Journal of Immigrant and Minority Health最新文献

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.

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.