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Heart attacks cause significant preventable morbidity and mortality among Hispanics in the United States. We examined the relationship between immigration status, acculturative variables, and heart attack symptom knowledge among Hispanics. Using 2014 and 2017 National Health Interview Survey data, we examined the following heart attack symptoms as our dependent variables: 1) chest discomfort; 2) jaw, neck, and back pain, and 3) arm and or shoulder pain. These symptoms were then analyzed by immigration status: US-born, naturalized citizens, and noncitizens. We calculated descriptive statistics and adjusted rate ratios. Naturalized and non-citizens had a lower prevalence than US-born Hispanics of correctly identifying any heart attack symptoms. All groups had the lowest prevalence of correctly identifying jaw, neck, and back pain as heart attack symptoms. After adjusting for demographic and socioeconomic variables, naturalized and non-citizens had a lower rate of correctly identifying any of the heart attack symptoms compared to US-born Hispanics. Heart attack educational campaigns and providers need to emphasize all heart attack symptoms, among all three groups of Hispanics, particularly among naturalized and noncitizens. Jaw, back, and neck pain were the symptoms least correctly identified in this population. Heart attack symptom knowledge should be bolstered to improve the health of Hispanics regardless of immigration status. [ABSTRACT FROM AUTHOR]

Objective: To understand communities' perceptions, beliefs, and health‐related behavior choices related to COVID‐19 in order to guide public health nursing communication and interaction with patients and the community. Design: A qualitative study, guided by the Health Belief Model (HBM), strove to comprehend the perceptions and reactions to COVID‐19 among Wisconsinites. Sample: Twenty‐five diverse Wisconsin residents aged 18 or older. Measurements: Semi‐structured interviews provided information about individuals' attitudes, perceptions, and reactions to COVID‐19. Interviews were audio‐recorded, transcribed, and thematic analysis was conducted to identify themes. Results: We identified three major themes: (1) "health care starts way before you ever enter the doors of a healthcare facility"; (2) "to live in a society is to help each other"; and (3) mental health as impacted by COVID‐19. Conclusions: This study demonstrated the need for greater public health support, as well as the role of Social Determinants of Health. Understanding perceptions and reactions to COVID‐19 can help public health nurses understand and better respond to future pandemics. [ABSTRACT FROM AUTHOR]

Background: There are over seven million older adult immigrants in the United States, and that number is expected to increase. Older adult immigrants in the United States have unique factors that influence their health.Methods: In this integrative review, we systematically review 20 years of peer-reviewed literature on the barriers (i.e. isolation, lack of English Language Proficiency, low health literacy, lack of SES resources, discrimination) and facilitators (i.e. English Language Proficiency and maintaining ones native language, social support, culturally sensitive providers, healthcare access) of health among older adult immigrants in the United States.Results: We found differing uses of the term 'older adult', emphasis on the lack of homogeneity among older adult immigrants, social support and isolation as significant barriers and facilitators of older adult immigrant health, and inconsistencies in uses and definitions of acculturation. We also examined relevant theories in the literature. Based on the literature review, focusing on Acculturation Theory, Social Cognitive Theory, and Successful Aging Theory, combining these three theories with findings from the literature to create the Older Adult Immigrant Adapted Model for Health Promotion.Conclusions: Public health strives to promote health and prevent adverse health outcomes. Our integrative review not only systematically and thoroughly explicates 20 years of literature, but the Older Adult Immigrant Adapted Model for Health Promotion, provides guidance for future research and interventions. [ABSTRACT FROM AUTHOR]

Asthma represents a significant burden among adult Hispanics in the United States. Traditionally, Hispanics have been studied as a group; however, Hispanics are a heterogeneous group, contending with differing asthma risk. Thus, the objective was to examine the influence of demographic, socioeconomic, acculturative, and neighborhood factors on asthma risk among three Hispanic subgroups in the United States: Mexicans, Puerto Ricans, and Dominicans. We selected data from the National Health Interview Survey, 2013-2017. The dependent variable was asthma diagnosis. We were interested in the difference in prevalence and risk factors for asthma among Mexicans, Puerto Ricans, and Dominicans. Independent variables were grouped in relation to demographic, socioeconomic, acculturative, and neighborhood variables. We calculated descriptive statistics and adjusted risk ratios. Asthma prevalence was similar among Mexicans and Dominicans, while prevalence among Puerto Ricans was nearly twice as high compared to Mexican and Dominicans. There were, however, major differences in the risk of asthma. After adjusting for the effects of demographic, socioeconomic, acculturative, and neighborhood variables, Puerto Ricans had a 2.7x greater risk of reporting asthma compared to Mexicans, while Dominicans were at 1.5x greater risk of reporting asthma compared to Mexicans. Hispanics in the United States are a heterogeneous group impacted by different socioeconomic and acculturative factors. Targeted interventions need to account for differences in risk among Mexicans, Puerto Ricans, and Dominicans living in the US. [ABSTRACT FROM AUTHOR]

The purpose of this theoretical article is to analyze the utility of postcolonial and Indigenous feminist frameworks in informing nursing research and practice specific to addressing intimate partner violence (IPV) in the lives of Indigenous women. Prevailing feminist narratives of the 20th century focused overwhelmingly on patriarchy as the sole source of oppression against women and root cause of IPV. These narratives failed to consider the complex historical ways in which patriarchy intersected with colonialism and racism to produce violence, affecting the contemporary realities of Indigenous women. In contrast, postcolonial and Indigenous feminist frameworks consider the colonial history that has disempowered Indigenous women and their nations over centuries of settler occupation. Situating IPV within historical, legal, social, and political contexts can unmask how current research and health care discourses may continue to constrain, rather than improve, access, care, and services for Indigenous victims of IPV. [ABSTRACT FROM AUTHOR]

There are numerous ethical and procedural challenges when conducting cross-language research, and there is a need to discuss the role of multilingual researchers, as much of the existing literature focuses on working with third-party interpreters or translators. In this article, we expand the recommendations for cross-language research for multilingual researchers and health studies, through an examination of literature and processes from a Community-Engaged Qualitative Photovoice project. We present adapted cross-language research methods for future cross-language research studies. These adapted methods include seven considerations: (i) What and why? Considerations for Study Design, (ii) When do we translate, and how many times? Question development, pilot testing, transcription, and translation, (iii) Who? The role of the translator/interpreter during the research process, (iv) Who again? Translator/interpreter credentials, (v) What are you really saying? Dynamic equivalence, (vi) Do your ears deceive you? Reflexive reflective reflexivity, and (vii) Triality, not just Duality, of the role of the Researcher. [ABSTRACT FROM AUTHOR]

The health of refugee women after settlement in a new country, can be adversely or positively affected by individual, interpersonal, community, and organizational factors. While much of the previous literature highlights these factors individually, there is a lack of comprehensive synthesis regarding how the factors interact to influence the health of refugee women. We conducted a thematic analysis in our literature review to elucidate how providers can work with refugee women to prevent adverse health outcomes and intervene at multiple levels to improve their health outcomes after resettlement. We reviewed peer-reviewed literature from 2009 to 2019 from Google Scholar, JSTOR, Global Health, PubMed, CINAHL, Sociological Abstracts, and Social Service Abstracts, and also used citation chaining, to identify relevant information pertaining to refugee women's health. The key terms used for our literature review were, health care, violence, social support, and mental health. In total, we included 52 articles, 3 books, and 8 other sources. We found that refugee women are vulnerable to violence during migration and typically have high rates of post-traumatic stress disorder. There were also concerns of secondary victimization by providers after resettlement. We also found that social support is an important factor for reducing isolation, and improving access to health care, as well as improving mental health outcomes. However, social support was often difficult to maintain, and was moderated by factors such as English language fluency. Health care was influenced by health literacy, cultural difference, communication concerns, and access issues. The findings suggest that at the individual and interpersonal levels there is a need to address language barriers, improve provider-patient communication, and provide appropriate medical and mental health screenings. At the organizational level, inter-organizational communication and awareness are vital. At the community level, providers can work with community leaders, to educate, create dialogue and collaboration, to help facilitate understanding and bolster community social support. Improved communication and knowledge about the unique needs and concerns of refugee women through an integrated, multi-system approach is necessary to improve their health outcomes. [ABSTRACT FROM AUTHOR]

This qualitative study assessed the impact of the Nia Imani model of care on homeless African-American women, many of whom abused drugs, experienced interpersonal violence, and faced other challenges when seeking to improve their lives and health. Nia Imani Family, Inc., is Milwaukee, Wisconsin's, only long-term transitional living facility. Grounded in Black feminist thought, our study included focus group interviews with 39 women who had lived at Nia Imani, and successfully completed its programs; and one individual interview with the founder, who had also experienced homelessness (N=40). Themes were identified through thematic analysis, and included the following: crucial social support, learning self-worth, stability and structure, appreciation for strict rules, and importance of parenting and financial literacy classes. To ensure effective interventions, there is a need for nurses to understand how community-based and community-led programs, like Nia Imani, impact the health and well-being of African-American women, who have experienced homelessness. [ABSTRACT FROM AUTHOR]

In this critical ethnographic study, we examined women's end of life experiences in Malawi, one of the few countries in the world with a national palliative care policy. Specifically, we explored how women's and their caregivers' experiences were shaped by family and community care, and material needs. Interviews and observations with female clients of a non-governmental organization in rural Central Malawi, and with their caregivers, revealed that community-level support was both precarious and critical. We found three main themes: (1) I stay with them well , (2) we eat together , and (3) everyone is for themselves. The analysis illustrates the centrality of community care, social in/exclusion, and availability of stable food, shelter, medical, and caregiving resources on health and wellbeing at end of life. We provide recommendations to strengthen community care opportunities and women's resource bases. • Malawi is one of few countries in the world with a national palliative care policy. • Examined women's experiences receiving end of life care and their caregivers in Malawi. • Community care affected women's health and wellbeing at end of life. [ABSTRACT FROM AUTHOR]

Effective communication is integral to the patient–provider relationship. Yet, as a result of structural factors that ignore the unique health care needs of different populations of patients who identify as Black—both African American and African immigrants—are confronted with communication challenges during health care seeking encounters. Using cultural safety as a framework, in this article, we thematically review communication challenges specifically experienced by patients of African descent in the U.S. health care system. In our review, we focus on complications that might arise from discrimination, mistrust, health literacy, and impacts of culture and language barriers on health literacy. In conclusion, we offer recommendations for improving the health care experiences and potential health outcomes for this population, through nursing care and health care delivery. [ABSTRACT FROM AUTHOR]

Background: Many LGBTQ youth experience rejection and discrimination in their families and schools, and the range of interventions for improving their resilience and well-being is limited. We developed and piloted an LGBTQ-youth-focused intervention to build resilience and promote health equity, called Pride Camp, in an urban environment in the Midwest. Methods: Using a mixed-method approach we examined the impact of Pride Camp on resilience and other measures of well-being among LGBTQ high school students who attended camp on a college campus in 2015, 2016, and 2017. Camp attendees and the research sample included a majority proportion of transgender and gender nonbinary (TGN) youth. Results: Pre- and post-test data from our quantitative surveys (n = 28), indicated significant increases in resilience, self-esteem, and quality of life in LGBTQ youth who attended camp. Similar results were found among the TGN participants (n = 19). Qualitative data from focus groups indicated that specifically for TGN youth, the affirming environment at the camp provided social opportunities that they had not found elsewhere. Conclusions: Findings suggest that the Pride Camp intervention provides a platform for LGBTQ youth to meet peers and engage in LGBTQ communities, improving their resilience and outlook on the future. A larger controlled study of the Pride Camp intervention including measurement of additional specific health outcomes over a longer follow-up period is warranted to examine the impact of this program on health equity. [ABSTRACT FROM AUTHOR]

The Westlawn Partnership for a Healthier Environment (WPHE) is a longstanding group of community stakeholders that was formed over a decade ago to identify, prioritize, and address environmental health (EH) concerns in a low‐income, predominantly African American, urban neighborhood, which faces a disproportionate burden of EH risks, particularly asthma. Launched by the University of Wisconsin‐Milwaukee College of Nursing, which established a nurse‐managed health center within the community 30 years ago, WPHE utilized the Protocol of Assessing Community Excellence in Environment Health methodology to develop, implement, and sustain the partnership. WPHE implemented programs for Healthy Homes, Healthy Day Cares, and bicycling, and made system and infrastructure changes within the community to address the top identified EH concerns: indoor and outdoor air pollution, mold exposure, access to safe and healthy food, and pesticide exposure. WPHE's efforts have resulted in significant local, state, and national policy impacts to promote environmental justice. This brief report shares how the partnership was formed, its priorities, major activities and accomplishments, and insights into sustaining a community‐based EH partnership, including recommendations for the key role that public health nurses can play to promote environmental justice. [ABSTRACT FROM AUTHOR]

Objective: To explore attitudes toward immigrants and refugees living in Ecuador. Design and Measures: A transnationalism framework informed this qualitative study, which utilized a semi‐structured interview guide to elicit responses from participants about their attitudes toward immigrants and refugees. Interviews were conducted in Spanish, audio‐taped, transcribed, coded, and analyzed in Spanish to identify emergent themes. Demographic data were analyzed using SPSS. Sample: Participants (n = 50) were recruited from five sectors that interact with refugees: health care, the press, the police, nongovernmental organizations, and education. Fifty interviews were conducted with adults in Quito, Ecuador, in 2017. Results: Participants reported concerns about the health and well‐being of immigrants and refugees, expressed a willingness to assist them, but within limits, noted discrimination and bias against refugees, and cited social policies and human rights as factors that influenced their attitudes. Conclusions: Our findings indicate that immigrants and refugees face challenges which impact their health and well‐being, according to participants in the study. Social policies can influence attitudes, but are also affected by rapidly shifting immigration patterns. Migration flows in South America is an under‐studied area of research, with opportunity for further public health nursing inquiry. [ABSTRACT FROM AUTHOR]