A Community-Based Organization Model to Promote Latinx Immigrant Mental Health Through Advocacy Skills and Universal Parenting Supports

Unveiling Cervical Cancer Inequities Among Georgia Immigrant Latinas: A Robust Qualitative Examination of the Facilitators and Barriers to Prevention, with Emphasis on the Impact of Community-Based Organizations

This qualitative study delves into the facilitators and barriers surrounding cervical cancer prevention among Latina women in Georgia, with a specific focus on the impact of community-based organizations (CBOs). Employing semi-structured interviews with healthcare providers and representatives from CBOs, faith-based organizations, and other key stakeholders, the study uncovers key themes and subthemes shaping cervical cancer disparities. Themes such as challenges in cross-cultural healthcare access, difficulties due to lack of US citizenship, and limited mobility emerge as significant barriers, while community and family support stand out as crucial facilitators to cancer prevention. Additionally, the study examines community intervention methods from CBOs to target cervical cancer disparity, highlighting the importance of public awareness campaigns, building trust within the Latina community, and providing medical support tailored to immigrant populations. Through this comprehensive examination, the study not only offers invaluable insights into the intricate web of issues surrounding cervical cancer prevention but also endeavors to serve as a catalyst for targeted interventions and evidence-based policies aimed at ameliorating cervical cancer disparities among immigrant Latinas in Georgia and beyond.

Strategies for Naming and Addressing Structural Racism in Immigrant Mental Health

Immigrants account for 13.7% of the US population, and the great majority of these individuals originate from Latin America or Asia. Immigrant communities experience striking inequities in mental health care, particularly lower rates of mental health service use despite significant stressors. Structural barriers are a significant deterrent to obtaining needed care and are often rooted in racist policies and assumptions. Here we review and summarize key pathways by which underlying structural racism contributes to disparities in immigrant mental health, including anti-immigration policies, labor and financial exploitation, and culturally insensitive mental health services. Significant accumulated research evidence regarding these barriers has failed to translate into structural reform and financial investment required to address them, resulting in pronounced costs to both immigrant populations and society at large. We propose specific strategies for addressing relevant structural inequities, including reforming economic and financial policies, community education initiatives, and task-sharing and strengths-based interventions developed in partnership with immigrant communities to promote access to mental health care for populations in dire need of culturally appropriate services. (Am J Public Health. 2023;113(S1): S72-S79. https://doi.org/10.2105/AJPH.2022.307165).

Movement Pandemic Adaptability: Health Inequity and Advocacy among Latinx Immigrant and Indigenous Peoples

The COVID-19 pandemic exacerbated longstanding inequities in resources and healthcare, stacked on top of historical systems that exploit immigrants and communities of color. The range of relief, mutual aid, and advocacy responses to the pandemic highlights the role of social movement organizations in addressing the ways that immigration status creates systemic barriers to adequate health and wellbeing. This paper conceptualizes what I call, “movement pandemic adaptability,” drawing from a decolonial-inspired study including participant-observation (September 2018–September 2020), interviews (n = 31), and focus groups (n = 12) with community members and health advocates. Data collection began before the COVID-19 pandemic (September 2018–February 2019) and continued during its emergence and the initial shelter-in-place orders (March 2019–September 2020). Movement pandemic adaptability emerged as a strategy of drawing from pre-existing networks and solidarities to provide culturally relevant resources for resilience that addressed vulnerabilities created by restrictions against undocumented people and language barriers for communities that speak Spanish and a range of Indigenous languages. This paper presents how the relationship between immigration status and health is influenced by the local context, as well as the decisions of advocates, policymakers, and community members.

Enhancing Self-Advocacy After Traumatic Brain Injury: A Randomized Controlled Trial

OBJECTIVE

To evaluate the efficacy of a novel intervention aimed at enhancing self-advocacy in individuals living with traumatic brain injury (TBI).

SETTING

Community.

PARTICIPANTS

Sixty-seven (35 allocated to treatment, 32 to control) community-dwelling adults 9 months or more post-TBI (mean of 8.9 years postinjury); previously discharged from inpatient or outpatient TBI rehabilitation; able to travel independently in the community, indicating a level of independence needed to engage in self-advocacy.

DESIGN

Longitudinal randomized 2-arm controlled trial (NCT no. 03385824). Computer-generated block randomization allocated participants to treatment/intervention or control/no-intervention. All outcome assessments completed by blinded study staff.

INTERVENTION

A manualized group intervention, Self-Advocacy for Independent Life (SAIL), addressing the self-efficacy beliefs, knowledge, and skills for self-advocacy following TBI.

MAIN OUTCOME MEASURES

The Self-Advocacy Scale (SAS) (primary); General Self-Efficacy Scale (GSE); Personal Advocacy Activity Scale (PAAS); Satisfaction With Life Scale (SWLS).

RESULTS

The treatment group showed significantly greater improvement than controls from baseline to posttreatment on the primary measure (SAS) of self-efficacy specific to self-advocacy after TBI (effect size = 0.22). Similar improvements were found on secondary measures of general self-efficacy and satisfaction with life from baseline to posttreatment. However, significant between-groups gains for primary and secondary measures were not maintained over 6- and 12-week follow-up.

CONCLUSIONS

Individuals living with chronic TBI sequelae can increase self-efficacy specific to self-advocacy, general self-efficacy, and satisfaction with life, through a TBI-specific intervention aimed at empowering individuals to advocate for their own needs and wishes. Sustaining gains over time may require ongoing community collaboration and support. This could involve community-based systems of self-advocacy education, resources, and peer support.

Systematic Review of Cultural Aspects of Stigma and Mental Illness among Racial and Ethnic Minority Groups in the United States: Implications for Interventions

Stigma is integral to understanding mental health disparities among racial and ethnic minority groups in the United States. We conducted a systematic review to identify empirical studies on cultural aspects of mental illness stigma (public, structural, affiliative, self) among three racial and ethnic minority groups (Asian Americans, Black Americans, Latinx Americans) from 1990 to 2019, yielding 97 articles. In comparison studies (N = 25), racial and ethnic minority groups often expressed greater public and/or self-stigma than White American groups. In within-group studies (N = 65; Asian American, n = 21; Black American, n = 18; Latinx American; n = 26), which were primarily qualitative (73%), four major cultural themes emerged: 1) service barriers including access and quality (structural stigma); 2) family experiences including concealment for family's sake, fear of being a burden, and stigma extending to family (affiliative stigma); 3) lack of knowledge about mental illness and specific cultural beliefs (public stigma); and 4) negative emotional responses and coping (self-stigma). These findings confirmed stigma has both similar and unique cultural aspects across groups. Despite this, few studies tested stigma reduction interventions (N = 7). These cultural insights can inform contextual change at the health systems and community levels to reduce stigma, and empowerment at the interpersonal and individual levels to resist stigma.

Violence, Place, and Strengthened Space: A Review of Immigration Stress, Violence Exposure, and Intervention for Immigrant Latinx Youth and Families

Latinx immigrant families are greatly impacted by US policies and practices that limit immigrant families' and children's rights. This article reviews the effects of such policies and the growing literature examining migration experiences. Latinx immigrant youth and parents may encounter multiple stressors across the stages of migration, including physical and structural violence, fear, poverty, and discrimination, which contribute to higher rates of mental health problems in this population. Despite significant trauma exposure, immigrants demonstrate incredible resilience within themselves, their families, and their communities and through movements and policies aimed at protecting their rights. Numerous culturally relevant universal, targeted, and intensive interventions were developed to magnify these protective factors to promote healing, advance immigration reform, and provide trauma-informed training and psychoeducation. Psychologistsplay a crucial role in implementing, evaluating, and advocating for accessible and collaborative approaches to care so that Latinx immigrant families have the resources to combat the harmful sequelae of immigration stress.