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Lababidi H, Lababidi G, Rifai MA, Nasir K, Al-Kindi S. Cardiovascular disease in Arab Americans: A literature review of prevalence, risk factors, and directions for future research. Am J Prev Cardiol 2024; 18:100665. [PMID: 38634110 PMCID: PMC11021916 DOI: 10.1016/j.ajpc.2024.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Recent evidence suggests Arab Americans, individuals with ancestry from Arabic-speaking countries, have an elevated risk for CVD compared to other ethnicities in the US. However, research focusing specifically on CVD in this population is limited. This literature review synthesizes studies investigating CVD prevalence, risk factors, and outcomes in Arab Americans. Multiple studies found higher rates of coronary heart disease, cerebrovascular disease, and hypertension compared to non-Hispanic White participants. The prevalence of type 2 diabetes, a major CVD risk factor, was also markedly higher, ranging from 16 % to 41 % in Arab Americans based on objective measures. Possible explanations include high rates of vitamin D deficiency, genetic factors, and poor diabetes control. Other metabolic factors like dyslipidemia and obesity did not consistently differ from general population estimates. Psychosocial factors may further increase CVD risk, including acculturative stress, discrimination, low health literacy, and barriers to healthcare access. Smoking, especially waterpipe use, was more prevalent in Arab American men. Though heterogenous, Arab Americans overall appear to have elevated CVD risk, warranting tailored screening and management. Culturally appropriate educational initiatives on CVD prevention are greatly needed. Future directions include better characterizing CVD prevalence across Arab American subgroups, delineating genetic and environmental factors underlying increased diabetes susceptibility, and testing culturally tailored interventions to mitigate CVD risks. In summary, this review highlights concerning CVD disparities in Arab Americans and underscores the need for group-specific research and preventive strategies.
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Affiliation(s)
- Hossam Lababidi
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
| | - Ghena Lababidi
- Medical program, American University of Beirut, United States
| | - Mahmoud Al Rifai
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
| | - Khurram Nasir
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
| | - Sadeer Al-Kindi
- Houston Methodist DeBakey Heart and Vascular Institute, Houston Methodist Hospital, 6550 Fannin St, Houston, TX 77030, United States
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Albdour M, DiMambro MR, Solberg MA, Jenuwine ES, Kurzer JAMJ, Hong JS. Association of adversities and mental health among first- and second-generation Arab American young adults. Res Nurs Health 2024; 47:208-219. [PMID: 37778014 DOI: 10.1002/nur.22340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/11/2023] [Accepted: 09/17/2023] [Indexed: 10/03/2023]
Abstract
The prevalence of mental health problems among young adults is widely recognized. However, limited research has examined the mental health of Arab American young adults specifically. To address this gap in the literature, this study aimed to investigate the effects of multiple stressors including adverse childhood experiences (ACEs), discrimination, and bullying victimization on the mental health of first- and second-generation Arab American young adults. The participants (N = 162) were recruited from a Midwest university using online and in-person methods. They were screened and completed a demographic questionnaire and self-report measures of ACEs, discrimination, bullying victimization, and mental health. Hierarchical multiple regression analysis was conducted to examine the effect of psychosocial stressors on mental health and the moderating effect of generation (first vs. second) on that relationship. Female gender, increased perceived discrimination, and more ACEs were associated with lower mental health scores (β = -0.316, p < 0.001, β = -0.308, p < 0.001, and β = -0.230, p = 0.002, respectively). There was a significant negative relationship between victimization and mental health for first-generation Arab Americans (β = -0.356, p = 0.010). However, that association all but disappeared for second-generation participants (β = 0.006, p = 0.953). The results highlight the impact of multiple adversities on Arab American young adults' mental health and indicate important nuances related to their generation in the association between bullying victimization and mental health. Implications for practice and future research are discussed.
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Affiliation(s)
- Maha Albdour
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | | | - Marvin A Solberg
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | | | | | - Jun Sung Hong
- School of Social Work, Wayne State University, Detroit, Michigan, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Albdour M, Templin T, Zilioli S, Hong JS, Lumley MA. Current and Cumulative Stress Experiences: A Model for Arab American Young Adults. J Am Psychiatr Nurses Assoc 2024; 30:364-377. [PMID: 36217725 DOI: 10.1177/10783903221110235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The effect of multiple stressors on immigrant young adults' endocrine functioning and health outcomes has not been comprehensively investigated. AIMS This study tested a theoretical model of cumulative and current stressor effects on the hypothalamic-pituitary-adrenocortical (HPA) axis functioning and health-related quality of life (HRQL) among Arab American young adults. METHODS Using a cross-sectional design, we recruited 160 participants, ages 18 to 24 years, from an urban university in the Midwest. Cumulative stress was assessed by self-report measures of childhood adversity, bullying victimization, and perceived ethnic discrimination. Current perceived stress was measured using the Perceived Stress Scale (PSS) while cortisol levels were measured in participants' hair. Structural equation modeling tested the effects of cumulative and current stress on cortisol and HRQL. RESULTS Cumulative stress was negatively associated with HRQL (standardized path coefficient = -.51, p < .05). Interestingly, however, cumulative stress was inversely associated with hair cortisol level (standardized path coefficient = -.51, p < .05). Current stress was positively associated with cortisol level (standardized path coefficient = .43, p < .05) and negatively associated with the mental HRQL (standardized path coefficient < -.37, p < .05). CONCLUSION Cumulative stress exhibited a different effect on HPA functioning from current perceived stress. Mental health was significantly impaired by both cumulative and current perceived stress. Implications for mental health nursing practice and research among Arab Americans are discussed.
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Affiliation(s)
- Maha Albdour
- Maha Albdour, PhD, APHN-BC, RN, College of Nursing, Wayne State University, Detroit, MI, USA
| | - Thomas Templin
- Thomas Templin, PhD, College of Nursing, Wayne State University, Detroit, MI, USA
| | - Samuele Zilioli
- Samuele Zilioli, PhD, Department of Family Medicine and Public Health Sciences, Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Jun Sung Hong
- Jun Sung Hong, PhD, School of Social Work, Wayne State University, Detroit, MI, USA
| | - Mark A Lumley
- Mark A. Lumley, PhD, Department of Psychology, Wayne State University, Detroit, MI, USA
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Chebli P, Strayhorn SM, Hanneke R, Muramatsu N, Watson K, Fitzgibbon M, Abboud S, Molina Y. A Scoping Review of Cancer Interventions with Arab Americans. J Immigr Minor Health 2024; 26:200-226. [PMID: 37266829 DOI: 10.1007/s10903-023-01497-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2023] [Indexed: 06/03/2023]
Abstract
This scoping review provides an overview of cancer interventions implemented with Arab Americans across the cancer control continuum, including an examination of outcomes and implementation processes. The search strategy included database searching and reviewing reference lists and forward citations to identify articles describing interventions with Arab adults living in the US, with no restrictions on date of publication or research methodology. The review included 23 papers describing 12 unique cancer interventions. Most interventions focused on individual-level determinants of breast and cervical cancer screening; used non-quasi-experimental research designs to evaluate intervention effectiveness; and demonstrated improvements in short-term cancer screening knowledge. Implementation processes were less commonly described. Most interventions were culturally and linguistically tailored to communities of focus; were delivered in educational sessions in community settings; engaged with the community mostly for recruitment and implementation; and were funded by foundation grants. Suggestions for research and intervention development are discussed.
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Affiliation(s)
- Perla Chebli
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
- NYU Department of Population Health, NYU Grossman School of Medicine, New York, NY, 10016, USA.
| | - Shaila M Strayhorn
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Rosie Hanneke
- Information Services & Research Department at the Library of the Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Naoko Muramatsu
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Karriem Watson
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian Fitzgibbon
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Sarah Abboud
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Yamilé Molina
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
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Haidar A, Kalantzis M, Nallajerla M, Vela A, Adler SR, Burnett-Zeigler I. A Qualitative Examination of Perceptions of Mindfulness Among Arab, Middle Eastern, and North African Americans: Implications for Cultural Adaptation of Mindfulness-Based Interventions. Glob Adv Integr Med Health 2024; 13:27536130241247074. [PMID: 38655072 PMCID: PMC11036918 DOI: 10.1177/27536130241247074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Background Mindfulness-based interventions (MBIs) are well-positioned to address health disparities among racial-ethnic minority communities, given their focus on stress reduction and potential for greater accessibility and acceptability than conventional mental health treatments. Yet, there are currently no peer-reviewed studies of MBIs in an Arab, Middle Eastern, or North African (MENA) American sample. Addressing this gap in the literature is critical for advancing integrative health equity, given the high burden of stress and high prevalence of stress-related health conditions among Arab/MENA Americans. Objective The present study sought to explore perceptions of mindfulness among Arab/MENA Americans and identify potential cultural adaptations to MBIs for this population. Methods 4 focus groups were conducted with 26 Arab/MENA American adults who had participated in an introductory mindfulness workshop. Participants were asked about their experience learning mindfulness skills, the usefulness of mindfulness for problems they face, the alignment of mindfulness with their cultural values and practices, and suggestions for adapting mindfulness programs. Qualitative coding of focus group session transcriptions was conducted to identify themes in the data. Conclusion The participants in this study described experiencing high levels of stress and identified micro- and macro-level stressors related to their Arab/MENA American identity, including discrimination, exclusion, historical and intergenerational trauma, and protracted sociopolitical crises in their heritage countries. They viewed mindfulness as a potentially useful approach to coping with stress. At the same time, participants identified aspects of mindfulness that could be adjusted to better align with their cultural values and experiences. Potential adaptations to MBIs for Arab/MENA Americans were identified based on suggestions from participants and issues they raised while discussing cultural strengths, stressors they face, and perceived barriers and facilitators to engaging in mindfulness practice.
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Affiliation(s)
- Andrea Haidar
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maria Kalantzis
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Meghana Nallajerla
- USC Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Alyssa Vela
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Shelley R. Adler
- UCSF Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Inger Burnett-Zeigler
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Ayyash M, Daviskiba S, Vriesen N, Yaquinto A, Roberson J, Pitts D. High rates of "atypical" single nucleotide polymorphism-based noninvasive prenatal screening results among consanguineous Arab American patients: A single center retrospective study. J Genet Couns 2023; 32:1040-1046. [PMID: 37066630 DOI: 10.1002/jgc4.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 03/16/2023] [Accepted: 03/28/2023] [Indexed: 04/18/2023]
Abstract
Noninvasive prenatal screening (NIPS), using placental cell-free DNA from a maternal blood sample, is currently the most sensitive and specific screening tool for detecting common fetal aneuploidies. The aim of this study was to compare the rates of "atypical" single nucleotide polymorphism (SNP)-based NIPS results and subsequent pregnancy outcomes between Arab American and non-Arab American patients. We conducted a retrospective cohort study of pregnant Arab and non-Arab American patients who had SNP-based NIPS performed between September 2018 and January 2021 at an urban health system in Michigan. The rate of "atypical" results and other perinatal outcomes were compared between groups using descriptive statistics. "Atypical" results due to multifetal gestations, either undisclosed or unknown at time of ordering, were excluded. Five thousand eight hundred and seventy-three patients underwent SNP-based NIPS: 771 (13.1%) were identified as Arab American, 5102 (86.9%) were non-Arab American, and 49 (0.8%) patients received "atypical" results. Arab patients represented only 13.1% of patients screened (771/5873) but had a significantly higher rate of "atypical" results than non-Arab American patients (17/771 [2.2%] vs. 32/5102 [0.6%]; p < 0.001). Of the 17 Arab patients with "atypical" results, 9 (52.9%) were in known consanguineous relationships. No major congenital anomalies or chromosomal aberrations were identified for any patients who had "atypical" results, and no significant differences in other perinatal outcomes were observed between Arab and non-Arab American patients. A better understanding of the association between consanguinity and "atypical" SNP-based NIPS results would aid in appropriate test selection and interpretation and may help physicians and genetic counselors provide better perinatal counseling and follow-up care for patients in consanguineous relationships.
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Affiliation(s)
- Mariam Ayyash
- Department of Women's Health, Obstetrics and Gynecology, Henry Ford Health, Detroit, Michigan, USA
| | - Sydney Daviskiba
- Department of Women's Health, Obstetrics and Gynecology, Henry Ford Health, Detroit, Michigan, USA
| | - Natalie Vriesen
- Division of Genetics, Department of Women's Health, Henry Ford Health, Detroit, Michigan, USA
| | - Alyxandra Yaquinto
- Division of Genetics, Department of Women's Health, Henry Ford Health, Detroit, Michigan, USA
| | - Jacquelyn Roberson
- Division of Genetics, Department of Women's Health, Henry Ford Health, Detroit, Michigan, USA
| | - D'Angela Pitts
- Department of Women's Health, Obstetrics and Gynecology, Henry Ford Health, Detroit, Michigan, USA
- Division of Maternal and Fetal Medicine, Department of Women's Health, Henry Ford Hospital, Detroit, Michigan, USA
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Khan AG, Eid N, Baddah L, Elabed L, Makki M, Tariq M, King EJ, Kusunoki Y. A Qualitative Study of Arab-American Perspectives on Intimate Partner Violence in Dearborn, Michigan. Violence Against Women 2022; 28:2286-2311. [PMID: 34636717 PMCID: PMC10896013 DOI: 10.1177/10778012211032696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few studies explore how intimate partner violence (IPV) affects Arab Americans. Through focus groups with stakeholders from an Arab-centered health organization and semistructured interviews with Arab-American female clients (18-65 years), we explore how IPV affects Arab-American women and factors that impede and facilitate their access to support services. We find that IPV is a critical concern among Arab Americans and that generational status, educational attainment, and support from family, friends, or religious leaders were perceived to influence access to IPV support services. This study has implications for developing culturally sensitive IPV interventions for Arab-American women.
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Affiliation(s)
- Angubeen G Khan
- Department of Community Health Sciences, Fielding School of Public Health, 25808University of California, Los Angeles, CA, USA
| | - Neda Eid
- Bouvé College of Health Sciences, 50919Northeastern University, Boston, MA, USA
| | - Lama Baddah
- 1259University of Michigan, Ann Arbor, MI, USA
| | - Layla Elabed
- 400234ACCESS Community Health & Research Center, Dearborn, MI, USA
| | - Mona Makki
- 400234ACCESS Community Health & Research Center, Dearborn, MI, USA
| | - Madiha Tariq
- 400234ACCESS Community Health & Research Center, Dearborn, MI, USA
| | - Elizabeth J King
- Department of Health Behavior and Health Education, 51331University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Yasamin Kusunoki
- Department of Systems, Populations and Leadership, 16121University of Michigan School of Nursing, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Abboud S, Flores DD, Bond K, Chebli P, Brawner BM, Sommers MS. Family Sex Communication Among Arab American Young Adults: A Mixed-Methods Study. J Fam Nurs 2022; 28:115-128. [PMID: 34694172 PMCID: PMC9795851 DOI: 10.1177/10748407211053931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
There is a significant gap in understanding the sexual health of Arab Americans. The purpose of this study is to explore family sex communication among Arab American young adults and its association with gender and sexual attitudes. We used a parallel mixed methods design and administered an electronic survey (N = 100); a subsample of 24 participants participated in five focus groups. We observed convergence in the findings. Participants reported rare occurrences of family sex communication, with women reporting less comfort than men. Family sex communication was often "unspoken," and reinforced prevailing social norms. Gender differences were reported based on sex communication topics. The most common source of sex information was peers/friends. Focus group participants perceived their parents to be more conservative and less knowledgeable about sex than they were. Future research on strategies to bridge generational differences is needed to promote family-based sex communication, given the multiple teachable moments at home.
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Affiliation(s)
| | | | - Keosha Bond
- The City University of New York, New York City, USA
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Kheil MH, Jain D, Jomaa J, Askar B, Alcodray Y, Wahbi S, Brikho S, Kadouh A, Harajli D, Jawad ZN, Fehmi Z, Elhage M, Tawil T, Fehmi O, Alzouhayli SJ, Ujayli D, Suleiman N, Kazziha O, Saleh R, Abada E, Shallal A, Kim S, Kumar VA, Zervos M, Cote ML, Ali-Fehmi R. COVID-19 Vaccine Hesitancy among Arab Americans. Vaccines (Basel) 2022; 10:610. [PMID: 35455359 DOI: 10.3390/vaccines10040610] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total of 73% reported willingness to receive a booster, and 72% plan to give their children the vaccine. On multivariate analysis, respondents were more likely to be vaccine-hesitant if they were hesitant about receiving any vaccine in general. They were less likely to be vaccine-hesitant if they were immigrants, over the age of 40, up to date on their general vaccination and if they believed that COVID-19 vaccines are safe and effective in preventing an infection. The belief that all vaccines are effective at preventing diseases was also associated with lower hesitancy. (4) Conclusions: This sample of AAs have higher vaccination rates and are more willing to vaccinate their children against COVID-19 when compared to the rest of the population. However, a reemergence of hesitancy might be arising towards the boosters.
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Dallo FJ, Kindratt TB, Seaton R, Ruterbusch JJ. The Disproportionate Burden of COVID-19 Cases among Arab Americans. J Racial Ethn Health Disparities 2022. [PMID: 35394622 DOI: 10.1007/s40615-022-01298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 10/26/2022]
Abstract
Racial and ethnic disparities in COVID-19 cases are pervasive. Some minority, immigrant, and marginalized groups, such as Arab Americans, have been excluded from the research. This population confronts barriers to health care, discrimination, and other factors that may affect understanding, testing, and treatment as it relates to COVID-19. Arab Americans are unique compared to Hispanic, non-Hispanic black, and Asians because Arab Americans do not have a specific ethnic identifier and are classified as non-Hispanic white. Given these issues, this study will estimate COVID-19 cases and examine associations among Arab Americans compared to Hispanic, non-Hispanic black, non-Hispanic white, and Asian adults. Data from the Michigan Disease Surveillance System (March 2020-July 2021), the American Community Survey (2015-2019), and an Arab/Chaldean surname algorithm were used. Chi-square tests were used to determine statistically significant differences between groups. Logistic regression was used to estimate age-adjusted and sex-stratified proportions among Arab Americans compared to non-Hispanic whites before and after adjusting for age and sex. Approximately 17% of Arab Americans tested positive for COVID-19 compared to 11.32% of Hispanics, 9.80% of non-Hispanic blacks, 7.50% of non-Hispanic whites, and 4.24% of Asians. Arab Americans had 2.63 (95% CI: 2.59, 2.66) times greater odds of testing positive for COVID-19 compared to non-Hispanic whites. When Arab Americans were disaggregated from non-Hispanic whites, alarming patterns in COVID-19 cases were observed for Arab Americans. To accurately represent the burden of COVID-19 among Arab Americans, this population needs to have an ethnic identifier that informs appropriate health policy decisions and practice.
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Abouhala S, Hamidaddin A, Taye M, Glass DJ, Zanial N, Hammood F, Allouch F, Abuelezam NN. A National Survey Assessing COVID-19 Vaccine Hesitancy Among Arab Americans. J Racial Ethn Health Disparities 2022; 9:2188-2196. [PMID: 34625919 PMCID: PMC8500465 DOI: 10.1007/s40615-021-01158-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Arab Americans' experiences during the COVID-19 pandemic have been largely undocumented. Disparities in vaccine hesitancy between non-Hispanic Whites and minoritized groups have been observed, warranting exploration into the prevalence of COVID-19 vaccine hesitancy among Arab Americans. METHODS Data from the Survey of Arab Health in America (SAHA) (n = 638), collected between May 2020 and September 2020, were analyzed to determine predictors for vaccine intention among Arab Americans. Chi-squared tests and logistic regression models were performed to determine the relationship between sociodemographic, immigration, acculturation, and COVID-19 risk variables and vaccine intention. RESULTS More than half (56.7%) of respondents reported an intention to be vaccinated with a COVID-19 vaccine, 35.7% reported uncertainty, and 7.5% reported being unlikely to receive a vaccine. Of those unlikely to receive the vaccine, 72.9% were women and 85.4% reported moderate to high religiosity (p < 0.01). Arab American women had higher odds of being uncertain of their vaccine intention (OR = 1.68; 95% CI: 1.10, 2.57) or being unlikely to receive the vaccine (OR = 5.00; 95% CI: 1.95, 12.83) than men in this sample. DISCUSSION Factors such as high religiosity and gender were positively associated with being unlikely to receive a COVID-19 vaccine. Future studies should qualitatively assess the beliefs that undergird vaccine intention among Arab Americans.
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Affiliation(s)
- Siwaar Abouhala
- grid.429997.80000 0004 1936 7531Department of Community Health, Tufts University, Medford, MA USA
| | - Alzahra Hamidaddin
- grid.22448.380000 0004 1936 8032College of Health and Human Services, George Mason University, Fairfax, VA USA
| | - Mahdi Taye
- grid.257167.00000 0001 2183 6649Hunter College Department of Biological Sciences, New York, NY USA
| | - Delaney J. Glass
- grid.34477.330000000122986657Department of Anthropology, University of Washington, Seattle, WA USA
| | - Noor Zanial
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Feda Hammood
- grid.257167.00000 0001 2183 6649Hunter College Department of Biological Sciences, New York, NY USA
| | - Farah Allouch
- grid.38142.3c000000041936754XHarvard T.H. Chan School of Public Health, Boston, MA USA
| | - Nadia N. Abuelezam
- grid.208226.c0000 0004 0444 7053Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA 02467 USA
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Abboud S, Flores D, Redmond L, Brawner BM, Sommers MS. Sexual attitudes and behaviours among Arab American young adults in the USA. Cult Health Sex 2021; 23:1591-1607. [PMID: 32744471 DOI: 10.1080/13691058.2020.1788163] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
While the sexual behaviours of different racial and ethnic groups have been studied extensively in the USA, Arab Americans are relatively understudied. The purpose of our study is to describe sexual attitudes and behaviours of Arab American young adults, to explore gender differences and the factors associated with five primary sexual behaviours (solo and partnered masturbation, oral, vaginal and anal sex). We conducted a cross-sectional quantitative study using a self-administered survey, which included measures of Arab ethnic identity, religiosity and sexual attitudes and behaviours. The survey was completed by 100 Arab American young adults (18-25 years old). Almost half of the sample reported being engaged in at least one of the five primary sexual behaviours in the past six months. In bivariate analysis, there were significant gender differences in sexual attitudes and all the primary sexual behaviours except for anal sex. Sexual attitudes and religiosity were significant predictors of partnered masturbation, oral and vaginal sex. Our findings challenge Arab societal assumptions that unmarried Arab American young adults do not engage in sexual behaviours, including risky behaviours, warranting further research to prevent unintended sexual health outcomes.
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Affiliation(s)
- Sarah Abboud
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Dalmacio Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Leni Redmond
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA
| | - Bridgette M Brawner
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Marilyn S Sommers
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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13
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Shallal A, Abada E, Musallam R, Fehmi O, Kaljee L, Fehmi Z, Alzouhayli S, Ujayli D, Dankerlui D, Kim S, Cote ML, Kumar VA, Zervos M, Ali-Fehmi R. Evaluation of COVID-19 Vaccine Attitudes among Arab American Healthcare Professionals Living in the United States. Vaccines (Basel) 2021; 9:942. [PMID: 34579179 PMCID: PMC8471462 DOI: 10.3390/vaccines9090942] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 08/09/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Vaccine hesitancy is the next great barrier for public health. Arab Americans are a rapidly growing demographic in the United States with limited information on the prevalence of vaccine hesitancy. We therefore sought to study the attitudes towards the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the United States. METHODS This was a cross sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine. RESULTS A total of 4000 surveys were sent via e-mail from 28 December 2020 to 31 January 2021, and 513 responses were received. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. On multivariable analysis, we found that respondents who had declined an influenza vaccine in the preceding 5 years (p < 0.001) and allied health professionals (medical assistants, hospital administrators, case managers, researchers, scribes, pharmacists, dieticians and social workers) were more likely to be vaccine hesitant (p = 0.025). In addition, respondents earning over $150,000 US dollars annually were less likely to be vaccine hesitant and this finding was significant on multivariable analysis (p = 0.011). CONCLUSIONS Vaccine hesitancy among health care providers could have substantial impact on vaccine attitudes of the general population, and such data may help inform vaccine advocacy efforts.
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Affiliation(s)
- Anita Shallal
- Division of Infectious Disease, Henry Ford Hospital, 2799 W. Grand Blvd, CFP 303, Detroit, MI 48202, USA; (A.S.); (M.Z.)
| | - Evi Abada
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, 3990 John R. Rd, Detroit, MI 48201, USA;
| | - Rami Musallam
- Wayne State University School of Medicine, 4201 St Antoine, Detroit, MI 48201, USA; (R.M.); (S.A.)
| | - Omar Fehmi
- The University of Michigan College of Literature, Science, and the Arts, 101 N Main St, Ann Arbor, MI 48104, USA; (O.F.); (Z.F.)
| | - Linda Kaljee
- Global Health Initiative, Henry Ford Health System, One Ford Place, 1E, Detroit, MI 48202, USA; (L.K.); (D.D.)
| | - Ziad Fehmi
- The University of Michigan College of Literature, Science, and the Arts, 101 N Main St, Ann Arbor, MI 48104, USA; (O.F.); (Z.F.)
| | - Suma Alzouhayli
- Wayne State University School of Medicine, 4201 St Antoine, Detroit, MI 48201, USA; (R.M.); (S.A.)
| | - Deema Ujayli
- Michigan State University College of Human Medicine, 965 Fee Rd A110, East Lansing, MI 48824, USA;
| | - Doreen Dankerlui
- Global Health Initiative, Henry Ford Health System, One Ford Place, 1E, Detroit, MI 48202, USA; (L.K.); (D.D.)
| | - Seongho Kim
- Biostatistics Core, Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, 4100 John R. St, Detroit, MI 48201, USA;
| | - Michele L. Cote
- Population Sciences and Disparities Research, Karmanos Cancer Institute, Department of Oncology, Wayne State University School of Medicine, 4100 John R. Rd, Detroit, MI 48201, USA;
| | - Vijaya Arun Kumar
- Department of Emergency Medicine, Wayne State University School of Medicine/Detroit Medical Center, 3990 John R. Rd, Detroit, MI 48201, USA;
| | - Marcus Zervos
- Division of Infectious Disease, Henry Ford Hospital, 2799 W. Grand Blvd, CFP 303, Detroit, MI 48202, USA; (A.S.); (M.Z.)
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine/Detroit Medical Center, 3990 John R. Rd, Detroit, MI 48201, USA;
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14
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Abuelezam NN, El-Sayed A, Galea S, Gordon NP. Understanding differences within ethnic group designation: comparing risk factors and health indicators between Iranian and Arab Americans in Northern California. BMC Public Health 2021; 21:1074. [PMID: 34090389 PMCID: PMC8178892 DOI: 10.1186/s12889-021-11121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Middle Eastern and North African (MENA) ethnic group is a diverse group composed of two primary subsets in the United States: Iranian and Arab Americans. We aimed to compare health risk factors, chronic health conditions, and mental health conditions of Iranian and Arab American adults in Northern California. METHODS We used cross-sectional electronic health record (EHR) data from a 2016 Northern California health plan study cohort to compare adults classified as Iranian or Arab American based on ethnicity, language, or surname. We produced age-standardized prevalence estimates of obesity, smoking, hyperlipidemia, prediabetes, diabetes, hypertension, depression, and anxiety for Iranian and Arab American men and women by age group (35-44, 45-64, and 65-84) and overall (35-84). We used generalized linear models to calculate prevalence ratios (PR) to compare Iranian and Arab American adults ages 35-84 on all health indicators. RESULTS Compared to Arab Americans, Iranian Americans had a lower prevalence of obesity (PR: 0.77, 95% confidence interval, CI: 0.73, 0.82), current smoking (PR: 0.80, 95% CI: 0.73, 0.89), and ever smoking (PR: 0.95, 95% CI: 0.91, 0.99), but a higher prevalence of hyperlipidemia (PR: 1.09, 95% CI: 1.06, 1.12), prediabetes (PR: 1.12, 95% CI: 1.09, 1.16), depression (PR; 1.41, 95% CI: 1.30, 1.52), and anxiety (PR: 1.52, 95% CI: 1.42, 1.63). Similar patterns were observed for men and women. CONCLUSION This work supports the need to collect granular data on race and ethnicity within the MENA ethnic group to improve identification in clinical care settings and population health reporting to better address the physical and mental health needs of different MENA subgroups.
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Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Chestnut Hill, MA, 02467, USA.
| | - Abdulrahman El-Sayed
- College of Literature, Science, & the Arts & Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA, USA
| | - Nancy P Gordon
- Kaiser Permanente Division of Research, Oakland, CA, USA
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15
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Abstract
Immigration has been historically and contemporarily racialized in the United States. Although each immigrant group has unique histories, current patterns, and specific experiences, racialized immigrant groups such as Latino, Asian, and Arab immigrants all experience health inequities that are not solely due to nativity or years of residence but also influenced by conditional citizenship and subjective sense of belonging or othering. Critical race theory and intersectionality provide a critical lens to consider how structural racism might uniquely impact the health of racialized immigrants, and to understand and intervene on the interlocking systems that shape these shared experiences and health consequences. We build on and synthesize the work of prior scholars to advance how society codifies structural disadvantages for racialized immigrants into governmental and institutional policies and how that affects health via three key pathways that emerged from our review of the literature: (1) formal racialization via immigration policy and citizenship status that curtails access to material and health resources and political and civic participation; (2) informal racialization via disproportionate immigration enforcement and criminalization including ongoing threats of detention and deportation; and (3) intersections with economic exploitation and disinvestment such as labor exploitation and neighborhood disinvestment. We hope this serves as a call to action to change the dominant narratives around immigrant health, provides conceptual and methodological recommendations to advance research, and illuminates the essential role of the public health sector to advocate for changes in other sectors including immigration policy, political rights, law enforcement, labor protections, and neighborhood investment, among others.
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Affiliation(s)
- Supriya Misra
- San Francisco State University, San Francisco, CA, USA
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16
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Abuelezam NN, El-Sayed AM, Galea S, Gordon NP. Health Risks and Chronic Health Conditions among Arab American and White Adults in Northern California. Ethn Dis 2021; 31:235-242. [PMID: 33883864 DOI: 10.18865/ed.31.2.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives To characterize the prevalence of chronic cardiovascular conditions and risk factors among Arab American adults stratified by sex and compare these with non-Hispanic Whites. Design Cross-sectional study using electronic health record data from visits between January 2015 and December 2016. Age-adjusted prevalence estimates were calculated for men and women and compared using generalized linear models. Setting Kaiser Permanente health plan in Northern California. Participants Non-Hispanic White (N=969,566) and Arab American (N=18,072) adult members. Main Outcome Measures Sex-stratified prevalence and prevalence ratios of diabetes, pre-diabetes, hypertension, and hyperlipidemia diagnosed by December 2016 and of obesity, ever smoking, and current smoking status. Results Arab American men had a significantly higher prevalence of ever smoking (41.8 vs 40.8%), diabetes (17.3 vs 12.5%), and hyperlipidemia (40.8 vs 34.7%) than White men, but a significantly lower prevalence of obesity (34.4 vs 37.8%) and hypertension (30.5 vs 33.3%). Arab American women had a significantly higher prevalence of diabetes (11.1 vs 8.7%) and hyperlipidemia (31.5 vs 28.3%) than White women but significantly lower prevalence of obesity (31.0 vs 34.2%), ever smoking (24.8 vs 34.5%), and hypertension (25.8 vs 28.4%). Conclusions Hospital and health systems should intentionally collect data on Middle Eastern and North African ethnicity in electronic health records to identify and reduce the disparities this minority group faces.
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Affiliation(s)
- Nadia N Abuelezam
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA
| | - Abdulrahman M El-Sayed
- College of Literature, Science, & the Arts & Department of Internal Medicine, University of Michigan, MI
| | - Sandro Galea
- Boston University School of Public Health, Boston, MA
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17
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Saad F, Ayyash M, Ayyash M, Elhage N, Ali I, Makki M, Hamade H, Blackwood RA. Assessing Knowledge, Physician Interactions and Patient-Reported Barriers to Colorectal Cancer Screening Among Arab Americans in Dearborn, Michigan. J Community Health 2021; 45:900-909. [PMID: 32189212 DOI: 10.1007/s10900-020-00807-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Colorectal cancer (CRC) is the second leading cause of cancer related deaths among men and women in the United States (Haggar and Boushey in Clin Colon Rectal Surg 22:191-197, 2009). Screening tests have shown to be successful at early detection of precancerous polyps. Between 2000 and 2010, there was a 72% growth in the population that identifies having an Arabic-speaking ancestry (Arab American Institute in https://www.aaiusa.org/demographics , 2011). Despite this, little research has been conducted to assess this unique community's knowledge regarding CRC. Given that low screening rates can be attributed to lack of knowledge, this study was designed to address CRC knowledge and screening barriers in an Arab American community. Between February 2016 and June 2017, an anonymous survey was conducted in English or Arabic among 131 patients from cancer programs at the Arab Community Center for Economic and Social Services (ACCESS) in Dearborn, MI. Program participants were expected to have greater insight and awareness about cancer risk than the general population. Knowledge deficiencies surrounding CRC and the screening process were identified. 70% of participants did not know what a colon polyp is and over 89% were not aware of their individual risk for CRC. 45.8% have never had a CRC screening and leading barriers included screening costs, lack of health insurance, and lack of advice by physicians. The goal of this study was to serve as a tool to healthcare providers by identifying evident gaps in medical knowledge surrounding CRC. In order to help better serve and educate patients, healthcare providers and community organizations are encouraged to fight the stigma and help to reduce misunderstandings.
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Affiliation(s)
- Fatima Saad
- University of Michigan-Dearborn, Dearborn, MI, USA. .,Arab American Health Initiative, Dearborn, MI, USA. .,Office for Health Equity and Inclusion-Michigan Medicine, The University of Michigan, 1301 Catherine St, Medical Science Building 1, Ann Arbor, MI, 48109, USA.
| | - Mariam Ayyash
- Arab American Health Initiative, Dearborn, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Obstetrics and Gynecology Henry Ford Health System, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Marwa Ayyash
- Arab American Health Initiative, Dearborn, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nadine Elhage
- Arab American Health Initiative, Dearborn, MI, USA.,Michigan State University College of Osteopathic Medicine, Detroit, MI, USA
| | - Iman Ali
- Arab American Health Initiative, Dearborn, MI, USA.,University of Michigan, Ann Arbor, MI, USA
| | - Mona Makki
- Arab Community Center for Economic and Social Services, ACCESS, Dearborn, MI, USA
| | - Hiam Hamade
- Arab Community Center for Economic and Social Services, ACCESS, Dearborn, MI, USA
| | - R Alexander Blackwood
- Arab American Health Initiative, Dearborn, MI, USA.,University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Pediatrics and Communicable Diseases, Office of Health Equity and Inclusion, Arab American Health Initiative, Dearborn, MI, USA.,Office for Health Equity and Inclusion-Michigan Medicine, The University of Michigan, 1301 Catherine St, Medical Science Building 1, Ann Arbor, MI, 48109, USA
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18
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Chebli P, Reyes K, Muramatsu N, Watson K, Fitzgibbon M, Abboud S, Molina Y. Perspectives of multisectoral community stakeholders on Arab American cancer patients' needs and suggested interventions. Support Care Cancer 2021; 29:5915-25. [PMID: 33763724 DOI: 10.1007/s00520-021-06169-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/18/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Multilevel barriers can arise after a cancer diagnosis, especially in underserved racial/ethnic minority patient populations, raising the need for diverse and contextually adapted interventions. However, limited data exists on Arab American (ArA) cancer patients' needs, partly due to their racial/ethnic misclassification as Whites. This study leveraged the perspectives of cancer survivors and community stakeholders (i.e., healthcare and community leaders) to identify ArA cancer patients' needs, as well as their preferred intervention strategies to address them. METHODS Using a hybrid inductive-deductive content analysis approach, we analyzed qualitative data from interviews with 18 ArA community stakeholders recruited through community partners in Chicago. RESULTS Participants associated cancer stigma to ArA patients' concealment of their diagnosis and aversion to cancer support groups. Economic and language barriers to treatment were emphasized. A lack of resources for ArA cancer patients was also noted and was partly attributed to their misclassification as White. In response to these needs, participants suggested peer mentorship programs to overcome privacy concerns, hospital-based patient navigation to address language and economic barriers in healthcare, diversification of the healthcare workforce to overcome language barriers, and community coalitions to recognize ArA as an ethnic group and increase cancer support resources. Such advocacy will be essential to accurately characterize patients' cancer burden and obtain funding to support community programs and resources. CONCLUSION Our findings suggest that multilevel interventions at the patient, healthcare, and community levels are needed to address ArA cancer patients' needs.
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Abuelezam NN, El-Sayed AM, Galea S, Gordon NP. Differences in Health Characteristics of Geographic Subgroups of Arab Americans in a Northern California Health Plan. J Racial Ethn Health Disparities 2021. [PMID: 33502685 DOI: 10.1007/s40615-021-00970-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Arab Americans are a diverse ethnic group originating from a large geographic area in the Middle East and North Africa (MENA). We aim to characterize differences in health between Arab Americans from different geographic subgroups within MENA. METHODS We used cross-sectional electronic health record (EHR) data for a subset of 4913 Arab Americans aged 20-84 in a 2016 Northern California health plan study cohort who could be assigned to one of 4 geographic subgroups (Gulf, African, Levant, and Other) based on EHR ethnicity data. We calculated age-adjusted prevalence estimates for men and women and used generalized linear models to compare Gulf, African, and Other subgroups to Levant Arabs on risk factors (obesity and smoking), chronic conditions (diabetes, hypertension, hyperlipidemia, and asthma), and mental health (depression and anxiety). RESULTS Among women, prevalence of smoking was lower among Gulf, African, and Other Arabs than Levant Arabs. Among men, prevalence of obesity, diabetes, and hyperlipidemia was lower among Gulf, African, and Other Arabs than Levant Arabs, while prevalence of depression was higher for these subgroups than Levant Arabs. DISCUSSION We found substantial differences in health characteristics across Arab Americans from different geographic subgroups. Our results suggest that more detailed race and ethnicity information should be collected on Arab Americans to better understand their diverse health risks.
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20
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Albdour M, El-Masri M, Hong JS. A Descriptive Study of Bullying Victimization Among Arab American Adolescents in Southeast Michigan Middle and High Schools. J Pediatr Nurs 2020; 55:232-238. [PMID: 32966963 DOI: 10.1016/j.pedn.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE This cross-sectional study examined the frequency of different forms of bullying victimization (verbal, physical, and social), predictors of victimization, and whether bullying is reported to an adult. DESIGN AND METHODS The study utilized a community sample of 150 Arab American adolescents, age 12 to 16 years. The Adolescent Peer Relations Instrument-Victimization Scale was used to determine the participant's experiences of victimization in the past year. The adolescents indicated where bullying occurred, why, and whether they reported the incidence to an adult. RESULTS Approximately 30% of the study sample reported that victimization occurred occasionally (once a month or more frequent). Classrooms and hallways were the most common locations where bullying had occurred. Country-of-origin and obesity were the most frequent reasons for victimization. Predictors varied among the different forms of victimization; however, cyber-victimization [OR = 24.5; 95% CI 5-119.5)], perceived problematic attire [OR = 8.4; 95% CI 2.2-31.9)], female gender [OR = 5.2; 95% CI 1.2-22.7)], and being overweight [OR = 0.14; 95% CI 0.01-2.6)] all predicted overall victimization. CONCLUSIONS Our findings provide a foundation for future research focusing on Arab American adolescents, an underrepresented population, more research is needed to understand the scope of bullying victimization among Arab American adolescents. PRACTICE IMPLICATIONS This study will inform future intervention research and practice to consider victimization and related factors among Arab American adolescents. Culturally sensitive and multilevel interventions are imperative to decrease bullying victimization among Arab American adolescents and prevent negative effects on their health and families.
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Affiliation(s)
- Maha Albdour
- College of Nursing, Wayne State University, MI, USA.
| | - Maher El-Masri
- Daphne Cockwell School of Nursing, Ryerson University, Canada
| | - Jun Sung Hong
- School of Social Work, Wayne State University, MI, USA
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21
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Ayyash M, Ayyash M, Bahroloomi S, Hamade H, Makki M, Hassouneh S, Blackwood RA. Knowledge Assessment and Screening Barriers for Breast Cancer in an Arab American Community in Dearborn, Michigan. J Community Health 2020; 44:988-997. [PMID: 31055704 DOI: 10.1007/s10900-019-00671-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Breast cancer (BC) is the most common malignancy afflicting women during their lifetime. Screening for breast cancer can reduce mortality through early cancer detection. Lack of knowledge is an important barrier leading to low screening rates. Little research has evaluated breast cancer knowledge and barriers to receiving appropriate screening among Arab Americans. Given that the Arab American population has grown approximately 47% since 2000, this study was designed to assess breast cancer knowledge and screening barriers in an Arab American community. An anonymous survey addressing knowledge assessment and screening for breast cancer was distributed at the Arab Community Center for Economics and Social Services in Dearborn, MI between June 2015 and August 2017. The survey was modified based on a similar study that was conducted Among Adult Saudi women in a primary health care setting. 102 non-BC survivors, 48 BC survivors and 50 men participated in this study. Gaps in knowledge around the role of age and family history, as well as cancer presentation were noted among the participants. Additionally, 51% of non-BC survivors over the age of 40 years have not had a screening mammogram in the past 2 years with leading causes being absence of symptoms, lack of health insurance, and absence of family history. Healthcare providers and community organizations should work towards increasing knowledge levels, reducing misconceptions and improving screening rates for breast cancer among Arab Americans. Increasing community outreach and education and navigating the community's health beliefs and practices can optimize the process of information delivery to community members.
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Affiliation(s)
- Mariam Ayyash
- University of Michigan Medical School, Ann Arbor, MI, USA.,Arab American Health Initiative, Dearborn, MI, 48126, USA
| | - Marwa Ayyash
- University of Michigan Medical School, Ann Arbor, MI, USA.,Arab American Health Initiative, Dearborn, MI, 48126, USA
| | | | - Hiam Hamade
- Arab Community Center for Economics and Social Services, ACCESS, Dearborn, MI, USA
| | - Mona Makki
- Arab Community Center for Economics and Social Services, ACCESS, Dearborn, MI, USA
| | - Samar Hassouneh
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - R Alexander Blackwood
- Department of Pediatrics and Communicable Diseases, Office for Health Equity and Inclusion, University of Michigan Medical School, 1150 W. Medical Center Drive, M7330 Medical Science Building 1, Ann Arbor, MI, 48109, USA. .,Arab American Health Initiative, Dearborn, MI, 48126, USA.
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22
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El Masri D, Koscielniak N, Piatt G, DiZazzo-Miller R, Arnetz J, Jaber LA. Barriers and facilitators to perceived diabetes self-management in Arab American patients with diabetes. Prim Care Diabetes 2020; 14:232-238. [PMID: 31575470 DOI: 10.1016/j.pcd.2019.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 11/28/2022]
Abstract
AIMS To assess perceptions surrounding diabetes self-management (DSM) behaviors in Arab American patients with diabetes. METHODS A 39-item survey was constructed from focus group discussions designed to better understand the impact of Arab American culture on DSM behaviors. The survey assessed perceptions about diet, adherence to medications, exercise, healthy lifestyle, and family support. RESULTS Two hundred Arab Americans with diabetes completed the survey via face-to-face interviews. Most patients were female (59%), over fifty years of age (79%), and immigrated from Lebanon (73%). Receiving instructions in Arabic, having family support, family understanding of food choices, and employment status were found to be important predictors of the perceived importance of DSM. CONCLUSIONS Our findings suggest that there are multiple factors that dictate Arab American's perception of the importance of DSM. The survey that was constructed may serve as a valuable tool for providers to assess DSM perceptions in order to provide patient-centered care that will help to improve diabetes outcomes. This study supports the importance of integrating cultural influences into DSM education and support when providing care to a population with a strong cultural identity.
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Affiliation(s)
- Dana El Masri
- Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI, 48201, USA.
| | - Nikolas Koscielniak
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI, 48109, USA
| | - Gretchen Piatt
- Department of Learning Health Sciences, University of Michigan, 1111 E. Catherine Street, Ann Arbor, MI, 48109, USA
| | - Rosanne DiZazzo-Miller
- Department of Health Sciences, Wayne State University, 259 Mack Avenue, Suite 2212, Detroit, MI, 48201, USA
| | - Judith Arnetz
- Department of Family Medicine, Michigan State University, 788 Service Road, B103 Clinical Center, East Lansing, MI, 48824, USA
| | - Linda A Jaber
- Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2134, Detroit, MI, 48201, USA
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Ayash C, Badreddine D, Gatarny R, Wu M, Alward Z, Roberts-Eversley N, Thompson H, Gany F. Associations with the Receipt of Colon Cancer Screening Among a Diverse Sample of Arab Americans in NYC. J Immigr Minor Health 2020; 22:503-511. [PMID: 31243689 PMCID: PMC7059222 DOI: 10.1007/s10903-019-00912-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Arab Americans (AA) face increased risk for colorectal cancer (CRC), the third leading cause of cancer-related death in the US, due to low utilization of preventative care and socioeconomic disparities. This study explores associations with the receipt of CRC screening among AA in New York City. A cross-sectional survey was conducted among 100 individuals attending religious and community organizations with interviewer-administered surveys in Arabic and English. Results from 100 participants showed they were more likely to complete CRC screening with a doctor recommendation (74%) and were more likely to get a recommendation with a high school education or higher (86%). Uninsured participants and those with public insurance were the least likely to complete screening. Those with a higher mean score in Spiritual Life/Faith (13.34 vs. 11.67) were less likely to complete screening. Findings suggest the need for culturally sensitive interventions to increase CRC screening rates among AA.
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Affiliation(s)
- Claudia Ayash
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA.
| | - Dalal Badreddine
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Redwane Gatarny
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Zeinab Alward
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
| | - Haley Thompson
- Oncology Department, Wayne State University School of Medicine, Detroit, USA
- Community Outreach and Engagement at Karmanos Cancer Institute (KCI), KCI's Office of Cancer Health Equity and Community Engagement, Wayne State University School of Medicine, Detroit, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd floor, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Kader F, Bazzi L, Khoja L, Hassan F, de Leon CM. Perceived Discrimination and Mental Well-being in Arab Americans from Southeast Michigan: a Cross-Sectional Study. J Racial Ethn Health Disparities 2020; 7:436-45. [PMID: 31833009 DOI: 10.1007/s40615-019-00672-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 12/13/2022]
Abstract
There is growing evidence for the adverse health effects of structural and individual forms of discrimination in multiple religious, ethnic, and racial groups. Since the September 11, 2001 terrorist attacks, Arab Americans have experienced increasingly more frequent and visible forms of discrimination. However, the impact of these experiences on their mental well-being requires further investigation. This study examines the association between perceived discrimination and several markers of mental health and well-being, using cross-sectional data from a convenience sample of 279 Arab American adults from southeast Michigan. After adjustment for a series of relevant confounders, perceived discrimination was significantly associated with depressive symptoms (estimate 0.93, 95% CI 0.53, 1.34, p < 0.01), anxiety symptoms (estimate 0.48, 95% CI 0.19, 0.77, p < 0.01), and poor self-rated health (OR 1.31, 95% CI 1.08, 1.58, p < 0.01). The study highlights the need to address and mitigate health disparities among individuals of Arab descent and improves awareness of the potential health effects of ongoing structural and interpersonal discrimination toward this population.
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Grineski SE, W. Collins T, Rubio R. Distributional Environmental Injustices for a Minority Group without Minority Status: Arab Americans and Residential Exposure to Carcinogenic Air Pollution in the US. Int J Environ Res Public Health 2019; 16:ijerph16244899. [PMID: 31817268 PMCID: PMC6950280 DOI: 10.3390/ijerph16244899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 01/24/2023]
Abstract
Distributional environmental injustices in residential exposure to air pollution in Arab American enclaves have not been examined. We conducted our investigation at the census tract-level across the continental United States using a set of socio-demographic variables to predict cancer risk from hazardous air pollutant (HAP) exposure. Arab enclaves had a mean cancer risk score of 44.08, as compared to 40.02 in non-enclave tracts. In terms of the specific origin groups, Moroccan enclaves had the highest cancer risk score (46.93), followed by Egyptian (45.33), Iraqi (43.13), Jordanian (41.67), and Lebanese (40.65). In generalized estimating equations controlling for geographic clustering and other covariates, Arab enclaves had significantly higher cancer risks due to HAPs (p < 0.001) than non-enclaves. When looking at specific ethnic origins, Iraqi, Palestinian, and Lebanese enclaves had significantly higher cancer risks due to HAPs (all p < 0.01) than non-enclaves. Results reveal significant environmental injustices for Arab American enclaves that should be examined in future studies. Results suggest that environmental injustice may be another way in which Arab Americans are disadvantaged as a racialized minority group without minority status.
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Affiliation(s)
- Sara E. Grineski
- Department of Sociology/Environmental and Sustainability Studies, University of Utah, 480 S 1530 E, Room 0310, Salt Lake City, UT 84112, USA;
- Correspondence: ; Tel.: +801-581-6153
| | - Timothy W. Collins
- Department of Geography/Environmental and Sustainability Studies, University of Utah, 332 1400 E, Salt Lake City, UT 84112, USA;
| | - Ricardo Rubio
- Department of Sociology/Environmental and Sustainability Studies, University of Utah, 480 S 1530 E, Room 0310, Salt Lake City, UT 84112, USA;
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Wu Y, Klahm C. Self-Protection, Routine Activities, and Victimization: Studying Arab Americans in Metro-Detroit. Violence Vict 2019; 34:1030-1048. [PMID: 31836649 DOI: 10.1891/0886-6708.vv-d-16-00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite continued publicity after 9/11, knowledge on Arab Americans' experience with criminal victimization remains limited and narrowly focused. Based on face-to-face interview data collected from a random sample of residents in the Detroit metropolitan area, this study compared the prevalence and covariates of property and violent crime victimization between Arab and non-Arab Americans. The main finding was promising as Arab and non-Arab American respondents reported similar victimization risks across six crime types. Less encouraging was that Arab Americans were significantly less likely than their counterparts to use self-protective measures, which were found to have a significant risk-reduction effect regarding property crime victimization. In addition, there was a significant, negative correlation between the likelihood of moving in the next 5 years and risk of victimization. Finally, regularly carrying a large amount of cash was associated with a higher risk of violent victimization for non-Arab Americans, but not Arab Americans. Implications for future research and policy are provided.
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Affiliation(s)
- Yuning Wu
- Department of Criminal Justice, Wayne State University, Detroit, Michigan
| | - Charles Klahm
- Department of Criminal Justice, Wayne State University, Detroit, Michigan
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Read JG, Ajrouch KJ, West JS. Disparities in functional disability among Arab Americans by nativity, immigrant arrival cohort, and country of birth. SSM Popul Health 2019; 7:100325. [PMID: 30581961 PMCID: PMC6293045 DOI: 10.1016/j.ssmph.2018.100325] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 11/26/2022] Open
Abstract
This study contributes to a growing literature that documents the importance of arrival cohort and country of birth for differentiating the health of U.S. immigrants. We use nationally-representative data from nine years of the American Community Survey (2008-2016) to examine if an immigrant health advantage exists among Arab Americans ages 40+ (n = 49,867) and test if differences among the foreign-born vary by arrival cohort (pre-1991, 1991-2000, and 2001+). Results from multivariate logistic regression models find that foreign-born Arab Americans have higher odds of physical and self-care disability, and this varies by immigrant arrival cohort. The post-2001 cohort had the highest odds of both disabilities, while the earlier two cohorts did not differ from the native-born after adjustments for covariates. Compositional differences in birthplace, particularly the large influx of immigrants from Iraq in the most recent cohort, explained these differences. Political instabilities globally have contributed to a growing number of U.S. immigrants with vulnerabilities that might be overlooked when arrival cohorts are not considered.
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Affiliation(s)
- Jen’nan G. Read
- Department of Sociology, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Kristine J. Ajrouch
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, MI, USA
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Abstract
This paper establishes preliminary benchmarks by comparing average values of social relations and health among Arab Americans, Blacks and Whites. Specifically, we expand traditional racial/ethnic categories to distinguish Arab Americans, historically and legally considered White. Data come from a unique random digit dial (RDD) sample of Arab Americans (N=96), Blacks (N=102) and Whites (N=100) from metro-Detroit collected in 2011, ranging in age from 19-89. Analysis of covariance (ANCOVA) was conducted to compare health, network structure, composition and support quality. Findings established preliminary benchmarks showing that Arab Americans reported more depressive symptoms (7.6) than Whites (5.2), but no difference in physical health. Arab Americans also reported more contact frequency (4.4) than Blacks (4.1) and Whites (4.0), yet lower proportions of networks comprised of the same ethnicity (77%) compared to Blacks (96%) and Whites (97%). Unpacking the White category to identify Arab Americans in a comparative analysis identified benchmarks to show how Arab American health and social relations are distinct from Blacks and Whites, yielding unique avenues for thinking about new ways to conceptualize how race and social relations impact health disparities.
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Abuelezam NN, Fontenot HB. Depression Among Arab American and Arab Immigrant Women in the United States. Nurs Womens Health 2017; 21:395-399. [PMID: 28987212 DOI: 10.1016/j.nwh.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 06/29/2017] [Indexed: 06/07/2023]
Abstract
The difficult and tense political climate Arab populations are currently facing may be exacerbating mental health issues, reducing forms of social support in friend circles, and decreasing the desire to seek health care. There is room to better understand the mental health needs of Arab women residing in the United States and to develop policies and interventions that keep these women safe and in care. This column reviews two recent studies; the first examines barriers to reporting intimate partner violence and depression among Arab American women and the second highlights stressors and social support for Arab women immigrants throughout their immigration experience.
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Shara NM, Zeymo A, Abudiab Z, Umans JG, Abu-Bader S, Getaneh A, Howard BV. Depression, Metabolic Syndrome, and Locus of Control in Arab Americans Living in the DC Metropolitan Area: A Structural Equation Model. J Immigr Minor Health 2017; 20:902-908. [PMID: 28744602 DOI: 10.1007/s10903-017-0626-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Arab Americans have high prevalences of metabolic syndrome (MetS) and depression. Depression and external locus of control (LOC) may worsen MetS. We examined the relationship between depression and MetS with a convenience sample of 136 Arab Americans living in the Washington, DC, metropolitan area. Participants were surveyed with the Multidimensional Health Locus of Control questionnaire and the Center of Epidemiological Studies-Depression scale. Laboratory measurements were collected based on the components of MetS. A structural equation model was used to explore the relationship between MetS and depression through analysis of LOC. MetS was significantly correlated with external LOC (powerful others and chance), and depression was correlated with a weak internal LOC. Future study of the effect of LOC on health outcomes in Arab Americans may be used to mitigate MetS and depression in this population.
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Affiliation(s)
- Nawar M Shara
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA.
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA.
| | - Alexander Zeymo
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
| | - Zeid Abudiab
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
| | - Jason G Umans
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | | | - Asqual Getaneh
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
| | - Barbara V Howard
- MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
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Abstract
BACKGROUND Despite the existing knowledge on the association between discrimination and poor mental health, very few studies have explored gender differences in this association in Arab Americans. OBJECTIVE The current study aimed to investigate whether gender moderates the association between the experience of discrimination and psychological distress in a representative sample of Arab Americans in Michigan. METHODS Using data from the Detroit Arab American Study (DAAS), 2003, this study recruited Arab Americans (337 males, 385 females) living in Michigan, United States. The main independent variable was discrimination. The main outcome was psychological distress. Covariates included demographic factors (age), socioeconomic status (education, employment, and income), and immigration characteristics (nativity and years living in United States). Gender was the focal moderator. We used multivariable regression with and without discrimination × gender interaction term. RESULTS In the pooled sample, discrimination was positively associated with psychological distress [B = 0.62, 95% confidence interval (CI) = 0.22-1.03, p = 0.003]. We found a significant gender × discrimination interaction in the pooled sample (B = 0.79, 95% CI = 0.01-1.59, p = 0.050), suggesting a stronger association in males than females. In our gender-specific model, higher discrimination was associated with higher psychological distress among male (B = 0.87, 95% CI = 0.33-1.42, p = 0.002) but not female (B = 0.18, 95% CI = -0.43 to 0.78, p = 0.567) Arab Americans. CONCLUSION While discrimination is associated with poor mental health, a stronger link between discrimination and psychological symptoms may exist in male compared to female Arab Americans. While efforts should be made to universally reduce discrimination, screening for discrimination may be a more salient component of mental health care for male than female Arab Americans.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Athamneh L, Essien EJ, Sansgiry SS, Abughosh S. Intention to quit water pipe smoking among Arab Americans: Application of the theory of planned behavior. J Ethn Subst Abuse 2015; 16:80-90. [PMID: 26720395 DOI: 10.1080/15332640.2015.1088423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
In this study, we examined the effect of theory of planned behavior (TPB) constructs on the intention to quit water pipe smoking by using an observational, survey-based, cross-sectional study design with a convenient sample of Arab American adults in Houston, Texas. Multivariate logistic regression models were used to determine predictors of intention to quit water pipe smoking in the next year. A total of 340 participants completed the survey. Behavioral evaluation, normative beliefs, and motivation to comply were significant predictors of an intention to quit water pipe smoking adjusting for age, gender, income, marital status, and education. Interventions and strategies that include these constructs will assist water pipe smokers in quitting.
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Affiliation(s)
- Liqa Athamneh
- a Department of Pharmaceutical Health Outcomes and Policy , University of Houston, Texas Medical Center , Houston , Texas
| | - E James Essien
- a Department of Pharmaceutical Health Outcomes and Policy , University of Houston, Texas Medical Center , Houston , Texas.,b Department of Health Promotion and Behavioral Science, School of Public Health , The University of Texas , Houston , Texas
| | - Sujit S Sansgiry
- a Department of Pharmaceutical Health Outcomes and Policy , University of Houston, Texas Medical Center , Houston , Texas
| | - Susan Abughosh
- a Department of Pharmaceutical Health Outcomes and Policy , University of Houston, Texas Medical Center , Houston , Texas
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Dallo FJ, Kindratt TB. Disparities in Chronic Disease Prevalence Among Non-Hispanic Whites: Heterogeneity Among Foreign-Born Arab and European Americans. J Racial Ethn Health Disparities 2015; 3:590-598. [PMID: 27294751 DOI: 10.1007/s40615-015-0178-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/28/2015] [Accepted: 10/15/2015] [Indexed: 12/30/2022]
Abstract
We estimated and compared the sex- and age-adjusted prevalence of chronic diseases (diagnosis only and comorbidity) among US- and foreign-born whites from Europe and the Arab Nations and examined associations between region of birth and chronic disease. We evaluated 213,644 adults using restricted data from the National Health Interview Survey (2000-2011) by (1) chronic disease diagnosis only (heart disease, asthma, cancer, diabetes, ulcer, or obesity) and (2) comorbidity (none, diagnosis only, comorbid). We used logistic regression to examine associations between region of birth and chronic disease while controlling for confounders. Foreign-born whites from the Arab Nations had a higher prevalence of being diagnosed with ulcer (4 %) compared to US- and European-born whites (2 %). Foreign-born whites from the Arab Nations had a lower prevalence of comorbid cancer (1 %) and ulcer (3 %) yet had higher estimates of comorbid heart disease (18 %), asthma (5 %), and obesity (13 %) when compared to European-born whites (all ps < 0.05). Arab Americans had the highest prevalence of comorbid diabetes (8 %) compared to both European- (5 %) and US-born whites (6 %). In multivariate logistic regression models, Arab Americans had a lower odds of reporting cancer, heart disease, and asthma before and after controlling for covariates. Our study builds on existing literature for Arab Americans as the first study evaluating chronic disease prevalence among foreign-born whites from countries in the Arab League of Nations geographically located in the Middle East. Methodologically robust studies are needed to better understand the influence of acculturation, country of origin, and other characteristics influencing health among foreign-born whites.
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Affiliation(s)
- Florence J Dallo
- Wellness, Health Promotion and Injury Prevention, Oakland University, 3148 Human Health Building, Rochester, MI, 48309-4428, USA.
| | - Tiffany B Kindratt
- Department of Physician Assistant Studies, University of Texas Southwestern Medical Center, 6011 Harry Hines Blvd., Suite V4.114, Dallas, TX, 75390-9090, USA
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El-Shahawy O, Haddad L. Correlation between nicotine dependence and barriers to cessation between exclusive cigarette smokers and dual (water pipe) smokers among Arab Americans. Subst Abuse Rehabil 2015; 6:25-32. [PMID: 25674035 PMCID: PMC4321602 DOI: 10.2147/sar.s72360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Evidence suggests that dual cigarette and water pipe use is growing among minority groups, particularly among Arab Americans. Differences in nicotine dependence and barriers to smoking cessation among such dual smokers have not been previously examined in this population. We examined potential differences that might exist between exclusive cigarette smokers and dual smokers (cigarette and water pipe) pertaining to nicotine dependence and barriers to cessation among Arab Americans. Methods We conducted a cross-sectional study using a convenience sample of self-identified Arab immigrant smokers (n=131) living in the Richmond, VA metropolitan area. Data were collected using four questionnaires: Demographic and Cultural Information questionnaire, Tobacco Use questionnaire, Fagerström Test for Nicotine Dependence (FTND) questionnaire, and Barriers to Cessation questionnaire. We examined differences in nicotine dependence and barriers to cessation between exclusive cigarette smokers and dual smokers of cigarettes and water pipe. Furthermore, we explored the correlations of these measures with select variables. Results There was a significant difference in the FTND scores between the exclusive cigarette smokers (mean M=2.55, standard deviation [SD] =2.10) and dual smokers (M=3.71, SD =2.42); t(129) = (2.51), P=0.0066. There was also a significant difference in the Barriers to Cessation scores between exclusive cigarette smokers (M=38.47, SD =13.07) and dual smokers (M=45.21, SD =9.27); t(129) = (2.56), P=0.0058. Furthermore, there was a highly significant correlation among FTND scores, Barriers to Cessation scores, and past quit attempts among dual smokers. Conclusion Water pipe tobacco smoking seems to be both adding to the dependence potential of cigarette smoking and enhancing barriers to cessation in our study sample. However, the high correlation between quit attempts, FTND, and barriers to cessation needs further investigation to ascertain the possible reasons behind it. This preliminary study utilized a cross-sectional survey among participants of a rather small convenience sample, especially in the dual smokers group. Thus, there is a need to examine these differences via a longitudinal design in a larger sample.
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Affiliation(s)
- Omar El-Shahawy
- Department of Social and Behavioral Health, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Linda Haddad
- College of Nursing, University of Florida, Gainesville, FL, USA
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Kira IA, Lewandowski L, Ashby JS, Templin T, Ramaswamy V, Mohanesh J. The Traumatogenic Dynamics of Internalized Stigma of Mental Illness Among Arab American, Muslim, and Refugee Clients. J Am Psychiatr Nurses Assoc 2014; 20:250-266. [PMID: 24994879 DOI: 10.1177/1078390314542873] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Understanding the dynamics of mental health stigma through existing frameworks, especially in minorities with higher stigma, is problematic. There is a need to reconceptualize stigma, particularly in highly traumatized groups. The current study examines the validity of a new development-based trauma framework that conceptualizes stigma as a type III chronic trauma that contributes to negative mental health effects. This framework proposes that public stigma is a unique chronic traumatic stress that mediates the effects of similar trauma types in mental health patients. To test this proposition, this study explores the relationships between internalized stigma of mental illness (ISMI), different trauma types, and posttrauma spectrum disorders. ISMI, posttraumatic stress disorder, other posttrauma spectrum disorders, and cumulative trauma measures were administered to a sample of 399 mental health patients that included Arab (82%), Muslim (84%), and refugee (31%), as well as American patients (18%). Age in the sample ranged from 18 to 76 years (M = 39.66, SD = 11.45), with 53.5% males. Hierarchical multiple regression, t tests, and path analyses were conducted. Results indicated that ISMI predicted posttraumatic stress disorder and other posttrauma spectrum disorders after controlling for cumulative trauma. ISMI was associated with other chronic collective identity traumas. While Arab Americans, Muslims, and refugees had higher ISMI scores than other Americans, the elevated chronic trauma levels of these groups were significant predictors of these differences. The results provide evidence to support ISMI traumatology model. Implications of the results for treating victims of ISMI, especially Arab Americans, Muslims and refugees are discussed.
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Affiliation(s)
- Ibrahim A Kira
- Ibrahim A. Kira, PhD, Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
| | - Linda Lewandowski
- Linda Lewandowski, PhD, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jeffrey S Ashby
- Jeffrey Ashby, PhD, Georgia State University, Atlanta, GA, USA
| | - Thomas Templin
- Thomas Templin, PhD, Wayne State University, Detroit, MI, USA
| | - Vidya Ramaswamy
- Vidya Ramaswamy, PhD, University of Michigan, Ann Arbor, MI, USA
| | - Jamal Mohanesh
- Jamal Mohanesh, MA, ACCESS Community Health and Research Center, Dearborn, MI, USA
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Tailakh AK, Evangelista LS, Morisky DE, Mentes JC, Pike NA, Phillips LR. Acculturation, Medication Adherence, Lifestyle Behaviors, and Blood Pressure Control Among Arab Americans. J Transcult Nurs 2014; 27:57-64. [PMID: 24848347 DOI: 10.1177/1043659614526456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The aim of this study was to examine the relationship between acculturation, medication adherence, lifestyle behaviors (e.g., physical activity, nutrition, weight control), and blood pressure control among hypertensive Arab Americans. DESIGN The study utilized a cross-sectional descriptive design. A convenience sample of 126 participants completed questionnaires and had measures of blood pressure, weight, and height. Forty-six participants were hypertensive and were included in the analysis. RESULTS Only 29.2% of participants reported high medication adherence. High medication adherence was associated with lower diastolic blood pressure, eating a healthy diet, and following lifestyle modifications. Acculturation was significantly associated with physical activity and body mass index. CONCLUSION Our study found that acculturated participants were more adherent to medications and physical activity and had better blood pressure control. Further studies are needed to explore how acculturation improves adherence and what factors contribute to better adherence in order to design culturally sensitive interventions.
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Qumseya BJ, Tayem YI, Dasa OY, Nahhal KW, Abu-Limon IM, Hmidat AM, Al-Shareif AF, Hamadneh MK, Riegert-Johnson DL, Wallace MB. Barriers to colorectal cancer screening in Palestine: a national study in a medically underserved population. Clin Gastroenterol Hepatol 2014; 12:463-9. [PMID: 24055899 DOI: 10.1016/j.cgh.2013.08.051] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 08/22/2013] [Accepted: 08/23/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Cultural, religious, and financial barriers can hinder uptake of colorectal cancer (CRC) screening in Arab communities. We aim to understand attitudes and barriers that contribute to the low rate of CRC screening among Palestinians in the West Bank. METHODS We performed a national, cross-sectional study of Palestinian adults older than 50 years. A self-administered questionnaire was developed and validated. Data were randomly collected in all major districts of the West Bank. The primary outcome was the willingness to undergo CRC screening. Multivariable logistic regression models were used to assess the strength of association between the primary outcome and its predictors while controlling for possible confounders. RESULTS Of 1601 people approached for an interview, 1352 agreed to participate (response rate, 84%). Only 193 had undergone CRC screening (14%); 1069 (79%) agreed to take a fecal occult blood test, 906 (67%) agreed to a colonoscopy examination, and 1098 (81%) were willing to undergo CRC screening if recommended by a physician. Only 194 (14%) said they had been informed about CRC screening by a physician. Urban residents were more likely to be screened for CRC than nonurban residents (odds ratio, 0.73; 95% confidence interval, 0.56-0.93; P = .011). Multivariable analysis showed that lack of education beyond elementary school or familiarity with CRC screening, distrust of Western medicine, religious objection, and finding the test to be embarrassing were all associated with decreased odds of accepting CRC screening. CONCLUSIONS Based on a national, cross-sectional study of Palestinian adults, there are many cultural and religious barriers to CRC screening. Improving our understanding of these could increase screening among Arab populations in the Middle East and in Western countries.
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Affiliation(s)
- Bashar J Qumseya
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | | | | | | | | | | | | | | | | | - Michael B Wallace
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
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Ezenkwele UA, Roodsari GS. Cultural competencies in emergency medicine: caring for Muslim-American patients from the Middle East. J Emerg Med 2013; 45:168-74. [PMID: 23478182 DOI: 10.1016/j.jemermed.2012.11.077] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 10/27/2012] [Accepted: 11/18/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cultural competency is crucial to the delivery of optimal medical care. In Emergency Medicine, overcoming cultural barriers is even more important because patients might use the Emergency Department (ED) as their first choice for health care. At least 2.2 million Muslims from Middle Eastern background live in the United States. OBJECTIVE We wanted to create a succinct guideline for Emergency care providers to overcome cultural barriers in delivering care for this unique population. METHOD A compensative search on medical and health databases was performed and all the articles related to providing healthcare for Muslim-Americans were reviewed. RESULT The important cultural factors that impact Emergency care delivery to this population include norms of modesty; gender role; the concept of God's will and its role in health, family structure, prohibition of premarital and extramarital sex; Islamic rituals of praying and fasting; Islamic dietary codes; and rules related to religious cleanliness. CONCLUSIONS The Muslim-American community is a fast-growing, under-studied population. Cultural awareness is essential for optimal delivery of health care to this minority. We have created a succinct guideline that can be used by Emergency Care providers to overcome cultural barriers. However, it is important to consider the heterogeneity and diversity of this population and to use this guideline on an individual basis.
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Affiliation(s)
- Ugo A Ezenkwele
- Woodhull Medical and Mental Health Center, New York University School of Medicine, Brooklyn, New York 11206, USA
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