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Objectives To reduce disparities in HIV care outcomes among Latin American and Caribbean (LAC) immigrants living with HIV in the U.S., it is necessary to identify factors influencing HIV care in this population. A systematic review that provides a comprehensive understanding of factors influencing retention in HIV care and viral suppression among LAC immigrants living with HIV in the U.S. is lacking. This systematic review used the Immigrant Health Services Utilization theoretical framework to provide an understanding of these factors. Design We searched for peer-reviewed publications in MEDLINE, EMBASE, CINAHL, PsycINFO, and ASSIA, from January 1996 to June 2020. Results A total of 17 qualitative (n = 10) and quantitative (n = 7) studies were included in the review. The most commonly reported general and immigrant-specific factors appearing in studies were undocumented immigration status, HIV stigma, homophobia, cultural norms, values and beliefs, family and social support, language barriers, structure, complexity and quality of the U.S. healthcare delivery system, and patient-provider relationship. Conclusion These findings highlight the importance of considering immigrant-specific factors along with general factors to improve the provision of HIV care services and HIV care outcomes among LAC immigrant populations.

Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants. Guided by ecological theory, this study examines the interaction effect between individual acculturation and ecology of family on cognitive function among older Chinese Americans.Data were derived from the Population Study of Chinese Elderly in Chicago (Older adults in the commanding-conflicted type had the lowest cognitive function. After controlling confounding variables, higher levels of acculturation (Acculturation to the dominant culture is identified as a cultural asset for cognitive function in older Chinese Americans. Social services could protect cognitive function of older immigrants in the commanding-conflicted type through enhancing cultural participation. Future research could test how affective and cognitive aspects of acculturation affect health.

Objective The insights of Latinx/@ immigrants are essential to developing interventions that better address complex multilevel phenomena impacting mental health. Despite important advances in methods that genuinely embody participatory research practices, attention to collaborative data collection, analysis, and dissemination are limited. Our aim is to describe the development and implementation of research practices to address these gaps through an emphasis on and understanding of the centrality of language in collaborative research processes. Method Guided from the outset by community-based participatory research principles, our community-academic research partnership recognized the importance of developing and intentionally studying our collaborative processes. As part of an ethnographic interview study with 24 Latinx/@ immigrants, a community-university research team developed innovative methods, including practices related to research team meetings, data collection, analysis, and dissemination, which we documented through ongoing discussion and reflection. Results The resulting participatory research processes were grounded in a theoretical framework of praxis and language and included six innovative and iterative stages: (a) Establishing the research team, (b) planning the interview process/data collection, (c) developing the data analysis methodology, (d) interpreting findings to adapt the intervention, (e) integrating results of the participatory process into the analysis, and (f) data analysis for dissemination. Conclusions A focus on praxis and language revealed how the language of research structures' power, meaning, feeling, collaboration, analysis, and transformation. We also found that bilingual participatory analytic processes have important implications with respect to achieving genuine inclusion in rigorous research that moves toward equity for Latinx/@ immigrants and other populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

OBJECTIVE Linked fate, or the degree to which individuals feel that their lives are tied to other group members' lives, can mobilize collective action and strengthen commonalities. Yet, linked fate remains underresearched, particularly among Asian Americans and Latinxs. METHOD Using the 2016 Collaborative Multiracial Postelection Survey, the present study draws on Garcia Coll et al.'s (1996) integrative model to examine associations between three domains of linked fate (immigrant, minority, coethnic) and demographic and structural factors (age, gender, nativity, education, income, language, skin color, neighborhood diversity, social stratification). RESULTS Education, discrimination, and feeling excluded are positively related to immigrant, minority, and coethnic-linked fate; age is negatively related. Income and nativity were not significant predictors. CONCLUSIONS Implications for fostering linked fate and coalition building within and across Asians and Latinxs are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Although anti-immigrant attitudes continue to be expressed around the world, identifying these attitudes as prejudice, truth or free speech remains contested. This contestation occurs, in part, because of the absence of consensually agreed-upon understandings of what prejudice is. In this context, the current study sought to answer the question, “what do people understand to be prejudice?” Participants read an intergroup attitude expressed by a member of their own group (an “in-group” member) or another group (an “out-group” member). This was followed by an interpretation of the attitude as either “prejudiced” or “free speech.” This interpretation was also made by in-group or an out-group member. Subsequent prejudice judgements were influenced only by the group membership of the person expressing the initial attitude: the in-group member's attitude was judged to be less prejudiced than the identical attitude expressed by an out-group member. Participants' judgements of free speech, however, were more complex: in-group attitudes were seen more as free speech than out-group attitudes, except when an in-group member interpreted those attitudes as prejudice. These data are consistent with the Social Identity Approach to intergroup relations, and have implications for the processes by which intergroup attitudes become legitimised as free speech instead of prejudice.

Objective Interest in the coproduction concept in healthcare is increasing. According to coproduction, services are, unlike goods, always coproduced by a user and a service provider. This study explored how immigrants and refugees perceive the coproduction of their healthcare service in clinical encounters. Methods We conducted semi-structured interviews with thirteen patients with varied backgrounds and health problems. Participants were purposefully recruited in an interdisciplinary clinic for immigrants and refugees at a Danish University Hospital. Interviews were transcribed, anonymized, and analyzed using meaning condensation. Results Patients emphasized the importance of a safe space where they could be themselves and feel supported. This encouraged them to be open and assume an active role in the coproduction of their health. A stable therapeutic alliance based on kindness and kinship helped them find strength and take responsibility for their own health. Conclusions This study improves our understanding of how immigrants and refugees experience the coproduction of healthcare services. Further studies, evaluating long-term outcomes of coproduction efforts, are required. Practice implications Providing a safe space in which health professionals have time to listen and empathically validate immigrant and refugee patients’ lived realities, can enable patients to open up and become agents of their own health.

OBJECTIVES In recent years, increased anti-immigrant hostility has trickled into school settings creating toxic climates for immigrant-origin (I-O) students (Rogers, School and society in the age of trump, 2019, UCLA's Institute for Democracy, Education, and Access). Through youth participatory action research (yPAR), this study qualitatively examined how a class of Emerging Bilingual (EB) students aimed to promote more inclusive learning environments by designing, implementing, and evaluating a school-wide program. Here, we consider how the students experienced growth in their civic development as well as how they contended with resistances encountered during the project. METHODS The current study took place at a majority I-O, northeastern high school and was led by an EB class (n = 20) and its teacher. Participants were as follows: on average 16.5 years; 60% female; and 65% Latinx, 30% Black, and 5% mixed-race (Black-Latino). Multiple data sources documenting the students' experiences were collected (including weekly student reflections and ethnographic field notes) and then thematically analyzed using open coding. RESULTS Participating students demonstrated civic development as evidenced through: growing confidence that the program could generate positive change; enhanced sense of connection toward their classmates; and increased commitment to future civic engagement. Nonetheless, some participants demonstrated initial trepidation in both disclosing their migration stories as well as the potential efficacy of engaging in the project. Furthermore, others were disappointed by the disinterest displayed by some of their peers and teachers. CONCLUSIONS Collaborative research can support I-O youths' civic development, though, the resistances encountered and engendered illuminate possible challenges to ensure its benefits. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

OBJECTIVES: Asian Americans have poor HIV-related outcomes, yet culturally salient barriers to care remain unclear, limiting development of targeted interventions for this group. We applied the “what matters most” theory of stigma to identify structural and cultural factors that shape the nature of stigma before and after immigration from China to the US. DESIGN: Semi-structured interviews were conducted with 16 immigrants to New York from China, recruited from an HIV clinic and community centers. Deductive followed by focal inductive qualitative analyses examined how Chinese cultural values (lian, guanxi, renqing) and structural factors influenced stigma before and after immigration. RESULTS: In China, HIV stigma was felt through the loss of lian (moral status) and limited guanxi (social network) opportunities. A social structure characterized by limited HIV knowledge, discriminatory treatment from healthcare systems, and human rights violations impinged on the ability of people living with HIV to fulfill culturally valued goals. Upon moving to the US, positions of structural vulnerability shifted to enable maintenance of lian and formation of new guanxi, thus ameliorating aspects of stigma. CONCLUSIONS: HIV prevention and stigma reduction interventions among Chinese immigrants may be most effective by both addressing structural constraints and facilitating achievement of cultural values through clinical, peer, and group interventions.

Familism is a central cultural value endorsed by Latinx youth that has been identified as a promotive factor for their psychological wellbeing (Stein et al., 2014). However, in the context of familial stress, familism values may instead serve to increase risk, but this research has not been extended to consider parental alcohol use as a risk context. Using a sample of 167 Latinx youth (Mage = 12.86, SD = 0.68, 52% female) from an immigrant community in the Southeast, we tested whether parental alcohol use moderated the association between familism values and youth depressive symptoms and self-esteem. Youth familism values were associated with greater self-esteem and fewer depressive symptoms. Parental alcohol use was not associated directly with either outcome, but, consistent with hypotheses, significantly interacted with familism values to predict self-esteem such that the promotive effect of familism on youth's self-esteem was not evident when parental alcohol use was high. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

To compare the rates of schizophrenia among 1st and 2nd generation immigrants from two distinct backgrounds and across sequential periods of immigration.A 30-years retrospective cohort study (187,184 individuals) of 1st and 2nd generation East-African immigrants (EAIs) and former Soviet-Union immigrants (FSUIs) who migrated to Israel between 1980 and 2012. EAIs were further divided according to waves of immigration. Period prevalence was calculated between the years 2002-2012. Multivariate logistic regression models were used to examine the association between immigration-related factors and prevalence of schizophrenia (Native-Born Israelis serving as reference group).The prevalence of schizophrenia in 1st generation EAIs and FSUIs was 1.8% and 1.2%, respectively, compared to 1.0% among NBIs (p0.001). The prevalence of schizophrenia among 2nd generation EAIs and FSUIs was 1.3% and 0.8%, respectively, compared to 0.6% among NBIs (p0.001). Adjusted odds ratios for developing schizophrenia compared to NBIs were 1.6 (95%CI:1.4-1.8) and 2.1 (95%CI:1.6-2.7), among 1st and 2nd generation EAIs and 1.1 (95%CI:0.9-1.2) and 1.3 (95%CI:1.0-1.8) among 1st and 2nd generation FSUIs respectively. Among EAIs, we observed the highest rate of schizophrenia in the pioneer wave of immigrants with gradual decline across subsequent waves: 2.4%, 1.9% and 1.0% for the 1st, 2nd and 3rd waves of immigration, respectively (p0.001).The increased risk for developing schizophrenia among 2nd generation immigrants and among pioneer groups of immigrants emphasizes the importance of persistent investment in acculturation. Further studies elucidating the impact of country of origin and ethnic density on the risk for developing schizophrenia are warranted.

Background: Patients’ illness stories are valuable information that supports person-centred care across the illness trajectory. Aims: To learn how older South Asian immigrant women experience living with heart illness long after discharge from hospital. Method: We used narrative inquiry, a personal experience method that explores and interprets lived and told stories through the three dimensions of experience. Design: Four participants, over the age of sixty, living with heart illness for over ten years, were invited to engage in narrative interview and Narrative Reflective Process. Outcomes: Giving patients voice, allows caregivers insight into the human experience of illness beyond hospitalization. Considering the increased migration of people around the globe, this knowledge is significant in provision of person-centred care. Implications: Person-centred care does not end with the hospitalization and outpatient clinics. Inter-disciplinary teams need to reconsider the trajectory of chronic illnesses and the care required throughout, especially for marginalized populations.

Latina immigrant farmworkers are a vulnerable and understudied population that face a host of socio-cultural and structural barriers that place them at risk for HIV infection. Cultural factors, including traditional gender roles (egalitarian and marianismo) that frequently inhibit communication between partners and promote rigid roles, may particularly affect self-efficacy for HIV prevention among this population. OBJECTIVE: This study examines the impact of women’s gender norms on HIV knowledge and safe sex negotiation skills, along with the moderating influence of HIV self-efficacy among Latina immigrants in a farmworker community. DESIGN: The current cross-sectional analysis study examines data from a sample (N=157) of mostly undocumented Latina immigrant farmworkers in South Miami-Dade County, Florida. Analysis was performed on secondary data obtained from baseline collected on an intervention pilot study. Measures of traditional American (egalitarian) and Latina (marianismo) gender norms, HIV self-efficacy, and HIV knowledge, as well as key demographic variables were collected. RESULTS: Findings revealed higher American (egalitarian) gender norms directly and indirectly predict higher HIV prevention factors. Additionally, HIV self-efficacy did not mediate effects of marianismo on HIV risk. CONCLUSION: Findings conclude that HIV prevention can be especially challenging due to socio-cultural and traditional gender norms faced by Latinas in farm working communities and that such norms should be taken into account when developing and adapting culturally appropriate interventions to reduce HIV related risk behaviors for Latinas residing in urban or farm working communities.

Building on perspectives on triadic group relations and status hierarchies, we predicted that Americans would be more likely to expect immigrants from a perceived low-status rather than high-status country of origin to assimilate to the U.S. mainstream culture and that ethnocentrism would mediate this effect (N = 2,246). Using 60 countries/areas as targets, Study 1 showed that perceived country status negatively predicted assimilation expectations for immigrants from that country. In Studies 2 through 3, participants were exposed to a news article which emphasized China's shortcomings, achievements, or status-irrelevant attributes. In Studies 4 through 7, including one preregistered study, participants were presented with a portrayal of a fictitious country with high (or intermediate) or low status. Compared with high-status (or intermediate status) conditions, American participants were more likely to expect immigrants from a low-status country to assimilate to the United States, and ethnocentrism (causally) mediated these effects even when alternative mediators were controlled. Moreover, assimilation expectations mediated the effect of country status on a tendency to Anglicize a new immigrant's name. A meta-analysis supported a significant effect of country status on assimilation expectations, and a mega-analysis verified the mediating role of ethnocentrism. This research reveals a status bias toward immigrants, broadening our views on how international relations affect domestic relations, highlighting the importance and malleability of ethnocentrism. The generalizability of current American findings to other countries is discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

To examine differences in the rate of cesarean delivery between Canadian-born women and immigrants to Canada and by duration of time in Canada and rate of cesarean delivery in their country-of-origin.We used linked data from hospitalization records and the Canadian Community Health Survey for all deliveries after 20 weeks gestation between 2002 and 2017 in Canada (excluding Québec). Odds of cesarean delivery in recent immigrants (5 y in Canada) and non-recent immigrants (≥5 y in Canada) were compared with those of Canadian-born women using multivariable logistic regression. Immigrants were further categorized using the cesarean delivery rate in their country-of-origin as low (10%), medium (≥10 to35%), or high (≥35%).Of the 53 505 women included, 89% were Canadian-born, 4% were recent immigrants and 7% were non-recent immigrants. Overall, 28.6% of women had a cesarean delivery. After adjusting for medical and socio-economic factors, the odds of cesarean delivery among recent immigrants (OR 1.12; 95% CI 0.95-1.34) and non-recent immigrants (OR 1.11; 95% CI 0.98-1.25) did not differ statistically from those of Canadian-born women. Recent immigrants from countries with lower cesarean delivery rates had higher odds of cesarean delivery (OR 1.34; 95% CI 1.05-1.70), whereas the odds of cesarean for recent immigrants from medium- and high-rate countries did not differ from those of Canadian-born women.After accounting for demographic and medical factors, few differences remained in cesarean delivery rates between immigrants and Canadian-born women. Country-of-origin practices are unlikely to reflect preferences for cesarean delivery in immigrant women in Canada.

Immigrant children are a diverse group and include refugees, asylees, and internationally adopted children. They have various infectious disease risk factors, depending on conditions within their country of origin, journey, and current living conditions. Infectious disease screening should take place within the framework of a comprehensive medical evaluation in the medical home. Some screening is recommended for all immigrant children including hepatitis B, syphilis, HIV, tuberculosis, and intestinal parasites; other diseases can be tested for based on individual risks. Although guidelines and resources are available, there is limited evidence supporting much of the care of immigrant children and youth.

Objective: Oral cancer is widespread in South Asia, particularly India. In Australia, Indians are one of the fastest‐growing communities. This study aimed to explore the oral cancer‐related knowledge, attitudes and practices of Indian immigrants in Australia. Methods: Fourteen semi‐structured interviews were conducted with Indian immigrants residing across New South Wales and Victoria. Purposive and snowball sampling were used for recruitment. Data were analysed through a directed content analysis approach. Results: All participants were knowledgeable of oral cancer risks associated with tobacco and alcohol, but few were familiar with the harmful effects of areca nut preparations. Varied attitudes were evident with most participants acknowledging the importance of oral cancer check‐ups, yet very few followed this practice. All participants admitted engaging in oral cancer risk practices including areca nut use at least once or more in their lifetime. Conclusion: Oral cancer risk practices are common among Indian immigrants in Australia who possess limited knowledge with varying attitudes in this area. Implications for public health: Preventative strategies are needed to limit the use of oral cancer risk products among Indian immigrants. General practitioners and community organisations can play a key role in raising awareness in this area.

Objective Discrimination is a minority-related stressor that contributes to mental health disparities between Latinx youth and their racial/ethnic peers. Discrimination activates the body's stress response system, resulting in a higher allostatic load that can cause mental health problems such as PTSD. We explored 1) the relation between perceived discrimination and PTSD symptoms among Latinx immigrant youth, and 2) how gender moderates this relation. Methods We conducted surveys with 306 Latinx first- and second-generation immigrant youth during the 2018-19 school year in Harris County, Texas and Rhode Island. Results We found that youth who perceived more discrimination were more likely to report PTSD symptoms. Female participants reported higher levels of PTSD symptoms than males, including higher levels of avoidance and reexperiencing symptoms. Perceived discrimination was associated with increased PTSD symptoms, including hypervigilance and avoidance symptoms, for female participants but not males. These interactions did not differ by location. Conclusion These results further provide support for research into discrimination as a potentially traumatic experience linked to PTSD and underscore the importance of including discrimination in assessments of trauma and adverse childhood outcomes among Latinx immigrant youth. Results further suggest the importance of an intersectional approach to understanding how discrimination relates to PTSD among Latinx immigrant youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective Group Well-Child Care (GWCC) has been described as providing an opportunity to enhance well-being for vulnerable families experiencing psychosocial challenges. We sought to explore benefits and challenges to the identification and management of psychosocial concerns in Group Well-Child Care (GWCC) with immigrant Latino families. Methods We conducted a case study of GWCC at an urban academic general pediatric clinic serving predominantly Limited English Proficiency Latino families, combining visit observations, interviews, and surveys with Spanish-speaking mothers participating in GWCC, and interviews with providers delivering GWCC. We used an adapted framework approach to qualitative data analysis. Results A total of 42 mothers and 9 providers participated in the study; a purposefully selected subset of 17 mothers was interviewed, all providers were interviewed. Mothers and providers identified both benefits and drawbacks to the structure and care processes in GWCC. The longer total visit time facilitated screening and education around psychosocial topics such as postpartum depression but made participation challenging for some families. Providers expressed concerns about the effects of shorter one-on-one time on rapport-building; most mothers did not express similar concerns. Mothers valued the opportunity to make social connections and to learn from the lived experiences of their peers. Discussions about psychosocial topics were seen as valuable but required careful navigation in the group setting, especially when fathers were present. Conclusions Participants identified unique benefits and barriers to addressing psychosocial topics in GWCC. Future research should explore the effects of GWCC on psychosocial disclosures and examine ways to enhance benefits while addressing the challenges identified.

OBJECTIVE Immigrant women are vulnerable to intimate partner violence (IPV), and differences in immigration history, language, and culture impact their trauma responses. Although Chinese are the largest Asian immigrant subgroup in the U.S., little IPV research has specifically focused on this population. Therefore, we aimed to gain a better understanding of help-seeking experiences of Chinese immigrant women who had IPV. METHOD Twenty female Chinese immigrant survivors of recent IPV completed a Mandarin-language qualitative phone interview about their IPV experiences, help-seeking behaviors, and barriers to services. Interviews were analyzed using thematic analyses. RESULTS Women in our sample relied on family, friends, and self-help strategies to cope with IPV. They experienced feelings of shame, stigma, and "losing face," and had little social support. They also faced significant sociocultural and immigration-specific problems with formal services (e.g., culturally incongruent therapists, language, financial and transportation barriers, concerns about partner's reputation and legal status), lacked knowledge about available services, and rarely engaged with them. CONCLUSIONS Abused Chinese immigrant women may be exceptionally isolated, and culturally specific barriers may substantially impact both their understanding of their IPV experiences and their use of services. Practitioners need training and support to engage survivors in culturally competent ways. While safety planning and other formal IPV services are critical to safety and trauma recovery, these survivors underutilize them, and community outreach is needed to U.S. Chinese communities to raise awareness regarding available IPV resources and services. Finally, research is needed to develop and test culturally competent, evidence-based interventions for this isolated and vulnerable population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Adverse birth outcomes of immigrant women and neonates are associated with the quality of perinatal care. For this reason, examining immigrant women's experiences of perinatal care is necessary if host country care systems are to respond appropriately to migration.The aim of the study was to evaluate the perinatal care experiences of immigrant women.The qualitative phenomenological design used in the study enabled to make an in-depth exploration of immigrant women's experiences. The participants were 24 women who had a pregnancy within the past 6 months and lived in Adana, Turkey, between September and December 2019. Data were collected using a semi-structured form through the snowball method. Qualitative data were analysed using the thematic analysis method.The participants' mean age was 21.41 [standard deviation (SD) 3.86] years. Mean age at first pregnancy was 17.27 (SD 4.59) years. It was determined that immigrant women received insufficient maternity services. In thematic analysis, 4 main themes indicating barriers to sufficient perinatal care were identified. The barriers to maternal care services were: language barrier, cultural incompatibility, decreased social support and inadequate information.Our findings indicated that perinatal care for immigrant women was inadequate and their experiences were generally negative. Although the barriers seem separate, they are actually intertwined, with the language barrier appearing to be the main one. Innovative approaches are needed to solve this problem. Mobile applications that translate instantly can be used by both immigrant women and health care professionals.تجارب النساء السوريات المهاجرات فيما يخص الرعاية في الفترة المحيطة بالولادة: دراسة كيفية للظواهر.بورجو فورجك، شوله سروجو، جميلة كورأوغلو، هبه عزو.ترتبط نتائج الولادة الضارة للنساء المهاجرات والأطفال حديثي الولادة بجودة الرعاية في الفترة المحيطة بالولادة. ولذا، فإن دراسة تجارب المهاجرات فيما يخص الرعاية في الفترة المحيطة بالولادة أمر ضروري إذا أُريد لنُظُم الرعاية في البلد المستضيف أن تستجيب للهجرة على النحو المناسب.هدفت هذه الدراسة إلى تقييم تجارب النساء المهاجرات فيما يخص الرعاية في الفترة المحيطة بالولادة.طُرق البحث: استخدمت الدراسة التصميم الكيفي لبحث الظواهر، الأمر الذي أتاح التعرُّف على تجارب النساء المهاجرات بصورة متعمقة. وشارك في الدراسة 24 امرأة حملن خلال الأشهر الستة الماضية وكن يعشن في مدينة أضنة بتركيا في الفترة ما بين سبتمبر/ أيلول وديسمبر/ كانون الأول 2019. وجُعت البيانات باستخدام شكل شبه منظم من خلال طريقة كرة الثلج. وحُلِّلت البيانات الكيفية باستخدام طريقة التحليل المواضيعي.بلغ متوسط عمر المُشارِكات 21.41 سنة (بانحراف معياري 3.86). وبلغ متوسط العمر عند الحمل الأول 17.27 سنة (بانحراف معياري 4.59). وخلصت الدراسة إلى أن المهاجرات يحصلن على خدمات أمومة غير كافية. وحدَّد التحليل المواضيعي أربعة مواضيع رئيسية تشير إلى وجود عقبات تحول دون كفاية الرعاية في الفترة المحيطة بالولادة. وتمثَّلت العقبات التي تحول دون الحصول على خدمات رعاية الأمهات فيما يلي: حاجز اللغة، وعدم التوافق الثقافي، وانخفاض الدعم الاجتماعي، وعدم كفاية المعلومات.أشارت النتائج التي توصلنا إليها إلى أن الرعاية في الفترة المحيطة بالولادة للنساء المهاجرات غير كافية وأن تجاربهن سلبية بوجه عام. وعلى الرغم من أن العقبات تبدو منفصلة، فإنها متشابكة في الواقع، حيث يبدو حاجز اللغة هو العقبة الرئيسية. وهناك حاجة إلى طرق مبتكرة لحل هذه المشكلة. ويمكن لكلٍ من المهاجرات ومهنيي الرعاية الصحية استخدام تطبيقات الأجهزة المحمولة التي تقدم خدمة الترجمة الفورية.Expériences des femmes syriennes immigrées en matière de soins périnatals : étude phénoménologique qualitative.Les issues défavorables de la grossesse chez les femmes immigrées et les nouveau-nés sont corrélées à la qualité des soins périnatals. Pour cette raison, il est nécessaire d'examiner les expériences des femmes immigrées en matière de soins périnatals pour que les systèmes de soins du pays d'accueil puissent apporter une réponse appropriée aux migrations.La présente étude visait à évaluer les expériences des femmes immigrées en matière de soins périnatals.Le modèle phénoménologique qualitatif utilisé pour l'étude a permis d'explorer de façon approfondie les expériences des femmes immigrées. Les participantes se composaient de 24 femmes ayant été enceintes au cours des six mois précédant l'étude et ayant vécu à Adana (Turquie) entre septembre et décembre 2019. Les données ont été collectées à l'aide d'un formulaire semi-structuré selon la méthode boule de neige. Les données qualitatives ont été analysées selon la méthode d'analyse thématique.L'âge moyen (écart type) des participantes était de 21,41 (3,86) ans. L'âge moyen (écart type) lors de la première grossesse était de 17,27 (4,59) ans. Il a été établi que les femmes immigrées ne bénéficiaient pas de services de maternité suffisants. Lors de l'analyse thématique, quatre thèmes principaux indiquant les obstacles à des soins périnatals suffisants ont été identifiés. Les obstacles aux services de soins maternels étaient les suivants : barrière linguistique, incompatibilité culturelle, diminution du soutien social et information inadéquate.Les résultats indiquent que les femmes immigrées ont bénéficié de soins périnatals insuffisants et que leurs expériences étaient généralement négatives. Bien que les obstacles paraissent indépendants, ils sont en réalité étroitement liés. Le principal d'entre eux semble être la barrière de la langue. Des approches innovantes sont nécessaires pour résoudre ce problème. Les applications mobiles proposant des traductions instantanées peuvent ainsi être utilisées à la fois par les femmes immigrées et les professionnels de soins de santé.

The global burden of viral hepatitis B is substantial, and monitoring infections across the care cascade is important for elimination efforts. There is little information on care disparities by immigration status, and we aimed to quantify disease burden among immigrant subgroups.In this population-based, retrospective cohort study, we used linked laboratory and health administrative records to describe the HBV care cascade in five distinct stages: (1) lifetime prevalence; (2) diagnosis; (3) engagement with care; (4) treatment initiation; and (5) treatment continuation. Infections were identified based on at least one reactive antigen or nucleic acid test, and lifetime prevalence was estimated as the sum of diagnosed and estimated undiagnosed cases. Care cascades were compared between long-term residents and immigrant groups, including subgroups born in hepatitis B endemic countries. Stratified analyses and multivariable Poisson regression were used to identify drivers for cascade progression. Between January 1997 and December 2014, 2,014,470 persons were included, 50,475 with infections, of whom 30,118 were engaged with care, 11,450 initiated treatment, and 6554 continued treatment1 year. Lifetime prevalence was estimated as 163,309 (1.34%) overall, 115,722 (3.42%) among all immigrants, and 50,876 (9.37%) among those from highly endemic countries. Compared to long-term residents, immigrants were more likely to be diagnosed (adjusted rate ratio [aRR], 4.55; 95% CI, 4.46, 4.63), engaged with care (aRR, 1.07; 95% CI, 1.04, 1.09), and initiate treatment (aRR, 1.09; 95% CI, 1.03, 1.16).In conclusion, immigrants fared well compared to long-term residents along the care cascade, having higher rates of diagnosis and slightly better measures in subsequent cascade stages, although intensified screening efforts and better strategies to facilitate linkage to care are still needed.

The objective was to study the intercultural role of attitudes towards violence against women in the Moroccan immigrant population. A first study analyzes the relationship between sexism and intimate partner violence and the differences based on origin and sex. About 122 native Spanish people and Moroccan immigrants participated. Men and Moroccan immigrants had more sexist attitudes than women and native people, with no differences in intimate partner violence based on sex or origin. A second study using two focus groups with Moroccan immigrants showed the relevance of the traditional values of gender and culture of honor, religiosity, and the socio-economic context.

In the present article, we use daily diary methodology to investigate how coping influences well-being via the engagement of positive emotions in immigrant farmworkers and university students from diverse ethnic backgrounds. In Study 1, in a sample of Latinx immigrant farmworkers (N = 76), we found that the daily use of adaptive coping strategies predicted greater daily well-being, and that this relationship was accounted for by greater daily experiences of positive emotions. In Study 2, in a sample of college students from Latinx, Asian, and European American backgrounds (N = 336), we replicated the mediating effect of positive emotionality on the effect of adaptive coping on daily well-being and extended these findings to an examination of longitudinal well-being. This work provides evidence of one mechanism by which coping affects well-being and is one of the first studies of these dynamics in Latinx samples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Minority older adults face multiple barriers when trying to access mental health services and often present with more severe symptoms of mental health conditions. We describe the multilevel factors that contributed to the engagement of an Asian immigrant older adult with depression. Systems-level innovations such as collaborative care in primary care can increase access to care for all, including minority older adults; however, one size fits all interventions may not meet the needs of communities of older adults with different life experiences, language needs, norms and values regarding help-seeking for mental health. Health outcomes remain unequal , suggesting the need to tailor interventions for minority older adults. For the patient, specific factors related to language and ethnic concordance between patient and healthcare provider, communication behaviors, ethnic identity, and social norms may be important to take into account. The recognition of the heterogeneity of patients and the limitations of cultural competence approaches defined as broad, general knowledge about ethnic cultures may be needed. A need to learn continuously from clinical experience and adopt a patient-oriented model of communication and decision-making may successfully engage Asian immigrant older adults in depression care services.

Background: Disparities in neuraxial analgesia use for childbirth by maternal origin have been reported in high-resource countries. We explored the association between maternal immigrant status (characterised separately by geographic continental origin and Human Development Index [HDI] of maternal country of birth) and neuraxial analgesia use. We hypothesised that immigrant women from low-resource countries may have more limited access to neuraxial analgesia than native French women. Methods: The study population, extracted from the 2016 National Perinatal Survey, a cross-sectional study of a representative sample of births in France, included only women who initially wished to deliver with neuraxial analgesia. We used multivariable multilevel logistic regression to explore the association between immigrant status and both use of neuraxial analgesia and its timely administration. Results: Among the 6070 women included, 88.1% gave birth with neuraxial analgesia and 15.8% were immigrants. There was no difference in neuraxial analgesia use between native French women and either immigrant women by geographic continental region of origin, or immigrants from countries with low HDI. However, immigrants from countries with very high HDI were more likely to give birth with neuraxial analgesia (adjusted odds ratio [aOR]=2.6; 95% confidence interval (CI), 1.2–5.8; P=0.018) and its timeliness

Given the increase of African immigrants from countries with high female genital cutting (FGC) prevalence, this study explored U.S. healthcare providers’ beliefs and attitudes regarding FGC. A total of 31 professionals who have provided services to FGC-experienced women in New York City were interviewed; data were analyzed using grounded theory. Results indicated that, although a majority of respondents emphasized maintaining a nonjudgmental and open-minded attitude toward clients’ experiences, some only focused on the negative aspects of FGC. Also, multifaceted efforts by providers to understand the cultural meanings of FGC and resolve their own cultural dissonance were identified. The implications for practice were discussed.

Resilient adaptation among immigrant youth provides the foundation for healthy and productive adult lives. Great diversity is observed in their adaptation. This diversity has been studied during the past decade from different angles and intellectual traditions. However, the results are disconnected. In this paper, first, we present a resilience conceptual model for understanding immigrant youth adaptation. We argue that its concepts and principles allow us to best pull together what is known and discover what is still unknown. Together with narrower topic-specific conceptual models, it can guide the formulation of hypotheses regarding immigrant youth resilience. Second, we examine comparatively, through the lens of this conceptual model, results of a content analysis on the abstracts of studies on individual differences in immigrant youth adaptation, conducted during the past decade in North American and European countries. Finally, we discuss the meaning of acculturation-related terms which are often used in an inconsistent way.

Cuban immigrants constitute an important group in both the United States and Spain, with different behaviors toward organ donation having been described among the different Latin American nationalities. We analyzed the attitude toward organ donation among the Cuban populations in Cuba, Spain, and Florida. The study population was Cuban immigrants over 15 years of age residing in Cuba, Spain, and Florida, with samples randomly stratified by age and sex. A validated questionnaire on psychosocial aspects of organ donation (PCID-DTO Rios) was used. Census was used as the sampling base in all 3 countries; however, additionally, in Spain and the United States (Florida), we sought the support of immigration support associations to determine the Cuban population without legal documentation. The questionnaire was completed anonymously and self-administered. The completion rate of the study was 74% (4123/5574) among 424 surveyed in Spain, 1224 in Florida, and 2475 in Cuba. The attitude in favor of donating their own organs upon death was 60.6% of those surveyed in Spain, 37.6% in Florida, and 68.9% in Cuba, or 58% of the global sample. Multivariate analysis showed that country of residence was an independent factor associated with attitude toward organ donation (odds ratio, 1.929). Other factors associated with attitude were sex, educational level, performance of prosocial activities, knowledge of the brain death concept, religion, the couple's opinion toward donation, fear of mutilation after donation, and attitude toward manipulation of the body after death. The attitude toward organ donation among Cubans in their country of origin and immigrants in Spain was similar, being significantly different from those who emigrate to Florida, where the attitude is much less favorable.

Background HPV self-sampling is an emerging HPV testing method that offers reliable identification of cervical precancer and cancer. To determine the feasibility of HPV self-sampling in the USA, information is needed regarding women's use of HPV test and willingness to use self-sampling, especially among disparate groups such as African American (AA) and sub-Saharan African immigrant (SAI) women. The purpose of this study was to examine factors associated with having had at least one HPV test and willingness to use HPV self-sampling among AA and SAI women. Methods AA and SAI women (n = 91) recruited from community settings completed a survey in a cross-sectional study. Data included sociodemographics, HPV and HPV testing knowledge, and willingness to use a HPV self-sampling test at home. Logistic regressions were performed to evaluate associations with having had a HPV test and willingness to use self-sampling. Results Respondents mean age was 38.2 years (SD = 12.6) and 65% were SAIs. The majority (84%) reported having had at least one Pap test and (36%) had at least one HPV test. Sixty-seven percent were willing to self-sample at home. Age, education, and HPV testing knowledge were associated with having had a HPV test. Being uninsured and likelihood to accept a Pap test if recommended were associated with willingness to use self-sampling at home for an HPV test. Conclusions Health care providers have an important role in recommending cervical cancer screening according to current guidelines. HPV self-sampling may be a promising strategy to reach older, less educated, uninsured, and underinsured Black women.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a disproportionate impact on Black, Hispanic, and other individuals of color, although data on the effect of a person’s language on SARS-CoV-2 infection are limited. Considering the barriers suffered by immigrants and non-English-speaking families, we tested whether children with a preferred language other than English was associated with SARS-CoV-2 infection. Children from families with a preferred language other than English had a higher predicted probability of SARS-CoV-2 test positivity (adjusted odds ratio, 3.76; 95% CI, 2.07–6.67) during the first wave of the pandemic. This discrepancy continued into the second wave (adjusted odds ratio, 1.64; 95% CI, 1.10–2.41), although the difference compared with families who prefer to speak English decreased over time. These findings suggest that children from non-English-speaking families are at increased risk of SARS-CoV-2 infection, and efforts to reverse systemic inequities causing this increased risk are needed.

Although they are an increasing share of the US child population (26% in 2020) and have much higher poverty rates than children in nonimmigrant families (20.9% vs 9.9%), children in immigrant families have much more restricted access to the social safety net, which can lead to increased economic hardship and health and developmental risks. More than 90% of children in immigrant families are US citizens, but they are excluded from the safety net due to restrictions that affect their parents and other family members. Exclusions that affect children in immigrant families include restricted categorical eligibility based on immigrant status, stricter income eligibility, reduced benefit levels, high administrative burden, and interactions with immigration policy such as public charge. These exclusions limit the ability of both existing and enhanced social programs to reduce child poverty among this population. Results derived from the Transfer Income Model simulations for the National Academy of Sciences, Engineering and Medicine's 2019 report A Roadmap to Reducing Child Poverty show that the poverty-reducing effects of potential enhancements to three main antipoverty programs result in unequal poverty reduction effects by family citizenship/immigration status with disproportionate negative effects on Hispanic children, 54% of whom live in immigrant families. Policy principles to improve equitable access and poverty-reduction effects of social programs for children in immigrant families include basing eligibility and benefit levels on the developmental, health and nutrition needs of the child instead of the immigration status of other family members, reducing administrative burden, and eliminating the link between immigration policy and access to the safety net.

Little research has explored how transgender people are impacted by the behaviors, statements, and policies of the Trump administration. To date no scholarship has explored the experiences of immigrant Latinx transgender people during the current political climate. Using a critical intersectional qualitative framework, the present study aimed to investigate how immigrant Latinx transgender people are impacted by Trump's administration. A community sample of 15 immigrant Latinx transgender people from a large metropolitan city in Florida participated in semistructured interviews to explore their experiences since the election of Donald Trump. Thematic analysis revealed seven themes related to experiences of oppression, including: (a) perceived increase in societal discrimination and violence, (b) perception of law enforcement surveillance, discrimination, and violence, (c) mental health toll, (d) decreased access to resources and opportunities, (e) perception of Trump's uninformed, hostile, and aggressive behavior, (f) rollback of discrimination protection, and (g) passing and conforming to norms. In addition, five themes emerged about participants' sources of coping and strength in response to the current political climate, including: (a) pride and resilience, (b) hope for a better future, (c) religion and spirituality, (d) family and community support, and (d) short-term avoidance as a form of resistance. Psychological practices and advocacy efforts such as using evidence-based practices to effectively work with immigrant Latinx transgender people are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background It is unknown whether the place of birth would affect colon cancer survival. Methods An observational study of colon cancer patient data using the SEER database from 1973 to 2010 was performed. Patients with more than one primary cancer in their lifetime or patients who were under age 18 were excluded. The primary outcome was cancer-specific survival. Cox proportional hazards analyses were performed, adjusting for patient demographics and oncological characteristics. Results A total of 262,618 colon cancer patients were analyzed, with the majority (86.0%) born in the US. The overall 5-year cancer-specific survival rate was 51.4% and was significantly lower for US-born than non-US born patients (50.4% vs 58.1%). This difference persisted in local/regional disease and in cases with distant metastasis, and across racial groups. On adjusted analysis, US-born patients had worse disease-specific survivals (HR 1.28, 95% CI 1.24-1.33), and this effect persisted in all racial groups except in Asians. Conclusion US-born patients have worse survivals than non-US born patients. This is paradoxical given known disparities in quality of care delivered to immigrant populations. It may be useful to consider including geographical histories in patient interviews.

Background Cardiac rehabilitation (CR) is a proven model of secondary prevention in which patient education is a core component. Objectives to translate and culturally-adapt CR patient education for Mandarin-speaking patients living in China as well as immigrants, and offer recommendation for best practices in adaptation for both. Methods these steps were undertaken in China and Canada: (1) preparation; (2) translation and adaptation; (3) review by healthcare providers based on PEMAT-P; (4) think-aloud review by patients; and (5) finalization. Results Two independent Mandarin translations were undertaken using best practices: one domestic (China) and one international (immigrants). Input by 23 experts instigated revisions. Experts rated the language and content as culturally-appropriate, and perceived the materials would benefit their patients. A revised version was then administered to 36 patients, based on which a few edits were made to optimize understandability. Conclusions some important differences emerged between translations adapted for native versus immigrant settings.

The intergenerational transmission of executive function may be enhanced or interrupted by culturally salient environmental stressors that shape the practice of executive function in the family. Building upon past research, the current study tests whether culturally relevant stressors such as economic stress and foreigner stress have a direct effect on adolescent executive function, as well as whether they modify the intergenerational transmission of mother–child executive function (i.e., working memory, inhibitory control, and shifting) in low-income Mexican immigrant families. The sample consists of 179 Mexican American adolescents (Mage = 17.03 years; SDage = 0.83; 58% females) and their Mexico-born mothers (Mage = 43.25 years; SDage = 5.90). Results show that mothers’ perceived economic stress is associated with poor inhibitory control in adolescents. Low levels of mothers’ perceived foreigner stress related to a stronger association between mothers’ and adolescents’ working memory, while high levels of mothers’ perceived foreigner stress related to enhanced intergenerational transmission of poor shifting ability. Study findings demonstrate the prominence of perceived foreigner stress as a contextually relevant factor moderating the intergenerational transmission of mother–child executive function in low-income Mexican immigrant families.

Background Immigrants and ethnic minorities have been shown to be at increased risk of hospitalization from COVID-19. Our aim was to analyse the contribution of socioeconomic and demographic risk factors on hospital admissions for COVID-19 among immigrants and ethnic minorities compared to the majority population. Methods We used nationwide register data on all hospitalized COVID-19 cases between February and June 2020 (N = 2232) and random controls from the general population (N = 498 117). We performed logistic regression analyses and adjusted for age, sex, comorbidity, and socioeconomic and demographic factors. The main outcome measure was hospitalization with COVID-19 and was estimated using odds ratios (OR) and 95% confidence intervals (95% CI). Results Among 2232 COVID-19 cases, the OR of hospitalization with COVID-19 among immigrants and descendants of non-Western origin was 2.5 times higher (95% CI: 2.23–2.89) compared with individuals of Danish origin with most pronounced results among individuals from Iraq, Morocco, Pakistan and Somalia. The OR was largely attributed to comorbidity and socioeconomic factors, especially household size, occupation, and population density. Conclusion There is a significantly higher OR of hospitalization with COVID-19 among non-Western immigrants and ethnic minorities compared with ethnic Danes. This knowledge is crucial for health policymakers and practitioners in both the current and future pandemics to identify more vulnerable groups and target prevention initiatives.

Immigrant clinicians are vital to population healthcare delivery and therefore population health. One in four physicians in the United States are foreign-born and notably represented in family and pediatric medicine - specialties charged with administering childhood/adolescent vaccines, such as Human Papillomavirus vaccine (HPVV). Our examination suggests there may be unique cultural and socialization factors that influence clinician HPVV recommendation practice; however, immigrant clinicians have not been adequately engaged within the national HPVV agenda. Given the volume and significance of immigrant clinicians, engagement of these clinicians, in both community and nation-wide efforts to increase HPVV, is a necessary step for improving and achieving the national health goal of optimizing HPVV for cancer prevention.

OBJECTIVES This cross-sectional study aimed to examine the associations between parental acculturation level and strategies and children's caries experience and oral health (OH) behaviors. METHODS Participants were immigrant parents of children aged 2-12 years. Data were collected by validated questionnaires gathering information on socio-demographics, child's OH behaviors, and parents'; acculturation and dental examinations determining child's caries experience using DMFT/dmft index. Univariate and multivariate regression analyses were used. RESULTS Three hundred and thirty-six parent/child dyads completed the study. Length of residency (B = 0.103; 95% CI: 0.064, 0.141) parents' education (B = 1.691; 95% CI: 1.228, 2.155), and household income (B = -0.959; 95% CI: -1.566, -0.352) significantly predicted acculturation level. Parents with high Canadian cultural knowledge reported higher frequency of children's toothbrushing (p-value = 0.015). Parents of children who consumed sugar >1/day had higher mean scores of acculturation to Canadian culture (p-value = 0.016), English language proficiency (p-value = 0.024), and Canadian food adoption (p-value = 0.046). Parents of children who visited the dentist within last 12 months had significantly higher assimilation and lower separation mean scores. Parents of children who visited dentist because of dental problems had higher marginalization mean score than those who went for check-ups (p-value = 0.046). Parental acculturation was not significantly correlated with their children's dmft/DMFT level. CONCLUSIONS Children of highly acculturated parents reported higher toothbrushing frequency and were more likely to consume sugar than children of less acculturated parents. Assimilated parents reported more and marginalized parents reported less favorable OH behaviors than other categories. Parental acculturation level or strategy was not associated with children's caries experience.

Introduction We sought to describe how Latina immigrants living in King County coped with the pandemic, including their attitudes and behaviors related to COVID-19, and the impact of the pandemic on their mental health and wellbeing. Method We conducted surveys by phone with adult Spanish-speaking Latina immigrants ( n = 137) in the summer of 2020. Results Very few women had been infected with COVID-19, and 23% reported having been tested. Most frequent reasons for not being tested were not knowing where to go (14%), concerns over the cost (15%), and not wanting to know if they were infected (12%). Most participants had concerns about paying for housing (76%) and food (73%). Depression and anxiety symptoms were in the moderate range. Almost all participants were practicing recommended preventive behaviors. Conclusion Although few participants had COVID-19 infection, the pandemic had significant impacts on their mental health and ability to meet basic needs.

There is potential to improve low colorectal cancer screening rates, reduce mortality, and narrow health disparities, if the distinctive screening barriers among Russian-speaking immigrants were better understood. However, there is little relevant research about the topic. To address this gap, this study aimed to identify barriers to timely colorectal cancer screening, especially colonoscopies, among Russian-speakers in New York City. Thirteen key informant interviews were performed with providers, community leaders, and academics. Eight focus groups were then conducted with 81 Russian-speaking individuals, age 50-75, who had not had a timely colonoscopy. Results were translated, transcribed, coded and analyzed. Barriers identified included individual, communal, and structural issues. Distinctive barriers, such as those related to culture and to the experiences of living under the Soviet system, were uncovered. Barriers identified can potentially be reduced through interventions suggested by the research, including more education and more effective provider recommendations.

Non-Hispanic Black women remain at increased risk for adverse birth outcomes, yet Black immigrant women are at lower risk than their US-born counterparts. This study examines whether neighborhood context contributes to the nativity advantage in preterm birth (PTB

BackgroundImmigration is a determinant of tuberculosis (TB) epidemiology. The US-Mexican border state of Tamaulipas serves as a migration waypoint for further immigration to the US, and has the second highest incidence of TB in Mexico. Here, we determined the contribution and characteristics of immigrants to the TB burden in Tamaulipas.MethodsTB surveillance data from Tamaulipas (2006-2013) was used to conduct a cross-sectional characterization of TB immigrants (born outside Tamaulipas) and identify their association with TB treatment outcomes.ResultsImmigrants comprised 30.8% of the TB patients, with >99% originating from internal Mexican migration. Most migration was from South to North, with cities adjacent to the US border as destinations. Immigrants had higher odds of risk factors for TB [older age (≥ 65 yr old, OR 2.4, 95% CI 2.1, 2.8), low education (OR 1.3, 95% CI 1.2, 1.4), diabetes (OR 1.2, 95% CI 1.1, 1.4)], or abandoning TB treatment (adjusted OR 1.2, 95% CI 1.0, 1.5).ConclusionsThe US port of entry of Tamaulipas has a predominant south to north migration, positively impacting TB prevalence in this region. There is a need to identify strategies to prevent and manage TB more effectively in this Mexican migration waypoint.

The health benefits of having a supportive community and access to community resources are well documented and for many immigrant communities, community-based organizations (CBOs) play an important role by providing culturally competent services. The current study uses communication infrastructure theory (CIT) to examine the associations between connections to CBOs, civic engagement, and protective health behaviors within the context of Boston Chinatown's Chinese immigrant community. According to CIT, neighborhood communication resources encourage residents to engage in civic activities and health-related problem-solving behaviors. To assess these associations, data from a needs assessment survey (N = 360) were analyzed. Results showed that connections to CBOs had a positive association with total number of protective health behaviors. Civic engagement was not found to be associated with health behaviors. We also found no indirect effect of connections to CBOs on the protective health behaviors via civic engagement. These results carry important theoretical and practical implications.

Migration is increasing at unprecedented rates worldwide, but inadequate mechanisms for granting citizenship or permanent residence have rendered many immigrants without legal status. We study the health of people without immigration status in Canada, building on a 2010 review on being without status and health. We employ an expanded definition of health, guided by the WHO Social Determinants of Health (SDoH) framework. Using a scoping review methodology, we reviewed literature from 2008 to 2018 on the SDoH of people without legal immigration status in Canada, selecting 33 articles for analysis. We found that structural determinants of health, such as stigmatization and criminalization, and intermediary determinants, such as fear of deportation and healthcare avoidance, produce ill health. We show how different social positions are produced by SDoH, finding immigration status to be the foundational determinant of health for people without status in Canada. We argue that lack of immigration status as a SDoH is missing from the WHO framework.

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

Background Intimate partner violence (IPV) disproportionately affects immigrant women, an understudied and underserved population in need for evidence-based rigorously evaluated culturally competent interventions that can effectively address their health and safety needs. Methods This study uses a sequential, multiple assignment, randomized trial (SMART) design to rigorously evaluate an adaptive, trauma-informed, culturally tailored technology-delivered intervention tailored to the needs of immigrant women who have experienced IPV. In the first stage randomization, participants are randomly assigned to an online safety decision and planning or a usual care control arm and safety, mental health and empowerment outcomes are assessed at 3-, 6- and 12-months post-baseline. For the second stage randomization, women who do not report significant improvements in safety (i.e., reduction in IPV) and empowerment from baseline to 3 months follow up (i.e., non-responders) are re- randomized to safety and empowerment strategies delivered via text only or a combination of text and phone calls with trained advocates. Data on outcomes (safety, mental health, and empowerment) for early non-responders is assessed at 6 and 12 months post re-randomization. Discussion The study’s SMART design provides an opportunity to implement and evaluate an individualized intervention protocol for immigrant women based on their response to type or intensity of intervention. The findings will be useful for identifying what works for whom and characteristics of participants needing a particular type or intensity level of intervention for improved outcomes. If found to be effective, the study will result in an evidence-based trauma-informed culturally tailored technology-based safety decision and planning intervention for immigrant survivors of IPV that can be implemented by practitioners serving immigrant women in diverse settings. Trial registration This trial was registered with ClinicalTrials.gov as NCT04098276 on September 13, 2019.

OBJECTIVES This phenomenographic analysis examines how news of family separations at the U.S.-Mexico border shaped variations of experience and perceptions among U.S. Latinx adolescents across parental residency status. METHOD In 2018-2019, 340 15-18-year-old Latinx adolescents in the Washington D.C. area participated in a study on immigration actions and responded to an open-ended question detailing how news of family separations at the border affected them and their families. The sample was comprised of equivalent numbers of adolescents whose parents had U.S. citizenship, permanent residency, temporary protected status, or were undocumented. Utilizing a phenomenographic analysis, we compared data across the participants' parental residency status. RESULTS Three categories captured the complex influences that news of family separations had on Latinx adolescents not directly affected. Perceptual Experiencing described the sympathetic and vicarious emotions produced by the news of family separations. Lived Experiencing described the tangible effects experienced by participants, including incidents of increased racism and fear. Catalyzing effects described spillover effects of the first two themes where internalized feelings induced fear and catalyzed family behaviors. All themes were noted across residency status; however, the third was most strongly supported by those whose parents had precarious statuses. CONCLUSIONS Findings suggest Latinx families across residency statuses can be negatively affected by news of the adversities experienced by a subgroup. Service and healthcare providers, and educators must be prepared to support Latinx youth faced with fear, discrimination, and isolation arising from exposure to news on immigration actions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: To study the relationship between sociodemographic factors and pyelonephritis. Methods: A nationwide open cohort study consisting of 2,052,873 women (76.2% Swedish-born) aged 15-50 years was conducted (1997-2018). The outcome was the first event of acute uncomplicated pyelonephritis diagnosed in primary healthcare settings in relation to the sociodemographic factors. Cox regression models were used in the analyses. Results: The study identified 40,724 cases. In the fully adjusted model, women from non-Western countries had a higher risk of pyelonephritis compared to Swedish-born women. Women from Latin America/the Caribbean had the highest risk (Hazard ratio = 1.60; 95% CI 1.49-1.72), followed by Eastern Europe (HR = 1.26; 95% CI 1.21-1.32) and the Middle East/North Africa (HR = 1.25; 95% CI 1.19-1.30). Low education, low income, urban living, and young age were also associated with higher risks of pyelonephritis. Conclusion: This study presents novel risk factors associated with pyelonephritis. Women from non-Western countries and with low socioeconomic status might disproportionately suffer from this serious infection. This might be due to biological predispositions and the fact that immigrant women do not acquire the same level of health or might receive less healthcare compared to native women, even in the presence of universal healthcare. (Less)

Background Schools are natural environments in which to enhance young people’s social and emotional skills, mental health, and contact between diverse groups, including students from refugee and immigrant backgrounds. A layered or tiered provision of services is recommended as it can be effective to meet the needs of war-affected adolescents who variably show mental health problems (such as posttraumatic stress disorder (PTSD)). The current protocol describes the study design for a multi-layered intervention model. The study will test the effectiveness of two interventions: a teacher-training intervention In-Service Teacher Training (INSETT) combined with targeted cognitive-behavioral treatment-based Teaching Recovery Techniques (TRT) and a classroom-focused preventive intervention Peer Integration and Enhancement Resources (PIER). We analyze, first, whether the interventions are effective in decreasing psychological distress and increasing positive resources, i.e., prosocial behavior and resilience among refugee and immigrant students. Second, we analyze which student-, school-, and parent-related factors mediate the possible beneficial changes. Third, we look at which groups the interventions are most beneficial to. Methods A three-arm cluster RCT with parallel assignment, with a 1:1:1 allocation ratio, is applied in 16 schools that agreed to participate in the Refugees Well School interventions and effectiveness study. Schools were randomized to three conditions of two active interventions and a waiting list control condition. Students, their parents, and teachers in intervention and control schools participated in the study at baseline before the interventions, after the interventions, and at 6 to 12 months after the interventions. The primary effectiveness criterion variables are psychological distress (SDQ) symptoms, resilience (CYRM-12), and prosocial behavior (SDQ). Discussion The current study presents a recommended universal approach of layered interventions aiming to reduce psychological distress and increase resilience among refugee and immigrant students. A combination of promotive, preventive, and targeted interventions may offer a holistic, ecological intervention package for schools to better address the needs of the whole group. Trial registration ISRCTN ISRCTN64245549. Retrospectively registered on 10 June 2020