Journal of Immigrant and Minority Health最新文献

Research demonstrates that stigma and resilience influence transgender peoples' healthcare use. Less is known about transgender Latinas in the U.S. South who face multilevel barriers to healthcare access. We used baseline data from the ChiCAS intervention study. Using logistic regression, we examined how stigma (perceived discrimination related to gender identity, race/ethnicity, sexual behavior and perceived documentation status and internalized transphobia), and resilience (ethnic group pride and social support) are associated with two healthcare outcomes (use of routine medical care and medically supervised gender-affirming hormones). We also explored barriers to accessing both types of care. After removing 13 participants with missing data, our sample size was 131 transgender Latinas in the U.S. South. Most participants (74.8%, n = 98) received routine medical care in the past year and 57.3% (n = 75) had ever received medically supervised gender-affirming hormones. Reports of discrimination were highest for gender identity and documentation status. Race/ethnicity-based discrimination was positively associated with accessing routine medical care in the past year (OR = 1.94, p = 0.048). Having more social support was positively associated with care (routine care: OR = 3.48, p = 0.002 and gender-affirming hormones: OR = 2.33, p = 0.003). The most commonly reported barriers to accessing both types of care included cost, insurance, and not knowing where to go. Findings highlight the importance of social support for healthcare use among transgender Latinas. Social support may be especially important when considering the unique experiences of discrimination faced by transgender Latinas in the U.S. South.

Prostate-specific antigen (PSA)-based prostate cancer screening is a preference-sensitive decision for which experts recommend a shared decision making (SDM) approach. This study aimed to examine PSA screening SDM in primary care. Methods included qualitative analysis of audio-recorded patient-provider interactions supplemented by quantitative description. Participants included 5 clinic providers and 13 patients who were: (1) 40-69 years old, (2) Black, (3) male, and (4) attending clinic for routine primary care. Main measures were SDM element themes and "observing patient involvement in decision making" (OPTION) scoring. Some discussions addressed advantages, disadvantages, and/or scientific uncertainty of screening, however, few patients received all SDM elements. Nearly all providers recommended screening, however, only 3 patients were directly asked about screening preferences. Few patients were asked about prostate cancer knowledge (2), urological symptoms (3), or family history (6). Most providers discussed disadvantages (80%) and advantages (80%) of PSA screening. Average OPTION score was 25/100 (range 0-67) per provider. Our study found limited SDM during PSA screening consultations. The counseling that did take place utilized components of SDM but inconsistently and incompletely. We must improve SDM for PSA screening for diverse patient populations to promote health equity. This study highlights the need to improve SDM for PSA screening.

Immigrant and refugee women are vulnerable to experiencing intimate partner violence (IPV) due to a range of factors associated with immigration. This study aims to consolidate existing research concerning IPV among Iranian immigrant women and examine its impact on their lives. A comprehensive literature search for articles of any design published in the English language in the past 15 years was performed using Medline, Embase, CINAHL, International Bibliography of the Social Sciences (ProQuest) and PsycINFO databases. The topic of IPV among Iranian immigrant women has been underexplored in research, and only 11 studies were identified that met the inclusion criteria for this topic. The findings from these studies indicate that Iranian immigrant women have experienced different forms of IPV, with psychological IPV being prominent and replacing physical violence. These experiences have had adverse effects on the women's physical and mental health. The women's experiences of IPV were influenced by various cultural, religious, and individual factors. They predominantly sought informal help rather than accessing formal resources to address their situations. There is a need for rigorous studies to thoroughly investigate IPV among Iranian immigrant and refugee women. Such research is essential for establishing effective strategies that are culturally sensitive to reduce IPV incidents within this population. Moreover, it is essential to enhance IPV awareness among these women and ensure their access to formal resources that are proficient in addressing IPV. This comprehensive approach not only tackles the immediate issue but also fosters a safer environment and promotes long-term wellbeing within this community.

US-bound immigrants and refugees undergo a mandatory overseas medical examination that includes tuberculosis screening; this exam is not routinely required for temporary visitors applying for non-immigrant visas (NIV) to visit, work, or study in the United States. US health departments and foreign ministries of health report tuberculosis cases in travelers to Centers for Disease Control and Prevention Quarantine Stations. We reviewed cases reported to this passive surveillance system from January 2011 to June 2016. Of 1252 cases of tuberculosis in travelers reported to CDC, 114 occurred in travelers with a long-term NIV. Of these, 83 (73%) were infectious; 18 (16%) with multidrug-resistant tuberculosis (MDR TB) and one with extensively drug-resistant tuberculosis (XDR TB). We found evidence that NIV holders are diagnosed with tuberculosis disease in the United States. Given that long-term NIV holders were over-represented in this data set, despite the small proportion (4%) of overall non-immigrant admissions they represent, expanding the US overseas migration health screening program to this population might be an efficient intervention to further reduce tuberculosis in the United States.

The employment of migrant care workers provides a remedy to face the challenges of increased demand for care of older adults. A scoping review aimed to identify, categorize, and summarize the existing knowledge about migrant care workers' working experiences in long-term care facilities. Identifying gaps in the literature can inform future research. Five electronic databases were searched in April 2024 in addition to a manual search for articles published in English. Forty-five articles were reviewed. A few studies described migrant care assistants' main tasks as assisting physical care and care assistants' characteristics grouped into personal and acquired qualities to provide good quality care. Migrant care workers experienced work satisfaction, achievement, adaptability and adjustment, organizational support, work burden, sense of loneliness, low wages, low social status, and loss of profession. They faced challenges involving inadequate knowledge of palliative care, communication and language barriers, cultural and religious differences, and health concerns. Friendly and discriminatory relationships were found between migrant care workers and stakeholders. Existing evidence regarding the experiences of migrant care workers in delivering palliative care to dying residents or facilitating death preparation is limited. Additionally, there is a notable absence of data from the perspectives of employers and residents on discrimination issues. Further research is necessary to investigate these areas.

Standard models of well-child care may not sufficiently address preventive health needs of immigrant families. To augment standard individual well-child care, we developed a virtual group-based psychoeducational intervention, designed to be delivered in Spanish as a single, stand-alone session to female caregivers of 0-6 month-olds. The intervention included a video testimonial of an individual who experienced perinatal depression followed by a facilitated discussion by the clinic social worker and an orientation to relevant community resources by a community health worker. To assess feasibility and acceptability of the intervention, we conducted an open pilot within an academic pediatric practice serving predominantly Latinx children in immigrant families. Participants included 19 female caregivers of infants attending the practice, of whom 16 completed post-intervention measures and 13 completed post-intervention semi-structured interviews. Quantitative measures of acceptability and satisfaction with the intervention were high. We found preliminary effects of the intervention on postpartum depression knowledge and stigma in the expected direction. In interviews, participants described increases in their familiarity with postpartum depression and about relevant community resources, including primary care for caregivers. Participants reported an appreciation for the opportunity to learn from other caregivers and provided suggestions for additional topics of interest. Trial registration: Registered 6/21/22 as NCT05423093.

Non-prescription weight loss substances, such as supplements and herbal remedies, can be harmful. Hispanic immigrant students may be highly susceptible to these substances, especially those advertised on social media. This study was a feasibility/acceptability pilot trial of an intervention to reduce this susceptibility. Latino or Hispanic immigrant students aged 18-35 were randomized to receive either a single-session, culturally tailored online intervention (Redes Sociales Para la Salud), or a dose-matched intervention focused on general support for immigrant students (Immigrant Support). Following the intervention, participants answered quantitative and open-ended questions about intervention satisfaction, and completed measures of susceptibility to non-prescription weight loss substances. Participants additionally completed measures of social media use and social norm perceptions. Fifty-five participants enrolled in the study, and 32 had primary outcome data. Participants were majority female (62.5%) and graduate students (81.3%) with a mean BMI of 24.6 ± 3.5 kg/m². Ratings of intervention satisfaction were moderate (3.5-3.7 out of 5). In open-ended questions, participants identified areas of high satisfaction (cultural appropriateness, learning new information) and suggested improvements (increase interactivity, improve presentation appearance). Considering signal of an effect, participant ratings indicated that susceptibility to non-prescription weight loss substances was lower after Redes Sociales Para la Salud compared to the control intervention. In exploratory analyses, susceptibility to non-prescription weight loss substances was positively associated with extent of social media use (r = 0.41-0.46) and social norms about use of these substances (r = 0.38). With additional refinement, the Redes Sociales Para la Salud has promise for addressing susceptibility to non-prescription weight loss substances.

Latinos form the largest ethnic population in the United States (18.5%), and the majority are Mexican Americans (61.4%). Many Mexican Americans have unique dietary behaviors, yet few food frequency questionnaires explicitly define Mexican American diets. The objective of this work was to engage with a population of rural Mexican Americans to develop a Mexican American food frequency questionnaire. Because acculturation is linked to dietary intake, we also examined acculturation by diet. We used mixed methods with three phases: (1) a qualitative phase in which a sample of rural Mexican-Americans (N = 15) identified and provided rich data about foods they ate; (2) a developmental phase in which 4 day food records were completed sequentially by two new and different samples of Mexican Americans (N = 19); and 3) a preliminary assessment phase where a new sample of Mexican Americans (N = 49) completed the final food frequency questionnaire. The final questionnaire included many traditional Mexican foods and beverages identified by study participants as part of their typical diet. Traditional Mexican foods and beverages were consumed regularly; little variation in diet was seen by level of acculturation. Respondents perceived diets containing commercial sugar-sweetened beverages as unhealthful, but not those with traditional Mexican drinks, which may represent an unappreciated source of added sugar in the diet. Future work includes studies examining dietary patterns in other urban and rural communities with traditional Mexican diets.

Individuals with limited English proficiency (LEP) are disproportionately more likely to experience suboptimal care outcomes compared to English-proficient individuals, attributed to multi-level social determinants of health, including the quality of the hospital where LEP patients are more likely to receive care. Evidence demonstrates that racial minority patients are more often admitted to lower-quality hospitals serving high proportions of minority patients, despite living closer to higher-quality hospitals. Less is known about where individuals with LEP reside, where they seek hospital care, and the quality of care in these hospitals. Using Geographic Information Systems (GIS) methods, we developed a density map characterizing residential patterns of the LEP population across zip code tabulation areas in New Jersey and designated hospitals as high, middle, or low-LEP volume. We described differences in 30-day hospital wide readmission rates for hospitals across varying LEP volume status using Centers for Medicare and Medicaid Services Hospital Care Compare Data. Most hospitals in ZCTAs with higher LEP populations serve a high proportion of LEP patients (i.e. their patients’ demographics are reflective of the community in which they are located). However, our results also show instances in which LEP patients may be forgoing receiving care at closer hospitals to instead receive care at further-distanced, high-LEP volume hospitals. significant. High-LEP volume hospitals have higher 30-day hospital wide readmission rates (20.1%) compared to middle (15%) and low (11.3%)-LEP volume hospitals (p < .001), indicating lower quality of care within high-LEP volume hospitals.

Refugees experience poorer health outcomes especially which can be exacerbated by or can be a result of low health literacy of refugee populations. To address poor health outcomes, health literacy, and health usage in refugee populations, it is essential to develop health educational interventions for refugees' healthcare integration. To do so, learning objectives must be identified based on refugees' health knowledge gaps. Therefore, the overall aim of this study is to identify these knowledge gaps. A modified Delphi method was employed for this study with three rounds of survey: the first to identify learning objectives, the second to prioritise learning objectives, and the third to categorise the learning objectives as not recommended, partially recommended, or highly recommended. An overarching theme of utilising the healthcare system and its various services effectively and efficiently was recognised to be an important learning objective for educational interventions to address refugees' health integration. Overall, learning objectives within the theme self-care and preventative health were ranked as most important.