Journal of Immigrant and Minority Health最新文献

Culturally sensitive palliative care for patients with a migration background (PwM) remains a critical but underexplored field, especially in the German healthcare context. Our study employs Dave Gray's empathy map to capture healthcare providers' perspectives on the challenges, needs, and experiences of PwM in hospice and palliative care. We investigated palliative care challenges through open-ended questions in an online survey conducted across various hospice and palliative care settings. Based on 332 completed responses, our analysis revealed significant barriers to delivering culturally sensitive care. Using qualitative content analysis, we applied an empathy map to identify categories. Findings showed that language barriers and cultural insensitivity notably hindered communication, access, and trust-building. PwM often relied on family networks, which caused delayed care-seeking and logistical difficulties. Despite these challenges, PwM strived for dignity, trust, and care aligned with their cultural background. Our study highlights the importance of empathy-based approaches in hospice and palliative care and the effectiveness of the empathy map as an instrument for identifying challenges and gaps. By addressing the specific needs of PwM, the findings contribute meaningful insights for healthcare providers, policymakers, and researchers.

Over 5 million South Asians (SAs) live in the United States, and it is one of the fastest-growing populations. SAs, have high rates of cardiovascular risk factors, and are likely to experience unique challenges as they age. The South Asian Healthy Aging Research project assesses attitudes toward aging and dementia in the SA community. A cross-sectional online survey was conducted in 2022-24 with participants ≥ 18 years old who self-identified as South Asians. Participants were recruited through community outreach efforts in Greater Atlanta to assess their perception of aging and dementia, stress, discrimination, and health literacy. 191 participants completed the surveys, with an average age of 43.9 (SD: 13.1) years and 50.5% were female. Approximately 80% were first-generation immigrants, and 97% had high school or above level education. Despite high education levels, language barriers were a concern, with 24% feeling misunderstood due to their language and 42.9% preferring healthcare materials in their native language. High levels of stress were reported with 25% experiencing workplace discrimination. More than 64% were aware of someone living with dementia but had misconceptions regarding the condition, with 66% believing memory loss is inevitable with age and 30.2% having stigma associated with dementia. Findings demonstrate a lack of awareness of risk factors of dementia and high levels of chronic stress within this SA cohort. The findings highlight the necessity for culturally tailored outreach and educational programs to improve awareness of healthy aging and brain health in this high-risk population.

Globalization has contributed to a significant rise in intercontinental migration from Africa, a trend expected to continue given the ongoing political and economic challenges in many African countries and the perceived opportunities in higher-income Western nations. These migration patterns threaten the preservation of valuable cultural practices and intergenerational food knowledge due to limited resources and supports for African families in host countries. While a considerable body of research exists on immigrant health and dietary acculturation broadly, there remains a notable gap in literature focusing specifically on the experiences of Sub-Saharan African immigrants in higher-income countries. This scoping review therefore aims to: (1) examine existing literature on the nutritional health and social wellbeing of Africans immigrants in higher-income countries; (2) explore the relationships between dietary behaviours, social norms, cultural practices and acculturation; and (3) identify priorities for future research, policy and interventions. Three online databases (PubMed, Scopus and PsycINFO) were utilized to identify relevant studies, yielding in 343 articles. These articles were uploaded into Covidence for screening, resulting in 44 studies included in the final extraction and analysis. Four key themes emerged, highlighting the nutritional, cultural, and social challenges that affect Sub-Saharan African immigrants' integration into new food environments. These interrelated challenges can hinder African immigrants' efforts to maintain cultural food practices and contribute to difficulties in establishing a sense of belonging in their host countries. Findings highlighted the need for further research on the lived experiences of Sub-Saharan African immigrants with an emphasis on culturally informed strategies to support their health, dietary wellbeing, and social inclusion.

Self-efficacy theory proposes that confidence to engage in a health behavior is associated with engaging in that specific behavior. Most research examining self-efficacy has been conducted with white young adult populations. This cross-sectional analysis examined the association of self-efficacy (i.e., confidence) for healthy eating and physical activity in two immigrant communities. At enrollment into the Healthy Immigrant Community study, a clinical weight management and cardiovascular risk reduction intervention set in southeastern Minnesota, 475 participants completed assessments about their confidence for healthy eating and physical activity. Measurements also included self-reports of dietary quality and intake, physical activity, quality of life, and biometric assessments. Study materials were available in English, Spanish, and Somali. In total, 450 adults (Hispanic/Latinx = 267; Somali = 183) completed measures at baseline and were included for analysis. Their average age was 45 years (range 18-87) and 59% were female. Confidence for healthy eating was significantly correlated with self-report of eating healthy snacks (p = < 0.0001) and less consumption of high-calorie drinks (p = 0.02) and regular soda (p = < 0.0001). Confidence to be physically active was significantly correlated with more self-reported physical activity (p = < 0.01). Confidence to eat healthy and be physically active appears to be correlated with having a healthier diet and higher levels of physical activity. Given the large sample size and strength of the associations, it also appears that the theoretical model of self-efficacy can be effectively measured and applied within these immigrant populations. Self-efficacy theory may be useful in understanding potential mediating mechanisms when designing future interventions with immigrant communities.ClinicalTrials.gov registration: NCT05136339; April 23, 2022.

Engagement with the criminal-legal system is known to disproportionately affect and harm marginalized patients, as well as erode institutional trust. However, the degree of law enforcement involvement in the care of traumatically injured patients nationally is not clearly established. This study aims to assess differences in criminal-legal system engagement among marginalized trauma patients by residence status and estimate effects on patient care. This cross-sectional retrospective study of housed, unhoused, or migrant and/or undocumented adult trauma patients utilized trauma registry data (2021-2022) in the Trauma Quality Programs (TQP) database. Pre-hospital police transport or discharge to court/law enforcement represented criminal-legal system engagement. Regression models estimated differences in rate of criminal-legal system engagement by residence status and predicted effect on hospital length of stay (LOS), adjusting for patient age, race, sex, ethnicity, payer, assault as mechanism, and injury severity score. 1,540,173 patients were included, of whom 15,805 were unhoused and 1,564 were migrant/undocumented. Unhoused patients had lower odds of police transport to the hospital (aOR:0.77 [95% CI:0.64-0.92]) but higher odds of discharge to the criminal-legal system (1.30 [1.16-1.45]) compared to housed patients. Migrant/undocumented patients had higher odds of police transport (17.5 [14.6-21.0]) and criminal-legal system discharge (19.6 [17.2-22.3]) than housed patients. Criminal-legal system discharge predicted reduced LOS, particularly for migrant/undocumented patients (beta:-70.9 h [-104.5,-37.3]). The trauma encounter may disproportionately act as a point of entry into the criminal-legal system for unhoused and migrant/undocumented patients regardless of pre-hospital police transport. Criminal-legal system engagement shortens hospital LOS, raising concerns for unwarranted differences in care.