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

This study aims to investigate the criticisms and support factors of the migratory experience of a group of asylum seekers (ASs) hosted in an Italian reception center. Starting from a psychosocial approach that gives importance to the intertwining of the personal history and context, the present study aims to explore the meaning that ASs give to their origins, the relationship of ASs with the host context and with professionals of the refugee centres, along with the representation of the Future. We conducted 27 semi-structured deep interviews with 9 male ASs with an average age of 24,4 years. In line with the research goals, we carried out an analysis of pencil-and-paper content using the interpretative-phenomenological-analysis. Three different types of refugee experience emerged: persecutory, ambivalent and integrated. The three conditions identified can help professionals to better understand the different experiences of ASs, allowing them to develop more effective interventions. [ABSTRACT FROM AUTHOR]

States vary in their participation in federal immigration enforcement, leading to differing state-level policy contexts that profoundly shape the lives of immigrants. This paper examines the effects of sanctuary policies and driver's licenses for undocumented immigrants on immigrants' children's access to preventative healthcare. The 2008–2016 Medical Panel Expenditure Survey merged with state-level policy data were analyzed using a difference-in-difference OLS regression. Outcome variables included whether the child had a usual source of care, any unmet medical needs, or a well child check-up. State driver's license and sanctuary policies were associated with having a usual source of care and fewer unmet medical needs among children of immigrants. The recent pandemic highlights the importance of access to preventative health care. State policies that limit federal immigration enforcement involvement are associated with improved access to preventative health services among immigrants' children, most of whom are U.S. citizens. [ABSTRACT FROM AUTHOR]

The International Rescue Committee's Life Skills Tailored Package for Early Marriage focuses on engaged, married, and divorced Syrian refugee girls aged 13–18 living in Lebanon. This paper details findings from a qualitative program evaluation. In-depth interviews (IDIs) and focus group discussions (FGDs) explored participants' viewpoints about program components. IDIs engaged program staff and adolescent girls. FGDs included adolescent girls, husbands/fathers, and mothers/mothers-in-law. Data were audio-recorded, transcribed, and assessed using inductive content analysis. Three themes emerged: (1) engaging influencers with discretion facilitated girls' participation, (2) reaching out to vulnerable girls required foresight and flexibility, and (3) participation fostered development of personal resources and adaptive capacities among adolescent girls, who described improvements in self-confidence for decision-making/time management, reproductive health knowledge, emotional regulation/understanding of healthy relationships, and self-protection. Efforts to improve psychosocial and reproductive health of refugee adolescent girls experiencing child marriage should integrate lessons learned through this program. [ABSTRACT FROM AUTHOR]

This paper assessed the effectiveness of Respondent Driven Sampling (RDS) in recruiting undocumented Latinx immigrants for a prevalence health study at a time of heightened immigration enforcement. RDS was used to collect and analyze data from clinical interviews with 254 undocumented Latinx immigrant adults, enabling inference to a population of 22,000. 45% of the sample reported having a chronic medical condition. The desired sample size was achieved and exceeded with three initial recruits and 10 waves of recruitment across 9 weeks. There was substantial cross-group mixing for recruitment in terms of sex and recency of immigration, which facilitated the emergence of diversity within recruitment chains. Primary factors that contributed to effective recruitment were location, flexibility, on-site childcare, and detailed explanation of the recruitment process. RDS is an effective recruitment method to study the health of undocumented Latinx immigrants, which is essential to informing intervention and policy. [ABSTRACT FROM AUTHOR]

It is important to understand genetics within the context of health. This paper assesses (a) genetic knowledge among Mexican-born farmworker and non-farmworker adults; (b) their interpersonal and device sources of genetic knowledge; and (c) the association between their genetic knowledge and the sources of this genetic knowledge. Interviews were conducted with Mexican-born farmworkers (100) and non-farmworkers (100) in North Carolina. Participants answered 15 questions to assess genetic knowledge, and sources from which they had seen or heard about genes and genetics. Results show limited knowledge of genetics, with farmworkers and non-farmworkers providing a similar level of correct responses (6.6 versus 7.3), but with farmworkers providing more incorrect responses (4.0 versus 2.7). Important sources of genetic information for farmworkers were promotoras (47%), compared to teachers (49%) for non-farmworkers. This study demonstrates a need for increased dissemination of genetic information to Mexican-origin farmworkers and non-farmworkers. [ABSTRACT FROM AUTHOR]

Dissociative experiences are common in traumatized individuals who can use dissociation as a psychological escape from emotional and physical distress associated with overwhelming traumatic events. Traumatic experiences and the cultural interpretation of trauma-related symptoms often serve to explain the wide range of dissociative phenomenology; in fact, dissociation is a complex and ubiquitous construct present in a variety of mental disorders. The Six-Dimensions Model of National Culture has been used as a tool to compare patients' different cultural background that could have accounted for the different clinical manifestations. This paper reports three clinical cases in which the focus of interest is represented by the dissociative alterations of consciousness, as a response to trauma, specifically related to migration, and their correlation with cultural environment. The study shows as Hofstede's model has been used for the first time as a tool to explain how different cultural background could shape clinical manifestations. [ABSTRACT FROM AUTHOR]

Latino farmworkers are exposed to a number of carcinogens in the workplace. Cancer survival rates for Latinos are below average. This paper describes Mexican immigrant farmworkers' knowledge of colorectal, breast, and testicular cancer, and compares farmworkers' cancer knowledge to that of other Mexican immigrants. Survey interviews for this study were conducted with 100 farmworkers and 100 non-farmworkers in 2015 in North Carolina as part of an ongoing community-based participatory research project. We found low to moderate levels of knowledge about colorectal, breast, and testicular cancer among farmworkers. Compared to non-farmworkers, farmworkers had similar levels of knowledge about breast and testicular cancer, but slightly lower knowledge about colorectal cancer (p = 0.0087). Few studies have used quantitative methods to assess farmworkers' knowledge of specific types of cancer. Our results demonstrate a need for increased dissemination of existing cancer education programs and further research to develop additional educational tools. [ABSTRACT FROM AUTHOR]

This paper reviews the experience of the Istanbul Tuberculosis Aid Program, which targeted tuberculosis (TB) disease in the growing irregular migrant populations of Istanbul. This experience illustrated the importance of community-based public health interventions when dealing with an infectious disease like TB among vulnerable groups. Our data is derived primarily from a qualitative study carried out with program stakeholders. We summarize lessons for success of ITAP as: (1) Strengthening impact and outreach of TB intervention among irregular migrant communities through involvement of multiple stakeholders (2) Increasing TB awareness through a community targeted approach (3) Increasing TB contact tracing and treatment success among infected irregular migrants, and, (4) Improving overall health seeking behavior of irregular migrants through empowerment and trust. Given these particularities we list our policy suggestions for revision of regulations regarding TB control and healthcare needs of irregular migrant populations. [ABSTRACT FROM AUTHOR]

The goal of this paper is to assess the frequency of depression symptoms among Brazilian immigrants living in Massachusetts, the second largest Brazilian immigrant population in the United States, and to identify correlates of depression. A convenience sample of Brazilian immigrants aged 18 or older residing in Massachusetts was used. Data were collected from December 2013 to March 2014, in the Consulate General of Brazil in Boston and in three religious events, using a structure questionnaire and the Center for Epidemiological Studies Depression Scale (CES-D). Depression symptoms were observed in 35.3% of the respondents, with equal distribution by sex. Correlates of depression were low income, being single, poor English proficiency, and poor self-perception of health. These results suggest a need for community outreach, sensitization, and counseling, in Portuguese and adapted to the culture of Brazilian immigrants. [ABSTRACT FROM AUTHOR]

Latinos/as, the fastest-growing ethnic group in the United States, experience high cancer rates. Factors contributing to treatment decisions among Latinos diagnosed with cancer must be studied. This paper aims to identify treatment decisions among Latinos with cancer and examine factors influencing these decisions. A qualitative exploratory study using semi-structured interviews of 60 Latino/as diagnosed with cancer was conducted. Close-ended responses were analyzed using percentages and frequency distributions, while open-ended responses were analyzed using open coding and thematic categorization. Surgery was the most commonly chosen treatment among participants because it was perceived as providing the highest chance of prolonging life. Only 57% of participants were provided with treatment options. Latinos/as typically prefer modest, paternalistic patient-physician relationships. Therefore, providing culturally appropriate information is valuable. This study underscores the need for health providers to present all available treatment options to enhance cancer treatment outcomes [ABSTRACT FROM AUTHOR]

This paper reports language differences in poor/fair self-rated health (SRH) among adults from six Hispanic groups in the United States. Data are from the cross-sectional 1997-2013 National Health Interview Survey (NHIS). The total sample of Hispanic adults with valid information for the variables considered in the study (n = 156,374) included Mexican-Americans (Mex-Am; n = 43,628), Mexicans (n = 55,057), Puerto Ricans (n = 14,631), Cubans (n = 8,041), Dominicans (from Dominican Republican, n = 4,359) and Other Hispanics (n = 30,658). We compared percentage of the population that reported poor/fair SRH among Hispanic individuals by language of interview and across origins using bivariate tests of association. Multivariable logistic regression analysis was used to study the odds of reporting poor/fair SRH based on language among the overall population and each group. Among the six Hispanic origins Puerto Ricans (15.92%), Cubans (16.36%) and Dominicans (15.32%) reported poor/fair SRH at higher levels than the overall sample (12.32%). In the logistic regression model adjusting potential covariates, those interviewed in Spanish were at higher odds of reporting poor/fair SRH than those interviewed in English (OR = 1.47, p < 0.0001). In the stratified analysis, Mexican-Americans were the only group where language of interview did not affect the odds of reporting poor/fair SRH. There are differences by Hispanic origin for reporting poor/fair SRH, and also by language of interview. Achieving accurate measurement of health status among Hispanics is a concern for all researchers, in particular those who study differences in health status by race/ethnicity in the United States. Future, research should account for Hispanic background and language of interviews. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between acculturation and oral health in a study of Somali refugees. This cross-sectional survey included structured surveys and dental examinations of a convenience sample of 439 Somali adults living in Massachusetts. Associations between an acculturation scale and: (1) lifetime history of caries and (2) access to oral health services were calculated. In bivariate analyses, many individual questions in the scale were associated with outcomes. In multivariate analysis, speaking English (OR 0.5, CI 0.28-0.84) was associated with better access to, and utilization of, dental health services while reading American books and newspapers in English was associated with increased lifetime history of dental disease (OR 2.6, CI 1.1-6.0). As specific elements of acculturation have different relationships with oral health among Somali refugees, a summary acculturation scale may have limited utility. Ongoing efforts to remove language barriers may improve oral health. [ABSTRACT FROM AUTHOR]

Understanding the concepts of mental health and help seeking behaviours of migrant and ethnic minority families constitutes an important step toward improving the intercultural competence of health and education professionals. This paper addresses these goals among ethnic and migrant minorities in Portugal. For this a multi-informant approach was selected. The study involved nine focus groups (N = 39) conducted with different samples: young immigrants (12-17 years), immigrant parents, teachers and health professionals. The results showed similarities and differences in concepts of mental health, as well as help seeking processes. Stigma continued to be recognized as a barrier in the access to mental health care. The paper argues that providing adequate training on mental health on cultural diversity competencies to health and education professionals can contribute to a better inter-communication and -relation system in the family-school-primary care triangle and thus facilitate access to mental health care for youth. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to investigate the relationships of stressful events with self-reported mental health problems in the general population, comparing non-western immigrants with Danish nationals. 11.500 individuals aged 18-64 years from eight ethnic groups were invited to participate in a bilingual telephone survey on health among ethnic minorities in Denmark in 2007. Overall response rate is 52.1%. 3.997 individuals were selected for the present study. Self-reported mental health problems is twice as high among immigrants from Ex-Yugoslavia (24.6%), Iraq (30.2%) Iran (20.5%), Lebanon (27.2%) and Pakistan (19.9%), as among Danish nationals (9.7%) χ (7, n = 3.997) = 21.57, P > 0.00. Non-western immigrants report twelve out of thirteen types of stressful events more frequently compared to Danish nationals. The most frequently reported stressful event among non-western immigrants is 'personal disease'. Immigrants perceive the perils of daily life as more stressful in comparison with host nationals probably because of the additional challenges of adjusting to a new environment. [ABSTRACT FROM AUTHOR]

Latino immigrants to the New Settlement area of the southeastern United States face structural and cultural obstacles to accessing the conventional health care system, and come from areas with long traditions of medical treatments from healers without professional training or licensure. Little is known about the use of such healers in New Settlement areas. This study focuses on sobadores, healers who use manipulative therapy. Goals were to describe sobadores practicing in North Carolina, including their background, conditions treated, and their understanding of the pathophysiology of their patients' conditions and how their treatments work. The paper also describes who sobadores treat and sobadores' understanding of where their treatment fits into patients' pursuit of relief from symptoms. This focused ethnography draws from in-depth, semi-structured interviews conducted with six sobadores from Mexico practicing in North Carolina. These sobadores appear to meet both structural and cultural needs for healthcare in the immigrant Latino population. [ABSTRACT FROM AUTHOR]

This study aimed to (1) identify differences in sleep patterns between Filipino migrants and non-migrants across 2 years and (2) explore the impact of discrimination trajectories on sleep trajectories. The Health of Philippine Emigrants Study (HoPES) consisted of a migrant (n = 832) and non-migrant cohort (n = 805), with baseline data collected in the Philippines. Both cohorts were followed longitudinally, with the non-migrants followed in the Philippines and the migrant cohort followed to the United States. Sleep duration, quality, and difficulty were assessed with the National Institutes of Health Patient-Reported Outcomes Information System (PROMIS) inventory, and discrimination was measured with an adapted version of the Everyday Discrimination scale. Migrants reported a faster decline in sleep duration (− 12 min a year) but higher sleep quality than non-migrants over 2 years. Migrants who reported high initial levels of everyday discrimination also reported faster declines in sleep duration and a slower decline in sleep difficulty. Further, migrants who reported stable (versus declining) levels of discrimination over 2 years reported a faster decline in sleep quality. These results speak to the complexity of immigrant health patterns and long-term associations between discrimination and sleep processes. [ABSTRACT FROM AUTHOR]

Farmworker family members risk poor mental health due to stressors including poverty, relocation, and documentation status. This paper explores the relationship between farm-work related stressors and depressive symptoms in women of Latino farmworker families. 248 mothers of young children completed fixed-response interviews in Spanish. Measures included the Center for Epidemiologic Studies-Depression Scale, Migrant Farmworker Stress Inventory, and USDA Household Food Security Survey Module. Bivariate analyses indicated greater depressive symptoms with more economic hardship, more farm work-related stressors, greater age, and being unmarried. In multivariable logistic regression, economic hardship remained the only factor associated with depressive symptoms. Greater economic hardship, but not general farm work-related stress, is a main factor associated with depression in women of Latino farmworker families. Maternal depression can have consequences for both mothers and families. Mental health services for women in farmworker families should be targeted to those with the greatest economic challenges. [ABSTRACT FROM AUTHOR]

Research from the United States suggests that Latin American immigrant and refugee women are one of the groups most greatly impacted by intimate partner violence (IPV) and associated mental health consequences including higher rates of depression than women from other ethno-racial groups. In Canada, little is known about the experience of IPV and mental health among this population. Even in the broader North American context, how Latin American women themselves perceive the connection between IPV and depression is unknown. This paper presents the findings of a pilot study that examined the perceived relationship between IPV and depression among Spanish-Speaking Latin American Women in Toronto, Canada. The theoretical framework guiding this qualitative study combined an ecological model for understanding gender based violence and mental health with critical intersectionality theory. Using a convenience and snowball sampling method, semi-structured interviews (n = 12) were conducted and thematic content analysis was completed supported by Nvivo9 qualitative data management software. All participants had experienced some form of IPV in their adult lives, with psychological violence being the most common. Women perceived a powerful connection between IPV and depression, a link made stronger by the accumulation of other adverse life experiences including childhood abuse, war traumas and migration. The results suggest that IPV is just one of the challenges experienced by Latin American refugee and immigrant women. IPV is experienced in the context of other traumatic experiences and social hardships that may work to intensify the association of IPV and depression in this population. [ABSTRACT FROM AUTHOR]

In Canada little is known about the challenges immigrant mothers of children with disabilities encounter in accessing formal and informal social support. This paper presents the perspectives of service providers on the mothers' challenges. Data was collected from 27 service providers in Toronto, Canada in 2012 through in-depth interviews. The interview guide was informed by published literature on families of children with special needs. Level one analyses entailed descriptive analyses; and level two consisted of applying House's 4 domains of social support to organize the themes. Following House's domains, challenges to (1) Structural support, (2) Instrumental support, (3) Emotional support, and (4) Perception of support were identified. Among providers who work with families of children with disabilities there is recognition of the mothers' particular challenges in light of their immigration status. Language and communication are significant barriers for immigrant mothers in accessing social support. [ABSTRACT FROM AUTHOR]

This paper takes a unique approach to the study of immigrant and native health differentials by addressing the role of internal as well as international mobility and considering the binational context in which such moves occur. The analyses take advantage of a unique dataset of urban residents in Mexico and the United States to compare Mexican origin immigrants and US-born Spanish-speaking residents in one urban setting in the United States and residents in a similar urban setting in Mexico. The binational approach allows for the test of standard indicators used to proxy acculturation (duration of residence in the United States, household language use) and measures of residential mobility among Mexican-Americans, Mexican immigrants and residents in Mexico. The results confirm a lower prevalence of obesity among Mexicans in Mexico and recent immigrants to the United States when compared to longer residents in the United States. However, for Mexican urban residents, more residential moves are associated with less obesity, while more residential mobility is associated with higher obesity in the urban sample in the United States. [ABSTRACT FROM AUTHOR]

Young Latina women (YLW) in the US and in Alabama are disproportionately affected by sexual health disparities. Our community based participatory research (CBPR) study's purpose was to examine YLW's perceptions and experiences of sexual healthcare access (SHCA) toward developing community-driven, multilevel intervention strategies. We conducted 20 semi-structured qualitative interviews with YLW between 15 and 19 years old and who had been in the US for 5 or more years. We content-analyzed the data guided by the Socioecological Model of Sexual Health (SEMSH). We began analyses by coding independently, built consensus on the codes, then finished coding transcripts independently. Sixty-five percent of participants were US-born and 60% had health insurance. Participants identified barriers/facilitators to SHCA including discrimination in clinical settings and embarrassment/stigma about SHCA. Our study is the first in AL to use CBPR to work with YLW. Interventions should consider the multi-level and intersectional nature of SHCA challenges. [ABSTRACT FROM AUTHOR]

There are few studies of the migration context factors and physical activity (PA) level among minority ethnic women in Europe. We investigated the association between migration context factors and moderate to vigorous physical activity (MVPA) among minority ethnic women. Objectively recorded MVPA were obtained from 487 minority ethnic women included in the STORK-Groruddalen Cohort Study at three time points in pregnancy/postpartum. We investigated the associations between (a) contact with ethnic Norwegians and (b) Norwegian language skills and. No associations were observed in pregnancy. Postpartum, women who reported contact with ethnic Norwegians accumulated 17 MVPA min/day (95% CI: -.60, 34.54) more than women with no contact. In complete case analyses, this difference was significant (27 MVPA min/day (95% CI: 8.60, 44.54)). In early postpartum women with contact with ethnic Norwegians seems to be more physically active than women without contact. No associations were observed in pregnancy. [ABSTRACT FROM AUTHOR]

To understand, and identify predictors of, long-term post-injury (i.e. 12 years post-injury) disability outcomes for migrants and non-migrants. This 12-year longitudinal study followed participants with entitlement claim injuries registered with New Zealand's universal no-fault injury insurer between 2007 and 2009. Information was collected about migrant status, other sociodemographic, health and disability characteristics, and injury characteristics. Disability outcome information was collected 12 years later. Of 1543 people interviewed 12 years post-injury, 1497 had disability and migrant status data available; 20% were migrants (n = 301). Migrants reporting inadequate pre-injury household income or those who perceived their injury as a threat to life at the time of injury were more likely to experience disability 12 years post-injury (aRR 2.08; 95% CI 1.09–4.03, aRR 2.93; 95%CI 1.17–6.69, respectively). Hospitalised injured migrants were significantly less likely to have long-term disability (aRR 0.18; 95%CI 0.04–0.55) than those not hospitalised. We found sociodemographic and injury-related characteristics were independently associated with long-term disability among migrants. We highlight that some characteristics, ascertained early in the injury pathway, predict risk of long-term disability. Early post-injury interventions focused on improving disability outcomes for migrants may also have long-term impacts. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has laid bare entrenched health inequalities in the U.S. health care system faced by structurally marginalized immigrant communities. Deferred Action for Childhood Arrivals (DACA) recipients are well suited to address these social and political determinants of health due to their large presence in service positions and skill sets. Yet their potential in health-related careers is limited by unique barriers related to uncertainty about their status and training and licensure processes. We report findings from a mixed-method (interview and questionnaire) study of 30 DACA recipients in Maryland. Nearly half of participants (14; 47%) worked in health care and social service fields. The longitudinal design featured three research phases conducted between 2016 and 2021, which enabled us to observe participants' evolving career trajectories and capture their experiences during a tumultuous period (due to the DACA rescission and COVID-19 pandemic). Using a community cultural wealth (CCW) framework, we present three case studies that demonstrate challenges recipients encountered as they embarked on health-related careers, including protracted educational journeys, concerns about program completion/licensure, and uncertainty about future employment. Yet participants' experiences also revealed valuable forms of CCW they deploy, including building on social networks/collective knowledge, forging navigational capital and sharing experiential knowledge, and leveraging identity to devise innovative strategies. Results highlight the critical value of DACA recipients' CCW that renders them particularly apt brokers and advocates in promoting health equity. Yet they also reveal the urgent need for comprehensive immigration and state-licensure reform to promote DACA recipients' inclusion in the health care workforce. [ABSTRACT FROM AUTHOR]

Immigrant Latinos frequently experience social isolation in their receiving communities. This paper investigates the prevalence of social isolation among immigrant workers in a new settlement area and delineates the association between social isolation and physical and mental health outcomes. Interviews were conducted in Spanish with immigrant Latino manual workers (N = 743) in western North Carolina. The CES-D and the SF-12 questionnaires assessed health outcomes. A social isolation scale was used to assess degree of social isolation. Nearly 1 in 5 workers (19.5 %) reported the highest level of social isolation. Social isolation was associated with higher depressive symptoms and poorer physical and mental health, related to quality of life. Social isolation is a common experience among immigrant Latinos that may have negative implications for physical and mental health. Community outreach efforts to minimize experiences of isolation may be useful in protecting immigrant physical and mental health. [ABSTRACT FROM AUTHOR]

This paper examines the compensation process for work-related injuries and illnesses by assessing the trajectories of a sample of immigrant and non-immigrant workers ( n = 104) in Montreal. Workers were interviewed to analyze the complexity associated with the compensation process. Experts specialized in compensation issues assessed the difficulty of the interviewees’ compensation process. Immigrant workers faced greater difficulties with medical, legal, and administrative issues than non-immigrants did. While immigrant workers’ claim forms tended to be written more often by employers or friends (58% vs. 8%), the claims were still more often contested by employers (64% vs. 24%). Immigrant workers were less likely to obtain a precise diagnosis (64% vs. 42%) and upon returning to work were more likely to face sub-optimal conditions. Such results throw into relief issues of ethics and equity in host societies that are building their economy with migrant workers. [ABSTRACT FROM AUTHOR]

Previous studies have found Latinx cultural values to be positively associated with healthy behaviors. This study aims to examine socioeconomic and cultural correlates of alcohol use among Latinx adult men living in Miami-Dade County, Florida. The study sample included 122 Latinx adult men (mean age = 44, SD = 10), predominantly of South and Central American origin. Data was collected using REDCap. Interviews included the Timeline Follow-Back scale for alcohol use. Results indicate that Caribbean participants were significantly less likely to report drinking in the past 90 days (aOR = 0.08, p = 0.042) compared to their Venezuelan counterparts. Higher machismo scores were associated with low drinking frequency (aRR = 0.67, p = 0.043), while no significant associations were found between machismo and other drinking outcomes. Drinking quantity and frequency are significantly associated with higher income and authorized immigration status in the US among Latinx men in South Florida. Higher machismo scores were associated with low drinking frequency. [ABSTRACT FROM AUTHOR]

While migration health studies traditionally focused on socioeconomic determinants of health, an emerging body of literature is exploring migration status as a proximate cause of health outcomes. Study 1 is a path analysis of the predictors of mental health amongst 582 documented migrant workers in Singapore, and shows that threat of deportation is one of the most important proximate social determinants of predicted mental illness, and a mediator of the impact of workplace conflict on mental health. Study 2 is a qualitative study of the narratives of 149 migrant workers who were in workplace conflict with their employers, and demonstrates that workers believed threats were used as a negotiating strategy during workplace conflicts. Findings suggest that migration status places workers who come into workplace conflict with their employers at heightened risk of mental illness because migration status can be used as a tool by employers in workplace negotiations. [ABSTRACT FROM AUTHOR]

Non-communicable diseases (NCDs) are high-prevalence health problems among Syrian refugees. In 2014, Médecins Sans Frontières (MSF) identified unmet NCD care needs and began providing free-of-charge services for Syrian refugees in Irbid, Jordan. This study aimed to describe current socioeconomic and medical vulnerabilities among MSF Irbid Syrian refugee patients and their households and raise awareness of their ongoing health needs that must be addressed. A cross-sectional survey among Syrian refugees attending MSF NCD services in Irbid Governorate, Jordan was conducted by telephone interviews in January 2021 to query sociodemographic characteristics, economic situation, self-reported NCD prevalence, and Ministry of Health (MoH) policy awareness. Descriptive analysis of indicators included proportions or means presented with 95% confidence intervals. The survey included 350 patient-participants in 350 households and 2157 household members. Mean age was 28.3 years. Only 13.5% of household members had paid or self-employed work; 44% of households had no working members. Mean monthly income was 258.3 JOD (95%CI: 243.5–273.1) per household. Mean expenditures were 320.0 JOD (95%CI: 305.1–334.9). Debt was reported by 93% of households. NCD prevalence among adults was 42% (95%CI: 40–45). Hypertension was most prevalent (31.1%, 95%CI: 28.7–33.7), followed by diabetes (21.8%, 95%CI: 19.7–24.1) and cardiovascular diseases (14.4%, 95%CI: 12.6–16.4). Only 23% of interviewees were aware of subsidized MoH rates for NCD care. Twenty-nine percent stated they will not seek MoH care, mainly due to the unaffordable price. Our findings highlight increased vulnerability among MSF Irbid Syrian refugee NCD patients and their households, including: an older population; a high percentage of unemployment and reliance on cash assistance; higher proportion of households in debt and a high number of households having to resort to extreme coping mechanisms when facing a health emergency; and a higher proportion of people with multiple comorbid NCDs and physical disability. Their awareness of subsidised MoH care was low. MoH care is expected to be unaffordable for many. These people are at increased risk of morbidity and mortality. It is vital that health actors providing care for Syrian refugees take action to reduce their risk, including implementing financial support mechanisms and free healthcare. [ABSTRACT FROM AUTHOR]

Various studies have shown that immigrant women in comparison to non-immigrant women of the same parity have lower rates of epidural anesthesia (EDA). Data from two studies on immigrant obstetric care in Berlin, Germany were analyzed to answer the following question: What reasons do the medical staff see for the lower rate of EDA in immigrant women? Between May and August 2017, 34 interviews with obstetricians and midwives in four obstetric clinics in Berlin were conducted on the topic of obstetric care for immigrant women. After anonymizing the more than 20 h of interview material, transcripts were coded with MaxQDa and analyzed according to the qualitative content analysis.The quantitative data is from an online survey conducted between May and October 2017, in all but one obstetric clinic in Berlin with obstetricians and midwives. Regarding the research question, 121 questionnaires could be analyzed. In the online survey, (multiple answers were possible), the top reason for a lower rate of EDA given was mostly fear on the part of the immigrant women (64%). A language barrier, which results in logistic and time constrictions, is mentioned as the second most frequent reason (50%). The explorative analysis of the interviews shows that doctors and midwives regard cultural aspects such as different expectations on the birth experience as a reason for a lower EDA rate. Furthermore, within the medical staff the impression persists that in some cases the companion decides on the behalf of the patient about the application of an EDA, which from time to time is against the wish of the immigrant woman giving birth. In the view of the medical staff, the reasons for a lower rate of EDA during birth for immigrant women were varied. On one side, this is attributed to the wishes of the respective women ("demand") but on the other side this can be attributed to the health care system ("supply"). In the case of a language barrier, the "supply" and the access of EDA for immigrant women is limited and can be then shifted to the German-speaking companion to make a decision regarding EDA ("structural deprivation of self-determination"). [ABSTRACT FROM AUTHOR]

We studied South Asian immigrant patients who did not return to Elmhurst Hospital Center (EHC) after emergent cardiac catheterization in order to propose interventions to improve follow up care. We identified 74 eligible patients, interviewed 30 about follow up practices, and analyzed findings. Most patients are Bangladeshi and 77% preferred a foreign language. Some were visiting the US during the admission without intent to follow up. Half were dissatisfied with EHC providers, complications, and inadequate care at follow up appointments. Some patients were unaware of scheduled appointments or the necessity of follow up. Most follow with private providers due to language accessibility, availability, and proximity. We found that language barriers contribute to loss to follow up and the true loss to follow up rate is lower than reported at EHC. This can inform practices at hospitals with immigrant populations, minimize resource waste, and improve quality of care. [ABSTRACT FROM AUTHOR]

This study assessed the psychological wellbeing and its associated factors amongst ethnic minorities during the coronavirus disease 2019 (COVID-19) pandemic. A total of 310 Hong Kong South Asians aged 41.3 (SD 13.7) years completed an anonymous online survey between July 2020 and February 2021. The results showed an overall moderate level of stress and high levels of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms amongst South Asian minorities. Multivariable regression analyses suggested that being single/divorced, following Hinduism or other non-Muslim religions, having lower perceived knowledge of COVID-19 and having worried about losing job were significant predictors of higher levels of depression, anxiety and/or stress; additionally, being male, having a low monthly household income, having worried about losing job and healthcare collapse were significant predictors of a higher level of PTSD symptoms. The findings suggest an urgent need to alleviate the psychological impacts of the COVID-19 pandemic on ethnic minorities, specifically for those most vulnerable to these impacts. [ABSTRACT FROM AUTHOR]

To examine the health beliefs that can influence engagement in cardiovascular disease (CVD) risk reduction health promotion activities among Zimbabwe-born immigrants in the US. Focus group interviews with 37 New England-based Zimbabwean immigrants in the US conducted between January and April 2019. Focus groups were led by study investigators who were members of the Zimbabwean community. Interviews were audio-recorded and transcribed. Data were analyzed using framework analysis. Five themes emerged: (1) negative attitudes toward ill health, (2) mistrust toward western medicine, (3) stigma and taboo toward ill health, (4) a negative change in eating habits and (5) negative attitudes toward physical exercise. The participants' attitudes and beliefs may interfere with their engagement in health promotion activities aimed at reducing the burden of CVD risk in this population. Understanding these beliefs paves the way for development of culturally congruent health promotion interventions in Zimbabwean and other African immigrant populations. [ABSTRACT FROM AUTHOR]

There is a limited understanding of how toxic exposures to agrichemicals vary relative to international migration over the life course. A life history calendar (LHC) was piloted to explore sequences of agrichemical exposure relative to international migration. LHCs were administered to 41 foreign born individuals from Mexico and Central America who had agricultural work experience during their lifetime and who were living in South Florida. Social sequence analysis was used to explore occupation-by-agrichemical events relative to migration. A three-cluster solution was used to classify low, moderate, and high lifetime exposure sequences. The odds of any perceived effects of agrichemicals on the body increased with time prior to migration in the moderate and high exposure sequence clusters and continued to increase 20% with each year following migration in the moderate exposure cluster. Workers with high lifetime agrichemical exposures prior to migrating internationally showed lower likelihoods of a perceived effect on the body following migration despite continued exposure. Further research on instrument validity is warranted. [ABSTRACT FROM AUTHOR]

Sri Lanka is a major labour sending country in Asia, with a high proportion of female labour migrants employed as domestic housemaids in the Middle East with increasing remittances. Despite such financial gains for families and national economy, health and social effects on the left-behind families have had limited exploration. This qualitative study was carried out across five districts with high labour migration rates in Sri Lanka. Twenty in-depth interviews were conducted with participants recruited through purposive sampling. Data was analysed using content and thematic analysis and emerging themes were mapped. Pre-migration socio-economic situation, economic difficulties and higher earning possibilities abroad were considered to be the major push and pull factors for labour migration. Post-migration periods were shown to be of mixed benefit to left-behind families and children suffer the negative effects of parental absence. The absence of support mechanisms for dealing with adverse events such as serious injury, death, abuse or imprisonment were cited as major concerns. Post-migration periods affect the health, well-being and family structures of left-behind families. Promoting economic prosperity while ensuring health and social protection is a formidable policy challenge for 'labour sending' countries such as Sri Lanka. [ABSTRACT FROM AUTHOR]

Background: This article examines how immigration policy uncertainty during the Trump presidency shaped how immigrant serving organizations (ISOs) responded to the needs of immigrant community members in the first six months of the COVID-19 pandemic. Methods: We draw on semi-structured interviews conducted over the summer of 2020 with 31 directors and program coordinators of ISOs and health clinics in three southern states (KY, NC, SC). Results: Responding to anti-immigrant policies laid the groundwork for organizations to respond quickly and nimbly to COVID-19 related upheavals. However, organizational flexibility may signal organizational precarity, especially given the long-term impacts of both Trump administration immigration policies and the COVID-19 pandemic. Discussion: Our findings underline how ISOs facilitate access to health and social services for immigrant families. Our findings suggest that this organizational adaptability may signal a relationship between organizational precarity and immigration policy uncertainty that could have an impact well beyond the pandemic. [ABSTRACT FROM AUTHOR]

There is ample evidence that exposure to Immigration and Customs Enforcement (ICE) activities could widen Latinas' health disparities. Whether or not residing near an ICE detention center (IDC) further impacts their health is unknown. During nationwide increased ICE activities Latinas (N=45) attended an intervention at two separate sites: one near and another one far from an IDC. A focus group discussion and an interview were conducted using a grounded theory approach. Quantitative data were collected and analyzed. Participants residing near an IDC benefited less from the intervention and reported changes in anxiety levels and in mobility, and a sense of powerlessness. They also requested resources to respond to ICE overreach and broadcasting of their reality. Our results suggest that proximity to IDCs impacts immigrant communities and public health programming, which is inevitably embedded in political realities. These need to be addressed when providing much needed interventions. [ABSTRACT FROM AUTHOR]

The three studies presented in this Special Topics in Immigrant Health report findings from a novel transnational, mixed-methods study with indigenous Mayans in Yucatán, Mexico, and their satellite communities in Southern California. Indigenous migrants comprise the largest proportion of recent, first-time migrants from Mexico to the United States and are among the migrant populations most vulnerable to discrimination (e.g. work place) and health disparities. The studies presented focus on three topics: perceived discrimination and mental health among indigenous migrants and non-migrants, risky alcohol use behaviors associated with migration to the U.S. and within Mexico, and gendered power dynamics related to sexual health care access and utilization. This transnational research sheds new light on health issues and gender differences affecting indigenous Mexican migrant men, women and their families. Findings can serve to inform intervention research to improve migrant health in the U.S. and Mexico as well as transnational collaboration between countries. [ABSTRACT FROM AUTHOR]

Understanding the immigrant experience accessing healthcare is essential to improving their health. This qualitative study reports on experiences seeking healthcare for three groups of immigrants in Toronto, Canada: permanent residents, refugee claimants and undocumented immigrants. Undocumented immigrants who are on the Canadian Border Services Agency deportation list are understudied in Canada due to their precarious status. This study will examine the vulnerabilities of this particular subcategory of immigrant and contrast their experiences seeking healthcare with refugee claimants and permanent residents. Twenty-one semi-structured, one-on-one qualitative interviews were conducted with immigrants to identify barriers and facilitators to accessing healthcare. The open structure of the interviews enabled the participants to share their experiences seeking healthcare and other factors that were an integral part of their health. This study utilized a community-based participatory research framework. The study identifies seven sections of results. Among them, immigration status was the single most important factor affecting both an individual's ability to seek out healthcare and her experiences when trying to access healthcare. The healthcare seeking behaviour of undocumented immigrants was radically distinct from refugee claimants or immigrants with permanent resident status, with undocumented immigrants being at a greater disadvantage than permanent residents and refugee claimants. Language barriers are also noted as an impediment to healthcare access. An individual's immigration status further complicates their ability to establish relationships with family doctors, access prescriptions and medications and seek out emergency room care. Fear of authorities and the complications caused by the above factors can lead to the most disadvantaged to seek out informal or black market sources of healthcare. This study reaffirmed previous findings that fear of deportation forestalls undocumented immigrants from seeking out healthcare through standard means. The findings bring to light issues not discussed in great depth in the current literature on immigrant health access, the foremost being the immigration status of an individual is a major factor affecting that person's ability to seek, and experience of, healthcare services. Further, that undocumented immigrants have difficulty gaining access to pharmaceuticals and so may employ unregulated means to obtain medication, often with the assistance of a doctor. Also, there exists two streams of healthcare access for undocumented immigrants-from conventional healthcare facilities but also from informal systems delivered mainly through community-based organizations. Finally, within the umbrella term 'immigrant' there appears to be drastically different healthcare utilization patterns and attitudes toward seeking out healthcare between the three subgroups of immigrants addressed by this study. [ABSTRACT FROM AUTHOR]

This study explored resilience among South Asian (SA) immigrant women who were survivors of intimate partner violence (IPV). Eleven women participated in in-depth interviews. Thematic analysis was conducted using constant comparison. We identified five cross-cutting themes: resources before and after the turning-point (i.e. decision to confront violence), transformations in self, modification of social networks, and being an immigrant. Women drew upon their individual cognitive abilities, social support, and professional assistance to move beyond victimization. All women modified their social networks purposefully. The changes in individual-self included an increased sense of autonomy, positive outlook, and keeping busy. The changes in collective-self occurred as women developed a stronger feeling of belonging to their adopted country. This hybrid identity created a loop of reciprocity and a desire to contribute to their community. Women were cognizant of their surmountable challenges as immigrants. SA immigrant women IPV survivors sought multiple resources at micro, meso and macro levels, signifying the need for socio-ecological approaches in programs and policies along with inter-sectoral coordination to foster resilience. [ABSTRACT FROM AUTHOR]

This research reports information from semi-structured interviews with 14 northern California Filipino Americans to explore how social connections are associated with methamphetamine use. The interviews examine how the social connections of Filipino American methamphetamine users are influenced by class and generational status. I hypothesize that drug users become involved in social networks that facilitate drug use and that cases of recovery occur among users when they change their social networks. Generational differences in age of first methamphetamine use suggest that drug usage among first generation users may be a way of coping with social class disadvantages. User social networks within social class groups generate ethnic solidarity and highlight the existence of a shared culture that plays an adaptive role in aiding survival, but such support does not appear to help Filipinos stop methamphetamine use. The realization by users that their networks have enabled and reinforced their drug usage serves as a major turning point in helping them “break free” from the social ties that foster continued usage. Those that maintain their ties to user networks tend to remain users. [ABSTRACT FROM AUTHOR]

In most countries, sex-work is criminalized and frowned upon. This leads to human rights abuses, especially for migrant female sex workers. The burden is heavier on migrant female sex-workers whose gender and foreign citizenship intersect to produce a plethora of adverse health, social, and legal outcomes. This phenomenological study explores the intersectionality of individual factors leading to human rights abuses among migrant Cameroonian female sex workers in N'Djamena, Chad. Ten female sex workers and two key-informants were interviewed, and being a small sample, they gave detailed information about their experiences. The data was later analyzed using thematic analysis. Participants narrated experiences of social exclusion, exposure to diverse abuses, and health risks due to gender, immigrant status, and illegality of sex work. The experiences of female migrant sex workers, within contexts of sex work criminalization, are exacerbated by the intersectionality of these factors. Women endure several vulnerabilities in many African countries, more so when they have to survive on sex work as foreigners in a country where the act is illegal. [ABSTRACT FROM AUTHOR]

Poor sleep is common among older adults, affecting a wide range of health outcomes. However, little is known about sleep issues among older Korean immigrants, the fastest growing Asian American subgroup in the United States. We aimed to explore multiple factors associated with sleep among this group. We analyzed cross-sectional survey data from 43 older immigrants living in two large Korean communities in Southern California. Perceived sleep quality was significantly associated with gender, living arrangement, employment status, mental health, and sleep-related beliefs (all p-values < 0.05). Living with someone and being employed for wages were significantly uniquely associated with better sleep quality, accounting for demographic and health-related factors (R2 = 51.8%, adjusted R2 = 38.7%, p = 0.002). These findings suggest a potential role of sociocultural factors on sleep. Further studies are needed to confirm these findings and to inform a sleep intervention program tailored to the characteristics of older Korean immigrants. [ABSTRACT FROM AUTHOR]

Medicaid beneficiaries in most states must go through a redetermination process every 6–12 months to demonstrate continued eligibility. This study sought to examine Medicaid redetermination experiences among beneficiaries with Limited English Proficiency (LEP). A sequential mixed methods study was conducted involving quantitative phone surveys and semi-structured, in-person interviews with Arabic, Chinese, Korean, and Vietnamese speaking beneficiaries in Illinois. Survey respondents experienced notable barriers during the redetermination process. Quantitative data showed LEP respondents to have 5.3 times the odds of losing their Medicaid benefits as compared to English proficient respondents. Qualitative interviews illustrated the impact of Medicaid loss on individuals and families, as well as strategies for successfully navigating redetermination. Findings suggest that language barriers hinder Medicaid redetermination and play a role in cancellation of benefits. Recommendations for better language supports during the Medicaid redetermination process are discussed. [ABSTRACT FROM AUTHOR]

Despite improvements in HIV prevention and treatment, Black individuals continue to be disproportionately affected by the HIV epidemic in the US. Using data from the National Survey on HIV in the Black Community, we examined the differences in demographic characteristics, risk behaviors, and HIV testing between US and non-US born Black adults. 868 individuals completed the survey and provided baseline data on sexual risk. Participants were grouped as US-born (N = 763) and non-US born (N = 101) based on self-reported place of birth. Amongst US-born participants, males were less likely to test for HIV, whereas those who reported a lifetime history of anal sex and sexually transmitted infections (STIs) were more likely to test for HIV. Non-US born participants who reported a single marital status were less likely to test for HIV, whereas those who reported a lifetime history of STIs were more likely to test for HIV. Some differences in predictors of HIV testing exist by place of birth. Understanding these differences is needed to develop HIV/AIDS prevention and treatment programs for US and non-US born Black individuals. [ABSTRACT FROM AUTHOR]

Hepatitis B is a major public health threat which leads to serious liver disease or cancer and disproportionately impacts immigrants. Pregnant people are routinely tested for hepatitis B to prevent perinatal transmission but may themselves not receive appropriate education and referrals. People contacted as part of the local health department's perinatal hepatitis B prevention program were offered culturally appropriate telephone patient navigation services to test if this would improve adherence with postpartum hepatitis B care. Four-hundred and nine people were enrolled in the intervention. Using laboratory-reported surveillance data as the outcome measure, those receiving the intervention were 1.66 times as likely to see a hepatitis B care provider within 6 months of childbirth compared with those who did not. Culturally appropriate patient navigation can improve adherence with recommended hepatitis B care in the postpartum period. Health departments can use similar interventions to address liver health disparities in immigrant populations. [ABSTRACT FROM AUTHOR]

We investigate the association between nativity status (U.S.- vs foreignborn) and viral suppression among women of color (WOC) with HIV (HIV +) and whether this association was modified by education and housing. Methods: Data were from 549 HIV + WOC, who participated in the Health Resources and Services Administration-funded WOC Initiative 2009–2013. We used generalized estimating equation models to quantify the association between the respondents' nativity status and viral suppression. Results: After adjusting for covariates, foreign-born WOC were 2.2 times (95% confidence interval: 1.25, 3.85) more likely to achieve viral suppression than U.S.-born WOC. This association was not modified by education or housing status. Conclusions: Despite facing barriers to care, foreign-born WOC were more likely to achieve viral suppression than U.S.-born WOC. Programs aiming to end the HIV epidemic and reduce HIV disparities in the U.S. should consider these findings as they provide a more nuanced understanding of HIV + WOC. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cancer in women. Asian American women have experienced steadily increasing breast cancer incidence rates over the past several decades. The increased rate might be in part due to acculturation. We tested the hypothesis that higher level of acculturation was associated with higher mammographic breast density (MBD), an indicator of breast cancer risk, in a cohort of 425 premenopausal Chinese immigrant women in Philadelphia. Generalized estimating equations accounted for repeated observations and adjusted for age, type of mammographic image, body mass index, months of breastfeeding, number of live births, age at first birth, and menopausal stage (pre, early peri, late peri, post). Results indicated that acculturation level was not associated with any of the MBD measures. Findings were contrary to our hypothesis and previous, cross-sectional studies. In this study population, reproductive factors had a greater effect on MBD than acculturation-related behaviors in adulthood. [ABSTRACT FROM AUTHOR]

Female Genital Mutilation/Cutting (FGM/C) affects millions of girls and women globally each year despite widespread criminalization of the practice. Eradication efforts have focused on the health risks associated with FGM/C however, it is important to understand the sociocultural context in which this practice exists. We conducted a cross-sectional study using retrospective chart review and structured interviews with women recruited through the Bellevue/New York University Program for Survivors of Torture. Of the 43 participants enrolled in the study, 88.4% initially indicated there is no benefit of undergoing FGM/C but when prompted, agreed that social acceptance (16.3%), religious approval (11.6%), and better marriage prospects (9.3%) are possible benefits. More sexual pleasure for the women (46.5%), avoiding pain (30.2%), and fewer medical problems (16.3%) were stated as benefits of not undergoing FGM/C. Overall, 40 (93%) participants believed the practice should be discontinued. This study highlights that there may be a perception of social benefit of undergoing FGM/C. Although most participants believed the practice should be discontinued, the complex social milieu within which this practice exists must be addressed. [ABSTRACT FROM AUTHOR]