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Read JG. Does an Immigrant Health Advantage Exist Among US Whites? Evidence from a Nationally-Representative Examination of Mental and Physical Well-Being. J Immigr Minor Health 2024; 26:878-886. [PMID: 38825664 PMCID: PMC11412786 DOI: 10.1007/s10903-024-01607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2024] [Indexed: 06/04/2024]
Abstract
This study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019-2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.
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Affiliation(s)
- Jen'nan G Read
- Department of Sociology, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
- Global Health Institute, Duke University, Durham, NC, 27708, USA.
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Glynn LM, Liu SR, Lucas CT, Davis EP. Leveraging the science of early life predictability to inform policies promoting child health. Dev Cogn Neurosci 2024; 69:101437. [PMID: 39260117 PMCID: PMC11415967 DOI: 10.1016/j.dcn.2024.101437] [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: 11/26/2023] [Revised: 04/30/2024] [Accepted: 08/12/2024] [Indexed: 09/13/2024] Open
Abstract
Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for "why unpredictability?", including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. Evidence that patterns of signals in the early environment promote brain maturation across species. 4. The uneven distribution of unpredictability across demographic populations that illuminates a possible focal point for enhancing health equity. We then outline the potential of unpredictability in terms of the "what"; that is, how might the concept of unpredictability be leveraged to inform policy? We emphasize the importance of interdisciplinary and community partnerships to the success of this work and describe our community-engaged research project. Finally, we highlight opportunities for the science of unpredictability to inform policies in areas such as screening, immigration, criminal justice, education, childcare, child welfare, employment, healthcare and housing.
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Affiliation(s)
- Laura M Glynn
- Department of Psychology, Chapman University, United States.
| | - Sabrina R Liu
- Department of Human Development, California State University San Marcos, United States
| | | | - Elysia Poggi Davis
- Department of Pediatrics, University of California Irvine, United States; Department of Psychology, University of Denver, United States
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Imanpour S, McMaughan DJ. 'You never know when you will need an antibiotic': A qualitative study of structural barriers and cultural assumptions in antibiotic misuse among immigrants in the United States. J Health Serv Res Policy 2024; 29:266-274. [PMID: 38725297 DOI: 10.1177/13558196241252748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
OBJECTIVES The use of nonprescribed antibiotics increases the risk of antibiotic resistance, which is a primary public health concern of the 21st century. This study explores structural and cultural determinants of antibiotic misuse among immigrants living in the United States who arrived from home countries with easier access to antibiotics. METHODS Adopting a qualitative approach, we interviewed 34 immigrants living in the United States and who had traveled back to their home countries within 1 year of the interview. We followed the steps of constructive grounded theory to analyze the data. RESULTS We found two primary influences of immigrants' use of nonprescribed antibiotics. The first was structural barriers to health care access in the host country, including insurance coverage, cost of an emergency department visit, cost of missing a paid day of work, complexity of the healthcare system, and communication issues with health care providers. The second was participants' cultural assumptions, including their experiences of antibiotics use, beliefs about antibiotics, a habit of self-medication, and uncertainty about future medical needs. CONCLUSIONS This study informs policymakers concerned with combating antibiotic resistance. Promoting antibiotic stewardship among immigrants from countries with lax antibiotic-prescribing practices and improving access to appropriate channels for preventative and same-day care may reduce the inappropriate use of antibiotics.
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Affiliation(s)
- Sara Imanpour
- School of Public Affairs, Pennsylvania State University, Harrisburg, PA, USA
| | - Darcy Jones McMaughan
- School of Community Health Sciences, Counseling and Counseling Psychology, Oklahoma State University, Stillwater, OK, USA
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Ibrahim A, Linton JM, Dawson-Hahn E. Providing Compassionate, Evidence-Based Care for Refugee, Immigrant, and Migrant Children. Adv Pediatr 2024; 71:1-16. [PMID: 38944476 DOI: 10.1016/j.yapd.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Immigrant children experience diverse migration paths to the United States facing unique challenges that impact their health and well-being. This article provides an overview of the pathways to health care and physical, mental, and behavioral health considerations for refugee and immigrant children. Health equity and cultural humility frameworks are reviewed. Approach to care guidance and clinical pearls are provided for the initial medical assessment in addition to medical screening, mental health, education, and developmental health. The importance of health literacy and advocacy are highlighted, emphasizing their ability to address health inequities and improve care.
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Affiliation(s)
- Anisa Ibrahim
- Department of Pediatrics, University of Washington, 325 9th Avenue, Seattle, WA 98104, USA.
| | - Julie M Linton
- Department of Pediatrics, University of South Carolina School of Medicine Greenville, 20 Medical Ridge Road, Greenville, SC 29605, USA
| | - Elizabeth Dawson-Hahn
- Department of Pediatrics, University of Washington, 325 9th Avenue, Seattle, WA 98104, USA
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Li Y, Peters BA, Yu B, Perreira KM, Daviglus M, Chan Q, Knight R, Boerwinkle E, Isasi CR, Burk R, Kaplan R, Wang T, Qi Q. Blood metabolomic shift links diet and gut microbiota to multiple health outcomes among Hispanic/Latino immigrants in the U.S. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.19.24310722. [PMID: 39072018 PMCID: PMC11275661 DOI: 10.1101/2024.07.19.24310722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Immigrants from less industrialized countries who are living in the U.S. often bear an elevated risk of multiple disease due to the adoption of a U.S. lifestyle. Blood metabolome holds valuable information on environmental exposure and the pathogenesis of chronic diseases, offering insights into the link between environmental factors and disease burden. Analyzing 634 serum metabolites from 7,114 Hispanics (1,141 U.S.-born, 5,973 foreign-born) in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we identified profound blood metabolic shift during acculturation. Machine learning highlighted the prominent role of non-genetic factors, especially food and gut microbiota, in these changes. Immigration-related metabolites correlated with plant-based foods and beneficial gut bacteria for foreign-born Hispanics, and with meat-based or processed food and unfavorable gut bacteria for U.S.-born Hispanics. Cardiometabolic traits, liver, and kidney function exhibited a link with immigration-related metabolic changes, which were also linked to increased risk of diabetes, severe obesity, chronic kidney disease, and asthma. Graphical abstract Highlights A substantial proportion of identified blood metabolites differ between U.S.-born and foreign-born Hispanics/Latinos in the U.S.Food and gut microbiota are the major modifiable contributors to blood metabolomic difference between U.S.-born and foreign-born Hispanics/Latinos.U.S. nativity related metabolites collectively correlate with a spectrum of clinical traits and chronic diseases.
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Appiah-Kubi R, Kim YH, Attanasio LB. African Immigrant Women's Experiences of Maternity Care in the United States. MCN Am J Matern Child Nurs 2024:00005721-990000000-00062. [PMID: 38976780 DOI: 10.1097/nmc.0000000000001043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OBJECTIVE The purpose of this study was to explore maternity care experiences of African immigrant women during the perinatal period including factors affecting access to and use of care. METHODS We used Sandelowski's (2010) qualitative descriptive approach to examine how African immigrant women from various countries of origin and with diverse ethnic backgrounds experienced and navigated the maternity care system in the United States during pregnancy and childbirth. We conducted semi-structured interviews with 15 African immigrant women living in the Columbus, Ohio area. Participants were recruited using purposive and snowball sampling between February 2021 and May 2021. Interviews were recorded, transcribed, and analyzed using a reflexive thematic analysis approach. FINDINGS Four major themes defined the experiences of our study participants: access to information, patient-clinician relationships, experiences of discrimination, and costs of maternity care. CLINICAL IMPLICATIONS Findings highlight key barriers to providing quality and acceptable maternity care to African immigrant women at multiple levels. This group's unique barriers underlie the importance of incorporating their diverse experiences into maternity care models and clinical practice. Further research is needed to evaluate and improve maternity care for African immigrant women.
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Olakunle OE, Bakdash L, Chai N, Amedi A, Ahuja A, Moran T, Loan P, Smith RN, Yaffee A, Zeidan A. Characterizing trauma encounters among patients with language other than English preference at a level 1 trauma center's emergency department. J Am Coll Emerg Physicians Open 2024; 5:e13205. [PMID: 38846103 PMCID: PMC11154787 DOI: 10.1002/emp2.13205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/09/2024] [Accepted: 05/13/2024] [Indexed: 06/09/2024] Open
Abstract
Objectives Injury-related visits constitute a sizeable portion of emergency department (ED) visits in the United States. Individuals with language other than English (LOE) preference face barriers to healthcare and visits for traumatic injury may be the first point of contact with the healthcare system. Yet, the prevalence of traumatic injuries in this population is relatively unknown. Our objective was to characterize the prevalence and purpose of trauma encounters, and healthcare utilization, among a LOE cohort. Methods We conducted a retrospective chart review of LOE patients who presented for a trauma encounter at a level 1 trauma and emergency care center between January 1, 2019 and December 31, 2021. LOE participants were identified by utilization of video-based language interpretive services. Variables evaluated included injury patterns and primary and subspeciality healthcare utilization. Quantitative analysis of categorical and continuous variables was performed. Results A total of 429 patients were included. Most patients presented for one trauma encounter and the majority spoke Spanish. The most common causes of injury were motor vehicle collisions (MVCs) (28.5%, n = 129), ground-level falls (15.9%, n = 72), and falls from heights (14.2%, n = 64). Occupational injuries made up 27.2% of trauma encounters (n = 123) and only 12.6% (n = 54) of patients had a primary care visit. Conclusion Our findings highlight the need for increased research and attention to all causes of injury, especially MVCs and occupational injuries, among those with LOE preference. Results reaffirm an underutilization of healthcare among this population and the opportunity for trauma encounters as points of access to care.
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Affiliation(s)
- Oreoluwa E. Olakunle
- Doctor of Medicine ProgramDepartment of Medicine, Emory University School of MedicineAtlantaGeorgiaUSA
| | - Leen Bakdash
- Doctor of Medicine ProgramDepartment of Medicine, Emory University School of MedicineAtlantaGeorgiaUSA
| | - Nita Chai
- Doctor of Medicine ProgramDepartment of Medicine, Emory University School of MedicineAtlantaGeorgiaUSA
| | - Alan Amedi
- Doctor of Medicine ProgramDepartment of Medicine, Emory University School of MedicineAtlantaGeorgiaUSA
| | - Avni Ahuja
- Doctor of Medicine ProgramDepartment of Medicine, Emory University School of MedicineAtlantaGeorgiaUSA
| | - Timothy Moran
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
| | - Philip Loan
- Doctor of Medicine ProgramAugusta University/University of Georgia (AU/UGA) Medical PartnershipAthensGeorgiaUSA
| | - Randi N. Smith
- Department of SurgeryEmory University School of MedicineAthensGeorgiaUSA
- Grady Health SystemAtlantaGeorgiaUSA
| | - Anna Yaffee
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Grady Health SystemAtlantaGeorgiaUSA
| | - Amy Zeidan
- Department of Emergency MedicineEmory University School of MedicineAtlantaGeorgiaUSA
- Grady Health SystemAtlantaGeorgiaUSA
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García MC, Rossen LM, Matthews K, Guy G, Trivers KF, Thomas CC, Schieb L, Iademarco MF. Preventable Premature Deaths from the Five Leading Causes of Death in Nonmetropolitan and Metropolitan Counties, United States, 2010-2022. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2024; 73:1-11. [PMID: 38687830 PMCID: PMC11065459 DOI: 10.15585/mmwr.ss7302a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Problem/Condition A 2019 report quantified the higher percentage of potentially excess (preventable) deaths in U.S. nonmetropolitan areas compared with metropolitan areas during 2010-2017. In that report, CDC compared national, regional, and state estimates of preventable premature deaths from the five leading causes of death in nonmetropolitan and metropolitan counties during 2010-2017. This report provides estimates of preventable premature deaths for additional years (2010-2022). Period Covered 2010-2022. Description of System Mortality data for U.S. residents from the National Vital Statistics System were used to calculate preventable premature deaths from the five leading causes of death among persons aged <80 years. CDC's National Center for Health Statistics urban-rural classification scheme for counties was used to categorize the deaths according to the urban-rural county classification level of the decedent's county of residence (1: large central metropolitan [most urban], 2: large fringe metropolitan, 3: medium metropolitan, 4: small metropolitan, 5: micropolitan, and 6: noncore [most rural]). Preventable premature deaths were defined as deaths among persons aged <80 years that exceeded the number expected if the death rates for each cause in all states were equivalent to those in the benchmark states (i.e., the three states with the lowest rates). Preventable premature deaths were calculated separately for the six urban-rural county categories nationally, the 10 U.S. Department of Health and Human Services public health regions, and the 50 states and the District of Columbia. Results During 2010-2022, the percentage of preventable premature deaths among persons aged <80 years in the United States increased for unintentional injury (e.g., unintentional poisoning including drug overdose, unintentional motor vehicle traffic crash, unintentional drowning, and unintentional fall) and stroke, decreased for cancer and chronic lower respiratory disease (CLRD), and remained stable for heart disease. The percentages of preventable premature deaths from the five leading causes of death were higher in rural counties in all years during 2010-2022. When assessed by the six urban-rural county classifications, percentages of preventable premature deaths in the most rural counties (noncore) were consistently higher than in the most urban counties (large central metropolitan and fringe metropolitan) for the five leading causes of death during the study period.During 2010-2022, preventable premature deaths from heart disease increased most in noncore (+9.5%) and micropolitan counties (+9.1%) and decreased most in large central metropolitan counties (-10.2%). Preventable premature deaths from cancer decreased in all county categories, with the largest decreases in large central metropolitan and large fringe metropolitan counties (-100.0%; benchmark achieved in both county categories in 2019). In all county categories, preventable premature deaths from unintentional injury increased, with the largest increases occurring in large central metropolitan (+147.5%) and large fringe metropolitan (+97.5%) counties. Preventable premature deaths from CLRD decreased most in large central metropolitan counties where the benchmark was achieved in 2019 and increased slightly in noncore counties (+0.8%). In all county categories, preventable premature deaths from stroke decreased from 2010 to 2013, remained constant from 2013 to 2019, and then increased in 2020 at the start of the COVID-19 pandemic. Percentages of preventable premature deaths varied across states by urban-rural county classification during 2010-2022. Interpretation During 2010-2022, nonmetropolitan counties had higher percentages of preventable premature deaths from the five leading causes of death than did metropolitan counties nationwide, across public health regions, and in most states. The gap between the most rural and most urban counties for preventable premature deaths increased during 2010-2022 for four causes of death (cancer, heart disease, CLRD, and stroke) and decreased for unintentional injury. Urban and suburban counties (large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan) experienced increases in preventable premature deaths from unintentional injury during 2010-2022, leading to a narrower gap between the already high (approximately 69% in 2022) percentage of preventable premature deaths in noncore and micropolitan counties. Sharp increases in preventable premature deaths from unintentional injury, heart disease, and stroke were observed in 2020, whereas preventable premature deaths from CLRD and cancer continued to decline. CLRD deaths decreased during 2017-2020 but increased in 2022. An increase in the percentage of preventable premature deaths for multiple leading causes of death was observed in 2020 and was likely associated with COVID-19-related conditions that contributed to increased mortality from heart disease and stroke. Public Health Action Routine tracking of preventable premature deaths based on urban-rural county classification might enable public health departments to identify and monitor geographic disparities in health outcomes. These disparities might be related to different levels of access to health care, social determinants of health, and other risk factors. Identifying areas with a high prevalence of potentially preventable mortality might be informative for interventions.
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Chen C, Shi H, Yang J, Bao X, Sun Y. The risk of breast cancer and gynecologic malignancies after ovarian stimulation: Meta-analysis of cohort study. Crit Rev Oncol Hematol 2024; 197:104320. [PMID: 38479585 DOI: 10.1016/j.critrevonc.2024.104320] [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: 10/17/2023] [Revised: 01/31/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024] Open
Abstract
The effects of ovarian stimulation on breast and gynecological tumor incidence remain controversial. Therefore, the aim of this meta-analysis was to study the risk of cancer in ovarian stimulation. Of the 22713 studies initially identified, 28 were eligible for inclusion. The results revealed that the impact of ovarian cancer (RR = 1.33, [1.05; 1.69]) and cervical cancer (RR = 0.67, [0.46; 0.97]) is significant among the overall effects. In subgroup analysis, in the nulliparous population (RR = 0.81 [0.68; 0.96]) was the protective factor for the breast cancer. In the Caucasians subgroup (RR = 1.45, [1.12; 1.88]), the ovarian cancer incidence was statistically significant. In the Asian subgroup (RR = 1.51, [1.00; 2.28]), the endometrial cancer incidence was statistically significant. In the subgroup of Asians (RR = 0.55 [0.44; 0.68]) and the multiparous population (RR = 0.31, [0.21; 0.46]), them can be the statistically protective factor for the cervical cancer.
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Affiliation(s)
- Chuanju Chen
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Cenetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Hao Shi
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Cenetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Jingya Yang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Cenetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Xiao Bao
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Cenetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yingpu Sun
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Cenetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Hodges JC, McKetchnie SM, González A, Hawkins SS. The Impacts of Inclusionary State Immigrant Policies on Psychosocial Outcomes Among Latinx Adolescents. J Am Acad Child Adolesc Psychiatry 2024; 63:355-364. [PMID: 37414094 DOI: 10.1016/j.jaac.2023.05.024] [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: 12/27/2022] [Revised: 04/28/2023] [Accepted: 06/16/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE State-level policies that exclude immigrants, primarily undocumented, from public services and benefits have been found to have negative psychosocial impacts on Latinx adults, regardless of nativity. The effects of inclusionary policies-that is, extending public benefits to all immigrants-remain underexamined, as well as the impacts on adolescents. METHOD We used data from the Youth Risk Behavior Survey from 2009 to 2019 to examine the association between 7 state-level inclusionary policies and bullying victimization, low mood, and suicidality among Latinx adolescents via 2-way fixed-effects log-binomial regression models. RESULTS Banning the use of eVerify in employment was associated with decreased bullying victimization (prevalence ratio [PR] = 0.63, 95% CI: 0.53-0.74), low mood (PR = 0.87, 95% CI: 0.78-0.98), and suicidality (PR = 0.73, 95% CI: 0.62-0.86). Extending public health insurance coverage was associated with decreased bullying victimization (PR = 0.57, 95% CI: 0.49-0.67), and mandating Culturally and Linguistically Appropriate Services (CLAS) training for health care workers was associated with decreased low mood (PR = 0.79, 95% CI: 0.69-0.91). Extending in-state tuition to undocumented students was associated with increased bullying victimization (PR = 1.16, 95% CI: 1.04-1.30), and extending financial aid was associated with increased bullying victimization (PR = 1.54, 95% CI: 1.08-2.19), low mood (PR = 1.23, 95% CI: 1.08-1.40), and suicidality (PR = 1.38, 95% CI: 1.01-1.89). CONCLUSION The relationships between inclusionary state-level policies and Latinx adolescent psychosocial outcomes were mixed. Although most inclusionary policies were associated with improved psychosocial outcomes, Latinx adolescents residing in states with inclusionary policies related to higher education had worse psychosocial outcomes. Results suggest the importance of elucidating the unintended consequences of well-intentioned policies and the importance of continued efforts to reduce anti-immigrant sentiment.
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Affiliation(s)
- James C Hodges
- School of Social Work, Boston College, Chestnut Hill, Massachusetts.
| | | | - Andrés González
- School of Theology and Ministry, Boston College, Chestnut Hill, Massachusetts
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Zaidi M, Fantasia HC, Penders R, Koren A, Enah C. Increasing U.S. Maternal Health Equity Among Immigrant Populations Through Community Engagement. Nurs Womens Health 2024; 28:11-22. [PMID: 38072010 DOI: 10.1016/j.nwh.2023.09.004] [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: 06/09/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 01/09/2024]
Abstract
Immigrant women in the United States are at an elevated risk of poor maternal health outcomes due to cultural, linguistic, or socioeconomic barriers that may lead to critical delays in obtaining adequate health care. Ensuring access to high-quality, culturally appropriate perinatal health care is crucial to improve the health and well-being of immigrant mothers and their children. Various aspects of perinatal health care for immigrant women can be improved through community engagement strategies. Barriers can be addressed by involving community members in designing and delivering culturally appropriate maternal health services. Some strategies discussed in this commentary include working with community health workers, encouraging telehealth through community health workers, providing breastfeeding and mental health support within cultural norms, and involving community-based doulas and midwives.
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Kelly EA, Echeverri Alegre JI, Promer K, Hayon J, Iordanov R, Rangwalla K, Zhang JJ, Fang Z, Huang C, Bittencourt CE, Reed S, Andrade RM, Bern C, Clark EH, Whitman JD. Chagas Disease Diagnostic Practices at Four Major Hospital Systems in California and Texas. J Infect Dis 2024; 229:198-202. [PMID: 37853514 PMCID: PMC11032249 DOI: 10.1093/infdis/jiad404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/15/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Chagas disease (CD) is a parasitic disease that affects ∼300 000 people living in the United States. CD leads to cardiac and/or gastrointestinal disease in up to 30% of untreated people. However, end-organ damage can be prevented with early diagnosis and antiparasitic therapy. METHODS We reviewed electronic health records of patients who underwent testing for CD at four hospital systems in California and Texas between 2016 and 2020. Descriptive analyses were performed as a needs assessment for improving CD diagnosis. RESULTS In total, 470 patients were tested for CD. Cardiac indications made up more than half (60%) of all testing, and the most frequently cited cardiac condition was heart failure. Fewer than 1% of tests were ordered by obstetric and gynecologic services. Fewer than half (47%) of patients had confirmatory testing performed at the Centers for Disease Control and Prevention. DISCUSSION Four major hospitals systems in California and Texas demonstrated low overall rates of CD diagnostic testing, testing primarily among older patients with end-organ damage, and incomplete confirmatory testing. This suggests missed opportunities to diagnose CD in at-risk individuals early in the course of infection when antiparasitic treatment can reduce the risk of disease progression and prevent vertical transmission.
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Affiliation(s)
- Emily A Kelly
- Department of Laboratory Medicine, University of California, SanFrancisco, San Francisco, California, USA
| | | | - Katherine Promer
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, California, USA
| | - Jesica Hayon
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Roumen Iordanov
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Khuzaima Rangwalla
- School of Medicine, University of California, SanFrancisco, San Francisco, California, USA
| | - Jerry J Zhang
- School of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Zian Fang
- School of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Cindy Huang
- School of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | | | - Sharon Reed
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, San Diego, California, USA
- Department of Pathology, University of California, San Diego, San Diego, California, USA
| | - Rosa M Andrade
- Department of Medicine, Division of Infectious Diseases, University of California, Irvine, Irvine, California, USA
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Eva H Clark
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA
| | - Jeffrey D Whitman
- Department of Laboratory Medicine, University of California, SanFrancisco, San Francisco, California, USA
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13
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Datta BK, Coughlin SS, Majeed B. Inequities in routine preventive care utilization among persons with overweight/obesity in the United States: An analysis of nativity, racial and ethnic identity, and socioeconomic status. DIALOGUES IN HEALTH 2023; 2:100125. [PMID: 37377782 PMCID: PMC10292657 DOI: 10.1016/j.dialog.2023.100125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/06/2023] [Accepted: 03/10/2023] [Indexed: 06/29/2023]
Abstract
Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obesity at the junction of their nativity, racial/ethnic identity, and socioeconomic status (i.e., income and education). Pooling data on 120,184 adults with overweight/obesity from the 2013-2018 waves of the National Health Interview Survey (NHIS), we estimated modified Poisson regressions with robust standard errors to obtain adjusted prevalence rates of preventive care visit, receiving flu shot, and having blood pressure, cholesterol and blood glucose screened. We found that immigrant adults with overweight/obesity had lower rates of utilization of all five preventive care services. However, these patterns varied by racial and ethnic sub-populations. While White immigrants had comparable rates of cholesterol and blood glucose screening, they had 2.7%, 2.9%, and 14.5% lower rates of preventive care visit, blood pressure screening, and getting a flu shot respectively, compared to native-born Whites. These patterns were similar for Asian immigrants as well. Black immigrants, on the other hand, had comparable rates of getting a flu shot and blood glucose screening, and had 5.2%, 4.9%, and 4.9% lower rates of preventive care visit, blood pressure screening, and cholesterol screening respectively. Lastly, the rates of utilization among Hispanic immigrants were significantly lower (ranging from 9.2% to 20%) than those of their native-born counterparts for all five preventive care services. These rates further varied by education, income, and length of stay in the US, within the racial and ethnic subgroups. Our findings thus suggest a complex relationship between nativity and racial/ethnic identity in relation to preventive care utilization among adults with overweight/obesity.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Steven S. Coughlin
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ban Majeed
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Salerno JP, Getrich CM, Fish JN, Castillo Y, Edmiston S, Sandoval P, Aparicio EM, Fryer CS, Boekeloo BO. Profiles of psychosocial stressors and buffers among Latinx immigrant youth: Associations with suicidal ideation. Psychiatry Res 2023; 330:115583. [PMID: 37995421 PMCID: PMC10841582 DOI: 10.1016/j.psychres.2023.115583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/25/2023]
Abstract
This study aimed to examine the associations of latent profile group membership based on post-migration psychosocial stressors (proximal immigrant minority stress) and buffers (family, peer, and school support, and ethnic identity importance), and distal stressors (pre- to post-migration victimization and forced immigration-related family separation) with suicidal ideation among immigrant youth from the Northern Triangle (NT). Surveys were administered in a public high school-based Latinx immigrant youth support program between Spring 2019 and Spring 2022 (N = 172). A three latent profile model was previously identified, characterized by moderate stress/low buffer (weak resources), moderate stress/moderate buffer (average resources), and low stress/high buffer (strong resources) levels of psychosocial stressors and buffers. Associations of profile membership and the previously mentioned distal stressors with suicidal ideation were examined using multivariable logistic regression. Findings revealed that youth in the strong resources group experienced significant protection from suicidal ideation compared to youth in both the average and weak resources groups. Distal stressors were not significantly associated with suicidal ideation in multivariable analysis. Immigrant youth from the NT may require substantial buffering resources (i.e., ethnic identity importance, and school, family, and peer support) and minimization of proximal immigrant minority stress during post-migration to experience protection from suicidal ideation.
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Affiliation(s)
- John P Salerno
- School of Social Work, Columbia University, New York, NY, United States.
| | - Christina M Getrich
- Department of Anthropology, College of Behavioral and Social Sciences, University of Maryland, College Park, MD, United States
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States
| | | | | | | | - Elizabeth M Aparicio
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Craig S Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
| | - Bradley O Boekeloo
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, United States
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15
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Glyn-Blanco MB, Lucchetti G, Badanta B. How do cultural factors influence the provision of end-of-life care? A narrative review. Appl Nurs Res 2023; 73:151720. [PMID: 37722788 DOI: 10.1016/j.apnr.2023.151720] [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: 11/28/2022] [Revised: 03/22/2023] [Accepted: 07/28/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Culture influences the way in which patients, families and professionals provide care and undergo decision-making at the end of life. OBJECTIVE Therefore, our research questions were: How do cultural aspects influence the needs, perceptions, and experiences of patients and their families in end-of-life care? What implications does cultural diversity have for professionals who care for individuals at the end of life? METHODS A narrative review was conducted between June and July 2022. Articles published between 2017 and 2022 in peer-reviewed journals were included. RESULTS A total of 43 studies were included. Our findings were grouped into four themes: 1) places to die and preferences about healthcare interventions (e.g. parts of the immigrant population tend to receive more aggressive and invasive interventions); 2) advance care planning and verbalization of death (e.g. less use of ACP in some minority groups); 3) rituals and family involvement during healthcare; 4) professionals addressing multiculturalism in care at the end of life (e.g. lack of training in addressing the context of multiculturalism). CONCLUSIONS These findings could contribute to making professionals more aware of cultural aspects that influence the process of death and highlight the need for further training in the handling of such situations.
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Affiliation(s)
| | - Giancarlo Lucchetti
- Department of Medicine, School of Medicine, Federal University of Juiz de Fora, 36036-900, Brazil
| | - Bárbara Badanta
- Research Group under the Andalusian Research CTS 1050 "Complex Care, Chronic and Health Outcomes", Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Spain.
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Platt R, Martin CP, Perry O, Cooper L, Tandon D, Richman R, Bettencourt AF, Polk S. A Mixed-Methods Evaluation of Virtually Delivered Group-Based Mothers and Babies for Latina Immigrant Mothers. Womens Health Issues 2023; 33:465-473. [PMID: 37330398 DOI: 10.1016/j.whi.2023.05.005] [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: 01/20/2023] [Revised: 04/27/2023] [Accepted: 05/10/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Immigrant Latinas are at higher risk for postpartum depression (PPD) than the general perinatal population, yet face numerous barriers to accessing mental health services. The goal of this study was to pilot an enhanced virtual group delivery of a PPD prevention program, Mothers and Babies (MB), among immigrant Latinas engaged in early childhood programming. METHODS Forty-nine Spanish-speaking mothers participated in one of four MB virtual groups, facilitated by trained bilingual staff at affiliated early learning centers. MB was enhanced to also target social determinants of health. A mixed-methods design was used to evaluate MB using participant interviews and pre-post surveys measuring depressive symptoms, parenting distress, and self-efficacy to manage emotions. RESULTS On average, participants attended 69% of MB virtual sessions and rated group cohesiveness at a 4.6 on a 5-point scale. Paired-samples t tests showed significant reductions in depressive symptoms (Cohen's d = 0.29; p = .03) and parenting distress (Cohen's d = 0.31; p = .02), and improved self-efficacy to manage emotions (Cohen's d = -0.58; p < .001). Participants reported both benefits and drawbacks of the virtual format and provided largely favorable feedback on program enhancements. CONCLUSIONS Results provide initial evidence for the acceptability, feasibility, and effectiveness of an enhanced virtual group PPD prevention program for immigrant Latinas, delivered in partnership with local early learning centers. These findings have important implications for extending the reach of preventive interventions among a population that faces many structural and linguistic barriers to traditional forms of mental health service delivery.
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Affiliation(s)
- Rheanna Platt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Caroline P Martin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Olivia Perry
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Darius Tandon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rebecca Richman
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Amie F Bettencourt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sarah Polk
- Centro SOL at Johns Hopkins, Baltimore, Maryland
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Serrano E, Voldal EC, Machado-Aranda D, DeUgarte DA, Kao L, Drake T, Winchell R, Cuschieri J, Krishnadasan A, Talan DA, Siparsky N, Ayoung-Chee P, Self WH, McGonagill P, Mandell KA, Liang MK, Dodwad SJ, Thompson CM, Padilla RM, Fleischman R, Price TP, Jones A, Bernardi K, Garcia L, Evans HL, Sanchez SE, Odom S, Comstock BA, Heagerty PJ, Lawrence SO, Monsell SE, Fannon EE, Kessler LG, Flum DR, Davidson GH. Trial Participation and Outcomes Among English-Speaking and Spanish-Speaking Patients With Appendicitis Randomized to Antibiotics: A Secondary Analysis of the CODA Randomized Clinical Trial. JAMA Surg 2023; 158:901-908. [PMID: 37379001 PMCID: PMC10308294 DOI: 10.1001/jamasurg.2023.2277] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/28/2023] [Indexed: 06/29/2023]
Abstract
Importance Spanish-speaking participants are underrepresented in clinical trials, limiting study generalizability and contributing to ongoing health inequity. The Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial intentionally included Spanish-speaking participants. Objective To describe trial participation and compare clinical and patient-reported outcomes among Spanish-speaking and English-speaking participants with acute appendicitis randomized to antibiotics. Design, Setting, and Participants This study is a secondary analysis of the CODA trial, a pragmatic randomized trial comparing antibiotic therapy with appendectomy in adult patients with imaging-confirmed appendicitis enrolled at 25 centers across the US from May 1, 2016, to February 28, 2020. The trial was conducted in English and Spanish. All 776 participants randomized to antibiotics are included in this analysis. The data were analyzed from November 15, 2021, through August 24, 2022. Intervention Randomization to a 10-day course of antibiotics or appendectomy. Main Outcomes and Measures Trial participation, European Quality of Life-5 Dimensions (EQ-5D) questionnaire scores (higher scores indicating a better health status), rate of appendectomy, treatment satisfaction, decisional regret, and days of work missed. Outcomes are also reported for a subset of participants that were recruited from the 5 sites with a large proportion of Spanish-speaking participants. Results Among eligible patients 476 of 1050 Spanish speakers (45%) and 1076 of 3982 of English speakers (27%) consented, comprising the 1552 participants who underwent 1:1 randomization (mean age, 38.0 years; 976 male [63%]). Of the 776 participants randomized to antibiotics, 238 were Spanish speaking (31%). Among Spanish speakers randomized to antibiotics, the rate of appendectomy was 22% (95% CI, 17%-28%) at 30 days and 45% (95% CI, 38%-52%) at 1 year, while in English speakers, these rates were 20% (95% CI, 16%-23%) at 30 days and 42% (95% CI 38%-47%) at 1 year. Mean EQ-5D scores were 0.93 (95% CI, 0.92-0.95) among Spanish speakers and 0.92 (95% CI, 0.91-0.93) among English speakers. Symptom resolution at 30 days was reported by 68% (95% CI, 61%-74%) of Spanish speakers and 69% (95% CI, 64%-73%) of English speakers. Spanish speakers missed 6.69 (95% CI, 5.51-7.87) days of work on average, while English speakers missed 3.76 (95% CI, 3.20-4.32) days. Presentation to the emergency department or urgent care, hospitalization, treatment dissatisfaction, and decisional regret were low for both groups. Conclusions and Relevance A high proportion of Spanish speakers participated in the CODA trial. Clinical and most patient-reported outcomes were similar for English- and Spanish-speaking participants treated with antibiotics. Spanish speakers reported more days of missed work. Trial Registration ClinicalTrials.gov Identifier: NCT02800785.
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Affiliation(s)
- Elina Serrano
- University of Washington, Seattle
- Fred Hutch Cancer Center, Seattle, Washington
| | - Emily C. Voldal
- University of Washington, Seattle
- Fred Hutch Cancer Center, Seattle, Washington
| | | | | | - Lillian Kao
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston
| | | | | | - Joseph Cuschieri
- Harborview Medical Center, UW Medicine, Seattle, Washington
- University of California, San Francisco, San Francisco
| | | | - David A. Talan
- Olive View–UCLA Medical Center, Los Angeles, California
- Ronald Reagan UCLA Medical Center, Los Angeles, California
| | | | - Patricia Ayoung-Chee
- Bellevue Hospital Center, NYU School of Medicine, New York, New York
- Tisch Hospital, NYU Langone Medical Center, New York, New York
- Morehouse School of Medicine, Atlanta GA
| | - Wesley H. Self
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | - Mike K. Liang
- Lyndon B. Johnson General Hospital, University of Texas, Houston
- University of Houston, HCA Healthcare, Kingwood, Kingwood, Texas
| | - Shan-Jahan Dodwad
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston
| | - Callie M. Thompson
- Vanderbilt University Medical Center, Nashville, Tennessee
- University of Utah, Salt Lake City
| | | | | | | | - Alan Jones
- The University of Mississippi Medical Center, Jackson
| | - Karla Bernardi
- Lyndon B. Johnson General Hospital, University of Texas, Houston
| | - Luis Garcia
- University of Iowa Hospitals and Clinics, Iowa City
| | - Heather L. Evans
- Harborview Medical Center, UW Medicine, Seattle, Washington
- The Medical University of South Carolina, Charleston
| | | | - Stephen Odom
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Raphael E, Azar KMJ, Gu D, Shen Z, Rubinsky A, Wang M, Pantell M, Lyles CR, Fernandez A, Bibbins-Domingo K, Pressman A, Nasrallah C, Hamad R. Racial and sociodemographic predictors of COVID-19 compared with influenza, appendicitis, and all-cause hospitalization: retrospective cohort analysis. ETHNICITY & HEALTH 2023; 28:836-852. [PMID: 36907661 DOI: 10.1080/13557858.2023.2179021] [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: 07/04/2022] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine whether inequities in COVID-19 infection and hospitalization differ from those for common medical conditions: influenza, appendicitis, and all-cause hospitalization. DESIGN Retrospective study based on electronic health records of three healthcare systems in San Francisco (university, public, and community) examining (1) racial/ethnic distribution in cases and hospitalization among patients with diagnosed COVID-19 (March-August 2020) and patients with diagnosed influenza, diagnosed appendicitis, or all-cause hospitalization (August 2017-March 2020), and (2) sociodemographic predictors of hospitalization among those with diagnosed COVID-19 and influenza. RESULTS Patients 18 years or older with diagnosed COVID-19 (N = 3934), diagnosed influenza (N = 5932), diagnosed appendicitis (N = 1235), or all-cause hospitalization (N = 62,707) were included in the study. The age-adjusted racial/ethnic distribution of patients with diagnosed COVID-19 differed from that of patients with diagnosed influenza or appendicitis for all healthcare systems, as did hospitalization from these conditions compared to any cause. For example, in the public healthcare system, 68% of patients with diagnosed COVID-19 were Latine, compared with 43% of patients with diagnosed influenza, and 48% of patients with diagnosed appendicitis (p < 0.05). In multivariable logistic regressions, COVID-19 hospitalizations were associated with male sex, Asian and Pacific Islander race/ethnicity, Spanish language, and public insurance in the university healthcare system, and Latine race/ethnicity and obesity in the community healthcare system. Influenza hospitalizations were associated with Asian and Pacific Islander and other race/ethnicity in the university healthcare system, obesity in the community healthcare system, and Chinese language and public insurance in both the university and community healthcare systems. CONCLUSIONS Racial/ethnic and sociodemographic inequities in diagnosed COVID-19 and hospitalization differed from those for diagnosed influenza and other medical conditions, with consistently higher odds among Latine and Spanish-speaking patients. This work highlights the need for disease-specific public health efforts in at-risk communities in addition to structural upstream interventions.
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Affiliation(s)
- Eva Raphael
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Family & Community Medicine, UCSF, San Francisco, CA, USA
| | - Kristen M J Azar
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
- Institute for Advancing Health Equity, Sutter Health, Walnut Creek, CA, USA
| | - Dian Gu
- Institute for Health & Aging, UCSF, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, UCSF, San Francisco, CA, USA
| | - Zijun Shen
- Institute for Advancing Health Equity, Sutter Health, Walnut Creek, CA, USA
- Center for Health Systems Research, Sutter Health, Walnut Creek, CA, USA
| | - Anna Rubinsky
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Michael Wang
- Department of Medicine, UCSF, San Francisco, CA, USA
| | | | - Courtney R Lyles
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, UCSF, San Francisco, CA, USA
| | | | - Kirsten Bibbins-Domingo
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
- Department of Medicine, UCSF, San Francisco, CA, USA
| | - Alice Pressman
- Department of Epidemiology & Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA
- Institute for Advancing Health Equity, Sutter Health, Walnut Creek, CA, USA
- Center for Health Systems Research, Sutter Health, Walnut Creek, CA, USA
| | | | - Rita Hamad
- Department of Family & Community Medicine, UCSF, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, UCSF, San Francisco, CA, USA
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Singer E, Molyneux K, Gogerly-Moragoda M, Kee D, Baranowski KA. The COVID-19 pandemic and its impact on health experiences of asylum seekers to the United States. BMC Public Health 2023; 23:1376. [PMID: 37464269 DOI: 10.1186/s12889-023-16313-3] [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: 03/03/2023] [Accepted: 07/14/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic exacerbated preexisting barriers to accessing healthcare and social services faced by asylum seekers to the United States. This study aimed to uncover the impact of the first year of the COVID-19 pandemic on asylum seekers, including socio-economic stressors and access to medical information, healthcare, and testing. METHOD We conducted 15 semi-structured, in-depth interviews with adult asylum seekers to the U.S. and systematically analyzed the resulting transcripts using a consensual qualitative research approach. RESULTS The transcripts yielded six domains: (1) knowledge and understanding of COVID-19; (2) attitudes and practices relating to COVID-19 precautions; (3) experience of COVID-19 symptoms; (4) current physical and mental health; (5) access to and interaction with health care; (6) discrimination based on asylum status. CONCLUSIONS Although participants had knowledge about COVID-19's communicability and regularly used masks, their living conditions frequently hindered their ability to quarantine and isolate, and their lack of insurance was often a deterrent to them seeking medical care. Notably, immigration status was not a significant factor discouraging participants from seeking care during the pandemic. The findings build on existing knowledge about this community and may help define areas where support and services can be expanded in current and future pandemics.
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Affiliation(s)
- Elizabeth Singer
- Departments of Emergency Medicine and Medical Education, Icahn School of Medicine at Mount Sinai, 1111 Amsterdam Avenue, New York, NY, 10025, USA.
| | - Kevin Molyneux
- Department of Emergency Medicine, Columbia University, New York, USA
| | | | - Dustin Kee
- Icahn School of Medicine at Mount Sinai, New York, USA
| | - Kim A Baranowski
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, USA
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Silva P, Pereira H. Promoting Psychosocial Well-Being and Empowerment of Immigrant Women: A Systematic Review of Interventions. Behav Sci (Basel) 2023; 13:579. [PMID: 37504026 PMCID: PMC10376121 DOI: 10.3390/bs13070579] [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: 05/11/2023] [Revised: 06/29/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023] Open
Abstract
This systematic review (SLR), based on the PRISMA 2020 guidelines, aims to present a current overview of interventions aimed at promoting the psychosocial well-being and/or empowerment (PWE) of immigrant women in order to guide future projects. Data collection was performed in the SCOPUS and Web of Science databases, with studies published between 2012 and 20 March 2023 in English, Portuguese, and Spanish. Inclusion and exclusion criteria were based on the PICO guidelines: (P) immigrant women, (I) interventions to improve PWE, (C) comparison between the initial and final phases, and (O) evaluated results for PWE. Risk of bias was assessed, and most of the studies met more than 80% of the JBI bias criteria and had moderate quality on GRADE. Thirteen studies with 585 participants were included, mostly non-randomized, non-equivalent, and with an experimental-control group design. The main components of interventions were health education/psychoeducation, counseling, cognitive restructuring, and expressive therapies. A descriptive synthesis of qualitative and quantitative data was made to evaluate the results of the interventions in PWE. In the experimental studies, results assessed improvements mainly in mood and depression levels, and stress reduction. Empowerment components were less covered. Experimental groups performed better in almost all variables in the comparison with control groups. The strongest interventions were psychoeducation and cognitive restructuring techniques. The main limitations of the studies were the lack of quality of several studies, sample size and representativeness, language, and the possibility of response bias. Even taking this into account, this article makes an original contribution by advocating for evidence-based practice and offering significant implications for health professionals, policy makers, and researchers that work with the integrative health of immigrant women. This SLR is registered in PROPESRO Registration: CRD42023399683. PS is a research fellow of the Foundation for Science and Technology (FCT) of Portugal.
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Affiliation(s)
- Patricia Silva
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
| | - Henrique Pereira
- Department of Psychology and Education, Faculty of Social and Human Sciences, University of Beira Interior, Pólo IV, 6200-209 Covilhã, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development (CIDESD), 5001-801 Vila Real, Portugal
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Serafica R, Fudolig M, Kawi J, Thomas Reyes A, Leyva EWA, Sy FS, Evangelista LS. Correlates of Psychological Distress Among Filipino Americans and Filipinos Living in Urban Areas in the United States and the Philippines. J Transcult Nurs 2023; 34:256-262. [PMID: 36927196 PMCID: PMC10330160 DOI: 10.1177/10436596231159004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Many Asian immigrants, including Filipino Americans (FilAms), experience psychological distress (PD) due to the challenges in adjusting to their new country and culture. This descriptive comparative study aimed to compare FilAms and Filipinos concerning their levels of PD, sources of stress, and use of health-promotion strategies. METHODS Data from 89 FilAms and 95 Filipinos living in urban cities, obtained from the I-HELP-FILIPINOS database, measuring cardiometabolic risks, mental health, and environmental stressors in 2017, including PD, were examined. RESULTS The mean age of all participants (N = 184) was 44.2 ± 22.8 years old. Both groups rated their health as good to excellent, although Filipinos were significantly more likely to be distressed (p < .001). Filipinos were also more likely to ascribe stress to employment (48.3% vs. 68.2%, p =.006) and finances (28.1% vs. 52.6%, p <.001) than FilAms. DISCUSSION While both groups shared comparative perspectives on health, FilAms reported lower PD than Filipinos. The most significant source of stress was the country of residence. We recommend tailoring interventions to each local context's unique social and environmental circumstances.
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Abudiab S, de Acosta D, Shafaq S, Yun K, Thomas C, Fredkove W, Garcia Y, Hoffman SJ, Karim S, Mann E, Yu K, Smith MK, Coker T, Dawson-Hahn E. "Beyond just the four walls of the clinic": The roles of health systems caring for refugee, immigrant and migrant communities in the United States. Front Public Health 2023; 11:1078980. [PMID: 37064664 PMCID: PMC10097984 DOI: 10.3389/fpubh.2023.1078980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Introduction Refugee, immigrant and migrant (hereafter referred to as "immigrant") communities have been inequitably affected by the COVID-19 pandemic. There is little data to help us understand the perspectives of health systems on their role, in collaboration with public health and community-based organizations, in addressing inequities for immigrant populations. This study will address that knowledge gap. Methods This qualitative study used semi-structured video interviews of 20 leaders and providers from health systems who cared for immigrant communities during the pandemic. Interviewees were from across the US with interviews conducted between November 2020-March 2021. Data was analyzed using thematic analysis methods. Results Twenty individuals representing health systems participated with 14 (70%) community health centers, three (15%) county hospitals and three (15%) academic systems represented. The majority [16 health systems (80%)] cared specifically for immigrant communities while 14 (70%) partnered with refugee communities, and two (10%) partnered with migrant farm workers. We identified six themes (with subthemes) that represent roles health systems performed with clinical and public health implications. Two foundational themes were the roles health systems had building and maintaining trust and establishing intentionality in working with communities. On the patient-facing side, health systems played a role in developing communication strategies and reducing barriers to care and support. On the organizational side, health systems collaborated with public health and community-based organizations, in optimizing pre-existing systems and adapting roles to evolving needs throughout the pandemic. Conclusion Health systems should focus on building trusting relationships, acting intentionally, and partnering with community-based organizations and public health to handle COVID-19 and future pandemics in effective and impactful ways that center disparately affected communities. These findings have implications to mitigate disparities in current and future infectious disease outbreaks for immigrant communities who remain an essential and growing population in the US.
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Affiliation(s)
- Seja Abudiab
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | | | - Sheeba Shafaq
- Community Leadership Board, National Resource Center for Refugees, Immigrants and Migrants, San Francisco, CA, United States
| | - Katherine Yun
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Christine Thomas
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Windy Fredkove
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, United States
| | - Yesenia Garcia
- Seattle Children's Research Institute, Seattle, WA, United States
| | - Sarah J. Hoffman
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Sayyeda Karim
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, United States
| | - Erin Mann
- Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, United States
| | - Kimberly Yu
- Independent Consultant, Seattle, WA, United States
| | - M. Kumi Smith
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Tumaini Coker
- Department of Pediatrics, University of Washington, Seattle, WA, United States
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23
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Meyer SR, Seff I, Gillespie A, Brumbaum H, Qushua N, Stark L. "We will need to build up the atmosphere of trust again": Service providers' perceptions of experiences of COVID-19 amongst resettled refugee adolescents. PLoS One 2023; 18:e0283599. [PMID: 36961778 PMCID: PMC10038302 DOI: 10.1371/journal.pone.0283599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
Adolescent resettled refugees across the United States have been significantly impacted by the COVID-19 pandemic, through socio-economic stressors in households, disproportionate morbidity and mortality in immigrant communities, and social isolation and loss of learning due to school closures and the shift to online learning. The Study of Adolescent Lives after Migration to America [SALaMA] investigates the mental health and wellbeing of adolescents who come from-or who have parents who came from-the Middle East and North Africa [MENA] region and settled in the U.S. There is a gap in understanding of the experiences during the pandemic of MENA-background adolescents in the U.S. The objective of this study was to describe the perspective of educators and other school-affiliated service providers on the impact of the COVID-19 pandemic on mental health and wellbeing of adolescent resettled refugees and access to and quality of education and support services for adolescent resettled refugees. The researchers collected data using in-depth interviews with key informants in Chicago, Illinois; Harrisonburg, Virginia; and Detroit Metropolitan Area [DMA], Michigan, Key informants were school administrators, managers of English language learning services and programs, teachers, therapists, staff of non-governmental organizations and/ or community-based organizations, and case workers. Data analysis was conducted utilizing directed content analysis to develop an initial codebook and identify key themes in the data. Findings revealed a number of pathways through which the pandemic impacted adolescent refugees and immigrants' mental health and wellbeing, with online programming impacting students' engagement, motivation and social isolation in terms of peer and provider relationships. Specific dynamics in refugee adolescents' households increased stressors and reduced engagement through online learning, and access to space and resources needed to support learning during school closures were limited. Service providers emphasized multiple and overlapping impacts on service quality and access, resulting in reduced social supports and mental health prevention and response approaches. Due to the long-term impacts of school closures in the first two years of the pandemic, and ongoing disruption, these data both provide a snapshot of the impacts of the pandemic at a specific moment, as well as insights into ways forward in terms of adapting services and engaging students within restrictions and limitations due to the pandemic. These findings emphasize the need for educators and mental health service providers to rebuild and strengthen relationships with students and families. These findings indicate the need to consider, support and expand social support and mental health services, specifically for refugee adolescent students, in the context of learning and well-being during the COVID-19 pandemic.
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Affiliation(s)
- Sarah R. Meyer
- The Institute for Medical Information Processing, Biometry, and Epidemiology, University of Munich, Munich, Germany
| | - Ilana Seff
- The Brown School at Washington University in St. Louis, St. Louis, MO, United States of America
| | - Alli Gillespie
- The Brown School at Washington University in St. Louis, St. Louis, MO, United States of America
| | - Hannah Brumbaum
- The Brown School at Washington University in St. Louis, St. Louis, MO, United States of America
| | - Najat Qushua
- The Brown School at Washington University in St. Louis, St. Louis, MO, United States of America
| | - Lindsay Stark
- The Brown School at Washington University in St. Louis, St. Louis, MO, United States of America
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Urcuyo AE, Conroy K, Sanchez AL, Silva K, Furr JM, Bagner DM, Comer JS. Psychometric Evaluation of the Abbreviated Multidimensional Acculturation Scale (AMAS) in a Treatment-Seeking Sample of First-Generation Immigrant Caregivers. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01525-w. [PMID: 36964458 DOI: 10.1007/s10578-023-01525-w] [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] [Accepted: 03/01/2023] [Indexed: 03/26/2023]
Abstract
The unique needs of first-generation immigrants and their families have not been prioritized in mental healthcare. Cultural tailoring of child services requires valid, reliable, and efficient assessments of family cultural identity. The Abbreviated Multidimension Acculturation Scale (AMAS) is a self-report of acculturation and enculturation that has been evaluated in community, but not clinical, samples. We offer the first AMAS psychometric evaluation in a treatment-seeking sample of first-generation immigrant caregivers presenting for children's mental healthcare (N = 219). Analyses examined the internal consistency, concurrent validity, and factor structures of the long-form AMAS (42 items, six subscales), AMAS-10 (10 items, four subscales), and AMAS-14 (14 items, six subscales). Findings provide support for the AMAS-10 and AMAS-14, but not the full-length AMAS, in the present sample. Given urgent needs for culturally responsive care for first-generation populations, the AMAS-10 and AMAS-14 can be used in clinical settings to support cultural assessment, case conceptualization, and treatment planning.
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Affiliation(s)
- Anya E Urcuyo
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Kristina Conroy
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | | | - Karina Silva
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jami M Furr
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Daniel M Bagner
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA
| | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
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25
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Renzaho AMN, Polonsky M, Yusuf A, Ferdous A, Szafraniec M, Salami B, Green J. Migration-related Factors and Settlement Service Literacy: Findings from the Multi-site Migrants' Settlement Study. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2023:1-21. [PMID: 37360640 PMCID: PMC10027273 DOI: 10.1007/s12134-023-01023-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 06/28/2023]
Abstract
Migrants' access and effective utilisation of settlement services depend on their level of settlement service literacy (SSL). However, SSL is multi-dimensional in nature and has many facets that are influenced by demographic and migration-related factors. Identifying factors that drive various components of SSL, and thus allowing for more focused development of specific dimensions, is critical. The aim of this study was to examine the relationship between components of SSL and migration-related and migrants' demographic factors. Using a snowball sampling approach, trained multilingual research assistants collected data on 653 participants. Data were collected using face-to-face or online (phone and via video platforms such as Zoom and Skype) surveys. Our findings suggest that demographic and migration-related factors explained 32% of the variance in overall SSL; and 17%, 23%, 44%, 8%, 10% of the variance in knowledge, empowerment, competence, community influence, and political components of SSL respectively. SSL was positively associated with pre-migration and post-migration educational attainment, being employed in Australia, being a refugee, coming from the sub-Saharan region but negatively associated with age and coming from the East Asia and Pacific region. Across SSL dimensions, post-migration education was the only factor positively associated with the overall SSL and all SSL dimensions (except the political dimension). Employment status in Australia was also positively associated with competency and empowerment, but not other dimensions. Affiliating with a religion other than Christianity or Islam was negatively associated with knowledge and empowerment whilst being a refugee was positively associated with knowledge. Age was negatively associated with the empowerment and competency dimensions. The study provides evidence of the importance of some pre- and post-migration factors that can assist in developing targeted initiatives to enhance migrants' SSL. Identifying factors that drive various components of SSL will allow for more focused development of specific dimensions and therefore is critical.
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Affiliation(s)
- Andre M. N. Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560 Australia
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, 3004 Australia
| | - Michael Polonsky
- Deakin Business School, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125 Australia
| | - Adnan Yusuf
- Deakin Business School, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125 Australia
| | - Ahmed Ferdous
- Deakin Business School, Deakin University, 221 Burwood Hwy, Burwood, VIC 3125 Australia
| | | | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, AB Canada
| | - Julie Green
- Murdoch Children’s Research Institute, Parkville, VIC Australia
- School of Medicine, Western Sydney University, Penrith, NSW Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC Australia
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26
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Harris NL, Richardson Cayama M, Arias C, Ansari F, Ilonzo C, Williams A, Sappenfield W, Kirby RS. Assessing the Unmet Preconception Care Needs of Men in the United States by Race/Ethnicity and Nativity. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100840. [DOI: 10.1016/j.srhc.2023.100840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/03/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023]
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27
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Pilato TC, Taki F, Sbrollini K, Purington Drake A, Maley B, Yale-Loehr S, Powers JL, Bazarova NN, Bhandari A, Kaur G. Knowledge of legal rights as a factor of refugee and asylum seekers' health status: a qualitative study. BMJ Open 2023; 13:e063291. [PMID: 36764728 PMCID: PMC9923268 DOI: 10.1136/bmjopen-2022-063291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/14/2023] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVES To examine health behaviours of refugees and asylum seekers, in relation to their knowledge of public benefits and legal rights. DESIGN Qualitative study, utilising an open-ended, semi-structured interview guide to ensure information-rich data collection. Thematic content was analysed using qualitative research software. SETTING Participants were drawn from the Weill Cornell Center for Human Rights (WCCHR) in New York City, a single-center, human rights clinic with a globally representative patient population. All interviews were conducted at the Weill Cornell Medicine Clinical and Translational Science Center, a multidisciplinary space within an urban academic medical center. PARTICIPANTS Twenty-four refugees and asylum seekers currently living in the greater New York City area. Eligible participants were 18 years of age or older and had previously sought services from the WCCHR. The recruitment rate was 55%. PRIMARY AND SECONDARY OUTCOME MEASURES Themes and concepts in participants' health, knowledge, perceptions of and experiences with accessing healthcare and public benefits programmes. RESULTS Twenty-four participants represented 18 countries of origin and 11 primary languages. Several impediments to accessing healthcare and public benefits were identified, including pragmatic barriers (such as prohibitive costs or lack of insurance), knowledge gaps and mistrust of healthcare systems. CONCLUSIONS There is low health engagement by refugees and asylum seekers, as a result of multiple, complex factors impeding the ability of refugee and asylum seekers to access healthcare and other public benefits for which they are eligible-with resultant detrimental health effects. However, there is an opportunity to utilise novel approaches, such as digital technologies, to communicate relevant information regarding legal rights and public benefits to advance the health of vulnerable individuals such as refugees and asylum seekers.
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Affiliation(s)
- Tara C Pilato
- Emergency Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA
| | - Faten Taki
- Anesthesiology, Weill Cornell Medicine, New York City, New York, USA
| | - Kaitlyn Sbrollini
- Department of Anesthesiology, Weill Cornell Medicine, New York City, New York, USA
| | - Amanda Purington Drake
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, New York, USA
| | - Brian Maley
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, New York, USA
| | | | - Jane L Powers
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, New York, USA
| | | | | | - Gunisha Kaur
- Anesthesiology, Weill Cornell Medicine, New York City, New York, USA
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28
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Campbell JI, Tabatneck M, Sun M, He W, Musinguzi N, Hedt-Gauthier B, Lamb GS, Domond K, Goldmann D, Sabharwal V, Sandora TJ, Haberer JE. Multicenter Analysis of Attrition from the Pediatric Tuberculosis Infection Care Cascade in Boston. J Pediatr 2023; 253:181-188.e5. [PMID: 36181869 DOI: 10.1016/j.jpeds.2022.09.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/12/2022] [Accepted: 09/23/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To characterize losses from the pediatric tuberculosis (TB) infection care cascade to identify ways to improve TB infection care delivery. STUDY DESIGN We conducted a retrospective cohort study of children (age <18 years) screened for TB within 2 Boston-area health systems between January 2017 and May 2019. Patients who received a tuberculin skin test (TST) and/or an interferon gamma release assay (IGRA) were included. RESULTS We included 13 353 tests among 11 622 patients; 93.9% of the tests were completed. Of 199 patients with positive tests for whom TB infection evaluation was clinically appropriate, 59.3% completed treatment or were recommended to not start treatment. Age 12-17 years (vs < 5 years; aOR 1.59; 95% CI, 1.32-1.92), non-English/non-Spanish language preference (vs English; aOR, 1.34; 95% CI, 1.02-1.76), and receipt of an IGRA (vs TST, aOR, 30.82; 95% CI, 21.92-43.34) were associated with increased odds of testing completion. Odds of testing completion decreased as census tract social vulnerability index quartile increased (ie, social vulnerability worsened; most vulnerable quartile vs least vulnerable quartile, aOR, 0.77; 95% CI, 0.60-0.99). Odds of completing treatment after starting treatment were higher in females (vs males; aOR, 2.35; 95% CI, 1.14-4.85) and were lower in patients starting treatment in a primary care clinic (vs TB/infectious diseases clinic; aOR, 0.44; 95% CI, 0.27-0.71). CONCLUSIONS Among children with a high proportion of negative TB infection tests, completion of testing was high, but completion of evaluation and treatment was moderate. Transitions toward IGRA testing will improve testing completion; interventions addressing social determinants of health are important to improve treatment completion.
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Affiliation(s)
- Jeffrey I Campbell
- Division of Infectious Diseases, Boston Children's Hospital, Boston, MA.
| | - Mary Tabatneck
- Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Mingwei Sun
- Center for Research Information Technology, Boston Children's Hospital, Boston, MA
| | - Wei He
- Center for Research Information Science and Computing, Massachusetts General Hospital, Boston, MA
| | - Nicholas Musinguzi
- Global Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Gabriella S Lamb
- Division of Infectious Diseases, Boston Children's Hospital, Boston, MA
| | - Kezia Domond
- Center for Global Health, Massachusetts General Hospital, Boston, MA
| | - Don Goldmann
- Division of Infectious Diseases, Boston Children's Hospital, Boston, MA
| | - Vishakha Sabharwal
- Division of Pediatric Infectious Diseases, Boston Medical Center, Boston, MA
| | - Thomas J Sandora
- Division of Infectious Diseases, Boston Children's Hospital, Boston, MA
| | - Jessica E Haberer
- Center for Global Health, Massachusetts General Hospital, Boston, MA
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29
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Verdaguer S, Ramya R, Hernández M, Flórez KR. Examining the Independent Association Between Acculturative Stress and Psychological Distress Among Mexican Immigrants in New York City: An Exploratory Study. Health Equity 2023; 7:197-205. [PMID: 36974196 PMCID: PMC10039280 DOI: 10.1089/heq.2022.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/29/2023] Open
Abstract
Objective This study examines the association between acculturative stress and psychological distress among Mexican immigrants living in New York City. It takes account factors such as language barriers, legal status, fear of deportation, and avoidance of social health and human services, and how these factors are implicated in the mental health status of the study population. Design Study draws from a community-based sample of Mexican American adults from the Social Network of Mexican Americans study recruited from a church-based community center in the Bronx, New York. Eighty Mexican immigrants were included in this analysis. Descriptive statistics were used to display participants' characteristics. Pearson correlation and multiple regressions were run to determine the relationship between acculturative stress and psychological distress, and also with each of the items from the acculturative stress scale. Both scales have been validated among Spanish-speaking Latino immigrants. Results A significant moderate positive relationship was found between acculturative stress and psychological distress. Within the acculturative stress scale, those items related to language discrimination, evasion of health services, and feeling guilty for leaving family/friends in home country had significant associations with increased psychological distress. Conclusion The findings support the need for interventions that account for the major stressors associated with being a Mexican immigrant in the United States to prevent psychological distress, especially given the anti-immigration policies.
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Affiliation(s)
- Sandra Verdaguer
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
- Address correspondence to: Sandra Verdaguer, MPH, Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th Street, New York, NY 10027, USA.
| | - Rachita Ramya
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - María Hernández
- El Instituto: Institute of Latina/o, Caribbean and Latin America Studies of College of Liberal Arts and Science, University of Connecticut, Storrs, CT, USA
| | - Karen R. Flórez
- Environmental, Occupational and Geospatial Sciences Department, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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30
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Kerani RP, Lugg A, Berzins B, Gaye O, Lipira LE, Bundy C, Kwakwa H, Holmes KK, Golden MR. Post-migration HIV acquisition among african immigrants in the U.S. J Immigr Minor Health 2022; 24:1459-1468. [PMID: 35415766 PMCID: PMC9554041 DOI: 10.1007/s10903-022-01356-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND African immigrants in the U.S. are more likely to have a late HIV diagnosis than U.S.-born people, potentially leading to onward transmission. We sought to determine the proportion of African-born people living with HIV (APLWH) who (1) had tested HIV negative prior to diagnosis, and (2) likely acquired HIV in the U.S. METHODS We interviewed APLWH from 2014 to 2017 and estimated the proportion with post-migration HIV acquisition based on clinical data, HIV testing history, immigration date, and behavioral data. RESULTS Of 179 participants, 113 (63%) were women. Less than half (44%) reported a negative HIV test prior to diagnosis. Among 142 (79%) participants with sufficient data to evaluate post-migration HIV acquisition, we estimate that 29% acquired HIV post-migration. Most APLWH acquire HIV prior to immigration. DISCUSSION Approximately one-quarter of APLWH acquire HIV post-migration and HIV testing is infrequent, highlighting the need for prevention efforts for African immigrants in the U.S.
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Affiliation(s)
- Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, WA, United States.
- HIV/STD Program, Public Health - Seattle and King County, Seattle, WA, United States.
- Department of Epidemiology, University of Washington, Seattle, WA, United States.
- Center for AIDS and STD, Harborview Medical Center, 325 9th Ave, Box 359932, 98104, Seattle, WA, United States.
| | - Amanda Lugg
- African Services Committee, New York, NY, United States
| | - Baiba Berzins
- Division of Infectious Diseases, Northwestern University, Evanston, IL, United States
| | - Oumar Gaye
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - Lauren E Lipira
- Department of Health Services, University of Washington, Seattle, WA , United States
- Oregon Health Authority and the Regional Research Institute, Portland State University, Portland, OR, United States
| | - Camille Bundy
- Division of Infectious Diseases, Northwestern University, Evanston, IL, United States
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Helena Kwakwa
- Philadelphia Department of Public Health, Philadelphia, PA, United States
| | - King K Holmes
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Matthew R Golden
- Department of Medicine, University of Washington, Seattle, WA, United States
- HIV/STD Program, Public Health - Seattle and King County, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
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31
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Sharma RK, Patel S, Gallant JN, Esianor BI, Duffus S, Wang H, Weiss VL, Belcher RH. Racial, ethnic, and socioeconomic disparities in the presentation and management of pediatric thyroid cancer. Int J Pediatr Otorhinolaryngol 2022; 162:111331. [PMID: 36206698 PMCID: PMC10115562 DOI: 10.1016/j.ijporl.2022.111331] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/26/2022] [Accepted: 09/27/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Disparities across race and socioeconomic status (SES) in cancer treatment exist for many malignancies. Disadvantaged groups have repeatedly been shown to receive sub-optimal treatment. This study intends to analyze racial and SES disparities in the presentation and management of pediatric thyroid cancer. METHODS A retrospective national database study of children who underwent thyroidectomy for thyroid papillary, medullary, and follicular carcinoma between 2007 and 2016 was conducted using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. Multivariable logistic regression was conducted to identify predictors of 1) tumor stage/size at diagnosis and 2) treatment modalities. RESULTS 1942 children were analyzed. The average tumor size at presentation was 20 mm for White patients, 26 mm for Non-White patients, and 27 mm for Hispanic patients (p < 0.001). Stage of disease differed significantly by race/ethnicity (p < 0.001) with Non-White and Hispanic patients having more distant disease than White patients at presentation. On multivariable regression, Hispanic patients (OR 1.41, 95%CI 1.06-1.87, p = 0.017) were more likely to be diagnosed at later stages. Non-White (OR 2.03, 1.50-2.73, p < 0.001) and Hispanic patients (OR 1.57, 1.19-2.07, p = 0.002) had larger tumors at diagnosis than White patients after controlling for other SES factors. CONCLUSIONS SES disparities exist in pediatric thyroid cancer. Non-White and Hispanic patients are more likely to present with larger tumors and distant disease as compared to White patients. Understanding and intervening on these SES disparities is essential to improve outcomes.
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Affiliation(s)
- Rahul K Sharma
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Siddharth Patel
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Meharry Medical College, Nashville, TN, USA
| | - Jean-Nicolas Gallant
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandon I Esianor
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sara Duffus
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Huiying Wang
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Vivian L Weiss
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ryan H Belcher
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
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First, do no harm: why anti-immigrant policies in the United States are a public health concern. J Public Health Policy 2022; 43:403-412. [PMID: 36138149 DOI: 10.1057/s41271-022-00364-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 11/21/2022]
Abstract
It can be argued that anti-immigrant policies, such as the 287(g) program, can have a direct impact on the health and well-being of the immigrant community in general, particularly undocumented immigrants in the United States. While there is yet to be a comprehensive and conclusive empirical assessment of this issue, what is known is that the immigrant community faces many stress factors and structural barriers that negatively impact health. We argue that it is urgent that public health responds to the unique experiences and challenges of the undocumented and wider immigrant community. In doing so, we propose three recommendations for addressing this issue: (1) Assess the causal relationship between anti-immigration policies and immigrant health, (2) Increase funding and access to health care services for immigrant communities in jurisdictions implementing anti-immigrant policies, and (3) For public health to engage in a conscious effort to service the undocumented immigrant community. Even though we focus specifically on the United States, our recommendations are applicable on a global scale since anti-immigration policies are prevalent across nations and are a pervasive human rights issue around the world.
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Sheng J, Abshire DA, Heiney SP, Wirth MD. Acculturation, Physical Activity, and Metabolic Syndrome in Asian American Adults. J Transcult Nurs 2022; 33:675-684. [PMID: 35924549 DOI: 10.1177/10436596221114150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Asian Americans (AsAms) have a high prevalence of metabolic syndrome (MetS) and are one of the least physically active racial groups in America. The purpose of this study was to examine the relationship between MetS and moderate-to-vigorous physical activity (MVPA) among AsAm adults and whether acculturation modifies this relationship. METHOD Data were from 2,259 AsAms participating in the 2011-2016 National Health and Nutrition Examination Survey. Physical activity (PA) was self-reported as minutes of weekly MVPA. Acculturation included nativity, length of residency in America, and language preference. The International Diabetes Federation criteria was used to determine the presence of MetS. RESULTS About 64.4% of AsAms did not meet the PA recommendation (MVPA ≥150 min/week). The prevalence of MetS was 39.2%. The odds of having MetS were greater among AsAms who did not meet MVPA recommendations compared with those who did meet MVPA recommendations (odds ratio [OR] = 1.5, 95% confidence interval [CI] = [1.11, 2.07]). When stratified by acculturation, this association remained statistically significant in the groups who immigrated to America more than 15 years ago and who spoke English only. CONCLUSION MVPA reduces MetS risk in AsAm adults, especially among more acculturated AsAms. Culturally adapted programs are warranted to promote PA and adequate knowledge of disease prevention in this population.
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Martínez-Donate AP, Correa-Salazar C, Bakely L, González-Fagoaga JE, Asadi-Gonzalez A, Lazo M, Parrado E, Zhang X, Rangel Gomez MG. COVID-19 testing, infection, and vaccination among deported Mexican migrants: Results from a survey on the Mexico-U.S. border. Front Public Health 2022; 10:928385. [PMID: 35968453 PMCID: PMC9372570 DOI: 10.3389/fpubh.2022.928385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Migrants detained and held in immigration and other detention settings in the U.S. have faced increased risk of COVID-19 infection, but data on this population is scarce. This study sought to estimate rates of COVID-19 testing, infection, care seeking, and vaccination among Mexican migrants detained by U.S. immigration authorities and forcibly returned to Mexico. Methods We conducted a cross-sectional probability survey of Mexican migrants deported from the U.S. to three Mexican border cities: Tijuana, Ciudad Juárez, and Matamoros (N = 306). Deported migrants were recruited at Mexican migration facilities after being processed and cleared for departure. A two-stage sampling strategy was used. Within each city, a selection of days and shifts were selected during the operating hours of these deportation facilities. The probability of selection was proportional to the volume of migrants deported on each day of the month and during each time period. During the selected survey shifts, migrants were consecutively approached, screened for eligibility, and invited to participate in the survey. Survey measures included self-reported history of COVID-19 testing, infection, care seeking, vaccination, intentions to vaccinate, and other prevention and risk factors. Weighted data were used to estimate population-level prevalence rates. Bivariate tests and adjusted logistic regression models were estimated to identify associations between these COVID-19 outcomes and demographic, migration, and contextual factors. Results About 84.1% of migrants were tested for COVID-19, close to a third were estimated to have been infected, and, among them, 63% had sought care for COVID-19. An estimated 70.1% had been vaccinated against COVID-19 and, among those not yet vaccinated, 32.5% intended to get vaccinated. Close to half (44.3%) of respondents had experienced crowdedness while in detention in the U.S. Socio-demographic (e.g. age, education, English fluency) and migration-related (e.g. type of detention facility and time in detention) variables were significantly associated with COVID-19 testing, infection, care seeking, and vaccination history. Age, English fluency, and length of detention were positively associated with testing and vaccination history, whereas detention in an immigration center and length of time living in the U.S. were negatively related to testing, infection, and vaccination history. Survey city and survey quarter also showed adjusted associations with testing, infection, and vaccination history, reflecting potential variations in access to services across geographic regions and over time as the pandemic unfolded. Conclusion These findings are evidence of increased risk of COVID-19 infection, insufficient access to testing and treatment, and missed opportunities for vaccination among Mexican migrants detained in and deported from the U.S. Deportee receiving stations can be leveraged to reduce disparities in testing and vaccination for deported migrants. In addition, decarceration of migrants and other measures informed by public health principles must be implemented to reduce COVID-19 risk and increase access to prevention, diagnostic, and treatment services among this underserved population.
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Affiliation(s)
- Ana P. Martínez-Donate
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
- *Correspondence: Ana P. Martínez-Donate
| | - Catalina Correa-Salazar
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Leah Bakely
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | | | - Ahmed Asadi-Gonzalez
- School of Medicine and Psychology, Autonomous University of Baja California, Tijuana, Mexico
| | - Mariana Lazo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Emilio Parrado
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, United States
| | - Xiao Zhang
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Maria Gudelia Rangel Gomez
- Mexico Section of the U.S.-Mexico Border Health Commission, Tijuana, Mexico
- El Colegio de la Frontera Norte, Tijuana, Mexico
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Dee EC, Gomez SL. Cancer among Immigrants: Diverse Histories, Diverse Disparities, Diverse Opportunities to Promote Equity. Cancer Epidemiol Biomarkers Prev 2022; 31:1251-1253. [PMID: 35775230 DOI: 10.1158/1055-9965.epi-22-0337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
Immigrants-people who live in a country different from their country of birth-constitute approximately 250 million people globally. Migrants are diverse in their reasons for immigration, ranging from those who are forced to flee their home country for survival, to those seeking a better life. Migrants face diverse barriers in access to care. Therefore, it is critical in the context of cancer health to improve our understanding of the epidemiology of cancer amongst migrants to inform policy, screening, and management. In this issue of Cancer Epidemiology, Biomarkers & Prevention, Yu and colleagues evaluate patterns in the incidence of infection-associated cancers-cancers of the stomach, liver, and cervix-amongst migrants in Australia. They demonstrate that the incidence of infection-related cancers is heterogeneous amongst immigrant populations, underscoring the value of studies that disaggregate groups in ways that reflect the diversity amongst these groups. In this editorial, we contextualize the work of Yu and colleagues in the setting of studies exploring cancer health amongst migrants in various parts of the world. We call attention to disparities in risk factors, prevention, screening, and access to care. Finally, we call on the research and medical communities to work to elucidate their diverse stories, understand their diverse disparities, and act upon diverse opportunities to promote equity. See related article by Yu et al., p. 1394.
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Affiliation(s)
- Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.,Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California
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Mattar S, Gellatly R. Refugee mental health: Culturally relevant considerations. Curr Opin Psychol 2022; 47:101429. [DOI: 10.1016/j.copsyc.2022.101429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
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Jain T, LaHote J, Samari G, Garbers S. Publicly-Funded Services Providing Sexual, Reproductive, and Maternal Healthcare to Immigrant Women in the United States: A Systematic Review. J Immigr Minor Health 2022; 24:759-778. [PMID: 34697702 PMCID: PMC10373793 DOI: 10.1007/s10903-021-01289-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/24/2022]
Abstract
Sexual, reproductive, and maternal health (SRMH) care in the US is highly politicized, with restrictions that impede immigrant women's health. This review describes SRMH outcomes among immigrant women accessing publicly-funded services. We examined articles published from December 2007 to August 2020 in PubMed, PsycINFO, and Web of Science databases, following PRISMA guidelines. Included articles (n = 9) consisted of predominantly Latina immigrant samples. The majority included a subsample of women classified as vulnerable due to low income, low educational attainment, and/or documentation status. Our search strategy included a range of SRMH outcomes; however, the majority of articles focused on prenatal care (PNC). Over half of the articles revealed that underserved immigrant women with access to Medicaid/CHIP during expansion had higher rates of PNC adequacy compared to those without access. There is a need for more research on the impact of publicly-funded services other than Medicaid on outcomes beyond PNC.
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Affiliation(s)
- Tanvi Jain
- Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
| | - Jessica LaHote
- Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA.
| | - Goleen Samari
- Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
| | - Samantha Garbers
- Heilbrunn Department of Population & Family Health, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, USA
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Public attitudes in the United States toward insurance coverage for in vitro fertilization and the provision of infertility services to lower income patients. F S Rep 2022; 3:122-129. [PMID: 35937442 PMCID: PMC9349243 DOI: 10.1016/j.xfre.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 11/20/2022] Open
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Amen TB, Chavez TJ, Dee EC, Varady NH, Yao JS, Paguio JA, Chen AF. Disparities in psychological distress and access to mental health services among immigrants with rheumatologic disease. Clin Rheumatol 2022; 41:2205-2211. [PMID: 35260950 DOI: 10.1007/s10067-022-06074-6] [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: 12/27/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patients with rheumatologic disease experience higher rates of comorbid mental health diseases than those without. Although mental health services (MHS) can improve musculoskeletal functional outcomes, access to MHS has been limited among vulnerable populations in the United States (US). The purpose of this study was to investigate contemporary patterns of severe psychological distress and receipt of MHS among immigrant populations with rheumatologic disease in the US. METHODS The National Health Interview Survey was queried for patients with rheumatologic disease from 2009 to 2018. Patient demographics, severe psychological distress, and receipt of MHS were collected and/or calculated. Multivariable logistic regressions assessed for factors associated with decreased receipt of MHS and severe psychological distress. RESULTS Immigrant patients with rheumatologic disease had higher rates of severe psychological distress than US-born patients (7.7% vs. 6.5%, p < 0.001), but were less likely to access MHS (8.3% vs. 11.0%, p < 0.001). Among immigrant patients, factors associated with lower MHS receipt included being Black (AOR 0.50, 95% CI 0.32-0.77, p = 0.002), Hispanic (AOR 0.80, 95% CI 0.30-1.00, p = 0.050), Asian (AOR 0.44, 95% CI 0.31-0.63, p < 0.001), older (p < 0.001), uninsured (p < 0.001), and having self-reported poor health (p < 0.001). DISCUSSION Immigrant patients with rheumatologic disease in the US had higher rates of severe psychological distress yet were less likely to receive MHS compared to US-born patients. Immigrants with rheumatologic illness were less likely to receive MHS if they were male, Black, Hispanic, Asian, older, lower income, or uninsured. This lack of MHS receipt may contribute to disparities in functional outcomes seen in immigrant minorities with musculoskeletal disease. Key Points • Immigrant patients with rheumatologic disease in the US had higher rates of severe psychological distress yet were less likely to receive MHS compared to US-born patients between 2009 and 2018 • Immigrants with rheumatologic illness were less likely to receive MHS if they were Black, Hispanic, Asian, older, lower income, or uninsured • Future efforts to carefully screen for mental health diseases in these vulnerable patient populations should be made while exploring patient-specific cultural considerations of MHS receipt.
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Affiliation(s)
- Troy B Amen
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., New York City, NY, 10021, USA.
| | - Tyler J Chavez
- Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, NM, USA
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, f1275 York Avenue, New York, NY, 10065, USA
| | - Nathan H Varady
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., New York City, NY, 10021, USA
| | - Jasper Seth Yao
- Department of Medicine, Albert Einstein Medical Center Philadelphia, 5501 Old York Rd., Philadelphia, PA, 19141, USA
| | - Joseph Alexander Paguio
- Department of Medicine, Albert Einstein Medical Center Philadelphia, 5501 Old York Rd., Philadelphia, PA, 19141, USA
| | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
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Mannoh I, Turkson-Ocran RA, Mensah J, Mensah D, Yi SS, Michos ED, Commodore-Mensah Y. Disparities in Awareness of Myocardial Infarction and Stroke Symptoms and Response Among United States- and Foreign-Born Adults in the National Health Interview Survey. J Am Heart Assoc 2021; 10:e020396. [PMID: 34845927 PMCID: PMC9075376 DOI: 10.1161/jaha.121.020396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Atherosclerotic cardiovascular disease, defined as nonfatal myocardial infarction (MI), coronary heart disease death, or fatal or nonfatal stroke, is the leading cause of death in the United States. MI and stroke symptom awareness and response reduce delays in hospitalization and mortality. Methods and Results We analyzed cross‐sectional data from the 2014 and 2017 National Health Interview Surveys on US‐ and foreign‐born adults from 9 regions of birth (Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia, and Southeast Asia). The outcomes were recommended MI and stroke knowledge, defined as knowing all 5 symptoms of MI or stroke, respectively, and choosing “call 9‐1‐1” as the best response. We included 63 059 participants, with a mean age 49.4 years; 54.1% were women, and 38.5% had a high school education or less. Recommended MI and stroke knowledge were highest in US‐born people. In both 2014 and 2017, MI knowledge was lowest in individuals born in Asia (23.9%±2.5% and 32.1%±3.3%, respectively), and stroke knowledge lowest for the Indian subcontinent (44.4%±2.4% and 46.0%±3.2%, respectively). Among foreign‐born adults, people from Russia and Europe had the highest prevalence of recommended MI knowledge in 2014 (37.4%±5.4%) and 2017 (43.5%±2.5%), respectively, and recommended stroke knowledge was highest in people from Europe (61.0%±2.6% and 67.2%±2.5%). Improvement in knowledge was not significant in all groups between 2014 and 2017. Conclusions These findings suggest a disparity in MI and stroke symptom awareness and response among immigrants in the United States. Culturally tailored public health education and health literacy initiatives are needed to help reduce these disparities in awareness.
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Affiliation(s)
- Ivy Mannoh
- School of Medicine Johns Hopkins University Baltimore MD
| | | | | | | | - Stella S Yi
- Grossman School of Medicine New York University New York NY
| | - Erin D Michos
- School of Medicine Johns Hopkins University Baltimore MD
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Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and Behavior Change. Harv Rev Psychiatry 2021; 28:371-394. [PMID: 33156156 PMCID: PMC7647439 DOI: 10.1097/hrp.0000000000000277] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
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Ayalew B, Dawson-Hahn E, Cholera R, Falusi O, Haro TM, Montoya-Williams D, Linton JM. The Health of Children in Immigrant Families: Key Drivers and Research Gaps Through an Equity Lens. Acad Pediatr 2021; 21:777-792. [PMID: 33529739 DOI: 10.1016/j.acap.2021.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/13/2021] [Accepted: 01/24/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The United States benefits economically and socially from the diverse skill-set and innovative contributions of immigrants. By applying a socioecological framework with an equity lens, we aim to provide an overview of the health of children in immigrant families (CIF) in the United States, identify gaps in related research, and suggest future areas of focus to advance health equity. METHODS The literature review consisted of identifying academic and gray literature using a MeSH Database, Clinical Queries, and relevant keywords in 3 electronic databases (PubMed, Web of Science, and BrowZine). Search terms were selected with goals of: 1) conceptualizing a model of key drivers of health for CIF; 2) describing and classifying key drivers of health for CIF; and 3) identifying knowledge gaps. RESULTS The initial search produced 1120 results which were screened for relevance using a meta-narrative approach. Of these, 224 papers were selected, categorized by topic, and reviewed in collaboration with the authors. Key topic areas included patient and family outcomes, institutional and community environments, the impact of public policy, and opportunities for research. Key inequities were identified in health outcomes; access to quality health care, housing, education, employment opportunities; immigration policies; and inclusion in and funding for research. Important resiliency factors for CIF included strong family connections and social networks. CONCLUSIONS Broad structural inequities contribute to poor health outcomes among immigrant families. While resiliency factors exist, research on the impact of certain important drivers of health, such as structural and cultural racism, is missing regarding this population. More work is needed to inform the development and optimization of programs and policies aimed at improving outcomes for CIF. However, research should incorporate expertise from within immigrant communities. Finally, interventions to improve outcomes for CIF should be considered in the context of the socioecological model which informs the upstream and downstream drivers of health outcomes.
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Affiliation(s)
- Betlihem Ayalew
- UofSC School of Medicine Greenville (B Ayalew and JM Linton), Greenville, SC
| | - Elizabeth Dawson-Hahn
- University of Washington, Seattle Children's Research Institute, Harborview Medical Center (E Dawson-Hahn), Seattle, Wash
| | - Rushina Cholera
- Department of Pediatrics, National Clinician Scholars Program, Duke School of Medicine and the Margolis Center for Health Policy, Duke University (R Cholera), Durham NC
| | - Olanrewaju Falusi
- Child Health Advocacy Institute and Division of General and Community Pediatrics, The George Washington University School of Medicine and Health Sciences, Children's National Hospital (O Falusi), Washington, DC
| | - Tamar Magarik Haro
- Federal and State Advocacy, American Academy of Pediatrics (TM Haro), North Washington, DC
| | - Diana Montoya-Williams
- Division of Neonatology, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research 2714 (D Montoya-Williams), Philadelphia, Pa
| | - Julie M Linton
- UofSC School of Medicine Greenville (B Ayalew and JM Linton), Greenville, SC; Prisma Health Children's Hospital (JM Linton), Greenville, SC.
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Marea CX, Warren N, Glass N, Johnson-Agbakwu C, Perrin N. Factors Associated with Health Care Provider Attitudes, and Confidence for the Care of Women and Girls Affected by Female Genital Mutilation/Cutting. Health Equity 2021; 5:329-337. [PMID: 34036217 PMCID: PMC8140356 DOI: 10.1089/heq.2020.0130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 11/12/2022] Open
Abstract
Background: Female genital mutilation/cutting (FGM/C) is a cultural practice that includes procedures that intentionally alter or cause harm to female genital organs for nonmedical reasons, affecting ∼200 million women and girls globally. Health care providers in the United States often lack confidence to provide appropriate FGM/C-related care, and experience attitudes that may negatively impact quality of care for FGM/C. Methods: We conducted a cross-sectional survey of health care providers to explore the associations between health care provider characteristics, awareness of health complications of FGM/C, attitudes, and confidence for FGM/C care. Results: Factors associated with more Confidence for Clinical FGM/C Care include awareness of health complications, ever cared for a woman with FGM/C, being a woman or person of color, and more than 5 years of clinical practice. Increased Confidence in Communication Skills for FGM/C Care was associated with awareness of more health complications for FGM/C. Women endorsed significantly less Negative Attitudes toward FGM/C compared with men; no other factors were associated with health care provider attitudes. Conclusion: Future research should further investigate factors associated with health care provider attitudes toward FGM/C and those affected by the practice to promote quality care. Health providers require adequate training for clinical FGM/C care and in the communication skills that promote patient/provider communication cross-culturally. Trial Registration: Clinical Trials.Gov ID no. NCT03249649, Study ID no. 5252. Public website: https://clinicaltrials.gov/ct2/show/NCT03249649.
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Affiliation(s)
- Christina X. Marea
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- School of Nursing and Health Studies, Georgetown University, Washington, District of Columbia, USA
| | - Nicole Warren
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nancy Glass
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Crista Johnson-Agbakwu
- Arizona State University Southwest Interdisciplinary Research Center, Phoenix, Arizona, USA
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Patel SG, Bouche V, Martinez W, Barajas K, Garcia A, Sztainer M, Hawkins K. "Se extraña todo:" Family separation and reunification experiences among unaccompanied adolescent migrants from Central America. New Dir Child Adolesc Dev 2021; 2021:227-244. [PMID: 33834587 DOI: 10.1002/cad.20404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There has been a record surge of unaccompanied immigrant minors (UAMs) entering the United States, with 86% of those apprehended at the US-Mexico border originating from the Central American countries of El Salvador, Guatemala, and Honduras. A majority of immigrant children are separated from either one or both parents at various points during the migration process. Although average separations last 4 or more years, and may be deeply distressing, there is little research on family separations among Central American UAMs. Further, little is known about the developmental impact of separations from extended family networks, or about reunification. To address these empirical gaps, this study used community-participatory qualitative methods to deeply explore the lived experiences and emotional repercussions of family separation and reunification. The sample included 42 adolescents who had all recently migrated to the Western United States from Central America. Thematic analyses revealed that separation experiences are distressing, multifaceted, and have important developmental implications for Central American UAMs. Results illustrate the socioemotional toll that family separation and reunification can have on this vulnerable population, and highlight the need for culturally responsive, developmentally informed, and contextually appropriate care focused on family reunification in order to foster healthy psychosocial adjustment among UAMs.
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Affiliation(s)
- Sita G Patel
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - Vicky Bouche
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - William Martinez
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Karla Barajas
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - Alex Garcia
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - Maya Sztainer
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
| | - Kathleen Hawkins
- Department of Clinical Psychology, Palo Alto University, Palo Alto, California, USA
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Villalonga-Olives E, Kawachi I, Rodríguez AM. Rasch model of the bridging social capital questionnaire. SSM Popul Health 2021; 14:100791. [PMID: 33997242 PMCID: PMC8095177 DOI: 10.1016/j.ssmph.2021.100791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 11/26/2022] Open
Abstract
Bridging social capital is defined as the connections between individuals who are dissimilar with respect to socioeconomic status and other characteristics. We previously identified an important gap in the literature related to its measurement. We developed and validated a scale to measure bridging social capital to be used in Latinx immigrant populations living in the U.S using Classical Test Theory. The structure of the questionnaire comprised the following sub-scales: Socializing in the work place (5 items); Participation in community activities (16 items); Socializing in community activities (5 items); Contact with similar/different people (7 items); Assistance (17 items); Trust of institutions, corporations and other people (14 items); and Trust of intimate people (3 items). Although basic psychometric validation was performed on our original instrument (e.g., content and construct validity, internal consistency reliability), modern testing theory recommends a more comprehensive set of evaluations, including assessment of data quality, scaling assumptions, targeting, reliability, validity and responsiveness. Rasch measurement theory (RMT) is one of the Modern Test Theory methods that assesses the extent to which rigorous measurement is achieved. In the present work, our objective was to further evaluate the instrument using CTT and to use modern psychometric techniques to further validate the questionnaire and create version 2 (v2) using a new sample (N = 224). We developed a Rasch model of the questionnaire to evaluate item fit statistics, item category thresholds, person separation index (PSI), local dependency, differential item functioning (DIF), unidimensionality and targeting and item locations. Assistance was the most problematic sub-scale of all, as item-to-total correlations ranged from 0.27 to 0.66. There were no disordered thresholds on any item, either examined as part of the overall score or as part of sub-scales. However, the analysis provided evidence of the need to modify some of the sub-scales as there was lack of support for unidimensionality or fit to the Rasch model. The Bridging Social Capital Questionnaire v2 has 61 items (compared to 67 in version 1). Our questionnaire may be suitable for adaptation to other immigrant groups in different countries. The measurement of bridging social capital is crucial in underserved populations. It is crucial to use valid questionnaires to evaluate bridging social capital. The use of modern psychometric techniques to evaluate questionnaires is key. We present a validated questionnaire using the Rasch model.
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Affiliation(s)
- E Villalonga-Olives
- Pharmaceutical Health Services Research Department, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - I Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - A M Rodríguez
- School of Rehabilitation Sciences, Faculty of Medicine, McGill University, Montreal, Canada
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46
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Heidelbaugh JJ. The Time is NOW. Prim Care 2020; 48:xiii-xiv. [PMID: 33516429 DOI: 10.1016/j.pop.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Joel J Heidelbaugh
- Departments of Family Medicine and Urology, University of Michigan Medical School, Ann Arbor, MI, USA; Ypsilanti Health Center, 200 Arnet Suite 200, Ypsilanti, MI 48198, USA.
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47
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Hopgood DA, Haile ZT, Conley S, Chertok IRA. Association between acculturation and sociodemographic factors and cardiovascular disease among immigrants to the United States. Public Health Nurs 2020; 38:47-55. [PMID: 33107097 DOI: 10.1111/phn.12825] [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: 05/14/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study investigated relationships among acculturation, sociodemographic, and health characteristics of adult U.S. immigrants and cardiovascular disease. DESIGN Secondary data analysis using population data from 1,945 immigrant participants in the 2017 National Health Interview Survey (NHIS). MEASUREMENTS Acculturation was measured using citizenship status, number of years in the U.S., and English language proficiency. Chi-square tests and multiple logistic regression modeling were utilized. RESULTS Approximately 4.3% of the study sample had cardiovascular disease. Compared to immigrants without U.S. citizenship, significantly higher proportion of immigrants with U.S. citizenship had cardiovascular disease (6.2% vs. 1.7%, p < .001). In the multivariable-adjusted model, compared to non-citizen immigrants, odds of cardiovascular disease were higher in immigrants with U.S. citizenship (odds ratio 3.80, 95% confidence interval 1.91, 7.56). CONCLUSION Acculturation factors, specifically U.S. citizenship, along with sociodemographic and health risk factors were associated with increased odds of cardiovascular disease among immigrants. This study builds upon previous findings demonstrating increased acculturation including U.S. citizenship in immigrant populations is associated with increased odds of cardiovascular disease. These findings inform public health specialists and clinicians of factors to consider for cardiovascular disease risk in immigrants as they adapt to their host country.
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Affiliation(s)
- Daniel A Hopgood
- School of Nursing, Ohio University College of Health Sciences and Professions, Athens, OH, USA
| | - Zelalem T Haile
- Heritage College of Medicine, Ohio University, Athens, OH, USA
| | - Sean Conley
- Heritage College of Medicine, Ohio University, Athens, OH, USA
| | - Ilana R A Chertok
- School of Nursing, Ohio University College of Health Sciences and Professions, Athens, OH, USA
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48
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Rizzolo K, Cervantes L. Immigration status and end-stage kidney disease: Role of policy and access to care. Semin Dial 2020; 33:513-522. [PMID: 33089565 DOI: 10.1111/sdi.12919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Immigration status is an important mitigating factor in determining the provision of dialysis and kidney-related care. Immigrants make up the largest uninsured group in the country. For immigrants with end-stage kidney disease (ESKD), dialysis access varies by insurance type and by state, leading to great variability in the availability of kidney care. In some states, undocumented immigrants may only qualify for hemodialysis when critically ill (emergency hemodialysis), which is associated with higher mortality, hospital length of stay, and cost, in addition to an emotional burden on patients, their caregivers, and healthcare professionals. Barriers to effective care for immigrants with ESKD include immigration status, insurance access, and availability of pre-end stage kidney disease care, vascular access, and transplant. Effective strategies for improving dialysis care for immigrants include advocacy at the state and federal level, broadening definitions under Emergency Medicaid, and improving benefits for home therapies and transplantation options.
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Affiliation(s)
- Katherine Rizzolo
- Division of Renal Disease and Hypertension, University of Colorado, Aurora, CO, USA
| | - Lilia Cervantes
- Division of Hospital Medicine and Office of Research, Denver Health, Denver, CO, USA.,Division of General Internal Medicine and Hospital Medicine, University of Colorado, Aurora, CO, USA
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Ross J, Diaz CM, Starrels JL. The Disproportionate Burden of COVID-19 for Immigrants in the Bronx, New York. JAMA Intern Med 2020; 180:1043-1044. [PMID: 32383754 DOI: 10.1001/jamainternmed.2020.2131] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jonathan Ross
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York.,Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Chanelle M Diaz
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York.,Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Joanna L Starrels
- Division of General Internal Medicine, Montefiore Health System, Bronx, New York.,Division of General Internal Medicine, Albert Einstein College of Medicine, Bronx, New York
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Arasteh K. Self-reported Hazardous Drinking, Hypertension, and Antihypertensive Treatment Among Hispanic Immigrants in the US National Health Interview Survey, 2016-2018. J Racial Ethn Health Disparities 2020; 8:638-647. [PMID: 32691328 DOI: 10.1007/s40615-020-00823-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/14/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
Compared to the US-born population, Hispanic immigrants are reported to have lower age-adjusted prevalence of hypertension. However, country of origin, race/ethnicity, and risk behaviors associated with acculturation, including hazardous drinking, can affect the prevalence of hypertension. Additionally, health disparities across immigration/nativity status may be associated with suboptimal antihypertensive treatment and control of hypertension. In the present study, population-based data from the years 2016 to 2018 of the National Health Interview Survey (NHIS) were analyzed to assess the association of nativity status and hazardous drinking with hypertension among US-born and foreign-born Hispanic populations. Age-adjusted prevalence of past-year hypertension among foreign-born Hispanics was lower than US-born Hispanics. However, the proportion of Hispanic immigrants who had their blood pressure checked by a healthcare professional was also smaller than US-born Hispanics, suggesting that the prevalence of hypertension among Hispanic immigrants may be underreported. Hazardous drinking was associated with decreased odds of antihypertensive treatment among the Hispanic immigrants.
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Affiliation(s)
- Kamyar Arasteh
- Department of Epidemiology, School of Global Public Health, New York University, 665 Broadway, Suite 800, New York, NY, 10012, USA.
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