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Hamza M, Edwards RC, Beaumont JD, De Pretto L, Torn A. Access to natural green spaces and their associations with psychological wellbeing for South Asian people in the UK: A systematic literature review. Soc Sci Med 2024; 359:117265. [PMID: 39217719 DOI: 10.1016/j.socscimed.2024.117265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/16/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
Use of natural green spaces (NGS) is associated with improved psychological well-being (PWB). Ethnic minorities, particularly South Asian (SA) communities in the UK, face unequal access to NGS and experience a greater prevalence of health challenges than the general population. Improving access to green space can contribute to addressing current health inequalities. Following PRISMA guidelines, this systematic literature review aimed to synthesise existing research on NGS access barriers experienced by SAs and associations between NGS use and PWB. A comprehensive search was conducted through SAGE, Science Direct, and SCOPUS in August 2022; we included qualitative, quantitative and mixed-methods studies with findings on NGS access and/or associations between NGS use and PWB for SAs in the UK. We employed deductive thematic analysis to explore inhibitors and enablers of access which were then conceptualised through a multidimensional framework. Associations between NGS and PWB were coded inductively and mapped separately. This review is registered on PROSPERO: CRD42022353711. Twenty-six studies were included in the review which varied substantially in their aims, methods, context, and participants. Included studies on NGS grouped SAs within broader demographic categories such as minority ethnic communities or Muslims. Our findings indicate that SAs are disadvantaged in their access to NGS due to numerous intersecting factors including unequal distribution, inadequate transport, racialisation of NGS, and safety concerns. Whilst these findings generally aligned with broader literature on NGS access, certain access barriers and enablers are particularly significant to SA communities. We also identified several dimensions of PWB that are enhanced for SAs through interacting with NGS including overall mental health outcomes, physical wellbeing, and social relatedness. This review highlights opportunities to improve access to NGS and thereby enhance PWB outcomes for SA people. It also identifies the lack of primary research exploring NGS access and PWB associations for SA communities, specifically in rural contexts.
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Affiliation(s)
- Mohammed Hamza
- Faculty of Social Science and Education, Leeds Trinity University, Leeds, LS18 5HD, UK.
| | - Rachael C Edwards
- Evidence for Policy and Practice Information Centre, UCL Social Research Institute, Institute of Education, University College London, London, WC1E 6BT, UK
| | - Jordan D Beaumont
- Sheffield Business School, Sheffield Hallam University, Sheffield, S1 1WB, UK
| | - Laura De Pretto
- Faculty of Social Science and Education, Leeds Trinity University, Leeds, LS18 5HD, UK
| | - Alison Torn
- Faculty of Social Science and Education, Leeds Trinity University, Leeds, LS18 5HD, UK
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Joji T, Mapaling C. Facilitators and barriers to mental health help-seeking in Indian immigrant youth in Gauteng, South Africa. FRONTIERS IN SOCIOLOGY 2024; 9:1265353. [PMID: 39385978 PMCID: PMC11461456 DOI: 10.3389/fsoc.2024.1265353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/09/2024] [Indexed: 10/12/2024]
Abstract
Introduction International literature has documented significant underutilisation of mental health services among Indian immigrants. This study aimed to identify facilitators and barriers to mental health help-seeking among Indian immigrant youth in South Africa by evaluating their personal and lived experiences. Methods A qualitative study with a phenomenological design was conducted to understand the lived experiences of Indian immigrant youth regarding mental health help-seeking. Nine participants were recruited through purposive sampling from Gauteng. Data collection was performed through online interviews exploring participants' lived experiences. Thematic analysis was used to analyse the data. Results Five facilitator subthemes were identified: encouragement to seek help for mental health difficulties, social media and mass media influence, university and school environments, availability and awareness of resources, and open conversations about mental health. Four barrier subthemes emerged: individual perspectives on mental health, lack of access to resources, parental factors discouraging help-seeking, and community factors discouraging help-seeking. Discussion An improved understanding of these barriers and facilitators may allow other Indian immigrant youth to better manage their help-seeking processes while increasing awareness about similar experiences within the community.
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Affiliation(s)
- Timmy Joji
- Community Psychosocial Research (COMPRES) Entity, North-West University, Mahikeng, South Africa
| | - Curwyn Mapaling
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
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Sharma N, Mehta TS, Wahab RA, Patel MM. Facilitating Culturally Competent Breast Imaging Care in South Asian Patients. JOURNAL OF BREAST IMAGING 2024; 6:529-538. [PMID: 38787594 DOI: 10.1093/jbi/wbae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Indexed: 05/25/2024]
Abstract
South Asians are a rapidly growing subset of the Asian population in the United States. They comprise people from multiple countries with diverse beliefs, languages, and cultural identities and values. The incidence of breast cancer is rising in South Asian women in the United States, with earlier onset and predilection for HER2-enriched tumors. Despite the rising incidence of breast cancer, participation in screening remains lower than other populations. Health care inequities in South Asian women are multifactorial and may be due to traditional health beliefs and practices, language barriers, cultural differences, and lack of overall awareness. Developing a culturally sensitive environment in breast imaging clinic practice can lead to improved patient care and adherence. Given the scarcity of data specific to the South Asian population in United States, there is a need for health service researchers and practice leaders to obtain more high-quality data to understand the needs of South Asian patient populations.
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Affiliation(s)
- Nidhi Sharma
- Department of Radiology, Texas A&M University, Dallas, TX, USA
| | - Tejas S Mehta
- Department of Radiology, UMass Memorial Medical Center/UMass Chan Medical School, Worcester, MA, USA
| | - Rifat A Wahab
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Miral M Patel
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Arundell LLC, Saunders R, Buckman JEJ, Lewis G, Stott J, Singh S, Jena R, Naqvi SA, Leibowitz J, Pilling S. Differences in psychological treatment outcomes by ethnicity and gender: an analysis of individual patient data. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1519-1531. [PMID: 38321296 PMCID: PMC11343885 DOI: 10.1007/s00127-024-02610-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/01/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE There are discrepancies in mental health treatment outcomes between ethnic groups, which may differ between genders. NHS Talking Therapies for anxiety and depression provide evidence-based psychological therapies for common mental disorders. This study examines the intersection between ethnicity and gender as factors associated with psychological treatment outcomes. Aims were to explore by gender: (1) differences in psychological treatment outcomes for minoritized ethnic people compared to White-British people, (2) whether differences are observed when controlling for clinical and socio-demographic factors associated with outcomes, and (3) whether organization-level factors moderate differences in outcomes between ethnic groups. METHODS Patient data from eight NHS Talking Therapies for anxiety and depression services (n = 98,063) was used to explore associations between ethnicity and outcomes, using logistic regression. Stratified subsamples were used to separately explore factors associated with outcomes for males and females. RESULTS In adjusted analyses, Asian (OR = 0.82 [95% CI 0.78; 0.87], p < .001, 'Other' (OR = 0.79 [95%CI 0.72-0.87], p < .001) and White-other (0.93 [95%CI 0.89-0.97], p < .001) ethnic groups were less likely to reliably recover than White-British people. Asian (OR = 1.48 [95% CI 1.35-1.62], p < .001), Mixed (OR = 1.18 [95% CI 1.05-1.34], p = .008), 'Other' (OR = 1.60 [95% CI 1.38-1.84], p < .001) and White-other (OR = 1.18 [95% CI 1.09-1.28], p < .001) groups were more likely to experience a reliable deterioration in symptoms. Poorer outcomes for these groups were consistent across genders. There was some evidence of interactions between ethnic groups and organization-level factors impacting outcomes, but findings were limited. CONCLUSIONS Across genders, Asian, 'Other' and White-other groups experienced worse treatment outcomes across several measures in adjusted models. Reducing waiting times or offering more treatment sessions might lead to increased engagement and reduced drop-out for some patient groups.
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Affiliation(s)
- Laura-Louise C Arundell
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK.
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK.
| | - Rob Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Joshua E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, W1T 7NF, UK
| | - Joshua Stott
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Satwant Singh
- Waltham Forest Talking Therapies, North-East London NHS Foundation Trust, London, UK
| | - Renuka Jena
- Waltham Forest Talking Therapies, North-East London NHS Foundation Trust, London, UK
| | | | - Judy Leibowitz
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Stephen Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
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Sadana S, Spees CK, Ramaswamy B, Taylor CA. Cultural Perceptions of Health in Asian Indian Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00394-4. [PMID: 39186023 DOI: 10.1016/j.jneb.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To gain an understanding of the cultural perceptions of health among Asian Indian adults in an urban setting. DESIGN Qualitative semistructured interviews. SETTING Midwest urban community PARTICIPANTS: Asian Indian adults (n = 20) aged ≥25 years, who self-identified as 100% Asian Indian descent. PHENOMENON OF INTEREST Individual interviews were conducted by a trained interviewer to assess cultural perceptions of health. ANALYSIS Transcript analysis was performed by 2 independent coders using verbatim transcripts. Content analysis was used to identify themes using a grounded theory approach. RESULTS The salient themes that emerged were a cultural definition of health, acculturation, mental health, and health information. Participants believed good health was associated with the ability to perform daily activities, regular exercise, and eating well. There was a lack of awareness of Asian Indian-specific body mass index categories and that overweight and obesity were an important risk factor for chronic diseases. CONCLUSION AND IMPLICATIONS These data provide a context for health promotion efforts and underscore a gap in awareness of risk factors risk for chronic diseases among the Asian Indian community. Culturally specific interventions targeted at the Asian Indian population, considering their worldview and perceptions of health, will help address this important public health concern.
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Affiliation(s)
- Susmita Sadana
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
| | - Colleen K Spees
- Divison of Medical Dietetics, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University Columbus, OH
| | - Bhuvaneswari Ramaswamy
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Christopher A Taylor
- Department of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH.
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Mohsin F, Aravala S, Rahman T, Ali SH, Taher MD, Mitra P, Misra S. Psychiatric Healthcare Experiences of South Asian Patients with Severe Mental Illness Diagnoses and Their Families in New York City: A Qualitative Study. Community Ment Health J 2024:10.1007/s10597-024-01323-1. [PMID: 39046623 DOI: 10.1007/s10597-024-01323-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024]
Abstract
South Asians (SAs) underutilize mental health services compared to many racial and ethnic groups in the United States (US), yet there is limited research on the experiences of SAs living with severe mental illness (SMI). This study examined psychiatric healthcare experiences of SA patients with SMI diagnoses (e.g., severe depression, bipolar disorder, schizophrenia) in New York City. Data collection included semi-structured interviews with 36 participants (21 patients, 11 family members, 4 clinicians). Data was managed in NVivo. Two pairs of SA researchers conducted thematic analysis. Limited mental health knowledge led to delayed care for SAs due to a low perceived need for help. Ease of access, linguistic resources, patient-provider relationships, and family involvement influenced psychiatric healthcare experiences. Prescribed medications, self-motivation, communication, and religious practices were factors aiding symptom management and recovery. Findings highlight the need for improving psychiatric healthcare access and culturally-salient mental health education for SA communities.
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Affiliation(s)
- Farhan Mohsin
- NYU Grossman School of Medicine, Institute for Excellence in Health Equity, 180 Madison Ave, New York, NY, 10016, USA
| | - Sai Aravala
- NYU School of Global Public Health, 708 Broadway, New York, NY, 10003, USA
| | - Tasfia Rahman
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, 708 Broadway, New York, NY, 10003, USA
| | - M D Taher
- Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| | - Paroma Mitra
- Department of Psychiatry, NYC Health + Hospitals/Bellevue, 462 First Avenue, New York, NY, 10016, USA
- Department of Psychiatry at NYU Grossman School of Medicine, 550 First Avenue, New York, NY, 10016, USA
| | - Supriya Misra
- Department of Public Health, San Francisco State University, 1600 Holloway Ave, San Francisco, CA, 94132, USA.
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Dougan MM, Tzuang M, Nam B, Meyer OL, Tsoh JY, Park VMT. Discrimination Experiences among Asian American and Pacific Islander Adults during the COVID-19 Pandemic and Their Association with Mental Health Outcomes: Updated Findings from the COMPASS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:799. [PMID: 38929045 PMCID: PMC11204087 DOI: 10.3390/ijerph21060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Reports of escalated discrimination experiences among Asian American and Native Hawaiian Pacific Islanders (AANHPI) continue. METHODS Using the original and follow-up surveys of the COVID-19 Effects on the Mental and Physical Health of AAPI (Asian American and Pacific Islanders) Survey Study (COMPASS I and COMPASS II) (n = 3177), we examined changes over approximately a 1-year period in discrimination experiences attributable to being AAPI and factors associated with worse mental health outcomes. RESULTS Experiences of discrimination remained high in COMPASS II with 60.6% (of participants (compared to 60.2% among the same people in COMPASS I) reporting one or more discrimination experiences, and 28.6% reporting worse mental health outcomes. Experiences of discrimination were associated with modest but significant increase in the odds of worse mental health: adjusted OR 1.02 (95% CI 1.01-1.04). Being younger, being of Native Hawaiian/Pacific Islander or Hmong descent (relative to Asian Indian), and having spent 50% or less of their lifetime in the US (vs. US born), were significantly associated with worse mental health. CONCLUSIONS The fall-out from the pandemic continues to adversely impact AANHPI communities. These findings may help influence policy initiatives to mitigate its effects and support interventions designed to improve mental health outcomes.
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Affiliation(s)
- Marcelle M. Dougan
- Department of Public Health and Recreation, San José State University, San Jose, CA 95192, USA
| | - Marian Tzuang
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA; (M.T.); (B.N.); (V.M.T.P.)
| | - Bora Nam
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA; (M.T.); (B.N.); (V.M.T.P.)
| | - Oanh L. Meyer
- Department of Neurology, School of Medicine, University of California, Davis (UCD), Sacramento, CA 95817, USA;
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA;
| | - Janice Y. Tsoh
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA;
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California-San Francisco, San Francisco, CA 94143, USA
| | - Van M. Ta Park
- Department of Community Health Systems, School of Nursing, University of California-San Francisco, San Francisco, CA 94143, USA; (M.T.); (B.N.); (V.M.T.P.)
- Asian American Research Center on Health (ARCH), University of California-San Francisco, San Francisco, CA 94143, USA;
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Ramanathan A, Miah SK, Nagularaj L, Sharif HS, Shaikh M. Perceived expressed emotion in individuals with a first episode of psychosis from a south Asian background. Early Interv Psychiatry 2024. [PMID: 38703089 DOI: 10.1111/eip.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/22/2024] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
AIM To explore perceived expressed emotion in the south Asian context for individuals with a first episode of psychosis (FEP). METHOD Semi-structured interviews were conducted with 16 service users experiencing a FEP to understand their experience of expressed emotion (EE) from their caregivers. Interviews were analysed using inductive thematic analysis. RESULTS Four main categories were identified: connection and support, understanding and awareness, boundaries and independence and context and influence. Factors influencing perceived expressed emotion such as acceptance, acculturation, warmth and expressions of love, communication and family values were identified. Findings highlight south Asian's experiences of being cared for, and their perception of EE, including warmth and connection as a strength and resource. CONCLUSION The findings shed light on culturally specific EE within the context of FEP that can be considered when working with south Asian communities within early intervention services. Findings highlight the impact of navigating and negotiating bicultural identities and generational differences in EE in the British south Asian context.
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Affiliation(s)
- Amrita Ramanathan
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Syed K Miah
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Lidushi Nagularaj
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Madiha Shaikh
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- North East London NHS Foundation Trust, Rainham, UK
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Lunia P, Krishnan K, Irani F, Hundal JS, Arastu S, Vonk JMJ, Sunderaraman P. A scoping review of neuropsychological assessment for Asian Indians in the United States - research and clinical recommendations. Clin Neuropsychol 2024:1-21. [PMID: 38565847 DOI: 10.1080/13854046.2024.2327674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
Objective: There is an increasing focus on understanding health disparities among various cultural groups in the United States. The need for heterogeneity in norms and test stimuli across ethnically diverse individuals are being increasingly recognized. However, to date it remains unknown whether and to what extent differences in cognitive norms and tests exist in Asian Indians, a fast-growing population in the U.S. It is essential to understand these differences to improve diagnostic accuracy and provide timely and appropriate clinical care. Method: In this study, we conducted a scoping review of available cognitive tests that were normed, developed, or adapted for Asian Indians living in the U.S. Results: The results suggested a paucity of norms and tests specifically examining cognition in this community. Conclusions: Based on the findings, we provide suggestions for research directions focusing on the development of culturally sensitive neuropsychological tools, normative data representative of this demographic, and interventions addressing healthcare access barriers. Overall, this review provides readers with relevant clinical information to immediately enhance patient care as well as provide actionable items in research to improve the future utility of neuropsychology for Asian Indians in the United States.
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Affiliation(s)
- Palak Lunia
- Thomas Jefferson Medical Center, Philadelphia, PA, USA
| | - Kamini Krishnan
- Cleveland Clinic Lou Ruvo Center for Brain Health, Cleveland, OH, USA
| | | | | | - Sana Arastu
- Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jet M J Vonk
- Memory and Aging Center, Department of Neurology, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Preeti Sunderaraman
- Department of Neurology, Medical Campus, Boston, MA, USA
- The Framingham Heart Study - Brain Aging Program, Framingham, MA, USA
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John R, Amodeo M, Montero-Zamora P, Schwartz S, Salas-Wright C. Examining the Role of Cultural and Family Factors in Substance Use Risk Among Indian American Youth. Subst Use Misuse 2024; 59:1031-1038. [PMID: 38403989 PMCID: PMC11034790 DOI: 10.1080/10826084.2024.2320371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
INTRODUCTION Although Indian Americans constitute the second-largest immigrant group in the United States, there is a paucity of information about Indian American youth, particularly with respect to substance use risk. We examined the relationship of social factors to permissive substance use beliefs (a proxy for substance use risk since they can lead to adulthood substance use and misuse) and family functioning. METHODS The study used structural equation modeling to examine the prevalence of permissive substance use beliefs in a sample of Indian American youth ages 12-17 (N = 223) and examined the degree to which discrimination, bicultural identity integration, and endorsement of the model minority stereotype were associated with permissive substance use beliefs. RESULTS Findings suggest that bicultural identity integration (B = 0.267 [SE = 0.112], p = 0.01) and discrimination (B = 0.294 [SE = 0.087], p = 0.001) are positively associated with permissive substance use beliefs. Bicultural identity integration (B = 0.415 [SE = 0.090], p = 0.0001) was positively associated with family support (B= -0.329 [SE = 0.108], p = 0.002) which, in turn, was associated with less permissive substance use beliefs. In contrast, endorsement of the model minority stereotype (B = 0.351 [SE = 0.090], p = 0.001) was positively associated with family closeness (B = 0.232 [SE = 0.927], p = 0.01) which, in turn, was associated with family support and then with less permissive substance use beliefs. CONCLUSIONS Discrimination and bicultural identity integration emerged as key constructs related to substance use risk among Indian American youth. These youth could benefit from culturally appropriate prevention programming that addresses the negative impact of discrimination and its effect on permissive substance use beliefs and highlights protective factors.
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Affiliation(s)
- R.S John
- Rutgers University School of Social Work; 264 Bay State Road, Boston, MA 02215
| | - M Amodeo
- Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215
| | - P Montero-Zamora
- University of Texas at Austin College of Education, 1912 Speedway, Stop D5000 Austin, Texas 78712
| | - S.J Schwartz
- University of Texas at Austin College of Education, 1912 Speedway, Stop D5000 Austin, Texas 78712
| | - C.P Salas-Wright
- Boston College School of Social Work, 140 Commonwealth Ave., Chestnut Hill, MA 02467
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Martin P, Haroz EE, Lee C, Bolton P, Martin K, Meza R, McCarthy E, Dorsey S. A qualitative study of mental health problems among children living in New Delhi slums. Transcult Psychiatry 2024:13634615231202098. [PMID: 38389504 DOI: 10.1177/13634615231202098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Children living in urban slums in India are exposed to chronic stressors that increase their risk of developing mental disorders, but they remain a neglected group. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived and prioritized locally to tailor interventions for this population. We used an existing rapid ethnographic assessment approach to identify mental health problems from the perspective of children living in Indian slums, including local descriptions, perceived causes, impact, and coping behavior. Local Hindi-speaking interviewers conducted 77 free-list interviews and 33 key informant interviews with children and adults (N = 107) from two slums in New Delhi. Results identified a range of internalizing and externalizing symptoms consistent with depression, anxiety, and conduct problems in children. Findings included both common cross-cultural experiences and symptoms as well as uniquely described symptoms (e.g., "madness or anger," "pain in the heart and mind") not typically included on western standardized measures of psychopathology. Mental health problems appeared to be highly interconnected, with experiences such as harassment and fighting often described as both causes and impacts of mental health symptoms in children. Community perspectives indicated that even in the face of several unmet basic needs, mental health problems were important to the community and counseling interventions were likely to be acceptable. We discuss implications for adapting mental health interventions and assessing their effectiveness to reduce the burden of mental illness among children living in urban slums in India.
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Affiliation(s)
- Prerna Martin
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Emily E Haroz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine Lee
- UNICEF New York Child Protection in Humanitarian Action, New York, NY, USA
| | - Paul Bolton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- USAID, Washington, DC, USA
| | - Kiran Martin
- Asha Community Health and Development Society, New Delhi, India
| | - Rosemary Meza
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, USA
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12
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Elahi S, Elsayed D, Ali S, Awaad R. Ethnic Differences in Muslim Women's Mental Health Beliefs, Rejection Attitudes, and Familiarity with Professional Mental Healthcare. Ment Health Relig Cult 2024; 26:890-907. [PMID: 38585328 PMCID: PMC10997350 DOI: 10.1080/13674676.2023.2243459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/28/2023] [Indexed: 04/09/2024]
Abstract
Prior work on Muslims' mental health help-seeking factors has emphasized their rejection attitudes, religious and cultural beliefs, and familiarity with mental health (Aloud & Rathur, 2009; Ali et al., 2021). However, no research has examined differences in these factors across different Muslim ethnic groups, and particularly among Muslim women. 1214 Muslim women living in the USA completed online questionnaires. Data was stratified based on history of mental health visits to control for previous service utilization. MANOVAs assessed ethnic group differences in beliefs, familiarity, and rejection attitudes toward professional mental healthcare. Results revealed significant differences between ethnic groups in all three factors; these differences depended on the women's history of service utilization. Findings suggest that barriers to accessing professional mental healthcare differ among Muslim ethnic groups. Results are discussed in light of clinical implications and other contributing factors to the underutilization of professional mental healthcare among ethnically diverse American Muslim women.
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Affiliation(s)
- Saadia Elahi
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Danah Elsayed
- Department of Family Relations and Applied Nutrition, University of Guelph, Canada
| | - Sara Ali
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Rania Awaad
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
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13
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Islam JY, Parikh NS, Lappen H, Venkat V, Nalkar P, Kapadia F. Mental health burdens among North American Asian adults living with chronic conditions: a systematic review. Epidemiol Rev 2023; 45:82-92. [PMID: 37147853 DOI: 10.1093/epirev/mxad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 04/14/2023] [Accepted: 05/01/2023] [Indexed: 05/07/2023] Open
Abstract
Asians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups-an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease-specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.
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Affiliation(s)
- Jessica Y Islam
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States
| | - Nina S Parikh
- Department of Social and Behavioral Science, New York University, New York, NY 10003, United States
| | - Hope Lappen
- Division of Libraries, New York University, New York, NY 10003, United States
| | - Vandana Venkat
- Department of Epidemiology, New York University, New York, NY 10003, United States
| | - Priyanka Nalkar
- Department of Epidemiology, New York University, New York, NY 10003, United States
| | - Farzana Kapadia
- Department of Epidemiology, New York University, New York, NY 10003, United States
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14
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Iqbal H, Lockyer B, Iqbal S, Dickerson J. "We lost a lot, but something good came out of it too:" Exploring the impact of the COVID-19 pandemic on the mental wellbeing of British Muslim Pakistani women with family responsibilities. PLoS One 2023; 18:e0292614. [PMID: 37796936 PMCID: PMC10553472 DOI: 10.1371/journal.pone.0292614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/25/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and associated restrictions caused major disruption globally, shedding light on the unprecedented strain upon the mental health and wellbeing of individuals around the world. Poor mental health in the pandemic is reported to be greater in women, with mothers being at increased risk. It is unclear whether there are differences in the impact of mental wellbeing on some ethnic groups over others. The aim of this study was to explore the experiences of British Muslim Pakistani women with family responsibilities during the COVID-19 pandemic, two years on from the first lockdown. METHODS Qualitative interviews with women were conducted via telephone using a semi-structured topic guide. The sample included 25 British Muslim Pakistani women with family responsibilities, both English and non-English speaking. Women lived in households that ranged in number and included extended family. Key themes were determined using thematic analysis. RESULTS Results were grouped under three themes. These were (1) Community, cultural and religious contributors to poor mental wellbeing, (2) religious and cultural mediators of mental distress, and (3) perceived positive impact on lifestyle. British Muslim Pakistani women were psychologically distressed by the high rates of virus transmission and deaths in their communities and at the prospect of older members of their extended family developing the virus. The impact of restrictions on fundamental religious and cultural interactions further exacerbated poor mental wellbeing in this population. Religion, community social capital and larger household structures were all effective coping strategies for British Muslim Pakistani women. Positive impacts of the pandemic included becoming closer to family and faith, and increased work/life harmony. CONCLUSIONS An exploration of religious and cultural coping mechanisms should be used to inform future national pandemic preparedness plans, as well as effective strategies for building and maintaining social capital. This may increase adherence to physical distancing and other protective behaviours in populations.
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Affiliation(s)
- Halima Iqbal
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
| | - Bridget Lockyer
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
| | - Syka Iqbal
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford, United Kingdom
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15
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Contractor AA, Rafiuddin HS, Kaur K, Asnaani A. Asian Indians in the United States and Posttraumatic Stress Disorder Interventions: A Narrative Literature Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:2395-2411. [PMID: 35543662 DOI: 10.1177/15248380221097435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Topic. Limited research has examined trauma and posttraumatic stress disorder (PTSD) among Asian Indians in the U.S. Thus, we (1) synthesize literature on trauma, PTSD, disparities in treatment for PTSD, the burden of untreated PTSD, and culturally-adapted (CA) PTSD interventions; and (2) discuss recommendations for clinicians/researchers working with this population.Method. We searched two databases using keywords related to Asian Indians, PTSD, and interventions. Of 238 identified articles, we used content from 26 articles to inform our review.Findings. Asian Indians report traumatic experiences before, during, or after immigration to the U.S. and consequential PTSD symptoms. Further, Asian Indians in the U.S. are disproportionately impacted by socio-cultural and economic determinants of poor mental health (e.g., shame/stigma associated with seeking mental health services, few culturally-responsive services), which may contribute to the under-reporting of PTSD and (interpersonal) traumas and less willingness to seek treatment. Additionally, CA PTSD interventions tailored to Asian Indians in the U.S. have not been developed. Socio-cultural considerations that can inform CA PTSD interventions for Asian Indians include: causal conditions (e.g., culturally-rooted beliefs about trauma/PTSD), intervening conditions/barriers (e.g., emotional inhibition), and mitigating/coping strategies (e.g., religious/spiritual practices, cultural idioms of distress). These considerations influence clinician/treatment preferences (e.g., solution-oriented and structured therapy, less emotional exposure). Lastly, we outline recommendations for clinicians/researchers: (1) need for national studies on trauma, PTSD, treatment utilization, and the burden of untreated PTSD; (2) consideration of immigration-related experiences influencing PTSD; (3) consideration of socio-cultural elements for CA PTSD interventions; and (4) need for culturally-valid PTSD assessments.
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Affiliation(s)
| | - Hanan S Rafiuddin
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Kiran Kaur
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Anu Asnaani
- Department of Psychology, University of North Texas, Denton, TX, USA
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16
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Park JK, Agarwala A. Cultural Shifts and Cardiovascular Risk: The Westernization of South Asian Lifestyle. Am J Cardiol 2023; 200:247-248. [PMID: 37391335 DOI: 10.1016/j.amjcard.2023.06.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Jong Kun Park
- Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas
| | - Anandita Agarwala
- Center for Cardiovascular Disease Prevention, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, Texas.
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17
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Shah MH, Roy S, Ahluwalia A. Time to address the mental health challenges of the South Asian diaspora. Lancet Psychiatry 2023; 10:381-382. [PMID: 37208111 DOI: 10.1016/s2215-0366(23)00144-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/21/2023]
Affiliation(s)
| | - Sakshi Roy
- School of Medicine, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Arjun Ahluwalia
- School of Medicine, Queen's University Belfast, Belfast BT9 7BL, UK
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18
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Quraishi Z. Addressing mental health, misinformation, & religious tensions among South Asian students across California higher education during the COVID-19 pandemic: A qualitative research study. Heliyon 2023; 9:e16396. [PMID: 37274702 PMCID: PMC10238891 DOI: 10.1016/j.heliyon.2023.e16396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/26/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
Background South Asian Americans comprise one of the fastest-growing ethnic groups in the US. Nevertheless, the scientific literature on the experiences of South Asian students is lacking, where often studies focused on Asian Americans exclude South Asians altogether. South Asian students have unique experiences in California higher education, often having to cope with high pressure to perform academically and various social responsibilities associated with being first-, second-, or third-generation American.Many South Asian countries have been more severely affected by COVID-19 due to the density of people living in close proximity to one another. Students of South Asian origin worry for their families overseas, especially as the COVID-19 pandemic has impacted populations there to a more considerable extent. Methodology This was a qualitative research study conducted using in-depth interviews with 25 students who identified as South Asian and were currently enrolled in higher education in California at the time they were interviewed. Ads were placed on social media networks, such as Facebook and Twitter, and participation in the study was voluntary. Students were chosen randomly to avoid bias. Study participants described their experiences navigating higher education throughout the ongoing COVID-19 pandemic in relation to their social, economic, cultural, and political spheres. Interviews were mainly conducted through Zoom, some through emails or phone calls. All participants will remain anonymous to protect the identities of students.This project sought to understand the experiences of South Asian students as they navigate the new normal amidst a global crisis. Qualitative responses were indexed by themes, with South Asian students reporting a relationship between the pandemic and worsened academic experiences, issues of exacerbated mental health, the spread of misinformation, and increased religious tensions.This research reflects pragmatism, and the findings of this paper are coupled with suggested recommendations to ameliorate pandemic related issues for future South Asian students. The project was conducted through both inductive and qualitative approaches. The research strategy is action research, and the research was meant to shine a light on issues South Asian students face and help university administrations understand how to better support students during a pandemic. The time horizon is cross-sectional. The research focuses on COVID-19 in relation to South Asian students' performance and health.At 25 participants, data saturation was reached. Further participants were not needed as the qualitative research data was sufficient to draw conclusions from. The research was deemed to pose no risk to students; therefore, approval from an ethical committee was not sought. All participants signed consent forms in order to participate.Follow-up interviews were conducted to address students' experiences with family in India experiencing the B.167.2 variant and the transition back to in-person learning following virtual schooling. Conclusions/significance South Asian students in higher education bear a unique set of responsibilities in addition to the already rigorous coursework associated with college. However, the stresses and health of South Asian students often go understudied or overlooked. This research serves to begin to fill in the gaps in literature of South Asian experiences in higher education.The pandemic posed additional challenges for students, who lost access to their campus communities with university education going virtual, and many South Asian students had to move back home. Through this qualitative research study analyzing the experiences of South Asians enrolled in California higher education, it can be concluded that there is a relationship between the COVID-19 pandemic and students' academic performance, mental health, as well as an increase in the amount of misinformation spread regarding COVID-19 public safety guidelines.
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19
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Quirk HD, Nagar R, Anderson PL. A qualitative exploration of college students' experiences using mobile apps to improve self-care during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37053590 DOI: 10.1080/07448481.2023.2198033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 02/09/2023] [Accepted: 03/19/2023] [Indexed: 06/19/2023]
Abstract
Objective: This project examines students' experiences using a mental health mobile application (app) as part of a class assignment developed to support student well-being. Participants: Data was collected from 265 undergraduate students enrolled in a psychology course during the COVID-19 pandemic. Methods: Students developed a self-care goal and used an app to support progress toward it. Thematic analysis was applied to students' written reflections about their experiences using the app and practicing self-care. Results: Students reported using an app for self-care was 1) more helpful than expected for improving focus, productivity, motivation, sleep, and mental health symptoms; 2) challenging due to loss of interest, slow improvement, difficulty integrating into routine, or negative feelings triggered; and 3) influenced by the pandemic and transition to remote learning. Conclusions: A classroom assignment designed to promote self-care using a mental health app shows promise. Future research is needed to better understand engagement and impact.
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Affiliation(s)
| | - Ria Nagar
- Psychology, Georgia State University, Atlanta, Georgia, USA
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20
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Jin L, Compton SE, Sameen DE, Cornish MV, Contractor AA. Mental Health Symptom Profiles and Treatment Parameters Among Asian Indians: Latent Profile Analyses. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01040-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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21
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22
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Goel NJ, Thomas B, Boutté RL, Kaur B, Mazzeo SE. "What will people say?": Mental Health Stigmatization as a Barrier to Eating Disorder Treatment-Seeking for South Asian American Women. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2023; 14:96-113. [PMID: 37283957 PMCID: PMC10241369 DOI: 10.1037/aap0000271] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study used focus group methodology to identify culturally-specific barriers to, and facilitators of, eating disorder (ED) treatment-seeking for South Asian (SA) American women. Seven focus groups were conducted with 54 participants (Mage=20.11 years, SD=2.52), all of whom had lived in the United States (US) for at least three years (63.0% of the sample was born in the US). Transcripts were independently coded by a team of researchers (n=4) and the final codebook included codes present in at least half of the transcripts. Thematic analysis identified salient themes (barriers, n=6; facilitators, n=3) for SA American women. Barriers to ED-treatment seeking were inextricable from barriers to mental health treatment, more broadly. In addition to generalized mental health stigma, participants cited social stigma (i.e., a pervasive fear of social ostracization), as a significant treatment-seeking barrier. Additional barriers were: cultural influences on the etiology and treatment of mental illness, parents' unresolved mental health concerns (usually tied to immigration), healthcare providers' biases, general lack of knowledge about EDs, and minimal SA representation within ED research/clinical care. To address these obstacles, participants recommended that clinicians facilitate intergenerational conversations about mental health and EDs, partner with SA communities to create targeted ED psychoeducational health campaigns, and train providers in culturally-sensitive practices for detecting and treating EDs. SA American women face multiple family, community, and institutional barriers to accessing mental health treatment generally, which limits their ability to access ED-specific care. Recommendations to improve ED treatment access include: (a) campaigns to destigmatize mental health more systematically, (b) collaboration with SA communities and, (c) and training providers in culturally-sensitive care.
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Affiliation(s)
- Neha J. Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Institute for Inclusion, Inquiry and Innovation (iCubed), Office of Institutional Equity, Effectiveness and Success, Virginia Commonwealth University, Richmond, VA, USA
| | - Brogan Thomas
- Department of Rehabilitation and Mental Health Counseling, Virginia Commonwealth University, Richmond, VA, USA
| | - Rachel L. Boutté
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Brahmpreet Kaur
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Biology, Virginia Commonwealth University, Richmond, VA, USA
| | - Suzanne E. Mazzeo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Institute for Inclusion, Inquiry and Innovation (iCubed), Office of Institutional Equity, Effectiveness and Success, Virginia Commonwealth University, Richmond, VA, USA
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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23
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Majid M, Ab Rahman A, Taib F. Adverse Childhood Experiences and Health Risk Behaviours among the Undergraduate Health Campus Students. Malays J Med Sci 2023; 30:152-161. [PMID: 36875202 PMCID: PMC9984113 DOI: 10.21315/mjms2023.30.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/22/2022] [Indexed: 03/05/2023] Open
Abstract
Background Adverse childhood experiences (ACEs) are linked with health risk behaviours (HRBs). The study aimed to evaluate ACEs in the undergraduate health campus of a public university located in the northeast of Malaysia and determine their association with HRBs. Methods A cross-sectional study was performed by recruiting 973 undergraduate students at the health campus of a public university from December 2019 to June 2021. The World Health Organization (WHO) ACE-International Questionnaire and the Youth Risk Behaviour Surveillance System questionnaire were distributed using simple random sampling according to year of study and the selected batch of students. Descriptive statistics were used for demographic findings and logistic regression analyses were performed to determine the association between ACE and HRB. Results The 973 participants (male [n = 245] and female [n = 728]) had a median age of 22 years old. The prevalence of child maltreatment among the study population was 30.2%, 29.2%, 28.7%, 9.1% and 6.1% for emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse, respectively, among both sexes. The most commonly reported household dysfunctions were parental divorce/separation (5.5%). Community violence was 39.3% among the surveyed participants. The highest prevalence of HRBs among respondents was 54.5% from physical inactivity. The findings confirmed that those exposed to ACEs were at risk of HRBs and that a higher number of ACEs was associated with a higher number of HRBs. Conclusion ACEs were highly prevalent among participating university students, ranging from 2.6%-39.3%. Hence, child maltreatment is an important public health problem in Malaysia.
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Affiliation(s)
- Mardhiah Majid
- Department of Paediatrics, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
| | - Azriani Ab Rahman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Fahisham Taib
- Department of Paediatrics, Hospital Universiti Sains Malaysia, Kelantan, Malaysia.,Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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24
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Nisar M, Kolbe-Alexander TL, Khan A. Bullying Experiences of South Asian Immigrants in Australia: a Mixed-Method Study. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:785-797. [PMID: 36595132 DOI: 10.1007/s11121-022-01487-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
Bullying is a pervasive problem faced by immigrants that negatively impacts their health and well-being. Understanding the factors that contribute to bullying and the prevalence of bullying victimisation may help to develop strategies to prevent bullying. Using a mixed-method approach, this study explored the perceptions and prevalence of bullying of South Asian immigrants living in Australia. Five focus group discussions (FGDs) were conducted to explore bullying experiences and to inform an online survey. The online survey included the California Bullying Victimisation Scale-Retrospective (CBVS-R) to measure prevalence, types, and places of bullying victimisation. Data collected from FGDs were thematically analysed while survey data were examined to identify factors associated with bullying. The main contributing factors reported by participants during FGDs were ethnic attire (clothing), religion, accent, workplace achievement, skin colour, and body shape. The online survey collected responses from 313 participants that included females (44%) and males (56%) with a mean age of 41.0 (SD ± 10.3) years. Almost 31% of participants surveyed experienced multiple bullying incidents per month with no differences observed between gender (32% in males, 31% in females). Males were mostly bullied (63%) in their workplaces while females were mostly bullied (56%) at bus or train stations. Country of birth, employment status, educational qualification, and English proficiency significantly associated with bullying experience (p < 0.001). These findings show that bullying affects male and female immigrants in different forms and settings; therefore, a large national assessment is needed to evaluate the magnitude of bullying and its consequences on immigrant health and well-being.
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Affiliation(s)
- Mehwish Nisar
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Tracy L Kolbe-Alexander
- School of Health and Medical Sciences, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.,Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
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25
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Lee KK, Norris ET, Rishishwar L, Conley AB, Mariño-Ramírez L, McDonald JF, Jordan IK. Ethnic disparities in mortality and group-specific risk factors in the UK Biobank. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001560. [PMID: 36963080 PMCID: PMC10021328 DOI: 10.1371/journal.pgph.0001560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/09/2023] [Indexed: 02/25/2023]
Abstract
Despite a substantial overall decrease in mortality, disparities among ethnic minorities in developed countries persist. This study investigated mortality disparities and their associated risk factors for the three largest ethnic groups in the United Kingdom: Asian, Black, and White. Study participants were sampled from the UK Biobank (UKB), a prospective cohort enrolled between 2006 and 2010. Genetics, biological samples, and health information and outcomes data of UKB participants were downloaded and data-fields were prioritized based on participants with death registry records. Kaplan-Meier method was used to evaluate survival differences among ethnic groups; survival random forest feature selection followed by Cox proportional-hazard modeling was used to identify and estimate the effects of shared and ethnic group-specific mortality risk factors. The White ethnic group showed significantly worse survival probability than the Asian and Black groups. In all three ethnic groups, endoscopy and colonoscopy procedures showed significant protective effects on overall mortality. Asian and Black women show lower relative risk of mortality than men, whereas no significant effect of sex was seen for the White group. The strongest ethnic group-specific mortality associations were ischemic heart disease for Asians, COVID-19 for Blacks, and cancers of respiratory/intrathoracic organs for Whites. Mental health-related diagnoses, including substance abuse, anxiety, and depression, were a major risk factor for overall mortality in the Asian group. The effect of mental health on Asian mortality, particularly for digestive cancers, was exacerbated by an observed hesitance to answer mental health questions, possibly related to cultural stigma. C-reactive protein (CRP) serum levels were associated with both overall and cause-specific mortality due to COVID-19 and digestive cancers in the Black group, where elevated CRP has previously been linked to psychosocial stress due to discrimination. Our results point to mortality risk factors that are group-specific and modifiable, supporting targeted interventions towards greater health equity.
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Affiliation(s)
- Kara Keun Lee
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America
- Integrated Cancer Research Center, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - Emily T Norris
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America
| | - Lavanya Rishishwar
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America
| | - Andrew B Conley
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America
| | - Leonardo Mariño-Ramírez
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States of America
| | - John F McDonald
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America
- Integrated Cancer Research Center, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America
| | - I King Jordan
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America
- Integrated Cancer Research Center, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States of America
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, GA, United States of America
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26
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Karim SI, Irfan F, Haris S, Al-Maflehi N, Ahmed AMA, Ponnamperuma G, Al Sayyari S, Al Faris E. Relationship Between Socio-Demographics, Study Skills and Distress Among Pakistani School Students: A Cross-Sectional Study in Riyadh, Saudi Arabia. Psychol Res Behav Manag 2023; 16:587-598. [PMID: 36890853 PMCID: PMC9987450 DOI: 10.2147/prbm.s394481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose The increasing prevalence of distress among students is of global concern. Several factors such as school and family environment and ineffective study skills could influence mental health. The study explored the rate of distress symptoms among school students' and its relationship with their study skills, stressors and demographic factors. Methods In this cross-sectional analytical study, a sample of 215 students from a community school participated in the study. Three questionnaires, demographic questionnaire, Study Skills Inventory and the Kessler Psychological Distress Scale, were used for data collection. Data were analyzed using Student's t-test, ANOVA, Pearson's correlation coefficient and stepwise linear regression. Results Response rate was 70% (n = 150). A high proportion of respondents (75%) was distressed (mean 27.28 ± 8.77). Correlation analysis showed that distress (K10 score) was negatively related to study skills (SSI total score) (r = -0.247, p = 0.002). The rate of distress symptoms was higher among female students (79%) compared to their male counterparts (72%). The factors associated with distress included negative association of teachers' level of help to develop competencies (p = 0.000, β = -0.278, R2 = 0.249), unfavorable school environment (p = 0.000, β = 0.285, R2 = 0.123), inability to cope with studies (p = 0.005, β = 0.205, R2 = 0.038), family problems (p = 0.014, β = 0.184, R2 = 0.173) and lower study skills (p = 0.031, β = -0.164, R2 = 0.270). The overall regression analysis explained 33.6% of the variance (corrected R2 = 0.336). Conclusion Higher than expected levels of distress (75%) was found in immigrant school students. Poor study skills have a significant relationship with distress. Learning environment and related stress factors were associated with distress among students. Based on the findings, it is recommended that stakeholders in education address the hidden curriculum, as it is usually unacknowledged and might affect students' wellbeing, and move from student centered to an interpersonal relation-centered education.
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Affiliation(s)
- Syed Irfan Karim
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Farhana Irfan
- King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Nassr Al-Maflehi
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M A Ahmed
- King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Gominda Ponnamperuma
- Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Eiad Al Faris
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,King Saud University Chair for Medical Education Research and Development, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Abstract
South Asian American (SAA) youth are culturally diverse with respect to migration patterns, language, religion, and social determinants of health. Culturally specific stressors related to family, acculturation, discrimination, and intersectionality converge during developmentally sensitive periods, impacting mental health and identity development. "Model minority" stereotypes and somatic expressions of distress contribute to underdetection and limited perceived need for treatment. SAA families navigate structural barriers, including limited access to culturally tailored services, limited English proficiency, referral bias, and stigma, resulting in underutilization of services. Cultural considerations must be integrated into diagnostic conceptualization and treatment recommendations to effectively engage SAA youth and families in treatment.
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A qualitative study exploring the factors influencing perceptions of mental illness and coping strategies in ethnic minority populations experiencing negative mood symptoms in Hong Kong. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Gullett LR, Alhasan DM, Gaston SA, Jackson WB, Kawachi I, Jackson CL. Neighborhood social cohesion and serious psychological distress among Asian, Black, Hispanic/Latinx, and White adults in the United States: a cross-sectional study. BMC Public Health 2022; 22:1191. [PMID: 35705933 PMCID: PMC9199195 DOI: 10.1186/s12889-022-13572-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Serious psychological distress (SPD) is common and more prevalent in women, older adults, and individuals with a low-income. Prior studies have highlighted the role of low neighborhood social cohesion (nSC) in potentially contributing to SPD; however, few have investigated this association in a large, nationally representative sample of the United States. Therefore, our objective was to investigate the overall and racial/ethnic-, sex/gender-, self-rated health status-, age-, and household income-specific relationships between nSC and SPD. METHODS We used data from survey years 2013 to 2018 of the National Health Interview Survey to investigate nSC and SPD among Asian, Non-Hispanic (NH)-Black, Hispanic/Latinx, and NH-White men as well as women in the United States (N = 168,573) and to determine modification by race/ethnicity, sex/gender, self-rated health status, age, and annual household income. nSC was measured by asking participants four questions related to the trustworthiness and dependability of their neighbors. nSC scores were trichotomized into low (< 12), medium (12-14), and high (15-16). SPD was measured using the Kessler 6 psychological distress scale with scores ≥ 13 indicating SPD. After adjusting for sociodemographic, health behavior, and clinical confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS Among 168,573 participants, most were Non-Hispanic (NH)-White (69%), and mean age was 47 ± 0.01 years. After adjustment, low vs. high nSC was associated with a 75% higher prevalence of SPD overall (PR = 1.75 [1.59-1.92]), 4 times the prevalence of SPD among Asian men (PR = 4.06 [1.57-10.50]), 2 times the prevalence of SPD among participants in at least good health (PR = 2.02 [95% CI: 1.74-2.35]), 92% higher prevalence of SPD among participants ≥ 50 years old (PR = 1.92 [1.70-2.18]), and approximately 3 times the prevalence of SPD among Hispanic/Latinx participants with household incomes ≥ $75,000 (PR = 2.97 [1.45-6.08]). CONCLUSIONS Low nSC was associated with higher SPD in the overall population and the magnitude of the association was higher in Asian men, participants who reported good health, older participants, and Hispanic/Latinx adults with higher household incomes. Future research should continue to examine how neighborhood contexts can affect health across various sociodemographic groups, especially among groups with multiple marginalized social identities.
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Affiliation(s)
- Lauren R Gullett
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA
| | - W Braxton Jackson
- Social and Scientific Systems, Inc., a DLH Holdings Company, NC, Durham, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, MD A3-05, Research Triangle Park, NC, 27709, USA. .,Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Tiwari BB, Zhang D“S. Differences in Mental Health Status Among Asian Americans During the COVID-19 Pandemic: Findings from the Health, Ethnicity, and Pandemic Study. Health Equity 2022; 6:448-453. [PMID: 35801151 PMCID: PMC9257548 DOI: 10.1089/heq.2022.0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose: This study aims to explore the differences in mental health status among Asian Americans during the COVID-19 pandemic. Methods: Data from the 2020 Health, Ethnicity, and Pandemic (HEAP) Study were used to explore the psychological distress of 2672 adults, using the Standard Kessler Psychological Distress Scale. Results: We observed that among Asian American subgroups, South Asian Americans had significantly higher odds of experiencing psychological distress than non-Hispanic White Americans (odds ratio = 1.82, 95% confidence interval = 1.00–3.31), after controlling for covariates. Conclusion: The study identified differences in mental health status among Asian American subgroups. We recommend the implementation of culturally appropriate interventions to help Asian Americans cope with mental health challenges.
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Affiliation(s)
- Biplav Babu Tiwari
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA
| | - Donglan “Stacy” Zhang
- Division of Health Services Research, New York University Long Island School of Medicine, Mineola, New York, USA
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Ba’yah Abdul Kadir N, Griffiths MD. Psychosocial Risk Factors for Depression Among Married Muslim Mothers in Malaysia. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-020-00452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Mudunna C, Antoniades J, Tran T, Fisher J. Factors influencing the attitudes of young Sri Lankan-Australians towards seeking mental healthcare: a national online survey. BMC Public Health 2022; 22:546. [PMID: 35305611 PMCID: PMC8933917 DOI: 10.1186/s12889-022-12842-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/14/2022] [Indexed: 11/12/2022] Open
Abstract
Background Sri Lankans, as part of the South Asian diaspora, comprise one of the largest migrant groups in Australia. Although few data are available, South Asian migrants appear to experience higher rates of mental health problems, but seek help at lower rates than other migrant groups. Understanding factors that underpin mental health care seeking is necessary to inform mental health promotion strategies, including access to care. The aim was to investigate factors influencing attitudes to seeking care for mental health problems among young Sri Lankan-Australians born in Sri Lanka or in Australia. Methods An anonymous cross- sectional online survey which included the Multiethnic Identity Measure, Perceived Stigma Questionnaire, General Help-Seeking Questionnaire, Attitudes Towards Seeking Professional Psychological Help questionnaire and study specific questions to ascertain sociodemographic characteristics. The survey was advertised on social media and specifically included young adults aged between 18–30, who self-identified as being of Sri Lankan heritage and were living in Australia. Participation was not possible for those that did not have access to the internet. Data were analyzed using bivariable and multivariable statistics. Results Of the 396 people who attempted the survey, 323 provided fully completed data, 2 provided > 50% completed data which were included in the analyses. 71 were excluded because < 50% of the survey was completed. From all participants, 39.70% were born in Australia (SLaus), 54.46% born in Sri Lanka (SLsl) and 5.8% born in other countries. SLsl had more stigmatizing attitudes towards mental illness (p = 0.027) and seeking professional psychological help (p = 0.03). Women, those who had spent more years living in Australia and whose fathers were more highly educated had less stigmatized attitudes toward mental illness and help-seeking. Conclusion Country of birth, family characteristics and gender influence stigma towards mental illness and help-seeking. Public health strategies to promote understanding of mental health problems and seeking mental healthcare are more likely to be effective if they address these factors directly.
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Wong CL, Leung AWY, Chan DNS, Chow KM, Chan CWH, Ng MSN, So WKW. Psychological Wellbeing and Associated Factors Among Ethnic Minorities During the COVID-19 Pandemic. J Immigr Minor Health 2022; 24:1435-1445. [PMID: 35220516 PMCID: PMC8882315 DOI: 10.1007/s10903-022-01347-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2022] [Indexed: 12/30/2022]
Abstract
This study assessed the psychological wellbeing and its associated factors amongst ethnic minorities during the coronavirus disease 2019 (COVID-19) pandemic. A total of 310 Hong Kong South Asians aged 41.3 (SD 13.7) years completed an anonymous online survey between July 2020 and February 2021. The results showed an overall moderate level of stress and high levels of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms amongst South Asian minorities. Multivariable regression analyses suggested that being single/divorced, following Hinduism or other non-Muslim religions, having lower perceived knowledge of COVID-19 and having worried about losing job were significant predictors of higher levels of depression, anxiety and/or stress; additionally, being male, having a low monthly household income, having worried about losing job and healthcare collapse were significant predictors of a higher level of PTSD symptoms. The findings suggest an urgent need to alleviate the psychological impacts of the COVID-19 pandemic on ethnic minorities, specifically for those most vulnerable to these impacts.
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Stroope S, Kent BV, Zhang Y, Spiegelman D, Kandula NR, Schachter AB, Kanaya A, Shields AE. 'Mental health and self-rated health among U.S. South Asians: the role of religious group involvement'. ETHNICITY & HEALTH 2022; 27:388-406. [PMID: 31466458 PMCID: PMC7048668 DOI: 10.1080/13557858.2019.1661358] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/26/2019] [Indexed: 05/21/2023]
Abstract
Objectives: Only one community-based study has assessed religious group involvement and health outcomes among South Asians in the U.S., with mixed results. Here, using a large, South Asian community-based sample, the effects of six religious group involvement predictors - religious tradition, attendance, group prayer, giving/receiving congregational emotional support, congregational neglect, and congregational criticism - were examined in relation to four health outcomes: self-rated health, positive mental health functioning, trait anxiety, and trait anger.Design: The study used a new religion/spirituality questionnaire in the Mediators of Atherosclerosis Among South Asians Living in America (MASALA), the largest study of mental and physical well-being among U.S. South Asians. Associations were assessed cross-sectionally using OLS regression in both the full sample (N = 928) and a subsample of congregation members (N = 312).Results: Jains reported better self-rated health compared to Hindus and Muslims. Group prayer involvement, when measured ordinally, was positively associated with self-rated health and mental health functioning. In reference group comparisons, individuals who participated in group prayer once/day or more had lower levels of anxiety and anger compared to several comparison groups in which individuals prayed less than once a day. Religious service attendance was associated with higher levels of anxiety. Giving/receiving congregational emotional support was positively associated with self-rated health and mental health functioning, and inversely associated with anxiety. Congregational criticism was associated with higher levels of anger and anxiety.Conclusions: This study provided a new assessment of religious group involvement and health in the U.S. South Asian population. Religious group participation was associated with mental and self-rated health in well-controlled models, indicating this is a fruitful area for further research. Group religious involvement may be a health-promoting resource for U.S. South Asians who are religiously active, but it is not an unalloyed boon.
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Affiliation(s)
- Samuel Stroope
- Louisiana State University Department of Sociology, Baton Rouge, LA
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
| | - Blake Victor Kent
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA
- Harvard Medical School, Boston, MA
| | - Ying Zhang
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA
| | - Donna Spiegelman
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- Yale School of Public Health, New Haven, CT
| | - Namratha R. Kandula
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Anna B. Schachter
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA
| | - Alka Kanaya
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- University of California, San Francisco, San Francisco, CA
| | - Alexandra E. Shields
- National Consortium on Psychosocial Stress, Spirituality, and Health, Boston, MA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Boston, MA
- Harvard Medical School, Boston, MA
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Emotional distress, anxiety and depression in South Asians with long-term conditions: a qualitative systematic review. Br J Gen Pract 2021; 72:e179-e189. [PMID: 35131838 PMCID: PMC8884439 DOI: 10.3399/bjgp.2021.0345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Background People with physical–mental comorbidity have a poorer quality of life, worse clinical outcomes, and increased mortality compared with people with physical conditions alone. People of South Asian (SA) origin are the largest minority group in the UK and are more likely to have long-term conditions (LTCs) such as diabetes and heart disease. People of SA origin are less likely to recognise symptoms that may represent mental health problems. Aim To explore how people of SA origin with LTCs understand, experience, and seek help for emotional distress, depression, and anxiety. Design and setting Systematic review of qualitative studies exploring emotional distress in people of SA origin with diabetes or coronary heart disease, within primary and community care settings worldwide. Method Comprehensive searches of eight electronic databases from inception to 1 September 2021 were undertaken. Data extracted included study characteristics, and understanding, experience, and help-seeking behaviour for emotional distress. Thematic synthesis was undertaken. The Critical Appraisal Skills Programme (CASP) checklist for qualitative studies was used to assess quality of articles, and Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) used to determine the overall strength of evidence. Results Twenty-one studies from 3165 unique citations were included. Three main themes were identified. Understanding of emotional distress: non-medical terminology used, such as ‘tension’, and a complex relationship between emotional and physical illness. Experiences of emotional distress: multiple forms of inequality, distress at diagnosis of their LTC, cultural factors, and sex differences. Help-seeking behaviour: self-management, support from family, friends, and faith, and inadequate clinical support. Conclusion This review provides a greater understanding of the conceptualisation of emotional distress in the context of LTCs by people of SA origin, to support improvement in its recognition and management.
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Basri T, Radhakrishnan K, Rolin D. Barriers to and Facilitators of Mental Health Help-Seeking Behaviors Among South Asian American College Students. J Psychosoc Nurs Ment Health Serv 2021; 60:32-38. [PMID: 34932419 DOI: 10.3928/02793695-20211215-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Despite the increasing size of the South Asian population in the United States, research on the mental health care wants and needs of this population is limited. The current study aimed to provide a better understanding of South Asian American college students' attitudes and behaviors with respect to professional help for psychological and mental health. Participants included 14 college students at a large central Texas university, aged at least 18 years and fluent in English, who identified ethnically as South Asian. Qualitative interviews held with participants included demographic questions. Five themes emerged from the interviews: Family Dynamics, Environment, University Resources, Access to Help, and Cultural Dynamics. High levels of mental illness, low levels of help-seeking, and unique identity interactions demonstrated a prevailing need for mental health support in South Asian American college students. Accessible mental health care in university settings can be a step toward providing appropriate mental health care for South Asian students most in need. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Poudel-Tandukar K, Jacelon CS, Rai S, Ramdam P, Bertone-Johnson ER, Hollon SD. Social and Emotional Wellbeing (SEW) Intervention for Mental Health Promotion Among Resettled Bhutanese Adults in Massachusetts. Community Ment Health J 2021; 57:1318-1327. [PMID: 33387182 DOI: 10.1007/s10597-020-00754-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/28/2020] [Indexed: 11/24/2022]
Abstract
Preventative behavioral interventions aimed at reducing mental problems among refugees are limited. We assessed the effect of a Social and Emotional Wellbeing (SEW) intervention on health-promoting behaviors (coping, social-networking, and conflict-resolution) and health-outcomes (stress, anxiety, and depression) among resettled Bhutanese adults in Western Massachusetts. The study was a community-based SEW intervention with pre-posttest evaluation among 44 Bhutanese adults in Western Massachusetts. The SEW is a culturally tailored 5-week, once-weekly health-education, problem solving, and mind-body exercise program to promote stress management skills. We used validated scales to measure outcomes. Mean scores of mental problems decreased by 5.9 for depression, 9.0 for anxiety, and 5.0 for stress post-intervention (p < 0.01). Mean scores increased by 27.3 for coping, 10.6 for social support, and 20.4 for conflict-resolution. Mean social-network scores increased by 4.6 for family, 4.7 for friends, and 1.8 for community networks (p < 0.01). Our Bhutanese participants reported improvement in their mental health after attending SEW intervention.
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Affiliation(s)
- Kalpana Poudel-Tandukar
- College of Nursing, University of Massachusetts Amherst, 651 North Pleasant St, Amherst, MA, 01003-9299, USA.
| | - Cynthia S Jacelon
- College of Nursing, University of Massachusetts Amherst, 651 North Pleasant St, Amherst, MA, 01003-9299, USA
| | - Shan Rai
- Bhutanese Christian Society of Western Massachusetts, Westfield, MA, 01085, USA
| | - Purna Ramdam
- Bhutanese Christian Society of Western Massachusetts, Westfield, MA, 01085, USA
| | - Elizabeth R Bertone-Johnson
- School of Public Health and Health Sciences, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003-9304, USA
| | - Steven D Hollon
- Department of Psychology, Vanderbilt University, Nashville, TN, 37203, USA
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Mirpuri S, Ocampo A, Narang B, Roberts N, Gany F. Discrimination as a social determinant of stress and health among New York City taxi drivers. J Health Psychol 2020; 25:1384-1395. [PMID: 29409354 PMCID: PMC8482413 DOI: 10.1177/1359105318755543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Discrimination is associated with poorer mental and physical health outcomes. Taxi drivers have a higher risk of exposure to discrimination and higher rates of chronic conditions. A cross-sectional needs assessment was conducted with a multilingual group of 535 male taxi drivers in New York City. Drivers reporting higher discrimination were more likely to have higher perceived stress and were more likely to have anxiety/depression and chronic pain, adjusting for confounders. Workplace-based interventions designed to help drivers cope with discrimination, stress, and chronic health conditions, interventions to educate the taxi-riding public, and greater attention to these issues from administrative agencies are warranted.
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Affiliation(s)
- Sheena Mirpuri
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alex Ocampo
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicole Roberts
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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Abstract
OBJECTIVE South Asians (SAs), a rapidly growing minority group in the United States are underrepresented in mental health research. They represent a unique sub-group of Asian immigrants in that their journey to the United States in the last 50 years was driven by the pursuit of academic and career opportunities. Our goal is to provide a topical overview of factors contributing to the mental health challenges of South Asian American (SAA) youth and to describe culturally sensitive approaches that would provide effective treatment for SAA youth and their families. METHODS We conducted a review of published literature in PubMed and PsycInfo search engines using the key words South Asian immigrants, South Asian Americans, psychological, psychiatric, mental health treatment, therapy and interventions. RESULTS The challenges faced by these highly educated families are distinctive in that there is a struggle to maintain ethnic identity based on collectivism while embracing American ideals of individualism. These opposing values along with model minority expectations put SAs at high risk for mental health concerns and acculturative family distancing. Furthermore, mental health stigma impedes help-seeking. Mental health practitioners must navigate the different value systems of the parent-child dyad without ostracizing either generation and deliver effective care. Hence, culturally adapted family therapy and community-based approaches may be particularly relevant in SA youth. CONCLUSION Our article outlines common family attitudes and issues pertinent to mental health in youth and discusses useful clinical approaches to dealing with SAA youth and their families.
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Affiliation(s)
- Neha Sharma
- Division of Child and Adolescent Psychiatry, Tufts Medical Center, Boston, MA, USA
| | - Deepika Shaligram
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
| | - Grace H Yoon
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
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