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van Bruggen S, Bennett RJ, Manchaiah V, Jager LBD, Swanepoel DW. Perceptions of Hearing Health Care: A Qualitative Analysis of Satisfied and Dissatisfied Online Reviews. Am J Audiol 2024; 33:386-410. [PMID: 38483218 DOI: 10.1044/2024_aja-23-00180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
PURPOSE The aim of this study was to examine the hearing health care experience of satisfied and dissatisfied consumers as reported on Google reviews. METHOD Using qualitative thematic analysis, open-text responses from Google regarding hearing health care clinics across 40 U.S. cities were examined. During the original search, 13,168 reviews were identified. Purposive sampling led to a total of 8,420 five-star reviews and 321 one-star reviews. The sample consisted of 500 five-star (satisfied) and 234 one-star (dissatisfied) reviews, describing experiences with audiology clinics, excluding reviews related to ear, nose, and throat services; other medical specialties; and those not relevant to hearing health care. RESULTS Satisfied and dissatisfied consumer reviews yielded nuanced dimensions of the hearing health care consumer experience, which were grouped into distinct domains, themes, and subthemes. Six and seven domains were identified from the satisfied and dissatisfied reviews, encompassing 23 and 26 themes, respectively. The overall experience domain revealed emotions ranging from contentment and gratitude to dissatisfaction and waning loyalty. The clinical outcomes domain highlights the pivotal contribution of well-being and hearing outcomes to the consumer experience, while the standard of care domain underscores shared expectations for punctuality, person-centered care, and efficient communication. Facility quality, professional competence, and inclusive care were also highlighted across positive and negative reviews. CONCLUSIONS Findings indicate dimensions of satisfied and dissatisfied hearing health care consumer experiences, identifying areas for potential service refinement. These consumer experiences inform person-centric service delivery in hearing health care.
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Affiliation(s)
- Sanchia van Bruggen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - Rebecca Jane Bennett
- National Acoustic Laboratories, Macquarie University, Sydney, New South Wales, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
- Ear Science Institute Australia, Subiaco, Western Australia, Australia
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab (a collaborative initiative between the University of Colorado and the University of Pretoria), Aurora, CO
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, India
| | - Leigh Biagio-de Jager
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
| | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab (a collaborative initiative between the University of Colorado and the University of Pretoria), Aurora, CO
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora
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Fuller-Rowell TE, Zeringue MM, Saini EK, Yip T, El-Sheikh M. Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination Among Adults? Psychosom Med 2024; 86:324-333. [PMID: 38588054 DOI: 10.1097/psy.0000000000001305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults. METHODS Participants were 874 adults residing in small towns and semirural contexts within the Southeastern region of the United States ( Mage = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs < 2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms). RESULTS Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems. CONCLUSIONS Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.
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Affiliation(s)
- Thomas E Fuller-Rowell
- From the Department of Human Development and Family Science (Fuller-Rowell, El-Sheikh), Auburn University, Auburn, Alabama; Department of Psychology (Zeringue), Middle Tennessee State University, Murfreesboro, Tennessee; Department of Human Development and Family Studies (Saini), Pennsylvania State University, University Park, Pennsylvania; and Department of Psychology (Yip), Fordham University, Bronx, New York
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Simela C, Akanbi-Akinlolu T, Okundi M, Abdalla H, McAdams TA, Harris A, Augustine A, Le H, Abdinasir K, Ayorech Z, Ahmadzadeh YI. Intergenerational consequences of racism in the United Kingdom: a qualitative investigation into parents' exposure to racism and offspring mental health and well-being. Child Adolesc Ment Health 2024; 29:181-191. [PMID: 38523495 DOI: 10.1111/camh.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Experiences of racism are linked to negative physical and mental health outcomes among those exposed. According to quantitative research derived mainly from the United States, these negative outcomes can have cascading effects in families, when parents' experiences of racism indirectly impact offspring. New research is warranted for families in the United Kingdom, informed by a qualitative approach to canvassing community knowledge and perspectives, exploring how existing findings relate to lived experiences. METHOD We conducted four online focus groups with 14 parents of school-aged children and 14 adolescents who had experienced racism in the United Kingdom. Participants were asked what children know of parents' experiences of racism, and how these experiences can impact parent-child interactions, mental health and well-being. Focus group recordings were transcribed, data coded and analysed through iterative categorisation. RESULTS Analyses drew four themes from participants' insights. Together, themes illuminated the pervasive nature of racism experienced by some families in the United Kingdom. Parent and child experiences of racism were connected and co-occurring, with indirect effects impacting mental health and well-being in both generations. These experiences were linked to both positive and negative changes in parenting behaviour and parent-child relationships, which could be moderated by intersecting identities such as the parent's generational status for immigration to the United Kingdom. Social cohesion, safe spaces and education programmes were highlighted for future intervention. CONCLUSIONS Findings corroborate existing literature, while further emphasising a broader bidirectional picture, requiring a family system and intersectional approach to understanding the mental health impact of racism in families. Avenues for future research are discussed to support development of equitable intervention and support strategies to prevent racism and support those affected.
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Affiliation(s)
| | | | | | | | | | - Androulla Harris
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Alex Augustine
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Huong Le
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
| | - Kadra Abdinasir
- Centre for Mental Health, Registered Charity No. 1091156, London, UK
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Alvarez D, Adynski H, Harris R, Zou B, Taylor JY, Santos HP. Social Support Is Protective Against the Effects of Discrimination on Parental Mental Health Outcomes. J Am Psychiatr Nurses Assoc 2024:10783903241243092. [PMID: 38600825 DOI: 10.1177/10783903241243092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Discrimination, or unfair treatment based on individual characteristics such as gender, race, skin color, and or sexual orientation, is a pervasive social stressor that perpetuates health disparities by limiting social and economic opportunity and is associated with poor mental and physical health outcomes. AIMS The purpose of the present study is to (1) examine the association between maternal experiences of discrimination and paternal experiences of discrimination; (2) explore how discrimination relates to parental (maternal and paternal) stress and depressive symptoms; and (3) examine whether social support exerts protective effects. METHODS The sample was 2,510 mothers and 1,249 fathers from the Child Community Health Network study. Linear regression models were conducted to explore associations between maternal and paternal discrimination. In addition, mediation analyses were conducted to explore if social support functioned as a mediator between discrimination on parental stress and depressive symptoms. RESULTS Most mothers (40.3%) and fathers (50.7%) identified race as the predominant reason for discrimination. Experiencing discrimination was significantly related to stress and depressive symptoms for both parents, and all forms of social support mediated these relationships. Our findings suggest that social support can act as a protective factor against the negative association between discrimination and both stress and depressive symptoms. CONCLUSIONS These findings highlight the need to integrate social support into existing interventions and include fathers in mental health screenings in primary-care settings. Finally, we briefly describe the role of nurses and other allied health professionals in addressing discrimination in health care and health policy implications.
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Affiliation(s)
- Dallis Alvarez
- Dallis Alvarez, BSN, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Harry Adynski
- Harry Adynski, PhD, RN, PMH-BC, University of California San Francisco, San Francisco, CA, USA
| | - Rebeca Harris
- Rebeca Harris BSN, RN, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Baiming Zou
- Baiming Zou, PhD, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacquelyn Y Taylor
- Jacquelyn Y. Taylor, PhD, RN, FAHA, FAAN, Columbia University, New York, NY, USA
| | - Hudson P Santos
- Hudson P. Santos Jr, PhD, RN, FAAN, University of Miami, Coral Gables, FL, USA
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Williams KKA, Baidoobonso S, Haggerty J, Lofters A, Adams AM. Anti-Black discrimination in primary health care: a qualitative study exploring internalized racism in a Canadian context. ETHNICITY & HEALTH 2024; 29:343-352. [PMID: 38332736 DOI: 10.1080/13557858.2024.2311429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVES A growing body of evidence points to persistent health inequities within racialized minority communities, and the effects of racial discrimination on health outcomes and health care experiences. While much work has considered how anti-Black racism operates at the interpersonal and institutional levels, limited attention has focused on internalized racism and its consequences for health care. This study explores patients' attitudes towards anti-Black racism in a Canadian health care system, with a particular focus on internalized racism in primary health care. DESIGN This qualitative study employed purposive maximal variation and snowball sampling to recruit and interview self-identified Black persons aged 18 years and older who: (1) lived in Montréal during the COVID-19 pandemic, (2) could speak English or French, and (3) were registered with the Québec health insurance program. Adopting a phenomenological approach, in-depth interviews took place from October 2021 to July 2022. Following transcription, data were analyzed thematically. RESULTS Thirty-two participants were interviewed spanning an age range from 22 years to 79 years (mean: 42 years). Fifty-nine percent of the sample identified as women, 38% identified as men, and 3% identified as non-binary. Diversity was also reflected in terms of immigration experience, financial situation, and educational attainment. We identified three major themes that describe mechanisms through which internalized racism may manifest in health care to impact experiences: (1) the internalization of anti-Black racism by Black providers and patients, (2) the expression of anti-Black prejudice and discrimination by non-Black racialized minority providers, and (3) an insensitivity towards racial discrimination. CONCLUSION Our study suggests that multiple levels of racism, including internalized racism, must be addressed in efforts to promote health and health care equity among racialized minority groups, and particularly within Black communities.
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Affiliation(s)
| | - Shamara Baidoobonso
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montréal, Canada
| | - Aisha Lofters
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, Canada
| | - Alayne M Adams
- Department of Family Medicine, McGill University, Montréal, Canada
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Chen CK, Keefe JR, Srinivasan R. Recommendations for Dynamic Treatment of Identity-Based Trauma: Opening the "I" to Reflection. Am J Psychother 2024; 77:15-22. [PMID: 37853715 DOI: 10.1176/appi.psychotherapy.20220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Current treatments for trauma are ineffective for many patients. For traumas involving violence that targets aspects of patients' identities, treatments that do not address systemic factors involved in the trauma (e.g., past and ongoing experiences of identity-based oppression and marginalization, developmental sequelae of invalidation or policing of identity, and identity-related patterns of transference and countertransference) may be ineffective. Psychodynamic approaches can flexibly address the identity-related dynamics between therapist and patient and incorporate patients' experiences of their various identities, in the context of trauma, into clinical formulation and treatment. The authors present concepts relevant to the dynamics of intersectional identities that may arise between therapist and patient and provide a case study illustrating how a patient's various identities affect their symptom manifestation and treatment course. The authors advocate for cultural humility and self-exploration of biases and assumptions among clinicians, because therapists do not hold expert knowledge of their patients' cultural experiences.
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Affiliation(s)
- Cory K Chen
- Department of Psychology, Long Island University, Brooklyn, New York City (Chen); Department of Veterans Affairs (VA) New York Harbor Healthcare System, New York City (Chen, Srinivasan); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Keefe); Department of Psychiatry, New York University, New York City (Srinivasan)
| | - John R Keefe
- Department of Psychology, Long Island University, Brooklyn, New York City (Chen); Department of Veterans Affairs (VA) New York Harbor Healthcare System, New York City (Chen, Srinivasan); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Keefe); Department of Psychiatry, New York University, New York City (Srinivasan)
| | - Ranjana Srinivasan
- Department of Psychology, Long Island University, Brooklyn, New York City (Chen); Department of Veterans Affairs (VA) New York Harbor Healthcare System, New York City (Chen, Srinivasan); Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, New York City (Keefe); Department of Psychiatry, New York University, New York City (Srinivasan)
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Hill-Jarrett TG, Choi M, Buto PT, Miramontes S, Thomas MD, Yang Y, Kim MH, Sims KD, Glymour MM. Associations of Everyday and Lifetime Experiences of Discrimination With Willingness to Undergo Alzheimer Disease Predictive Testing. Neurology 2024; 102:e208005. [PMID: 38266219 DOI: 10.1212/wnl.0000000000208005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/13/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Rapid developments in Alzheimer disease (AD) biomarker research suggest that predictive testing may become widely available. To ensure equal access to AD predictive testing, it is important to understand factors that affect testing interest. Discrimination may influence attitudes toward AD testing, particularly among racially and ethnically minoritized populations, because of structural racism in health care systems. This study examined whether everyday or lifetime discrimination experiences shape interest in AD predictive testing. METHODS In the 2010 and 2012 biennial Health and Retirement Study waves, respondents were randomly selected to complete questions on interest in receiving free testing that could determine whether they would develop AD in the future. The exposures were everyday discrimination (6 items) and lifetime discrimination (7 items); both were transformed into a binary variable. Logistic regression models predicting interest in AD testing were controlled for deciles of propensity scores for each discrimination measure. Odds ratios were re-expressed as risk differences (RDs). RESULTS Our analytic sample included 1,499 respondents. The mean age was 67 (SD = 10.2) years, 57.4% were women, 65.7% were White, and 80% endorsed interest in AD predictive testing. Most of the participants (54.7%) experienced everyday discrimination in at least one domain; 24.1% experienced major lifetime discrimination in at least one domain. Those interested in predictive testing were younger (66 vs 70 years) and more likely to be Black (20% vs 15%) or Latinx (14% vs 8%) than participants uninterested in testing. The probability of wanting an AD test was not associated with discrimination for Black (RD everyday discrimination = -0.026; 95% CI [-0.081 to 0.029]; RD lifetime discrimination = -0.012; 95% CI [-0.085 to 0.063]) or Latinx (RD everyday discrimination = -0.023, 95% CI [-0.082 to 0.039]; RD lifetime discrimination = -0.011; 95% CI [-0.087 to 0.064]) participants. DISCUSSION Despite historical and contemporary experiences of discrimination, Black and Latinx individuals express interest in AD testing. However, Black and Latinx individuals remain underrepresented in AD research, including research on AD testing. Interest in personalized information about dementia risk may be a pathway to enhance their inclusion in research and clinical trials.
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Affiliation(s)
- Tanisha G Hill-Jarrett
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Minhyuk Choi
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Peter T Buto
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Silvia Miramontes
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Marilyn D Thomas
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Yulin Yang
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Min Hee Kim
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Kendra D Sims
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - M Maria Glymour
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
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De Jesús-Romero R, Holder-Dixon AR, Buss JF, Lorenzo-Luaces L. Race, Ethnicity, and Other Cultural Background Factors in Trials of Internet-Based Cognitive Behavioral Therapy for Depression: Systematic Review. J Med Internet Res 2024; 26:e50780. [PMID: 38300699 PMCID: PMC10870215 DOI: 10.2196/50780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/05/2023] [Accepted: 11/16/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND There is a growing interest in developing scalable interventions, including internet-based cognitive behavioral therapy (iCBT), to meet the increasing demand for mental health services. Given the growth in diversity worldwide, it is essential that the clinical trials of iCBT for depression include diverse samples or, at least, report information on the race, ethnicity, or other background indicators of their samples. Unfortunately, the field lacks data on how well diversity is currently reported and represented in the iCBT literature. OBJECTIVE Thus, the main objective of this systematic review was to examine the overall reporting of racial and ethnic identities in published clinical trials of iCBT for depression. We also aimed to review the representation of specific racial and ethnic minoritized groups and the inclusion of alternative background indicators such as migration status or country of residence. METHODS Studies were included if they were randomized controlled trials in which iCBT was compared to a waiting list, care-as-usual, active control, or another iCBT. The included papers also had to have a focus on acute treatment (eg, 4 weeks to 6 months) of depression, be delivered via the internet on a website or a smartphone app and use guided or unguided self-help. Studies were initially identified from the METAPSY database (n=59) and then extended to include papers up to 2022, with papers retrieved from Embase, PubMed, PsycINFO, and Cochrane (n=3). Risk of bias assessment suggested that reported studies had at least some risk of bias due to use of self-report outcome measures. RESULTS A total of 62 iCBT randomized controlled trials representing 17,210 participants are summarized in this study. Out of those 62 papers, only 17 (27%) of the trials reported race, and only 12 (19%) reported ethnicity. Reporting outside of the United States was very poor, with the United States accounting for 15 (88%) out of 17 of studies that reported race and 9 (75%) out of 12 for ethnicity. Out of 3,623 participants whose race was reported in the systematic review, the racial category reported the most was White (n=2716, 74.9%), followed by Asian (n=209, 5.8%) and Black (n=274, 7.6%). Furthermore, only 25 (54%) out of the 46 papers conducted outside of the United States reported other background demographics. CONCLUSIONS It is important to note that the underreporting observed in this study does not necessarily indicate an underrepresentation in the actual study population. However, these findings highlight the poor reporting of race and ethnicity in iCBT trials for depression found in the literature. This lack of diversity reporting may have significant implications for the scalability of these interventions.
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Affiliation(s)
- Robinson De Jesús-Romero
- Department of Psychological and Brain Sciences, Indiana University - Bloomington, Bloomington, IN, United States
| | - Amani R Holder-Dixon
- Department of Psychological and Brain Sciences, Indiana University - Bloomington, Bloomington, IN, United States
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - John F Buss
- Department of Psychological and Brain Sciences, Indiana University - Bloomington, Bloomington, IN, United States
| | - Lorenzo Lorenzo-Luaces
- Department of Psychological and Brain Sciences, Indiana University - Bloomington, Bloomington, IN, United States
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Bird CM, Kate Webb E, Cole SW, Tomas CW, Knight JM, Timmer-Murillo SC, Larson CL, deRoon-Cassini TA, Torres L. Experiences of racial discrimination and adverse gene expression among black individuals in a level 1 trauma center sample. Brain Behav Immun 2024; 116:229-236. [PMID: 38070623 PMCID: PMC10872243 DOI: 10.1016/j.bbi.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/28/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023] Open
Abstract
Up to 40 % of individuals who sustain traumatic injuries are at risk for posttraumatic stress disorder (PTSD) and the conditional risk for developing PTSD is even higher for Black individuals. Exposure to racial discrimination, including at both interpersonal and structural levels, helps explain this health inequity. Yet, the relationship between racial discrimination and biological processes in the context of traumatic injury has yet to be fully explored. The current study examined whether racial discrimination is associated with a cumulative measure of biological stress, the gene expression profile conserved transcriptional response to adversity (CTRA), in Black trauma survivors. Two-weeks (T1) and six-months (T2) post-injury, Black participants (N = 94) provided a blood specimen and completed assessments of lifetime racial discrimination and PTSD symptoms. Mixed effect linear models evaluated the relationship between change in CTRA gene expression and racial discrimination while adjusting for age, gender, body mass index (BMI), smoking history, heavy alcohol use history, and trauma-related variables (mechanism of injury, lifetime trauma). Results revealed that for individuals exposed to higher levels of lifetime racial discrimination, CTRA significantly increased between T1 and T2. Conversely, CTRA did not increase significantly over time in individuals exposed to lower levels of lifetime racial discrimination. Thus, racial discrimination appeared to lead to a more sensitized biological profile which was further amplified by the effects of a recent traumatic injury. These findings replicate and extend previous research elucidating the processes by which racial discrimination targets biological systems.
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Affiliation(s)
| | - E Kate Webb
- McLean Hospital, Division of Depression and Anxiety Disorders, Belmont, MA USA; Harvard Medical School, Department of Psychiatry, Boston, MA USA
| | - Steven W Cole
- Cousins Center for Psychoneuroimmunology, Jane & Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, USA
| | - Carissa W Tomas
- Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, WI, USA
| | - Jennifer M Knight
- Department of Trauma and Surgery, Medical College of Wisconsin, WI, USA
| | | | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Lucas Torres
- Department of Psychology, Marquette University, Milwaukee, WI, USA
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Song J. Patterns of Adverse Childhood Experiences and Psychiatric Disorders Among Adolescents with ADHD: A Latent Class Analysis. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01645-3. [PMID: 38110757 DOI: 10.1007/s10578-023-01645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/20/2023]
Abstract
There is limited existing research on whether specific combinations of Adverse Childhood Experiences (ACEs) are associated with different psychiatric disorders among adolescents with ADHD. This study aimed to address this gap by identifying classes of ACEs and examining their association with behavioral problems, anxiety, and depression in adolescents with ADHD aged 11-17 (n = 1,806), using data from the 2018 National Survey of Children's Health (NSCH). A latent class analysis revealed a four-class solution: (1) low-risk ACEs (61.6%), (2) moderate-risk ACEs (25.2%), (3) high discrimination and neighborhood violence exposure (7.6%), and (4) high-risk ACEs (5.6%). The "high-risk ACEs" and the "high discrimination and neighborhood violence exposure" class showed a higher likelihood of behavioral problems and depression, and anxiety and depression respectively. These findings provide some insight into the ACE patterns that are more likely to be associated with mental health problems among adolescents with ADHD.
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Affiliation(s)
- Jihee Song
- Florida Department of Children and Families, Tallahassee, FL, 32303, USA.
- Department of Family, Youth, and Community Sciences, University of Florida, Gainesville, FL, 32611, USA.
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11
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Herres J, Ortelli O, Rodriguez I, Onyewuenyi AC. Factors associated with perceived stress and depressive symptoms among college students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-12. [PMID: 38015144 DOI: 10.1080/07448481.2023.2266039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/24/2023] [Indexed: 11/29/2023]
Abstract
The COVID-19 pandemic had detrimental effects on college students' psychosocial well-being due to campus closures starting in Spring 2020. This study examined changes in perceived stress and depressive symptoms before and during the pandemic using longitudinal data collected from students over the 2019-2020 academic year. We also compared data from this sample in Fall 2019 (N = 282) to data collected from another sample in Fall 2020 (N = 240). Latent change modeling showed increases in stress during Spring 2020. Additionally, the Fall 2020 sample had higher levels of stress than the Fall 2019 sample. Differences in stress and depressive symptoms did not depend on underrepresented minority (URM) status, income, gender, or membership in Greek life or other organizations. However, third- and fourth-year students and student-athletes experienced more stress during the pandemic. Findings suggest an adverse and differential impact of the pandemic on students' psychosocial well-being.
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Affiliation(s)
- Joanna Herres
- Department of Psychology, The College of New Jersey, Ewing, NJ, USA
| | - Olivia Ortelli
- Department of Psychology, The College of New Jersey, Ewing, NJ, USA
| | - Isabel Rodriguez
- Department of Psychology, The College of New Jersey, Ewing, NJ, USA
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12
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Kane VA, Andrikopoulou M, Bertozzi-Villa C, Mims J, Pinson K, Gyamfi-Bannerman C. Low-dose aspirin and racial disparities in spontaneous preterm delivery in low-risk individuals. AJOG GLOBAL REPORTS 2023; 3:100273. [PMID: 38034022 PMCID: PMC10682009 DOI: 10.1016/j.xagr.2023.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Preterm birth is a leading cause of perinatal morbidity and mortality. There are significant racial disparities in the rates of preterm delivery in the United States, with Black individuals at disproportionately higher risk than their White counterparts. Although low-dose aspirin is currently under investigation for reducing the rates of preterm delivery, limited data are available on how the use of low-dose aspirin might affect racial and ethnic disparities in the rates of preterm delivery. OBJECTIVE Our group and others have shown that low-dose aspirin decreases spontaneous preterm delivery in low-risk parturients. This study aimed to examine whether the relationship between low-dose aspirin and the risk of spontaneous preterm delivery is modified by race and ethnicity. STUDY DESIGN This was a secondary analysis of a randomized clinical trial examining low-dose aspirin for preeclampsia prevention in low-risk nulliparous individuals. The parent trial defined low risk as the absence of preexisting hypertension or other medical comorbidities. Participants received 60-mg aspirin or placebo between 13 and 25 weeks of gestation. Here, multiple pregnancies, fetal anomalies, terminations or abortions at <20 weeks of gestation, and participants with previous miscarriages were excluded. Our exposure, race and ethnicity, was self-reported in the parent trial and categorized as non-Hispanic White, Hispanic, non-Hispanic Black, and other. The primary outcome was spontaneous preterm delivery at <34 weeks of gestation; the secondary outcomes included spontaneous preterm delivery at <37 weeks of gestation and all preterm deliveries at <34 and <37 weeks of gestation. Fit logistic regression models were used to examine how the use of low-dose aspirin modified the relationship between race and ethnicity and preterm delivery, adjusting for confounders. Furthermore, sensitivity analyses were performed to compare the rates of preterm delivery by race and ethnicity. RESULTS Of note, 2528 of 3171 parent study participants were included in this analysis. Of the participants, 425 (16.8%) were White, 819 (32.4%) were Hispanic, 1265 (50%) were Black, and 19 (0.8%) were other. The baseline characteristics differed among racial and ethnic groups, including maternal age, body mass index, education level, marital status, tobacco and alcohol use, and pregnancy loss. The rate of spontaneous preterm delivery at <34 weeks of gestation was significantly higher in Black participants (2.8%) than in White (1.2%) and Hispanic (1.2%) participants (P=.04). Logistical regression analysis showed that Black race was no longer an independent risk factor for spontaneous preterm delivery at <34 weeks of gestation when controlling for low-dose aspirin (adjusted odds ratio, 1.71; 95% confidence interval, 0.67-4.40). A similar pattern was found for spontaneous preterm delivery at <37 weeks of gestation and preterm delivery at <34 and <37 weeks of gestation. In our sensitivity analyses, spontaneous preterm delivery at <34 weeks of gestation differed by race and ethnicity in the placebo group (P=.01) but did not differ in the low-dose aspirin group (P=.90). CONCLUSION The use of low-dose aspirin mitigated racial disparities in spontaneous preterm delivery at <34 weeks of gestation. Additional investigation is warranted to assess the reproducibility of our findings.
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Affiliation(s)
- Veronica A. Kane
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY (Ms Kane)
| | - Maria Andrikopoulou
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY (Drs Andrikopoulou and Bertozzi-Villa)
| | - Clara Bertozzi-Villa
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY (Drs Andrikopoulou and Bertozzi-Villa)
- Department of Obstetrics and Gynecology and Women's Health, Montefiore Medical Center, Bronx, NY (Dr Bertozzi-Villa)
| | - Joseph Mims
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego Health, La Jolla, CA (Drs Mims, Pinson, and Gyamfi-Bannerman)
| | - Kelsey Pinson
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego Health, La Jolla, CA (Drs Mims, Pinson, and Gyamfi-Bannerman)
| | - Cynthia Gyamfi-Bannerman
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego Health, La Jolla, CA (Drs Mims, Pinson, and Gyamfi-Bannerman)
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13
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Scott K, Poondru S, Jackson KL, Kundu RV. The need for greater skin of color training: perspectives from communities of color. Arch Dermatol Res 2023; 315:2441-2444. [PMID: 37166525 DOI: 10.1007/s00403-023-02635-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 02/21/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Abstract
More than half of the population will belong to a minority group by the year 2044. Further research needs to be done into the perceptions of those with skin of color regarding their dermatologic care. This study assessed the perceptions and preferences of communities of color regarding the care of their skin and hair. An anonymous, cross-sectional, multiple-choice, online survey was administered from August through October 2021. Participants were recruited using ResearchMatch, a national volunteer health registry supported by the US National Institutes of Health. Eligibility criteria included being 18 years or older, identifying with at least one racial/ethnic group within skin of color, and living in the United States. A total of 547 participants completed the survey, 463 women (84.6%) and 84 men (15.4%) with a mean (standard deviation) age of 44.1 (15.4) years. 301 self-identified as Black (55.0%), 84 Latinx (15.4%), 90 Asian (16.5%), and 72 Multiracial (13.2%). Participants did not feel like dermatologists are trained to treat skin of color (69.5%, n = 380) or ethnic hair (75.1%, n = 411). Participants believed that all dermatologists should have training in skin of color (92.3%, n = 505) and would be more likely to see a dermatologist if they had skin of color training (80.1%, n = 438) as they felt dermatologists who have skin of color training are better equipped to treat their conditions (67.1%, n = 367). Participants were more comfortable receiving treatment at clinics that specialize in skin of color (75.1%, n = 411), but overwhelmingly had never heard of skin of color clinics (94.1%, n = 515). Participants were willing to contribute non-identifiable photos (96.3%, n = 527) and stories about skin and hair diseases (94.1%, n = 515) to create skin of color resources to train dermatologists. Overall, perceptions of communities of color on dermatologic care need to be improved. Greater skin of color training including all races/ethnicities and skin tones is imperative, and greater visibility and resources should also be put into skin of color clinics and formal skin of color research.
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Affiliation(s)
- Kourtney Scott
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St Ste 1600, Chicago, IL, 60611, USA
| | - Sneha Poondru
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St Ste 1600, Chicago, IL, 60611, USA
| | - Kathryn L Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Roopal V Kundu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St Ste 1600, Chicago, IL, 60611, USA.
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14
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Hunter EA, Meyer JM, Brown GM, Hanks MA. Stress indicators in minorities with multiple sclerosis. Mult Scler Relat Disord 2023; 78:104914. [PMID: 37499341 DOI: 10.1016/j.msard.2023.104914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/12/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
Black Americans with multiple sclerosis (MS) experience higher levels of disease-related disability compared to White Americans (Marrie et al., 2006). Comorbidities such as depression and anxiety, which are underdiagnosed and undertreated in this population, negatively impact quality of life and treatment outcomes for people living with multiple sclerosis (plwMS) (D'Alisa et al., 2006; Marrie et al., 2009; Stepleman et al., 2014). Acts of discrimination toward Black Americans is associated with stress, which is a contributing factor for depression (Carter, 2017; Nadimpalli, 2015; Williams and Mohammed, 2009). This study compared the severity of multiple sclerosis symptoms amongst Black Americans and White Americans, and whether worsened MS symptoms in Black Americans are associated with increased experiences of discrimination. Data was analyzed from 143 plwMS in the Stress Indicators in Minorities with Multiple Sclerosis (SiMMS) study. Using the Mann-Whitney U test, significant differences were found on the NIH Emotional Distress - Anxiety measure (U = 1466.500, p = 0.045) and NIH Sleep Disturbance measure (U = 1467.000, p = 0.044) between the Black participant and the White participant groups. Discrimination was significantly correlated with both NIH Emotional Distress - Anxiety (r = 0.677, p < .001) and NIH Sleep Disturbance (r = 0.446, p = .007) in Black MS individuals. Additionally, several physiological condition and psychological outcome measures were correlated with the NIH Emotional Distress - Anxiety and NIH Sleep Disturbance measures. This study contributes to literature highlighting the negative impacts of discrimination and race related stress on the physical and mental health of Black Americans.
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Affiliation(s)
- Evelyn A Hunter
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States.
| | - J M Meyer
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| | - G M Brown
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
| | - M A Hanks
- Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, United States
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15
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Espinosa A, Ruglass LM, Conway FN. The relative contribution of ethnic identity and ethnic discrimination on alcohol, tobacco, and other drug use disorders among Hispanic/Latin American individuals. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:208963. [PMID: 37654011 DOI: 10.1016/j.josat.2023.208963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/09/2022] [Accepted: 01/17/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Racial/ethnic discrimination and ethnic identity, the affiliation and connection to one's ethnic group, are important for understanding alcohol, tobacco, and drug use disorders (AUD, TUD, DUD, respectively) among Hispanic/Latin American individuals. Although discrimination is a well-recognized risk factor, the role of ethnic identity is less understood. Moreover, no study has examined which of these factors is more important for informing AUD, TUD, and DUD. This information is necessary for creating effective prevention and treatment programs tailored for Hispanic/Latin American people. Herein we examined the role and relative importance of racial/ethnic discrimination and Hispanic ethnic identity on past year AUD, TUD, and DUD. METHODS Hispanic/Latin American participants of the National Epidemiologic Survey on Alcohol and Related Conditions-III constituted the sample for this cross-sectional secondary data analysis. Participants (N = 7037) were 39.93 years old on average (SD = 15.32). More than half were female (56.1 %) and had family incomes below the median household income in the United States (58.7 %). Most had national origins in North America (79.3 %), including US dependent territories and Mexico. Confirmatory factor analysis (CFA) verified the psychometric properties of the discrimination and Hispanic ethnic identity measures. Logistic regressions, supplemented with dominance analysis, estimated the role and relative contribution of discrimination and Hispanic ethnic identity on the probability of past year AUD, TUD, and DUD. RESULTS The CFAs yielded adequate convergent validity and reliability for each construct. More racial/ethnic discrimination and a higher Hispanic ethnic identity related to a higher and lower probability of AUD, TUD, and DUD, respectively. The magnitude of the association between Hispanic ethnic identity and the probability of TUD exceeded that of racial/ethnic discrimination, but the converse was the case for AUD and DUD. CONCLUSIONS Prevention and treatment programs for TUD that highlight the value of having a strong sense of self as a member of a Hispanic ethnic group, and that encourage the individual to explore their Hispanic ancestry may prove effective among Hispanic/Latin American individuals, particularly those who have experienced racial/ethnic discrimination. Programs for AUD and DUD tailored for Hispanic Latin/American adults should also incorporate coping strategies to address experiences with racial/ethnic discrimination.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, The City College of New York, CUNY, United States of America; Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, United States of America.
| | - Lesia M Ruglass
- Department of Psychology, The City College of New York, CUNY, United States of America; Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, NJ, United States of America
| | - Fiona N Conway
- Steve Hicks School of Social Work, The University of Texas at Austin, United States of America
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Xiao Z, Zeng L, Pan PL, Lee J, Wu A. Racism, self-rated general health status, and health-related quality of life among Black and Asian Americans. Health Mark Q 2023; 40:458-481. [PMID: 37494547 DOI: 10.1080/07359683.2023.2238161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities. Extant research shows significant health inequities between white and Black people. However, little is known about health gaps between or among other racial groups. This study investigated how Blacks and Asian Americans perceive and experience racism in healthcare settings and in general daily life situations, and how these factors relate to their self-rated general health status and health-related quality of life. Findings from an online survey suggest strong similarities and subtle differences between the two racial groups and within the Asian subgroups.
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Affiliation(s)
- Zhiwen Xiao
- Valenti School of Communication, University of Houston, Houston, TX, USA
| | - Li Zeng
- School of Media and Journalism, Arkansas State University, Jonesboro, AR, USA
| | - Po-Lin Pan
- Communication, Arkansas State University, Jonesboro, AR, USA
| | - Jae Lee
- Valenti School of Communication, University of Houston, Houston, TX, USA
| | - Allen Wu
- Woodside Priory School, Portola Valley, CA, USA
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17
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Williams JC, Andreou A, Castillo EG, Neff J, Goldenberg M, Lee CR, Aysola J, Rohrbaugh R, Isom J. Antiracist Documentation Practices - Shaping Clinical Encounters and Decision Making. N Engl J Med 2023; 389:1238-1244. [PMID: 37754291 PMCID: PMC10617745 DOI: 10.1056/nejmms2303340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- J Corey Williams
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Ashley Andreou
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Enrico G Castillo
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Joshua Neff
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Matthew Goldenberg
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Courtney R Lee
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Jaya Aysola
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Robert Rohrbaugh
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
| | - Jessica Isom
- From the Department of Psychiatry, Georgetown University, Washington, DC (J.C.W.); the Department of Psychiatry, Yale University, New Haven, CT (J.C.W., M.G., R.R.); the Department of Psychiatry, Columbia University, New York (A.A.); the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles (E.G.C.); the Department of Psychiatry, University of California, San Francisco, San Francisco (J.N.); the Leonard Davis Institute of Health Economics (C.R.L.) and the Department of Medicine, Perelman School of Medicine (J.A.), University of Pennsylvania, Philadelphia; and the Department of Behavioral Health, Codman Square Health Center, Boston (J.I.)
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Cook SH, Wood EP, Risner E, Weng CA, Xin Y. A national examination of discrimination, resilience, and depressive symptoms during the COVID-19 pandemic: the All of Us Research Program. Front Psychol 2023; 14:1175452. [PMID: 37823074 PMCID: PMC10562571 DOI: 10.3389/fpsyg.2023.1175452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
Objective To examine the impact of resilience on the association between discrimination and trajectories of depressive symptoms during the COVID-19 pandemic across racial and ethnic groups. Methods Data were drawn from 5 waves of the All of Us Research Program's survey on the impact of COVID-19 on the lives of American adults. Linear mixed-effects models were fitted to assess the association between discrimination exposure throughout the pandemic and depressive symptoms over time. An interaction term was introduced between resilience and discrimination exposure to assess if resilience buffered the association between discrimination and depressive symptoms over time. Race-stratified linear mixed-effects models examined racial/ethnic differences in the association between resilience, discrimination, and depressive symptoms over time. Results Fifty-one thousand nine hundred fifty-eight participants completed surveys between May and December of 2020. Results indicated that exposure to more discrimination was associated with increasing trajectories of depressive symptoms over time (b = 0.48, p < 0.001). However, resilience moderated the association between discrimination and well-being over time such that higher resilience mitigated the detrimental effect of experiencing discrimination on depressive symptoms across time (b = -0.02, p < 0.001). Conclusion Identifying protective features such as resilience can promote the development of culturally tailored interventions to address mental health in the context of discrimination.
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Affiliation(s)
- Stephanie H. Cook
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Erica P. Wood
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, United States
| | - Emma Risner
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Chenziheng Allen Weng
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
| | - Yao Xin
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, United States
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Green CA. Racism as a Public Health Issue for Nurses of Color in Clinical and Academic Settings: Ten Nurses Tell Their Stories. Nurs Educ Perspect 2023; 44:279-284. [PMID: 37594419 DOI: 10.1097/01.nep.0000000000001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
AIM The aim of this study was to bring awareness to how racism and discrimination, accompanied by bullying and incivility, negatively impact the health of nurses of color. BACKGROUND Racism and discrimination encountered in the daily lives of nurses of color present risk for psychological and physiological damage to their health. Repeated exposure to racism and discrimination leads to cumulative stress that may pose a negative impact on the health status of affected nurses. METHODS Phenomenology served as the methodology for this research study. The principal investigator transcribed and coded data from 10 nurse participants. RESULTS Data illustrate a pattern of nurses of color experiencing discrimination and racism, with racism being a potential public health issue. Their stories may empower others to make positive, productive decisions and persevere. CONCLUSION Long-term exposure to racism and its related potential effects on nurses' health presents a grave concern for nurses of color.
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Affiliation(s)
- Cheryl Ann Green
- About the Author Cheryl Ann Green, PhD, DNP, RN, LCSW, CNE, is DNP chair and committee member, Abilene Christian University, Abilene, Texas.For more information, contact her at
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Baiden P, Onyeaka HK, Aneni K, Wood B, LaBrenz CA, Muoghalu C, Peoples JE, Szlyk HS, Gobodzo EC, Baiden JF, Adeku Y, Mets VE, Brown FA, Cavazos-Rehg P. Perceived racial discrimination and polysubstance use among racial/ethnic minority adolescents in the United States. Drug Alcohol Depend 2023; 248:109894. [PMID: 37167795 PMCID: PMC11003345 DOI: 10.1016/j.drugalcdep.2023.109894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/28/2023] [Accepted: 04/20/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Polysubstance use among adolescents is a significant public health concern, yet most studies on adolescent substance use focus on a singular substance. This study is one of the first to investigate the association between perceived racial discrimination (PRD) in school and polysubstance use among racial/ethnic minority adolescents using a nationally representative sample. METHODS Data was from the 2021 Adolescent Behaviors and Experiences Survey. The sample included 4145 racial/ethnic minority adolescents (52.8% female). Hierarchical binary logistic regression was used to examine the association between PRD in school and polysubstance use among racial/ethnic minority adolescents. RESULTS About 12% of racial/ethnic minority adolescents engaged in polysubstance use and 23.4% reported experiencing PRD in school sometimes/most of the time/always. Controlling for other factors, experiencing PRD in school sometimes/most of the time/always was associated with 1.52 times higher odds of polysubstance use when compared to adolescents who never experienced PRD in school (OR=1.52, p=.044, 95% CI=1.01-2.30). Cyberbullying victimization, symptoms of depression, and being emotionally abused by a parent during COVID-19 were also associated with polysubstance use. CONCLUSION Controlling for demographic characteristics and psychosocial stressors, PRD in school was significantly associated with higher odds of polysubstance use among racial/ethnic minority adolescents. The findings of this study could inform clinicians and policymakers of the association between PRD in school and polysubstance use, which could contribute to early identification of polysubstance use among racial/ethnic minority adolescents.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA.
| | - Henry K Onyeaka
- Harvard Medical School, Department of Psychiatry, Boston, MA02115, USA; Massachusetts General Hospital, Department of Psychiatry, Boston, MA02115, USA; McLean Hospital, Department of Psychiatry, Boston, MA02478, USA
| | | | - Bethany Wood
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Catherine A LaBrenz
- The University of Texas at Arlington, School of Social Work, 501 W. Mitchell St., Box 19129ArlingtonTX76019USA
| | - Chioma Muoghalu
- Plains Regional Medical Center, Clovis, New Mexico, NM88101, USA
| | - JaNiene E Peoples
- The Brown School at Washington University in St. Louis, One Brookings Drive, St. Louis, MO63130, USA
| | - Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
| | | | - John F Baiden
- East Airport International School, P.O. Box KAPM 57, KIA, Accra, Ghana
| | - Yvonne Adeku
- Western University, Department of Sociology, Social Science Centre, Room 5306, London, OntarioN6A 5C2, Canada
| | - Vera E Mets
- University of Ghana, Legon, Department of Social Work, P.O. Box LG 419, Legon, Accra, Ghana
| | - Fawn A Brown
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr, Box 19528, Arlington, TX76019, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Box 8134, St. Louis, MO63110, USA
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21
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Hong S, Walton B, Kim HW, Rhee TG. Predicting the Behavioral Health Needs of Asian Americans in Public Mental Health Treatment: A Classification Tree Approach. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:630-643. [PMID: 36988832 PMCID: PMC10052246 DOI: 10.1007/s10488-023-01266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
Given the fact that experiencing pandemic-related hardship and racial discrimination worsen Asian Americans' mental health, this study aimed to identify unique characteristics of behavioral health needs among Asian Americans (N = 544) compared to White Americans (N = 78,704) and Black Americans (N = 11,252) who received publicly funded behavioral health services in Indiana before and during the COVID-19 pandemic. We used 2019-2020 Adults Needs and Strengths Assessment (ANSA) data for adults eligible for Medicaid or funding from the state behavioral health agency. Chi-squared automatic interaction detection (CHAID) was used to detect race-specific differences among demographic variables, the pandemic status, and ANSA items. Results indicated that, regardless of age, gender, or pandemic status, Asian Americans who received behavioral health services, struggled more with cultural-related factors compared to White and Black individuals. Within this context, intersections among behavioral/emotional needs (psychosis), life functioning needs (involvement in recovery, residential stability, decision making, medical/physical health), and strengths (job history, interpersonal, and spiritual) further differentiated the mental health functioning of Asian from White and Black Americans. Classification tree algorithms offer a promising approach to detecting complex behavioral health challenges and strengths of populations based on race, ethnicity, or other characteristics.
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Affiliation(s)
- Saahoon Hong
- Indiana University School of Social Work, Indianapolis, IN, USA.
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA.
| | - Betty Walton
- Indiana University School of Social Work, Indianapolis, IN, USA
- Division of Mental Health and Addiction, Indiana Family and Social Services Administration, Indianapolis, IN, USA
| | - Hea-Won Kim
- Indiana University School of Social Work, Indianapolis, IN, USA
| | - Taeho Greg Rhee
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
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22
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Niu L, Zhang D, Shi L, Han X, Chen Z, Chen L, Wen M, Li H, Chen B, Li J, Su D, Li Y. Racial Discrimination and Sleep Quality during the COVID-19 Pandemic: Findings from the Health, Ethnicity, and Pandemic (HEAP) Study. J Urban Health 2023; 100:431-435. [PMID: 37382863 PMCID: PMC10323061 DOI: 10.1007/s11524-023-00743-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/30/2023]
Abstract
Previous research has documented the association between racial discrimination and poor sleep quality. However, few studies have examined this association during the COVID-19 pandemic when racial discrimination is on the rise due to structural injustice and racism against people of color. Using data from the Health, Ethnicity, and Pandemic (HEAP) Study, a nationally representative survey of US adults, we assessed the association between racial discrimination and sleep quality among overall adults and by race and ethnicity. We found that racial discrimination during the pandemic was significantly associated with higher risks of poor sleep quality among non-Hispanic Black (OR = 2.19, 95% CI: 1.13-4.25) and Asian (OR = 2.75, 95% CI: 1.53-4.94) participants, but not among the other groups. The results suggested that sleep quality among Black and Asian populations may have been disproportionately affected by racial discrimination during the pandemic. Further study is needed to assess the causal relationship between racial discrimination and sleep quality.
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Affiliation(s)
- Li Niu
- Department of Psychology, Beijing Normal University, Beijing, China
| | - Donglan Zhang
- Department of Foundations of Medicine, New York University Long Island School of Medicine, Long Island, NY, USA
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Xuesong Han
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Hongmei Li
- Department of Media, Journalism and Film, Miami University, Oxford, OH, USA
| | - Baojiang Chen
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, CA, USA
| | - Dejun Su
- Center for Reducing Health Disparities, Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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23
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Schick MR, Nalven T, Egan A, Spillane NS. The role of culture in the association between racial discrimination and alcohol use among North American Indigenous adolescents reporting recent drinking. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1109-1118. [PMID: 37095073 PMCID: PMC10289135 DOI: 10.1111/acer.15088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND North American Indigenous (NAI) communities have identified alcohol use as a primary health concern. Experiences of racial discrimination are associated with greater alcohol use, but findings are mixed regarding the role of culture in this relationship. The goal of the present study was to examine the role of culture in the association between racial discrimination and alcohol use. METHODS Across two studies (Study 1: N = 52; Study 2: N = 1743), NAI adolescents living on or near NAI reservations who reported recent alcohol use completed self-report measures of racial discrimination, cultural affiliation, and alcohol use (e.g., frequency). RESULTS Bivariate correlations revealed a significant positive association between racial discrimination and alcohol use (Study 1: r = 0.31, p = 0.029; Study 2: r = 0.14, p < 0.001) but not between cultural affiliation and alcohol use. Racial discrimination and cultural affiliation were significantly positively correlated in Study 1 (r = 0.18, p < 0.001), but not in Study 2. Across both studies, the interactions between racial discrimination and cultural affiliation significantly predicted alcohol use in unadjusted models (Study 1: b = 0.70, SE = 0.32, p = 0.033, 95% CI [0.06, 1.33]; Study 2: b = 0.01, SE = 0.01, p = 0.041, 95% CI [0.001, 0.03]), such that the association between racial discrimination and alcohol use was stronger for adolescents reporting high (vs. low) levels of cultural affiliation. In adjusted models controlling for age and sex, the interaction between racial discrimination and cultural affiliation remained significant in Study 2 (b = 0.01, SE = 0.01, p = 0.0496, 95% CI [0.00002, 0.03]) but was no longer significant in Study 1. CONCLUSIONS Findings speak to the need to reduce racial discrimination against NAI youth and to consider youths' different needs based on level of cultural affiliation to reduce subsequent alcohol consumption.
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Affiliation(s)
- Melissa R. Schick
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Tessa Nalven
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI
| | - Alana Egan
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI
| | - Nichea S. Spillane
- PATHS Lab, University of Rhode Island Department of Psychology, Kingston, RI
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Dong S, Campbell A, Shadden P, Massie JD. Racial Identity and Mindfulness as Predictors of Posttraumatic Growth in Black Adults Experiencing Race-Based Trauma. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2023; 45:1-19. [PMID: 37359034 PMCID: PMC10155663 DOI: 10.1007/s10447-023-09509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 06/28/2023]
Abstract
Racial discrimination and race-based trauma (RBT) have led to the development of various negative psychological and physiological effects among Black adults in the USA. There is a lack of understanding in relation to how various psychosocial factors influence posttraumatic growth (PTG) in the context of RBT among Black adults. The authors examined associations of RBT, racial identity, and mindfulness with PTG among Black adults while controlling for gender, household income, and duration of trauma. The sample consisted of 134 self-identified Black adults who met the criteria for RBT from the USA. The hierarchical regression analysis showed the final model with all the predictors accounted for 35% of the total variance of PTG, with racial identity and mindfulness facets accounting for 26% of the variance. The study provides a foundation for future research addressing RBT and promoting PTG in Black adults.
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Affiliation(s)
- Shengli Dong
- Department of Educational Psychology and Learning Systems, College of Education, Florida State University, 1114 W. Call Street, Tallahassee, FL 32303 USA
| | - Amanda Campbell
- Department of Educational Psychology and Learning Systems, College of Education, Florida State University, 1114 W. Call Street, Tallahassee, FL 32303 USA
| | - Paige Shadden
- Department of Educational Psychology and Learning Systems, College of Education, Florida State University, 1114 W. Call Street, Tallahassee, FL 32303 USA
| | - Jada Devonn Massie
- Department of Educational Psychology and Learning Systems, College of Education, Florida State University, 1114 W. Call Street, Tallahassee, FL 32303 USA
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25
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Muruthi JR, Muruthi BA, Thompson Cañas RE, Romero L, Taiwo A, Ehlinger PP. Daily discrimination, church support, personal mastery, and psychological distress in black people in the United States. ETHNICITY & HEALTH 2023; 28:503-521. [PMID: 35733281 DOI: 10.1080/13557858.2022.2078481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE This study used the stress process model to test the mediating effects of personal mastery and moderating effects of church-based social support on the relationship between daily discrimination and psychological distress across three age groups of African American and Afro-Caribbean adults. METHODS Using a national sample of 5008 African Americans and Afro-Caribbean adults from the National Survey of American Life Study, this study employs structural equation modeling to investigate the relationships between daily discrimination, personal mastery, church-based social support, and psychological distress. RESULTS Daily discrimination was an independent predictor of psychological distress across all groups. Group- and age-specific comparisons revealed significant differences in the experience of daily discrimination and psychological distress. Mastery was a partial mediator of the relationship between discrimination and psychological distress among Afro-Caribbeans while church support was a significant moderator only among the young and older African Americans. IMPLICATIONS Together, our study findings provide useful first steps towards developing interventions to reduce the adverse psychological impacts of daily discrimination on African Americans and Afro-Caribbeans. Intervention efforts such as individual psychotherapy aimed to improve Afro-Caribbean individuals' sense of mastery would be a partial solution to alleviating the adverse effects of discrimination on their psychological health.
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Affiliation(s)
- James R Muruthi
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Bertranna A Muruthi
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Reid E Thompson Cañas
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Lindsey Romero
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Abiola Taiwo
- Department of School Psychology, University of Oregon, Eugene, USA
| | - Peter P Ehlinger
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
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26
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Vincent W, Del Río-González AM, Neilands TB, Bowleg L. Resilience and Its Limits: The Roles of Individual Resilience, Social Capital, Racial Discrimination, and Binge Drinking on Sexual Behavior Among Black Heterosexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1419-1434. [PMID: 36512168 DOI: 10.1007/s10508-022-02488-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/21/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
In response to the increased recognition of racism as a public health crisis, we assessed links between racial discrimination and HIV-related risk behavior for Black men. Specifically, using survey data from 530 Black heterosexual men (18-44 years old, M = 31.0, SD = 7.8), we tested two moderated-mediation models: (1) a protective model, in which resilience and social capital protected against the indirect effect of racial discrimination on alcohol-related sexual behavior via binge drinking, and (2) a bounded model, in which racial discrimination limited the indirect effects of resilience and social capital on alcohol-related sexual behavior via binge drinking. We found support for the bounded model only. Specifically, resilience was indirectly associated with decreased alcohol-related sexual behavior via lower binge drinking when racial discrimination was low to moderately high, but not when racial discrimination was at its highest levels. Resilience was not directly associated with alcohol-related sexual behavior. Social capital was directly related to lower odds of alcohol-related sexual behavior. At high levels of racial discrimination, however, social capital was indirectly related to increased alcohol-related sexual behavior via binge drinking. High levels of racial discrimination limit beneficial effects of resilience on alcohol-related sexual behavior. Social capital maintains a beneficial effect if social bonds are not associated with binge-drinking norms or behaviors. Results highlight the limitations of individual-level resilience and the need to conceptualize and support resilience as a social-structural resource.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, USA.
| | | | - Torsten B Neilands
- Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, The George Washington University, Washington, DC, USA
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27
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Oakley LP, Li X, Tartof SY, Wilkes-Grundy M, Fassett MJ, Lawrence JM. Racial Disparities in Severe Maternal Morbidity in an Integrated Health Care System, Southern California, 2008-2017. Womens Health Issues 2023; 33:280-288. [PMID: 36740539 PMCID: PMC10213118 DOI: 10.1016/j.whi.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The study's objectives were to examine rates of severe maternal morbidity (SMM) over a 10-year period and assess racial/ethnic disparities in SMM among insured women in a large, integrated health care system in Southern California. METHODS We included Kaiser Permanente Southern California (KPSC) health plan members who gave birth at ≥20 weeks' gestation in a KPSC-owned hospital during 2008-2017. An SMM case was defined as presence of one or more indicators of an SMM event during a birth hospitalization, identified using maternal electronic health records. Crude SMM rates/10,000 births were calculated by year and maternal race/ethnicity. Modified Poisson regression models were used to assess the association between race/ethnicity and SMM adjusted for other maternal demographics, pregnancy characteristics, and preexisting conditions. RESULTS We identified 5,915 SMM cases among 335,310 births. Crude SMM rates increased from 94.7 per 10,000 in 2008 to 192.6 in 2015 and 249.5 in 2017. Non-Hispanic Black (adjusted risk ratio [aRR] 1.52; 95% confidence interval [CI] 1.37-1.69), Asian/Pacific Islander (aRR 1.29, 95% CI 1.18-1.41), and Hispanic (aRR 1.18, 95% CI 1.10-1.27) women had greater likelihood of SMM than non-Hispanic White women. After further adjusting for preexisting health conditions, differences in SMM by race/ethnicity remained. CONCLUSIONS SMM rates increased during 2008-2017 and women of racial and ethnic minority groups, particularly non-Hispanic Black women, were more likely to experience an SMM event than non-Hispanic White women. Multilevel approaches to understanding structural and social factors that may be associated with racial and ethnic disparities in SMM are needed to develop and test effective interventions to reduce SMM.
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Affiliation(s)
- Lisa P Oakley
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California.
| | - Xia Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Sara Y Tartof
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Madalynne Wilkes-Grundy
- Department of Family Medicine, Kaiser Permanente West Los Angeles Medical Center, Los Angeles California
| | - Michael J Fassett
- Department of Obstetrics and Gynecology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, California
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
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28
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Hennessy Garza R, Cho Y, Hlavka H, Weinhardt L, Yasin T, Smith S, Adler K, Otto K, Florsheim P. A Multi-Topic Bystander Intervention Program for Upper-Level Undergraduate Students: Outcomes in Sexual Violence, Racism, and High-Risk Alcohol Situations. JOURNAL OF INTERPERSONAL VIOLENCE 2023:8862605231165778. [PMID: 37102607 DOI: 10.1177/08862605231165778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Few bystander intervention trainings programs have evaluated behavioral outcomes in previously trained upper-level undergraduate students. Rigorous study designs are necessary to understand how multi-topic programs influence student outcomes to intervene against sexual violence, racism, and high-risk alcohol situations. A single-session bystander training for emphasizing communication strategies was developed for juniors and seniors on a private, Midwestern college campus. The training addressed sexual violence, racism, and high-risk alcohol situations and was evaluated using a randomized waitlist-control design in student-housing units. Online Qualtrics surveys were completed by 101 student participants (57 in the intervention group and 44 in the control group). Students responded to nine harm scenarios involving sexual violence, racism, and high-risk alcohol situations at baseline and 7 weeks follow-up. Between-group changes in scores were compared to determine the effect of the program on students' (a) readiness to intervene; (b) confidence to intervene; (c) bystander behaviors among students who witnessed actual or potentially harmful events; and (d) bystander reports of their experiences. Qualitative analysis assessed how the program influenced the use of positive verbal communication strategies. Program effects increased positive bystander experiences when helping someone who had too much to drink and needed assistance. Over time both groups reported increased confidence levels to intervene when someone intoxicated was being isolated with sexual intent. There were no further significant findings in readiness, confidence, behaviors, or other experiences, though some positive nonsignificant trends emerged. The program demonstrated little efficacy. Results suggest opportunities to improve bystander outcomes in low-risk primary prevention situations and racist scenarios, suggesting that targeted intervention of these outcomes may be useful when developing programming with previously-trained students. As universities expand prevention work beyond the first year, lessons learned may help inform multi-year programming across health topics to prevent harm and create healthier college campuses.
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Affiliation(s)
| | - Young Cho
- University of Wisconsin, Milwaukee, USA
| | | | | | | | - Sara Smith
- Marquette University, Milwaukee, WI, USA
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29
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Sullivan JM, Harman M. John Henryism Active Coping and COVID-19 policy compliance. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:1408-1426. [PMID: 36696690 DOI: 10.1002/jcop.23007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/17/2023] [Indexed: 06/17/2023]
Abstract
The aim of this paper is to examine whether the way one copes with stressful situations, as measured by John Henryism Active Coping (JHAC), influences behavioral responses to the pandemic, such as whether they engaged in mask wearing, social distancing, and hand washing. The data for this study come from the 2020 Blair Center Poll, which was conducted by the Blair Center of Southern Politics and Society at the University of Arkansas. Results show that high JHAC had a significant effect on COVID-19 policy compliance. Additionally, there was an interaction effect between JHAC and race on COVID-19 policy compliance. This effect was significant for only African Americans and Hispanics-not Whites. In other words, among African Americans and Hispanics, high JHAC had a significant effect on their compliance with COVID-19 policies. These findings suggest that coping structures policy compliance during the COVID-19 pandemic.
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Affiliation(s)
- Jas M Sullivan
- Department of Psychology, Political Science and African American Studies, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Moriah Harman
- Department of Political Science, Louisiana State University, Baton Rouge, Louisiana, USA
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Cela T, Marcelin LH, Waldman R, Dembo R, Demezier D, Clement R, Arcayos A, Santisteban D, Jean-Gilles M, Hogue A. Haitian and Haitian American experiences of racism and socioethnic discrimination in Miami-Dade county: At-risk and court-involved youth. FAMILY PROCESS 2023; 62:216-229. [PMID: 35272392 PMCID: PMC9463396 DOI: 10.1111/famp.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/22/2022] [Accepted: 01/31/2022] [Indexed: 05/26/2023]
Abstract
We examine how juvenile justice-involved youth of Haitian descent in Miami-Dade County cope with structural racism and its impact on their mental health. Drawing on longitudinal ethnography, psychosocial assessment data, and a family-based clinical intervention funded by the National Institute on Drug Abuse, this article explores youth narratives of discrimination prior to and during the COVID-19 pandemic. We use critical race theory and theory of practice to understand youths' perceptions as racialized bodies and stigmatized selves, highlighting the experiences and perspectives of a particular black immigrant group, ethnic beings caught up in the everyday practices of racialization, sociocultural marginalization, and racism. We frame these experiences as a variation of the complex continuum of structural racism and racial domination in the US. These experiences have caused anger, fear, anxiety, chronic anticipatory distress, and hopelessness among youth of Haitian descent. We conclude with some recommendations for therapeutic support that encourages youth to process their experiences, promotes their development of a positive self-concept, and provides them with mind-body techniques to attenuate the physical impacts of discriminatory events. The clinical trial registration number for this study intervention is NCT03876171.
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Affiliation(s)
- Toni Cela
- Department of Anthropology, Global Health Studies Program, University of Miami, Coral Gables, Florida, USA
- Laboratory on Health, Family and Migration, Interuniversity Institute for Research and Development (INURED), Port-au-Prince, Haiti
| | - Louis Herns Marcelin
- Department of Anthropology, Global Health Studies Program, University of Miami, Coral Gables, Florida, USA
- Laboratory on Health, Family and Migration, Interuniversity Institute for Research and Development (INURED), Port-au-Prince, Haiti
- Department of Public Health Sciences, University of Miami, Coral Gables, Florida, USA
| | - Rachel Waldman
- Global Health Studies Program, University of Miami, Coral Gables, Florida, USA
| | - Richard Dembo
- Department of Criminology, University of South Florida, Tampa, Florida, USA
| | - Danna Demezier
- School of Education, Barry University, Miami Shores, Florida, USA
| | - Roy Clement
- Department of Anthropology, University of Miami, Coral Gables, Florida, USA
| | - Alexandra Arcayos
- Global Health Studies Program, University of Miami, Coral Gables, Florida, USA
| | - Daniel Santisteban
- School of Education and Human Development, University of Miami, Coral Gables, Florida, USA
| | - Michèle Jean-Gilles
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Aaron Hogue
- Research and Clinical Science, Family and Adolescent Clinical Technology & Science (FACTS), Partnership to End Addiction, New York, New York, USA
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Slavich GM, Roos LG, Mengelkoch S, Webb CA, Shattuck EC, Moriarity DP, Alley JC. Social Safety Theory: Conceptual foundation, underlying mechanisms, and future directions. Health Psychol Rev 2023; 17:5-59. [PMID: 36718584 PMCID: PMC10161928 DOI: 10.1080/17437199.2023.2171900] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/19/2023] [Indexed: 02/01/2023]
Abstract
Classic theories of stress and health are largely based on assumptions regarding how different psychosocial stressors influence biological processes that, in turn, affect human health and behavior. Although theoretically rich, this work has yielded little consensus and led to numerous conceptual, measurement, and reproducibility issues. Social Safety Theory aims to address these issues by using the primary goal and regulatory logic of the human brain and immune system as the basis for specifying the social-environmental situations to which these systems should respond most strongly to maximize reproductive success and survival. This analysis gave rise to the integrated, multi-level formulation described herein, which transforms thinking about stress biology and provides a biologically based, evolutionary account for how and why experiences of social safety and social threat are strongly related to health, well-being, aging, and longevity. In doing so, the theory advances a testable framework for investigating the biopsychosocial roots of health disparities as well as how health-relevant biopsychosocial processes crystalize over time and how perceptions of the social environment interact with childhood microbial environment, birth cohort, culture, air pollution, genetics, sleep, diet, personality, and self-harm to affect health. The theory also highlights several interventions for reducing social threat and promoting resilience.
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Affiliation(s)
- George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Lydia G. Roos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Christian A. Webb
- McLean Hospital, Belmont, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Eric C. Shattuck
- Institute for Health Disparities Research and Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Daniel P. Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jenna C. Alley
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Thyden NH, McGuire C, Slaughter-Acey J, Widome R, Warren JR, Osypuk TL. Estimating the Long-Term Causal Effects of Attending Historically Black Colleges or Universities on Depressive Symptoms. Am J Epidemiol 2023; 192:356-366. [PMID: 36331286 PMCID: PMC10372863 DOI: 10.1093/aje/kwac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/27/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Racism is embedded in society, and higher education is an important structure for patterning economic and health outcomes. Historically Black Colleges and Universities (HBCUs) were founded on antiracism while predominantly White institutions (PWIs) were often founded on white supremacy. This contrast provides an opportunity to study the association between structural racism and health among Black Americans. We used the National Longitudinal Study of Adolescent to Adult Health (Add Health) to estimate the long-term causal effect of attending an HBCU (vs. PWI) on depressive symptoms among Black students in the United States from 1994-2018. While we found no overall association with attending an HBCU (vs. PWI) on depressive symptoms, we found that this association varied by baseline mental health and region, and across time. For example, among those who attended high school outside of the South, HBCU attendance was protective against depressive symptoms 7 years later, and the association was strongest for those with higher baseline depressive symptoms. We recommend equitable state and federal funding for HBCUs, and that PWIs implement and evaluate antiracist policies to improve mental health of Black students.
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Affiliation(s)
- Naomi Harada Thyden
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health
- University of Minnesota, Minnesota Population Center
- University of Illinois – Chicago, Community Health Sciences, Center of Excellence in Maternal and Child Health
| | - Cydney McGuire
- University of Minnesota, Division of Health Policy and Management
- University of Indiana, Paul H. O’Neill School of Public and Environmental Affairs
| | - Jaime Slaughter-Acey
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health
| | - Rachel Widome
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health
| | - John Robert Warren
- University of Minnesota, Minnesota Population Center
- University of Minnesota, Department of Sociology
| | - Theresa L Osypuk
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health
- University of Minnesota, Minnesota Population Center
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Rivera R, Capers T, Chandler M, Matthews E, Rzewinski J, Rees J, Israel S, Lushin V. Socioeconomic Stability Buffers Racial Discrimination Effect on Depression in a Marginalized Community. J Racial Ethn Health Disparities 2023; 10:130-140. [PMID: 35040107 DOI: 10.1007/s40615-021-01203-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/03/2023]
Abstract
Depression disproportionately burdens poverty-affected minority communities. Racism and racial discrimination are well-known determinants of depression among members of marginalized minority communities. Less is known about potential buffers of the discrimination effects on depression, particularly those that could serve as targets for efficient community-based policies and interventions. Our secondary analysis of data from a community needs assessment survey (N = 677) in an urban minority neighborhood of low socio-economic status revealed that high school completion and current employment significantly weakened the association between discrimination and depression. Our findings frame community-level efforts to foster high school completion and employment as potential strategies to reduce the footprint of racism on the mental health of marginalized community members. Implications for future research and policy are discussed.
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Affiliation(s)
- Rebecca Rivera
- Long Island University Brooklyn Campus, Brooklyn, NY, USA
| | - Tracey Capers
- Bedford Stuyvesant Restoration Corporation, Brooklyn, NY, USA
| | | | | | | | - Jo Rees
- School of Health Professions, Long Island University Brooklyn Campus, Brooklyn, NY, USA
| | - Shimonah Israel
- Bedford Stuyvesant Restoration Corporation, Brooklyn, NY, USA
| | - Victor Lushin
- Long Island University Brooklyn Campus, Brooklyn, NY, USA.
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De Leon AN, Woerner J, Dvorak RD, Cox J, Magri TD, Hayden ER, Ahuja M, Haeny AM. An Examination of Discrimination on Stress, Depression, and Oppression-Based Trauma During the COVID-19 Pandemic and the Racial Awakening of 2020. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2023; 7:24705470231152953. [PMID: 36726452 PMCID: PMC9884951 DOI: 10.1177/24705470231152953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/10/2023] [Indexed: 01/28/2023]
Abstract
Background Discrimination is a pervasive societal issue that monumentally impacts people of color (POC). Many Black, Asian, and Hispanic/Latinx individuals report experiencing race-based discrimination in their lifetime. Discrimination has previously been linked to adverse health outcomes among POC, including stress, depressive, and posttraumatic stress disorder symptoms. These health disparities are posited to have become exacerbated by COVID-19 and the racial awakening of 2020. The current study examined the short- and long-term effects of discrimination on stress, depression, and oppression-based trauma among POC. Methods Participants were (n = 398) who identified as Black, Indigenous, Hispanic/Latinx, and Asian completed an online self-report survey assessing discrimination, depression, stress, and oppression-based trauma collected at 3 time points: (T1) beginning of the COVID-19 pandemic (May 2020), (T2) 6 weeks later during the racial awakening of 2020 (June 2020), (T3) one year later (June 2021). Results Significant positive paths were revealed from T1 discrimination to T2 depression, T2 stress, and T3 oppression-based trauma. The association between T1 discrimination and T3 oppression-based trauma was partially mediated by T2 depression, but not by stress; total and total indirect effects remained significant. The final model accounted for a significant proportion of the variance in T3 oppression-based trauma, T2 depression, and T2 stress. Conclusion Findings are consistent with prior research linking discriminatory experiences with mental health symptomatology and provide evidence that race-based discrimination poses harmful short-and long-term mental health consequences. Further research is necessary to better understand oppression-based trauma to improve the accuracy of clinical diagnosis and treatment of POC.
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Affiliation(s)
- Ardhys N. De Leon
- University of Central
Florida, Orlando, FL, USA
- Ardhys De Leon, University of Central
Florida, Orlando, FL 32816, USA.
| | | | | | | | | | | | - Manik Ahuja
- East Tennessee State
University, Johnson City, TN, USA
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Jang Y, Cho YJ, Park NS, Chiriboga DA, Hong S, Kim MT. Perceived racial discrimination and mental distress in older Korean Americans: the moderating role of ethnic resources. ETHNICITY & HEALTH 2023; 28:1-11. [PMID: 34971333 PMCID: PMC9243182 DOI: 10.1080/13557858.2021.2022105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To examine associations among perceived racial discrimination, ethnic resources, and mental distress in older Korean Americans. Ethnic resources included ethnic identity (how closely individuals identify themselves with other members of the same ethnic background) and sense of community (individuals' feelings of belonging to their ethnic group). We examined the direct effect of perceived racial discrimination and these ethnic resources, as well as their interactions, hypothesizing that mental distress associated with perceived racial discrimination would be reduced by ethnic resources. DESIGN Using survey data from the Study of Older Korean Americans (N = 2,150), linear regression models of mental distress were examined for direct and interactive roles of perceived racial discrimination and ethnic resources. RESULTS Mental distress was directly associated with perceived racial discrimination (B = 1.90, SE = .20, p < .001), ethnic identity (B = -.41, SE = .13, p < .01), and sense of community (B = -.45, SE = .12, p < .001). Perceived racial discrimination interacted significantly with sense of community (B = -1.86, SE = .28, p < .001). Subgroup analyses suggested that in the context of experiencing racial discrimination, a high sense of community can serve as a buffer against mental distress. CONCLUSIONS Ethnic resources are a benefit in coping with experiences of discrimination. The moderating role of sense of community suggests the value of fostering social capital in ethnic communities to protect and promote older immigrants' mental health.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California
| | - Yong Ju Cho
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California
| | | | | | - Seunghye Hong
- Thompson School of Social Work & Public Health, University of Hawai’i at Mānoa
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Harb F, Bird CM, Webb EK, Torres L, deRoon-Cassini TA, Larson CL. Experiencing racial discrimination increases vulnerability to PTSD after trauma via peritraumatic dissociation. Eur J Psychotraumatol 2023; 14:2211486. [PMID: 37229524 DOI: 10.1080/20008066.2023.2211486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 05/27/2023] Open
Abstract
Background: Racial discrimination is a traumatic stressor that increases the risk for posttraumatic stress disorder (PTSD), but mechanisms to explain this relationship remain unclear. Peritraumatic dissociation, the complex process of disorientation, depersonalization, and derealization during a trauma, has been a consistent predictor of PTSD. Experiences of frequent racial discrimination may increase the propensity for peritraumatic dissociation in the context of new traumatic experiences and contribute to PTSD symptoms. However, the role of peritraumatic dissociation in the relationship between experiences of discrimination and PTSD has not been specifically explored.Objective: The current study investigated the role of peritraumatic dissociation in the impact of racial discrimination on PTSD symptoms after a traumatic injury, and the moderating role of gender.Method: One hundred and thirteen Black/African American individuals were recruited from the Emergency Department at a Level I Trauma Center. Two weeks after the trauma, participants self-reported their experiences with racial discrimination and peritraumatic dissociation. At the six-month follow-up appointment, individuals underwent a clinical assessment of their PTSD symptoms.Results: Results of longitudinal mediation analyses showed that peritraumatic dissociation significantly mediated the effect of racial discrimination on PTSD symptoms, after controlling for age and lifetime trauma exposure. A secondary analysis was conducted to examine the moderating role of gender. Gender was not a significant moderator in the model.Conclusions: Findings show that racial discrimination functions as a stressor that impacts how individuals respond to other traumatic events. The novel results suggest a mechanism that explains the relationship between racial discrimination and PTSD symptoms. These findings highlight the need for community spaces where Black Americans can process racial trauma and reduce the propensity to detach from daily, painful realities. Results also show that clinical intervention post-trauma must consider Black Americans' experiences with racial discrimination.
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Affiliation(s)
- Farah Harb
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Claire M Bird
- Trauma Research Consortium, Baylor Scott and White Research Institute, Baylor Scott & White Health, Dallas, TX, USA
| | - E Kate Webb
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Lucas Torres
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Terri A deRoon-Cassini
- Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Complex effects of racism and discrimination on African Americans' health and well-being: Navigating the status quo. Soc Sci Med 2023; 316:115421. [PMID: 36270847 DOI: 10.1016/j.socscimed.2022.115421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/29/2022] [Indexed: 01/07/2023]
Abstract
Most research on the effects of racism and discrimination on the health and well-being of African Americans utilize a deficit perspective, one that homogeneously paints African Americans as disadvantaged victims. Such approaches do little to highlight the variability in the effects of racism and discrimination on relevant outcomes, and the resources that African Americans have drawn upon to navigate an environment characterized by varying levels of racialized hostility. The goal of this special issue is to inspire more refined conceptualizations of how African Americans navigate an often-hostile status quo in service of their health and well-being. The articles in this special issue examine within-race heterogeneity in African Americans' responses to varying manifestations of racism and discrimination, as well as subsequent heterogeneity in the effects of racism and discrimination on African Americans' health and well-being at the individual level. The commentaries and articles address the goals of this special issue in three broad categories of health outcomes: biological/physiological, mind and brain, and health behavior. These contributions demonstrate several critical themes that can guide future work to achieve a more comprehensive understanding of the heterogeneity in the effects of racism and discrimination on health and well-being among African Americans.
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Baluran DA. Life expectancy, life disparity, and differential racialization among Chinese, Asian Indians, and Filipinos in the United States. SSM Popul Health 2022; 21:101306. [PMID: 36567799 PMCID: PMC9772563 DOI: 10.1016/j.ssmph.2022.101306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
This article advances differential racialization as a lens to frame health disparity trends within the Asian racial category. Using formal demographic methods, I analyzed data from the Multiple Cause of Death File and the American Community Survey to examine the trends in life expectancy and life disparity among Chinese, Asian Indians, and Filipinos in the United States between 2005 and 2019. While Chinese, Asian Indian, and Filipino life expectancy oscillated between each period under study, those oscillations contributed to an overall widening advantage for Chinese over their Asian Indian and Filipino counterparts. I posit that widening inequalities between the three groups are suggestive of their increasingly disparate racial statuses. These findings underscore the importance of contextualizing disaggregated health data within the social conditions that produce inequalities, namely race/racialization/racism.
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Williams SZ, Lewis CF, Muennig P, Martino D, Pahl K. Self-reported anxiety and depression problems and suicide ideation among black and latinx adults and the moderating role of social support. J Community Health 2022; 47:914-923. [PMID: 35921053 DOI: 10.1007/s10900-022-01127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 01/09/2023]
Abstract
Suicide is a critical public health problem. Over the past decade, suicide rates have increased among Black and Latinx adults in the U.S. Though depression is the most prevalent psychiatric contributor to suicide risk, Black and Latinx Americans uniquely experience distress and stress (e.g., structural adversity) that can independently operate to worsen suicide risk. This makes it important to investigate non-clinical, subjective assessment of mental health as a predictor of suicide ideation. We also investigate whether social support can buffer the deleterious impact of poor mental health on suicide ideation.We analyzed data from 1,503 Black and Latinx participants of the Washington Heights Community Survey, a 2015 survey of residents of a NYC neighborhood. Multivariable logistic regression was conducted to examine the effect of subjectively experienced problems with anxiety and depression on suicide ideation independent of depression diagnosis, and the role of social support as a moderator.Estimated prevalence of past two-week suicide ideation was 5.8%. Regression estimates showed significantly increased odds of suicide ideation among participants reporting moderate (OR = 8.54,95% CI = 2.44-29.93) and severe (OR = 16.84,95% CI = 2.88-98.46) versus no problems with anxiety and depression, after adjustment for depression diagnosis. Informational support, i.e., having someone to provide good advice in a crisis, reduced the negative impact of moderate levels of anxiety and depression problems on suicide ideation.Findings suggest that among Black and Latinx Americans, subjective feelings of anxiety and depression account for a significant portion of the suicide ideation risk related to poor mental health. Further, social support, particularly informational support, may provide protection against suicide ideation.
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Affiliation(s)
- Sharifa Z Williams
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA. .,Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, USA.
| | - Crystal Fuller Lewis
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA.,Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Peter Muennig
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Daniele Martino
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA
| | - Kerstin Pahl
- Center for Research on Cultural and Structural Equity in Behavioral Health, Division of Social Solutions & Services Research, Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Bldg. 35, 10962-1159, Orangeburg, NY, USA.,Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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Cela T, Demezier D, Waldman R, Clement R, Dembo R, Jean-Gilles M, Hogue A, Arcayos A, Santisteban D, Marcelin LH. Juvenile justice-involved Haitian families' experiences of structural racism and socioethnic discrimination. FAMILY RELATIONS 2022; 71:1993-2010. [PMID: 36817967 PMCID: PMC9937033 DOI: 10.1111/fare.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/21/2022] [Indexed: 06/18/2023]
Abstract
Objective This article examines how Haitian families with youth interfacing with the juvenile justice system cope with structural racism and socioethnic discrimination (RSD). Background Haitian families' experiences of discrimination based on their histories, immigrant status, and positionality illustrates the need for more scientific scrutiny of the experiences of RSD among Black immigrant groups. This National Institute on Drug Abuse (NIDA)-funded study details the narratives of and responses to RSD experienced by Haitian families interfacing with the juvenile justice system. Method Data are drawn from psychosocial assessment tools, therapeutic sessions, and ethnographic interviews conducted with Haitian families participating in a family-based therapeutic intervention. Using critical race theory, we foreground the voices of those negatively impacted and use Bourdieu's theory of practice to examine the intersectionality of race and ethnicity in this population's experiences of RSD. Results The different experiences of and responses to RSD among youth and caregivers of Haitian descent are both a variation of the complex continuum of structural racism in the United States and unique to their immigrant experience of marginalization and cultural invalidation by public institutions, community members, and peers. Conclusion Professionals working with this population must be sensitive to the ways these experiences impact young people's identity development processes, their health, and well-being. Haitian caregivers should be encouraged to protect their children by engaging in racial and socioethnic socialization that validates their RSD experiences. Implications Understanding the intergenerational experiences of RSD among Black, immigrant groups and encouraging family dialogue and adolescent support will strengthen family cohesion during this period of racial reckoning.
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Affiliation(s)
- Toni Cela
- Department of Anthropology, University of Miami, Coral Gables, FL
- Interuniversity Institute for Research and Development (INURED), Port-au-Prince, Haiti
| | - Danna Demezier
- Department of Anthropology, University of Miami, Coral Gables, FL
| | - Rachel Waldman
- Department of Anthropology, University of Miami, Coral Gables, FL
| | - Roy Clement
- Department of Anthropology, University of Miami, Coral Gables, FL
| | - Richard Dembo
- Department of Criminology, University of South Florida, Tampa, FL
| | - Michèle Jean-Gilles
- Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL
| | - Aaron Hogue
- Family and Adolescent Clinical Technology & Science (FACTS) Partnership to End Addiction, New York, NY
| | | | | | - Louis Herns Marcelin
- Interuniversity Institute for Research and Development (INURED), Port-au-Prince, Haiti
- Departments of Anthropology & Public Health Sciences, University of Miami, Coral Gables, FL
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Cénat JM. Complex Racial Trauma: Evidence, Theory, Assessment, and Treatment. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 18:675-687. [PMID: 36288462 DOI: 10.1177/17456916221120428] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Racial trauma refers to experiences related to threats, prejudices, harm, shame, humiliation, and guilt associated with various types of racial discrimination, either for direct victims or witnesses. In North American, European, and colonial zeitgeist societies, Black, Indigenous, and people of color (BIPOC) experience racial microaggressions and interpersonal, institutional, and systemic racism on a repetitive, constant, inevitable, and cumulative basis. Although complex trauma differs from racial trauma in its origin, the consistency of racist victimization beyond childhood, and the internalized racism associated with it, strong similarities exist. Similar to complex trauma, racial trauma surrounds the victims’ life course and engenders consequences on their physical and mental health, behavior, cognition, relationships with others, self-concept, and social and economic life. There is no way to identify racial trauma other than through a life-course approach that captures the complex nature of individual, collective, historical, and intergenerational experiences of racism experienced by BIPOC communities in Western society. This article presents evidence for complex racial trauma (CoRT), a theoretical framework of CoRT, and guidelines for its assessment and treatment. Avenues for future research, intervention, and training are also presented.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa
- Interdisciplinary Centre for Black Health, University of Ottawa
- University of Ottawa Research on Black Health, University of Ottawa
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Dhanani LY, LaPalme ML, Pham CT, Hall TK. The Burden of Hate: How Nonwork Discrimination Experienced During the COVID-19 Pandemic Impacts Asian American Employees. JOURNAL OF BUSINESS AND PSYCHOLOGY 2022; 38:621-635. [PMID: 36213150 PMCID: PMC9530437 DOI: 10.1007/s10869-022-09848-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 05/03/2023]
Abstract
The COVID-19 pandemic has been accompanied by a sharp increase in prejudice and discrimination targeting Asian Americans in the USA. Thus, in addition to the public health risks associated with the virus, exposure to discrimination poses a unique threat to the health and well-being of Asian Americans. Indeed, empirical evidence has documented the linkage between experiencing anti-Asian discrimination during the pandemic and health decrements among Asian Americans. The goal of this study was to expand that research to also consider the ways experiencing discrimination in a nonwork context may spill over to affect the general and job-related well-being of Asian American employees as well as the potential mitigating role of coworker compassion. Results from a sample of 311 Asian American employees demonstrated that experiencing nonwork discrimination was associated with decrements in physical health and increased depression and job-related exhaustion. Further, there were significant interactions between nonwork discrimination and coworker compassion for engagement, emotional exhaustion, and depressive symptoms such that nonwork discrimination was more strongly related to each outcome when coworker compassion was low. The findings from the current study suggest that experiences of racial derogation, even those that occur outside the workplace environment, are detrimental to the well-being of employees and that coworker compassion is a positive resource that may foster healthier and more inclusive work environments. Supplementary Information The online version contains supplementary material available at 10.1007/s10869-022-09848-6.
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Affiliation(s)
- Lindsay Y. Dhanani
- School of Management and Labor Relations, Rutgers University, 94 Rockafeller Road, Piscataway, NJ 08904 USA
| | | | - Carolyn T. Pham
- DePaul University, 2219 North Kenmore Avenue, Chicago, IL 60614 USA
| | - Taylor K. Hall
- Ohio University, 22 Richland Avenue, Athens, OH 45701 USA
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Hendrix CL, Werchan D, Lenniger C, Ablow JC, Amstadter AB, Austin A, Babineau V, Bogat GA, Cioffredi LA, Conradt E, Crowell SE, Dumitriu D, Elliott AJ, Fifer W, Firestein M, Gao W, Gotlib I, Graham A, Gregory KD, Gustafsson H, Havens KL, Hockett C, Howell BR, Humphreys KL, Jallo N, King LS, Kinser PA, Levendosky AA, Lonstein JS, Lucchini M, Marcus R, Monk C, Moyer S, Muzik M, Nuttall AK, Potter AS, Rogers C, Salisbury A, Shuffrey LC, Smith BA, Smyser CD, Smith L, Sullivan E, Zhou J, Brito NH, Thomason ME. Geotemporal analysis of perinatal care changes and maternal mental health: an example from the COVID-19 pandemic. Arch Womens Ment Health 2022; 25:943-956. [PMID: 35962855 PMCID: PMC9375091 DOI: 10.1007/s00737-022-01252-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/29/2022] [Indexed: 01/21/2023]
Abstract
Our primary objective was to document COVID-19 induced changes to perinatal care across the USA and examine the implication of these changes for maternal mental health. We performed an observational cross-sectional study with convenience sampling using direct patient reports from 1918 postpartum and 3868 pregnant individuals collected between April 2020 and December 2020 from 10 states across the USA. We leverage a subgroup of these participants who gave birth prior to March 2020 to estimate the pre-pandemic prevalence of specific birthing practices as a comparison. Our primary analyses describe the prevalence and timing of perinatal care changes, compare perinatal care changes depending on when and where individuals gave birth, and assess the linkage between perinatal care alterations and maternal anxiety and depressive symptoms. Seventy-eight percent of pregnant participants and 63% of postpartum participants reported at least one change to their perinatal care between March and August 2020. However, the prevalence and nature of specific perinatal care changes occurred unevenly over time and across geographic locations. The separation of infants and mothers immediately after birth and the cancelation of prenatal visits were associated with worsened depression and anxiety symptoms in mothers after controlling for sociodemographic factors, mental health history, number of pregnancy complications, and general stress about the COVID-19 pandemic. Our analyses reveal widespread changes to perinatal care across the US that fluctuated depending on where and when individuals gave birth. Disruptions to perinatal care may also exacerbate mental health concerns, so focused treatments that can mitigate the negative psychiatric sequelae of interrupted care are warranted.
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Affiliation(s)
- Cassandra L Hendrix
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA.
| | - Denise Werchan
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA
| | - Carly Lenniger
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA
| | | | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Autumn Austin
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA
| | - Vanessa Babineau
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - G Anne Bogat
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | | | - Elisabeth Conradt
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Sheila E Crowell
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, University of Utah Medical School, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, University of Utah Medical School, Salt Lake City, UT, USA
| | - Dani Dumitriu
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
| | - Amy J Elliott
- Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA
- Avera Research Institute, Sioux Falls, SD, USA
| | - William Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Morgan Firestein
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Wei Gao
- Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Biomedical Imaging Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ian Gotlib
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Alice Graham
- Department of Psychiatry, Oregon Health & Sciences University, Portland, OR, USA
| | - Kimberly D Gregory
- Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hanna Gustafsson
- Department of Psychiatry, Oregon Health & Sciences University, Portland, OR, USA
| | - Kathryn L Havens
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Christine Hockett
- Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA
- Avera Research Institute, Sioux Falls, SD, USA
| | - Brittany R Howell
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
- Department of Human Development and Family Science, Virginia Tech University, Blacksburg, VA, USA
| | - Kathryn L Humphreys
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Nancy Jallo
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Lucy S King
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Patricia A Kinser
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Joseph S Lonstein
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Rachel Marcus
- Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Catherine Monk
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Sara Moyer
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Maria Muzik
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, VA, USA
| | - Amy K Nuttall
- Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | | | - Cynthia Rogers
- Department of Psychiatry, Washington University Medical School in Saint Louis, Saint Louis, MO, USA
| | - Amy Salisbury
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Lauren C Shuffrey
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Beth A Smith
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
- Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute, Los Angeles, CA, USA
- Division of Research On Children, Youth, and Families, Childrens Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christopher D Smyser
- Departments of Neurology, Pediatrics, and Radiology, Washington University Medical School in Saint Louis, Saint Louis, MO, USA
| | - Lynne Smith
- The Lundquist Institute, Department of Pediatrics, Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Elinor Sullivan
- Department of Psychiatry, Oregon Health & Sciences University, Portland, OR, USA
| | - Judy Zhou
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Natalie H Brito
- Department of Applied Psychology, New York University, New York, NY, USA
| | - Moriah E Thomason
- Department of Child and Adolescent Psychiatry, New York University Medical Center, New York, NY, USA
- Neuroscience Institute, New York University Medical Center, New York, NY, USA
- Department of Population Health, New York University Medical Center, New York, NY, USA
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Serpas DG, García JJ, Arellano-Morales L. A path model of racial/ethnic discrimination and cardiovascular disease risk factors among college students of color. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1926-1930. [PMID: 33151821 DOI: 10.1080/07448481.2020.1841772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 09/04/2020] [Accepted: 10/18/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveRacial/ethnic minorities experience disproportionately greater risk to cardiovascular diseases (CVDs). This study examined racial/ethnic discrimination-as a psychosocial stressor-in a path model and its associations with CVD health risk factors among undergraduate students of color (SoC). Participants: The sample included 404 SoC whose ages ranged from 18 to 54 (Mage = 21.82, SD = 5.26; 65% female) from a Hispanic Serving Institution in Southern California. Methods: Participants responded to measures assessing the following traditional and non-traditional CVD indicators: depression, anxiety, and body mass index (BMI). A path model was configured with paths corresponding from racial/ethnic discrimination to BMI, depression, and anxiety symptoms, controlling for gender and age. Results: After accounting for covariates, findings revealed greater levels of racial/ethnic discrimination was uniquely associated with greater BMI, depression, and anxiety symptoms. Conclusions: Findings demonstrate racial/ethnic discrimination is associated with CVD health risk factors among SoC. Data highlight the importance and magnitude of adverse psychosocial experiences on CVD health.
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Affiliation(s)
- Dylan G Serpas
- Department of Psychology, University of La Verne, La Verne, California, USA
| | - James J García
- Department of Psychology, University of La Verne, La Verne, California, USA
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Layug A, Krishnamurthy S, McKenzie R, Feng B. The Impacts of Social Media Use and Online Racial Discrimination on Asian American Mental Health: Cross-sectional Survey in the United States During COVID-19. JMIR Form Res 2022; 6:e38589. [PMID: 36121698 PMCID: PMC9488547 DOI: 10.2196/38589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/13/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background
During the COVID-19 pandemic, increased social media usage has led to worsened mental health outcomes for many people. Moreover, due to the sociopolitical climate during the pandemic, the prevalence of online racial discrimination has contributed to worsening psychological well-being. With increases in anti-Asian hate, Asian and Asian American social media users may experience the negative effects of online racial discrimination in addition to the reduced psychological well-being resulting from exposure to online COVID-19 content.
Objective
This study aims to investigate the impact of COVID-19–related social media use and exposure to online racial discrimination during the pandemic on the mental health outcomes (ie, anxiety, depression, and secondary traumatic stress [STS]) of Asian Americans compared with those of non-Asian Americans. In addition, this study explores the mediating role of negative affect and the moderating role of racial/ethnic identification.
Methods
An online survey was conducted through Amazon Mechanical Turk and a university-wide research portal from March 3 to March 15, 2021. A total of 1147 participants took the survey. Participants’ social media usage related to COVID-19 and exposure to 2 online forms of racial discrimination (individual and vicarious), mental health outcomes (anxiety, depression, and STS), racial/ethnic identification, negative affect, and demographics were assessed.
Results
Our results showed that COVID-19–related social media use, individual discrimination, and vicarious discrimination were predictors of negative mental health outcomes (anxiety, depression, and STS). Asian Americans reported higher vicarious discrimination than Latinx and White Americans, but Asian Americans’ mental health outcomes did not differ substantially from those of the other racial/ethnic groups. Racial/ethnic identification moderated the relationship between both types of discrimination and STS, and negative affect served as a mediator between both types of discrimination and all 3 mental health outcomes.
Conclusions
These results suggest that social media exposure continues to have a dire effect on mental health during the COVID-19 pandemic. This study helps to contextualize the rise of anti-Asian American hate and its impact on mental health outcomes in the United States.
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Affiliation(s)
- Alyan Layug
- Department of Asian American Studies, University of California, Davis, Davis, CA, United States
- Department of Psychology, University of California, Davis, Davis, CA, United States
| | | | - Rachel McKenzie
- Department of Communication, University of California, Davis, Davis, CA, United States
| | - Bo Feng
- Department of Communication, University of California, Davis, Davis, CA, United States
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Li Y, Yang H, Dong F, Cui N. The COVID-19 Pandemic, Racism, and Sleep Among Chinese Immigrants in the United States. J Psychosoc Nurs Ment Health Serv 2022; 61:45-51. [PMID: 36099489 DOI: 10.3928/02793695-20220906-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study aimed to investigate Chinese immigrants' sleep quality and associations between the coronavirus disease 2019 pandemic's impact and racism and sleep disruption using a cross-sectional online survey. A total of 507 Chinese immigrants were recruited via social network sites. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The pandemic's impact and racism were measured using questions developed for this study. More than 42% of participants reported poor sleep quality. Those who reported having been affected by the pandemic had poorer subjective sleep quality, longer sleep latency, and greater daytime dysfunction. Those who experienced racist incidents were more likely to use sleep medication and exhibit poor subjective sleep quality, long sleep latency, short sleep duration, and daytime dysfunction. Chinese immigrants' sleep health warrants particular consideration by health care professionals. Timely, effective interventions, such as relaxation techniques and online psychoeducation, need to be delivered in the Chinese community. [Journal of Psychosocial Nursing and Mental Health Services, 61(4), 45-51.].
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Sheehan BE, Derlega VJ, Maduro RS, Totonchi DA. Willingness to Engage in Collective Action After the Police Killing of an Unarmed Black Man: Differential Pathways for Black and White Individuals. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:153-165. [PMID: 35166387 PMCID: PMC9542025 DOI: 10.1002/ajcp.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
This cross-sectional survey study examined the underlying psychosocial constructs of Black (n = 163) and White (n = 246) university students' willingness to endorse racially motivated collective action. Consistent with the defensive motivation system model, we expected the police shooting of an unarmed Black American to activate concerns about personal safety, thereby eliciting negative affect, lack of forgiveness of the perpetrator, and motivation to engage in collective action. This path model was expected for both Black and White participants, with stronger associations among Black participants. In the full model, Black participants identified more with the victim and indicated greater personal threat, which led to (1) more negative affect and greater endorsement of collective action and (2) greater avoidance of the shooter and greater endorsement of collective action. In the Black participants model, collective action was explained by identifying with the victim and feeling personally threatened. In the White participants model, collective action was explained by three pathways stemming from identifying with the victim and personal threat, including negative affect, seeking avoidance, and seeking revenge. The results indicate different mechanisms to explain Black and White individuals' motivation to endorse collective action to prevent police-involved shootings of unarmed Black Americans.
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Affiliation(s)
- Brynn E. Sheehan
- Department of Psychiatry and Behavioral SciencesEastern Virginia Medical School, Healthcare Analytics and Delivery Science InstituteNorfolkVirginiaUSA
| | | | - Ralitsa S. Maduro
- Sentara Healthcare, Quality Research InstituteVirginia BeachVirginiaUSA
| | - Delaram A. Totonchi
- Center for Advanced Study of Teaching and LearningUniversity of VirginiaCharlottesvilleVirginiaUSA
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Non AL, Clausing ES, D’Anna Hernandez KL. Changes in sociocultural stressors, protective factors, and mental health for US Latina mothers in a shifting political climate. PLoS One 2022; 17:e0273548. [PMID: 36007002 PMCID: PMC9409595 DOI: 10.1371/journal.pone.0273548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
Abstract
Background
To investigate changes in sociocultural stressors and protective factors, and mental health in Latina mothers before and after the 2016 Republican presidential nomination.
Methods
We examined changes in sociocultural stressors, protective factors, and mental health from two prospective cohorts of Latina mothers from interior and border US cities (Nashville, TN, n = 39 and San Diego, CA, ns range = 78–83; 2013–2020).
Results
We identified significant longitudinal increases in depression, anxiety, and perceived stress in the border city, and reductions in protective factors (e.g., optimism, social support, and familism) across sites. Discrimination varied by location, and was associated with higher stress only at baseline in the border city, and with higher anxiety in the interior city at follow-up. Acculturative stress was consistently associated with worse mental health across time points in the border city. Various protective factors were associated with reduced stress and anxiety across time points in both cities.
Discussion
We identified decreased mental health at the border city, and reduced protective factors in Latina mothers across both study sites in the years following the 2016 presidential nomination, during a time of shifting sociopolitical climate. We also identify increased acculturative stress and discrimination over time, particularly at the border city. Interventions to maintain and enhance psychosocial protective factors amongst Latina mothers are warranted.
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Affiliation(s)
- Amy L. Non
- Department of Anthropology, University of California, San Diego, La Jolla, CA, United States of America
- * E-mail:
| | - Elizabeth S. Clausing
- Department of Anthropology, University of California, San Diego, La Jolla, CA, United States of America
- School of Global Integrative Studies, University of Nebraska, Lincoln, Lincoln, NE, United States of America
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49
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Oppedal B, Keles S, Røysamb E. Subjective Well-Being Among Unaccompanied Refugee Youth: Longitudinal Associations With Discrimination and Ethnic Identity Crisis. Front Psychol 2022; 13:920657. [PMID: 36092076 PMCID: PMC9453845 DOI: 10.3389/fpsyg.2022.920657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022] Open
Abstract
Unaccompanied refugee youth (URY), who as children fled their countries to seek asylum in a foreign country without the company of an adult legal caretaker are described as being in a vulnerable situation. Many of them struggle with mental reactions to traumatic events experienced pre-migration, and to the daily hassles they face after being granted asylum and residence. Despite continuous high levels of mental health problems URY demonstrate remarkable agency and social mobility in the years after being granted asylum in their destination countries. A sense of subjective well-being (SWB) may enable resilient outcomes in people exposed to past or ongoing adversities. To fill the gap in the research literature about positive psychological outcomes among URY, the overall aim of this study was to explore the longitudinal associations between SWB and two taxing acculturation hassles: perceived discrimination and ethnic identity crisis. Three annual waves of self-report questionnaire data were collected from a population-based sample of URY; n = 581, Mage = 20.01(SD = 2.40), Mlength of stay = 4.63 (SD = 4.40), 82 % male, mainly from Afghanistan, Somalia, Iraq, and Sri Lanka. The longitudinal associations between SWB, perceived discrimination and ethnic identity crisis across time were analyzed using auto-regressive cross-lagged modeling. The results revealed that perceived discrimination, but not ethnic identity crisis, negatively predicted subsequent levels of SWB. More importantly, high levels of SWB at one timepoint predicted decreases in both discrimination and ethnic identity crisis at subsequent timepoints. Further, increases in SWB from one timepoint to the next was associated with significant co-occurring decreases in both discrimination and ethnic identity crisis, and vice versa. Despite the negative effect of perceived discrimination on SWB, promoting SWB in URY can protect them from future hazards of acculturation hassles in complex ways. We underscore the need for more research on SWB among URY and other refugee youth. We further discuss the potential of SWB to foster resilient outcomes in young refugees and suggest that interventions to strengthen SWB among them should consider their transnational and multicultural realities and experiences.
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Affiliation(s)
- Brit Oppedal
- Division of Mental and Physical Health, Department of Child Health and Development, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- *Correspondence: Brit Oppedal,
| | - Serap Keles
- Knowledge Centre for Education, University of Stavanger, Stavanger, Norway
| | - Espen Røysamb
- Division of Mental and Physical Health, Department of Child Health and Development, Norwegian Institute of Public Health (NIPH), Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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50
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Lassiter JM, Mims I. "The Awesomeness and the Vastness of Who You Really Are:" A Culturally Distinct Framework for Understanding the Link Between Spirituality and Health for Black Sexual Minority Men. JOURNAL OF RELIGION AND HEALTH 2022; 61:3076-3097. [PMID: 34138442 PMCID: PMC9314292 DOI: 10.1007/s10943-021-01297-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/23/2021] [Indexed: 06/12/2023]
Abstract
Despite health inequities, many Black sexual minority men are resilient and often utilize spirituality as a culturally distinct self-protective and self-enhancing resource to maintain their health. However, little is known about how spirituality impacts health within a cultural framework that is specific to Black sexual minority men. We conducted 10 individual in-depth interviews, reaching code saturation, with Black sexual minority men across the USA. Our study was guided by grounded theory and a Black psychology theoretical framework. Seven themes were discovered and revealed that participants' level of spiritual consciousness influenced their engagement in psychological and behavioral processes that were related to mental and physical health. These themes were: (a) suboptimal worldview, (b) emotional revelation, (c) emotional emancipation, (d) emotional regulation, (e) health motivations, (f) health behaviors, and (g) links between spiritual consciousness, mental health, and physical health. Implications of these findings for clinicians and researchers are discussed.
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Affiliation(s)
| | - Ivie Mims
- Department of Psychology, Muhlenberg College, 2400 W. Chew Street, Allentown, PA, 18104, USA
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