Journal of Immigrant and Minority Health最新文献

Work has not examined if acculturation or enculturation may predict endorsed benefits, barriers, and intentions to seek mental health services for depression, specifically among Latino students enrolled in a rural and majority Latino immigrant institution of higher education. An improved understanding of factors informing mental health help-seeking is needed to identify possible intervention points to address gaps in accessing depression treatment. Participants (N = 406) read a vignette depicting a person with depressive symptoms. Participants were asked if they would seek help for depression if in the situation described in the vignette. Participants provided text responses about their preferences for managing depression symptoms and their mental health help-seeking history. Additionally, participants completed a self-report depression symptom screener, demographic surveys, acculturation assessment, and questionnaires on perceived benefits and barriers to seeking mental health services. Path analysis was used to test the link between acculturation status and intent to seek services for depression, with benefits and barriers as mediators. The results revealed that higher perceived benefits and lower barriers were directly associated with greater intentions to seek help. Furthermore, an indirect effect of acculturation on help-seeking intentions via higher perceived benefits of seeking care was observed. These findings persisted after controlling for age, gender, depression, and history of seeking care for depression. Future work should test the replicability of this finding with diverse college students living in predominantly immigrant communities. Universities might consider tailoring outreach initiatives to provide information on the range and accessibility of mental health services, the location of mental health service centers, and the procedures for accessing such services.

Immigrants, nearly half of whom prefer a language other than English (LOE), face structural barriers to healthcare. This subgroup is believed to be at increased risk for reduced access to quality healthcare, yet few studies have examined the health needs and utilization patterns of LOE-preferring patients who seek care in the Emergency Department (ED). Given that the ED is often an entry point to the health system, we sought to characterize the health patterns of this population in an urban ED setting. We conducted a retrospective chart review of the electronic medical records of 1,566 patients who utilized interpreter services in the ED or Urgent Care) at an urban safety net hospital. We found that LOE-preferring patients had high levels of chronic disease. We also found that the majority of these patients had not seen a primary care provider (PCP) within the study period. PCP visits were positively associated with ED utilization suggesting that those without a PCP are less likely to receive ED care. These findings point to a need for greater policy and community health solutions addressing the high burden of chronic disease and underutilization of healthcare for those with LOE preferences.

Health information technology (HIT) use among foreign-born adults of Middle Eastern and North African (MENA) descent is understudied. MENA Americans are currently categorized as "White" in the United States (US) on federal forms. Our purpose was to uncover the prevalence of HIT use among MENA immigrants compared to US- and foreign-born White adults before and after adjusting for covariates. The 2011-2018 National Health Interview Survey data (n = 161,613; ages 18 + years) were analyzed. HIT uses evaluated were searching for health information, filling prescriptions, scheduling appointments, and communicating with healthcare providers via email (last 12 months). Crude and multivariable logistic regression models were used to estimate the odds of each HIT use (searching for health information, filling prescriptions, scheduling appointments, and/or communicating with healthcare providers via email), and overall use of any HIT before and after adjustment. The most common HIT use was looking up health information (46.4% foreign-born MENA, 47.8% foreign-born White, 51.2% US-born White; p = .0079). Foreign-born adults of MENA descent had lower odds (OR = 0.64; 95% CI = 0.56-0.74) of reporting any HIT use, but no difference in reporting all HIT uses compared to US-born White adults. This is the first study to explore HIT use among MENA Americans. Results contribute to growing body of literature showing the health of MENA Americans differs from White Americans. A separate racial/ethnic identifier is needed to better capture HIT uses among populations of MENA descent.

Cervical cancer is a significant global health issue, ranking as the second most prevalent cancer among women of reproductive age. While prevention strategies like HPV vaccination and screening have made it highly preventable, these benefits are mostly seen in high-HDI nations. In contrast, LMICs lag behind, with Afghanistan facing a growing crisis due to war, poverty, and lack of awareness. The recent influx of Afghan evacuees to the U.S. poses a risk of introducing undiagnosed cases. Addressing this requires collaborative efforts to raise awareness, promote screening, and vaccination among Afghan women, leveraging culturally sensitive approaches and community partnerships to improve health outcomes.

The COVID-19 pandemic disproportionately affected African, Caribbean, and Black (ACB) people in Canada. Despite higher SARS-CoV-2 exposure risks, likelihood of being quarantined, and risk of severe disease outcomes, little is known about the pandemic's effects on this community's mental health. This study aims to identify factors associated with changes in ACB Canadians' mental health during the pandemic and provide guidance for improved access to mental health resources. Data was collected from May to July 2021 using a cross-sectional, national, online survey. Eligible participants for this community-based study were ACB adults residing in Canada. Survey measures included demographics, pandemic-related experiences, mental health status, and access to mental health services. Bivariate analyses and multinomial logistic regression examined associations between variables. Among the 1,556 participants, 25.4% reported improved mental health and 33.1% reported worsened mental health since the pandemic's onset. Improved mental health was associated with younger age, receiving at least one pandemic-related benefit, and living in a home that became safer. In contrast, worsened mental health was associated with younger age, working less, the pandemic having a major impact on ability to pay bills, not receiving pandemic-related benefits, home becoming less safe, and increased substance use. Barriers to accessing mental health services included difficulty getting an appointment, cost, pandemic measures, and lack of culturally competent care. These insights underscore the positive impact of pandemic-related emergency relief, the challenges in accessing mental health services, and the gaps in culturally competent mental health care.

Xenophobia among healthcare professionals can significantly impact the quality of care provided to immigrant and refugee populations, particularly in countries with high influxes such as Türkiye. This study evaluated xenophobia among resident physicians at Pamukkale University Hospital and identified factors influencing these attitudes. This cross-sectional study involving 271 resident physicians at Pamukkale University Hospital was conducted between August 1 and August 20, 2022. The participants were randomly selected and stratified by department. Data were collected via a 38-item questionnaire, including the 11-item Xenophobia Scale. Descriptive statistics, the Mann‒Whitney U test, the Kruskal‒Wallis test, and multiple linear regression analysis were used for data analysis. The mean xenophobia scale score among participants was 57.53 (SD = 7.82), indicating high levels of xenophobic attitudes. The significant factors associated with higher xenophobia scores included being from a surgical department (B = 0.571, p < 0.001) and lacking foreign nationals in their close environment (B = 0.724, p < 0.001). Additionally, 58.7% of the resident physicians opposed providing free healthcare services to refugees, and 10.0% indicated that they might delay providing health services to these patients because of their status. Additionally, 7.7% of the resident physicians admitted to discriminating against migrant/refugee patients. The study reveals pervasive xenophobic attitudes among resident physicians in Türkiye, which are influenced by departmental affiliation and the social environment. These findings underscore the need for targeted interventions to address xenophobia in healthcare settings, including cultural competence training and policy changes, to ensure equitable healthcare access for all patients.

Emerging research suggests that the increasing population of Arab immigrants and refugees living in the United States (U.S.) has a greater risk for depression and anxiety than other groups. The purpose of this meta-analysis was to estimate the prevalence of depression and anxiety for Arabs in the U.S., to examine the moderating effects of key demographic variables (gender, immigration status, ethnicity) and study characteristics (research design and quality) on the prevalence of anxiety and depression, and to evaluate the direct effects of additional demographic and study characteristics on prevalence rates. Using guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), we searched PubMed, Embase, CINHAL, ProQuest, and the Web of Science databases for articles published between January 2000 and March 2023. Two reviewers each individually extracted the articles' data and evaluated the reported study's methodological quality using a well-established checklist. Statistical analyses consisted of random effects models to estimate the pooled prevalence of depression and anxiety across all studies, separate random effects models for distinct demographic (e.g., immigration status) and methodologic (e.g., study quality) subgroups that might have unique prevalence rates, and a meta-regression to identify additional variables (e.g., age of individuals) that might influence prevalence rates. Our review included 17 studies with a total sample population size of 22, 558 participants. Results indicated that the estimated prevalence of depression overall was 48% (CI 34, 63%) and 58% (CI 33, 83%) for the prevalence of anxiety. Our subgroup analyses uncovered notable variations in prevalence rates based on gender composition, immigration status, ethnicity, and research quality while results of the meta-regressions demonstrated effects of publication year and age of the Arab individual on the estimated prevalence of depression and anxiety. The high prevalence rates for depression and anxiety identified through this meta-analysis are very concerning and underscore the urgent need to address mental health concerns in Arab communities. Results of subgroup and meta-regression analyses suggest that refugees, individuals from specific countries of origin, and younger Arabic persons may need particular attention by clinicians in screening for and treating their depression and anxiety. Our results also signify the need for further high-quality studies to more rigorously assess prevalence of these mental health problems, since we found evidence of potential publication bias and approximately one third of the studies in the review had less optimal methodological quality based on our evaluation. Ultimately, in-depth research regarding the causes of anxiety or depression among Arab individuals will be essential to the development of culturally competent interventions that may reduce their very high prevalence rates.

We investigated the relationship between parent and child mental health, including parents' general psychological distress, among refugees resettled in Australia. We utilised longitudinal data from a sample (N = 602 children and 377 parents) of recently settled refugees from the Building a New Life in Australia Survey). Parent psychological distress and post-traumatic stress symptoms (PTSS) were measured by the Kessler 6 and PTSD-8, respectively. Harsh and Warm parenting behaviours were also measured to explore the mechanisms underlying the parent-child mental health relationship. Child mental health was measured using the SDQ. Using path analysis, we found that increases in parent psychological distress directly contribute to harsher parenting practices, which in turn increase child mental health difficulties as reported by parents. Parent psychological distress at Waves 1 and 3 also directly impacted child emotional and conduct difficulties, whilst parent PTSS was indirectly associated with all measured child mental health problems. While both parent PTSS and psychological distress indirectly impacted child mental health, only psychological distress directly impacted on any area of child mental health difficulty and overall explained more variance in the final model. Our findings highlight that non-trauma specific symptoms warrant attention in refugee parents' and children's mental health. Clinicians should assess for general psychological symptoms in addition to trauma-specific symptoms, and we recommend that parental mental health is assessed and treated simultaneously when working with refugee children. Moreover, to reduce the impact of other stressors in refugees' lives, community sector organisations should be resourced adequately to support refugee families in settlement.

Although there is recent growing attention on mental health and mental well-being across the globe, supports in this area of healthcare can be a challenge for immigrant and racialized groups with experiences of hardship across several domains. This study aimed to gather perspectives from immigrants and racialized community members on strategies central to support their mental health and well-being, with the aim of addressing research to practice gaps. The study was co-designed in collaboration with a Community Action Table in Markham, Ontario, a setting with 93% of residents self-identifying as visible minorities. Using a community-focused mixed methods Concept Mapping approach, 68 residents, service providers, and policymakers were engaged through three phases of brainstorming, sorting and rating, and interpretation. Their brainstorming led to 68 statements which they sorted into groups and rated for importance and feasibility to act in next six months. Further analysis led to a 9-cluster concept map comprising of Family Wellness, Awareness & Education, Cultural Sensitivity, Social Service Access, Community Building, Socioeconomic, Food Security, Healthcare Access, and Housing Stability. These clusters are important in advancing knowledge on ways to support and prioritize mental health and well-being of immigrants and racialized communities. Overall, participants viewed mental health and well-being as being closely tied to their living and working conditions while also focusing on family wellness and intergenerational dynamics. Novel insights from this project are important for the planning of mental health and well-being supports for immigrant groups in Canada and can help improve foci across sectors through service implementation.