Journal of Immigrant and Minority Health最新文献

In the United States, it is estimated that 15% of Latinos will experience a depressive or anxiety disorder during their lifetime. Education, prevention programming, and health interventions around topics such as stress, nutrition, mental health, and health maintenance for Latino immigrants are lacking, inadequate, or nonexistent. This type of programming may be protective against depression and anxiety. A total of 19 Latina women completed a five-week, group-based intervention to learn about stress, stress management, nutrition, mental health, and healthy behaviors in a culturally sensitive environment taught by native Spanish speakers. Program evaluation occurred through in-depth interviews and changes in anxiety and depression scores via the Generalized Anxiety Scale and the Patient Health Questionnaire, respectively. The team saw statistically significant decreases in the GAD-7 scores pre- and post-intervention (8.00 versus 5.08, p<0.05), but no differences in the PSS or the PHQ-2 scores. Group-based intervention and education taught by native Spanish speakers may be an acceptable and feasible approach to addressing anxiety in Latina immigrants.

To analyze stigma related to depression, beliefs about psychotropics, and associated factors in a population of Japanese ancestry in Brazil. This cross-sectional study was conducted between March and June, 2022. Beliefs about psychotropics (BMQ-specific) and depression-related stigma (The Stigma Scale) were collected through an online questionnaire. Multiple linear regression analysis was performed to identify the factors associated with these dependent variables. Ninety-three respondents of Japanese ancestry completed the questionnaire. Participants were more focused on the necessity of the prescribed psychotropics than on possible adverse effects. Married individuals (β=-4.68 [95%CI -8.74, -0.63]; p = 0.024) were less concerned with their psychotropics than single individuals, while those undergoing treatment for longer years (β = 6.23 [95%CI 1.35, 11.11]; p = 0.013) perceive a greater necessity for treatment than those who started it recently. In addition, older individuals perceived less necessity for treatment (β=-5.83 [95%CI -10.76, -0.90]; p = 0.021) than younger individuals. Unemployed people (β = 12.09 [95%CI 0.47, 23.70]; p = 0.042) perceived more depression-related stigma than those employed. Aspects of Japanese cultural heritage related to depression and its treatment are still prevalent among people of Japanese ancestry in Brazil. Factors such as age, treatment duration, and marital status affects the perception of beliefs about psychotropics, whereas occupation affects the perception of stigma.

We investigated the associations between sociodemographic factors, religiosity traits, and the perception of discrimination among Muslim Americans in both everyday life and medical settings. A self-administered web-based questionnaire, comprising validated measures of discrimination and religiosity, was completed by a convenience sample of English-speaking adult Muslim Americans, recruited through both in-person and online channels. Among the 1281 respondents, less than half were born in the USA (46%), and a significant portion displayed visible religious markers, such as wearing a hijab or having a beard (61%). Only 154 (12%) reported never experiencing everyday discrimination, while 358 (28%) reported not experiencing discrimination in medical settings. In a multivariable linear regression model, greater perceived everyday discrimination (β = 1.053, p < 0.01) was positively associated with greater discrimination in medical settings. Participants more comfortable self-identifying as Muslim in hospital settings (β = -0.395, p < 0.05) were less likely to perceive healthcare discrimination. Those visibly expressing their religiosity (β = 0.779, p < 0.01) and those with greater intrinsic religiosity (β = 0.231, p < 0.05) were more likely to encounter everyday discrimination. Conversely, older participants (β = -0.015, p < 0.05), adult immigrants to the US (β = -0.375, p < 0.05), those in better health (β = -0.157, p < 0.05), and those more comfortable identifying as Muslim (β = -0.305, p < 0.05) had lower perceptions of everyday discrimination. This study underscores the significance of the relationship between religiosity characteristics and experiences of both hospital and everyday discrimination for Muslim Americans.

Individuals living with cancer and survivors of cancer who self-identify as Hispanic experience higher pain burden and greater barriers to pain management compared with their non-Hispanic counterparts. The Society for Integrative Oncology-ASCO guideline recommends acupuncture and massage for cancer pain management. However, Hispanic individuals' expectations about these modalities remain under-studied and highlight a potential barrier to treatment utilization in this population. We conducted a subgroup analysis of baseline data from two randomized clinical trials to evaluate ethnic differences in treatment expectations about integrative pain treatment modalities among Hispanic and non-Hispanic cancer patients and survivors of cancer. The Mao Expectancy of Treatment Effects (METE) instrument was used to measure treatment expectancy for electro-acupuncture, auricular acupuncture, and massage therapy. Results of this study demonstrated that Hispanic participants reported greater expectation of benefit from electroacupuncture, auricular acupuncture, and massage (all P < 0.01). After controlling for age, gender, race, and education, Hispanic ethnicity remained significantly associated with greater expectation of benefit from integrative therapies for pain (coef.=1.47, 95% CI, 0.67-2.27). Non-white race (coef.=1.04, 95% CI, 0.42-1.65), no college education (coef.=1.16, 95% CI, 0.59-1.74), and female gender (coef.=0.94, 95% CI, 0.38-1.50) were also associated with a greater expectation of benefit from integrative therapies. Pain management should be informed by a shared decision-making approach that aligns treatment expectancy with treatment selections to optimize outcomes. Compared with non-Hispanic participants, Hispanic individuals reported higher expectation of benefit from acupuncture and massage, highlighting the potential role for integrative therapies in addressing ethnic pain disparities. Trial Registration NCT02979574 NCT04095234.

An estimated 7.7 million Venezuelans have fled a severe humanitarian crisis in their country, most (70%) to other middle-income host countries in the same Andean region. Migration-related exposures during periconception and other critical gestational periods can adversely impact maternal-perinatal outcomes. Emerging evidence suggests that Venezuelan refugee and migrant women (VRMW) who migrate to Andean host countries are at-risk for delivering preterm and low birthweight infants and for Cesarean-sections. However, relatively few studies have examined obstetrical complications that could contribute to these or other short- and longer-term health outcomes of VRMW and/or their offspring. Our exploratory study analyzed four recent years of national hospital discharge data (2018-2021) from Ecuador to compare the primary discharge diagnoses of VRMW (n = 29,005) and Ecuadorian nationals (n = 1,136,796) for ICD-10 O code obstetrical complications related to or aggravated by pregnancy, childbirth, or the puerperium. Our findings indicated that VRMW were hospitalized for 0.5 days longer than Ecuadorian reference group women and they had higher adjusted odds (aOR) for a primary discharge diagnosis for obstetrical complications including preeclampsia (aOR:1.62, 95% CI:1.55,1.69), preterm labor (aOR:1.20, 95% CI:1.11,1.31), premature rupture of membranes (aOR: 1.72, 95% CI:1.63,1.83), oligohydraminos (aOR:1.24, 95% CI:1.12,1.36), obstructed labor (aOR: 1.39, 95% CI:1.31,1.47), perineal lacerations/other obstetric trauma (aOR:1.76, 95% CI:1.63, 1.91), STIs (aOR:2.59, 95% CI:1.29,2.92), anemia (aOR:1.33, 95% CI:1.24,1.42), and ectopic pregnancy (aOR:1.16 95% CI:1.04,1.28). They had similar aOR for diagnosed gestational diabetes and spontaneous abortion (SAB) compared to the reference group but a reduced aOR for genitourinary infections (aOR:0.79, 95% CI:0.74,0.84) and early pregnancy hemorrhage not ending in SAB (aOR:0.43, 95% CI:0.36,0.51). Our findings underscore the vulnerability of VRMW for a number of potentially serious obstetrical complications with the potential to adversely impact the short- and longer-term health of mothers and their offspring. Future studies should collect more detailed information on the migration status, experiences, and exposures of MRMW that influence their risk for obstetrical complications. These are needed to expand our findings to better understand why they have excess risk for these and to inform social and public health policies, programs and targeted interventions aimed at reducing the risk of this vulnerable refugee and migrant group.

Systemic health barriers, economic challenges, and lack of follow-up care exacerbate self-management of chronic diseases like diabetes among Hispanic agricultural workers. The primary objective of this pilot project was to determine the benefit of using community coaches to decrease A1C levels and increase diabetes knowledge among agricultural workers with diagnosed diabetes in the Texas Panhandle. A longitudinal study design with two phases was used to create, deliver, and evaluate a diabetes coaching program. Phase 1 was the development of the program and community coaches training (n = 4). In Phase 2, the coaches then delivered the program over 12 weeks to thirteen clients. Phase 1: All coaches were Hispanic females, 28.3 (SD 3.8) years of age, half had at most a high school education level and the other half had a vocational certification (n = 4). Mean DKQ-24 score was 54.2% (SD = 29.7) at baseline and 75.0% (SD = 31.4) after training (t (4) = 4.6, P < 0.05). We observed a very large difference between mean baseline and exit DKQ-24 scores relative to the pooled standard deviation, resulting in an effect size estimate of 0.59 indicative of a medium to large learning effect. Phase 2: Clients were Hispanic Spanish-speaking, predominantly female (55%), 44.4 (SD 6.8) years of age with at most a high school level of education (88.9%) and occupations varied from dairy farm worker (33.3%), meat processing worker (33.3%), and other agriculture or manufacturing position (33.3%). The mean SKILLD score was 40.0% (SD = 28.7) at baseline, increasing to 72.2% (SD = 25.4) at 12 weeks upon completion of the coaching program (t (9) = 2.956, P < 0.05). We observed a very large difference between mean baseline and exit SKILLD scores relative to the pooled standard deviation, resulting in an effect size estimate of 1.13 indicative of a large learning effect. The mean A1C levels at baseline screening was 8.3% (SD = 3.0) and 7.6% (SD = 3.0) at exit screening, representing a 0.7% decrease (p = 0.4730). No statistically significant differences were observed between depression (p = 0.786) or anxiety (p = 1.000) measures at baseline compared to exit. Training and coaching programs for hard-to-reach agricultural and meat processing workers must be culturally, linguistically, and literacy appropriate for both coaches and clients. The program must be feasible and sustainable, focus on empowering community members, capitalize on technological advances and persisting new-normals from the COVID-19 pandemic as well as dismantle common systemic barriers to health and understanding lived-experiences of agricultural working populations in rural regions.

This study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019-2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.

This study aimed to conduct a cross-sectional questionnaire survey of foreign patients to analyze the impact of patients' illness perceptions on their need for professional medical interpreters. From February 2022 to May 2023, an online questionnaire was distributed to 4,962 individuals aged 18 years or older who were non-native speakers of Japanese. These individuals were enrolled in organizations such as international exchange associations and Japanese language support classes and had utilized medical institutions in Japan due to their own illness or injury or that of their children. Among the 312 valid responses, international patients with a high score for illness perception were more likely to want to utilize professional medical interpreters than those with a low score for illness perception (odds ratio, 1.968; 95% confidence interval, 1.044-3.709; P = 0.036). Our findings suggest that hospitals should be better prepared to meet the potential language needs of international patients with a higher illness perception.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease. We aimed to investigate the potential similarities and differences regarding the disease among Arabs and Jews. Retrospective study included all patients older than 18 years with NAFLD diagnosis according to ICD-10 codes. Data regarding demographics, comorbidities, and outcomes were retrieved using the MdClone platform from "Clalit" in Israel. Data concerning 34,090 Arab patients and 173,500 Jewish patients with NAFLD were included. Arab patients were significantly younger at diagnosis (35.0 ± 13 years vs. 43.6 ± 15 years, p < 0.001) and had higher rates of obesity and diabetes mellitus (69.5% vs. 56.5% and 27.0% vs. 22.7%, p < 0.001, respectively). Arab patients had higher rates of cirrhosis and portal hypertension-related complications (2.5% vs. 2.0%, p < 0.001), esophageal varices (0.9% vs. 0.5%, p < 0.001), spontaneous bacterial peritonitis (0.3% vs. 0.1%, p < 0.001), and hepatorenal syndrome (0.3% vs. 0.1%, p < 0.001). There was no significant difference in the prevalence of hepatocellular carcinoma between study groups (0.4% vs. 0.5%, p = 0.156). Liver transplantation was performed in 0.2% of Arab NAFLD patients compared to 0.07% of Jewish NAFLD patients (p < 0.001). Lower rates of all-cause mortality were found among the Arab NAFLD patients versus Jewish NAFLD patients (7.7% versus 11.5%, p < 0.001). According to the Cox regression model, Arab ethnicity is a risk factor for death with OR of 1.36. Significant differences regarding comorbidities, complications, liver transplantations rates, and all-cause mortality were found among NAFLD patients of different ethnicities, hence specific population need specific consideration in prevention, early diagnosis and follow up.

The health of refugees has been widely documented, as has the impact of a range of factors throughout the migration journey from being exposed to violence to the impacts of immigration detention. This study adds to our understanding of health-related quality of life amongst refugees and asylum seekers by evaluating health-related quality of life as measured by the Short-Form 36 (SF-36) Health Survey using meta-analysis. The aims of this study were to (1) provide a summary and overview of health-related quality of life (as measured by the SF-36), including the extent to which this varies and (2) explore the factors that influence health-related quality of life (as measured by the SF-36) amongst refugees and asylum seekers. A search was undertaken of MEDLINE, CINAHL, PSYCINFO and SCOPUS, returning 3965 results. Papers were included if they sampled refugees (or asylum seeker or those with refugee-like experiences) and used the SF-36 (or its variants) as an outcome measure. Mean scores and standard deviations were pooled using a random effects model. The pooled sample size was 18,418. The pooled mean scores for the SF-36 physical summary measures was 54.99 (95% CI 46.01-63.99), while the mental health summary measure was 52.39 (95% CI 43.35-61.43). The pooled mean scores for each of the sub-scales ranged from 49.6 (vitality) to 65.54 (physical functioning). High heterogeneity was found between both summary measures and all sub-scales. In comparison to SF-36 results from general populations in high and middle income countries, these results suggest that refugee quality of life is generally poorer. However, this varied substantially between studies. One issue that is not well clarified by this review are the factors that contributed to health-related quality of life.