Ethnicity & Health最新文献

Objective: To explore the role of Black-led community organisations in supporting Black mental health and wellbeing in the UK.

Design: A qualitative, Black Emancipatory Action Research Framework was adopted. Framework application involved adequately compensating community organisations for their consultancy role; having 'research conversations' rather than interviewing participants; and focusing outputs on community benefit. Eight individual and group research conversations took place with nine Black directors, employees and volunteers working with Black-led community organisations, aged between 19 and 62, living in the UK. Reflexive thematic analysis was used to analyse conversations.

Results: Three themes were developed in relation to what Black-led community organisations do for Black mental health. These are: identify and respond to mental health needs; selectively build relationships with mainstream services; and drive social and systemic improvements. Findings revealed that Black-led community organisations uniquely identify and address mental wellbeing by offering respite from racism, hosting activities, and meeting urgent needs. They navigate and facilitate access to health and social systems, protect communities from harmful services, and advocate for social and systemic change. Drawing on the study design, findings, and the broader literature, we propose three key changes to current funding, community, and research practices. These are a reconsideration of how Black-led organisations' work is valued and measured, a forging of greater collaboration between these organisations, and bolder consideration of how research practice can benefit Black communities.

Conclusions: Black-led organisations play multiple roles in supporting individual and collective mental health, crucial for mediating the effects of racism and mitigating ethnic inequalities. To our knowledge, this is the first study to both illuminate the critical role of community organisations in promoting Black mental health in the UK and to prioritise participant, and community, benefit throughout the research process.

Objectives: Breast cancer is the most common cancer in the UK, accounting for 15% of all new cases in women. Evidence still points to disparities in outcomes linked to ethnicity and screening uptake is overall lower in South Asians than the White population. We investigated the experiences and perceptions of Gujarati Hindu community members on their 'cancer journeys'.

Design: This study took a participatory approach, involving participants in generating and refining recommendations to improve treatment based on their cohort's experiences and perceptions. Data were collected through two focus groups in 2022, followed by a feedback workshop session, where participants helped refine the research team's initial analysis and agree recommendation. Data were analysed thematically.

Results: 14 women participated in this study from the same support group. They had experienced breast cancer or were undergoing breast cancer treatment at the time of data collection and lived in Greater London. Barriers to engaging in the three key stages of their 'cancer journey' (screening, diagnosis, and treatment) were identified. These centred around language difficulties, not knowing what to expect, and not knowing who to ask for information. Suggestions for improvements included recruiting community champions, having diverse representation on educational materials, and referrals to support groups.

Conclusion: This study adds to the growing literature on the need for culturally tailored and sensitive approaches to cancer treatment. It reinforces the need for health professionals' training around effectively communicating with diverse groups and normalising referral to support groups.

Objective: The resident population in nursing homes is increasingly racially diverse. The purpose of this study was to assess racial differences in the quality of care interactions among nursing home residents with dementia.

Design: The study utilized baseline data from the Testing the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD), a randomized controlled pragmatic trial. The Quality of Interaction Scale (QuIS) was used to measure quality of staff-resident care interactions. The sample included 531 residents. An analysis of covariance was conducted to address the aim.

Results: The majority of interactions were positive social (42%) or positive care (37%). Black residents living with dementia had higher QuIS scores (M = 5.98, SD = 1.66) than White residents with dementia (M = 5.40, SD = 1.75), whereas higher QuIS scores indicating more positive interactions. However, the results of the analysis of covariance indicated that there was not a significant difference in QuIS scores between Black versus White residents living with dementia (p =.203).

Conclusion: The findings suggest that care interactions in nursing homes are consistent between Black residents and White residents. Future research should evaluate the impact of staff race on the quality of care interaction among nursing home residents.

Background: Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities by influencing patient-provider communication and utilization of healthcare services.

Objective: This study aimed to investigate how Asian American subgroups differ in their perception of everyday racism, internalized racism, and perceived racism in healthcare settings and whether these perceptions predict their interactions with their health care providers and their utilization of healthcare services.

Methods: An online survey study was conducted. ANOVA tests were employed to compare the differences in perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system among Filipino (N = 310), Japanese (N = 242), Chinese (N = 287), Asian Indian (N = 304), Korean (N = 199) and Vietnamese (N = 151) participants. Multiple regression analyses assessed whether perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system predicted healthcare service utilization and patient-provider communication among the Asian subgroups sampled.

Results: There were significant group differences in perceived everyday racism (F = 8.56, p < .001), internalized racism (F = 3.46, p < .01), perceived racism in healthcare (F = 4.57, p < .001). Perceptions of racism and socioeconomic variables were found to predict patient-provider communication and utilization of healthcare services disparately across various Asian subgroups. For instance, the perception of everyday racism was a significant predictor of patient-provider communication for each of the subgroups, excluding the Vietnamese participants. Internalized racism was a significant predictor only for Filipino and Chinese participants. Surprisingly, perceived racism in healthcare was not a predictor for any of the subgroups.

Conclusion: Findings highlight the complex interplay of sociodemographic factors and perceived racism in shaping patient-provider communication and healthcare service utilization within the Asian American community. Implications are suggested for addressing the unique challenges faced by different Asian American subgroups and for promoting equitable healthcare access and fostering positive patient-provider relationships among the Asian American subgroups.

Objective: Older Black adults continue to experience heightened rates of chronic illness and poor health outcomes. Further, older Black adults must navigate interlocking systems of oppression (e.g. racism, ageism, ableism, and classism etc.) that impact their healthcare utilization. Telehealth has emerged as a common health care modality, which presents unique concerns for aging populations.

Design: The present study explored the motivators of and barriers to in-person healthcare and video telehealth use among a sample of predominantly lower-income, older Black adults. The researchers collaborated with community scientists to recruit, facilitate focus groups and provide technological support for participants. Sixteen virtual focus groups were conducted (n = 147) with older Black adults aged 55-84 years. The researchers utilized a thematic analysis approach to identify twelve distinct themes.

Results: Participants identified the following as motivators to using in-person health care: improved patient-provider relationships, increased community support, and more culturally sensitive resources. Limited accessibility, discrimination and resulting distrust, and poor patient-provider communication were identified as barriers to in-person health care use. E-health literacy and accessibility both emerged as motivators of and barriers to using telehealth, while disinterest in telehealth and impersonal patient-provider relationships were noted as additional barriers.

Conclusion: These findings provide key implications for reducing the burden of health care inequity for older Black adults. Future implementation research should use equity-focused frameworks such as the patient-centered culturally sensitive health care (PC-CSHC) model. Additionally, collaboration with the community is necessary to create and implement the necessary culturally sensitive health interventions.

Background: Identifying factors impacting vaccination and testing for COVID-19 is crucial to reduce health disparities, especially for rural/agricultural, low access and high poverty Latino communities disproportionately affected by the pandemic. This study examined differences in perceived barriers and facilitators (such as values, beliefs, and concerns) to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino community members in Southwest Florida.

Methods: Rural Latino community members (N = 493) completed a cross-sectional survey in Spanish (86.0%) or English (14.0%) on perceived COVID-19 vaccine/testing barriers and facilitators, as well as demographics, mental health, medical history, health perceptions, and health literacy.

Results: At the time of the survey, approximately 43% of participants were unvaccinated and 46.4% were testing hesitant. Significantly more vaccinated participants acknowledged keeping their family (d = .25), community (d = .27), and themselves (d = .22) safe as facilitators to vaccination (ps < .001). Among the unvaccinated participants, the most common concerns for getting vaccinated were side effects (d = -.53) and lack of knowledge about how the vaccine works (d = -.35, ps < .001). Testing hesitant participants reported concerns including not knowing where to get tested (d = -.25, p = 0.01) and less confidence in a positive test result (d = -.40, p < 0.001). Doctors and faith leaders were ranked as the most trusted information sources across groups. In logistic regression models, vaccination was linked to age, gender, education, and protecting others, while concerns about needles and side effects reduced odds; testing was driven by education, anxiety, hope, and safety concerns.

Conclusion: Promoting family and community safety may be effective facilitators influencing vaccine and testing intention in rural Latino communities. Enhanced education by trusted information sources, such as doctors and faith leaders may alleviate associated concerns. Our findings may inform actions for future pandemics. Further studies should determine the generalizability of our findings across other rural migrant communities and other vaccines.

Objective: Despite second generation Black immigrants being a rapidly growing population, they are often overlooked in health attribution research that treats Black populations as a monolithic group. Very few studies focus on how discrimination, societal pressure, and racial identity play a role in the health attributions of Black immigrant women. Even fewer studies have examined this relationship solely with second generation Black immigrant women. Research has shown, however, that increased racial and ethnic identity but decreased experiences with racism are related to higher internal health attributions in Black populations. Thus, we addressed this dearth in research in the current study by examining the relationship between racial centrality, racism stress, and internal health attributions in a sample of 123 second generation Black immigrant women.

Design: Health attributions were assessed using the Illness Attribution Scale, racism stress using the Schedule of Racist Events, and racial centrality using the Multidimensional Inventory of Black Identity. Multiple regression analyses were conducted to test the hypotheses that lower levels of racism stress, but higher ratings of racial centrality would relate to higher scores of internal health attributions.

Results: A positive relationship was found between racial centrality and internal health attributions but not racism stress.

Conclusion: The results indicated that stronger affirmations with Black identity are associated with a greater importance of the causes of illness to be within one's perceived control for second generation Black immigrant women, which highlights the importance of examining wthin-group differences via collective identity measures to better explain health attribution behavioirs.

Introduction: Visible minorities, a growing segment of Canada's population, have voiced concerns about experiencing racism while receiving care in the emergency department (ED). Understanding the ED care experiences of visible minorities is crucial to improving care and reducing health disparities.

Methods: From June to August 2021, we collected data from participants in Kingston, Ontario using a sensemaking approach. Individuals who had accessed emergency care or accompanied someone else to the ED in the prior 24 months were eligible to participate. After sharing a brief narrative about their care experience, participants interpreted the experience by plotting their perspectives on a variety of pre-determined questions. Here, we conducted a thematic analysis of narratives involving patients who identified as visible minorities and complemented it with quantitative analysis of the participants' interpretative responses. This mixed-methods approach highlighted the distinct experiences of visible minority participants in relation to a comparison group.

Results: Of the 1973 unique participants, 117 identified as a visible minority and 949 participants did not identify with an equity-deserving group (comparison group). Visible minority participants were more likely to report that too little attention was paid to their identity and more likely to express a desire for a balance between receiving the best medical care and being treated with kindness and respect. Visible minorities' ED experiences were also more likely to be impacted by how emergency staff behaved. Qualitative analysis revealed negative experiences of feeling uninformed and disempowered, facing judgement and discrimination, and experiencing language barriers. Positive experiences of receiving compassionate care from staff also emerged.

Conclusion: Visible minority perceptions of ED care were often negative and mainly focused on staff treatment. Cultural competency and language translation services are key areas for improvement to make ED care more accessible and equitable.

Objectives: We examined the association of urinary incontinence (UI) with physical, mental, and social health among older Korean Americans living in subsidized senior housing.

Design: Data were obtained from surveys conducted in 2023 with older Korean Americans residing in subsidized senior housing in the Los Angeles area (n = 313). UI was measured using a question about the frequency of involuntary urine loss. Physical, mental, and social health risks were assessed with a single item for self-rated health (fair/poor rating), the Patient Health Questionnaire-9 (probable depression), and the Lubben Social Network Scale-6 (isolation from family and friends).

Results: Over half of the sample reported UI, with 46.3% experiencing it infrequently (i.e. seldom) and 10.3% frequently (i.e. sometimes or often). UI was significantly associated with physical and mental health indicators; the odds of reporting fair or poor health and having probable depression were 1.94-7.32 times higher among those with either infrequent or frequent UI compared to those without UI. While family isolation was not associated with UI, the odds of being isolated from friends were 2.85 times greater among those with frequent UI compared to those without UI.

Conclusion: Our findings confirm the adverse impact of UI on physical and mental health and highlight its unique role in social health. UI-associated social isolation was significant only in relationships with friends, providing new insights into the distinction between isolation from family and friends. These findings enhance our understanding of the health risks associated with UI and inform strategies for health management and promotion within the senior housing context.

Objectives: Prior research shows that perceived racism was associated with higher risks of suicidal ideation among US Asians. Nevertheless, the relationship between internalized racism and the suicidal risks of US Asians has not been adequately researched. In addition, as an important social institution, religion has been left out of the studies of racism and suicide for US Asians. This study is aimed at filling in these gaps and contributing to a better understanding of internalized racism, religion, and the mental health of US Asians.

Design: This study surveyed 970 Asian or Asian American adults living in the United States. Survey participants were recruited using Qualtrics online panel samples between April and June 2024. Quotas were set for key demographic variables, such as sex and ethnicity, following the national census.

Results: The main results suggest that even after controlling important mental health measures such as anxiety and loneliness, higher internalized racism was still tied to higher risks of suicidal ideation. The effect of internalized racism was not only robust but also stronger than other mental health measures as well as perceived external racism. Finally, the deleterious internalized racism effect on suicidal ideation was stronger among US Asians, who attend religious services more often.

Conclusion: Internalized racism exerts a fairly strong and robust effect on suicidal ideation among US Asians. This deleterious effect is also interactive with the religious characteristics of US Asians. Healthcare providers, community workers, and religious leaders may want to take internalized racism into consideration in their future service to the US Asian community.