Journal of Immigrant and Minority Health最新文献

Colorectal cancer (CRC) is the second leading cause of cancer mortality among Latinos who remain underrepresented in screening and are more often diagnosed at later stages, leading to poorer outcomes. Barriers include low health literacy, lack of insurance, limited access to screening, and cultural mistrust of healthcare and research. To implement the Colorectal Health Research Champion (CHRC) Model to address CRC screening disparities among immigrant Latinos, primarily from Central and South America, residing in Richmond, VA's urban Latino community. The CHRC model integrates evidence-based strategies from Screen to Save (S2S), the National Outreach Network Community Health Educator (NON-CHE) program, and Massey Comprehensive Cancer Center's Community Champion program. Five trained champions conducted peer-to-peer chats on CRC symptoms, risk factors, screening guidelines, healthy behaviors, and clinical trials. Pre and post-surveys were collected from 52 Latino participants. The Wilcoxon signed-rank test assessed changes in knowledge and screening intent. Baseline CRC awareness and screening rates were low. Post-intervention, participants showed notable improvements in recognizing CRC risk factors such as physical inactivity, family history, and the importance of early detection. Participants also demonstrated a better understanding of screening options like the FIT test and expressed willingness to adopt healthier behaviors and pursue screening. However, mistrust and limited understanding of research remained challenges. The CHRC model successfully enhanced CRC knowledge, screening, and early detection awareness among Latinos, while encouraging consideration of clinical trial participation. Success was driven by trusted community champions leveraging social networks, culturally tailored education, addressing research hesitancy, and using flexible outreach strategies.

Forced displacement has reached unprecedented levels globally, with women and girls comprising over half of the refugee population. In South and Southeast Asia, transit refugee women face unique health challenges, yet their health experiences and needs remain underexplored and underserved. This review explores the existing evidence on the health experiences and healthcare access of transit refugee women in these regions. A search was conducted using PubMed [MEDLINE], Scopus, Google Scholar, alongside UNHCR, WHO, and IOM databases between October 2023 and January 2024. Peer-reviewed and grey literature published from 2013 to 2024 that analysed health outcomes and experiences of transit refugee women in South and Southeast Asia were included. A narrative synthesis was used to identify the major themes related to the health outcomes and healthcare access of transit refugee women. Fourteen articles met the inclusion criteria, of which a majority of the studies were from Bangladesh, Thailand-Myanmar border, and Malaysia, mainly drawing insights from Rohingya, Karen, and Chin communities. Key health issues included sexual and reproductive health, including family planning, contraceptive use, HIV transmission, sexual and gender-based violence, and mental health. Distance and availability of health services, spousal consent for health-seeking, out-of-pocket health expenditure, cultural and religious beliefs, and stigmatization were barriers to accessing healthcare. These barriers may contribute to foregoing contraceptive usage, poor family planning, poor HIV-related health knowledge transmission, high psychological distress, and poor mental health outcomes. However, targeted interventions such as having the UNHCR card, the availability of health clinics within camps, recruiting female health workers, provision of counselling and health education programs, can positively influence health outcomes, healthcare seeking and utilization behaviours, and health knowledge transmission. Transit refugee women in South and Southeast Asia face significant challenges due to unmet health needs and limited healthcare access. These insights highlight the need for future health research, programs and policy action to better integrate targeted, gender-responsive interventions that can enhance health access of this vulnerable subgroup regionally.

The current use of identifiers to describe immigrant patients in Electronic Health Records (EHRs) is poorly described and lacks standardization, but nevertheless has broad implications related to clinical care and research of this population. We conducted interviews with stakeholders to discern strong identifiers for use to identify patients who have immigrated to the United States (U.S.). Language, country of origin, time in the U.S., and race/ethnicity were identified as effective, ethical, and acceptable for use. Limitations of each of these identifiers were noted, highlighting the need to use multiple identifiers in combination when describing patients in EHRs. The processes used to collect these identifiers in clinical settings and the ethical implications of using these identifiers must also be carefully considered. Our results highlight the need for standards related to documentation of immigrant patients in EHRs. Further research is also needed to validate the identifiers we have outlined, discern additional identifiers that are useful and acceptable in specific clinical and research contexts, and explore how strong identifiers can be operationalized in EHRs for clinical, research, and community engagement purposes.

This study examines the attitudes of students in Medical and Health Sciences faculties in Turkey toward Syrians and identifies the factors shaping these attitudes. 465 students were included in the cross-sectional study. Data were collected via an online survey form, which included demographic questions and the Attitudes Towards Syrians Scale. The survey included demographic questions and the Attitudes Toward Syrians Scale. Descriptive statistics, t-tests, ANOVA, and linear regression analysis were employed for data analysis. Age was negatively correlated with discrimination scores (r=-0.203, p < 0.001), suggesting that older students exhibited lower levels of discrimination. Students with negative experiences involving Syrians had significantly higher discrimination scores (p < 0.001). Those perceiving fewer cultural similarities also had higher discrimination scores (p < 0.001). Faculty differences were significant, with Health Sciences students displaying higher discrimination scores than medical students (p = 0.008). Among departments, Emergency and Disaster Management students reported the highest levels of discrimination (p < 0.001). Age, cultural perceptions, and personal experiences influence students' attitudes toward Syrians. Cultural awareness programs and opportunities for positive interactions may help reduce discrimination, particularly among younger students and those with limited cultural engagement. These findings emphasize the importance of inclusive education policies in fostering social cohesion within healthcare settings.

During the first year of respiratory syncytial virus (RSV) immunoprophylaxis availability in 2023, quantitative studies found increased acceptance amongst parents who speak languages other than English, and qualitative studies of English-speaking parents identified hesitation about the novelty and side effects of the immunization. In this study, we sought to explore perspectives of Spanish-speaking parents on RSV immunoprophylaxis. Qualitative methodology was used to interview, using an interpreter, parents who speak Spanish (the most common non-English primary language of our patient population) of healthy term and late preterm newborns admitted to the maternity and well-newborn units between October 2024- February 2025. Semi-structed interviews were performed in a constant comparative matter until thematic sufficiency was reached. We conducted 21 interviews that included 25 participants; 81% of participants planned to give RSV immunoprophylaxis to their infant. Four major themes emerged: (1) most Spanish-speaking parents of healthy newborns reported a general lack of knowledge about RSV and RSV immunoprophylaxis, (2) many reported that they would trust the pediatricians on whatever was recommended to protect their newborns, (3) discussions around RSV immunoprophylaxis upon admission to the postpartum unit was not ideal, and (4) quality of interpretation services may have affected decision-making. Spanish-speaking parents frequently accepted the pediatricians' and nurses' recommendations for RSV immunoprophylaxis despite reporting a lack of knowledge on the subject. We identified potential inequities in the newborn immunization consenting process with families who speak Spanish which require further exploration.

Mixed-documentation status Latino families face unique barriers to accessing healthcare and public benefits. We examined the experiences of undocumented Latina mothers in North Carolina and the role of anti-immigrant policies and rhetoric in their decisions to access care and public benefits for themselves and their U.S.-born infants. We conducted a qualitative descriptive study to explore Latina mothers' experiences seeking care for themselves and their infants during the perinatal period. We used Emergency Medicaid at delivery as a proxy to identify undocumented mothers with U.S.-born infants. Twenty semi-structured audio interviews were conducted in Spanish via Zoom. We used rapid qualitative content analysis for timely, action-oriented analysis. Rapid qualitative analysis uses visual displays, such as matrices, to connect and analyze findings. Five themes emerged: confusion around public benefit eligibility and complicated enrollment processes; concerns and fears around immigration policy and rhetoric; cost as the most influential barrier to healthcare; positive experiences with language support and respectfulness of providers; "making it work" with the help of social support systems. While mothers narrated their experiences in the setting of prohibitive costs of accessing healthcare and fears and confusion about public benefits, they viewed meeting their child's health needs as a necessity, with social support systems important in navigating complex systems. Postpartum undocumented mothers with U.S.-born infants experience several barriers to NC Medicaid and public benefit enrollment for their infants, including complicated application processes, costs, and immigration-related fear. Advocacy is needed to prevent the dismantling of existing policies and create inclusive policies for immigrants.

Undocumented immigrants in the US rely on community health clinics (CHCs) and emergency departments (EDs) for preventive and acute care due to health insurance ineligibility and financial constraints. CHCs provide low-cost, accessible healthcare for thousands of undocumented immigrants in cities throughout the U.S. Limited evidence exists on this population's use of EDs despite establishing care in CHCs. This cross-sectional study described the key characteristics of ED visits among undocumented immigrants with established care at a single CHC in a major US city. ED visits (n = 319) were extracted using a random sample of patient records from a CHC serving a largely undocumented population between April 1, 2023, and April 1, 2024. The most common discharge diagnoses were categorized as infections (23%), injuries (22%), gastrointestinal diseases (16%), and OB/GYN diseases (11%). Disposition data showed that 81% of patients were discharged directly from the ED, 14% were admitted to the hospital, and 4% were placed under observation. For 309 visits, 61% were classified as preventable by the NYU ED algorithm (NYU-EDA). These findings suggest that most visits were preventable or primary care treatable, often driven by acute health issues rather than chronic care needs. Study results inform how CHCs, EDs, and health systems can address care gaps, enhance preventative care strategies, and advance equitable care delivery.

This study assessed the impact of reproductive health literacy training for general, digital, and reproductive health literacy among Afghan and Arab refugees. From September 2023 to June 2024, the research team offered reproductive health literacy training (RHLT) series to Dari-, Pashto-, and Arabic-speaking refugees online and at public libraries in Sacramento, California. The RHLT series presented information on cervical cancer prevention, family planning, and maternal health with an emphasis on participants' ability to independently find reliable health information and use it for their own and their families' health decisions. A total of 203 participants completed the pre-assessment and post-assessment, administered two weeks after the final training session. Each assessment included validated scales, including the European Health Literacy Survey Questionnaire 6 (HLS-EU-Q6) and the eHealth Literacy Scale (eHEALS). Study participants in all three language groups significantly improved general health literacy, reproductive health literacy and reproductive knowledge (p < 0.05). Improvements in the digital health literacy scale (eHEALS) were borderline significant (p = 0.0506) and significant for Dari speakers (p < 0.05). There were no differences among the three language groups when controlling for age, education, and length of stay in the United States. These results showed that reproductive health literacy training that focuses on understanding and using health information is effective in increasing health literacy among Afghan and Arab refugee women with diverse cultural and demographic backgrounds. Scalable health literacy modules have the potential to reduce health disparities and empower informed decision-making within underserved populations.