Journal of Immigrant and Minority Health最新文献

With more immigrants coming to Canada, mental health providers are supporting increasingly diverse clients. The Supporting Successful Transplantation (SST) tool offers a potential solution to explore intersectional aspects of newcomer identities; to identify their diverse challenges, including shared issues like racism and discrimination, as well as their unique strengths, and resources. The SST tool emerged from the findings of a study of immigrants to southern Alberta. Using the universal visual metaphor of a tree planted in new conditions, it seeks to provide an intuitive and collaborative way to identify migrants' strengths and challenges and honour their diverse contexts. In this note from the field, we overview the SST resource and its development and provide suggestions for how various community professionals may utilize it in collaboration with their newcomer clients.

Low vaccination coverage is highlighted as a challenge in Ukraine and among Ukrainian refugees, however there is limited knowledge on coverage among Ukrainian refugees living in European countries. Individual-level data from the National Population Register for children (<20 years) with at least one parent from Ukraine were linked to the Norwegian Immunisation Registry (SYSVAK). We estimated vaccination coverage according to Norwegian Childhood Immunisation Program recommendations among 1) Ukrainian refugee children (i.e. immigrated after 01.02.2022) (N = 8,804) and 2) children born in Norway to Ukrainian refugee parent(s) (N = 224), compared to national coverage. National coverage rates were 95.8% to 96.5% (2-year-olds), 94.5% to 96.7% (9-year-olds), and 90.0% to 94.0% (16-year-olds). Corresponding rates among Ukrainian refugee children were 39.5% to 60.5%, 27.3% to 58.6%, and 9.2% to 34.3%, respectively. Coverage among Norwegian-born children of Ukrainian refugees was >91%. In all, 31% of Ukrainian refugee children had no vaccinations registered in SYSVAK. Coverage for Human Papilloma Virus (HPV) catch-up vaccination among Ukrainian refugee boys was lowest (9%), however, routine HPV vaccination coverage was 63%. Ukrainian children with a refugee background showed lower vaccination coverage than the national coverage. We found large differences between routine versus catch-up vaccination. Our findings suggest that access to catch-up vaccination, routines for retrospective registration of vaccines given outside of Norway and surveillance reporting, as well as vaccine hesitancy should all be considered when assessing childhood vaccination coverage among Ukrainian refugees. These factors should be addressed to improve vaccine uptake and surveillance in this population.

Despite growing immigrant populations, healthcare systems often fail to address linguistic and cultural barriers, necessitating models like Tzu Chi's volunteer-driven approach. This qualitative study examines how cultural competence and volunteerism enhance healthcare delivery for immigrants at the Tzu Chi Boston Service Center, a volunteer-driven organization serving diverse urban communities. Through thematic analysis of 17 semi-structured interviews, five participant observations, and 22 documents, the study explores the effectiveness of this model. Three key themes were developed: cultural competence with language services fosters trust and equity; community-based, tailored care enhances accessibility; and compassionate, holistic support promotes well-being. Volunteers' multilingual skills and cultural sensitivity bridge linguistic and cultural divides, while community-embedded services address intersectional barriers like poverty and isolation. Tzu Chi's model, grounded in Buddhist compassion, adapts to Chinese, Latino, and African immigrants, offering a scalable framework for multicultural settings. These findings advocate integrating cultural competence and volunteerism into healthcare policies to reduce disparities and ensure equitable care for immigrant populations.

Cardiovascular diseases (CVD) and cancers are chronic, often preventable diseases that remain the leading causes of mortality and morbidity globally. Immigrants are at higher risk of developing CVD and cancers, therefore, and it is important to understand the effectiveness of health-related education targeted to this group to improve knowledge, attitudes, and behaviours related to chronic disease prevention. The objective of this systematic review is to examine the effectiveness of health-related education delivered to new immigrants to western countries at improving knowledge, attitudes, and health behaviours to prevent chronic disease. A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Literature was searched using Medline, Embase, Emcare, Global Health, and Google Scholar was used to identify grey literature. Each database was searched from its inception through April 16th, 2024. A narrative synthesis was completed. Appropriate validated tools were utilized to assess the methodological quality of each study. A comprehensive assessment of study quality was undertaken for all the studies using the QUaDS tool. A total of 11 studies were included in the review, which included quantitative, qualitative and mixed-method studies. The 11 studies included 1,212 participants with age range from 18-75 years of age. The studies included changes in knowledge, (deeper understanding of food and health, recipes to cook traditional foods with healthier recipes, diabetes prevention strategies), behaviours (an increase in weekly step count, reading food labels when doing grocery shopping, purchasing food based on nutritional quality, eliminating unhealthy foods, consumption of more fruits and vegetables, quitting smoking, and improved sleep behaviours). Several methodological limitations of the included studies were identified. This review highlights that the use of behaviour change theories can assist clinicians better understand behaviour change and at the same time inform the development of evidence-based interventions. Given the significant burden of chronic diseases in immigrant populations, it is imperative that health-related education programs are made available, and immigrant populations are informed and valued at each phase of the program. Tailored approaches, for example, story-telling, in-class instructions, healthy heart melas (community gatherings), video and pictorial illustrations have been found to be particularly effective.

Student-run asylum clinics (SRACs) are organizations that provide pro bono forensic medical evaluations to support the legal asylum cases of individuals seeking refuge away from their home country, increasing the likelihood that asylum status is granted. Although thousands of children seek asylum in the U.S. every year, there are fewer forensic medical evaluations performed for children relative to adults. This cross-sectional survey study investigates the extent of forensic medical evaluation services provided to children by SRACs in the United States. An online, cross-sectional survey evaluating the scope of pediatric practice and barriers to completing pediatric forensic evaluations was distributed to 27 student-run asylum clinics. Of fourteen organizations that completed the survey, 35.7% (n = 5) received referrals in the past year for pediatric forensic evaluations, while 92.9% (n = 13) received referrals for adult evaluations. 53.8% (n = 7) of respondents indicated that a barrier to performing pediatric evaluations was a limited number of physicians specialized in this area. There is likely an unmet need for pediatric forensic medical evaluations, and a significant barrier is a shortage of physicians specialized in performing these evaluations. Given the large volume of children who seek asylum in the United States every year, it is imperative to train additional physicians to perform pediatric evaluations to expand asylum services nationwide to children.

This project aimed to describe diabetes prevalence and evaluate diabetes screening among newly arrived U.S. refugees. We included refugees ≥ 18 years who underwent domestic medical exams (DME) at three sites between January 2012-September 2022. Data was obtained from electronic health records. We identified refugees with diagnosed diabetes at DME using ICD-9/10 diagnosis codes. Refugees were classified as having undiagnosed diabetes if they had a diabetes diagnosis code or hemoglobin A1c ≥ 6.5% within 3 months of DME. Among refugees without diagnosed diabetes at DME, we used modified American Diabetes Association Standards of Care 2022 criteria to classify them as "screening-eligible." We considered refugees as receiving diabetes screening if they had a hemoglobin A1c or fasting glucose result. Demographic data included patient age, sex, race, ethnicity, and country of origin. We provide prevalence of diagnosed and undiagnosed diabetes and evaluate diabetes screening among newly arrived refugees. We included 4,521 refugees, 127 (2.8%) had diagnosed diabetes at DME, and 244 (5.4%) were diagnosed with diabetes within 3 months. Of those without known diabetes at DME (n = 4,384), 63.3% (n = 2,863) were screening-eligible and of those, 25.4% (n = 726) had screening within 3 months. While the prevalence of overall diabetes among newly arriving refugees was lower than the general U.S. population (8.2% vs. 11.6%), this may be an underestimate as only one-fourth of screening-eligible patients were screened. Adding routine diabetes screening recommendations to DME guidance may decrease the time for diabetes diagnosis for refugee patients.

Amid the recent global refugee crisis, the United States (U.S.) hosts over 200,000 Afghan refugees, many struggling to integrate into U.S. society. The COVID-19 pandemic and its subsequent health and social sequelae have severely affected Afghan refugees' lives, especially women, further complicating their integration. This study examines how the pandemic has influenced Afghan refugee women's integration through challenges and facilitators at various socio-ecological levels. Semi-structured interviews with 34 Afghan refugee women and 18 service providers in California were conducted. Interview data were analyzed using the thematic framework to identify themes indicating the impacts of COVID-19 on refugee women's integration based on Ager and Stange's integration framework. Findings revealed multifaceted challenges in refugee women's integration across multiple socio-ecological levels exacerbated by the pandemic including changes in roles, financial illiteracy, language barriers, cultural adaptation issues, inefficient policies, patriarchal culture, administrative overload, and systemic barriers in employment and education. However, factors like empowerment through education and employment, family/friends/community support, socializing, childcare support, awareness of laws and women's rights, and access to culturally competent job opportunities facilitated their integration. This study recommends policies and programs addressing Afghan refugee women's integration challenges and facilitators impacted by the pandemic for better integration into the U.S.