Social capital, acculturation, mental health, and perceived access to services among Mexican American women

Impacts of Acculturation on Depressive Symptoms and Activities of Daily Living of U.S. Older Chinese Immigrants

BACKGROUND AND OBJECTIVES

Acculturation is a critical aspect of social experience for immigrants, including Asian immigrants. Existing literature has shown mixed findings on the health impacts of acculturation and largely relied on cross-sectional studies, preventing drawing definitive conclusions. This study aimed to examine the long-term effects of acculturation on depressive symptoms and activities of daily living (ADL) limitations in a large sample of older Chinese immigrants in the United States.

RESEARCH DESIGN AND METHODS

Data were drawn from 2,811 older Chinese immigrants from the Population Study of Chinese Elderly in Chicago. Acculturation was assessed at baseline, and questionnaires on depressive symptoms and ADL limitations were completed at 4 assessments.

RESULTS

Overall, results showed that acculturation was not associated with depressive symptoms at baseline but was associated with a faster decline in depressive symptoms over time. No associations were found between acculturation and ADL limitations. Stratified analyses showed that the significant relationship between acculturation and a faster decline in depressive symptoms was only evident among female participants. Also, acculturation was associated with a lower risk of reporting ADL limitations at baseline in female participants but a higher risk of reporting ADL limitations in male participants.

DISCUSSION AND IMPLICATIONS

This study indicates the long-term benefits of acculturation on mental health among older Chinese immigrants in the United States, particularly among females. Initiatives supporting the acculturation process need to consider sex disparities and individual preferences, aiming to foster sustained benefits for healthy aging in this population.

Immigrant Perspectives of Social Connection in a Nontraditional Migration Area

Social connection is a core dimension of health and wellness among all populations, yet the experience of moving to and living in a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Using hybrid (inductive/deductive) qualitative analysis, we identified seven domains of social connection from the perspective of the interviewed participants: (1) lens of the individual; (2) immigrant experience; (3) interpersonal support; (4) community belonging; (5) community capital; (6) community navigation; and (7) social acceptance. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of social connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. Additionally, these results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess the social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.

The Role of Ethnic Community Social Capital in the Association between Acculturation and Psychological Distress among Older Korean Americans

Guided by the theories of social capital and stress-buffering, we examined how the association between low acculturation and poor mental health among older immigrants would be modified by social capital in ethnic communities (social cohesion, social engagement, perceived ethnic density, and the quality of social interaction). Using data from the Study of Older Korean Americans (N = 2,150, Mean age = 73.4), direct and interactive effect models were examined. Lower acculturation was associated with a greater level of psychological distress, and their link was modified by social cohesion (β = .19, p < .01) and negative social interactions (β =  - .97, p < .01). Findings suggest that the mental health risk associated with low acculturation could be intensified when older immigrants perceive low sense of cohesion in their ethnic communities or have negative interactions with ethnic community members.

The relevance of social capital and sense of coherence for mental health of refugees

Introduction

Migration puts refugees in a completely new social context when simultaneously some have to deal with previously experienced traumatic events and post-migration stressors. Social capital and sense of coherence could be key resources to improve mental health of refugees. This study aims to examine the interplay between social capital (structural and cognitive), sense of coherence and mental health of refugees in the Netherlands.

Objective

The present study was conducted to i) examine if social capital (structural and cognitive) and mental health are related in a population of Dutch refugees, and ii) test if sense of coherence has a moderating and/or a mediating effect on this relation.

Method

Data were collected through questionnaires (n = 154) in a cross-sectional survey at different locations throughout the Netherlands. The data were analysed with multiple regression analyses and nonparametric bootstrapping using SPSS.

Results

Social capital (structural and cognitive) was positively related to mental health. In addition a positive relation between sense of coherence and mental health of refugees was found. The relationship between cognitive social capital and mental health was completely mediated by sense of coherence. No moderation effect of sense of coherence on the relation between social capital and mental health was found.

Conclusions

The current study contributed to understanding the social mechanism that determines refugee mental health: participating in social groups (structural social capital) and having supportive and trusting relationships (cognitive social capital), whilst experiencing life as comprehensible, manageable, and meaningful (sense of coherence) are positively related to better mental health of refugees. Findings indicate that preventive interventions aiming to enhance refugees' mental health may be more effective when targeting and promoting both social capital and sense of coherence, from a relatively early stage after arrival in the Netherlands.

The Relationship Between Latinxs' Acculturative Experiences and Mental and Behavioral Disorder in the National Latino and Asian American Study

Mental and behavioral disorders are among the leading contributors to disability among US-residing Latinxs. When treated as a homogeneous group, important disparities in the prevalence of such disorders among Latinx subgroups (e.g., by ethnic heritage) are obscured. However, Latinxs may also be characterized by their acculturative experiences while living in the USA, such as discrimination, neighborhood context and family conflict. Latent Profile Analysis with distal outcomes was used to estimate differences in psychiatric disorder prevalence across acculturative subgroups. Data from 2,541 Latinx participants (age 18 +) in the National Latino and Asian American Study (NLAAS) were used to estimate differences in the proportion of three categories of DSM-IV disorder: depressive, anxiety and substance use by four latent subgroups of Latinxs based on their acculturative experiences. Latinxs reporting more positive acculturative experiences had the lowest prevalence of all three disorders (14.8%, 13.6% and 7.1%, respectively). Those whose lives were characterized by high levels of family conflict and discrimination combined with low levels of social cohesion and neighborhood safety had the highest disorder prevalence (34.0%, 26.6% and 22.5%; all p < 0.01 compared to positive experiences subgroup). Latinxs with moderate levels of discrimination and conflict, along with those with high conflict and cohesion, were better off as compared to those with high negative experiences and low cohesion. These latent subgroups of Latinxs according to their acculturative experiences hold important implications for identifying high-risk groups for developing a psychiatric disorder. Findings also point to the protective role of family and neighborhood cohesion when facing high levels of adversity, which may inform prevention and intervention efforts.

Investigating the effectiveness of psychological interventions in response to stress, anxiety, and depression in coronavirus disease 2019 patients: A systematic review

Coronavirus disease 2019 (COVID-19) has caused different kinds of psychological consequences. Identifying and providing psychological plans and protocols can be effective in promoting patients' mental health. The study was conducted to investigate the effect of psychological interventions in response to stress, anxiety, and depression in COVID-19 patients. The present study was performed based on a systematic review. The studies were done by using different combinations of keywords in databases such as Science Direct, ProQuest, PubMed, and Google scholar search engines and in Persian databases such as Magiran, SID, Iranmedex from July 25 to September 7, 2020. Out of 4533 articles that were found after extensive search, 9 articles were evaluated and qualitatively analyzed for data extraction with the 2010 consort checklist. The final articles were from different countries of China, the USA, France, Italy, and Iran and were about COVID-19 patients and their health-care providers. Interventions ranged from relaxation, music therapy to mental health and extensive psychological skills including adaptation methods, mindfulness and self-care, and crisis management. Anxiety was the highest and then stress and depression were the next indicators. The results showed a positive effect of these interventions on stress, anxiety, depression, and even the quality of life, sleep and family and child function. The number of studies in this field is increasing. We see a variety of psychological and educational interventions every day. It is hoped that by designing standard protocols for psychological intervention, effective steps can be taken to improve the mental health of patients and health-care providers.

Depression among Underserved Rural and Urban Caregivers of Latinas with Breast Cancer

Among Latino/as, informal caregiving duties are often deemed a family responsibility. Understanding psychological outcomes tied to caregivers of Latina breast cancer survivors is important to identify the impacts of cancer. Secondary analysis of baseline data collected in a randomized clinical trial (RCT) from 230 Latina breast cancer survivor-caregiver dyads. Characteristics of caregivers residing in rural/underserved and urban areas were compared using t- or chi-square tests. General linear models were used to analyze depressive symptoms in relation to residence, survivor-caregiver relationship, acculturation, obligation, reciprocity, and comorbidities. Urban residence was significantly associated with higher levels of depression controlling for survivor-caregiver relationship acculturation, obligation, reciprocity, and comorbidities. Mother caregivers had significantly higher levels of depression than other caregivers. Depression among Latino/a caregiver's providing care to an adult child is an important consideration as Latino/as are less likely to seek out/have access to mental health services than other groups.

Explaining civic engagement: The role of neighborhood ties, place attachment, and civic responsibility

This study examines whether neighborhood ties (comprising neighborhood trust and neighborhood friendship), place attachment, and civic responsibility influence a person's decision to engage in neighborly civic activities. Three personality traits were added to the model as potential moderators: egoism, altruism, and fear of negative evaluation. Using data from a survey of German citizens (n = 610), the structural equation model adopted revealed that place attachment and civic responsibility (partially) mediate the effect of neighborhood trust (neighborhood friendship) on local civic engagement intention. Furthermore, egoism negatively moderates the relationship between civic responsibility and engagement intention.

Resilience and the Role of Depressed and Anxious Mood in the Relationship Between Perceived Social Isolation and Perceived Sleep Quality During the COVID-19 Pandemic

BACKGROUND

The aim of the study was to examine the mediating role of depressed and anxious mood in the relationship between perceived social isolation and perceived sleep quality during the COVID-19 pandemic. We also aimed to investigate the moderating role of psychological resilience in this mediation.

METHODS

A cross-sectional study of adults (18+ years old) was conducted using an online, multi-language, international survey between March 31 and May 15, 2020. Simple and moderated mediation analyses were performed using the PROCESS macro for SPSS, with perceived social isolation as an independent variable, change in perceived sleep quality (during vs. before the COVID-19 pandemic) as a dependent variable, depressed and anxious mood (Patient Health Questionnaire-4, PHQ-4) as a mediator, and resilience (Brief Resilience Scale, BRS) as a moderator.

RESULTS

A convenience sample of 3816 participants (2692 = female) from 94 countries (47.4% USA) met criteria for inclusion in the analyses. Results showed that depressed and anxious mood mediated the relationship between perceived social isolation and change in perceived sleep quality. This mediation was moderated by resilience; the indirect effect of perceived social isolation on change in perceived sleep quality through depressed and anxious mood decreased as the level of resilience increased (index of moderated mediation = 0.008, SE = 0.003, 95%CI [0.001; 0.014]).

CONCLUSIONS

The study findings indicate benefits of psychological resilience in buffering negative effects of perceived isolation, suggesting potential benefits of developing targeted strategies to enhance resilience during times of significant crises.

Refining acculturation measures for health research: Latina/o heterogeneity in the National Latino and Asian American Study

OBJECTIVES

This study factor analyzes six scales relating to acculturation and related experiences among a nationally representative sample of United States-residing Latina/os (n = 2,541) from the National Latino and Asian American Study (NLAAS), using measurement invariance (MI) testing to explore differences in latent constructs by Latina/o subgroup.

METHODS

Factor Analysis (FA) within an Exploratory Structural Equation Modeling framework was used to analyze the factor structure of six scales measuring acculturation and related experiences (i.e., acculturation [language use and preference], enculturation [ethnic identity], discrimination, neighborhood context, and family environment). We tested for MI by two important Latina/o subgroups: ethnic heritage and generational status.

RESULTS

The underlying latent factors resulting from FA strongly aligned with the NLAAS subscales. No scale achieved full MI, yet the degree to which MI held varied greatly by scale and by subgroup.

CONCLUSIONS

Findings show that Latina/os are heterogeneous, but that this often depends on the construct and subgrouping of interest. Future research should use these scales in a latent framework, accounting for the lack of MI, to ensure that the underlying acculturative constructs of interest are validly measured when investigating their association with mental health outcomes in this population.

Does acculturation really matter for internal migrants' health?Evidence from eight cities in China

It is widely recognized that China has experienced the largest internal migration in its history and that these internal migrants are largely excluded from urban services, posing major challenges to their health outcomes. This paper attempts to address this issue from a socio-ecological lens, examining John W. Berry's conceptual framework of acculturation on internal migrants' health in China. We employed the National Migrant Dynamic Monitoring Survey (MDMS; 2014) data, with around 16,000 samples from eight cities. Our results showed that compared to their hometown culture, where migrants can successfully integrate into the mainstream culture of the destination area, mental health stress can be prevented and self-assessed health status is improved. Well-integrated migrants showed the best self-reported health (SRH) and mental health status, while segregated or marginalized migrants received lower health scores. It was interesting to see that the origin culture only protected SRH whereas the local culture could promote both mental health and SRH. This evidence may be alarming. Local government must respect origin cultures when carrying out social integration policy. In addition, macro-migration policies should encourage local mobility within the same cultural areas to minimize the negative effects of migration.

Social Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Disease 2019 (COVID-19) Outbreak in January 2020 in China

Background

From the end of December 2019, coronavirus disease 2019 (COVID-19) began to spread in central China. Social capital is a measure of social trust, belonging, and participation. This study aimed to investigate the effects of social capital on sleep quality and the mechanisms involved in people who self-isolated at home for 14 days in January 2020 during the COVID-19 epidemic in central China.

Methods

Individuals (n=170) who self-isolated at home for 14 days in central China, completed self-reported questionnaires on the third day of isolation. Individual social capital was assessed using the Personal Social Capital Scale 16 (PSCI-16) questionnaire. Anxiety was assessed using the Self-Rating Anxiety Scale (SAS) questionnaire, stress was assessed using the Stanford Acute Stress Reaction (SASR) questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Path analysis was performed to evaluate the relationships between a dependent variable (social capital) and two or more independent variables, using Pearson’s correlation analysis and structural equation modeling (SEM).

Results

Low levels of social capital were associated with increased levels of anxiety and stress, but increased levels of social capital were positively associated with increased quality of sleep. Anxiety was associated with stress and reduced sleep quality, and the combination of anxiety and stress reduced the positive effects of social capital on sleep quality.

Conclusion

During a period of individual self-isolation during the COVID-19 virus epidemic in central China, increased social capital improved sleep quality by reducing anxiety and stress.

Volunteerism and Cardiovascular Health: The HCHS/SOL Sociocultural Ancillary Study

OBJECTIVES

The objective of this study was to examine the association between volunteerism and favorable cardiovascular health (CVH) among Hispanics/Latinos living in the US.

METHODS

Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) Sociocultural Ancillary Study were used (N = 4,926; ages 18-74 years). Favorable CVH was defined as positive profiles of all major CVD risk factors: low total serum cholesterol, blood pressure, and body mass index; not having diabetes; and not smoking. Survey-weighted logistic regression models were adjusted for sociodemographic, lifestyle, and psychological factors. In secondary analyses, we tested whether the volunteerism-CVH association was modified by sex, age, or years lived in the US (<10 vs. ≥10 years; a proxy acculturation measure).

RESULTS

Prevalence of volunteerism was 14.5%. Compared to non-volunteers, volunteers had 1.67 higher odds of favorable CVH in the fully-adjusted model (Odds Ratio [OR] = 1.67, 95% Confidence Interval [CI] = 1.11, 2.52). There was evidence of effect modification by acculturation; only volunteers who had lived in the US ≥10 years had 2.41 higher odds of favorable CVH (OR = 2.41, 95% CI=1.53, 3.80). There was no evidence of effect modification by sex or age.

CONCLUSIONS

Volunteerism was associated with favorable CVH among US Hispanics/Latinos.

Heterogeneity of Latina/os' acculturative experiences in the National Latino and Asian American Study: a latent profile analysis

PURPOSE

This study characterized unobserved subgroups of acculturative experiences among a nationally representative sample of U.S.-residing Latina/os (n = 2541) from the National Latino and Asian American Study.

METHODS

Latent profile analysis was used to characterize the sample by acculturative experiences using nine-factor score indicators regarding discrimination, neighborhood context, family environment, acculturation (language use and preference), and enculturation (ethnic identity). Predictors of profile membership are also examined, including sociodemographics, Latina/o heritage (i.e., ethnic group), generational status, and two acculturative stress domains (legal and interpersonal).

RESULTS

Four Latina/o subgroups were identified based on acculturative experiences. Profiles were differentiated by family context, neighborhood context, and discrimination: (1) positive experiences (n = 1,743, 69%), (2) cohesive conflict (n = 424, 17%), (3) marginalized conflict (n = 237, 9%), and (4) marginalized (n = 137, 5%). Generational status, heritage, and marital status were the salient predictors of profile membership. Among the foreign-born sample (n = 1617), legal acculturative stress also predicted profile membership.

CONCLUSIONS

Latina/os have heterogeneous experiences living in the United States. Discrimination, family context, and neighborhood environment are more related to varying experiences as opposed to traditional measures of acculturation and enculturation. Future research should characterize Latina/o heterogeneity using these experiences rather than strictly by observed demographics, such as heritage or generational status.

Acculturation and Food Insecurity Among Puerto Ricans Living in Boston

OBJECTIVE

To examine the associations among acculturation, food environment, and food insecurity among Puerto Ricans in Boston.

METHODS

The researchers used data from the second wave of the Boston Puerto Rican Health Study. The sample included 719 Puerto Rican adults in Boston. The researchers used logistic regression to examine the associations between psychological and language acculturation and food insecurity.

RESULTS

Individuals with medium psychological acculturation were more likely to be food insecure than were those with low or high psychological acculturation (P = .01). The association between language acculturation and food insecurity differed by distance of residence from primary shopping location (P = .02).

CONCLUSIONS AND IMPLICATIONS

This study extends the understanding of acculturation and food insecurity by investigating the impact of psychological and language acculturation. The findings highlight biculturalism, indicated by medium psychological acculturation, as a risk factor for food insecurity. People with low language acculturation who live far from food shopping locations had the highest prevalence of food insecurity.

An Examination of the Association of Multiple Acculturation Measures with Asthma Status Among Elementary School Students in El Paso, Texas

Some researchers posit that the lower prevalence of asthma among those of Mexican descent may result from an under-diagnosis and recommend a critical appraisal of factors related to race/ethnicity, like acculturation, and its influence on asthma status. Survey data were analyzed using multinomial logistic regression to examine the association of child's asthma status (no wheezing/no asthma symptoms, possible undiagnosed and diagnosed asthma) with measures of acculturation among Hispanic students (n = 1095). In this population, the prevalence of diagnosed asthma (15%) was higher than both national (7.6%) and state (6.8%) averages for Hispanic children in 2012. While bivariate analyses showed significant associations for asthma status and measures of acculturation, multivariate analyses did not. There is an underestimated burden of illness among Hispanic children in El Paso County. More research on the suitability of acculturation constructs is needed to delineate what they actually measure and how acculturation influences asthma status.

Changes in social capital and depressive states of middle-aged adults in Japan

The present study examines the relationships between changes in bonding and bridging types of social capital and depressive states among middle-aged adults in Japan using a nationally representative sample. Data was collected from a nationwide, population-based survey conducted from 2005 to 2013 in nine annual waves. A total of 16,737 middle-aged men and 17,768 middle-aged women provided data. They reported about depressive states, measured by Kessler 6 scores, and bonding and bridging types of social capital, measured by reported participation in different social activities. Latent growth modeling was conducted to examine relations between changes in bonding and bridging types of social capital and depressive states within individuals across the nine waves. The results showed that, for both men and women, increases in bonding social capital were associated with decreases in depressive states, while changes in bridging social capital were not related to changes in depressive states. In addition, the results showed that changes in bonding social capital, but not bonding social capital at the baseline, affected changes in depressive states. Future studies should take changes in social capital as an independent variable into consideration.

Association between Social Capital and Self-Efficacy among Latinas in Nebraska

Ensuring the health and well-being of Latinas is critical given the size of the population and its rapid growth across the United States. Social capital may be a tool for alleviating some of the individual, neighborhood, and societal challenges that Latina immigrants face. This study uses bivariate tests and multivariate regression to assess the association between social capital and self-efficacy among Latina immigrants in the Midwest (N = 94). Self-efficacy was positively correlated with bonding and bridging social capital. Findings from a multiple regression model indicate that bonding and bridging social capital are significantly associated with self-efficacy after adjusting for the effect of related covariates. Public health interventions may benefit from building and fostering bonding and bridging social capital among immigrants as way to improve self-efficacy, promote health, and enhance public health practice.

Family Support and Family Negativity as Mediators of the Relation between Acculturation and Postpartum Weight in Low-Income Mexican-Origin Women

BACKGROUND

Obesity presents a significant health concern among low-income, ethnic minority women of childbearing age.

PURPOSE

The study investigated the influence of maternal acculturation, family negativity, and family support on postpartum weight loss among low-income Mexican-origin women.

METHODS

Low-income Mexican-origin women (N=322; 14% born in the U.S.) were recruited from a prenatal clinic in an urban area of the Southwest U.S. Acculturation was assessed during a prenatal home visit (26-38 weeks gestation), and post-birth family support and general family negativity were assessed at 6 weeks postpartum. Objective maternal weight measures were obtained at five time points across the first postpartum year.

RESULTS

Higher acculturation predicted higher family support and family negativity. Higher family support predicted decreasing weight across the first postpartum year, and higher family negativity predicted higher weight at 6 weeks postpartum and increasing weight across the first postpartum year. In combination, family negativity and support mediated the impact of acculturation on postpartum weight gain.

CONCLUSIONS

Cultural and family-related factors play a significant role in postpartum weight gain and loss for low-income Mexican-origin women.

The Oppression of Latina Mothers: Experiences of Exploitation, Violence, Marginalization, Cultural Imperialism, and Powerlessness in Their Everyday Lives

Despite Latinos being the largest growing population in the United States, research has not examined the impact of social structures on the well-being of Latina immigrants; negative social discourse and restrictive laws exacerbate inequality and discrimination in this population. Through combined inductive/deductive analysis of in-depth semistructured interviews, we examined immigrant Mexican mothers' ( N = 32) descriptions of oppression in the United States. All five forms of oppression, described in Young's oppression framework are evident: exploitation, violence, marginalization, cultural imperialism, and powerlessness. Discrimination places a high burden on Latinas due to the intersection of forms of oppression and nondominant identities.

"Si Dios Quiere": Fatalismo and use of mental health services among Latinos with a history of depression

Latinos are less likely to seek professional mental health care than other groups in the United States. While fatalismo has long been hypothesized to be responsible for this behavior, there is little evidence on this assumption. Using an adapted version of the Behavioral Model of Health Service Use (BMHSU), and a nationally representative sample, this study examined the association between fatalismo and mental health service use among Latinos with a history of depression. Participants (n = 703) were drawn from the 2007 Pew Hispanic Healthcare survey. Results showed that fatalismo was significantly associated with the use of psychiatric care, even after controlling for traditional deterrents of health care access and utilization. The findings underscore the importance of fatalismo in predicting Latinos' use of psychiatric care. Implications for practice are discussed.

Acculturative stress is associated with trajectory of anxiety symptoms during pregnancy in Mexican-American women

Over half of pregnant women report anxiety symptoms and these symptoms may be precipitated by stressful experiences. Anxiety rates may be higher in Mexican-American women who experience sociocultural stressors, such as acculturation, acculturative stress and discrimination. However, the role of such stressors on the trajectory of anxiety symptoms across pregnancy is not yet known. Mexican-American women (n=151) completed surveys across pregnancy about acculturation, acculturative stress, perceived discrimination, and state anxiety. Multilevel modeling found that acculturation (Anglo orientation, b=0.050, SE=0.379, t (137.561)=0.134, p=0.894; Mexican orientation, b=0.775, SE=0.692, t (133.424)=1.121, p=0.264) and perceived discrimination (b=-1.259, SE=0.921, t (137.489)=-1.367, p=0.174) were not associated with the trajectory of anxiety symptoms. However, acculturative stress, even while controlling for perceived stress, was associated with high levels of anxiety symptoms that were elevated early in pregnancy (b=-0.045, SE=0.022, t (135.749)=-2, p=0.047). This work highlights the unique role of acculturative stress in risk for prenatal anxiety in early pregnancy.

Developing a Peer-to-Peer mHealth Application to Connect Hispanic Cancer Patients

Cancer and its treatment can significantly impact health-related quality of life (HRQOL) (J Pain Symptom Manag 9 (3):186-192, 1994; Soc Sci Med 46:1569-1584, 1998), particularly for Hispanics (Healthcare Financ Rev 29 (4):23-40, 2008; Psycho-Oncology 21 (2):115-124, 2012). Moreover, providers of cancer support for this population may encounter unique challenges. Grounded in social capital theory, this study identified Spanish-speaking, Hispanic breast cancer survivor support needs and preferences for a mHealth intervention. A user-centered, community-engaged research design was employed, consisting of focus groups made up of constituents from a local Hispanic-serving, cancer support organization. Focus group audio-recordings, translated into English, were coded using a grounded theory analytic approach. First, lead researchers read the complete transcripts to obtain a general sense of the discussion. Next, coding rules were established (e.g., code at the most granular level; double and triple code if necessary, code exhaustively) and initial codebook was created through open-coding. Three new coders were trained to establish requisite kappa statistic levels (≥.70) for inter-rater reliability. With training and discussion, kappa estimates reached .81-.88. Focus group (n = 31) results revealed a mHealth intervention targeting Hispanic cancer patients should not only offer information and support on disease/treatment effects but also respond to the individual's HRQOL, particularly emotional and social challenges. Specifically, participants expressed a strong desire for Spanish content and to connect with others who had gone through a similar experience. Overall, participants indicated they would have access to and would use such an intervention. Findings indicate positive support for a mHealth tool, which is culturally tailored to Spanish speakers, is available in Spanish, and connects cancer patients with survivors.

Sensitivity and Specificity in Three Measures of Depression Among Mexican American Women

This paper examined the prevalence of depressive symptomotology among women of Mexican ancestry (N = 205), over the age of 18, of diverse incomes and nativity. We examined differences in rates of diagnosis by Spanish/English preference and the sensitivity and specificity of three common measures: the Patient Health Questionnaire (PHQ9), the Kessler Psychological Distress Scale (K-10), and depression questions from the Composite International Diagnostic Interview, Short Form (MDD CIDI-SF); PHQ9 was used as the "gold standard" measure. Results indicated 18-32 % of participants met criteria for depression with higher rates found among Spanish preference participants. The K-10 had significantly higher sensitivity (0.81) but lower specificity (0.79) than the MDD CIDI-SF items (0.57 and 0.89, respectively). This study suggests that the K-10 and MDD CIDI-SF measures are complementary to each other for screening of depressive symptomatology. Implications for cultural and linguistic assessment of depression are further discussed.

Differences in Acculturation and Trajectories of Anxiety and Alcohol Consumption Among Latina Mothers and Daughters in South Florida

This study documents generational differences in the impact of acculturation related factors on anxiety and alcohol use behaviors between adult Latino mothers and adult daughters. Findings indicate that for mothers (n = 144) and daughters (n = 149), self-reported anxiety levels decreased from baseline to follow up (p = 0.001). For mothers at follow up (n = 147), results indicate that affiliation to Latino culture is negatively associated with anxiety (p = 0.018). Conversely, employment and partner relationship stress are positively associated with anxiety (p = 0.05 and p = 0.016 respectively). In addition, self-reported anxiety is positively associated with alcohol intake (p = 0.002) and employment (p = 0.007). For daughters(n = 149), partner relationship stressors, anxiety and alcohol intake decreased significantly from baseline to follow up at a p = 0.01, p = 0.01, p = 0.05 respectively. In addition, for daughters at baseline (n = 160), affiliation to U.S. culture is positively associated with self-reported anxiety (p = 0.01). Employment is negatively associated with alcohol consumption (p = 0.027). At follow up (n = 152), daughters' partner relationship stress is positively associated with self- reported anxiety (p = 0.049). Findings in this study can be used to develop culturally appropriate interventions, support groups and individual therapy sessions by taking into consideration generational differences among Latino women.

Assessing the Individual, Neighborhood, and Policy Predictors of Disparities in Mental Health Care

This study assesses individual- and area-level predictors of racial/ethnic disparities in mental health care episodes for adults with psychiatric illness. Multilevel regression models are estimated using data from the Medical Expenditure Panel Surveys linked to area-level data sets. Compared with Whites, Blacks and Latinos live in neighborhoods with higher minority density, lower average education, and greater specialist mental health provider density, all of which predict lesser mental health care initiation. Neighborhood-level variables do not have differential effects on mental health care by race/ethnicity. Racial/ethnic disparities arise because minorities are more likely to live in neighborhoods where treatment initiation is low, rather than because of a differential influence of neighborhood disadvantage on treatment initiation for minorities compared with Whites. Low rates of initiation in neighborhoods with a high density of specialists suggest that interventions to increase mental health care specialists, without a focus on treating racial/ethnic minorities, may not reduce access disparities.

A longitudinal analysis of cross-border ties and depression for Latino adults

Recent scholarship suggests a significant association between cross-border ties, or ties maintained with family and friends in countries and communities of origin, and the mental health of immigrants and their descendants. To date, this research has been exclusively cross-sectional, precluding conclusions about a causal association between cross-border ties and mental health outcomes. In the present study we undertake a longitudinal analysis of the relationship between cross-border ties and depression measured over a ten-year period for a sample of immigrant and U.S.-born Latinos. Data are from the Sacramento Area Latino Study on Aging (1998-2008), a population-based, prospective study of Latin American-origin adults 60 years and older. We find that cross-border ties reported at baseline were significantly associated with depression in subsequent study waves, even after controlling for the presence of depression at baseline, albeit with substantial differences by gender and nativity. Specifically, communication with family and friends in Latin America and travel to Latin America at baseline were each significantly associated with greater odds of depression for immigrant women, but with lower odds of depression for U.S.-born Latina women over the study period. Travel to Latin America at baseline was significantly associated with lower odds of depression for Latino men across the study. Across all models we control for depressive symptomatology at baseline to account for the reciprocal nature of depressive symptoms and engagement with social ties, including cross-border ties. Our findings suggest that cross-border ties may represent a unique source of both resilience and risk for the long-term mental health of immigrant Latinos and their descendants.

Sleep Moderates and Mediates the Relationship Between Acculturation and Depressive Symptoms in Pregnant Mexican-American Women

OBJECTIVE

Greater acculturation is associated with adverse perinatal outcomes in Mexican-American women, but the mechanisms by which acculturation influences perinatal outcomes are unclear. Pregnant acculturated Mexican-American women are more likely to engage in unhealthy prenatal behaviors relative to those less acculturated, including poor sleep. As sleep disruptions are associated with acculturation and negative perinatal outcomes, particularly maternal depression, alterations in sleep may adversely affect pregnant Mexican-American women.

METHODS

Sixty pregnant women of Mexican descent completed surveys about sleep, acculturation, depressive symptoms and potential protective factor of social support.

RESULTS

Acculturation, but not social support, significantly predicted increased sleep disruptions as well as overall feeling less refreshed upon waking across pregnancy. Moderation analysis indicated that more acculturated women who took longer to fall asleep reported increased depressive symptoms. Feeling refreshed upon waking also mediated the relationship between increased acculturation and elevated maternal depressive symptoms.

CONCLUSIONS

Acculturation and altered sleep contribute to greater risk in Mexican-American women for maternal depressive symptoms in the perinatal period. These findings have implications for prevention and treatment of maternal mental health disorders, which may adversely affect perinatal outcomes in the vulnerable Mexican-American population.

FBO Leaders' Perceptions of the Psycho-social Contexts for Rural Latinos

Latinos comprise the largest minority rural population in the US, and they are often exposed to adverse social health determinants that can detrimentally affect their mental health. Guided by community-based participatory research (CBPR) principles, this study aimed to describe faith-based organizations (FBOs) leaders' perceptions of the contexts affecting the mental well-being of rural Latino immigrants and potential approaches to mental health promotion for these immigrants. This is a descriptive, qualitative arm of a larger study in which community-academic members have partnered to develop a culturally-tailored mental health promotion intervention among rural Latinos. FBO leaders (N = 15) from different denominations in North Florida were interviewed until saturation was reached. FBO leaders remarked that in addition to religiosity, which Latinos already have, more community building and involvement are necessary for the promotion of mental health.

Trauma-Exposed Latina Immigrants' Networks: A Social Network Analysis Approach

OBJECTIVE

Trauma exposure among Latina immigrants is common. Social support networks can buffer the impact of trauma on mental health. This study characterizes the social networks of trauma-exposed Latina immigrants using a social network analysis perspective.

METHODS

In 2011-2012 a convenience sample (n=28) of Latina immigrants with trauma exposure and presumptive depression or posttraumatic stress disorder was recruited from a community clinic in Washington DC. Participants completed a social network assessment and listed up to ten persons in their network (alters). E-Net was used to describe the aggregate structural, interactional, and functional characteristics of networks and Node-XL was used in a case study to diagram one network.

RESULTS

Most participants listed children (93%), siblings (82%), and friends (71%) as alters, and most alters lived in the US (69%). Perceived emotional support and positive social interaction were higher compared to tangible, language, information, and financial support. A case study illustrates the use of network visualizations to assess the strengths and weaknesses of social networks.

CONCLUSIONS

Targeted social network interventions to enhance supportive networks among trauma-exposed Latina immigrants are warranted.

Acculturation in context: knowledge sharing through ubiquitous technologies

In this paper, we assess the feasibility of using a retooled mobile and ubiquitous computer system to facilitate knowledge dissemination between users during the process of acculturation. Focused on the foreign population of a Japanese post-graduate university, the system provides a platform on which to study not only the behavior of participants but also the process of acculturation dynamically in context. Both quantitative and qualitative data were analyzed, with quantitative data being obtained through the use of survey instruments based on proven instruments in the field of acculturation and qualitative data obtained via the use of semi-structured interviews. The results of this study demonstrate that the retooled mobile and ubiquitous computer system used had measurable benefit in aiding participants undergoing the process of acculturation.

Using patient engagement in the design and rationale of a trial for women with depression in obstetrics and gynecology practices

INTRODUCTION

Significant health disparities exist among socioeconomically disadvantaged women, who experience elevated rates of depression and increased risk for poor depression treatment engagement and outcomes. We aimed to use stakeholder input to develop innovative methods for a comparative effectiveness trial to address the needs of socioeconomically disadvantaged women with depression in women's health practices.

METHODS

Using a community advisory board, focus groups, and individual patient input, we determined the feasibility and acceptability of an electronic psychosocial screening and referral tool; developed and finalized a prioritization tool for women with depression; and piloted the prioritization tool. Two intervention approaches, enhanced screening and referral using an electronic psychosocial screening, and mentoring using the prioritization tool, were developed as intervention options for socioeconomically disadvantaged women attending women's health practices. We describe the developmental steps and the final design for the comparative effectiveness trial evaluating both intervention approaches.

CONCLUSIONS

Stakeholder input allowed us to develop an acceptable clinical trial of two patient-centered interventions with patient-driven outcomes.

Collectivistic orientation, acculturative stress, cultural self-efficacy, and depression: a longitudinal study among Chinese internal migrants

The current study examined the longitudinal relationship of collectivistic orientation and depression and the mediating effects of acculturative stress and cultural self-efficacy between collectivistic orientation and depression. We expect that collectivistic orientation would decrease acculturative stress and increase cultural self-efficacy, and in turn, improve depression. Using data from 641 Chinese internal migrants during a 1-year period, the results supported the hypothesis that collectivistic orientation predicted decreased depression. Moreover, collectivistic orientation alleviated depression through reducing acculturative stress. Although cultural self-efficacy was also a significant mediator, collectivistic orientation relieved depression through decreasing cultural self-efficacy. Implications for future research directions and counseling are discussed.

Individualism and sociocultural adaptation: Discrimination and social capital as moderators among rural-to-urban migrants in China

This study examined the associations of sociocultural adaptation with individualism and collectivism and the moderating roles of discrimination and social capital in the associations among rural-to-urban migrants (N = 641) in Beijing, China. Results indicated that individualism was associated with poorer adaptation for migrants reporting low perceived discrimination or low social capital. However, migrants reporting high perceived discrimination showed poorer adaptation, regardless of individualism; and migrants reporting high social capital showed better adaptation, regardless of individualism. Collectivism was not related to adaptation. Findings suggest that individualism may be detrimental to migrants' adjustment to a collectivistic society.

Neighborhood social capital, neighborhood attachment, and dental care use for Los Angeles Family and Neighborhood Survey adults

OBJECTIVES

We tested the hypothesis that neighborhood-level social capital and individual-level neighborhood attachment are positively associated with adult dental care use.

METHODS

We analyzed data from the 2000-2001 Los Angeles Family and Neighborhood Survey that were linked to US Census Bureau data from 2000 (n = 1800 adults aged 18-64 years across 65 neighborhoods). We used 2-level hierarchical logistic regression models to estimate the odds of dental use associated with each of 4 forms of social capital and neighborhood attachment.

RESULTS

After adjusting for confounders, the odds of dental use were significantly associated with only 1 form of social capital: social support (adjusted odds ratio [AOR] = 0.85; 95% confidence interval [CI] = 0.72, 0.99). Individual-level neighborhood attachment was positively associated with dental care use (AOR = 1.05; 95% CI = 1.01, 1.10).

CONCLUSIONS

Contrary to our hypothesis, adults in neighborhoods with higher levels of social capital, particularly social support, were significantly less likely to use dental care. Future research should identify the oral health-related attitudes, beliefs, norms, and practices in neighborhoods and other behavioral and cultural factors that moderate and mediate the relationship between social capital and dental care use.