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Suicide Behavior Among Indigenous and Non-Indigenous Living with HIV: A Cross-Sectional Study in Indonesia 土著和非土著艾滋病毒感染者的自杀行为:印度尼西亚的一项横断面研究
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-15 DOI: 10.1007/s10903-024-01593-7
Elfride Irawati Sianturi, Viona Stephany Longe, Retha Arjadi, Nur Fadilah Bakri, Elsye Gunawan, Ego Srivajawaty Sinaga

Suicide remains a major public health problem, with nearly 1 million deaths per year. The number tends to increase over time and factors leading to suicide suicidal behaviors are complex. However, there is a paucity of evidence on suicidal behaviors and the associated factors among people living with HIV (PLWH) in Indonesia. Therefore, this study aimed to estimate the prevalence and associated factors of suicidal behavior between indigenous and non-indigenous living with HIV who were on Dolutegravir and Efavirenz therapies. The cross-sectional data were collected using questionnaires. Participants completed the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Depression Anxiety Stress Scale-42 (DASS-42), HIV Stigma-Sowell Scale, and demographic information questions. The outcome was low and high self-reported suicidal behaviors, while logistic regression analyses were used to estimate adjusted odds ratios (aOR) for associated factors of high suicidal behaviors. A total of 200 PLWH were enrolled and 8.5% of the participants had high levels of suicidal behaviors. The majority of participants were Efavirenz users (84.0%), and Papuans as Indigenous (75.5%). More than half had a high school education (60.5%), were female (58%), married (54%), and unpaid (59%). The multiple logistic regression model showed that indigenous (aOR = 0.122; 95% CI = 0.029–0.514), and people who had children (aOR = 0.221; 95% CI = 0.051–0.957) were more likely to have low suicidal behaviors. Participants who were aged 18–27 years (aOR = 5.894; 95% CI = 1.336–30.579), had high self-blame (aOR = 1.342; 95% CI) = 1.004–1.792), and detectable HIV viral load (aOR = 6.177; 95%CI = 1.118–34.119) had high suicidal behavior. This study identified the risk of suicidality among PLWHs is high and routine suicide assessment is prioritized. The findings are also useful for intervention design and the development of clinical practice guidelines to manage the well-being of PLWH such as using digital intervention to cope with hindrances.

自杀仍然是一个重大的公共卫生问题,每年有近 100 万人死于自杀。随着时间的推移,这一数字呈上升趋势,而导致自杀行为的因素十分复杂。然而,有关印度尼西亚艾滋病病毒感染者(PLWH)自杀行为及其相关因素的证据却很少。因此,本研究旨在估算接受多鲁特韦和依非韦仑治疗的土著和非土著艾滋病病毒感染者的自杀行为发生率和相关因素。研究采用问卷调查的方式收集横断面数据。参与者填写了自杀行为问卷-修订版(SBQ-R)、抑郁焦虑压力量表-42(DASS-42)、HIV 耻辱-索威尔量表以及人口统计学信息问题。结果为自我报告的自杀行为较少和较多,而逻辑回归分析则用于估算与自杀行为较多相关因素的调整几率比(aOR)。共有 200 名 PLWH 参与了这项研究,其中 8.5% 的参与者有严重的自杀行为。大多数参与者为依非韦伦使用者(84.0%),原住民为巴布亚人(75.5%)。半数以上受过高中教育(60.5%),女性(58%),已婚(54%),无报酬(59%)。多元逻辑回归模型显示,原住民(aOR = 0.122;95% CI = 0.029-0.514)和有子女的人(aOR = 0.221;95% CI = 0.051-0.957)更有可能有低自杀行为。年龄在 18-27 岁(aOR = 5.894;95% CI = 1.336-30.579)、自责程度高(aOR = 1.342;95% CI = 1.004-1.792)、可检测到 HIV 病毒载量(aOR = 6.177;95%CI = 1.118-34.119)的参与者自杀行为发生率较高。这项研究发现 PLWHs 的自杀风险很高,因此应优先进行常规自杀评估。研究结果还有助于设计干预措施和制定临床实践指南,以管理 PLWH 的福祉,如使用数字干预措施来应对障碍。
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引用次数: 0
Co-designing a Physical Activity Service for Refugees and Asylum Seekers Using an Experience-Based Co-design Framework 利用基于经验的共同设计框架,为难民和寻求庇护者共同设计体育活动服务
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-12 DOI: 10.1007/s10903-024-01587-5
Grace McKeon, Jackie Curtis, Reza Rostami, Monika Sroba, Anna Farello, Rachel Morell, Zachary Steel, Mark Harris, Derrick Silove, Belinda Parmenter, Evan Matthews, Juliana Jamaluddin, Simon Rosenbaum

People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or ‘touchpoints’ including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing.

在澳大利亚重新定居的难民和寻求庇护者往往面临着身心健康状况不佳的交叉风险。体育锻炼可以促进健康状况的改善,但针对这一人群的体育锻炼计划却十分有限。因此,了解如何支持难民和寻求庇护者参与体育锻炼至关重要。本文旨在介绍如何利用基于经验的共同设计(EBCD)过程来确定为难民和寻求庇护者提供新的体育活动服务的优先事项。通过使用 EBCD 框架,我们在澳大利亚悉尼的一个社区中心与服务使用者(生活在社区中的难民和寻求庇护者)和服务提供者进行了定性访谈和共同设计研讨会。16 名参与者(包括 8 名服务使用者和 8 名服务提供者)参与了为期 12 个月的 EBCD 流程。访谈揭示了一些共同的主题或 "接触点",包括参与体育活动的障碍和促进因素,如交通、安全和竞争压力。随后的共同设计焦点小组确定了五个基本优先事项和可行策略:确保文化和心理安全、促进无障碍环境、为满足基本需求提供便利支持、提高体育活动素养以及促进社会联系。本研究采用 EBCD 方法,利用服务使用者和提供者的见解和生活经验,共同为难民和寻求庇护者设计了一项安全、支持、社交和无障碍的体育活动服务。该计划的实施和评估结果仍在进行中。
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引用次数: 0
The Need for Standardized Nomenclature in Electronic Documentation of Female Genital Cutting in Health Records 健康记录中切割女性生殖器官的电子文档需要标准化术语
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-08 DOI: 10.1007/s10903-024-01595-5
Jae Creger, Kalthum Abdikeir, Kyra Kaczmarczik, Nicole Chaisson, Crista E. Johnson-Agbakwu, Beatrice “Bean” E. Robinson, Jennifer Jo Connor

To evaluate the quality of Electronic Health Record (EHR) documentation practices of Female Genital Cutting (FGC) by medical providers. A retrospective chart review study of 99 patient encounter notes within the University of Minnesota health system (inclusive of 40 hospitals and clinics) was conducted. Extracted data included but was not limited to patient demographics, reason for patient visit, ICD code used in note, and provider description of FGC anatomy. Data was entered into REDCAP and categorized according to descriptive statistics. Out of 99 encounters, 45% used the unspecified code for FGC. The most common reason for patient visits was sexual pain, though many notes contained several reasons for the visit regarding reproductive, urological, or sexual concerns. 56% of visits discussed deinfibulation. 11 different terms for FGC were used, with “female circumcision” being the most common. 14 different terms for deinfibulation were found within 64 notes. 42% of encounters included a description of introitus size in the anatomical description, and only 38% of these provided a metric measurement. This study found significant variation in the quality of FGC documentation practices. Medical providers often used the unspecified FGC code, subjective and/or seemingly inaccurate descriptions of FGC/anatomy, and several different terms for both FGC and deinfibulation. Clearly, more education is needed in clinical training programs to (1) identify FGC type, (2) use the corresponding ICD code, and (3) use specific, objective descriptions (including presence/absence of structures and infibulation status).

目的:评估医疗服务提供者有关切割女性生殖器官(FGC)的电子病历(EHR)记录质量。我们对明尼苏达大学医疗系统(包括 40 家医院和诊所)内的 99 份患者就诊记录进行了回顾性病历审查研究。提取的数据包括但不限于患者人口统计学特征、患者就诊原因、病历中使用的 ICD 代码以及医疗服务提供者对 FGC 解剖的描述。数据被输入 REDCAP,并根据描述性统计进行分类。在 99 次就诊中,45% 使用了未指定的 FGC 代码。患者就诊的最常见原因是性疼痛,尽管许多病例记录中包含多个就诊原因,涉及生殖、泌尿或性方面的问题。56%的就诊者讨论了脱肛问题。使用了 11 种不同的术语来描述女性割礼,其中 "女性包皮环切术 "最为常见。在 64 份记录中发现了 14 个不同的脱阴毛术语。42% 的病例在解剖描述中包含了对阴道口大小的描述,其中只有 38% 提供了公制测量值。这项研究发现,FGC 文件记录的质量差异很大。医疗服务提供者经常使用未指定的 FGC 代码、主观和/或看似不准确的 FGC/解剖描述,以及 FGC 和脱纤毛术的多个不同术语。显然,临床培训课程中需要开展更多的教育,以便:(1)识别 FGC 类型;(2)使用相应的 ICD 代码;(3)使用具体、客观的描述(包括存在/不存在结构和脱纤状态)。
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引用次数: 0
Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees 口腔健康教育计划对难民口腔健康知识的影响
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-08 DOI: 10.1007/s10903-024-01594-6
Romana Muller, Lisa Bilich, Merri Jones

Inadequate comprehension of healthcare information contributes to poor health outcomes. Ethnic minorities are one of the populations most affected by low health and oral health literacy (OHL). The hypothesis of the current study was that an oral health education program (OHEP) can improve the OHL, oral health awareness and behaviors of refugees. We also hypothesized that there will be a difference between OHL in English and native language in the Pre-intervention phase. Fifty-two adult refugees participated in an educational program that included a comprehensive and culturally sensitive PowerPoint presentation and hands-on learning activities on oral health topics. The study used a cross-sectional pre-post study design. Before the program (Pre-intervention group), participants completed 2 surveys: Sociodemographic Survey and Oral Health Perceptions of Refugees in a bilingual format, and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English, and in the participants’ native language. Immediately after an OHEP (Post-intervention group), participants completed the EOHL-BL40 survey in English only. Two weeks after OHEP (Follow-up intervention), participants completed again the Sociodemographic Survey and Oral Health Perceptions of Refugees and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English only. The mean percentage of words understood on Pre-intervention EOHL-BL40 survey were significantly higher in native languages (47.3% ±3.7%) compared with survey in English (15.3% ±1.2%, P < 0.001). Post-intervention scores, immediately after educational program, were higher (28.6% ±2.4%), P < 0.001) for survey in English compared with the Pre-intervention (15.3% ±1.2%). The follow-up (2 weeks later) scores (25.5% ±2.4) were slightly lower than Post-intervention but still significantly higher (P < 0.001) than Pre-intervention. Results for both Sociodemographic Survey and Oral Health Perceptions of Refugees surveys were similar: the OHEP positively affected oral health awareness and oral health behaviors. Results of the study suggested that OHEP may improve oral health literacy, oral health awareness, and personal oral hygiene practices of refugees.

对医疗保健信息理解不足会导致不良的健康后果。少数民族是受低健康水平和口腔健康素养(OHL)影响最严重的人群之一。本研究的假设是,口腔健康教育计划(OHEP)可以提高难民的口腔健康素养、口腔健康意识和行为。我们还假设,在干预前阶段,英语和母语的口腔健康素养将存在差异。52 名成年难民参加了一个教育项目,该项目包括一个全面的、具有文化敏感性的 PowerPoint 演示和有关口腔健康主题的实践学习活动。该研究采用了横断面前后研究设计。在课程开始前(干预前组),参与者完成了两项调查:社会人口调查和难民口腔健康认知(双语),以及口腔健康素养评估--双语40(EOHL-BL40)(英语和参与者的母语)。OHEP结束后(干预后组),参与者仅用英语完成EOHL-BL40调查。OHEP结束两周后(后续干预组),参与者再次用英语完成 "社会人口调查"、"难民口腔健康认知 "和 "口腔健康素养评估-双语40"(EOHL-BL40)调查。在干预前的 EOHL-BL40 调查中,用母语理解单词的平均百分比(47.3% ±3.7%)明显高于用英语进行的调查(15.3% ±1.2%,P < 0.001)。与干预前(15.3% ±1.2%)相比,干预后(教育项目结束后)的英语调查得分更高(28.6% ±2.4%),P < 0.001。随访(2 周后)得分(25.5% ±2.4)略低于干预后得分,但仍显著高于干预前得分(P < 0.001)。社会人口调查和难民口腔健康认知调查的结果相似:OHEP 对口腔健康认知和口腔健康行为产生了积极影响。研究结果表明,OHEP 可提高难民的口腔健康素养、口腔健康意识和个人口腔卫生习惯。
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引用次数: 0
Caregiver Experience with Bicultural, Bilingual Family Navigators to Support Early Childhood Development 照顾者使用双文化、双语家庭导航员支持儿童早期发展的经验
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-08 DOI: 10.1007/s10903-024-01591-9
Abigail R. Grant, Brenna Cockburn, Farhiyo Ahmed, Rachel Dumanian, Yesenia Garcia, Jon Gould, Fernanda Martinez-Novoa, Madeline McFarland, Elizabeth Dawson-Hahn

Recognizing the inequities in developmental screening and services for children in immigrant families, a pediatric primary care clinic in partnership with a community-based early childhood program co-created a bicultural, bilingual early childhood developmental (ECD) family navigator program in Seattle, Washington. The primary aim of this study is to explore caregivers’ perspectives about this program. Twenty-seven caregivers of young children participated in semi-structured interviews that were thematically analyzed. Three key themes were identified: 1) sharing language and culture, 2) facilitating accessibility, and 3) promoting development. Caregivers valued linguistic and cultural concordance between the navigator and the family, the navigator’s approach to screening to improve accessibility and reduce barriers, and the focus on supporting early childhood development. Understanding caregivers’ experience with the ECD family navigator development program and the aspects they value, informs clinic-based approaches to ensure families of diverse language and cultural backgrounds have accessible development screening and connection to services.

华盛顿州西雅图市的一家儿科初级保健诊所认识到,移民家庭的儿童在发育筛查和服务方面存在不平等现象,因此与社区儿童早期发展项目合作,共同创建了一项双文化、双语的儿童早期发展(ECD)家庭导航员项目。本研究的主要目的是探讨照顾者对该计划的看法。27 名幼儿保育员参加了半结构式访谈,并对访谈进行了主题分析。确定了三个关键主题:1) 分享语言和文化,2) 促进无障碍环境,3) 促进发展。看护者重视导航员与家庭之间在语言和文化上的一致性、导航员为提高可及性和减少障碍而采取的筛查方法,以及对支持儿童早期发展的关注。了解照护者在幼儿发展家庭导航员发展计划方面的经验以及他们所重视的方面,可为诊所的方法提供参考,以确保不同语言和文化背景的家庭都能获得发展筛查和相关服务。
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引用次数: 0
Vision Loss in Children from Immigrant and Nonimmigrant Households: Evidence from the National Survey of Children’s Health 2018–2020 移民和非移民家庭儿童的视力损失:来自 2018-2020 年全国儿童健康调查的证据
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-06 DOI: 10.1007/s10903-024-01597-3

Abstract

The aim of this study was to determine whether immigrant generation is associated with caregiver-reported vision loss in children adjusting for sociodemographic characteristics. Nationally representative data from the National Survey of Children’s Health (2018–2020) was used. The primary exposure was immigrant generation defined as: first (child and all reported parents were born outside the United States); second (child was born in the United States and at least one parent was born outside the United States); third or higher (all parents in the household were born in the United States). The main outcome was caregiver-reported vision loss in child. Adjusted odds ratios (aOR) and 95% confidence intervals were computed based on immigration generation. The study sample included 84,860 US children aged 3–17 years. First generation children had higher adjusted odds of caregiver-reported vision loss (aOR 2.30; 95% CI 1.21, 4.35) than third or higher generation children after adjusting for demographic characteristics and social determinants of health. For Hispanic families, first generation (aOR 2.99; 95% CI 1.34, 6.66), and second-generation children (aOR 1.70; 95% CI 1.06, 2.74) had a higher adjusted odds of vision loss compared with third or higher generation children. Even when adjusting for sociodemographic characteristics, first generation children had greater odds of vision loss, especially in Hispanic households, than third generation children. Immigration generation should be treated as an independent risk factor for vision loss for children and is a social determinant of eye health.

摘要 本研究旨在确定移民世代是否与照顾者报告的儿童视力下降有关,并对社会人口特征进行调整。研究采用了全国儿童健康调查(2018-2020 年)中具有全国代表性的数据。主要暴露是移民世代,定义为:第一代(孩子和所有报告的父母都出生在美国境外);第二代(孩子出生在美国,父母中至少有一人出生在美国境外);第三代或以上(家庭中所有父母都出生在美国)。主要结果是护理人员报告的儿童视力下降。根据移民世代计算调整后的几率比(aOR)和 95% 的置信区间。研究样本包括 84,860 名 3-17 岁的美国儿童。在对人口特征和健康的社会决定因素进行调整后,第一代儿童与第三代或更高世代的儿童相比,其护理人员报告的视力下降调整几率更高(aOR 2.30;95% CI 1.21,4.35)。就西班牙裔家庭而言,第一代(aOR 2.99;95% CI 1.34-6.66)和第二代(aOR 1.70;95% CI 1.06-2.74)儿童与第三代或以上儿童相比,视力下降的调整后几率更高。即使对社会人口特征进行调整,第一代儿童视力下降的几率也高于第三代儿童,尤其是在西班牙裔家庭中。移民世代应被视为儿童视力丧失的一个独立风险因素,也是眼健康的一个社会决定因素。
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引用次数: 0
The Association Between Perceived Discrimination, Age and Proportion of Lifetime in the United States Among Somali Immigrants: A Cross-Sectional Analysis 索马里移民感知到的歧视、年龄与在美国终生居住比例之间的关系:横断面分析
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-05 DOI: 10.1007/s10903-024-01589-3
Abby M. Lohr, Rebekah Pratt, Hana Dirie, Yahye Ahmed, Hindi Elmi, Omar Nur, Ahmed Osman, Paul Novotny, Ahmed A. Mohamed, Joan M. Griffin, Irene G. Sia, Mark L. Wieland

Discrimination is detrimental to health. Little is known about perceived discrimination among Somali immigrants. We examined whether age or proportion of lifetime in the United States was associated with perceived discrimination among Somali immigrants. Guided by Intersectionality, we described a secondary analysis of Everyday Discrimination Scale (EDS) survey data from the Healthy Immigrant Community study. Younger participants ( ≤40 years) experienced more discrimination than older participants ( >40 years). Higher education, being male, and earning $20,000-$39,999 was associated with more perceived discrimination. These findings suggest that Somali immigrants who are younger, more formally educated, male, and/or earn $20,000-$39,000 report more discrimination than their counterparts. Possible explanations include exposure to discrimination outside the Somali community or more awareness about racism. Alternatively, the EDS may not capture the discrimination experienced by Somali women or older adults. Further research is needed to address the discrimination experienced by Somali immigrants. Clinical Trial Registration: NCT05136339, November 29,2021.

歧视不利于健康。人们对索马里移民感受到的歧视知之甚少。我们研究了年龄或终生居住在美国的比例是否与索马里移民感知到的歧视有关。在交叉性的指导下,我们对健康移民社区研究中的日常歧视量表(EDS)调查数据进行了二次分析。年轻的参与者(≤40 岁)比年长的参与者(40 岁)更容易受到歧视。教育程度较高、男性、收入在 20,000 美元至 39,999 美元之间的人受到的歧视更多。这些结果表明,年龄较小、受过较正规教育、男性和/或收入在 20,000 美元至 39,000 美元之间的索马里移民比他们的同龄人受到更多歧视。可能的解释包括在索马里社区以外受到歧视或对种族主义有更多的认识。另外,EDS 可能没有反映出索马里妇女或老年人所遭受的歧视。针对索马里移民遭受的歧视还需要进一步研究。临床试验注册:NCT05136339,2021 年 11 月 29 日。
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引用次数: 0
Health Disparities Among Children in Immigrant Households: New York City 2009 and 2017 移民家庭儿童的健康差异:纽约市 2009 年和 2017 年
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-03 DOI: 10.1007/s10903-024-01588-4
Jennifer Woo Baidal, Mary-Elizabeth Vachon, Amanda Hernandez, Diksha Brahmbhatt, Janet E. Rosenbaum, Sheng Li

We tested the hypothesis that children in New York City (NYC) with an immigrant parent were more likely to lack health insurance and report poorer parent-rated health compared to those of US-born parents in this serial, cross-sectional study using existing data from 2009 to 2017 among children age < 12 years in two NYC health surveys. Main outcomes were parent-reported responses for (1) child insurance coverage and (2) child general health status. In multivariable logistic regression models, we estimated likelihood of outcomes for children of immigrants compared to those of US-born parents, adjusting for child, parent, and household characteristics. We included 2,637 children in 2009 and 7,042 in 2017 in NYC. In 2017, children of immigrant parents were more likely to experience uninsurance than children of US-born parents [adjusted odds ratio (AOR) 2.36 (95% CI: 1.05–5.31)]. Compared to children of US-born parents, children with an immigrant parent were more likely to have a gap in insurance coverage in both 2009 (AOR 1.88; 95% CI: 1.08–3.27) and 2017 (AOR 1.60; 95% CI: 1.06–2.41). Although more children of immigrants had poor/fair health than those of US-born parents in both years, differences were not statistically significant after adjusting for covariates. Our findings among a sample of children eligible for health insurance suggest policies intended to expand child health care access did not equitably reach children of immigrants despite their eligibility for health insurance. Tailored interventions for children of immigrants are needed to mitigate disparities in health insurance coverage.

在这项系列横断面研究中,我们利用 2009 年至 2017 年纽约市两次健康调查中年龄为 12 岁的儿童的现有数据,检验了以下假设:与美国出生的父母相比,纽约市(NYC)父母一方为移民的儿童更有可能缺乏医疗保险,其父母评价的健康状况也更差。主要结果是家长报告的(1)儿童保险覆盖率和(2)儿童总体健康状况。在多变量逻辑回归模型中,我们估计了与美国出生的父母相比,移民子女的结果可能性,并对儿童、父母和家庭特征进行了调整。我们纳入了纽约市 2009 年的 2637 名儿童和 2017 年的 7042 名儿童。2017 年,父母均为移民的儿童比父母均在美国出生的儿童更有可能未参加保险[调整后的几率比(AOR)为 2.36(95% CI:1.05-5.31)]。与父母均在美国出生的儿童相比,父母一方为移民的儿童更有可能在 2009 年(AOR 1.88;95% CI:1.08-3.27)和 2017 年(AOR 1.60;95% CI:1.06-2.41)出现保险缺口。虽然在这两年中,健康状况较差/一般的移民子女多于父母均在美国出生的子女,但在调整协变量后,差异在统计学上并不显著。我们在符合医疗保险资格的儿童样本中的研究结果表明,尽管移民子女符合医疗保险资格,但旨在扩大儿童医疗保健机会的政策并没有公平地惠及他们。需要针对移民儿童采取有针对性的干预措施,以减少医疗保险覆盖面的差异。
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引用次数: 0
Asian American Women's Experiences of Discrimination and Health Behaviors during the COVID-19 Pandemic. 新冠肺炎大流行期间亚裔美国妇女的歧视经历和健康行为。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-01 Epub Date: 2023-10-26 DOI: 10.1007/s10903-023-01558-2
Katarina Wang, Alice Guan, Janice Seto, Debora L Oh, Kathie Lau, Christine Duffy, Esperanza Castillo, Valerie McGuire, Michelle Wadhwa, Clifford G Tepper, Heather A Wakelee, Mindy C DeRouen, Salma Shariff-Marco, Iona Cheng, Scarlett Lin Gomez

The COVID-19 pandemic exacerbated racism experienced by Asian Americans, especially women and older individuals. Little is known about how discriminatory experiences during the pandemic have influenced health behaviors among Asian Americans. Between 10/2021 and 6/2022, we surveyed 193 Asian American women in the San Francisco area. Participants were asked to report types of discrimination they experienced since March 2020. We explored bivariable associations of discrimination and changes in health behaviors and healthcare utilization. Most women were Chinese American (75%) and over 45-years-old (87%). The top three discriminatory experiences reported were being treated with less respect (60%), being treated unfairly at restaurants/stores (49%), and people acting as if they are better (47%). Chinese American women (vs. non-Chinese Asian American women) reported higher frequencies of being threatened/harassed (40% vs. 22%). Women who reported any discriminatory experience (vs. none) were more likely to report less physical exercise (42.7% vs. 26.3%) and canceling/rescheduling medical appointments (65.0% vs. 45.1%). Our findings begin to elucidate Asian American women's experiences of discrimination since the pandemic and provide evidence of the harmful impacts of anti-Asian racism on health behaviors.

新冠肺炎大流行加剧了亚裔美国人,尤其是妇女和老年人所经历的种族主义。人们对疫情期间的歧视经历如何影响亚裔美国人的健康行为知之甚少。2021年10月至2022年6月,我们对旧金山地区的193名亚裔美国女性进行了调查。参与者被要求报告自2020年3月以来所经历的歧视类型。我们探讨了歧视、健康行为变化和医疗利用的双变量关联。大多数女性是华裔(75%)和45岁以上(87%)。报告的前三大歧视经历是受到的尊重较少(60%),在餐馆/商店受到的不公平待遇(49%),以及人们表现得好像自己更好(47%)。华裔美国女性(与非华裔亚裔美国女性相比)受到威胁/骚扰的频率更高(40%与22%)。报告有任何歧视经历(与无歧视经历相比)的女性更有可能报告较少的体育锻炼(42.7%与26.3%)和取消/重新安排医疗预约(65.0%与45.1%)。我们的研究结果开始阐明自疫情以来亚裔美国女性的歧视经历,并为反亚裔种族主义对健康行为的有害影响提供证据。
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引用次数: 0
Delayed Diagnosis of Human Immunodeficiency Virus in the Latino Population at a Federally Qualified Community Health Center in New Jersey. 新泽西州一家联邦合格社区医疗中心对拉丁裔人群中人类免疫缺陷病毒的延迟诊断。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-01 Epub Date: 2023-12-26 DOI: 10.1007/s10903-023-01544-8
Zoee U D'Costa, Shane S Neibart, Laura E Jones, Mansi K Shah, Kathleen Page, Sneha Jacob

Late diagnosis of human immunodeficiency virus (HIV) is associated with early progression to acquired immunodeficiency syndrome (AIDS). We examined racial/ethnic differences in presentation with advanced HIV/AIDS at a community health center in New Jersey. Records of patients diagnosed with HIV between 1990 and 2018 were reviewed. Odds ratios (OR) of presenting with AIDS at HIV diagnosis were computed in unadjusted and adjusted models. There were 182 (48.3%) Latino, 48 (12.7%) non-Latino White (NLW), 130 (34.5%) non-Latino Black, and 17 (4.5%) non-Latino of other race/ethnicity included in the analysis. Over 75% of the Latinos were foreign-born. Latino patients had higher odds of presentation with AIDS at time of HIV diagnosis than NLW in unadjusted (OR = 4.85, 95% confidence interval (95% CI): 2.28-10.31) and adjusted models (OR = 3.71, 95%CI: 1.60-8.59). Latino patients, particularly foreign-born and bisexual, had higher odds of being diagnosed with AIDS at presentation with HIV in this cohort.

人类免疫缺陷病毒(HIV)的晚期诊断与获得性免疫缺陷综合征(AIDS)的早期发展有关。我们研究了新泽西州一家社区医疗中心的艾滋病晚期患者的种族/民族差异。我们查阅了 1990 年至 2018 年期间确诊为艾滋病患者的记录。在未经调整和调整的模型中计算了在确诊艾滋病毒时出现艾滋病的风险比(OR)。纳入分析的有 182 名(48.3%)拉丁裔、48 名(12.7%)非拉丁裔白人、130 名(34.5%)非拉丁裔黑人和 17 名(4.5%)其他种族/族裔的非拉丁裔。超过 75% 的拉丁裔患者在国外出生。在未调整模型(OR = 4.85,95% 置信区间 (95%CI):2.28-10.31)和调整模型(OR = 3.71,95%CI:1.60-8.59)中,拉丁裔患者在确诊艾滋病毒时出现艾滋病的几率高于北欧裔。在该队列中,拉丁裔患者,尤其是在国外出生的患者和双性恋患者,在感染艾滋病毒时被诊断为艾滋病的几率更高。
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Journal of Immigrant and Minority Health
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