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Informed by Bronfenbrenner's ecological model of development, this mixed-methods study's aims are to: (1) describe rural Latino/a adolescents' (N = 62) narratives and lived social experiences in the context of rurality, and (2) examine their personal networks to better understand their social interactions (subset of 30 adolescents). Rural Latino/a adolescents move in limited social circles and experience geographic, cultural, and social isolation due to immigration status problems, socioeconomic issues, racial discrimination, and family dynamics. This limitation is reflected by personal networks that tend to be homogenous in terms of ethnicity, age, and sociodemographic characteristics. School, although characterized by weak social ties often disconnected from community and family contacts, emerged as the dominant context of sociability where adolescents build their social identity outside the circle of dense family ties. Findings suggest a critical need for interventions to reduce isolation and enhance social connectedness between family, school, and rural community in this population.

Lesbian, gay, bisexual, transgender, questioning/queer, and other gender diverse (LGBTQ+) adolescents face daunting hardships within the rural contexts they navigate (e.g., community, school), and these onerous demands make it difficult for them to maintain optimal mental well-being. This scoping review described the psychosocial protective and risk factors that shape mental well-being for rural LGBTQ+ adolescents and identified the mental health issues commonly reported by them. About 30 articles published between 2005 and 2020 were examined. A myriad of factors indicated protection of or risks to LGBTQ+ rural adolescents' mental well-being through the social-ecological levels: individual (e.g., pressure to conform to gender norms, sexual exploration, coming out), interpersonal (e.g., connectedness, fear of rejection, religious beliefs), institutional/school (e.g., bullying victimization, social exclusion, peer/teacher intervention), and rural community (e.g., community size, local ties, social isolation). More research is needed to better understand and address rural mental health disparities for this vulnerable group.

Background: Haitian Americans have been disproportionately exposed to risk factors known to play a significant role in the development of mental illness. Yet despite the documented effectiveness of mental health treatment, a high proportion of Haitian Americans with mental health disorders have not received care. Local problem: Internalized stigma of mental illness (ISMI) was reported as one of the primary reasons Haitian Americans do not seek help for mental illnesses, resulting in poor long-term outcomes for individuals and families in this community. This quality improvement project characterized ISMI among Haitian Americans, examined associated demographic factors, and tested the impact of a culturally relevant ISMI educational video intervention on willingness to seek mental health treatment. Methods: Haitian Americans who self-reported mental illness (N = 20) were recruited from a South Florida clinic. Descriptive statistics, correlations, and thematic analyses were completed to analyze the data. Interventions: Participants completed the nine-item ISMI scale, watched an educational video about ISMI, completed a post-intervention survey, and engaged in conversations about mental health and ISMI. Results: Sixty-five percent of participants reported mild levels of ISMI. Sex was significantly correlated with ISMI (r =2 0.458, p = .042); male participants experienced higher levels of ISMI. The educational video improved participants' knowledge of ISMI, and 85% indicated increased willingness to seek treatment. Conclusions: When caring for Haitian Americans with mental illnesses, nurse practitioners should initiate conversations about ISMI, consider gender differences in mental illness beliefs and attitudes, and provide culturally responsive psychoeducational interventions to promote more mental health treatment utilization. [ABSTRACT FROM AUTHOR]

In the present scoping review, we explore whether existing evidence supports the premise that social determinants of health (SDoH) affect immigrant health outcomes through their effects on the microbiome. We adapt the National Institute on Minority Health and Health Disparities' research framework to propose a conceptual model that considers the intersection of SDoH, the microbiome, and health outcomes in immigrants. We use this conceptual model as a lens through which to explore recent research about SDoH, biological factors associated with changes to immigrants' microbiomes, and long‐term health outcomes. In the 17 articles reviewed, dietary acculturation, physical activity, ethnicity, birthplace, age at migration and length of time in the host country, socioeconomic status, and social/linguistic acculturation were important determinants of postmigration microbiome‐related transformations. These factors are associated with progressive shifts in microbiome profile with time in host country, increasing the risks for cardiometabolic, mental, immune, and inflammatory disorders and antibiotic resistance. The evidence thus supports the premise that SDoH influence immigrants' health postmigration, at least in part, through their effects on the microbiome. Omission of important postmigration social‐ecological variables (e.g., stress, racism, social/family relationships, and environment), limited research among minoritized subgroups of immigrants, complexity and inter‐ and intra‐individual differences in the microbiome, and limited interdisciplinary and biosocial collaboration restrict our understanding of this area of study. To identify potential microbiome‐based interventions and promote immigrants' well‐being, more research is necessary to understand the intersections of immigrant health with factors from the biological, behavioral/psychosocial, physical/built environment, and sociocultural environment domains at all social‐ecological levels. [ABSTRACT FROM AUTHOR]

Background and Objectives Alzheimer's disease and related dementia (ADRD) is a major cause of death in the United States. While effective interventions have been developed to deliver palliative care to nursing home residents with ADRD, little work has identified effective interventions to reach assisted living (AL) residents with dementia. Research Design and Methods One hundred and eighteen AL residents with dementia from 10 different ALs in Florida participated. A pilot study using a cluster randomized trial was conducted, with 6 sites randomized to receive a palliative care educational intervention for staff (N = 23) to deliver care to residents; 4 sites were usual care. The feasibility of the intervention was assessed by examining recruitment, retention, and treatment fidelity at 6 months. Cohen's d statistic was used to calculate facility-level treatment effect sizes on key outcomes (documentation of advance care planning [ACP] discussions, hospice admission, and documentation of pain screening). Results The intervention proved feasible with high ratings of treatment fidelity. The intervention also demonstrated preliminary evidence for efficacy of the intervention, with effect sizes for the treatment group over 0.80 for increases in documentation of ACP discussions compared to the control group. Hospice admissions had a smaller effect size (0.16) and documentation of pain screenings had no effect. Discussion and Implications The pilot results suggest that the intervention shows promise as a resource for educating and empowering AL staff on implementing person-centered palliative care delivery to persons with dementia in AL. A larger, fully powered randomized trial is needed to test for its efficacy. [ABSTRACT FROM AUTHOR]

The authors urge governments and health systems in Brazil to recognize nurses for the heroic efforts and sacrifices they make daily before, during, and after the COVID-19 pandemic. Topics mentioned include the response of political leaders to the physical isolation protocol, the complexities of the country's socio-economic and geographic conditions, and areas of challenge for nurse leaders who experience the privation of working in their full capacities as advanced practitioners.

Background and Purpose: Although the Haitian population in the United States continues to grow, there is a lack of instruments in Haitian Creole to assess risk factors associated with poor mental health such as migration-related stress. This study described the translation of the Demands of Immigration Scale (DIS) and evaluated psychometric properties, meaning equivalence, and understandability of the Haitian Creole/English DIS. Methods: I applied the Functional Assessment of Chronic Illness Therapy translation procedures and recruited 76 first-generation Haitian immigrants to pilot test the DIS. Results: Reliability was strong (α > .93). Meaning equivalence was maintained ( r = .979), 75% understood both DIS versions equally, and 80% rated the translation as excellent/good. The DIS significantly correlated with gender, income, age, age at migration, English fluency, and depression. Conclusions: The DIS can reliably identify immigration-related social determinants of mental health and is ready for use in Haitian Creole., (© 2024 Springer Publishing Company.)

The prevalence of obesity and obesity-related illnesses is higher among Hispanics (Latinos) than other racial and ethnic groups, and rates increase exponentially with the number of years living in the United States. Mounting evidence suggests that the origins of many chronic illnesses among disadvantaged minority groups may lie with cumulative exposure to chronic psychological and physiological stressors through the biobehavioral process of allostatic load (AL). Among immigrant Latinos, acculturation stress may contribute to an increase in AL and thus may be an independent risk factor for the development of obesity and obesogenic illnesses. The purpose of this theoretical article is to present a proposed model of the effects of acculturation stress on AL and obesity among Latino immigrants. Such a model can be useful to guide intervention efforts to decrease obesity among immigrant Latinos by adding education, skill building, and social integration strategies to healthy eating and physical activity to reduce the deleterious impact of acculturation stress.