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Background: Cultural factors are often mentioned as a possible explanation for the observed differences between immigrant populations compared to general populations with regards to COVID-19 disease burden and vaccination rates, but usually without any further exploration of what this entails. This paper aims to capture the thoughts of immigrants themselves and explore how they think culture may or may not have affected vaccination rates and health behavior during the pandemic. Methods: We performed qualitative interviews with 18 immigrants from Poland, Somalia and Sri Lanka living in Norway. Group interviews and individual interviews were transcribed and analyzed using systematic text condensation. Results: We identified four main themes the participants thought could influence spread of infection and vaccine hesitancy: cultural factors, transcultural factors, host society factors, and other personal factors. Social habits, religious traditions, attitudes towards and trust in the healthcare system, sense of community and societal duty were understood as cultural factors that influenced health behavior and vaccination hesitancy. However, different cultural factors could have varied impact on immigrants' behavior related to COVID-19 and possibly other health settings for different immigrant groups. In addition, we found examples of other factors related to being 'between cultures', and we found structural and socioeconomic factors not linked to culture. Conclusions: Our paper brings awareness to how rules and guidelines may hit harder and interfere more in the way of life in some communities than others. In the continued work towards equity in health promotion and healthcare services, policymakers ought to keep the existence of such cultural differences in mind, to be able to make policies well fitted to ensure good health and quality of life for all. [ABSTRACT FROM AUTHOR]

BackgroundCOPD is the third most frequent cause of death globally, with much of this burden attributable to household biomass smoke exposure in developing countries. As biomass smoke exposure is also associated with cardiovascular disease, lower respiratory infection, lung cancer, and cataracts, it presents an important target for public health intervention.MethodsLung function in Guatemalan women exposed to wood smoke from open fires was measured throughout the Randomized Exposure Study of Pollution Indoors and Respiratory Effects (RESPIRE) stove intervention trial and continued during the Chronic Respiratory Effects of Early Childhood Exposure to Respirable Particulate Matter (CRECER) cohort study. In RESPIRE, early stove households received a chimney woodstove at the beginning of the 18-month trial, and delayed stove households received a stove at trial completion. Personal exposure to wood smoke was assessed with exhaled breath carbon monoxide (CO) and personal CO tubes. Change in lung function between intervention groups and as a function of wood smoke exposure was assessed using random effects models.ResultsOf 306 women participating in both studies, acceptable spirometry was collected in 129 early stove and 136 delayed stove households (n = 265), with a mean follow-up of 5.6 years. Despite reduced wood smoke exposures in early stove households, there were no significant differences in any of the measured spirometric variables during the study period (FEV1, FVC, FEV1/FVC ratio, and annual change) after adjustment for confounding.ConclusionsIn these young Guatemalan women, there was no association between lung function and early randomization to a chimney stove or personal wood smoke exposure. Future stove intervention trials should incorporate cleaner stoves, longer follow-up, or potentially susceptible groups to identify meaningful differences in lung function.