Journal of Immigrant and Minority Health最新文献

Forced migration, as exemplified by the ongoing Syrian refugee crisis, has been consistently associated with elevated rates of psychiatric conditions, including post-traumatic stress disorder (PTSD), depression, anxiety, and increased suicide risk. However, the psychological mechanisms linking trauma-related symptoms to suicide risk in refugee populations remain insufficiently understood. The present study examines the mediating role of anxiety sensitivity in the relationship between PTSD symptoms and suicide risk among Syrian refugees residing in Turkey. Data were collected from 627 Syrian refugees aged 18-65 years living in Bursa province. Participants completed validated self-report measures assessing PTSD symptoms (Impact of Event Scale-Revised; IES-R), depression (Beck Depression Inventory; BDI), anxiety sensitivity (Anxiety Sensitivity Index-3; ASI-3), and suicide risk (Suicide Probability Scale; SPS). Elevated PTSD symptom levels were observed in 81.2% of the sample. Logistic regression and mediation analyses were conducted to examine associations between PTSD symptom clusters, anxiety sensitivity dimensions, and suicide risk. Results indicated that intrusion and hyperarousal symptoms were positively associated with suicide risk, whereas avoidance symptoms and physical concern (ASI-3 subscale) were negatively associated. Mediation analysis revealed that cognitive concern-defined as fear of losing mental control-partially mediated the association between PTSD symptoms and suicidal ideation (SPS suicidal ideation subscale). Taken together, these findings suggest that maladaptive interpretations of cognitive distress may represent a clinically relevant target for reducing suicide risk in trauma-exposed refugee populations. In contrast, avoidance and heightened awareness of bodily sensations may function as temporary protective strategies in the context of overwhelming stress. Overall, the findings underscore the importance of trauma-informed interventions that prioritize suicide stabilization in forcibly displaced individuals prior to the initiation of PTSD-focused treatment.

Despite being eligible for transplant, undocumented transplant recipients have reported being told they were ineligible for transplantation due to their citizenship status, delaying access to transplant. The objective of this nationally representative survey-based study was to understand nephrology trainees' knowledge of transplant eligibility, transplant benefits, and clinical experience working with undocumented immigrants, utilizing an existing annual survey instrument by the American Society of Nephrology in May 2023. The main outcome was responses to survey items, and logistic regression and Chi-square tests were used to evaluate associations between transplant eligibility knowledge and transplant referral practices. Of 954 nephrology fellows, 450 responded (response rate 47%). A minority correctly identified undocumented individuals were eligible for transplant (39.1% for living donor and 31.7% for deceased donor). 45% of trainees were unsure of the available insurance options for undocumented immigrants. Correctly identifying living and deceased donor transplant eligibility was significantly associated with referring undocumented people to transplant (p<0.001). To our knowledge, this is the first study to examine clinicians' knowledge and experiences regarding transplant eligibility for undocumented individuals. These findings highlight the need for targeted educational interventions to improve trainees' understanding of transplant eligibility and insurance barriers for undocumented immigrants, ultimately fostering more equitable access to kidney transplantation for this vulnerable population.

Hepatitis C virus (HCV) infection is increasingly reported among Rohingya refugees in Cox's Bazar, with active infection rates in adults reaching 20% by 2023. The risk of liver disease progression and hepatocellular carcinoma (HCC) may be amplified by coexisting factors such as chronic malnutrition, coinfections, aflatoxin exposure, metabolic disorders, and environmental toxins. Despite WHO-led efforts, data on these risk factors remain fragmented, and access to care is limited. This study underscores the need for comprehensive surveillance, epidemiological research, and long-term prevention strategies to reduce HCV-related morbidity and the future burden of HCC in displaced Rohingya populations.

Domestic Abuse [DA] is a pattern of behavior that is used to gain or maintain power and control over a partner or family member. Despite the prevalence of DA in African communities across Canada, little is known about their level of DA knowledge, or the causes and perceptions about DA in these communities. Our study sought to investigate the level of DA knowledge held by African communities in Canada, and identify what they believe to be the causes and solutions to DA. A cross-sectional survey was conducted with members of African communities in Alberta Canada. Participants were recruited using convenience and snowball sampling. A pilot tested survey questionnaire was used for data collection. Using Slovin's formula, the minimum sample size was determined to be 385 participants. Out of 478 participants, 370 (77.4%) had high DA knowledge. The association between sociodemographic variables and knowledge of DA-related behaviors was not statistically significant. Involvement of community and faith leaders was most popular for raising DA awareness, and DA education was most popular for preventing DA. Economic and cultural factors were deemed the main causes of DA, while counselling was most popular for DA intervention. The findings suggest a knowledge-attitude gap in DA awareness, emphasizing the need for education that addresses deeper sociocultural and systemic contributors to abuse. Applying a socio-ecological lens, interventions should target multiple levels of influence to be culturally relevant and effective.

Various systematic reviews underscore the relevance of social support for resilience among refugees. This meta-analysis aims to determine the quantitative assessment of social support and resilience among refugees and the extent of the associations between social support and resilience among refugees. After a systematic literature search, we included twenty-three studies, and performed random-effects meta-regressions. Studies on resilience and social support among refugees very heterogeneously operationalize both constructs. While increases in social support among refugees accompany higher resilience in numerous studies, these associations are not significant. In contrast to previous reviews' conclusions, the current data cannot confirm a relationship between resilience and social support among refugees. Substantiated conclusions about the relationship between resilience and social support among refugees might be reached by a population-specific clear conceptualization and operationalization of the constructs, the content differentiation of the constructs, representative samples, and longitudinal and intervention studies.

Immigrants in the United States may experience varying levels of exposure to perfluoroalkyl substances (PFAS) depending on their duration of residency and their region of origin. PFAS are persistent environmental pollutants linked to adverse health outcomes, yet little is known about exposure levels among immigrant populations. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) 2003-2018 to assess serum PFAS concentrations among adults by length of U.S. residency and race/ethnicity (used as proxy for origin). Several PFAS compounds were analyzed using ANCOVA and general linear models. U.S.-born adults represented 74.9% (n = 8,272) of the sample. Overall, PFAS levels increased with time in the U.S., converging towards levels observed in U.S.-born individuals-, consistent with the long biological half-lives of certain PFAS compounds. Significant differences in ∑PFAS were found for immigrants residing less than 5 years (geometric mean ratio [GMR]: 0.73, 95% CI: 0.64-0.84, P < 0.0001), with smaller differences in those residing 5-10 years (GMR: 0.84, 95% CI: 0.77-0.91, P < 0.0001) or 10-15 years (GMR: 0.84, 95% CI: 0.77-0.93, P = 0.0004), compared to U.S.-born. The pace of convergence varied by race/ethnicity, reflecting both environmental exposure in the U.S. and likely differences in exposure prior to migration. These results emphasize the need to consider duration of residency and background when evaluating chemical exposure disparities. The study highlights the need for public health interventions to address PFAS exposure among immigrants, especially those newly arrived, considering their potential differential exposure risks.

African-born Black women living in the US experience markedly higher rates of HIV diagnosis than their US-born counterparts, with condom use and PrEP remaining underutilized despite their effectiveness. Existing HIV prevention interventions for African-born Black women are limited in scope; some lack cultural tailoring, linguistic appropriateness, and most not do include PrEP. Using the ADAPT-ITT model, we culturally adapted two evidence-based interventions for US Black women-Sister-to-Sister and Sisters Informing Sisters about Topics on AIDS (SISTA)-to increase condom use and PrEP uptake among African-born Black women through community stakeholder input. DADA, which was adapted from SISTA, consists of two 3-hour peer-led, group-level intervention and Dada kwa Dada (DKD), adapted from Sister-to-Sister, is a 1-hour individual-level intervention. To test feasibility and acceptability, 29 African-born women without HIV were recruited from social media groups and community partner listservs in Massachusetts and New York; 17 were randomized to DKD and 12 to DADA. Participants completed risk assessments at baseline and provided post-intervention feedback interviews and surveys. Both adapted interventions demonstrated high feasibility and acceptability, with participants expressing positive qualitative and quantitative feedback regarding their culturally appropriateness, and relevance. This study addresses critical gaps in tailored HIV prevention approaches for African-born Black women and paves the way for future trials to improve condom use and PrEP in this population. Next steps are to conduct a fully-powered comparative effectiveness trial to assess the relative impact of both interventions on increased condom use and uptake of PrEP.

The increasing immigrant population in the U.S. faces unique challenges in navigating the healthcare system, including language and cultural barriers, and knowledge of services. Immigrant parents may face additional challenges as they attempt to navigate the healthcare system on behalf of their children. This study investigated associations between parents' immigrant status and their perceptions of shared decision-making (SDM) in their child's healthcare. Participants included 27,082 parent respondents from U.S. households in the 2021-22 National Survey of Children's Health. Measures included parents' immigrant status and reports of shared decision-making in their child's healthcare. Potential moderators of the association between immigrant status and SDM included time spent providing or arranging children's healthcare, household economic strain, parenting support, needing extra help to arrange care, and household language. Logistic regression analyses showed that compared to U.S.-born parents, immigrant parents were more likely to report lower levels of SDM. Immigrant parents who reported needing extra help coordinating or arranging healthcare services for their child had significantly higher odds of low SDM compared to their counterparts. To improve child health outcomes, immigrant families may benefit from increased SDM and support in coordinating their children's healthcare services.