Ethnicity & Health最新文献

Objectives: To examine the individual- and systemic-level barriers and facilitators that influence cervical cancer screening behaviors among African and African American women, and to highlight both shared and unique factors through the lens of the Social Determinants of Health (SDH) framework.

Design: A qualitative systematic review was conducted in accordance with PRISMA 2020 standards. Twelve peer-reviewed qualitative studies published between January 2020 and May 2025 were included. Data were analyzed thematically to classify barriers and facilitators at both individual and systemic levels, using the SDH framework.

Results: Across both populations, common barriers included limited awareness, cultural and religious stigma, and financial concerns. African women frequently reported infrastructural and logistical barriers such as distance and shortages of trained providers, while African American women emphasized institutional mistrust, racial discrimination, and inconsistent communication with providers. However, factors such as community-based education, peer and partner support, and personal motivation facilitated screening uptake in both groups.

Conclusion: The study shows that even though African women and African American women share similar barriers and facilitators to cervical cancer screening, the underlying causes differ. Among African women, poor screening uptake is largely due to inadequate health infrastructure, whereas African American women's barriers are rooted in historical medical mistrust. These findings highlight the need for culturally tailored interventions, such as community-driven awareness and culturally trained providers, that respond to the lived experiences of each population rather than adopting a monolithic approach.

Objectives: Chronic exposure to psychological stress is a well-established social determinant of health, particularly among racial and ethnic minority groups. Repeated stress can lead to persistent activation of the biological stress response, which may become maladaptive and harm both physical and mental health. Latinx immigrants are especially susceptible due to ongoing acculturative stress-challenges associated with adapting to a new culture and environment. Despite these risks, Latinx immigrants also exhibit strong resilience, which can help buffer the negative health effects of acculturative stress. Minimal research has explored associations among measures of acculturative stressors, psychosocial resilience factors, and immunological biomarkers of the physiological stress response. The current study examines these relationships within a Latinx immigrant population.

Design: We conducted a secondary analysis of baseline data collected between June 2018 and January 2020 from a community-engaged research study of Latinx immigrants in the U.S. Southeast aged 18-44 (N = 391). Participants completed self-report measures of acculturative stressors, resilience factors, and health, as well as urine specimens for biomarker analysis using immunoassays. Hypotheses were tested with Spearman's correlations and multivariate linear regressions.

Results: In bivariate correlations, only IL-18, a pro-inflammatory cytokine, and IL-10, an anti-inflammatory cytokine, were associated with acculturative stressors. In our final regression models accounting for acculturative stressors and resilience factors, no moderation effects were observed, and only BMI remained a significant predictor of IL-18. Exploratory mediation analysis demonstrated that BMI partially mediated the relationship between pre-migration stress and IL-18.

Conclusions: The results highlight significant associations among acculturative stressors, inflammatory cytokines, and BMI. Further exploration of these relationships can identify key social determinants and mechanisms underlying health inequities, such as those related to obesity and cardiometabolic health. These findings may contribute to the design of more effective health promotion and disease prevention interventions for Latinx immigrant populations.

Background: The prevalence of diabetes has rapidly increased for East Asian immigrant populations, exceeding rates in East Asian populations in their home countries and the general population of host countries. The increased risk highlights the complex interplay between genetic predisposition and socio-cultural environmental factors associated with migration. Managing diabetes and navigating unfamiliar healthcare systems are challenging for immigrant populations underscoring the need for research on barriers and effective targeted strategies.

Objectives: Identify barriers to best diabetes management practices and effective interventions among East Asian immigrant populations.

Methods: Studies were identified through PUBMED, OVID MEDLINE, CINAHL COMPLETE and SCOPUS databases utilising Arksey and O'Malley's framework. Peer-reviewed, English reports between January 2010 and August 2024 relating to challenges and barriers of best management practices among adult East Asian immigrants and interventions that facilitated management were identified. Studies of people with type 1 or gestational diabetes and those <18 years old were excluded.

Results: Of 576 articles screened, 18 studies meeting the criteria were included in this review. Twelve studies included Chinese immigrants, 13 studies were from the United States, including six among American-Korean immigrants, three were from Australia and two from Canada. Barriers to best diabetes management practices identified from observational studies were themed as relating to (1) 'Cultural Views' (diabetes, diet, medication, traditional remedies, health professional hierarchy and family roles); (2) 'Immigration Challenges' (communication, communication, transport, financial, time constraints, emotional distress and dissatisfaction with Western healthcare systems). Randomised controlled trials (n = 2) and single-group trials (n = 6) reported on effective interventions that improved self-management and/or cardiometabolic risk factors, focusing on self-management (n = 3), nutritional (n = 4) and social media (n = 1) educational programmes.

Conclusion: Barriers to best diabetes management practices included clashes with cultural views, immigration-related challenges and dissatisfaction with Western healthcare systems. Effective interventions were mostly associated with culturally-tailored, didactic and bilingual diabetes education programmes.

Background: Black women are more likely to experience sleep difficulties compared to their White counterparts. This disparity may be fueled by differences in economic opportunities, race - and gender-based discrimination, and other societal factors. Guided by the socio-ecological model, the purpose of this study was to examine the multi-level barriers and facilitators of sleep among Black women in the United States.

Methods: A qualitative description study design was used. Semi-structured interviews were conducted in English among 28 Black women with sleep difficulties. Interviews were audio-recorded and transcribed. Thematic analysis was used to analyze data.

Results: Participants (mean age = 47.3 years) were primarily single (52%) and employed (84%). Through qualitative interviews, four key themes emerged: (a) Individual-level barriers and facilitators, such as chronic health issues, poor sleep hygiene, stress, trauma, financial strain, and coping strategies like prayer and relaxation routines; (b) Interpersonal influences, including caregiving demands, emotional burdens from family dynamics, and social support; (c) Community-level factors, such as neighborhood noise, violence, and safety concerns contributing to hypervigilance; and (d) Societal-level influences, notably the "strong Black woman" schema and experiences of racism and gendered discrimination, which shaped sleep experiences.

Discussion and conclusion: Black women's sleep is impacted by intersecting factors across individual, interpersonal, community, and societal levels. Culturally grounded, trauma-informed, and equity-focused interventions, targeting all socioecological levels, are essential to improve sleep health of Black women.

Objectives: Aligning with past work positioning racial discrimination as invalidation, or a form of interpersonal rejection and devaluation with myriad psychological effects, we aim to examine the role of Strong Black Woman/Superwoman Schema (SBW/SWS) in the relation between racial discrimination and borderline personality disorder (BPD) symptoms among Black women. We predicted that SWS would explain the relation between experiences of racial discrimination and BPD symptoms. We also hypothesized that while SWS would contribute to emotional control and thereby higher BPD symptoms, SWS would also contribute to racial pride and thereby lower BPD symptoms. Exploratorily, we examined whether emotion regulation challenges moderate the relation between SWS and BPD symptoms.

Methods: A national community sample of 81 Black women (M_age = 37.8, SD_age = 12.8) endorsing racial discrimination were recruited through ResearchMatch and reported on SBW/SWS, BPD symptoms, and other emotion-focused assessments. Simple and serial mediation were used to examine the primary hypotheses.

Results: While racial discrimination was not significantly associated with BPD symptoms, SWS did explain this relation. There was further a significant serial effect such that racial discrimination contributed to SWS, which then fueled emotional overcontrol, and higher BPD symptoms. Racial pride did not emerge as a buffer from BPD symptoms. Lastly, the tendency to use interpersonal pathways to enhance positive affect strengthened the relation between SWS and BPD symptoms.

Conclusions: This paper furthers our understanding of how SWS and associated emotion processes link identity-based discrimination to emotional, identity, and interpersonal challenges among Black women.

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.