Social isolation and perceived barriers to establishing social networks among Latina immigrants

Exploring the Role of Marianismo and Loneliness in Latinas' Physical and Mental Well-Being

The goal of this study is to better understand the role of social relationships and traditional gender norms in Latina health. Utilizing Hawkley and Cacioppo's theoretical model of loneliness and health as a framework, loneliness is proposed as a key component in the relationship between the Latina gender norm of marianismo and health. Participants were 178 female adults who identified as Latina (N = 97) or non-Latina White (N = 81), ranging in age from 19-88, who completed measures of loneliness, marianismo, depression, overall health, and health practices. Results indicate that being Latina was associated with family pillar marianismo, which includes characteristics centered on women's roles as the core of the family, that was associated with lower loneliness, and lower loneliness was subsequently associated with better overall health, lower depression, and beneficial health practices. However, being Latina had no association with silencing self to maintain harmony marianismo, that in turn had no association with loneliness, or health outcomes. These results suggest that elements of marianismo can play a protective role in Latina health and well-being, particularly when Latinas endorse the positive aspects of the gender norm that place women at the center of their families. Results also help explain the Latino health paradox by providing more specificity in the links between Latina ethnicity and positive health outcomes.

Mujeres Unidas: A Pilot Study to Educate Latina Women

In the United States, it is estimated that 15% of Latinos will experience a depressive or anxiety disorder during their lifetime. Education, prevention programming, and health interventions around topics such as stress, nutrition, mental health, and health maintenance for Latino immigrants are lacking, inadequate, or nonexistent. This type of programming may be protective against depression and anxiety. A total of 19 Latina women completed a five-week, group-based intervention to learn about stress, stress management, nutrition, mental health, and healthy behaviors in a culturally sensitive environment taught by native Spanish speakers. Program evaluation occurred through in-depth interviews and changes in anxiety and depression scores via the Generalized Anxiety Scale and the Patient Health Questionnaire, respectively. The team saw statistically significant decreases in the GAD-7 scores pre- and post-intervention (8.00 versus 5.08, p<0.05), but no differences in the PSS or the PHQ-2 scores. Group-based intervention and education taught by native Spanish speakers may be an acceptable and feasible approach to addressing anxiety in Latina immigrants.

Study design: The social wellbeing of newly-arrived adolescent migrants in reception education in Flanders (socNAMs)

AIMS

socNAMs provides a comprehensive and comparative dataset for researchers to identify how students' recent migration and their school setting relates to their social wellbeing, particularly regarding their feelings of loneliness. Results: This study design article delineates a quantitative cross-sectional research study (socNAMs) which successfully developed three questionnaires that were administered with unique and hard to reach populations, newly-arrived adolescent migrants (NAMs) and school staff offering reception education in Flanders, Belgium.

METHODS

At the individual level, socNAMs collected information on: (1) socio-demographic variables of NAMs; (2) migration and family context; (3) social relationships; (4) school experiences; (5) self-perceived wellbeing (physical and social); and (6) experiences with discrimination. The questionnaire developed for NAMs is available in 16 languages. To gain a further understanding of the impact of the school environment on NAMs, socNAMs collected contextual information primarily concerning school social capital by including data collected from teachers and reception-class coordinators. The final sample included 1379 NAMs, 50 teachers and 26 reception-class coordinators, from 35 schools offering reception education.

CONCLUSIONS

In this article, we present the rationale for this study, the methodology of sampling and recruitment, the development and content of the questionnaires, some preliminary descriptive results and the strengths and limitations of the study. Future empirical studies will address the research aims outlined in this protocol paper. In addition, we highlight the opportunities that the dataset provides for advancing research regarding the social wellbeing of NAMs in varying school and national contexts.

Mexican-origin women's individual and collective strategies to access and share health-promoting resources in the context of exclusionary immigration and immigrant policies

BACKGROUND

A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being.

METHODS

We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014.

RESULTS

Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network.

CONCLUSIONS

Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.

Amigas Latinas Motivando el Alma: Participant Perspectives on an In-Person and Online Implementation of an Intervention to Promote Mental Health in Latina Immigrant Women

Amigas Latinas Motivando el Alma is a community-based intervention designed to increase social support and coping strategies among Latina immigrant women at risk for depression and anxiety. To assess satisfaction and perceived efficacy of the intervention, we conducted interviews with 32 participants that received the intervention in-person and online. Participants across both modalities found the program supportive in maintaining their mental health. They learned stress management techniques and found the support from facilitators and other participants helpful. Those receiving the intervention in-person were able to connect with other participants more easily than those that received it online. Those receiving it online noted distractions at home that made it challenging to fully engage. Community-based interventions that promote coping strategies and social support are a promising strategy for addressing mental health disparities among Latina immigrant women.TRN: NCT03749278, date of registration: November 21, 2018.

Sociocultural Responsive Frameworks to Increase Engagement in Service Systems Through a Peer-to-Peer Model

Service engagement is critical when working with children and families experiencing chronic adversities because of their socially marginalized status. Further, sociodemographic disparities exist in service engagement within service systems including Community-Based Behavioral Health; likely in part, a result of structural issues driving unresponsive service systems. Despite this knowledge, a large proportion of the family engagement literature continues to be approached through a deficit-based and family-centric lens leaving out important systemic considerations and furthering health inequities. Drawing from a Socio-Ecological Framework (Stokols, 1996), this study focuses on exploring the value of peer support providers (PSPs) to understand how sociocultural responsiveness functions under this service model. Individual interviews and focus group data were collected from both families and PSPs. Thematic analysis (Braun & Clarke in Qualitative Research in Psychology, 3(2), 77-101, 2006) was utilized to code and synthetize the data collected. Findings highlight the importance of capitalizing on meaningful and trusting relationships to foster family engagement in services. These findings solidify the understanding that family engagement is a function of crucial relationships between family, provider, and systems. This work also illustrates how PSPs organic embodiment of sociocultural responsiveness through cultural humility is an avenue through which family engagement can be sustained.

Promoting mental health in Latina immigrant women: Results from the Amigas Latinas Motivando el Alma intervention trial

INTRODUCTION

Latina immigrants are at increased risk of depression and anxiety and limited access to mental health care. This study evaluated the effectiveness of Amigas Latinas Motivando el Alma (ALMA), a community-based intervention to reduce stress and promote mental health among Latina immigrants.

METHODS

ALMA was evaluated using a delayed intervention comparison group study design. Latina immigrants (N = 226) were recruited from community organizations in King County, Washington from 2018 to 2021. Although originally developed to be delivered in-person, due to the COVID-19 pandemic the intervention was adapted mid-study to be delivered online. Participants completed surveys to assess changes in depression and anxiety post-intervention and at a two-month follow-up. We estimated generalized estimating equation models to assess differences in outcomes across groups, including stratified models for those receiving the intervention in-person or online.

RESULTS

In adjusted models, participants in the intervention group had lower levels of depressive symptoms than the comparison group post-intervention (β = -1.82, p = 0.01) and at two-month follow-up (β = -1.52, p = 0.01). Anxiety scores decreased for both groups, and there were no significant differences post-intervention or at follow-up. In stratified models, participants in the online intervention group had lower levels of depressive (β = -2.50, p = 0.007) and anxiety (β = -1.86, p = 0.02) symptoms than those in the comparison group, but there were no significant differences among those that received the intervention in-person.

CONCLUSIONS

Community-based interventions can be effective in preventing and reducing depressive symptoms among Latina immigrant women, even when delivered online. Further research should evaluate the ALMA intervention among larger more diverse Latina immigrant populations.

Our voices, our lives: Unforeseen stories after the violence and opening the door to becoming whole again

We are a group of 11 women in Albuquerque, New Mexico. Nine of us are immigrants from Mexico. One of us is from an immigrant household. One of us is neither. We have been working collaboratively on a research study called Tertulias (Spanish for "a social gathering"), which is an innovative women's peer support group approach we created to reduce social isolation, depression, and stress among women immigrants from Mexico, and to increase their resilience and sense of empowerment. In the process of implementing the Tertulias study, we are revealing the profound power of peer support, friendship, and small, quotidian kindnesses. But we are also exposing the immensity and scope of trauma, fear, loneliness, depression, and self-blame that exist in the Mexican immigrant community because of domestic violence. Our experience with domestic violence and with the consciousness-raising and support we found in Tertulias has made us want to be involved in a positive manner to do something about this issue in our community. We want our experience to mean something-to be used to make a difference. We are opening our hearts and sharing our stories and ideas. We wanted to be included as co-authors of this article because we want our stories to be received and heard by other women. We want to plant seeds to help other women find their inner strength to be able to escape from their chains. We have to return for others. It is a commitment-to understand how we were able to do it and share that with others. Through our experience participating in Tertulias, we learned that we could overcome what felt overwhelming and impenetrable. We could leave the violence and rediscover and recreate ourselves and our lives.

Measuring Latinx/@ immigrant experiences and mental health: Adaptation of discrimination and historical loss scales

Migration processes encompass uncertainty, discrimination, racism, stigma, social isolation, lack of access to resources, fear of deportation, and family separation, having a critical impact on the health of Latinx/@ immigrants in the United States. It is essential to accurately measure the ways in which social, legal, economic, and political contexts impact mental health. This article discusses adaptation and use of discrimination and historical loss measures in a multilevel community-based advocacy, learning, and social support intervention (Immigrant Well-Being Project) with Latinx/@ immigrants in New Mexico, using participatory research approaches. Participants (n = 52) were recruited through community partner organizations and completed four qualitative and quantitative interviews over a 12-month period. The present analysis draws on the baseline quantitative data. Results show it is possible to adapt standardized measures of discrimination developed to assess the experiences of other racial/ethnic groups; however, the most common responses involved response options added by our research team. For the historical loss instrument, there was a high frequency of "never" answers for many items, suggesting that they were not relevant for participants or did not capture their experiences of loss. As with the discrimination measures, the items we added resonated the most with participants. The contexts of discrimination and loss for Latinx/@ immigrant populations are complex, thus the tools we use to measure these experiences and their impact on health must account for this complexity. This study contributes to these endeavors through involving community members in the conceptualization and measurement of discrimination and historical loss among Latinx/@ immigrants. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Racial and Ethnic Differences in Maternal Social Support and Relationship to Mother-Infant Health Behaviors

OBJECTIVE

To examine racial and ethnic differences in maternal social support in infancy and the relationship between social support and mother-infant health behaviors.

METHODS

Secondary analysis of baseline data from a multisite obesity prevention trial that enrolled mothers and their 2-month-old infants. Behavioral and social support data were collected via questionnaire. We used modified Poisson regression to determine association between health behaviors and financial and emotional social support, adjusted for sociodemographic characteristics.

RESULTS

Eight hundred and twenty-six mother-infant dyads (27.3% non-Hispanic Black, 18.0% Non-Hispanic White, 50.1% Hispanic and 4.6% Non-Hispanic Other). Half of mothers were born in the United States; 87% were Medicaid-insured. There were no racial/ethnic differences in social support controlling for maternal nativity. US-born mothers were more likely to have emotional and financial support (rate ratio [RR] 1.14 95% confidence interval [CI]: 1.07, 1.21 and RR 1.23 95% CI: 1.11, 1.37, respectively) versus mothers born outside the United States. Mothers with financial support were less likely to exclusively feed with breast milk (RR 0.62; 95% CI: 0.45, 0.87) yet more likely to have tummy time ≥12min (RR 1.28; 95% CI: 1.02, 1.59) versus mothers without financial support. Mothers with emotional support were less likely to report feeding with breast milk (RR 0.82; 95% CI: 0.69, 0.97) versus mothers without emotional support.

CONCLUSIONS

Nativity, not race or ethnicity, is a significant determinant of maternal social support. Greater social support was not universally associated with healthy behaviors. Interventions may wish to consider the complex nature of social support and population-specific social support needs.

"We Need Health for All": Mental Health and Barriers to Care among Latinxs in California and Connecticut

Latinx (im)migrant groups remain underserved by existing mental health resources. Past research has illuminated the complex factors contributing to this problem, including migration-related trauma, discrimination, anti-immigrant policies, and structural vulnerability. This paper uses decolonial-inspired methods to present and analyze results from two studies of Latinx (im)migrant communities in central California and southern Connecticut in the United States. Using mixed quantitative and qualitative analysis, we demonstrate the intersectional complexities to be addressed in formulating effective mental health services. Relevant social and structural factors including knowledge of mental health, access to insurance, and experiencing discrimination were significantly associated with anxiety symptoms, based on linear regression analysis. Ethnographic interviews demonstrate how complex trauma informs mental health needs, especially through the gendered experiences of women. Overlapping aspects of gender, language barriers, fear of authorities, and immigration status contoured the lived experiences of Latinx (im)migrants. Thematic analyses of open-ended survey responses also provide recommendations for solutions based on the experiences of those directly affected by these health disparities, particularly relating to healthcare access, affordability, and capacity. Building from these findings and past research, we recommend the adoption of a comprehensive model of mental health service provision for Latinx (im)migrants that takes into account Indigenous language access, structural competency, expanded health insurance, and resources for community health workers.

Acceptability of Behavioral Activation for Depression Among Latinas: A Mixed Methods Study

Latinxs represent the largest ethnoracial minority population in the United States. Despite having significant rates of depression, Latinxs underutilize behavioral health services. This, combined with the association between gender and depression (women have higher rates of depression than men), underscores the importance of developing an improved understanding of how Latinas view behavioral activation (BA), an empirically supported treatment for depression. In this mixed methods study, participants consisted of 77 Latinas; participants were provided with a vignette depicting a fictional character that underwent BA for depression. Participants in the quantitative study completed a measure of treatment acceptability of BA (n = 60); participants in the qualitative study completed a semistructured interview assessing their views on BA (n = 17). Latinas had generally positive attitudes about BA, although they also identified some elements that they perceived might act as barriers to treatment success. Because we were interested in the interplay of cultural factors and treatment acceptability, we also examined enculturation and acculturation as predictors of treatment acceptability-enculturation only was a significant predictor treatment acceptability. Our sample was relatively small, social desirability may have influenced our responses, and it is not known to what extent our results generalize to Latinx men. Latina women find BA to be an acceptable treatment for depression, which suggests promise with regard to clinical outcomes for depressed Latinas receiving BA. Addressing potential barriers to treatment engagement may improve outcomes for depressed Latinas receiving BA.

Psychosocial and behavioral health indicators among immigrant and non-immigrant recent mothers

BACKGROUND

Perinatal risk factors can vary by immigration status. We examined psychosocial and behavioral perinatal health indicators according to immigration status and immigrant characteristics.

METHODS

We conducted a population-based cross-sectional study of 33,754 immigrant and 172,342 non-immigrant childbearing women residents in Manitoba, Canada, aged 15-55 years, who had a live birth and available data from the universal newborn screen completed within 2 weeks postpartum, between January 2000 and December 2017. Immigration characteristics were from the Canadian federal government immigration database. Logistic regressions models were used to obtain Odds Ratios (OR) with 95% confidence intervals (CI) for the associations between immigration characteristics and perinatal health indicators, such as social isolation, relationship distress, partner violence, depression, alcohol, smoking, substance use, and late initiation of prenatal care.

RESULTS

More immigrant women reported being socially isolated (12.3%) than non-immigrants (3.0%) (Adjusted Odds Ratio (aOR): 6.95, 95% CI: 6.57 to 7.36) but exhibited lower odds of depression, relationship distress, partner violence, smoking, alcohol, substance use, and late initiation of prenatal care. In analyses restricted to immigrants, recent immigrants (< 5 years) had higher odds of being socially isolated (aOR: 9.04, 95% CI: 7.48 to 10.94) and late initiation of prenatal care (aOR: 1.50, 95% CI: 1.07 to 2.12) compared to long-term immigrants (10 years or more) but lower odds of relationship distress, depression, alcohol, smoking and substance use. Refugee status was positively associated with relationship distress, depression, and late initiation of prenatal care. Secondary immigrants, whose last country of permanent residence differed from their country of birth, had lower odds of social isolation, relationship distress, and smoking than primary migrants. There were also differences by maternal region of birth.

CONCLUSION

Immigrant childbearing women had a higher prevalence of social isolation but a lower prevalence of other psychosocial and behavioral perinatal health indicators than non-immigrants. Health care providers may consider the observed heterogeneity in risk to tailor care approaches for immigrant subgroups at higher risk, such as refugees, recent immigrants, and those from certain world regions.

A systematic review of loneliness and social isolation among Hispanic/Latinx older adults in the United States

Loneliness and social isolation are growing public health problems in older adults, associated with physical and mental comorbidity and increased mortality. In the United States, Hispanic/Latinx individuals constitute the largest racial/ethnic minority. Studies retrieved from PsycInfo, Embase, and PubMed were examined. The initial search yielded 1476 publications. Using the updated PRISMA Flow guidelines, a total of 17 studies met our review criteria. Eight studies assessed loneliness, six evaluated social isolation, and three investigated both. The reports varied in the details of methodology, preventing meta-analyses. Differences in the experience of loneliness and social isolation between Hispanic/Latinx and White adults are not consistent. Of the three studies of loneliness or social isolation among Hispanic/Latinx groups of different national origins, two reported significant differences. Loneliness was associated with greater overall comorbidity, but two studies found higher risk of metabolic and cardiovascular disorders in Hispanic/Latinx with loneliness. Social isolation was generally associated with worse physical health, being older, male, and unmarried, and having lower education and income, and more smoking, along with frailty and cognitive impairment. We make specific suggestions for future research on loneliness and social isolation in Hispanic/Latinx adults and offer guidelines for clinical management.

The unreachable doorbells of South Texas: community engagement in colonias on the US-Mexico border for mosquito control

Mosquitoes and the diseases they transmit continue to place millions of people at risk of infection around the world. Novel methods of vector control are being developed to provide public health officials with the necessary tools to prevent disease transmission and reduce local mosquito populations. However, these methods will require public acceptance for a sustainable approach and evaluations at local settings. We present our efforts in community engagement carried out in colonias of the Lower Rio Grande Valley in south Texas for mosquito surveillance, control, and ecological projects. Along the US-Mexico border the term colonia refers to impoverished communities that are usually inhabited by families of Hispanic heritage. The different engagements were carried out from September 2016 to February 2019; during this time, we had three distinct phases for community engagement. In Phase 1 we show the initial approach to the colonias in which we assessed security and willingness to participate; in Phase 2 we carried out the first recruitment procedure involving community meetings and house-to-house recruitment; and in Phase 3 we conducted a modified recruitment procedure based on community members' input. Our findings show that incorporating community members in the development of communication materials and following their suggestions for engagement allowed us to generate culturally sensitive recruitment materials and to better understand the social relationships and power dynamics within these communities. We were able to effectively reach a larger portion of the community and decrease the dropout rate of participants. Progress gained with building trust in the communities allowed us to convey participant risks and benefits of collaborating with our research projects. Community engagement should be viewed as a key component of any local vector control program as well as for any scientific research project related to vector control. Even in the face of budgetary constraints, small efforts in community engagement go a long way.

Loneliness, age at immigration, family relationships, and depression among older immigrants: A moderated relationship

Guided by a convoy model of social relations, this study explores the complex relationships between loneliness, age at immigration, familial relationships, and depressive symptoms among older immigrants. This study used 2010 Health and Retirement Study data from a sample of 575 immigrants (52% female, age range 65-99 years). Ordinary least squares regression models were estimated. The findings indicate that for older immigrants who came to the United States at age 45 or older, loneliness was significantly positively associated with depressive symptoms. Further, perceived negative strain and hours spent helping family moderated this relationship such that the effect of loneliness on depressive symptoms was stronger among respondents who perceived more negative family strain and spent fewer hours helping family. Familial relationships are crucial for the psychological well-being of older immigrants because they can be a source of either stress or support. The results have implications for how research and practices can support the immigrant families.

Financial Worry and Psychological Distress Among Immigrants in the United States, 2013-2018

The coronavirus disease 2019 (COVID-19) pandemic has highlighted links among economic stability, health outcomes, and migration. The facets of financial worry and their associated psychological burden have been understudied among the immigrant population. The goal of this study was to determine the specific facets of financial worry and associated psychological burden in immigrants. This cross-sectional study, which used data from the 2013 to 2018 National Health Interview Survey (NHIS), examined patient-reported measures of worry regarding financial strain. The NHIS is a household survey of noninstitutionalized, nonmilitary adults in the United States. Multivariable ordinal logistic regressions were used to define adjusted odds ratios (AORs) for financial worry and psychological distress, adjusting for various sociodemographic variables. Among 131,669 US-born and 26,155 non-US-born participants who responded to all 6 questions on the 6-item Kessler Psychological Distress Scale (K6), the overall prevalence of participants reporting any serious psychological distress (K6 score ≥13) was 3.0% and 2.25%, respectively. Despite these overall prevalence data, there were specific areas of financial worries that were higher in non-US-born participants than in US-born participants. Compared with US-born participants, non-US-born participants had higher rates of financial worries regarding retirement [75.78% vs. 69.08%, AOR=1.37, 95% confidence interval (CI) 1.29-1.45, P<0.001], medical costs due to illness (worry about not being able to pay medical costs of a serious illness or accident) (74.94% vs. 65.27%, AOR=1.37, 95% CI: 1.29-1.45, P<0.001), standard of living (74.25% vs. 65.29%, AOR=1.42, 95% CI: 1.34-1.51, P<0.001), and medical cost of health care (worry about not having enough to pay medical costs for normal health care) (66.52% vs. 52.67%, AOR=1.51, 95% CI: 1.43-1.60, P<0.001), among other costs. Notably, serious psychological distress in non-US-born individuals was associated with increased financial worry relative to US-born individuals with a similar level of psychological distress. Further research is needed to evaluate the role physicians can play in mitigating psychological distress in patients with increased financial worry.

Adverse Childhood Experiences and Depressive Symptoms among Young Adult Hispanic Immigrants: Moderating and Mediating Effects of Distinct Facets of Acculturation Stress

Hispanic immigrants experience more adverse childhood experiences (ACEs) and depressive symptom chronicity/severity than non-Hispanic peers. Acculturation stress relates to both depressive symptoms and ACEs, but the mechanism is not well-understood. We conducted a secondary data analysis of baseline data, from an ongoing longitudinal study to test theoretically-based mediating and moderating effects of acculturation stress on the relationship between ACEs and depression in a sample of young adult Hispanic immigrants (N = 391). Results indicated ACEs predicted depressive symptoms. Mediation and moderation effects were significant for cumulative and distinct facets of acculturation stress. Implications for mental health nurses are discussed.

Which roads lead to depression in Latinas? A network analysis of prenatal depressive symptoms, discrimination, acculturative stress, and low birth weight

Although immigrant mothers from some Latinx subgroups initially achieve healthy birth outcomes despite lower socioeconomic status, this advantage deteriorates across generations in the United States. Interpersonal discrimination and acculturative stress may interact with economic hardship to predict an intergenerational cascade of emotional and biological vulnerabilities, particularly perinatal depression. Network analyses may elucidate not only how and which psychosocial experiences relate to depressive symptoms, but which symptom-to-symptom relationships emerge. This study aims to understand (1) how economic, acculturative, and discrimination stressors relate to prenatal depression and low birth weight and (2) how Latinas may respond to and cope with stressors by exploring symptom-symptom and symptom-experience relationships. A sample of 151 pregnant Latinas (predominantly foreign-born and Mexican and Central American descent) completed the EPDS and psychosocial questionnaires (discrimination, acculturation, acculturative stress, economic hardship) during pregnancy (24-32 weeks). Birth weights were recorded from postpartum medical records. We created network models using the Extended Bayesian Information Criterion Graphical Least Absolute Shrinkage and Selection Operator to estimate the relationship between variables. Discrimination exposure connected psychosocial stressors to depressive symptoms, particularly worry, crying, sadness, and self-blame. Discrimination also revealed a connection between acculturation and low birth weight. Furthermore, younger age of migration and greater acculturation levels were correlated to greater discrimination stress and low birth weights. Perinatal research in Latinas must account not only for measures of cultural adaptation but recognize how developmental exposures across the life span, including discrimination, may be associated with adverse health trajectories for a mother and her child.

The brief sense of community scale: Testing dimensionality and measurement invariance by gender among Hispanic/Latinx youth

Psychological sense of community is defined as feelings of belongingness and a shared belief that community members will meet one another's needs. Psychological sense of community has four dimensions: membership, influence, needs fulfillment, and emotional connection. In this study, multigroup confirmatory factor analysis was used to examine the first and second-order factor structure of the brief sense of community scale (BSCS) between male and female Hispanic/Latinx adolescents from an urban community (N = 947). To help validate the BSCS model, the second-order factor model was tested with regression to predict the measures of intrapersonal psychological empowerment and ethnic identity, as constructs conceptually related to psychological sense of community. Findings support that: (1) psychological sense of community can be measured through the BSCS and as a four-factor model among Hispanic/Latinx youth, supporting McMillan and Chavis's (1986) original theoretical discussions; (2) while no differences between genders were present at the model-level, there was path-specific variation; and (3) intrapersonal psychological empowerment and ethnic identity were associated with psychological sense of community.

Migration-related emotional distress among Vietnamese psychiatric patients in Germany: An interdisciplinary, mixed methods study

Culture and socialization influence how individuals perceive and express emotional distress. Research therefore, must consider the context to capture individual experiences. However, the majority of studies on factors associated with emotional distress among migrants use quantitative approaches, limiting an in-depth understanding. This study investigates emic themes of emotional distress among Vietnamese migrants by integrating anthropological and psychiatric approaches. The mixed methods study first quantified differences in reported themes of distress between Vietnamese (n = 104) and German (n = 104) patients, who utilized two psychiatric outpatient clinics in Berlin, Germany. Based on these differences, ethnographic interviews were conducted with 20 Vietnamese patients. In the quantitative part, differences in frequency of reported distress between Vietnamese and German patients indicate cultural and migration-related issues among Vietnamese migrants, such as the upbringing of children in a transcultural context. In the qualitative part, interviews with Vietnamese patients elicited contextualizing information and additional themes of distress. Besides commonly expressed socioeconomic themes, such as work and finances, we identified affectively charged themes concerning roles toward partnership and children. A central emic theme is expressed as "moments of speechlessness," which go beyond a lack of language proficiency and challenge patients in different spheres of life. Migration entails complex affective dynamics, determined by a specific migratory and post-migratory context. Within this context, norms and values determine which themes of distress patients articulate openly. Therefore, an interdisciplinary, mixed-methods approach can yield a contextualized understanding of emotional distress and the complex nature of migration.

A Conceptual Review of Loneliness in Adults: Qualitative Evidence Synthesis

The paper reports an evidence synthesis of how loneliness is conceptualised in qualitative studies in adults. Using PRISMA guidelines, our review evaluated exposure to or experiences of loneliness by adults (aged 16+) in any setting as outcomes, processes, or both. Our initial review included any qualitative or mixed-methods study, published or unpublished, in English, from 1945 to 2018, if it employed an identified theory or concept for understanding loneliness. The review was updated to include publications up to November 2020. We used a PEEST (Participants, Exposure, Evaluation, Study Design, Theory) inclusion criteria. Data extraction and quality assessment (CASP) were completed and cross-checked by a second reviewer. The Evidence of Reviews of Qualitative Research (CERQual) was used to evaluate confidence in the findings. We undertook a thematic synthesis using inductive methods for peer-reviewed papers. The evidence identified three types of distinct but overlapping conceptualisations of loneliness: social, emotional, and existential. We have high confidence in the evidence conceptualising social loneliness and moderate confidence in the evidence on emotional and existential loneliness. Our findings provide a more nuanced understanding of these diverse conceptualisations to inform more effective decision-making and intervention development to address the negative wellbeing impacts of loneliness.

Stress, social support and their relationship to depression and anxiety among Latina immigrant women

OBJECTIVE

Latina immigrant women in the United States are at increased risk of adverse mental health outcomes due to economic, political, cultural and social stressors related to migration and resettlement. However, few studies have described how stress and social supports are related to depression and anxiety symptoms among Latina immigrant women.

METHOD

This cross-sectional study used survey data collected from a community-based sample as part of the Amigas Latinas Motivando el Alma (ALMA) study to describe levels of stress, social support, depression and anxiety among Latina immigrant women (N=153). We also estimated associations between stressors, social supports and mental health.

RESULTS

At baseline, 29% of participants reported moderate to severe depressive symptoms and 32% of participants reported moderate to severe anxiety symptoms. In adjusted regression models, stressors including social isolation (β=0.2, p<0.001), perceived stress (β=0.6, p<.0001), and law/immigration enforcement stress (β=0.3, p=0.04) were associated with higher levels of depression symptoms. Perceived stress (β=0.6, p<0.001) and stress associated with meeting basic needs (β=0.6, p<0.001) were associated with higher levels of anxiety symptoms, while social support received through positive social interactions was associated with fewer anxiety symptoms (β=-0.8, p=0.03).

CONCLUSIONS

Latina immigrant women experience a number of stressors associated with immigration and their social position, which in turn are associated with increased symptoms of depression and anxiety. Future research should examine how social support, along with programs and policies that reduce stress, can improve mental health outcomes in this population.

Perceived loneliness and the role of cultural and intergenerational belonging: the case of Portuguese first-generation immigrants in Luxembourg

The risk of loneliness for migrants, particularly in older age, has been documented across multiple studies. Migration is a life-changing transition. While often retaining links to their country of origin, an important developmental task for migrants is the establishment of bonds in the receiving country. Drawing on recent studies, I will explore the role of cultural and intergenerational belonging in order to identify both protective and risk factors regarding loneliness in middle and older age in a sample of first-generation immigrants from Portugal living in Luxembourg. The sample comprises N = 131 participants (51.9% female) between the ages of 41 and 80 (M = 56.08; SD = 7.80) who have on average spent M = 31.71 years (SD = 8.81) in Luxembourg and raised children in Luxembourg. They took part in the IRMA project ('Intergenerational Relations in the Light of Migration and Ageing') which was funded by the Fonds National de la Recherche Luxembourg. A standardised questionnaire assessed socio-demographic data, aspects of cultural belonging (i.e. cultural attachment to both countries, bicultural identity orientation, acculturative stress), intergenerational belonging (i.e. family cohesion, family conflict, perceived intergenerational value consensus) and perceived loneliness. Results showed that while cultural and intergenerational belonging were protective factors, the strongest predictors for participants' perceived loneliness were cultural identity conflict and, even more so, intergenerational conflict. Our findings suggest that establishing roots and bonds in the host country is a protective factor against loneliness, whereas the feeling of not fitting in is a strong risk factor.

Dairy is Different: Latino Dairy Worker Stress in Vermont

Latino immigrant dairy workers face significant challenges. Dairy's employment of immigrants is recent compared to other sectors, though today immigrants account for over half of US dairy workers. This study applies the Migrant Farmworker Stress Inventory to dairy for the first time. Interviews of 173 workers were conducted using the MFWSI, augmented with dairy specific indictors. Bivariate analysis identified associations between dairy worker characteristics and stress. Findings were compared to other studies using the MFWSI. Average stress was 74.6/156 points, with 36.5% at risk for clinically significant stress. Vermont ranked eighth among 11 MFWSI studies, and fourth of seven studies for significant stress. Primary stressors differed from studies of fruit and crop workers. Over a third of Vermont immigrant dairy workers risk debilitating stress. The MFWSI underestimates dairy farmworker stress and should be modified for this sector. Identified stressors indicate Spanish-language, dairy safety training may be beneficial.

"I Don't Have Time to Be Sad": Experiences and Perceptions of Sadness among Latina Mothers

Maternal depression affects 10 percent to 17 percent of mothers in the United States. Women of color, particularly Latina women, may be at an elevated risk for adverse consequences of maternal depression. However, scant research addresses cultural experiences and perceptions of maternal depressive feelings. This study included interviews with 30 Latina immigrant mothers who were living in rural or small towns in the Midwest. Data were analyzed in Spanish using a thematic network approach. Authors identified three themes in relation to the experiences that Latina immigrant mothers described around sadness and depressive feelings: (1) normalization of feelings of sadness, (2) lack of social support that exacerbates feelings of isolation and sadness, and (3) traditional gender roles that compromise disclosure of feelings. The results from this study indicate that it is critical to increase support, provide culturally grounded discussions around mental health among Latina immigrant women, and continue these conversations beyond the perinatal period.

Marianismo Beliefs, Intimate Partner Violence, and Psychological Distress Among Recently Immigrated, Young Adult Latinas

Marianismo is a Latino cultural value that describes both positive and negative aspects of traditional Latina femininity. Marianismo emphasizes culturally valued qualities such as interpersonal harmony, inner strength, self-sacrifice, and morality. Endorsement of marianismo is hypothesized to correlate with individual economic, educational, and personal variables. Marianismo also is theorized to potentially influence attitudes about, experiences of, and responses to intimate partner violence (IPV) among Latina women. The present study examined whether endorsement of marianismo beliefs mitigated or exacerbated psychological distress after experiences of IPV in a sample of 205 recently immigrated Latina women, aged 18 to 23 years. Latina women experiencing higher levels of IPV and endorsing greater marianismo beliefs were hypothesized to indicate greater psychological distress. Unexpectedly, women who endorsed more Subordinate to Others/Self-Silencing to Maintain Harmony marianismo beliefs indicated more psychological distress (p = .05), greater symptoms of psychological distress (p = .01), and greater average distress (p = .03) when they also reported less IPV than peers. Implications for understanding Latinas' responses to and reporting of IPV, as well as for culturally tailored counseling interventions for this underserved and understudied population, are discussed.

Culturally Responsive Trauma-Informed Services: A Multilevel Perspective from Practitioners Serving Latinx Children and Families

Using a multilevel ecological framework, we take a qualitative approach to examining important cultural considerations that support successful implementation of trauma-informed services within the Latinx community. We conducted key informant interviews with community practitioners recruited primarily in the Phoenix, AZ metro area. Themes that emerged from interviews captured societal, community, and individual barriers to effective implementation of a culturally responsive trauma-informed approach. Specifically, multilevel barriers included socioeconomic circumstances, normalization of trauma exposure, and the transgenerational impact of trauma. Practitioners also reported approaching their work using relationship-focused and family-centered frameworks as facilitators to service engagement. We highlight the critical need for a culturally responsive trauma-informed approach that stresses the importance of context, recognizes transgenerational vulnerabilities, and promotes equity and the utilization of cultural humility in order to lessen the multilayered disparities in service accessibility experienced by minoritized communities.

Mexican-Born Women's Experiences of Perinatal Care in the United States

Mexican-born women represent a significant proportion of the obstetric patient population in California and have higher incidence of adverse obstetric outcomes than white women, including maternal postpartum hemorrhage and perinatal depression. Little is known, however, about Mexican-born women's experiences of maternity care in the United States. Qualitative methods were used to conduct a secondary analysis of interview transcripts, field notes, original photographs, and analytic memos from a study of 7 Mexican-born women's birth experiences. Participants reported social isolation influenced their expectations of maternity care. Disconnection, characterized by unmet physical and relational needs, yielded negative experiences of maternity care, while positive experiences were the result of attentive care wherein they felt providers cared about them as individuals.

A randomized control trial to test a peer support group approach for reducing social isolation and depression among female Mexican immigrants

BACKGROUND

Female Mexican Immigrants (FMIs) experience high rates of depression compared with other populations. For this population, depression is often exacerbated by social isolation associated with the experience of immigration. Aim 1. To measure whether a culturally situated peer group intervention will reduce depression and stress associated with the experience of immigration. Aim 2. To test whether an intervention using a "women's funds of knowledge" approach results in improved resilience, knowledge and empowerment. Aim 3. To investigate whether a culturally situated peer group intervention using a women's funds of knowledge approach can give participants a sense and experience of social and physical connection ("emplacement") that is lost in the process of immigration.

METHODS

This mixed-methods study will implement "Tertulias" ("conversational gatherings" in Spanish), a peer support group intervention designed to improve health outcomes for FMI participants in Albuquerque, New Mexico. We will document results of the intervention on our primary hypotheses of a decrease in depression, and increases in resilience and social support, as well as on our secondary hypotheses of decreased stress (including testing of hair cortisol as a biomarker for chronic stress), and an increase in social connectedness and positive assessment of knowledge and empowerment.

DISCUSSION

This project will address mental health disparities in an underserved population that experiences high rates of social isolation. Successful completion of this project will demonstrate that health challenges that may appear too complex and too hard to address can be using a multi-level, holistic approach. Our use of hair samples to test for the 3-month average levels of systemic cortisol will contribute to the literature on an emerging biomarker for analyzing chronic stress.

TRIAL REGISTRATION

This study was registered with ClinicalTrials.gov on 2/3/20, Identifier # NCT04254198 .

Skin and Soft Tissue Infection in People Living With Human Immunodeficiency Virus in a Large, Urban, Public Healthcare System in Houston, Texas, 2009-2014

BACKGROUND

Skin and soft tissue infections (SSTIs) disproportionately impact patients with human immunodeficiency virus (HIV). Recent declines in the incidence of SSTIs have been noted in the non-HIV population. We sought to study the epidemiology and microbiology of SSTIs in a population of 8597 patients followed for HIV primary care in a large, urban county system from January 2009 to December 2014.

METHODS

SSTIs were identified from the electronic medical record by use of International Classification of Diseases-9 billing codes. Charts were reviewed to confirm each patient's diagnosis of acute SSTI and abstract culture and susceptibility data. We calculated the yearly SSTI incidences using Poisson regression with clustering by patient.

RESULTS

There were 2202 SSTIs identified. Of 503 (22.8%) cultured SSTIs, 332 (66.0%) recovered Staphylococcus aureus as a pathogen, of which 287/332 (86.4%) featured S. aureus as the sole isolated organism. Among the S. aureus isolates that exhibited antibiotic susceptibilities, 231/331 (69.8%) were methicillin resistant, and the proportion did not change by year. The observed incidence of SSTI was 78.0 per 1000 person-years (95% confidence interval 72.9-83.4) and declined from 96.0 infections per 1000 person-years in 2009 to 56.5 infections per 1000 person-years in 2014 (P < .001). Other significant predictors of SSTI incidences in both univariate as well as multivariate analyses included a low CD4 count, high viral load, and not being a Spanish-speaking Hispanic.

CONCLUSIONS

SSTIs remain a significant problem in the outpatients living with HIV, although rates of SSTIs appear to have declined by approximately 40% between 2009 and 2014.

Ethnic density, social support, and loneliness among Chinese immigrants in Philadelphia

Living in more 'ethnically dense' areas is thought to promote health, possibly by facilitating social support and a sense of belonging. Because of kin networks and cultural obligations, family relationships may be particularly important for Asian immigrants. Chinese-origin individuals are the largest group of Asian Americans and among the most highly segregated, but the psychosocial benefits of living in Chinese neighborhoods are not established. We examined whether Chinese immigrants in areas of higher ethnic density report more social support from family and friends, and less loneliness. For 606 participants recruited 1/2016-5/2019 throughout the Philadelphia region, residences were linked to American Community Survey 2013-2017 data. Ethnic density, operationalized as percent of Census tract residents who were Chinese, was categorized into quintiles. Family/friend support and loneliness were self-reported, then dichotomized to distinguish high levels of family support, friend support, and loneliness. In logistic regression adjusting for age, sex, and individual- and tract-level socioeconomic characteristics, ethnic density was associated with high family support (odds ratio (OR) 1.85, 95% confidence interval (CI) 1.09, 3.11) for highest vs. lowest ethnic density quintile)) and inversely associated with loneliness (OR 0.31, 95% CI 0.12, 0.79, highest vs. lowest quintile). Our findings support the hypothesis that residents of areas with higher ethnic density report more social support from family and less loneliness. Whether these benefits arise from characteristics of the community overall or from the aggregation of individual assets remains to be clarified but has implications for efforts to develop community resources that would benefit all their residents.

Muxeres en Acción: The Power of Community Cultural Wealth in Latinas Organizing for Health Equity

Community psychology, despite its commitment to social justice, is prone to engage in deficit-based perspectives that do not appropriately capture the strengths of Latinx communities. Given these limitations, we use a Community Cultural Wealth (CCW) (Yosso, 2005) framework to describe how muxeres, Latina women who identify as promotoras, madres, and mamás, leveraged their political power and culturally informed leadership to improve the health and well-being of their communities. We highlight instances from our fieldwork, witnessing the agency of muxeres en acción for health equity. We offer three case studies to describe how we approached our collaborations with three groups of muxeres situated in different geographic locations in the state of California. The first case study discusses how immigrant muxeres who identify as promotoras (e.g., health workers) in the Central Valley developed their research skills through a promotora model that allowed them to build the capacity to advocate for the well-being of their communities. The second example offers reflections from a Community-Based Participatory Action Research (CBPAR) project with a group of Mexican immigrant madres in a gentrified community in San José. Lastly, the third case study describes how a group of mamás in the East Side of Los Angeles addressed issues of educational inequities. Together, these case studies illustrate muxeres' advocacy for their health and well-being. Because women in general, and muxeres in particular, are considered gatekeepers of culture and tradition within their families, it is crucial that community psychologists ground their work in ethically and culturally appropriate frameworks that highlight the power of muxeres.

Physiologic and psychosocial changes of the menopause transition in US Latinas: a narrative review

Latinos comprise the fastest-growing minority group in the USA, with Hispanic women (Latinas) constituting 17% of women aged 45-54 years. The menopause transition (MT) is associated with many physiological, behavioral, and psychosocial changes that can affect disease risk in women. While several epidemiologic investigations have enhanced our understanding of the MT, to date, menopause research has mostly focused on non-Latina White women. As a consequence, there is a dearth of information on strategies for managing menopause-related issues in Latinas and important factors to consider to provide culturally appropriate care and promote lifestyles that may reduce adverse health outcomes. This narrative review summarizes existing evidence of the MT in Latinas, with a focus on hormonal alterations, menopausal symptoms, mental health, cognition, and cardiometabolic health. The clinical and research implications of the current literature will also be discussed.

"My own corner of loneliness:" Social isolation and place among Mexican immigrants in Arizona and Turkana pastoralists of Kenya

This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural shaping of expectations for social lives and the ways in which structural vulnerability and violence can undermine these expectations. We draw on ethnographic research with two groups of migrants: Mexican immigrants living in southern Arizona and Turkana pastoralists of Kenya who experience displacement and unpredictable mobility as a result of low intensity violence. For Mexican immigrants, feelings of loneliness intertwine with the emotions of fear, trauma, and sadness, all closely associated with social isolation. The Turkana describe loneliness associated with the loss of their animals, or the shifting social landscapes they must traverse to keep their families safe. The culturally salient experiences described by these two communities highlight the complexity of defining loneliness. Given the pace of global migration and the number of refugees and displaced persons, closer scrutiny of how cultural expectations and structural violence interact to produce feelings of loneliness seems overdue.

Associations of Sociodemographic Factors With Health-Related Social Networks Among Premigration Filipinos

Social networks provide health information that is useful to prevent illness, promote health, and facilitate treatment for health problems. One understudied facet is which people in social networks provide health information. The present article fills a critical gap in the empirical literature by identifying which social networks are reported based on a premigrant's sociodemographic status that operate as their source of health information. Data were analyzed from the Health of the Philippine Emigrants Study (HoPES) (n = 829) migrant sample. Findings indicated having high English proficiency and educational attainment reduces the likelihood of reporting no one in their network as a source of health information. Those who reported family/relatives are less likely to be younger, and those who reported friends are also less likely to be living-in with a partner. This article informs social work researchers and practitioners in implementing interventions among premigration immigrants to help increase and broaden their social networks.

The Health of Undocumented Latinx Immigrants: What We Know and Future Directions

Undocumented Latinx immigrants experience unique factors prior to migration, during migration, and after migration that shape their health. Our review summarizes the limited but growing literature highlighting how exposure to trauma, immigration enforcement, changes to social networks, and discrimination negatively affect the mental and physical health of undocumented Latinx immigrants. We also discuss how policies and social ties can promote their health. We focus on areas of particular concern, including health care, mental health, and HIV. Future research should use interdisciplinary approaches and intersectional frameworks to understand and address health inequities. Conducting research with undocumented Latinx immigrant communities requires community engagement, assurance of confidentiality, and creative recruitment and retention strategies. Recommendations for public health practice include investing in community health centers and organizations to ensure access to health and social services; presenting results with sufficient contextualization to interpret their generalizability; and advocating for federal-, state-, and local-level policy changes that reduce the negative health consequences associated with being undocumented.

The Relationships between Loneliness, Social Support, and Resilience among Latinx Immigrants in the United States

Globally, international migrants are at elevated risk for experiencing loneliness due to separation from social networks in their countries of origin. In the United States, the political rhetoric has been particularly exclusionary against Latinx immigrants, exposing them to discrimination and fear of deportation. Such environments may result in heightened levels of social isolation, which may contribute to greater risk of poor mental and physical health outcomes. Latinx immigrants, however, may access social support in their destination communities that buffers against these negative outcomes. This study sought to examine how social support and loneliness shape Latinx immigrants' abilities to address the challenges related to migration. Multivariate linear regression analyses were conducted with survey data collected from Latinx immigrants in New York City (n=306). Results revealed that Latinx immigrants with greater social support and less feelings of loneliness were more resilient. Specifically, findings suggest that social support may partially protect against the negative impact of isolation on Latinx immigrants' capacity to thrive. Clinical social workers who work with immigrant groups may consider how migration during the life course affects immigrants' social supports and experiences of loneliness. Social work interventions that integrate strategies to increase social support may provide opportunities to address social isolation and other obstacles associated with migration. Such approaches acknowledge loneliness not only as a psychological symptom, but also as a consequence of unfavorable social environments towards immigrant populations. Future research may develop and assess culturally relevant strategies to promote social support and reduce loneliness among marginalized immigrants.

The Connecting and Reflecting Experience (CARE): theoretical foundation and development of mentalizing-focused parenting groups

In underserved communities with limited resources and disproportionately high morbidity and mortality rates, attachment-based, short-term, group interventions that are effective yet simple to disseminate can have a profound public health impact. This paper describes the implementation of a mentalizing-focused group parenting intervention. The Connecting and Reflecting Experience (CARE) serves primary caregivers of children from birth to 18 years within a diverse and impoverished community setting. Families living in communities facing health disparities are at heightened risk for intergenerational cycles of trauma which give rise to myriad public health crises at high societal cost. CARE's mission is to facilitate the intergenerational transmission of secure attachment which can profoundly reduce rates of psychiatric illness for future generations. The theoretical and empirical bases for the intervention and the evidence base for existing mentalizing-focused parenting interventions are reviewed. The program's structure and treatment goals are presented in the context of clinical case material.

"Se vale llorar y se vale reír": Latina Immigrants' Coping Strategies for Maintaining Mental Health in the Face of Immigration-Related Stressors

Latina immigrant women in the U.S. are at increased risk for poor mental health status, due to socioeconomic- and immigration-related stressors. We sought to describe the mechanisms linking immigration-related stressors and mental health, including how the current social and political climate affects women's mental health status, and which coping strategies are used to maintain well-being. We conducted four focus groups with Latina immigrants (N = 58) recruited through local community-based organizations. We drew on the stages of migration framework to guide our study design and analysis. Focus group transcripts were analyzed to identify emergent themes across groups. On average, focus group participants were 35.5 years old and had lived in the U.S. for 12.5 years. Most were from Mexico. Participants reported immigration-related stressors including unsafe migration, worry about immigration enforcement, broken social ties, and limited access to health and social services. In the face of these stressors, they relied on transnational social networks and connections with other Latina immigrant women. Social ties with family in the U.S. also helped them alleviate social isolation and overcome barriers to social services. Those who were mothers expressed that their children were a source of encouragement and comfort with feelings of stress. Immigration policies that contribute to unsafe migration, worry about immigration enforcement, limited social ties, and limited access to social services were associated with increased stress among Latina immigrants who participated in the focus groups. These participants could benefit from increased access to mental health care and community-based programs that connect them to resources.

Age-friendly communities and perceived disconnectedness: the role of built environment and social engagement

Objective: To examine the effect of access to outdoor space and buildings and social or community events on elders' perceived disconnectedness. Method: Data were from a representative survey conducted as part of an age-friendly community initiative in a large midwestern city in the United States. Hierarchical logistic regression was employed to examine the relationships between environment, engagement, and connection. Results: Having access to ramps to enter buildings reduced the odds of perceived disconnectedness by 79%, participation in social or community events reduced the odds of perceived disconnectedness by 83%. The odds of perceived disconnectedness for elders "not sure" of their access to public buildings were around 6 times that of those without access, holding all else constant. Discussion: Ensuring access to ramps to enter buildings, disseminating information about the accessibility of parks and buildings, and social or community events may reduce elders' perceived disconnectedness.

First-Generation Immigrant Mothers Report Less Spanking of 1-Year-Old Children Compared with Mothers of Other Immigrant Generations

Introduction The American Academy of Pediatrics discourages spanking, especially of infants and young toddlers. This study examines the association between maternal immigrant generation and reported spanking of 1-year-old children, and whether this association is impacted by domestic violence (DV). Methods We conducted a cross-sectional secondary data analysis using 1-year wave data from the Fragile Families and Child Wellbeing Study. We used descriptive statistics to explore demographic differences among first-generation, second-generation, and third-generation or higher (reference group) mothers. We conducted logistic regression to examine the association between immigrant generation and spanking, controlling for covariates. We used stratified logistic regression to evaluate how experiencing DV may impact the association between immigrant generation and spanking. Results The study included 370 first-generation mothers, 165 second-generation mothers, and 1754 reference group mothers. The prevalence of spanking differed across immigrant generations (p = 0.004). First-generation mothers had statistically significant lower odds of spanking compared with the reference group (adjusted OR 0.26; CI 0.11-0.64). Second-generation mothers also had lower odds of spanking compared with the reference group, although this result did not reach statistical significance (adjusted OR 0.60; CI 0.22-1.63). Mothers' report of experiencing DV appeared to impact the relationship between immigrant generation and spanking. Discussion First-generation immigrant mothers had lower odds of reported spanking compared to reference group mothers, an association which is attenuated for both second-generation immigrant mothers and mothers who have experienced DV. Future work should explore the potential factors that drive variations in spanking between immigrant generations.

The Role of Cultural and Family Values on Social Connectedness and Loneliness among Ethnic Minority Elders

OBJECTIVES

Ethnic minority elders have high levels of social isolation and loneliness. Assumptions about the family providing enough social support exist in the literature, contradicting ethnic minority elders' reported levels of isolation and loneliness. While structural barriers influence feelings of isolation and loneliness, limited information exists about the role of cultural factors such as acculturation and family values. Accordingly, this study investigated the roles of acculturation and family values on loneliness and social isolation among ethnic minority elders.

METHODS

Ethnic minority elders (N = 123) completed a questionnaire that assessed their social connectedness, measured by social network and levels of loneliness, and structural factors such as income. Additionally, cultural and family values were assessed by acculturation and the 'family as referents' dimension of familism, which refers to the belief that family members' behaviour should meet with familial expectations.

RESULTS

Statistical analysis using hierarchical regression indicated that 'family as referents' and acculturation predicted loneliness, but not social network.

CONCLUSIONS

This study raises the importance of considering cultural values when investigating predictors of loneliness among ethnic minority elders.

CLINICAL IMPLICATIONS

Findings highlight the importance of addressing familial expectations in programs aimed at alleviating loneliness among ethnic minority elders.

Migration and cognitive function: a conceptual framework for Global Health Research

BACKGROUND

Migration is a fundamental demographic process that has been observed globally. It is suggested that migration is an issue of global health importance that can have an immediate and lasting impact on an individual's health and well-being. There is now an increasing body of evidence linking migration with cognitive function in older adults. In this paper, we synthesized the current evidence to develop a general conceptual framework to understand the factors contributing to the association between migration and cognitive function.

METHODS

A comprehensive review of the literature was conducted on the associations between migration and cognition among middle-aged and older adults.

RESULTS

Five potential mechanisms were identified from the literature: 1) socioeconomic status-including education, occupation, and income; 2) psychosocial factors-including social networks, social support, social stressors, and discrimination; 3) behavioral factors-including smoking, drinking, and health service utilization; 4) physical and psychological health status-including chronic conditions, physical function, and depression; and 5) environmental factors-including both physical and social environment. Several underlying factors were also identified-including early-life conditions, gender, and genetic factors.

CONCLUSIONS

The factors linking migration and cognitive function are multidimensional and complex. This conceptual framework highlights potential implications for global health policies and planning on healthy aging and migrant health. Additional studies are needed to further examine these mechanisms to extend and refine our general conceptual framework.

Latinx Use of Traditional Health Care: The Social Network Effect

Studies on access to health care among Latinx communities have overlooked (a) the use of traditional healers and (b) the role of social networks in seeking traditional healers. Framed within the network-episode model, this study aimed to examine the role of individual, institutional, and personal network systems in the use of curanderxs among Latinxs in the United States. Using a nationally representative sample of Latinx adults (N = 3,997) from the 2007 Hispanic Healthcare Survey, authors conducted multivariate logistic regression analyses to investigate the impact of individual, institutional, and personal network systems on the use of curanderxs. Respondents who believed in spiritual healing (adjusted odds ratio [AOR] = 3.06) and came from a household that used curanderxs (AOR = 13.4) were more likely to seek the help of curanderxs when in need of health care. The personal network system had most explanatory power in the use of curanderxs. The findings add insight to the integration of traditional medicine in the provision of health care services to Latinxs in the United States. (Authors use the terms "Latinx" and "curanderx" to be inclusive of all gender identities.).

Self-rated health and its association with perceived environmental hazards, the social environment, and cultural stressors in an environmental justice population

Background

Communities with large minority populations often are located near sources of pollution and have higher crime rates, which may work in combination with other factors to influence health. Poor self-rated health is related to chronic health conditions and premature mortality, with minority populations most likely to report poor health. To address how both resident perception of neighborhood environments and chronic health conditions individually and collectively influence health, we examined self-rated health and its association with multiple types of perceived environmental hazards in a majority-Hispanic urban population.

Methods

We conducted interviews with 354 residents of Chelsea, Massachusetts, US and asked about self-rated health, perceptions of their neighborhood, including participant-reported environmental hazards (e.g., air quality, odors and noise), aspects of the social environment (e.g., feeling safe, neighborhood crime, social cohesion), and culture-related stressors (e.g., immigration status, language stress, ethnic identity). Log-linear models examined the independent and multivariable associations between these factors and fair/poor self-rated health, controlling for socio-demographic characteristics and preexisting health conditions.

Results

Forty-one percent of participants reported fair/poor self-rated health. Participants frequently perceived environmental hazards such as problems with pests and regular noise disturbance as well as feeling unsafe. In a multivariable model, a greater number of reported noise disturbances (≥ 2 noise sources = 1.53 [1.04–2.26]) and reported insecurity with immigration status (1.66 [1.01–2.73]) were positively associated with fair/poor self-rated health. High social cohesion was inversely associated (0.74 [0.48–1.14]) with fair/poor self-rated health in the multivariable model.

Conclusions

Negative perceptions of environmental hazards and reported cultural stressors were significantly associated with fair/poor self-rated health among residents in a low-income majority-minority community, with social cohesion having a beneficial association with self-rated health. Efforts to improve health should recognize the importance of public perceptions of social and environmental hazards found in neighborhood environments, and benefits of strengthening community connections.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5797-7) contains supplementary material, which is available to authorized users.