Ethnicity & Health最新文献

Objectives: Despite an effective human papillomavirus (HPV) vaccine, uptake among sexual and gender minority (SGM) young adults remains suboptimal, including among Hispanic/Latino SGM. This study aimed to describe awareness/knowledge, health beliefs, attitudes, clinician recommendation receipt, and HPV vaccine intentions among unvaccinated Spanish-speaking Hispanic/Latino SGM young adults assigned male at birth in Florida and Puerto Rico.

Design: Participants completed a cross-sectional online survey between August 2021 and August 2022. Eligibility criteria included being 18-26 years old, male sex assigned at birth, identifying as Hispanic/Latino, identifying as gay, bisexual, or queer, speaking Spanish, living in Florida or Puerto Rico, and having access to the internet. Survey items assessed previous healthcare experiences, HPV vaccine awareness, knowledge, beliefs, attitudes, discussions, clinician recommendation receipt, and vaccine intentions. Descriptive analyses were performed.

Results: Among the 102 unvaccinated participants, all (100%) identified as gay and/or bisexual. Most participants self-reported male gender (96%), being of Puerto Rican descent (92%), and living in Puerto Rico (86%). Only 18.6% of participants reported having received a clinician recommendation for the HPV vaccine. HPV vaccine knowledge was low (Mean=3.2; Standard Deviation [SD] = 2.6; Range: 0-9), attitudes were neutral (Mean=2.5; SD = 0.7; range=1.0-4.3), and perceived barriers were moderate (Mean=2.4; SD = 1.0; range=1.0-4.7). Approximately 35% reported being very likely to seek additional HPV vaccination information in the next year. Approximately one-in-nine (11.8%) reported being very likely to receive the HPV vaccine in the next year, whereas approximately one-third (30.4%) reported being very likely to receive the vaccine at some point in the future.

Conclusion: Findings suggest potential modifiable and multilevel targets for future interventions to promote HPV vaccination among Spanish-speaking Hispanic/Latino SGM young adults assigned male at birth. Such multilevel interventions could address specific knowledge gaps, beliefs, and attitudes among patients and promote clinician recommendations in order to improve HPV vaccination rates among Hispanic/Latino SGM young adults.

Objectives: To identify facilitators, barriers, and perceptions of older Latino adults regarding sedentary behaviors (SB) and physical activity (PA) SB and PA following a randomized controlled trial designed to replace SB with PA; we investigate how these factors differed between study groups.

Design: Qualitative descriptive study. Semi-structured post-intervention interviews were conducted in Spanish with 38 Latino mid-life and older adults from Chicago in the Physical Activity Program to Disrupt Sedentary Time in Older Latinos study. After translation, two independent coders coded transcripts deductively and inductively to identify categories and themes.

Results: Compared to factors identified prior to the intervention, new barriers emerged around age, finances, and technology. Adapting exercise to one's needs, Fitbits, and PA feasibility were new facilitators. Two new categories characterized participants' underlying needs for engaging in PA (e.g. accessible facilities and education) and their knowledge and attitudes regarding SB and PA. Participants began to connect both SB and PA to cognitive function, discussed behavior changes related to the intervention, and often shared the intervention's information about both SB and PA with their community.

Conclusion: Feasibility, accessibility, and awareness play an important role in reducing SB for mid-life and older Latino adults. This intervention shows promise for decreasing barriers in these areas and positively impacting knowledge, attitudes, and behaviors towards both PA and SB.

Objective: Black women consistently exhibit some of the highest labor force participation rates in the United States, yet they are among the least wealthy group across race and gender which carries a disparity with profound implications for both economic and health outcomes.

Design: This phenomenological study employed semi structured interviews with 13 Black women as heads of households. Collin's Black Feminist Theory provides the framework for this study, underscoring race and gender within the context of labor as an essential factor in the wealth accumulation process and health outcomes.

Results: Part of a larger study, themes reported here revealed four themes of labor: hustle labor, emotional labor, spiritual labor, and resistance labor, actions taken to maintain dignity and self-worth in the face of systemic oppression, emerged as a new form of labor.

Conclusion: The study makes visible Black women's labor beyond the U.S. traditional economic metrics. Recommendations for social policy and public health interventions central to wealth accumulation and health outcomes are offered.

Objective: Adverse childhood experiences (ACEs) are prevalent and have profound negative health impacts across the life course. This study examined childhood adversity prevalence among US non-Hispanic Black adults, with particular attention to gender specific patterns in cumulative risk, individual ACE types and associated sociodemographic factors.

Design: We analyzed data from Black adults aged 18 and older who completed the 2019 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. Childhood adversity indicators were derived from the ACE Module administered in 21 states. Individual ACE exposures were dichotomized, and we calculated prevalence estimates and cumulative risk scores for Black women and Black men separately.

Results: The analytic sample included 14,685 non-Hispanic Black adults (62% Black women). Over half (54%) reported experiencing at least one ACE, with 19% of Black women and 15% of Black men reporting four or more ACEs - a threshold indicating high risk for toxic stress. Black women experienced significantly higher rates of childhood sexual abuse, while Black men reported more childhood physical abuse than Black women (28% vs 23%, p = 0.003). Higher cumulative risk ACE scores were inversely associated with socioeconomic position.

Conclusions: The observed gender differences in childhood adversity prevalence among Black adults likely reflect distinct social and structural risk factors. These differential ACE patterns suggest that pathways to toxic stress exposure may vary by gender within Black communities. Understanding these distinctions is crucial for developing targeted interventions and addressing the structural determinants that contribute to health inequities in communities disproportionately affected by childhood adversity.

Objectives: Building on prior research that suggests Hispanic audiences respond more favorably to advertisements featuring Hispanic endorsers, this study examines the effectiveness of culturally tailored type 2 diabetes (T2D) risk communication messages. Specifically, we investigate whether the inclusion of Hispanic endorsers in health-related advertisements enhances audience engagement, attitudes toward the ad, and intentions to share the message on social media.

Design: This study employs an explanatory sequential mixed-methods approach, beginning with a quantitative approach, followed by qualitative in-depth interviews. The initial quantitative phase measures Hispanic audience reactions to advertisements featuring either Hispanic or White endorsers. The qualitative phase further explores perceptions and attitudes toward these ads, focusing on the role of cultural relevance in health messaging.

Results: Findings show that Hispanic participants felt a stronger connection with Hispanic endorsers, leading to more favorable attitudes toward the ad, which then increased their intentions to adopt health behaviors and share the message. Additionally, qualitative analysis indicates that endorsements were more effective when they included culturally relevant nutritional advice, authentic cultural representation, and highlighted the importance of cultural tailoring in T2D-risk communication.

Conclusion: This study emphasizes that enhancing cultural relevance, especially by incorporating nutritional guidance aligned with Hispanic dietary traditions, can boost the effectiveness of health messages and increase the persuasive power of prevention campaigns. These findings provide valuable insights for public health campaigns and advertisers aiming to develop more impactful T2D prevention strategies for Hispanic communities.

Objectives: Latinos are disproportionately impacted by Alzheimer's disease and related dementias (ADRD). It is estimated that interventions targeting lifestyle and health behaviors could prevent or delay up to 50% of ADRD cases worldwide. This study aimed to explore middle-aged Latinos' perceptions of the link between physical activity and nutrition with the maintenance of brain health.

Design: Individual, semi-structured interviews were conducted with 30 English- or Spanish-speaking Latinos 35 to 64 years old. Participants were recruited via social media, flyers, direct contact of participants from prior studies, and snowball sampling. Questions addressed knowledge about the brain, perceptions of aging, and ideas of how to care for the brain. Responses that emerged pertaining to physical activity and nutrition were analyzed using conceptual content analysis to quantify the frequency of themes and identify trends.

Results: Most participants were female (n = 18) and college educated (n = 17), with an average age of 47 years; two thirds reported being foreign born, and half reported lower acculturation levels. Physical activity and nutrition were spontaneously described as strategies to promote brain health by 22 and 24 participants, respectively. With regards to physical activity, walking was most often mentioned (n = 8), followed by yoga (n = 4). Few participants clarified frequency (n = 3), duration (n = 1), or intensity (n = 2). With regards to nutrition, common strategies mentioned were increasing fruit and vegetable consumption (n = 19), limiting processed foods (n = 9), and taking vitamins or supplements (n = 9).

Conclusion: Most participants demonstrated foundational knowledge of the link between nutrition, physical activity, and brain health. Some misconceptions were identified, such as participants overestimating the benefits of vitamins/supplements, which have weak correlations with preventing cognitive decline. Messaging may benefit from emphasizing recommendations regarding the role of frequency, duration, and intensity in physical activity, and specific nutrient, portioning, and preparation recommendations for dietary practices. Incorporating these messages into intergenerational programming may be particularly beneficial.

Background: Black women in the United States face disproportionately high rates of cervical cancer incidence and mortality, driven in part by structural racism, medical mistrust, and barriers to culturally responsive care. Existing interventions often overlook the lived experiences of Black women and fail to address the systemic roots of healthcare inequities.

Objective: To explore how Black women conceptualize healthcare mistrust and identify multilevel changes needed to improve cervical cancer screening and equity-centered preventive care.

Methods: Seventeen in-depth, semi-structured interviews were conducted with self-identified Black women aged 21-65 years between February and April 2023. Guided by an integrated theoretical framework including Ecological Systems Theory, Ecosocial Theory of Embodiment, Intersectionality, and Black Feminist Thought. Interviews were thematically analyzed to surface key barriers and recommendations. Participants were recruited through purposive sampling, and thematic saturation was achieved.

Results: Four major themes emerged: (1) increasing access to affordable, community-centered healthcare; (2) expanding reproductive health knowledge and addressing informational gaps; (3) enhancing provider training in diversity, equity, and culturally responsive care; and (4) implementing systemic reforms to rebuild trust and deliver holistic, justice-driven healthcare. Participants underscored the importance of long-term community engagement, generational knowledge transfer, and trauma-informed care. Trust was framed as a central determinant, shaped by intersecting histories of discrimination and institutional exclusion.

Conclusions: This study highlights the urgent need for systemic transformation in preventive care delivery. Improving cervical cancer outcomes among Black women requires multilevel strategies that prioritize trust, equity, and the leadership of communities most affected. These insights inform policy, provider training, and structural reforms aimed at advancing justice in healthcare.

Objectives: Rates of anxiety and depression have risen among Asian adults in the U.S., and sociodemographic factors such as immigration, financial hardship, and parental education are associated with different health outcomes. However, less is known about mental health by these indicators. While many affective disorders present between young adulthood (ages 18-29), research on this developmental period among Asian adults is scant. Since more than half of all Asian Americans are enrolled in some form of higher education during this age range, colleges and universities are meaningful settings to investigate social factors associated with mental health outcomes among young Asian adults.

Design: Secondary data were analyzed examining a large sample of young Asian students (n = 8,669) who participated in the 2022-2023 Healthy Minds Study (HMS), which is a national survey evaluating mental health among enrollees in higher education. Multivariable logistic regressions were conducted to evaluate differences in anxiety and depression by citizenship status, financial hardship, and highest level of parental education obtained, adjusting for age, ethnic subgroup, sexual orientation, and sex.

Results: The mean age of respondents was 21.3 years (SD = 2.9) and most participants identified as female (70%, n = 6,064). Roughly one quarter of participants (27%, n = 2,365) reported not holding U.S. citizenship. Depression and anxiety were high among the sample overall, with symptoms being greater for those with more financial hardship. Regarding immigrant status, U.S. citizens had higher odds of meeting criteria for both clinical depression and anxiety compared to those without U.S. citizenship. Mixed findings were found regarding parental education and affective symptoms.

Conclusion: Findings support the need to prioritize social determinants of health such as basic needs and financial resources in mental health service delivery for Asian communities in the U.S. More research is also needed to better understand how to assess and promote mental wellbeing among diverse young Asian immigrants.

Drawing on critical multiracial theory, the objective of this study was to describe Multiracial emerging adults' experiences with mental health care. A total of 12 Multiracial emerging adults participated in this phenomenological study that used semi-structured interviews. Participants shared that Multiracial and Black providers were emphatic, but White providers engaged in covert and subtle racism. They further discussed the need for providers to be more culturally competent and the need for more racial and ethnic representation among mental health care providers. Findings suggest that providers need to understand their clients' experiences better, such as participants' experiences with racism when both receiving mental health care and navigating developmental milestones, such as dating. This understanding, in turn, could improve the quality of mental health care. Participants in this study also provided suggestions for improving the quality of mental health care, with recommendations ranging from broaching the topic of race to increased racial representation among providers.