Journal of Immigrant and Minority Health最新文献

Immigrants intended to more rely on self-medication because of the difficulty of accessing formal healthcare in host countries. Negative consequences could occur when self-medication was inappropriate. This study aimed to systematically explore the prevalence, sources and determinants of immigrants' self-medication and the extent of their inappropriate self-medication episodes. PubMed, Scopus, SpringerLink, and ScienceDirect were used for data searching. The search date was 10th June 2023, with no beginning date to limit searching articles. Thirty-two studies were included. The prevalence of immigrants' self-medication presented from 18 studies ranged between 20.2% and 94.6%. Major sources of immigrants' self-medication were commonly obtained from their home countries, local markets or shops, and informal networks. The determinants of immigrants' self-medication were systematically collated into four themes: (1) illness and self-medication perception, (2) access to healthcare and medication, including 6 dimensions: accessibility, availability, affordability, acceptability, awareness and accommodation, (3) worry, and (4) predisposing factors of immigrants. About 46% of immigrant's self-medication episodes were inappropriate, especially antibiotic use. About 66% of the included studies described antibiotic self-medication. Prevalence rates of self-medication among different immigrantsvaried based on different time frames, context of diseases and migrated countries. Immigrants' cultural health belief, facing significant worry about job security, legal status, and cultural barriers influenced their self-medication. When immigrants have greater availability, accommodation, awareness, accessibility, acceptability, and affordability of health services in host countries, they are less likely to use self-medication. The predisposing factors like age, income, work status and immigrants' language also influenced their self-medication.

Contraceptive use is the most effective means of preventing unintended pregnancies among sexually active individuals. Foreign-born women are less likely to use contraception when compared to US-born women. However, there are limited studies focused on understanding factors that influence contraceptive use among foreign-born women in the US. This study aimed to explore the factors associated with contraceptive use in the early reproductive lives of foreign-born women in the US. This study utilized the 2017-2019 National Survey on Family Growth to conduct a cross-sectional secondary data analysis. Analyses were restricted to observations from 708 women who identified as foreign-born, were aged 15-49 years, and provided information about their first pregnancies. Chi-square tests and multivariable logistic regression were used to assess the factors influencing contraceptive use. 70.9% of the participants had used a form of contraception in the period leading to their first pregnancy. Multivariable regression analysis identified significant predictors of contraceptive use: educational level, age, religion, income levels, health insurance, and race/ethnicity. Those with a religious affiliation and were 25 years and above had greater odds of contraceptive use while non-Hispanic blacks and non-Hispanic other/multiple race participants had lower odds of contraceptive use. Based on the predictors identified, public health interventions should be tailored to address specific socio-demographic factors that influence contraceptive decisionmaking among foreign-born women in the US. Additionally, understanding the disparities in contraceptive use across racial/ethnic backgrounds underscores the need for culturally sensitive approaches that acknowledge and respect diverse beliefs surrounding contraception.

U.S. immigrant parents encounter various challenges during the migration and resettlement process, such as acculturative stress and dissonance in parenting practices between the cultures in the U.S. and those in their country of origin. Although studies have established a link between increased perceived stress and reduced parenting self-efficacy in U.S.-born parents, which could be alleviated by levels of parental empowerment, little is known about this pathway in the context of migration. Guided by the Family Adjustment and Adaptation Response Model and with a focus on low-income immigrant parents of young children, we examined (1) the association between perceived stress and parenting self-efficacy, and (2) whether parental empowerment constitutes a buffer between perceived stress and parenting self-efficacy. Participants included foreign-born, low-income parents (n = 680) with preschool-aged children enrolled in Head Start of Greater Boston. Linear regression models were conducted to examine the relationship between perceived stress and parenting self-efficacy. An interaction term between perceived stress and empowerment was included to test the moderating effect of each dimension of parental empowerment (i.e., resource empowerment, critical awareness, and relational empowerment). Results showed higher perceived stress was associated with lower parenting self-efficacy and this relationship was moderated by relational empowerment. Findings suggest that relational empowerment can be an important resource for immigrant parents with high stress and a protective factor to improve self-efficacy in their parenting. These results pose important implications regarding how healthcare professionals and clinicians may support parents, for example, through the development of culturally sensitive parenting interventions and the creation of safe environments for parent-to-parent relationships.

The lack of health insurance coverage is one of the most serious challenges confronting refugees and an important public policy issue. This study examines how refugees' human and social capital is linked to their health insurance coverage. This study uses the 2020 Annual Survey of Refugees public use data file to test the relationship between refugees' human and social capital and their health insurance coverage. 770 refugees who entered the U.S. between 2015 and 2019 are included in the sample. Health insurance coverage is measured in three different levels: no coverage at all, coverage with a gap, and coverage all year long. This study employs an ordered probit regression. The findings show that refugees' human capital, regardless of whether it is from refugees' home country or the U.S., is not associated with health insurance coverage. However, refugees' social capital, in terms of their involvement in religious organizations and their informal bridging network with people from a different culture, is positively associated with coverage. The analysis also reveals a gap in coverage once the initial government assistance ends, and refugees' paid employment and household income are negatively associated with health insurance coverage. The findings suggest that refugees' social capital in the new country plays an important role in obtaining the necessary information for healthcare access while the positive impacts of human capital on healthcare access may not apply to the refugee population. Therefore, resettlement programs should place an emphasis on helping refugees build and enhance social connections with people of diverse cultural backgrounds.

A growing body of evidence suggests that leisure-time physical activity (LTPA) impacts one's mental health (MH) positively. The suggested MH benefits of LTPA may present a promising avenue to promote the MH of immigrants/refugees, who often face various stressors that may impede their MH. The CAN-HEAL study aimed to examine LTPA needs as they pertain to MH among Arab Canadians. The study adopted a collaborative community-based participatory research and integrated knowledge translation approach. Three methods were triangulated: qualitative interviews, Photovoice and a quantitative survey. A combination of sampling strategies (convenience, purposive and snowball) was utilized to recruit 60 socio-demographically diverse Arab Canadian participants. The study was informed by an integrated bio-psycho-socio-cultural framework. Although participants were knowledgeable of recommendations and MH benefits of LTPA, a high prevalence of physical inactivity (87%) was found. Intersections between age, gender, socio-economic and employment status, length of residency, and immigration status were associated with substantial LTPA inequities and negative MH within Arab communities. Older adults and low-income participants reported significantly lower LTPA levels than younger adults and those with higher income. Female participants reported lower LTPA levels than their male counterparts. Study findings demonstrate that the LTPA-MH relationship among Arab Canadians is multi-faceted, with various LTPA-related bio-psycho-socio-cultural pathways/mechanisms influencing Arab Canadians' MH. Intersectoral collaboration is required to implement a co-created community- and political-level action plan to address LTPA inequities and achieve health equity for Arab Canadians and other similar vulnerable groups.

Underserved communities were disproportionately affected during the coronavirus (COVID-19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language. The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status. A cross-sectional study examined parturient patients admitted to an urban safety-net hospital from May 2020 to May 2022 who were tested for SARS-CoV-2on admission. Percentages and prevalence ratios of SARS-CoV-2 between refugee status, insurance type, vaccination status, and race/ethnicity were calculated across four time periods, corresponding with variant surges of the pandemic. 3,502 patients delivered, 476 (13.6%) were refugees. Self-pay (46.4%) and Medicaid (46.4%) were the most frequent insurance types with a Hispanic predominance (64.5%) by race/ethnicity. Only 12.8% of patients received at least one vaccine before delivery: 13.2% in non-refugees versus 10.3% refugees 192 (5.5%) of the mothers tested positive during the study period with 6.1% refugees positive versus 5.4% among non-refugees, (prevalence ratio, 1.13; P = 0.53, 95% confidence interval [0.77, 1.66]). Positive tests ranged between 4.7% and 6.3% across insurance types and between 4.4% and 7.5% across race/ethnicity categories. The highest prevalence ratio (refugee/non-refugee) of 2.01 was during the Delta Surge (P = 0.12, 95% confidence interval [0.84, 4.82]) and the lowest prevalence ratio of 0.64 was during the Omicron Surge (P = 0.21, 95% CI [0.32, 1.30]). Among refugees when examined by primary language, 51.7% of positive tests were from those speaking languages of the African Great Lakes region (Kinyarwanda, Kirundi, Swahili, Kiswahili). We observed only small differences in SARS-CoV-2 prevalence between refugees and non-refugees or in vaccination status. Variations in prevalence ratio were seen by refugee status by variant surge. Subsets of the refugee population, when grouped by language/region, appeared to be more affected. This warrants future research on the impact of the SARS-CoV-2 pandemic on specific refugee communities, rather than refugee communities as a heterogenous unit.

One Midwest, non-profit clinic aimed to increase access to contraceptive services by improving their care delivery process through the implementation of a population-specific, contraception education program. The program included patient education, timely follow-up appointments, and free contraception. In this quality improvement project, a total of twenty-two mostly Spanish-speaking women signed up for a group education session that lasted thirty minutes and was offered monthly. The session was led by a female, bilingual provider and focused on contraception benefits, side effects, and common myths. After the session, the clinic offered same-day initiation of contraception for oral contraceptives, Depo-Provera injections, and Nexplanon implants. In this clinic, offering the class in conjunction with immediate initiation of the chosen birth control method decreased the average time to care delivery, showing a positive impact on access to these essential services.

The purpose of this study was to evaluate Chaldean American perspectives towards legalization and moral acceptability of recreational and medicinal marijuana in the state of Michigan. An online survey was created and distributed through various social media groups, churches, and Chaldean organizations which resulted in a total of 637 respondents following the removal of respondents who did not meet criteria. The survey was open from March 20th, 2022 to April 20th, 2022. The independent variable was level of religiosity. The dependent variables were moral acceptability, opinion towards legalization of recreational and medicinal marijuana, and risk of cannabis use disorder. Logistic regression was used to estimate the strength of the association between the independent and dependent variables. Approximately 64% of the sample was female and 54.6% were between the ages of 21 to 29. Almost 80% of respondents reported high religiosity and 83.4% strongly or somewhat supported the legalization of medicinal marijuana. In addition, 85.8% felt medicinal marijuana was morally acceptable and 58.9% believed recreational marijuana was morally wrong. In the fully adjusted models, individuals who reported high religiosity (compared to low/moderate) were more likely to oppose legalization of recreational marijuana (OR = 2.80; 95% CI = 1.46, 5.39) and believed that marijuana was morally wrong (OR = 2.36; 95% CI = 1.16, 4.78). This trend was not observed with medicinal marijuana. These findings have important implications in better understanding a traditionally conservative ethnic minority group in their attitudes towards marijuana and how religion influences their perspectives. Additional studies are needed to examine any changes in opinion overtime as this is the first study of its kind.

Familism is a multidimensional construct that includes familial support. However, limited research examines whether the sub-components of familism equally contribute to mental health and whether familism protects against depression beyond social support. To address these gaps, we test associations between the multidimensional components of familism (familial support, familial obligations, family as referents) and social support with depressive symptoms among immigrant Dominican women in New York City. We tested associations between the multidimensional components of familism, specifically, familial support, familial obligations, and family as referents (Sabogal et al., 1987), as well as social support, with depressive symptoms among 419 women. Multiple regression analysis indicated that whereas familial support predicted decreases in depressive symptoms (β = - 0.15), family obligations, and family as referents did not. However, only social support predicted decreased depressive symptoms (β= - 0.18) when accounting for covariates and familism subscales. Controlling for covariates, age predicted decreased depressive symptoms (β = - 0.19), whereas self-rated poor health exhibited the inverse effect (β = 0.17). These findings highlight the need for a nuanced understanding of familism, social support, and the association of cultural and demographic values on Latina mental health. These results illustrate the need for further analysis of social support and the multiple components of the familism construct.

Improving communication between American Indian caregivers and their youth has been suggested as an Indigenous-forward strategy to help alleviate the sexual and reproductive health (SRH) disparities faced by American Indian youth as a result of the legacy of colonial violence against American Indian communities. Studies with non-American Indian and American Indian populations suggest that effective communication about SRH between parents and youth plays a role in reducing sexual risk behaviors among youth. There is limited research that examines youth sexual risk behaviors in relation to communication patterns separately assessed in caregivers and youth. The current study aimed to examine the association between caregiver-youth communication patterns and engagement in sex, age at sexual debut, and condom use among American Indian youth in the United States. The study draws on baseline caregiver and youth data collected from Nen ŨnkUmbi/EdaHiYedo, a stepped wedge design trial with American Indian youth living on the Fort Peck Reservation in Montana. 113 caregiver responses were matched to 145 youth for the current study. Caregiver-youth communication patterns were examined in relation to youth engagement in sex, age at sexual debut, and number of protected acts of vaginal and/or anal sex. Multivariable models were used to adjust for confounders and to examine relationships between caregiver-youth communication and youth sexual risk outcomes. An increase in overall level of self-reported youth communication with caregivers about sexual and reproductive health topics was significantly associated with a greater likelihood of youth ever having engaged in sex. A significant interaction effect between youth communication and convergence with caregiver response was observed for the number of protected acts of vaginal and/or anal sex, where caregiver communication (regardless of self-reported youth communication with caregivers) was associated with a greater number of protected sex acts. This study fills a gap in the extant literature by reporting on relationships between communication about SRH, assessed separately in caregivers and youth, and youth sexual risk behaviors. Findings emphasize the importance of involving American Indian caregivers in SRH interventions to improve SRH outcomes among American Indian youth, and inform future experimental research that will evaluate how changes in caregiver communication potentially impact youth SRH.