Journal of Immigrant and Minority Health最新文献

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.

Physical activity (PA) is critical for healthy aging, yet < 16% of U.S. older adults meet federal recommendations for moderate to vigorous PA. Asian Americans are a rapidly growing segment of the older adult population, who are less likely to meet these guidelines, and are frequently under-represented in clinical trials. This quasi-experimental pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of a culturally tailored walking program to improve PA and social engagement for older Chinese Americans in Boston, MA. Participants at two community organizations were assigned to an enhanced walking or walking only condition for 12 weeks. Mixed effect repeated measures analysis addressed the study aims. The enhanced walking group (intervention) had fewer steps at baseline and less of a reduction in steps by 12 weeks as compared with the walking only (control) condition. Mean social engagement scores were significantly higher at 12 weeks (p = .03) for the intervention group. A culturally tailored walking intervention was feasible and acceptable for older Chinese Americans, improving social engagement and PA scores.

The aim of this review is to investigate barriers and enablers of diabetes self-management strategies among migrant Arabic-speaking background [ASB] individuals living with type 2 diabetes in high-income Western countries. Despite living in high-income Western countries, individuals from ASB are perceived to have difficulties adopting self-management strategies and this necessitates gaining an understanding of factors that may impact the uptake of these strategies. Ten studies are included in this review: five quantitative and five qualitative. Quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal and Hawker tools. The findings of the quantitative studies were descriptively analysed, while thematic analysis was performed for the qualitative studies. The results indicate that individuals from ASB are perceived to have low levels of adherence to diabetes self-management. It is also suggested that participants who did not complete high school have poorer glycaemic control compared to those with a high school qualification (30 vs. 16%). Regular exercise was reported to be less likely to be adopted by ASBs homemakers, and those who were unemployed, by 82% and 70%, respectively, compared to those employed (homemakers: OR = 0.187, P = 0.006; 95% CI = 056-0.620), (unemployed OR = 0.30, P = 0.046; 95% CI = 0.093-0.980). Cultural, social, religious beliefs, lack of knowledge and language barriers are some of the factors identified that impact self-management among ASB individuals. It is suggested that diabetes self-management education program (DSME) tailored to ASB immigrants culture may be an effective way to encourage them to uptake self-management strategies.

Community Health Workers (CHWs) are an effective strategy to address the health needs of specified communities. The purpose of this scoping review was to explore the use of CHWs to address the health needs of the Latino male population. This project used specific search terms to identify relevant articles from PubMed, PsycINFO, and Google Scholar. Eligible articles included studies, conducted in the U.S. and in English from 2010 to 2022, that assessed the use of CHWs among a predominantly male (≥ 50%) Latino population. Twenty articles consisting of 13 interventions were identified for review and were further categorized into male-only participant samples (n = 10) and mixed-gender but predominantly-male participant samples (n = 10) for synthesis. Male-only participant samples focused on occupational health and participant's social support and networks. Predominantly-male, mixed-gender participant sample interventions were disease-centered and emphasized the longitudinal support of CHWs as well as social networks. Of the 13 interventions reviewed, almost all (n = 10) utilized existing social networks for engagement and nearly half (n = 6) employed community-based participatory research (CBPR) principles. Findings suggest that recruiting CHWs from within existing social networks and using CBPR are important factors for successful health promotion among male Latinos.

We conducted an analysis to identify factors influencing the use of traditional complementary and alternative medicine (TCAM), with a particular emphasis on ethnic variations. Using the 2015 Asian American Quality of Life survey (N = 2,609), logistic regression analyses were performed, considering acculturation, health status, healthcare accessibility/utilization, and socio-demographic factors. Ethnicity, specifically being Chinese or Korean Americans, having chronic medical conditions, experiencing unmet healthcare needs, and having regular check-ups were significant predictors of TCAM use among Asian Americans as a whole. However, when we delved into sub-ethnic groups, different patterns were found. Among Vietnamese and Filipino Americans, having unmet healthcare needs emerged as the most prominent predictor of TCAM use. Furthermore, acculturation level and English proficiency were significant in predicting Vietnamese and Filipino Americans' TCAM use, with the direction varying by sub-ethnicity. Being old emerged as a predictor of TCAM use for Chinese, Indian, Korean, and 'other' Americans. Our findings underscore the importance of adopting an ethnically sensitive approach when addressing the healthcare needs of diverse Asian American populations.

Although breast cancer is the second leading cause of death among women in the United States, women from ethnic minorities still underutilize mammogram screenings. Immigrant Muslim women (IMW) demonstrated low mammogram screening rates compared to the national target of 77.1% determined by Healthy People 2030. Although IMW comprise an understudied population in the health field, a limited number of studies have proposed that Islamic religious beliefs have an impact on their behaviors and practices in regard to mammogram use. This study aimed to understand the meanings IMW ascribe to their religious beliefs in relation to mammogram utilization. A qualitative thematic analysis study was conducted on a purposive sample. A total of 28 IMW were recruited for one-on-one interviews in either Arabic or English, and inductive thematic analysis as per Braun and Clarke (2008) informed data analysis, guided by symbolic interactionism. A total of 28 interviews (10 in English and 18 in Arabic) were conducted with IMW whose mean age was 54.7. During these interviews, three major themes emerged regarding the participants' experience with mammograms, within the context of their religious beliefs: (a) 'Your body is a trust,' (b) the notions of al-tawakkul and al-tawaakoul, and (c) religious methods for coping with mammogram use. Results from this study suggests some religious means that can be integrated into an educational program designed for IMW to enhance their mammogram screening rates.

Despite the improvements in HIV care outcomes in the United States (US), non-US-born persons continue to be disproportionately affected by HIV. We analyzed National HIV Surveillance System (NHSS) data on HIV diagnoses, stage 3 (AIDS) at diagnosis, linkage to medical care, and viral suppression for non-US-born persons by region of birth (RoB) reported to the (NHSS) in 2020 to determine care outcomes among this population. Overall, a larger proportion of non-US-born persons received a late-stage diagnosis [stage 3 (AIDS)] classification. Among all non-US-born persons, African-born males, Asian-born females, and persons aged 55 + years had the highest proportions of late-stage diagnosis. Despite a late-stage of diagnosis, a higher proportion of non-US-born persons were linked to medical care and were virally suppressed compared to US-born persons. HIV care outcomes varied by RoB and selected characteristics. Knowing the RoB of non-US-born persons is necessary to identify culturally sensitive approaches for prevention planning and increasing testing activities to ultimately increase early diagnosis in this population.

The aim of this project was to increase willingness to receive the influenza vaccine to the optimal rate of ≥ 70%. Low acuity adult patients who visited an Emergency Department (ED) were assessed regarding their willingness to receive the influenza vaccine before and after an educational intervention that included a provider recommendation and an educational handout. A total of seventy-six patients (n = 76) were assessed. Patients' willingness to receive the influenza vaccine rose from 29% pre-intervention to 72% post-intervention without disrupting the clinical flow in a busy ED. Similar vaccine educational strategies can be applied to influenza and other vaccines in EDs  to increase vaccination willingness in patients, including those who use the ED as a primary point of contact for healthcare, decreasing the burden of influenza illness in the community.

Ethnic minority women experience disparities in mammography screening utilisation and breast cancer outcomes. This systematic review and meta-analysis synthesised multidomain and multilevel factors that intersect to influence the utilisation of mammography among ethnic minorities. A literature search was conducted in five databases (PubMed, Ovid MEDLINE, EMBASE, CINAHL, and PsycINFO) from inception to May 2022. Guided by the National Institute on Minority Health and Health Disparity research framework, the retrieved data were synthesised using narrative summaries and meta-analyses. Among the 27 studies, most (n = 24) reported individual, interpersonal, and community factors in the health care system domain. In the sociocultural domain, interpersonal and societal (n = 8) factors, such as modesty and karma beliefs, were less frequently identified than individual (n = 20) factors in relation to acculturation. Only individual-level factors were reported for the biological and physical/built environment (e.g., rural residence) domains. In the behavioural domain, cancer screening behaviours had a high combined prediction ability (odds ratio = 18.23; I² = 23%), whereas interpersonal (e.g., family obligations) and community (e.g., neighbourhood violence) factors discouraged mammography screening. Special focus should be given to ethnic minority women, especially those living in rural areas, those with considerable family obligations, and those who have suffered from violence and other life pressures, to increase their access to mammography services. Multidomain and multilevel efforts, culturally appropriate strategies, and equity-advancing policies such as geographic access and insurance coverage would help to mitigate the ethnic disparities in mammography screening.

In Japan, a considerable number of foreigners encounter challenges in accessing appropriate healthcare services due to the lack of insurance coverage. However, the absence of a public database on these individuals makes it difficult to assess their health problems and healthcare access status. This study aims to investigate the characteristics of vulnerable Thai patients in Japan and to shed light on the specific challenges they face within Japan's healthcare system. A retrospective analysis was conducted using records of patients who required emergency healthcare support from the Royal Thai Embassy in Tokyo between 2004 and 2020. Descriptive statistical analyses were performed to examine the general characteristics, insurance status, and diseases of the patients. Additionally, patients were classified as either prolonged residents or brief residents based on their duration of stay in Japan until hospital admission (1 year or more or less than 1 year). A total of 74 patients were identified, with the majority (91.9%) lacking insurance coverage. Notably, there was an increase in the number of brief residents, including tourists, during the 2010s. Prolonged residents were more likely to experience chronic diseases, whereas brief residents were more prone to sustaining injuries. The patient records from the Thai Embassy consistently highlight the urgent requirement for emergency healthcare support within this population. However, the existing policies in Japan fall short in adequately addressing the healthcare access needs of this vulnerable population. Therefore, it is crucial to provide additional support and interventions to enhance their healthcare access.