Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100243
Ana Hagström , Henna Hasson , Anna-Clara Hollander , Carl Vahtra , Sara Delilovic , Hanna Augustsson
Background
Forced migrants are at risk of developing mental illness, yet challenges remain with underutilization of mental healthcare among this population. This study examined the implementation of the Refugee Health Screener-13 (RHS-13) in the health assessment for forced migrants in eight primary health care centres in Stockholm Region, Sweden.
Methods
A mixed-methods convergent parallel design was used, combining nurses self-reported quantitative data on the levels and reasons for RHS-13 use in the health assessment with qualitative interview data on the barriers and facilitators for RHS-13 use. The Consolidated Framework for Implementation Research (CFIR) was used as a coding framework for the qualitative analysis.
Results
Levels of RHS-13 use varied between primary health care centres, resulting in two groups: three centres with high-level (65–92%) and five centres with low-level (0–36%) implementation. Factors related to the tool itself, as well as the inner and outer context, influenced the use of RHS-13. Language barriers, insufficient time, and lack of trust in the validity and utility of RHS-13 were the main barriers, while its availability in many languages and that it was perceived as an important complement to the health assessment were the main facilitators.
Conclusion
RHS-13 contributes to the standardization of assessing mental health in the health assessment. Identifying context-based implementation strategies and addressing language and time issues as well as nurses trust in the tool's utility are recommended to enhance the use of RHS-13.
{"title":"“Sometimes it can be like an icebreaker”: A mixed method evaluation of the implementation of the Refugee Health Screener-13 (RHS-13)","authors":"Ana Hagström , Henna Hasson , Anna-Clara Hollander , Carl Vahtra , Sara Delilovic , Hanna Augustsson","doi":"10.1016/j.jmh.2024.100243","DOIUrl":"10.1016/j.jmh.2024.100243","url":null,"abstract":"<div><h3>Background</h3><p>Forced migrants are at risk of developing mental illness, yet challenges remain with underutilization of mental healthcare among this population. This study examined the implementation of the Refugee Health Screener-13 (RHS-13) in the health assessment for forced migrants in eight primary health care centres in Stockholm Region, Sweden.</p></div><div><h3>Methods</h3><p>A mixed-methods convergent parallel design was used, combining nurses self-reported quantitative data on the levels and reasons for RHS-13 use in the health assessment with qualitative interview data on the barriers and facilitators for RHS-13 use. The Consolidated Framework for Implementation Research (CFIR) was used as a coding framework for the qualitative analysis.</p></div><div><h3>Results</h3><p>Levels of RHS-13 use varied between primary health care centres, resulting in two groups: three centres with high-level (65–92%) and five centres with low-level (0–36%) implementation. Factors related to the tool itself, as well as the inner and outer context, influenced the use of RHS-13. Language barriers, insufficient time, and lack of trust in the validity and utility of RHS-13 were the main barriers, while its availability in many languages and that it was perceived as an important complement to the health assessment were the main facilitators.</p></div><div><h3>Conclusion</h3><p>RHS-13 contributes to the standardization of assessing mental health in the health assessment. Identifying context-based implementation strategies and addressing language and time issues as well as nurses trust in the tool's utility are recommended to enhance the use of RHS-13.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100243"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000321/pdfft?md5=0229f441ddf971c562a651826f4dd247&pid=1-s2.0-S2666623524000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100248
Lauren J. Shiman , Sarah Pickering , Diana Romero , Heidi E. Jones
Purpose
United States (US) immigrant populations face unique barriers to accessing health care, including reproductive health care. Abortion access and experiences among immigrant populations in the US are not well understood.
Methods
We conducted a systematic review to synthesize existing literature about US immigrant populations’ access to and use of abortion services. Eight studies met the eligibility criteria, which included being published in English and presenting at least one finding relevant to US immigrant populations’ access to or experience utilizing abortion; key findings were identified using content analysis.
Results
We present results organized within three main categories: (1) overall rates of abortion among immigrant versus US-born individuals, (2) characteristics of US immigrants who receive abortion services, and (3) barriers to abortion access for US immigrant populations, which included concepts pertaining to discrimination, challenges navigating the healthcare systems, and lack of knowledge about legal rights.
Conclusion
Study findings illustrate three categories of results relevant to immigrant experiences accessing abortion care in the US, including revealing barriers to abortion services rooted in lack of knowledge of US institutional systems and mistreatment in clinical and legal settings due to race or immigration status. Further research is needed to better understand nuances in experiences among immigrant subpopulations, experiences of US immigrants who speak a language other than English or Spanish, and use of self-managed abortions or abortions in informal settings among US immigrants.
{"title":"Abortion care access and experience among U.S. immigrants: A systematic review","authors":"Lauren J. Shiman , Sarah Pickering , Diana Romero , Heidi E. Jones","doi":"10.1016/j.jmh.2024.100248","DOIUrl":"10.1016/j.jmh.2024.100248","url":null,"abstract":"<div><h3>Purpose</h3><p>United States (US) immigrant populations face unique barriers to accessing health care, including reproductive health care. Abortion access and experiences among immigrant populations in the US are not well understood.</p></div><div><h3>Methods</h3><p>We conducted a systematic review to synthesize existing literature about US immigrant populations’ access to and use of abortion services. Eight studies met the eligibility criteria, which included being published in English and presenting at least one finding relevant to US immigrant populations’ access to or experience utilizing abortion; key findings were identified using content analysis.</p></div><div><h3>Results</h3><p>We present results organized within three main categories: (1) overall rates of abortion among immigrant versus US-born individuals, (2) characteristics of US immigrants who receive abortion services, and (3) barriers to abortion access for US immigrant populations, which included concepts pertaining to discrimination, challenges navigating the healthcare systems, and lack of knowledge about legal rights.</p></div><div><h3>Conclusion</h3><p>Study findings illustrate three categories of results relevant to immigrant experiences accessing abortion care in the US, including revealing barriers to abortion services rooted in lack of knowledge of US institutional systems and mistreatment in clinical and legal settings due to race or immigration status. Further research is needed to better understand nuances in experiences among immigrant subpopulations, experiences of US immigrants who speak a language other than English or Spanish, and use of self-managed abortions or abortions in informal settings among US immigrants.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100248"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000370/pdfft?md5=e9a020ec03fabcf1366c1641621728bb&pid=1-s2.0-S2666623524000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100279
Judith K Bass , Amanda Nguyen , Kittipong Sornlorm , Ye Htut Oo , Jarntrah Sappayabanphot , Catherine Lee , Wongsa Laohasiriwong
<div><h3>Background</h3><div>People living with non-communicable diseases (NCDs) such as hypertension and diabetes are at high risk for mental health and psychosocial problems. These problems, in turn, can lead to social isolation, lower quality of life, greater health needs, and poorer health outcomes. The prevalence of NCDs is rising in humanitarian settings, where residents are already at an increased risk of mental health problems due to trauma and stressful living conditions. Yet there has been limited focus on understanding experiences and intersections between these often-co-occurring health conditions in humanitarian settings. Improving this understanding holds promise for supporting integrated care and better patient health outcomes.</div></div><div><h3>Objective</h3><div>To describe mental health problems of displaced Myanmar adults with current poor medication adherence for hypertension and/or type 2 diabetes mellitus and identify factors associated with poor mental health among this population.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis of 224 adults with poor medication adherence (<70 %) for diabetes and/or hypertension treatment. Medication adherence was assessed using pill count. Demographic and physical health characteristics were collected; mental and behavioral health outcomes included a mental health symptom severity score generated based on symptoms of depression, anxiety and posttraumatic stress as well indicators of substance use. Data on sleep quality and self-efficacy for managing chronic disease were also collected. Multiple linear regression was used to identify factors associated with more severe mental health symptoms.</div></div><div><h3>Findings</h3><div>Among the 224 participants, 63.84 % were taking medication for hypertension, 17.86 % for diabetes mellitus, and 18.30 % for both. The sample was 70.98 % female and more than a third (37.5 %) were overweight or obese. Among the total sample, 29.91 % and 65.63 % reported ever using tobacco and betel nuts, respectively. In bivariate analyses, reported religious affiliation, financial situation, hypertension and diabetes comorbidity and more sleep problems were all significantly associated with poorer mental health; all of these factors other than religious affiliation remained significant in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>More than one-third of the displaced Myanmar adults who had suboptimal adherence to their chronic illness medications are living with moderate to severe mental health problems. The factors associated with more severe mental health problems were identified as having debt along with poor financial situation, having comorbid hypertension and diabetes, and having the worse scoring on the sleep problems scale. Integrating mental health support programs into chronic disease care systems is needed to help improve the overall health of this vulnerable population. Holistic approaches to improve economic
{"title":"Mental and behavioral health problems among displaced Myanmar adults exhibiting suboptimal adherence to chronic disease medication treatment in Thailand","authors":"Judith K Bass , Amanda Nguyen , Kittipong Sornlorm , Ye Htut Oo , Jarntrah Sappayabanphot , Catherine Lee , Wongsa Laohasiriwong","doi":"10.1016/j.jmh.2024.100279","DOIUrl":"10.1016/j.jmh.2024.100279","url":null,"abstract":"<div><h3>Background</h3><div>People living with non-communicable diseases (NCDs) such as hypertension and diabetes are at high risk for mental health and psychosocial problems. These problems, in turn, can lead to social isolation, lower quality of life, greater health needs, and poorer health outcomes. The prevalence of NCDs is rising in humanitarian settings, where residents are already at an increased risk of mental health problems due to trauma and stressful living conditions. Yet there has been limited focus on understanding experiences and intersections between these often-co-occurring health conditions in humanitarian settings. Improving this understanding holds promise for supporting integrated care and better patient health outcomes.</div></div><div><h3>Objective</h3><div>To describe mental health problems of displaced Myanmar adults with current poor medication adherence for hypertension and/or type 2 diabetes mellitus and identify factors associated with poor mental health among this population.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis of 224 adults with poor medication adherence (<70 %) for diabetes and/or hypertension treatment. Medication adherence was assessed using pill count. Demographic and physical health characteristics were collected; mental and behavioral health outcomes included a mental health symptom severity score generated based on symptoms of depression, anxiety and posttraumatic stress as well indicators of substance use. Data on sleep quality and self-efficacy for managing chronic disease were also collected. Multiple linear regression was used to identify factors associated with more severe mental health symptoms.</div></div><div><h3>Findings</h3><div>Among the 224 participants, 63.84 % were taking medication for hypertension, 17.86 % for diabetes mellitus, and 18.30 % for both. The sample was 70.98 % female and more than a third (37.5 %) were overweight or obese. Among the total sample, 29.91 % and 65.63 % reported ever using tobacco and betel nuts, respectively. In bivariate analyses, reported religious affiliation, financial situation, hypertension and diabetes comorbidity and more sleep problems were all significantly associated with poorer mental health; all of these factors other than religious affiliation remained significant in the multivariate analysis.</div></div><div><h3>Conclusions</h3><div>More than one-third of the displaced Myanmar adults who had suboptimal adherence to their chronic illness medications are living with moderate to severe mental health problems. The factors associated with more severe mental health problems were identified as having debt along with poor financial situation, having comorbid hypertension and diabetes, and having the worse scoring on the sleep problems scale. Integrating mental health support programs into chronic disease care systems is needed to help improve the overall health of this vulnerable population. Holistic approaches to improve economic","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100279"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100283
I Muhumed , J Meinilä , R Klemetti , FA Adebayo , SM Virtanen , M Erkkola
Background
Breastfeeding is a cornerstone of child health and survival as it provides crucial, non-replaceable nourishment necessary for infant's growth and development. Immigration has been shown to influence breastfeeding particularly among immigrants from low- and middle-income countries. Our aim was to examine breastfeeding practices and sociodemographic characteristics of Somali-, Arabic-, and Russian-speaking in comparison with Finnish-speaking mothers.
Methods
We analyzed data from 5348 mothers with infants who participated in FinChildren survey conducted in 2020. Univariate and multivariate analysis were used to estimate the association between maternal origin and breastfeeding practices by comparing immigrant mothers with native-born mothers.
Results
Somali-/Arabic-speaking mothers were younger, less educated and had higher BMI than Russian- and native Finnish-speaking mothers. Proportions of exclusive breastfeeding at 4–5 months of age were lowest among Somali-/Arabic-speaking mothers (21 %) compared to native-born (49 %) and to Russian-speaking mothers (52 %). Again, Somali-/Arabic-speaking mothers had the highest proportions of mixed feeding (66 %) compared to native Finnish-speaking (38 %) and Russian-speaking mothers (32 %). Being a Somali-/Arabic-speaking mother decreased the odds of exclusive breastfeeding five times (OR 0.20, 95 % CI 0.10–0.45) and quadrupled (OR 4.0, 95 % CI 2.18–7.37) the odds of mixed feeding at 4–5 months of age.
Conclusion
Even though the number of immigrant mothers was low, this study suggests that maternal origin is a significant predictor of suboptimal breastfeeding independent of sociodemographic and antenatal characteristics. There is a need for culturally sensitive interventions to promote breastfeeding among these groups.
背景母乳喂养是儿童健康和生存的基石，因为它为婴儿的成长和发育提供了不可替代的重要营养。研究表明，移民会影响母乳喂养，尤其是来自中低收入国家的移民。我们的目的是研究讲索马里语、阿拉伯语和俄语的母亲与讲芬兰语的母亲的母乳喂养习惯和社会人口特征。结果讲索马里语/阿拉伯语的母亲比讲俄语和芬兰语的母亲更年轻、受教育程度更低、体重指数（BMI）更高。与本地出生的母亲（49%）和讲俄语的母亲（52%）相比，讲索马里语/阿拉伯语的母亲在婴儿4-5个月大时进行纯母乳喂养的比例最低（21%）。同样，讲索马里语/阿拉伯语的母亲混合喂养的比例最高（66%），而讲芬兰语和俄语的母亲混合喂养的比例分别为38%和32%。作为索马里语/阿拉伯语母亲，纯母乳喂养的几率降低了五倍（OR 0.20，95 % CI 0.10-0.45），4-5个月大时混合喂养的几率增加了四倍（OR 4.0，95 % CI 2.18-7.37）。有必要采取文化敏感性干预措施来促进这些群体的母乳喂养。
{"title":"Breastfeeding practices among immigrants living in Finland: Results from the FinChildren survey","authors":"I Muhumed , J Meinilä , R Klemetti , FA Adebayo , SM Virtanen , M Erkkola","doi":"10.1016/j.jmh.2024.100283","DOIUrl":"10.1016/j.jmh.2024.100283","url":null,"abstract":"<div><h3>Background</h3><div>Breastfeeding is a cornerstone of child health and survival as it provides crucial, non-replaceable nourishment necessary for infant's growth and development. Immigration has been shown to influence breastfeeding particularly among immigrants from low- and middle-income countries. Our aim was to examine breastfeeding practices and sociodemographic characteristics of Somali-, Arabic-, and Russian-speaking in comparison with Finnish-speaking mothers.</div></div><div><h3>Methods</h3><div>We analyzed data from 5348 mothers with infants who participated in FinChildren survey conducted in 2020. Univariate and multivariate analysis were used to estimate the association between maternal origin and breastfeeding practices by comparing immigrant mothers with native-born mothers.</div></div><div><h3>Results</h3><div>Somali-/Arabic-speaking mothers were younger, less educated and had higher BMI than Russian- and native Finnish-speaking mothers. Proportions of exclusive breastfeeding at 4–5 months of age were lowest among Somali-/Arabic-speaking mothers (21 %) compared to native-born (49 %) and to Russian-speaking mothers (52 %). Again, Somali-/Arabic-speaking mothers had the highest proportions of mixed feeding (66 %) compared to native Finnish-speaking (38 %) and Russian-speaking mothers (32 %). Being a Somali-/Arabic-speaking mother decreased the odds of exclusive breastfeeding five times (OR 0.20, 95 % CI 0.10–0.45) and quadrupled (OR 4.0, 95 % CI 2.18–7.37) the odds of mixed feeding at 4–5 months of age.</div></div><div><h3>Conclusion</h3><div>Even though the number of immigrant mothers was low, this study suggests that maternal origin is a significant predictor of suboptimal breastfeeding independent of sociodemographic and antenatal characteristics. There is a need for culturally sensitive interventions to promote breastfeeding among these groups.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100283"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100254
Khouani Jeremy , Anne Desrues , Constance Decloitre-Amiard , Marion Landrin , Rachel Cohen Boulakia , Didier Thery , Gaëtan Gentile , Pascal Auquier , Maeva Jego
Background
Incidence of sexual violence among recently arrived asylum-seeking women in France (INCIDAVI) is a French study which found a past year incidence of 26 % for postarrival sexual violence (SV) among asylum-seeking women (ASW). It reported that fewer than 1 out of 10 victims consulted a healthcare professional when SV occurred. These findings raise the question of how ASW who have been victims of SV get involved in care. We aimed to explore the mechanisms and obstacles to seeking care in the host country among this population.
Methods
This qualitative phase of INCIDAVI was based on a grounded theory approach. Twenty semi structured interviews were conducted between February 1, 2022, and July 29, 2022. The interviews explored the conditions under which women talk about SV, the care pathway in France and the perceived consequences of care. We performed an inductive analysis using NVivo® 14 software.
Findings
Life paths of ASW are traversed by SV which influence their health and safety behaviour and can re-expose them to SV. Talking about SV is a rare choice focused on seeking protection. When appropriate care is used, it is perceived as beneficial and leads to a change in the perception of a possible recovery.
Interpretation
The failure of ASW to seek care for SV is shaped by the fact that SV is initially perceived as ordinary. A proactive attitude on the part of carers towards detecting such violence leads to positive experiences of care, which in turn influence women's initial perceptions of SV, enabling them to envisage health recovery.
{"title":"Strategies for seeking care in the host country among asylum-seeking women who have been victims of sexual violence: A French qualitative study","authors":"Khouani Jeremy , Anne Desrues , Constance Decloitre-Amiard , Marion Landrin , Rachel Cohen Boulakia , Didier Thery , Gaëtan Gentile , Pascal Auquier , Maeva Jego","doi":"10.1016/j.jmh.2024.100254","DOIUrl":"10.1016/j.jmh.2024.100254","url":null,"abstract":"<div><h3>Background</h3><p>Incidence of sexual violence among recently arrived asylum-seeking women in France (INCIDAVI) is a French study which found a past year incidence of 26 % for postarrival sexual violence (SV) among asylum-seeking women (ASW). It reported that fewer than 1 out of 10 victims consulted a healthcare professional when SV occurred. These findings raise the question of how ASW who have been victims of SV get involved in care. We aimed to explore the mechanisms and obstacles to seeking care in the host country among this population.</p></div><div><h3>Methods</h3><p>This qualitative phase of INCIDAVI was based on a grounded theory approach. Twenty semi structured interviews were conducted between February 1, 2022, and July 29, 2022. The interviews explored the conditions under which women talk about SV, the care pathway in France and the perceived consequences of care. We performed an inductive analysis using NVivo® 14 software.</p></div><div><h3>Findings</h3><p>Life paths of ASW are traversed by SV which influence their health and safety behaviour and can re-expose them to SV. Talking about SV is a rare choice focused on seeking protection. When appropriate care is used, it is perceived as beneficial and leads to a change in the perception of a possible recovery.</p></div><div><h3>Interpretation</h3><p>The failure of ASW to seek care for SV is shaped by the fact that SV is initially perceived as ordinary. A proactive attitude on the part of carers towards detecting such violence leads to positive experiences of care, which in turn influence women's initial perceptions of SV, enabling them to envisage health recovery.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100254"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000436/pdfft?md5=2f22992b7b16df2e259f3c6a66707b8d&pid=1-s2.0-S2666623524000436-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100267
Lara K Marquez, Natasha K Martin, Steffanie A Strathdee, Britt Skaathun
Background
Travel restrictions implemented to mitigate the spread of SARS-CoV-2 decreased mobility and reduced physical contact during 2020–2021 for many in the general population. This analysis explored changes to network contacts among people who inject drugs (PWID) in the San Diego Border Region (SDBR) by cross-border mobility before and during the COVID-19 era.
Methods
Baseline data collected between October 2020–2021, from a cohort study of PWID in the SDBR were used to retrospectively describe differences in baseline characteristics across cross-border PWID groups (cross-border PWID [CB-PWID]: n = 206; San Diego PWID [SD-PWID]: n = 203; Tijuana PWID [TJ-PWID]: n = 202). Chi-square and Fisher's exact tests evaluated sociodemographic, injecting risk behaviors, harm reduction service history, incarceration history, non-fatal overdose, HCV, HIV. Median differences in sex, drug/alcohol, and close partners before and during the pandemic among all PWID and by cross-border PWID status were evaluated using Kruskal-Wallis tests. Pairwise associations across cross-border PWID groups were assessed using the Dwass, Steel, Critchlow-Fligner multiple comparison test.
Results
Among 611 PWID, the number of sex, drug/alcohol-related partners and close contacts before and during the pandemic remained relatively stable (psex=0.71;pdrug/alcohol=0.15;pclose=0.09). PWID in San Diego experienced the greatest difference in drug/alcohol-related partners (median[IQR]:-1[-6,0]), while cross-border PWID reported the smallest change in close contacts versus pre-pandemic (median[IQR]:0[0,1]). PWID in Tijuana had the greatest proportion (87%) of close contacts who injected drugs of all three groups.
Conclusions
Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time.
{"title":"Differences in characteristics and interactions with close contacts among PWID in the San Diego Border Region before and during the COVID-19 pandemic","authors":"Lara K Marquez, Natasha K Martin, Steffanie A Strathdee, Britt Skaathun","doi":"10.1016/j.jmh.2024.100267","DOIUrl":"10.1016/j.jmh.2024.100267","url":null,"abstract":"<div><h3>Background</h3><div>Travel restrictions implemented to mitigate the spread of SARS-CoV-2 decreased mobility and reduced physical contact during 2020–2021 for many in the general population. This analysis explored changes to network contacts among people who inject drugs (PWID) in the San Diego Border Region (SDBR) by cross-border mobility before and during the COVID-19 era.</div></div><div><h3>Methods</h3><div>Baseline data collected between October 2020–2021, from a cohort study of PWID in the SDBR were used to retrospectively describe differences in baseline characteristics across cross-border PWID groups (cross-border PWID [CB-PWID]: <em>n</em> = 206; San Diego PWID [SD-PWID]: <em>n</em> = 203; Tijuana PWID [TJ-PWID]: <em>n</em> = 202). Chi-square and Fisher's exact tests evaluated sociodemographic, injecting risk behaviors, harm reduction service history, incarceration history, non-fatal overdose, HCV, HIV. Median differences in sex, drug/alcohol, and close partners before and during the pandemic among all PWID and by cross-border PWID status were evaluated using Kruskal-Wallis tests. Pairwise associations across cross-border PWID groups were assessed using the Dwass, Steel, Critchlow-Fligner multiple comparison test.</div></div><div><h3>Results</h3><div>Among 611 PWID, the number of sex, drug/alcohol-related partners and close contacts before and during the pandemic remained relatively stable (p<sub>sex</sub>=0.71;p<sub>drug/alcohol</sub>=0.15;p<sub>close</sub>=0.09). PWID in San Diego experienced the greatest difference in drug/alcohol-related partners (median[IQR]:-1[-6,0]), while cross-border PWID reported the smallest change in close contacts versus pre-pandemic (median[IQR]:0[0,1]). PWID in Tijuana had the greatest proportion (87%) of close contacts who injected drugs of all three groups.</div></div><div><h3>Conclusions</h3><div>Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100267"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100266
Nurul Amanina Binte Hussain , Sheena Ramazanu , Priscilla Ang , Halina Talib , Si Ying Tan , Hui Xiang Chia , Sharon Tan , Jeremy Fung Yen Lim , Jason CH Yap
Background
The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services.
Methods
A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP).
Results
The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %).
Conclusion
This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.
{"title":"Building a healthy migrant workforce in Singapore – A cross-sectional study to understand health-seeking behaviours of male migrant workers","authors":"Nurul Amanina Binte Hussain , Sheena Ramazanu , Priscilla Ang , Halina Talib , Si Ying Tan , Hui Xiang Chia , Sharon Tan , Jeremy Fung Yen Lim , Jason CH Yap","doi":"10.1016/j.jmh.2024.100266","DOIUrl":"10.1016/j.jmh.2024.100266","url":null,"abstract":"<div><h3>Background</h3><div>The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP).</div></div><div><h3>Results</h3><div>The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %).</div></div><div><h3>Conclusion</h3><div>This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100266"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach.
Three themes were generated during the analysis. The first SRH services: dual perceptions and experiences shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second Sexuality education: an eye-opener or a joke? reflects participants’ both positive and negative experiences and attitudes when receiving sexuality education in schools. The third SRH information: beyond formal services and education captures participants’ ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.
{"title":"Young people with migration experience and their (non) encounters with Swedish sexual and reproductive health services and information: An explorative study","authors":"Nada Amroussia , Malin Lindroth , Catrine Andersson","doi":"10.1016/j.jmh.2024.100270","DOIUrl":"10.1016/j.jmh.2024.100270","url":null,"abstract":"<div><div>Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach.</div><div>Three themes were generated during the analysis. The first <em>SRH services: dual perceptions and experiences</em> shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second <em>Sexuality education: an eye-opener or a joke?</em> reflects participants’ both positive and negative experiences and attitudes when receiving sexuality education in schools. The third <em>SRH information: beyond formal services and education</em> captures participants’ ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100270"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100264
Nasim Ahamed Mondal
Aims
This study aims, probably for the first time, to compare the fertility intentions of migrants and non-migrants of the same nationality at origin based on their self-rated health, wellbeing, and gender.
Methods
The study utilized data from the Families of Poles in the Netherlands (FPN) survey and the Generations and Gender Survey (GGS). This study used Blinder-Oaxaca decomposition models and generalized ordered logit models (gologit).
Results
The findings reveal that both migrants and non-migrants who have good self-rated health and wellbeing are more likely to express a desire to have children in the short-term. The impact of perceived health on the intention to have children is significant for both female and male irrespective of their migration status. Additionally, the average fertility intentions score is higher for Polish migrants residing in the Netherlands compared to Polish non-migrants residing in Poland across the models. The study emphasizes the role good perceived health plays in shaping fertility intentions.
{"title":"Fertility intentions and perceived health status: A study of Polish migrants and non-migrants","authors":"Nasim Ahamed Mondal","doi":"10.1016/j.jmh.2024.100264","DOIUrl":"10.1016/j.jmh.2024.100264","url":null,"abstract":"<div><h3>Aims</h3><p>This study aims, probably for the first time, to compare the fertility intentions of migrants and non-migrants of the same nationality at origin based on their self-rated health, wellbeing, and gender.</p></div><div><h3>Methods</h3><p>The study utilized data from the <em>Families of Poles in the Netherlands (FPN) survey</em> and the <em>Generations and Gender Survey (GGS)</em>. This study used Blinder-Oaxaca decomposition models and generalized ordered logit models (gologit).</p></div><div><h3>Results</h3><p>The findings reveal that both migrants and non-migrants who have good self-rated health and wellbeing are more likely to express a desire to have children in the short-term. The impact of perceived health on the intention to have children is significant for both female and male irrespective of their migration status. Additionally, the average fertility intentions score is higher for Polish migrants residing in the Netherlands compared to Polish non-migrants residing in Poland across the models. The study emphasizes the role good perceived health plays in shaping fertility intentions.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100264"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000539/pdfft?md5=6e372efc78f0aa055b738ab7197cc713&pid=1-s2.0-S2666623524000539-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100225
Ebrahim Masoudnia, Fatemeh Rahmati Farmani
Background
Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.
Method
The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.
Results
The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (p < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (p < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (p < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (P < 0.01) and significant negative correlation between internal locus of control and PTSD (P < .01).
Conclusion
Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.
{"title":"Psychosocial etiology of post-traumatic stress disorder caused by war trauma among Iran–Iraq war immigrants in Mehran, Iran","authors":"Ebrahim Masoudnia, Fatemeh Rahmati Farmani","doi":"10.1016/j.jmh.2024.100225","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100225","url":null,"abstract":"<div><h3>Background</h3><p>Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.</p></div><div><h3>Method</h3><p>The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.</p></div><div><h3>Results</h3><p>The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (<em>p</em> < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (<em>p</em> < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (<em>p</em> < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (<em>P</em> < 0.01) and significant negative correlation between internal locus of control and PTSD (<em>P</em> < .01).</p></div><div><h3>Conclusion</h3><p>Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"9 ","pages":"Article 100225"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000151/pdfft?md5=a8ce671d159a8d6443ca3720fd00dcb6&pid=1-s2.0-S2666623524000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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