Psychosocial predictors of anxiety among immigrant Mexican migrant farmworkers: implications for prevention and treatment

Psychosocial Determinants of Mental Healthcare Use Among Mexican-origin Women from Farmworker Families in Southern California

Little is known about the contribution of psychosocial factors related to mental healthcare use among Mexican-origin women from farmworker families. Therefore, this study assessed relationships between acculturative stress, depressive symptoms, mental healthcare service use, and preferences for seeking care. Linear and logistic regression models and chi-square tests were performed to analyze survey data from 78 Mexican-origin women from farmworker families. Women were recruited in collaboration with promotoras and completed measures of acculturative stress, depressive symptoms, and mental healthcare use and preferences. Overall, 29.5% of the sample reported clinically significant depressive symptomatology. Acculturative stress was positively associated with depressive symptoms (b = 0.43, 95%CI = 0.27,0.59) after controlling for years in the U.S., primary language, and demographic characteristics. In addition, acculturative stress was associated with lower odds of mental healthcare use (OR = 0.96) after controlling for years in the U.S. and depressive symptoms. However, this association was no longer statistically significant when controlling for health insurance status and access to transportation. Mexican-origin women with high levels of acculturative stress were significantly more likely to seek care from a psychiatrist/psychologist than their peers (54.3% vs. 45.7%); however, this preference was not indicative of their use of mental healthcare services. Results suggest that acculturative stress is a risk factor for depressive symptoms and might contribute to a delay in seeking mental healthcare services in Mexican-origin women from farmworker families. Thus, interventions for this group should address aspects of acculturative stress as a strategy to increase mental health services use.

Developing and validating a university needs instrument to measure the psychosocial needs of university students

BACKGROUND

University students are four times more likely to experience elevated levels of psychological distress compared to their peers. The psychosocial needs of university students are associated with high psychological distress, stressful life events, and academic performance. Our study focuses on developing a measure to help universities identify these psychosocial needs.

AIMS

The study aimed to develop and validate the factor structure of the University Needs Instrument and identify the relationship between psychosocial needs, psychological distress and academic performance among university students.

SAMPLE

Undergraduate university students (N = 511) currently studying at university.

METHOD

Participants completed demographic questions, the University Needs Instrument and the Kessler-10 Psychological Distress scale. The University Needs Instrument comprises 30 items within six psychosocial factors (academic support, financial support, support from family, support from friends, practical support and emotional support), each consisting of five items.

RESULTS

Confirmatory factor analysis showed that all items significantly loaded on the six hypothesized factors. The hypothesized model was supported by the data displaying excellent model fit and psychometric properties. Our analysis determined that the UNI has strong internal consistency. The results also confirmed that university students' high levels of psychological distress and their academic performance may be affected by their psychosocial needs.

CONCLUSIONS

Our findings have provided an initial validation of the UNI to help screen and identify the psychosocial needs of university students. This scale can be used to identify the appropriate psychosocial support that can be offered to students and in turn could help reduce their psychological distress, improve their psychosocial well-being and increase academic performance.

The Relationship Between Acculturative Stress and Postmigration Mental Health in Iraqi Refugee Women Resettled in San Diego, California

Due to the lack of research on the adverse impact of acculturative stress on the mental health, the current study examined the associations between acculturative stress and post-migration mental health outcomes among 219 Iraqi refugee women resettled in San Diego, California. Mental illness, trauma history, and acculturative stress were measured and descriptive statistical analyses, and multivariate logistic regression analyses were conducted to determine the association between acculturative stress, depression, and anxiety among the refugee women.About half of the participants were categorized as having anxiety (45.6%) and depression (55.3%). The multivariate regression analysis found that the odds of a mental health outcome of depression and anxiety in relation to acculturative stress, increases by a factor of 1.056 and 1.076 respectively, for every point increase on the acculturative stress scale.The study's findings reflect a linear association of acculturative stress with depression and anxiety among Iraqi refugee mothers resettled in San Diego. The mental well-being of refugees does not always improve nor does their trauma disappear by resettling in a new country. Policy makers should consider extending the evaluation, follow-up, and support of Iraqi refugee mental health long beyond the current 90 post arrival policy.

Association between food insecurity and fall-related injury among adults aged ≥65 years in low- and middle-income countries: The role of mental health conditions

PURPOSE

We investigated the association between food insecurity and fall-related injury among older adults from six low- and middle-income countries (LMICs), and the extent to which this association is mediated by mental health.

METHODS

Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression analysis and mediation analysis were conducted to assess associations.

RESULTS

Data on 14,585 adults aged ≥65 years [mean (SD) age 72.5 (11.5) years; 54.9% females] were analyzed. After adjustment for potential confounders, severe food insecurity (versus no food insecurity) was associated with 1.95 (95%CI = 1.11-3.41) times higher odds for fall-related injury. Moderate food insecurity was not significantly associated with fall-related injury (OR = 1.34; 95%CI = 0.81-2.25). The mediation analysis showed that 37.3%, 21.8%, 17.7%, and 14.0% of the association between severe food insecurity and fall-related injury was explained by anxiety, sleep problems, depression, and cognition, respectively.

CONCLUSION

Severe food insecurity was associated with higher odds for injurious falls among older adults in LMICs, and a large proportion of this association may be explained by mental health complications. Interventions to improve mental health among those who are food insecure and a strong focus on societal and government efforts to reduce food insecurity may contribute to a decrease in injurious falls.

Intergenerational transmission of anxiety in Chinese migrant families: The mediating role of parents' perceptions of coparenting

BACKGROUND

There is evidence that anxiety transmits across generations. However, little is known about the intergenerational transmission of anxiety in Chinese migrant families and the potential mediators of the intergenerational transmission. Therefore, this study investigated the intergenerational transmission of anxiety from both fathers and mothers to children in Chinese migrant families and the mediating role of both mothers' and fathers' perceptions of coparenting.

METHODS

Participants were 477 elementary school-age children and both their parents in Chinese migrant families. Mothers and fathers self-reported their anxiety and perceptions of coparenting. Children's anxiety was measured based on maternal report and paternal report. Structural equation modelling was used to evaluate the mediating role of both mothers' and fathers' perceptions of coparenting in the intergenerational transmission of anxiety.

RESULTS

Anxiety was transmitted across generations from both fathers and mothers to migrant children, and fathers' (but not mothers') perceptions of coparenting mediated the intergenerational transmission of anxiety from both fathers and mothers to migrant children.

LIMITATIONS

Causal conclusions cannot be drawn based on cross-sectional research design.

CONCLUSIONS

Coparenting seemed to play an important role in the intergenerational transmission of anxiety. Interventions preventing the intergenerational transmission of anxiety should designate relevant effort enhancing fathers' perceptions of coparenting by changing fathers' negative perceptions and evaluations of the coparenting relationship and increasing mothers' high-quality coparenting behavior.

Religion and Mental Health in Racial and Ethnic Minority Populations: A Review of the Literature

Religion has been an important source of resiliency for many racial and ethnic minority populations. Given the salience, sociohistorical context, and importance of religion in the lives of black and Latino Americans, this literature review focuses on the mental health and well-being outcomes of religion among black and Latino Americans across the adult life course and specifically in later life. This review provides an overview of religious participation and religiosity levels and an in-depth discussion of extant research on the relationship between the multiple dimensions of religiosity and mental health in these 2 populations. Racial differences between blacks, Latinos, and non-Latino whites are also examined. Suggestions for limitations of the current literature and future directions for research on religion and mental health in racial/ethnic minority populations, especially older minorities, are proposed.

Household food insecurity is associated with depressive symptoms: results from a Mexican population-based survey

The objective of this cross-sectional study was to assess the relationship between food insecurity and depression in the Mexican population. We used data from the 2012 health and nutrition survey (ENSANUT), which is representative of the Mexican population. Food insecurity was determined by the Latin American and Caribbean Food Security Scale (ELCSA). Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale Short-Form (CES-D-SF). Adjusted logistic regression analyses and ANCOVA were used. Out of 33,011 participants, 5788 (18%) had high depressive symptoms and 24,098 (73%) experienced food insecurity. The adjusted logistic regression analysis showed that, participants with mild food insecurity, (OR = 1.47,95% CI = 1.27 to 1.71), moderate food insecurity (OR = 2.14,95% CI = 1.85 to 2.47) and severe food insecurity (OR = 3.01,95% CI = 2.51 to 3.60,) were more likely to have high depressive symptoms than food secure participants. Participants with moderate food insecurity (OR =1.45, 95% CI = 1.28 to 1.64) and severe food insecurity (OR =2.04, 95% CI = 1.76 to 2.37) were more likely to suffer from depression as compared to participants with mild food insecurity. Participants with severe food insecurity were more likely (OR=1.41, 95% CI = 1.21 to 1.65) to suffer from depression compared to participants with moderate food insecurity. This paper provides an overview of the complex problem of food insecurity and mental health. Despite the unknown causality, the analysis suggests a strong association between depression and food insecurity. This problem calls for much more attention from the scientific community. Given the high prevalence of depression and the high prevalence of household food insecurity in Mexico, the implementation of successful public health programs to improve food security is necessary.

Key Risk Factors Affecting Farmers' Mental Health: A Systematic Review

Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers' mental health, and information on how to reduce help-seeking barriers amongst farmers.

Stress Among Latinos: Does it Vary by Occupation and Agricultural Season?

OBJECTIVE

Stress is pervasive among Latino immigrants. We identified seasonal and occupational patterns in stress among rural Latino immigrants.

METHODS

During three agricultural periods, farmworker and non-farmworker participants responded to a 24-item stress questionnaire (Snipes et al, 2007). We measured the associations of stress with occupation, with season, and occupation within season, adjusting for demographic variables.

RESULTS

The highest levels of stress were observed in the pre-thinning season when pruning takes place among farmworkers. Stress is significantly higher in farmworkers compared with non-farmworkers only in the non-spray season when crops are dormant. Higher income was associated with decreased stress in the pre-thinning and thinning seasons when buds and small fruit are removed from orchards.

CONCLUSIONS

Identification of strategies to reduce stress in Latino migrants is warranted. Although some sources of stress may be intractable, others may be amenable to intervention.

Psychiatric problems among returned migrants in Mexico: updated findings from the Mexican Migration Project

PURPOSE

Migration is often a stressful process that can have deleterious effects on health. We study the potential mental health consequences of migration by comparing Mexican migrants to the United States who have since returned to Mexico with Mexicans who have never migrated.

METHODS

Data from the Mexican Migration Project were used to compare returned migrants and non-migrants in Mexico for the years 2007-2016 (N = 7716). Random intercept logistic regression models were used to estimate the associations between characteristics of migration and psychiatric problems. Coarsened exact matching was implemented to account for the selection bias inherent to migration.

RESULTS

Relatively healthier Mexicans were more likely to migrate to the United States, regardless of their documentation status. Returned migrants in Mexico who traveled to the United States while undocumented were significantly more likely to report that they experienced psychiatric problems when compared with non-migrant Mexicans, even after adjusting for demographic, socioeconomic, pre-migration health, and community-level factors.

CONCLUSIONS

Undocumented return migrants in Mexico are at-risk of developing psychiatric problems, despite evidence that suggests migrants tend to be healthier than non-migrants before they travel to the United States. Mental health services should encompass strategies for migrants on both sides of the border.

Miles over mind: Transnational death and its association with psychological distress among undocumented Mexican immigrants

Objective: This study examined the association between transnational death and psychological distress among undocumented Mexican immigrants. The Minority Stress Model and a disenfranchised grief perspective were used as frameworks for this study.Method: Respondent driven sampling (RDS) was used to collect data from clinical interviews with 248 undocumented Mexican immigrants residing near the US-Mexico border.Results: After controlling for relevant covariates, experiencing transnational death was a significant predictor of clinically significant distress in this at-risk population.Conclusions: Our findings underscore the need to contextualize transnational death among undocumented immigrants from a perspective of disenfranchised grief that requires the development of contextually and culturally sensitive interventions aimed at addressing the high prevalence of transnational death and its associated distress in this marginalized population.

Global output of research on the health of international migrant workers from 2000 to 2017

BACKGROUND

Approximately 150 million international migrant workers work under conditions that increase their risk of illness and injuries. The current study aimed to assess and analyze the global output of research on the health of international migrant workers to promote national and international policies that could help improve the health of international migrant workers.

METHODS

A bibliometric methodology was implemented using Scopus database after retrieving documents relevant to the health of migrant workers during the study period from 2000 to 2017.

RESULTS

In total, 955 documents were retrieved. The mean number of authors per document was 4.5 while the mean number of citation per document was 10.2. The retrieved documents were mainly in health policy and systems (n = 452; 47.3%), infectious diseases (n = 252; 26.4%), and mental and psychosocial health (n = 239; 25.0%). The health of Latino migrant farmworkers represented the largest cluster of keywords. The USA led (n = 389; 40.7%) with regard to the number of publications followed by China (n = 86; 9.0%) and the UK (n = 66; 6.9%). Researchers from the USA and Spain dominated the field. There were limited international research collaboration and a limited number and size of research networks. The American Journal of Industrial Medicine was most active (7.1%; n = 68) in publishing documents on health of migrant workers while the Wake Forest University was the most active (10.9%; n = 104) institution in this topic.

CONCLUSION

The volume of global research output on the health of migrant workers was low. There was inadequate research on non-communicable diseases and maternal health of migrant workers. International research collaboration and the number of research networks were limited. Role of several world regions, particularly Arab region with 11% of international migrant workforce was also limited. There is an urgent need to prioritize research on migrant workers, especially female migrant workers in regions with low research contribution.

Stress of working abroad: a systematic review

Purpose

Many companies target international markets to expand their business. Companies need to manage international teams with a wide variety of skills, knowledge and values to run their business effectively; however, there are many issues of acculturation stress. Not only business travellers and expatriates, but also immigrant workers have issues adjusting to foreign culture. The aim of the present study is to identify the stress factors affecting foreign-born workers via a systematic review.

Methods

The systematic review was conducted using PubMed, PsycINFO, Embase and Cochrane Library databases. Articles on the subject of workers living abroad, such as immigrants, expatriates and business travellers, were included. The risk of bias in the included articles was assessed using the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials (RCTs), RoBANS for non-RCT studies, and CASP for qualitative studies.

Results

For the systematic review, 45 out of 14,994 articles were analysed. Six components, communication, cultural differences in the workplace, daily life, relationships with family and colleagues, financial problems and social inequality, were extracted.

Conclusion

Foreign-born workers are suffering from acculturation and occupational stress. The results of the present study can help greatly with understanding of the stress structure of working abroad.

Electronic supplementary material

The online version of this article (10.1007/s00420-018-1333-4) contains supplementary material, which is available to authorized users.

Prenatal and Postnatal Mother-to-Child Transmission of Acculturation's Health Effects in Hispanic Americans

BACKGROUND

Hispanic Americans consistently exhibit an intergenerational increase in the prevalence of many noncommunicable chronic physical and mental disorders.

METHODS

We review and synthesize evidence suggesting that a constellation of prenatal and postnatal factors may play crucial roles in explaining this trend. We draw from relevant literature across several disciplines, including epidemiology, anthropology, psychology, medicine (obstetrics, neonatology), and developmental biology.

RESULTS

Our resulting model is based on evidence that among women, the process of postmigration cultural adjustment (i.e., acculturation) is associated, during pregnancy and after delivery, with psychological and behavioral states that can affect offspring development in ways that may alter susceptibility to noncommunicable chronic disease risk in subsequent-generation Hispanic Americans. We propose one integrated process model that specifies the biological, behavioral, psychological, and sociocultural pathways by which maternal acculturation may influence the child's long-term health. We synthesize evidence from previous studies to describe how acculturation among Hispanic American mothers is associated with alterations to the same biobehavioral systems known to participate in the processes of prenatal and postnatal developmental programming of disease risk. In this manner, we focus on the concepts of biological and cultural mother-to-child transmission across the prenatal and postnatal life phases. We critique and draw from previous hypotheses that have sought to explain this phenomenon (of declining health across generations). We offer recommendations for examining the transgenerational effects of acculturation.

CONCLUSION

A life course model with a greater focus on maternal health and well-being may be key to understanding transgenerational epidemiological trends in minority populations, and interventions that promote women's wellness may contribute to the elimination or reduction of health disparities.

Apoyo social, resiliencia y región de origen en la salud mental y la satisfacción vital de los inmigrantes

Se analiza la relación del apoyo social y la resiliencia con la satisfacción vital y la salud mental de los inmigrantes, y las diferencias en dichas variables según la región de origen (África, Europa, Latinoamérica y Asia). En el estudio han participado 1094 inmigrantes que residen en España. Los resultados de la regresión por pasos muestran que la tenacidad, el apoyo social de la familia y de los autóctonos, y el control personal son los mejores predictores de la satisfacción vital. La tenacidad, el apoyo de la familia y el control lo son de la salud mental.

Coping Strategies That Mitigate Against Symptoms of Depression Among Latino Farmworkers

Latino farmworkers have a higher rate of depression when compared with other Latinos and the general adult population in the United States. Researchers have suggested oppressive labor policies, acculturation stressor, anti-immigrant polices and attitudes, and the dangers associated to farm work as culprits to high rates of depression among farmworkers. We examined the traits farmworkers reported that helped them mitigate symptoms of depression. Our sample consisted of 64 adult male and female farmworkers who lived in western Texas and worked in Eastern New Mexico. We used the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) and self-reports of symptoms of depression to assess for depression. We found that, among this sample, the rates of depression were similar to other studies and that farmworkers used cognitive restructuring strategies to mitigate symptoms of depression.

The Impact of Acculturation Style and Acculturative Hassles on the Mental Health of Somali Adolescent Refugees

Refugee adolescents often immigrate to a new society because of experiences of persecution and trauma, which can have profound effects on their mental health. Once they immigrate, many refugees experience stressors related to resettlement and acculturation in the new society. The current study examined relationships among acculturation styles and hassles and the well-being of young refugees as well as the role of gender. Data were collected from 135 young refugees (M age = 15.39, SD = 2.2; 62 % male) from Somalia resettled in the United States The findings from our study indicate that in addition to trauma history, acculturative hassles and acculturation style impact the wellbeing of Somali refugee adolescents. These findings indicate the need to understand both past experiences as well as current challenges. Potential areas for intervention are discussed.

Does Acculturative Stress Influence Immigrant Sexual HIV Risk and HIV Testing Behavior? Evidence from a Survey of Male Mexican Migrants

OBJECTIVE

Migration is a structural factor that increases HIV vulnerability. Acculturative stress represents a possible mechanism through which migration may negatively impact HIV risk. This study investigated socio-ecological factors associated with acculturative stress levels and examined the association between acculturative stress and HIV-related behavior among Mexican im/migrants.

METHODOLOGY

We used data from a probability survey of Mexican im/migrants (N = 1383) conducted in Tijuana, Mexico, in 2009-2010. The sample included migrants returning to Mexico via deportation or voluntarily after a recent stay in the USA. Linear regression models were estimated to identify individual, migration, and contextual factors independently associated with overall acculturative stress levels. Logistic regression models were used to test for associations between acculturative stress, sexual HIV risk, and HIV testing history behavior.

RESULTS

We found that levels of acculturative stress were significantly and independently related to socio-economic markers, acculturation level, legal residence status, and sexual minority status. The analyses also showed that acculturative stress was positively related to sexual HIV risk behavior and negatively related to recent HIV testing.

CONCLUSIONS

The results underscore that both individual and environmental factors contribute to levels of acculturative stress among Mexican im/migrants. In turn, acculturative stress may exacerbate sexual HIV risk and impede testing among this im/migrant population. Targeted interventions to prevent and decrease acculturative stress represent a potential strategy to reduce sexual HIV risk behavior and promote HIV testing among this vulnerable population of im/migrants in the USA.

Immigration Stress and Alcohol Use Severity Among Recently Immigrated Hispanic Adults: Examining Moderating Effects of Gender, Immigration Status, and Social Support

OBJECTIVE

Identifying and understanding determinants of alcohol use behavior among Hispanic immigrants is an increasingly significant public health concern. Although prior research has examined associations of cultural stressors with alcohol use among Hispanics, few studies have tested these associations among recent adult immigrants. As such, this study aimed to examine (a) the association of immigration stress on alcohol use severity among recently immigrated Hispanic adults (≤ 1 year in the United States) and (b) the moderating effects of gender, immigration status, and social support.

METHOD

A hierarchical multiple regression and moderation analyses were conducted on a sample of 527 participants in South Florida.

RESULTS

Results indicated that, after controlling for demographic variables, preimmigration drinking behavior, and dimensions of social support, the association of higher immigration stress with higher alcohol use severity was statistically significant. Moderation analyses indicated that immigration stress had a statistically significant association with alcohol use severity among men, but not women. Also, dimensions of social support consistently reduced the deleterious effect of immigration stress on alcohol use severity.

CONCLUSION

This study adds to the scarce literature on cultural stressors and alcohol use among recent Hispanic immigrants. Findings suggest that it may be important to design gender-specific interventions and that increasing levels of social support may offset the effects of immigration stress on alcohol use.

Longitudinal study of stress, social support, and depression in married Arab immigrant women

Using a stress and social support framework, this study explored the trajectory of depression in 388 married Arab immigrant women. The women provided three panels of data approximately 18 months apart. Depression at Time 3 was regressed on Time 1 depression, socio-demographic variables, and rate of change over time in stress and social support. The regression model was significant and accounted for 41.16% of the variation in Time 3 depression scores. Time 1 depression, English reading ability, husband's employment status, changes over time in immigration demands, daily hassles, and social support from friends were associated with Time 3 depression.

Acculturative Stress, Psychological Distress, and Religious Coping Among Latina Young Adult Immigrants

Religion is a source of strength in Latina/o culture during challenging life transitions, such as the immigration process. Guided by a sociological stress-process model, this study examines relations between dimensions of religious coping, acculturative stress, and psychological distress among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Higher levels of acculturative stress were associated with higher levels of psychological distress. Negative religious coping (i.e., the tendency to struggle with faith) moderated the relation between acculturative stress and psychological distress. Participants experiencing higher levels of acculturative stress reported greater psychological distress when they indicated more negative religious coping. Positive religious coping (i.e., the tendency to relate to faith with comfort and certainty) was not linked with acculturative stress or psychological distress. Implications for culturally tailored counseling interventions for this underserved and understudied population are discussed.

Cardiovascular disease risk factors among Latino migrant and seasonal farmworkers

Migrant and seasonal (MS) farmworkers are an important component of the US economy. Their unique occupational health concerns have garnered research, but chronic disease research in this population is lacking. It is unclear whether health differences exist between migrant (those who migrate to and travel a distance from the home environment and thus live in temporary housing for the purpose of employment) and seasonal workers (those who work in the agricultural industry on a seasonal basis, whose long-term home environments are often near work locations and thus may be considered more "settled"), since most research presents MS farmworkers as a homogenous group. This study explored potential differences in cardiovascular disease risk factors, (i.e., diabetes, current smoking, obesity, hypertension, and hypercholesterolemia) by sex and MS status among a sample of 282 English- and Spanish- speaking Latino MS farmworkers in the Midwest using cross-sectional survey and clinical laboratory data. Results showed that in multivariate logistic regression analyses, migrant workers (odds ratio [OR] = 2.15) had a higher likelihood of being obese compared with seasonal workers (P < .05). MS farmworkers did not differ in likelihood of smoking, diabetes, hypertension, or hypercholesterolemia. In adjusted analyses, females were more likely to be obese (OR = 3.29) and have diabetes (OR = 4.74) compared with males (P < .05); and males were more likely to be current smokers (OR = 7.50) as compared with females (P < .05). This study provides insight into chronic health concerns among this predominantly Latino farmworker population and suggests that future prevention and intervention research may need to focus on sex differences rather than MS farmworker status.

Musculoskeletal pain, depression, and stress among Latino manual laborers in North Carolina

The jobs of Latino manual laborers place their mental and physical health at risk. This study evaluates the associations among musculoskeletal pain, mental health, and work organization in Latino manual laborers. Farmworkers and nonfarmworkers (n = 189) in North Carolina were interviewed for self-reported musculoskeletal pain, depressive symptoms, stress, work safety climate, and precarious job status. More nonfarmworkers than farmworkers had neck and shoulder pain, but they did not differ in other areas of musculoskeletal pain. Depressive symptoms had a significant association with neck and shoulder pain (p < .05). Precariousness had a significant association with back pain (p < .05). Farmworker participants had H-2A visas and were afforded some protection compared to nonfarmworker manual workers. Research is needed to improve policy that relieves pain and improves mental health for all Latino manual workers.

Evaluating Short-Form Versions of the CES-D for Measuring Depressive Symptoms Among Immigrants From Mexico

This article examines the feasibility of using a short-form version of the Center for Epidemiologic Studies–Depression Scale (CES-D) in community mental health research with Mexican immigrants. Several features of three published short versions of the CES-D were examined using data combined from seven diverse Mexican immigrant samples from across the United States ( N= 685). Results indicate that published short-form versions of the CES-D are reliable, they account for most of the variance in scores from the full CES-D, and there is little evidence that the use of short forms attenuates associations with other concepts relevant to understanding the mental health of Mexican immigrants. Although additional validation research is necessary, the results of this study suggest that short-form versions of the CES-D can be used to study mental health among Mexican immigrants.

Latino Immigrants Describe Residence in Rural Midwestern Meatpacking Communities: A Longitudinal Assessment of Social and Economic Change

The authors describe results from a longitudinal investigation of Latino immigrants residing in three rural, Midwestern, meatpacking communities. Qualitative and quantitative data were collected from 43 Latino immigrants. Survey data assessed economic strain, community concerns, and community service access and availability; in-depth interviews focused on satisfaction with rural Midwestern residence. The following year, 23 of the original participants were located. They completed the same instruments and engaged in an in-depth interview to assess change during the previous year. Results of this investigation are presented as are suggestions for further work and advocacy efforts.

The Hispanic health paradox: From epidemiological phenomenon to contribution opportunities for psychological science

Similar to non-Hispanic Blacks, Hispanics/Latinos experience a range of psychosocial and physical health challenges, including high rates of poverty, neighborhood segregation, discrimination, poor healthcare access, and high rates of obesity, diabetes, and undiagnosed and late-stage diagnosed diseases. Despite such risks, Hispanics generally experience better physical health and lower mortality than non-Hispanic Whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. With the basic phenomenon increasingly well-established, attention now turns to the sources of such resilience. The current aims are to briefly examine the epidemiological paradox and highlight potential sociocultural resilience factors that may contribute to the paradoxical effects. We conclude with presentation of a framework for modeling sociocultural resilience and discuss future directions for psychological contributions.

Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time

The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children's health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.

Federal Farmworker Housing Standards and Regulations, Their Promise and Limitations, and Implications for Farmworker Health

The housing available to most farmworkers is substandard and unacceptable in 21st-century America. The federal government established minimal occupational safety and health standards applicable to migrant farmworker labor camps decades ago, and some states have statutory schemes and regulations that set standards for farm labor camps and employee housing. Many of these federal and state regulations no longer reflect current employment and housing trends, and enforcement success varies greatly. These regulations implicitly recognize the connection between housing conditions and health, but do not effectively address that connection. This review describes the current state of farmworker housing, discusses laws and regulations pertaining to such housing, and highlights the literature on health risks associated with inadequate housing. We propose specific recommendations to strengthen enforcement and reduce the risks of substandard housing for the health of farmworkers and their families.

Intergenerational transmission of the effects of acculturation on health in Hispanic Americans: a fetal programming perspective

We propose a transdisciplinary, life span framework for examining the underlying cause of the observed intergenerational decline in health among Hispanic Americans. We focus on acculturation, and we posit that acculturation-related processes in first-generation Hispanic immigrant mothers may affect the intrauterine development of an unborn child, via the process of fetal programming, to produce phenotypic effects that may alter the susceptibility for noncommunicable chronic diseases. In this manner, an intergenerational cascade of perpetuation may become established. Our framework may shed light on the biological, behavioral, and social causes of intergenerational cycles of vulnerability among immigrant minority groups, with public health and policy implications for primary prevention and intervention.

Alcohol use among Latino migrant workers in South Florida

BACKGROUND

A significant segment of the Latino migrant worker population in the United States is at high risk for alcohol abuse and related risk behaviors. Information about the prevalence of alcohol use and abuse and its association with sociodemographic and psychological variables is needed for designing effective intervention prevention strategies.

METHODS

Cross-sectional data were drawn from a baseline assessment that was part of a randomized controlled trial of 278 Latino migrant workers (LMWs) conducted between 2008 and 2010.

RESULTS

About one-third (32%) of participants engaged in heavy drinking in the past 30 days prior to baseline interview. More females than males reported no alcohol use in the past 30 days (53.5% vs. 20.5%). On the other hand, more males reported drinking every day or nearly (25.2% vs. 7.1%). Five factors-gender, country of origin, relationship status, living arrangements, and acculturation-were significantly associated with frequency of alcohol consumption. Multivariate analyses indicated that gender, country of origin, education attainment, relationship status, living arrangement, living with children, length of stay in the US, religious beliefs, acculturation, and depression were associated with frequent heavy drinking, alcohol abuse/dependence, and unprotected sex under the influence of alcohol.

CONCLUSIONS

There is significant variation in alcohol use among Latino migrant workers. Although a substantial proportion of this population abstains from alcohol, an equally substantial proportion report levels of alcohol use that pose significant risk. More research is needed to better understand drinking patterns in this community in order to design prevention strategies specifically tailored for this population.

Rural-to-urban migrations: acculturation experiences among university students in Botswana

Many students in Botswana migrate from small rural villages and towns to the larger urban centres to attend university, and are subsequently required to adapt or acculturate to their new environments. However, the existing literature and research on acculturation experiences of students who migrate from rural-to-urban centres in Botswana is almost non-existent. The current study was therefore a qualitative exploratory investigation of the experiences of the students who migrate from rural-to-urban centres. Purposive sampling was used to recruit participants who contributed to a Talking Circle focus group. Researchers transcribed the interviews and used content analysis to uncover response themes. Findings indicated that the majority of students experienced some culture shock and a number of environmental and specific systemic stressors in their first two years of university life. Theoretical implications for understanding rural-to-urban acculturation and practical implications for university counselling approaches are also discussed.

Effects of Self-Esteem and Ethnic Identity

We examined whether self-esteem and ethnic identity moderated or mediated the relationship between two types of acculturative stress (American-based and Mexican-based) and psychological well-being among 171 first-generation Mexican immigrant adults. American-based acculturative stress (ABAS) was defined as the stress related to the pressure from Anglo-Americans to improve English and adopt their cultural practices, while Mexican-based acculturative stress (MBAS) was related to the pressure from Mexican immigrants to improve Spanish and retain Mexican cultural practices. The findings suggested that self-esteem was negatively affected by acculturative stress, which, in turn, led to decreased psychological well-being. However, having high self-esteem alleviated the debilitating effects of acculturative stress against psychological well-being. In contrast to self-esteem, ethnic identity exacerbated the negative effect of acculturative stress on psychological well-being.

Culture and psychiatric evaluation: operationalizing cultural formulation for DSM-5

The Outline for Cultural Formulation (OCF) introduced with DSM-IV provided a framework for clinicians to organize cultural information relevant to diagnostic assessment and treatment planning. However, use of the OCF has been inconsistent, raising questions about the need for guidance on implementation, training, and application in diverse settings. To address this need, DSM-5 introduced a cultural formulation interview (CFI) that operationalizes the process of data collection for the OCF. The CFI includes patient and informant versions and 12 supplementary modules addressing specific domains of the OCF. This article summarizes the literature reviews and analyses of experience with the OCF conducted by the DSM-5 Cross-Cultural Issues Subgroup (DCCIS) that informed the development of the CFI. We review the history and contents of the DSM-IV OCF, its use in training programs, and previous attempts to render it operational through questionnaires, protocols, and semi-structured interview formats. Results of research based on the OCF are discussed. For each domain of the OCF, we summarize findings from the DCCIS that led to content revision and operationalization in the CFI. The conclusion discusses training and implementation issues essential to service delivery.

Religion-based emotional social support mediates the relationship between intrinsic religiosity and mental health

Although previous research suggests that increased religiosity is associated with better mental health and many authors have conjectured that religion-based social support may help explain this connection, scant research has directly examined whether religion-based support mediates religiosity and mental health. The present study examined whether various dimensions of religion-based support (social interaction, instrumental, and emotional) mediated the relationship between religiosity and mental health in college students in the Midwest United States. As expected, of the support dimensions, perceived emotional support was the strongest predictor of decreased hopelessness, depression, and suicide behaviors; and the relationships among intrinsic religiosity and the mental health variables were fully mediated by emotional support. These findings provide strong support to the notion that the relationship between religiosity and mental health can be reduced to mediators such as social support. Research and theoretical implications are discussed.

In their own voices: Latinas' experiences with a randomized controlled trial

We conducted exit interviews with a random sample of 39 predominantly Central American immigrant mothers who had completed a longitudinal randomized controlled trial to prevent perinatal depression. We found that rates and levels of perinatal depression in the intervention and control groups were lower than expected and did not differ between groups at 1 year postpartum. Therefore, we conducted extensive semistructured interviews to (a) understand why these high-risk women had such low rates of major depressive episodes and depressive symptoms, and (b) determine if the mechanisms responsible for reductions in depression differed between the intervention and usual care groups. We discovered that the intervention group learned specific mood-management skills from their participation in the intervention, and that the control group experienced their participation in the study as a "low-dose" intervention. Our experience highlights the importance of conducting qualitative studies to understand quantitative outcomes of intervention studies.

Acculturative stress and diminishing family cohesion among recent Latino immigrants

This study investigates a theorized link between Latino immigrants' experience of acculturative stress during their two initial years in the United States (US) and declines in family cohesion from pre- to post-immigration contexts. This retrospective cohort study included 405 adult participants. Baseline assessment occurred during participants' first 12 months in the US. Follow-up assessment occurred during participants' second year in the US. General linear mixed models were used to estimate change in family cohesion and sociocultural correlates of this change. Inverse associations were determined between acculturative stress during initial years in the US and declines in family cohesion from pre-immigration to post-immigration contexts. Participants with undocumented immigration status, those with lower education levels, and those without family in the US generally indicated lower family cohesion. Participants who experienced more acculturative stress and those without family in the US evidenced a greater decline in family cohesion. Results are promising in terms of implications for health services for recent Latino immigrants.

Stress, depression and coping among Latino migrant and seasonal farmworkers

Research shows that one in four migrant farmworkers experienced an episode of one or more mental health disorders such as stress, depression, or anxiety in their lifetime. The purpose of this mixed methods study was to explore experiences and perceptions related to stress and depression among Latino migrant and seasonal farmworkers (MSFWs), and to identify their coping behaviors for dealing with these mental health conditions. Using a mixed methods research approach, three focus group interviews of a sample of Latino MSFWs (N = 29) were conducted and a quantitative survey was implemented (N = 57) at community sites in eastern North Carolina. Four major themes emerged from the focus group data: (1) physical stress related to working conditions; (2) mental stress related to family situations, work environment, documentation status, and lack of resources; (3) depression related to separation from family and the lack of resources; and (4) use of positive and negative mechanisms for coping with stress and depression. A discussion of these themes, results from the survey findings, implications for intervention and outreach programs, along with recommendations for further research, are provided.

Alcohol use among recent Latino immigrants before and after immigration to the United States

BACKGROUND

US-born Latinos have higher rates of alcohol use than Latinos who have immigrated to the United States. However, little is known about the pre-immigration drinking patterns of Latino immigrants or about the changes in their drinking behaviors in the 2 years post-immigration.

OBJECTIVES

This article reports findings of a longitudinal study that compared rates of regular, binge, and heavy drinking among a cohort of recent Latino immigrants, ages 18-34, prior to immigration to the United States and in the 2 years post-immigration.

METHODS

Baseline data were collected on the drinking patterns of 405 Latino immigrants living in the United States for 12 months or less. A follow-up assessment occurred during their second year in the United States.

RESULTS

Findings indicate that number of days of drinking declined significantly post-immigration. Binge alcohol use (five or more drinks on the same occasion during the past 90 days) significantly declined during the post-immigration period. Heavy alcohol use (five or more drinks on the same occasion on five or more days during the past 90 days) also significantly decreased.

CONCLUSIONS

Results suggest a need for continued exploration of pre-immigration drinking patterns and research to uncover underlying factors associated with declines in rates of problematic alcohol use among recent Latino immigrants.

SCIENTIFIC SIGNIFICANCE

The results of this study can aid in furthering our understanding of the alcohol use of Latino immigrants ages 18-34 prior to and post immigration to the United States to guide future research and the development of culturally tailored clinical interventions.

Health status and needs of Latino dairy farmworkers in Vermont

Vermont is a new Latino destination where many Spanish-speaking migrants have found work on dairy farms. One hundred twenty Latino workers were surveyed on 59 Vermont dairy farms to develop a demographic profile and evaluate their self-assessed health status and barriers to care. The study found, similar to other studies, the majority of workers were young, male Mexicans. However, the workers in this study, as compared to others, originated farther south in Mexico and there were significant regional differences in educational attainment. Workers defined health in terms of their ability to work and the majority believed themselves to be in good health. The majority felt that moving to the United States has not changed their health status. The most common health issue reported was back/neck pain, followed by dental and mental health issues. Workers are both physically and linguistically isolated and reported isolation as the most challenging aspect of dairy farm work. Fear of immigration law enforcement was the primary barrier to care. Community-based initiatives, including partnerships with colleges and universities, outreach to farm employers and the adoption of "bias-free policing" are strategies that can increase access to health care for Latino dairy farmworkers in the United States.