nmol/l among Saudi Arabian men (Ahmad 2013). The study thus concludes that vitamin D deficiency among Saudi Arabians is not only common for women who wear veils, but also for men. Generally, vitamin D deficiency is common among women in Arab countries, including Saudi Arabia (Sedrani 2011). This is an alarming trend and is linked to the lack of sufficient exposure of individuals’ skin to sunlight. This problem stems from the kinds of clothes that women wear, in line with their country’s cultural expectations. A lack of sufficient amounts of vitamins has undoubtedly resulted in a significant increase in hypertension cases among Saudi Arabian women (Stolzt 2006). Hypertension is itself the leading cause of heart failure in the world today. Apotential remedy for the problems faced by the women of Saudi Arabia would be to alter their dress code and ensure that their skin receives sufficient exposure to sunlight (Laura 2005). Limiting the skin’s access to sufficient sunlight will inevitablylead to low formation of 25-hydroxyvitamin D in the body, a common phenomenon among adults in Saudi Arabia;this especially applies to individualswho are obese or overweight. Most veiled women in Saudi Arabia face a constant threat of vitamin D deficiency and the ailments related to it. This problem occurs largely due to strict cultural and religious practices that reduce the skin’s contact with sunlight (Yousef 2011). Research Objectives This research proposal’s objective is to address the issue of Vitamin D deficiency among veiled women in Saudi Arabia resulting from minimal exposure to the sun’s ultraviolet rays. There are a number of factorsas to why these women get little or no exposure tothe sun’s rays, which they so need. This research aims to investigate these factors, as well as the cultural perspectives behind vitamin D deficiency, and will seek to document the vitamin D concentrations of women who are partially or completely covered byveils. As such, there are several objectives forthis study: Objective 1: To seek an understanding of the cultural factors thatcausevitamin D deficiency among Saudi Arabian women Objective 2: To determine vitamin D concentrations in veiled Saudi Arabian women Hypothesis The hypothesis for the study is that culture is the principal cause of vitamin D deficiency among veiled Saudi Arabian women. Aims The study aims toidentify whether the lack of exposure to sunlight among Saudi women causes vitamin D deficiency. Research Question The research question is, does lack of exposure to sunlight cause vitamin D deficiency among veiled women inSaudi Arabia? Problem Statement Veiled Saudi Arabian women get minimal exposure to sunlight because of their traditional cultural requirements. This situation is directly linked tothe women who receiveminimal exposure to the sundue totraditional cultural beliefs that require women to remain indoors for the greater part of the day, and require them to be covered from head to toe with veils and other clothing when they do leave their houses. Vitamin D is associated with a variety of immunology-related conditions,which include allergiesand autoimmunity. Vitamin Ddeficiency has also led to some conditions such as rickets and other related syndromes (Laura 2005, p. 162). This is a major problem affecting Saudiwomen and it thusconstitutesa topic for investigation, given the adverse effects experienced as a result. Study Design A cross-sectional design will be adopted in this proposal because it is the most appropriate for exploring and gaining a deep comprehension of behavioural issues through observation (Klopper 2008, p.62). The observation will offer an overview of the characteristics and outcomes associated with veiled Saudi Arabian women during the period of the study, andit is therefore the best method for observing issues related to vitamin D deficiency in the Arab femalesub-population. Through observation, the researchers will be able to look into the participants’ cultural perceptions towards vitamin D deficiency and will ultimately offer promise for addressing the related health issues. Cultural aspects that lead to the wearing of a veil account for many of these health-related perceptions, which are likely to change over time, especially depending on the time of the year. This is because there are seasons in the year when the sun is overhead making the duration of sunshine to change. From acultural perspective, it is believedthat culture is constructed and deconstructed overtime (Zaidi 2010, p. 12). The participants’ knowledge of this cultural reality is essential in establishing the vitamin D deficiency experience among study subjects. Methodological Approach The study focuses on a qualitative research approach towards investigating the relationship between completely and partially veiled Saudi Arabian women, and vitamin D deficiency (Chen et al. 2008, p. 123). This kind of research method will ensure that the research gathers data on women’s perspectives or experiences related to the problem. Little information is thus far known about the problem being discussed, and I intend to use the results of the studyto generalise its findings. Using prior information and this study’s results will make the process credible,and the research will thus be validated (Tsourtos 2013, p. 51). The study will beconducted faithfully through first-hand contact with my participants. I intend to invite other participants in the analysis and interpretation of research results (Klopper 2008, p.67). In the qualitative approach, analytic observational studies will measure the quantities of the serum among Arab women who wear the veil (cause) and its effect onhealth conditions. The advantage of this study is presentation of results on the issue of Vitamin D deficiency to explain social causes that negatively impact women’s health (Tsourtos 2013, p. 38). Methods The method to be used in this research is afocus group, whereby information will be obtained from Saudi Arabian womenat a local university in a systematic and organised manner. Focus groups are the preferred method, as they will assist in brainstorming on the issues related to vitamin D deficiency as a result of culture issues (Marshal 1996, p. 524). Religious and cultural aspects are best examined in small groups because they are sensitive issues involvingfamiliar or similar kinds of individuals (Marshal 1996, p. 524). Discussion with community workers requires a feasible and appropriate method for the participants. As such, this study employs focus group discussions as the appropriate method. The setting for engaging with the samplegroups is the local hospital, where questions will be provided to one group of women whose veils cover their entire bodies,and one group consisting of womenwho are covered by theirveils but have their faces and hands exposed. Some of these women are on record as having confirmed their vitamin D concentrations from the health facility after giving birth. Participants Target Population This study will select fortysubjects,twenty women covered completely by their veils and twenty others who are only partially covered. This selection will be based on inclusion criteria. Among these women, the first groupwore dresses that cover their bodies completely, while the second were partially covered, leaving their hands and faces exposed to the sun. Students from the local university will be included asthe subjects of this study. This study will be conducted during very sunny days, whereby all the volunteers will be interviewed and provided with a questionnaire, and will then undergo essential laboratory tests to determine their serum concentrations for vitamin D. Identify and Recruit As mentioned above, the study will consist of forty participants (twentyfully covered and twentypartially covered). All participants live in local neighborhoods, and consist of students from the local universities and housewives from the neighborhood. Using a computer-generated sequence, the study will randomly select, from the hospital records,women who have already had children in the past. This is because most of thesewomen have been tested previously for concentrations of vitamin D serum. This study will self-identify other women from the local university based on the way they cover themselves in veils.Accessing the participants from the hospital will be facilitated by a project worker specialisingin vitamin D,and who has a long-standing relationship with the women who occasionally visit the health facility. Sampling Technique The study will use the systematic sampling technique. This is because the study population is homogenous, comprising women from the same locality,and because the veiled women are openly identified according to their dress code. This method is also especially appropriate in qualitative research,particularly in cases where the researchers have certain expectations in mind (Marshal 1996, p. 522). This style will allowfor better analysis of information and effective drawing of conclusions. It is essential to choose the appropriate technique for sampling in order to generalizethe study’s findings. Sample Size In actuality, the sample size will be less than forty participants due to budgetary constraints. The sample size will be fully determined when the data reach saturation. The size of focus groups is estimated to be between 8-10 people in each group (Sedrani 2011, p. 186). This sample size is also suitable because the research budget will only allow for four focus groups of between 8-10 women. Both women who are completely covered and those who are partially covered will be interviewed separately when in their groups, but will be allowed to share their answers on their views regardingsome aspects of the study. This applies specifically to the women who have recorded their serum levels in the past by attending the same clinic. Having given birth in this hospital, they would be able to discuss the effects of vitamin Ddeficiency on their children (if their children exhibited symptoms of illness) Theproposed sampling method and the rationale behind its selection will need to be described to the sample groups (Bonita 2006, p.52). Materials The data collection employed in this research is an inductive strategy, whereby the research is focused on a conceptual framework. Here, data collected throughthis research will examine existing documents on serum samples of women exposed to sunshine and those with limited exposure. This collection will involve a blood test to measure the serum concentrations of participants in the focus group discussions,along with components pertaining to social and demographic information (educational, occupational and residential, nutritional and medical history), as well as personal and anthropometric aspects. A research investigator and two trained assistants will administer survey questions pertaining to lifestyle and nutritional factors. The questions are preferred because they will address personal and sensitive issues while considering the respondents’ opinions (Miles 1994, p. 33). The focus group discussions will be audiotaped and then transcribed by the undergraduate student researcher. Handwritten notes from the focus groups and the transcription will be combined into one transcript. Some questions to be discussed by the focus groups will be: 1. Does the wearing of the veil lead to vitamin D deficiency? 2. In your opinion, do you think culture is to blame for the deficiency? 3. What measures do you think are appropriate in addressing the deficiency? Chronological Procedure The research will adhere to a strict chronological procedure, which will involve the following activities: hypotheses formulation, statement of objectives, research question,statement of the research problems, choice of methodological approach and methods, and identification and recruitment of subjects in the targeted population. The sampling size, technique and the target population will be considered as we determine the research design. The materials, including interview schedules and questions, will be made available at this stage. It is expected that data will later be recorded, interpreted and analysed, after which a report will be written. This procedure lies within the timeline for the research process. Data Analysis The transcripts from the interviews will be thematically analysed. Thisapproach will involve identification, analysis and reporting of the themes within data. Voice recordings will be listened to thrice. The research assistants who code the transcripts will read and re-read the transcripts. These will then be grouped into categories of similar codes, which initiated the development of certain themes. These themes then be refined later on. Timeline Months of Year Jan-Dec(2013) Activities 1J 2F 3M AA 5M 6J 7J 8A 9S 1O 1N 1D Ethical Approval Group meetings Recruitment and training of research assistants Data collection Data analysis Group and team meetings Reporting andpublications Ethical Considerations Ethical considerations are a relevant aspect in research, so as not to violate the subject’s rights (Chatters 2000, p. 334). Our research will ensure that there is high objectivity in the collection of information regarding the subjects. We will seek authority from the relevant departments atthe local hospitals and schools before proceeding with our research. As part of confidentiality concerns, confidentiality forms will be providedin the focus groups to assure the subjects of their safety, autonomy and privacy. The participant’s religious and cultural beliefs will also not be violated in any way whatsoever by our research team. Our research aims to display competency in a professional way that will promote social well-being among the subjects, who will be treated equally regardless of their social status. Budget (earY) 2013 Personnel Salaries $14,100 Chief Investigator $18,000 Graduate Research Assistants $4,000 Principal Investigator 36,100$ Subtotal Project Expenses $500 Focus groups and Interview expenses $27,500 Incumbent jobs $769 Equipment,supplies and stationery. $2,000 Travel and communication $9161 Miscellaneous and Indirect costs 39,930$ Project Expenses Subtotal TOTAL BUDGET REQUESTED Year 2013 ($) Salaries & Wages $36,100 Projects Expenses $39,930 Total $76,030 Conclusion This study demonstrates the need for the promotion of health strategies in a trial to combat vitamin D deficiency among veiled women in the Saudi Arabian community. Providing knowledge or information alone about various health issues is not enough in the quest for sustained lifestyle and behavioural change. This study reports that there exists wide enablers and determinants thatinfluence health promotion and behaviour.Health practitioners must consider these as critical elements that are cultural and gender-based, and which influence interventions aimed at minimising vitamin D deficiency.These interventions could include creating environments that are supportive for veiled women, and in the process support behaviours that take into account cultural differences and promote long-term change. This studyrecommends more research to establish medical and nutritional interventions so that the veiled women can benefit from adequate vitamin D supplementation in ways that are culturally acceptable. Health promotion campaigns have to involve peer education in addressing vitamin D deficiency. References Ahmad, A 2013, ‘Vitamin D deficiency threatens 80% of Saudi females’, Saudi Gazette, viewed 8 June 2013, Bonita, R, Beaglehole, R &Kjellstrom, T 2006, Basic epidemiology, 2ndedn, World Health Organization. Chatters, LM 2000,‘Religion and health: public health research and practice’,Annual review of public health,vol. 21, no. 1, pp. 335-367. Chen TC, Chimeh, F&Lu, Z 2007, ‘Factors That Influence the Cutaneous Synthesis and Dietary Sources of Vitamin D’, Arch BiochemBiophys, vol. 460, pp. 213–7. Fonseca, V, Tongia, M &Abu-Aisha, H 1984,‘Exposure to Sunlight and Vitamin D Deficiency in Saudi Arabian Women’, Postgraduate medical journal,vol. 60, no. 707, pp. 589-591. Klopper, H 2008.‘The qualitative research proposal’,Curationisvol. 31, no. 4, pp. 62-72. Laura, V 2005, Vitamin D Deficiency in Arabian Women and Children: Time for Action,Nova Science Publishers, New York Marshall, N 1996, ‘Sampling for qualitative research’,Family practice,vol.13, no. 6,pp. 522-526. Miles, MB & Michael, HA 1994.Qualitative data analysis: An expanded sourcebook. Sage Publications Incorporated. O'shea, S 2006, Sea of Faith: Islam and Christianity in the Medieval Mediterranean World. Walker, New York. Sedrani, SH 2011, Study of Vitamin “D”: Status and Factors Leading to its Deficiency in Saudi Arabia,King Saud University, Saudi Arabia. Stolzt, VD, 2006, NewTopics in Vitamin D Research, Nova Science Publishers, New York. Tsourtos, G 2013, Graduate Studies in Public Health, Research Methods for Social Epidemiology, PHCA 8503, semester 1, Flinders University, Adelaide. Yousef, F 2011, ‘Vitamin D status and Breast Cancer in Saudi Arabian Women: case control study’, PhD thesis, The University of Arizona Zaidi, S 2010, Power of vitamin D, Outskirts Press, Denver,Colorado Read More