Contextualizing acculturation: gender, family, and community reception influences on Asian immigrant mental health

Environment matters: How are neighborhood structural indexes associated with parenting stress among Asian immigrant families?

The Asian immigrant population is the fourth largest immigrant population in the United States, and its parenting stress issues have been consistently recognized in previous studies. However, little attention has been paid to neighborhood-level factors and their parenting stress. Using the Study of Asian American Families and 2016 American Community Survey 5-year estimates, this study examined the association between neighborhood structural indexes and Asian immigrant parents' parenting stress, along with the mechanism driving the relationship. We found that cultural orientation and social support fully mediated the effects of economic disadvantages on parenting stress among Asian immigrant parents. Only cultural orientation mediated the direct effects of ethnic heterogeneity on Asian parents' parenting stress. Improving Asian immigrants' living environment, including economic status and ethnic diversity, would be critical to relieve the parenting stress of Asian immigrant families. Interventions and preventions to increase social support, and inform cultural orientation and acculturation are emphasized.

A longitudinal study of immigrant mothers' destination-language proficiency and their children's psychological well-being: Evidence and mechanisms from a study in South Korea

RATIONALE

Despite the well-established link between an immigrant's destination-language proficiency and psychological well-being, little is known about the relationship between an immigrant's destination-language proficiency and well-being of their children.

OBJECTIVE

This study investigated whether and how immigrant mothers' Korean proficiency is associated with life satisfaction and depressive symptoms among their children in South Korea. A comprehensive set of potential underlying mechanisms was also examined.

METHODS

Using four waves of data from the Multicultural Adolescents Panel Study (MAPS), this study estimated fixed effects regression models to reduce the possibility of bias due to individual-level heterogeneity. To test for mediation formally, Sobel mediation tests were conducted.

RESULTS

Fixed effects estimates suggested that immigrant mothers' Korean proficiency is positively associated with their children's psychological well-being. Specifically, a one-standard-deviation increase in Korean proficiency was associated with an increase in life satisfaction by 13% of a standard deviation and a decrease in depressive symptoms by 9% of a standard deviation. Mediation tests revealed that this association is explained by a combination of social-psychological factors. Friend support was the most salient mediator, followed by lower acculturation stress, positive perceptions of local community, and teacher support.

CONCLUSIONS

The findings of this study suggest that efforts to improve immigrant mothers' destination-language proficiency would also benefit their children's psychological well-being. Furthermore, promoting children's relationships with peers at school may mitigate the negative psychological consequences of immigrant mothers' limited language proficiency.

Linguistic Adaptation and Cognitive Function in Older Chinese and Korean Immigrants in the United States: A Cross-Sectional Study

OBJECTIVES

To examine the cross-sectional association of linguistic adaptation with cognitive function, as well as its interactions with sociodemographic and health profiles in older Chinese and Korean immigrants in the U.S.

METHODS

Using harmonized data (N = 5063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we examined between- and within-group differences in the role of linguistic adaptation (English use in older Chinese Americans and English proficiency in older Korean Americans) in cognitive function.

RESULTS

The positive association between linguistic adaptation and cognitive function was common in both groups. We also found that the relationship was pronounced among subgroups with the underlying linguistic and cognitive vulnerabilities (i.e., the very old, women, those with low education, and newly immigrated individuals).

DISCUSSION

Findings show the importance of linguistic adaptation in older immigrants' cognitive health and suggest a need for targeted interventions for high-risk groups.

Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans

Background

Studies generally show that higher acculturation is associated with greater cardiovascular disease (CVD) risk among immigrants in the United States (US). However, few studies have compared how proxies of acculturation are differentially associated with metabolic abnormalities measured using objective biomarkers, self-reported diagnosis, and medication use, particularly among East Asian Americans.

Methods

Survey data and biomarker measurements collected from random (non-fasting) blood samples of Chinese and Korean immigrants in the US (n = 328) were used to examine the associations between two proxies for acculturation (years living in the US and English speaking proficiency) with three cardiometabolic abnormalities (high triglyceride levels, diabetes, and hypercholesterolemia). Poisson regression models estimated prevalence ratios adjusted for demographic characteristics, socioeconomic factors, and body mass index. Gender, Asian subgroup, and household income were tested as potential effect modifiers.

Results

Living longer in the US was associated with greater likelihood of having high triglycerides. In addition, living longer in the US was associated with greater likelihood of diabetes for people with lower household income and greater likelihood of hypercholesterolemia for people with higher household income. Higher level of English proficiency was less consistently associated with higher cardiometabolic risk, although there was a significant association with greater likelihood of hypercholesterolemia.

Conclusions

Longer time lived in the US is associated with higher risk of cardiometabolic abnormalities among Chinese and Korean Americans. Future studies of acculturation and cardiometabolic risk should carefully consider potential mechanisms and what proxy measures of acculturation capture.

Trial Registration Number

NCT03481296, date of registration: 3/29/2018.

Family Factors Related to Three Major Mental Health Issues Among Asian-Americans Nationwide

Asian-Americans (AAs) constitute the fastest growing minority group in the USA. AAs share a common emphasis on collective cultural strengths, especially family values. Using the National Latino and Asian American Study (NLAAS) data, this study investigated the roles of family cohesiveness, along with other cultural strength factors and negative family interactions in three psychiatric disorders. Supporting the study's hypotheses, multivariate analyses showed that family cohesiveness was associated with a lower incidence of general anxiety disorder (GAD), while regular religious attendance was linked with a lower likelihood of having substance use disorder (SUD). Conversely, negative family interactions increased the likelihood of experiencing major depression disorder (MDD) and SUD. Whereas perceived discrimination was related to higher odds of all diagnoses, family cohesiveness moderated the relationship between discrimination and GAD. These findings suggest that family relationships play a critical role in AAs' mental health and should be further explored through a prospective design.

A pathway to negative acculturation: marital maladjustment mediates the relationship between the length of residency and depressive symptoms in immigrant women in Taiwan

Background

Immigrant women in Taiwan experience a variety of acculturative and marital problems that result in a mental-health problems. We examined the mediational effect of marital adjustment on the relationship between acculturation and depressive symptoms in immigrant women in Taiwan.

Methods

All participants (N = 127) were interviewed to collect data regarding their basic sociodemographics, depressive symptoms, acculturation (using language proficiency and years in Taiwan as indicators), and marital adjustment. We used a Sobel test to examine how marital adjustment mediates the relationship between acculturation and depressive symptoms.

Results

Our results indicated that an increased length of residency exacerbated depressive symptoms (β = 0.62, p = 0.03) and that this relationship contributed, in part, to the mediational effect of marital adjustment. That is, marital adjustment deteriorated with the length of residency (β =  − 0.26, p = 0.0013), resulting in the development of depressive symptoms (β =  − 0.95, p = 0.0013).

Conclusion

Although the duration of residency may be useful as a proxy for acculturation in the assessment of some health outcomes, our findings imply that it is better to conceptualize it as a cumulative stress when considering the mental health of immigrant women. Marital maladjustment acts as a mediator in this relationship. As such, it is important to provide immigrant families with programs and resources to assist them in adapting to their marriages and to improve the mental health of immigrant women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01334-0.

Influencing Factors of Depression among Adolescent Asians in North America: A Systematic Review

Background: Asian American adolescents experience rates of depression comparable to or greater than those of other ethnic minorities. The purpose of this systematic review is to summarize psychosocial factors related to depressive symptoms of Asian American adolescents between the ages of 10 to 19. Methods: Various electronic databases were systematically searched to identify research articles published from 2000 to 2021, and the psychosocial factors influencing depression among Asian adolescents in North America were examined. Results: A total of 81 studies were included in this systematic review. Consistent findings on relationships between depressive symptoms and influencing factors included (a) acculturative stress, (b) religious or spiritual significance for females, (c) parent–child cohesion, (d) harsh parenting style, (e) responsive parenting style, (f) racial or ethnic discrimination, (g) being bullied, (h) positive mentor presence, and (i) exposure to community violence. Collectively, the majority of included studies suggest that depressive symptoms were more likely found among Asian American adolescents who (a) are older, (b) are female, (c) have immigrant status, (d) exhibit coping behaviours, (e) face academic challenges, (f) face a poor socioeconomic situation, (g) perceive parent–child conflict, (h) perceive maternal disconnectedness, and (i) perceive negative peer relations. A number of conflictive findings also existed. Discussion/Conclusions: This systematic review provides a summary of the various psychosocial factors on individual, familial, and social levels, which influenced the depressive symptoms of Asian American adolescents. Such findings offer a starting point to examine what factors should be necessarily included in related depression-preventive intervention design and evaluation. Culturally sensitive care, strengthened family–school–community collaboration, and targeted research efforts are needed to meet the needs of Asian adolescents experiencing a range of depressive symptoms.

Acculturation and Self-rated Health Among Asian Immigrants: The Role of Gender and Age

Using the 2002–2003 National Latino and Asian American Study (NLAAS), we examine the relationship between acculturation and poor-to-fair self-rated health (SRH) among Asian immigrants (N = 1639). Using latent class analysis, we construct a multidimensional measure of acculturation that considers dimensions of involvement in U.S. culture as well as attachment to Asian ethnic cultures and identify three classes of Asian immigrants: the assimilated, who most strongly adhere to U.S. culture; the integrated, who align with both U.S. and Asian ethnic cultures; and the separated, who are almost exclusively attached to Asian ethnic cultures. Logistic regression results revealed that among the pooled sample of Asian immigrant adults, the separated are significantly more likely to report poor-to-fair SRH than the assimilated. We then tested for gender and age differences in the acculturation–SRH relationship, and found that stratifying by gender yields noticeably different patterns. Among Asian immigrant women, the probability of reporting poor-to-fair SRH increases with age for the separated and the integrated, while it declines with age for the assimilated. Conversely, among Asian immigrant men, the probability of reporting poor-to-fair SRH increases most steeply with age for the assimilated, while it is shallower for the separated and the integrated. Future research should continue to develop a dynamic understanding of acculturation and examine its association with other health outcomes, including how these relationships differ across subsets of immigrant groups.

A person-centered examination of acculturation and psychological functioning among Chinese and Korean immigrant mothers in the United States

Objectives: The present research used a person-centered approach to examine the acculturation styles of Chinese and Korean immigrant mothers in the United States and demographic characteristics and psychological functioning associated with each acculturation style. Method: The sample comprised 240 first-generation Chinese immigrant mothers (CIMs; M = 37.80 years, SD = 4.55) and 222 first-generation Korean immigrant mothers (KIMs; M = 36.00 years, SD = 3.69) of preschool children. Latent profile analysis was used to identify latent acculturation styles among CIMs and KIMs. We further examined whether mothers' acculturation styles were associated with their sociodemographic characteristics and psychological functioning within each cultural group. Results: Four acculturation styles were revealed among CIMs: (a) behaviorally undifferentiated/psychologically assimilated, (b) behaviorally marginalized/psychologically separated, (c) behaviorally psychologically assimilated, and (d) behaviorally integrated/psychologically undifferentiated. Three acculturation styles were uncovered among KIMs: behaviorally psychologically separated, behaviorally psychologically assimilated, and behaviorally psychologically integrated. Chinese behaviorally integrated/psychologically undifferentiated mothers and Korean behaviorally psychologically separated perceived the highest levels of coethnic concentration in their communities. Chinese behaviorally marginalized/psychologically separated mothers reported poorer psychological functioning than other Chinese mothers. Korean behaviorally psychologically separated mothers had poorer psychological functioning than other Korean mothers. Conclusions: Findings revealed the significant role of participation in the American mainstream culture for Asian immigrant mothers' psychological adjustment. The heterogeneity in the acculturation experiences of Asian immigrants in the United States was highlighted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Migrant adolescents' behavioral problems compared to host adolescents and adolescents in their region of origin: a longitudinal study

BACKGROUND

Since the 1990s, families from the ecologically hostile mountainous southern areas of Ningxia Province, China, have been migrating to the northern areas of the province. This study compared the prevalence of behavioral problems among migrant adolescents to those among host adolescents (adolescents from the northern areas) and adolescents in the region of origin (adolescents from the southern areas), to determine whether ecological migration is related to adolescent behavioral problems, and possible changes in such problems over time.

METHODS

We used the Children and Adolescents Ecological Migration Survey on Mental Health, administered to 4805 students aged 12-16 years and their parents between 2012 and 2014 (W1), of whom 1753 students and their parents completed the follow-up between 2014 and 2017 (W2). Parents answered questions related to adolescent behavioral problems, main source of family income, parents' desire to reverse migrate, improved standard of living, and parents' educational attainment, while children completed the Eysenck Personality Questionnaire and a classroom environment questionnaire.

RESULTS

The prevalence of behavioral problems among the migrant adolescents (28.04%) was significantly higher than among host adolescents (21.59%) or adolescents in the region of origin (24.37%; p < 0.001) at W1. After adjusting for gender and age, parents' work outside the home was the main source of family income (OR = 1.42, 95% CI = 1.13-1.78), and adolescents' learning burden (OR = 1.04, 95% CI = 1.01-1.06) in school negatively influenced behavioral problems. Strong student-teacher relationships (OR = 0.97,95% CI = 0.94-0.99) and parents who had no intention to move back to the original residence (OR = 0.70, 95% CI = 0.52-0.94) exerted a protective effect at W1; at W2, a protective effect was associated with improved living conditions (OR = 0.39-0.55, 95% CI = 0.25-0.84). The extent of behavioral problems among migrant adolescents significantly decreased after two years.

CONCLUSION

Ecological migration will increase children's behavioral problems in the early stage, with various factors influencing the extent of these problems.

Gender as a Moderator of the Effect of Education and Acculturation on Cognitive Function: A Study of Older Korean Immigrants

Objectives: This study examined gender variations in the effect of education and acculturation on cognitive function in a group of older immigrants. Methods: Data were from the Study of Older Korean Americans, a multistate survey of Korean Americans aged 60 years and older (N = 2061). Multivariate linear regression models of cognitive function, measured with the Mini-Mental State Examination, were tested to examine the independent and interactive effects of education, acculturation, and gender. We hypothesized that gender would be a moderator in the relationships of education and acculturation with cognitive function. Results: Supporting the hypothesis, the positive effect of both education and acculturation was greater among women than men. Furthermore, the positive association of education with cognitive function was pronounced among women with low acculturation. Discussion: Our findings suggest that gender plays a critical role in determining the cognitive health benefit arising from education and acculturation singularly and in concert.

Mental Illness Public Stigma and Generational Differences Among Vietnamese Americans

Public stigma is one barrier to accessing behavioral health care among Vietnamese Americans. To explore and identify features of culture and acculturation that influence behavioral health-related stigma, six focus groups were conducted with Vietnamese American participants in three generational groups and eleven key informant interviews were conducted with Vietnamese community leaders, traditional healers, and behavioral health professionals. Data were analyzed using Link and Phelan's (Annu Rev Sociol 27(1):363-385, 2001) work on stigma as an organizing theoretical framework. Findings underline several key cultural and generational factors that intersect to affect perceptions, beliefs, and stigma about mental health treatment. In particular, participants in the youngest groups highlighted that while they recognized the value of mental health services, they felt culturally limited in their access. This appeared to be closely related to intergenerational communication about mental health. The findings suggest avenues for further research as well as interventions to increase mental health treatment access and adherence.

Neighborhood Social Cohesion and Serious Psychological Distress Among Brazilian Immigrants in Boston

Recent migrants to the United States face various stressors, including adjustment to new community norms and practices. To ease this transition, migrant groups have traditionally formed enclaves where they might live in close proximity and access institutions designed to serve their cultural interests. For newer migrant groups, such as Brazilians residing in New England, neighborhood social cohesion may therefore be particularly important for buffering against serious psychological distress. We use representative data from the 2007 Boston Metropolitan Immigrant Health and Legal Status Survey to estimate the association of serious psychological distress with neighborhood-level social cohesion among foreign-born Brazilian adults. We find that serious psychological distress is inversely related to neighborhood social cohesion (OR 0.66, 95% CI 0.46, 0.94). Annual earnings were also negatively associated with distress (OR 0.97, 95% CI 0.93, 0.99). Our findings suggest that neighborhood social ties may buffer against serious psychological distress for Brazilian migrants in New England.

Ethnic density effects for adult mental health: systematic review and meta-analysis of international studies

BACKGROUND

Despite increased ethnic diversity in more economically developed countries it is unclear whether residential concentration of ethnic minority people (ethnic density) is detrimental or protective for mental health. This is the first systematic review and meta-analysis covering the international literature, assessing ethnic density associations with mental health outcomes.

METHODS

We systematically searched Medline, PsychINFO, Sociological Abstracts, Web of Science from inception to 31 March 2016. We obtained additional data from study authors. We conducted random-effects meta-analysis taking into account clustering of estimates within datasets. Meta-regression assessed heterogeneity in studies due to ethnicity, country, generation, and area-level deprivation. Our main exposure was ethnic density, defined as the residential concentration of own racial/ethnic minority group. Outcomes included depression, anxiety and the common mental disorders (CMD), suicide, suicidality, psychotic experiences, and psychosis.

RESULTS

We included 41 studies in the review, with meta-analysis of 12 studies. In the meta-analyses, we found a large reduction in relative odds of psychotic experiences [odds ratio (OR) 0.82 (95% confidence interval (CI) 0.76-0.89)] and suicidal ideation [OR 0.88 (95% CI 0.79-0.98)] for each 10 percentage-point increase in own ethnic density. For CMD, depression, and anxiety, associations were indicative of protective effects of own ethnic density; however, results were not statistically significant. Findings from narrative review were consistent with those of the meta-analysis.

CONCLUSIONS

The findings support consistent protective ethnic density associations across countries and racial/ethnic minority populations as well as mental health outcomes. This may suggest the importance of the social environment in patterning detrimental mental health outcomes in marginalized and excluded population groups.

Conflicting Cultural Values, Gender Role Attitudes, and Acculturation: Exploring the Context of Reproductive and Mental Health of Asian-Indian Immigrant Women in the US

Asian-Indians, one of the fastest growing US immigrant groups, experience depression and anxiety, particularly among women. In this mixed-methods study, quantitative (n = 217) and qualitative (n = 36) data explored egalitarian vs. traditional views regarding women's roles and rights. Bicultural integration, family planning decision-making ability, and anxiety were associated with more egalitarian views, while Punjabi language preference, depression, and more births were associated with traditional views. Health care professionals serving this population need to be aware of the potential cultural values conflicts and gender role expectations that influence decisions around reproductive health and mental health care for Asian-Indian immigrant women.

Racial/Ethnic Differences in Emotional Health: A Longitudinal Study of Immigrants' Adolescent Children

First, discrimination was conceptualized as a major source of stress for immigrants' adolescent children. Next, such children's emotional health (indicated by measures of self-esteem and depression) was examined for possible associations with discrimination, psychosocial supports, and social structure; additionally, race/ethnicity's possible moderating role in such associations was evaluated. Data from the first 2 waves of the Children of Immigrants Longitudinal Study (1991-2006) were employed, focusing on 3 groups: Asians, Hispanics, and Whites. Linear regression analyses were used to weigh how discrimination, psychosocial supports, and social structure measured at Wave 1 and Wave 2 related to self-esteem and depression measured at Wave 2. Asians exhibited the highest level of depression and were most likely to perceive discrimination; Asians' self-esteem was also low, compared to other groups'. Discrimination and psychosocial supports appeared to operate differentially in explaining the 3 groups' emotional health.

The Acculturation of Community Psychology: Is There a Best Way?

In this paper I describe a community psychology perspective on acculturation and adjustment of immigrants and refugees and suggest that this field of acculturation research has in turn something to offer heuristically as we consider our identity and training for future generations of community psychologists over the next 50 years. I suggest that honoring our heritage, maintaining our disciplinary identity as community psychologists, and sustaining doctoral programs that offer training specific to community psychology are crucial for our survival as a field and is not antithetical to, and is indeed necessary for, interdisciplinary collaborations.

Toward a Culturally Responsive Model of Mental Health Literacy: Facilitating Help-Seeking Among East Asian Immigrants to North America

Studies have consistently found that East Asian immigrants in North America are less likely to use mental health services even when they experience levels of distress comparable to Euro-Americans. Although cultural factors that may prevent East Asian immigrants from seeking mental health care have been identified, few studies have explored ways to foster appropriate help-seeking and use of mental health services. Recent work on mental health literacy provides a potential framework for strategies to increase appropriate help-seeking and use of services. This paper reviews the literature on help-seeking for mental health problems among East Asian immigrants living in Western countries to critically assess the relevance of the mental health literacy approach as a framework for interventions to improve appropriate use of services. Modifications needed to develop a culturally responsive framework for mental health literacy are identified.

Association between Social Integration and Health among Internal Migrants in ZhongShan, China

Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants’ health statuses with varying years of residence, and explored the associations between the migrants’ social integration and health. We used the data from 2014 Internal Migrant Dynamic Monitoring Survey of Health and Family Planning in ZhongShan, China. Health status was measured from four aspects: self-reported health, subjective well-being, perception of stress, mental health. We measured social integration through four dimensions: economy, social communication, acculturation, and self-identity. The analyses used multiple linear regressions to examine the associations between self-reported health, subjective well-being, and perception of stress, mental health and social integration. The analytical sample included 1,999 households of the internal migrants and 1,997 local registered households, who were permanent residents in ZhongShan. Among the internal migrants, Adults in the labor force, who were aged 25 to 44 years old, accounted for 91.2% of the internal migrant population, while 74.6% of the registered population were in that age group. Median residential time among migrants was 2.8 (1.3–6.2) years, and 20.2% of them were migrating in the same Guangdong province. Except for mental health, other health statuses among migrants had significant differences compared with local registered population, e.g. self-reported health was better, but subjective well-being was worse. However, these health measurements were improved with more years of residence. Moreover, our results show that two aspects of social integration, economic integration and self-identity, were significantly associated with health status. Subjective feeling of relative social status levels were more associated with health, which prompted the attention to social fairness and the creation of a fair and respectful culture. More interventions could be experimented, such as encouraging internal migrants to participate in community activities more actively, educating local registered residents to treat internal migrants more equally, and developing self-identity among internal migrants. Better social, economic, and cultural environment can benefit internal migrants’ health statuses.

Acculturation and Psychological Adjustment of Vietnamese Refugees: An Ecological Acculturation Framework

Acculturation to the culture of the host society as well as to one's heritage culture have been shown to impact immigrants' adjustment during the years following resettlement. While acculturation has been identified as an important factor in adjustment of Vietnamese immigrants (Birman and Tran in Am J Orthopsychiatr 78(1):109-120. doi: 10.1037/0002-9432.78.1.109 , 2008), no clear pattern of findings has emerged and too few studies have employed an ecological approach. The purpose of this paper is to contextualize the study of acculturation and adjustment by taking an ecological approach to exploring these relationships across several life domains, using a bilinear scale, and examining mediators of these relationships for adult Vietnamese refugees (N = 203) in the United States. We call this approach the Ecological Acculturation Framework (EAF). Results of a structural equation model (SEM) showed that job satisfaction fully mediated the relationship between American acculturation and psychological distress, demonstrating that this relationship was specific to an occupational domain. However, while Vietnamese acculturation predicted co-ethnic social support satisfaction, it did not predict reduced psychological distress. Implications for a life domains approach, including domain specificity, are discussed.

Clinical Encounters with Immigrants: What Matters for U.S. Psychiatrists

About 3.2 percent of the population across the globe are migrants. Today, unprecedented numbers of people are relocating in the U.S. and more than ever, psychiatrists find themselves caring for immigrant patients. International migration is a multilayered issue that often has implications for the mental health of migrants. Thus, there is an increasing interest in understanding how the different factors associated with migration processes affect the mental health outcomes of immigrants. We group these factors into three categories: immigrant process, clinical encounter, and mental health services. When possible, we incorporate a gendered and life span perspective and suggest avenues for including what we know into the care of children, adults, and elderly psychiatric patients with immigrant backgrounds. We pay special attention to the immigrant paradox literature, which explains why some immigrants are healthier when they start their journey, and why their mental health deteriorates as they live longer in the host societies. We aim at providing psychiatrists an understanding of what to ask, assess, and consider when caring for patients who are international migrants.

An Exploration of Parenting Stress in Immigrant and Taiwanese Mothers

To assess parenting stress and major difficulties experienced in early motherhood among immigrant and Taiwanese women in Pingtung, southern Taiwan. A comparative, descriptive, cohort study of parenting stress and maternal psychological health, using the Child Care Stress Checklist and Edinburgh Postpartum Depression Scale. A purposive sample of 26 foreign-born Vietnamese and 162 Taiwanese mothers were surveyed at 6 weeks' postpartum. Both groups of mothers experienced similar parenting difficulties including the establishment of a regular sleeping schedule for the infant, consoling a crying infant, awareness of infant's needs, conflict with family members, and difficulties managing household chores. Curtailment of social activities was reported more often by Taiwanese mothers, whereas inaccessibility to other experienced mothers and poor maternal-infant bonding were experienced more by immigrant mothers. There were significant differences between groups, with high levels of child care stress and postpartum depression symptoms reported more often by immigrant mothers. Nurses-midwives and community child health nurses need to be sensitive to the particular difficulties and stresses of parenting in mothers from different backgrounds and provide effective interventions and support activities.

Hispanic residential ethnic density and depression in post-acute coronary syndrome patients: Re-thinking the role of social support

BACKGROUND

The ethnic density hypothesis suggests that ethnic density confers greater social support and consequently protects against depressive symptoms in ethnic minority individuals. However, the potential benefits of ethnic density have not been examined in individuals who are facing a specific and salient life stressor.

AIMS

We examined the degree to which the effects of Hispanic ethnic density on depressive symptoms are explained by socioeconomic resources and social support.

METHODS

Patients with acute coronary syndrome (ACS, N = 472) completed the Beck Depression Inventory (BDI) and measures of demographics, ACS clinical factors and perceived social support. Neighborhood characteristics, including median income, number of single parent households and Hispanic ethnic density, were extracted from the American Community Survey Census (2005-2009) for each patient using his or her geocoded address.

RESULTS

In a linear regression analysis adjusted for demographic and clinical factors, Hispanic ethnic density was positively associated with depressive symptoms (β = .09, standard error (SE) = .04, p = .03). However, Hispanic density was no longer a significant predictor of depressive symptoms when neighborhood characteristics were controlled. The relationship of Hispanic density on depressive symptoms was moderated by nativity status. Among US-born patients with ACS, there was a significant positive relationship between Hispanic density and depressive symptoms and social support significantly mediated this effect. There was no observed effect of Hispanic density to depressive symptoms for foreign-born ACS patients.

CONCLUSION

Although previous research suggests that ethnic density may be protective against depression, our data suggest that among patients with ACS, living in a community with a high concentration of Hispanic individuals is associated with constrained social and economic resources that are themselves associated with greater depressive symptoms. These data add to a growing body of literature on the effects of racial or ethnic segregation on health outcomes.

Asian American problem drinking trajectories during the transition to adulthood: ethnic drinking cultures and neighborhood contexts

OBJECTIVES

We aimed to identify problem drinking trajectories and their predictors among Asian Americans transitioning from adolescence to adulthood. We considered cultural and socioeconomic contextual factors, specifically ethnic drinking cultures, neighborhood socioeconomic status, and neighborhood coethnic density, to identify subgroups at high risk for developing problematic drinking trajectories.

METHODS

We used a sample of 1333 Asian Americans from 4 waves of the National Longitudinal Study of Adolescent to Adult Health (1994-2008) in growth mixture models to identify trajectory classes of frequent heavy episodic drinking and drunkenness. We fitted multinomial logistic regression models to identify predictors of trajectory class membership.

RESULTS

Two dimensions of ethnic drinking culture-drinking prevalence and detrimental drinking pattern in the country of origin-were predictive of problematic heavy episodic drinking and drunkenness trajectories. Higher neighborhood socioeconomic status in adolescence was predictive of the trajectory class indicating increasing frequency of drunkenness. Neighborhood coethnic density was not predictive of trajectory class membership.

CONCLUSIONS

Drinking cultures in the country of origin may have enduring effects on drinking among Asian Americans. Further research on ethnic drinking cultures in the United States is warranted for prevention and intervention.

Enculturation and attitudes toward intimate partner violence and gender roles in an asian Indian population: implications for community-based prevention

This study examined the relationships among enculturation, attitudes supporting intimate partner violence (IPV-supporting attitudes), and gender role attitudes among one of the largest Asian Indian population groups in the US. Data were collected via computer-assisted telephone interviews with a random sample of Gujarati men and women aged 18-64 in Metropolitan Detroit. Using structural equation modeling, we modeled the effects of three components of enculturation (behavior, values, and community participation) on gender role attitudes and IPV-supporting attitudes among married respondents (N = 373). Analyses also accounted for the effects of respondent age, education, religious service attendance, perceived financial difficulty, and lengths of residence in the US. The second-order, overall construct of enculturation was the strongest predictor of IPV-supporting attitudes (standardized B = 0.61), but not gender role attitudes. Patriarchal gender role attitudes were positively associated with IPV-supporting attitudes (B = 0.49). In addition to the overall effect of the enculturation construct, two of the components of enculturation had specific effects. "Enculturation-values" had a specific positive indirect association with IPV-supporting attitudes, through its relationship with patriarchal gender role attitudes. However, "enculturation-community participation" was negatively associated with IPV-supporting attitudes, suggesting the importance of community-based prevention of IPV among this immigrant population group.

Is family functioning and communication associated with health-related quality of life for Chinese- and Korean-American breast cancer survivors?

PURPOSE

This study aims to investigate direct and indirect pathways of family flexibility, social support, and family communication on health-related quality of life (HRQOL) for Chinese- and Korean-American breast cancer survivors (BCS).

METHODS

A total of 157 Chinese (n = 86)- and Korean-American (n = 71) BCS were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County. The present study was guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation.

RESULTS

Structural equation modeling demonstrated that (1) family communication was directly associated with HRQOL for both groups; (2) family flexibility was indirectly associated with HRQOL through family communication for Korean-Americans only; (3) social support mediated the relationship between family flexibility and family communication for Chinese-Americans only; and (4) acculturation was directly related to social support for both groups. Multigroup analysis demonstrated that the structural paths were equivalent between Chinese- and Korean-American BCS, although statistical differences in baseline parameters were noted.

CONCLUSIONS

Our findings suggest that family communication impacts HRQOL among Asian-American BCS. Our results show that while there are commonalities in family characteristics among Asian-Americans, specific ethnic variations also exist. Therefore, specific cultural and familial contexts should be assessed to better inform interventions to enhance family communication strategies and improve HRQOL.