Acculturative Stress, Resilience, and a Syndemic Factor Among Latinx Immigrants.

BACKGROUND: The process of immigration and subsequent adaptation can expose Latinx immigrants to chronic and compounding challenges (i.e., acculturative stress), but little is known about how resilience factors and these stressors interact to influence syndemic conditions, intertwined epidemics that disproportionally affect historically marginalized communities. OBJECTIVES: The purpose of this study was to describe the influence of acculturative stress and resilience on the syndemic factor underlying substance abuse, intimate partner violence, HIV risk, and mental conditions. METHODS: Baseline cross-sectional data from a community-engaged, longitudinal study of 391 adult (ages 18-44 years) Latinx immigrants in North Carolina were obtained using standardized measures available in English and Spanish. Structural equation modeling tested the syndemic model, and random forest variable importance identified the most influential types of acculturative stressors and resilience factors, including their interactions, on the syndemic factor. RESULTS: Results indicated that a single syndemic factor explained variations in heavy drinking, drug use, intimate partner violence, depression, and anxiety and fit the data well. Age, being a woman, acculturative stress, acculturation to the United States, and emotional support were significantly related to the syndemic factor. The relationship between acculturative stress and the syndemic factor was buffered by ethnic pride, coping, enculturation, social support, and individual resilience. The most influential acculturative stressors were marital, family, and occupation/economic stress. DISCUSSION: Findings from this study underscore the importance of considering the co-occurrence of behavioral and mental health conditions among Latinx immigrants. Health promotion programs for Latinx immigrants should address acculturative stress and bolster ethnic pride, social support, and coping as sources of resilience.

Acculturation, Acculturative Stress, Adverse Childhood Experiences, and Intimate Partner Violence Among Latinx Immigrants in the US.

Latinx immigrants bear a disproportionate burden associated with intimate partner violence (IPV); however, efforts to develop evidence-based IPV prevention strategies and address health disparities have been impeded by a lack of understanding of the unique cultural (i.e., acculturation and acculturative stress) and socio-environmental (i.e., adverse childhood experiences [ACEs]) factors that contribute to IPV in this historically marginalized population. Guided by a contextual framework for IPV and a life-course perspective viewed through a gendered lens, this study aims to (a) identify relationships among acculturation, acculturative stress, ACEs, and IPV victimization and perpetration; and (b) explore whether profiles of IPV risk factors differ by gender (women vs. men) among Latinx immigrants. This cross-sectional, descriptive, correlational study was a secondary analysis of data from the baseline assessment of 331 ever-partnered Latinx immigrants aged 18 to 44 in a longitudinal study named Salud (Health), Estrés (Stress), y Resilencia (Resilency) (SER) Hispano. Logistic regressions adjusting for individual characteristics and gender subgroup analyses were used to address study aims. The majority of the participants were women (71.30%). More than half of all participants had experienced IPV victimization (57.70%) or IPV perpetration (60.73%). Latinx immigrants with higher family stress (adjusted odds ratio [aOR] = 1.16; p < .001) had an elevated risk for IPV victimization; those with more ACEs (aOR = 1.08; p = .005) had an increased risk for IPV perpetration. Women had a lower risk of IPV victimization (aOR = 0.45; p = .03) and a higher risk for IPV perpetration (aOR = 3.26; p = .001) compared to men. Although further research is warranted, the profiles of risk factors for IPV perpetration were different for women than for men. Culturally tailored preventions focused on acculturative stress and ACEs are needed to help Latinx immigrant communities minimize exposure to life-course adversities, improve positive adaptation to the US, and eliminate IPV-relevant health disparities.

Acculturation Stress, Age at Immigration, and Employment Status as Predictors of Sleep Among Latinx Immigrants.

Sleep is important for physical and mental health. Latinx individuals are thought to experience worse sleep and associated health outcomes, resulting in health disparities. There is a dearth of research on the factors (e.g., employment status, age at immigration) that predict poor sleep among Latinx immigrants. The present study aimed to (1) examine the link between demographic factors, immigration-related factors, and acculturation stress, and sleep, and (2) identify factors that either attenuate or intensify the link between acculturation stress and sleep among Latinx immigrants in the US South, an immigrant-hostile area that is home to an increasing Latinx population that remains understudied. Hierarchical regressions were used to analyze data from 391 Latinx adult immigrants, examining the link between demographic factors, immigration-related factors, acculturation stress, and two sleep variables (sleep quality, difficulty falling asleep). Employment status and age at immigration were examined as moderators of the link between acculturation stress and sleep. Data were collected through in-person surveys. Regressions showed that acculturation stress was significantly linked to worse sleep quality (ß = 0.30, p = 0.001) and more difficulty falling asleep (ß = 0.41, p < 0.001), while controlling for participant characteristics. Younger age at immigration (ß = - 0.14, p = 0.005) and being unemployed (ß = - 0.13, p = 0.006) were associated with more difficulty falling asleep. Age at immigration intensified the relationship between acculturation stress and sleep quality (ß = 0.14, p = 0.005), difficulty falling asleep (ß = 0.15, p = 0.002). Reducing acculturation stress is a meaningful intervention focus, with important implications for sleep health, particularly for recent Latinx immigrants. Age at immigration and employment status are also important factors to consider when designing targeted interventions.

Cultural and linguistic adaptation of psychosocial measurements for latinx participants-Leveraging community-engaged research methods.

Predominantly Spanish-speaking Latinx individuals are underrepresented in research, and one primary barrier is the lack of infrastructure to effectively engage, among them, adequate cultural and linguistic adaptation of research measures. Capitalizing on existing recommendations for appropriate and ethical engagement of Latinx individuals in research, we present a comprehensive approach to cultural and linguistic adaptation, and describe the application of this approach in the context of an ongoing longitudinal, observational, community-engaged study that follows a cohort of young adult Latinx immigrants (ages 18-44) in the Southeastern region of the United States who were predominantly Spanish-speakers (N = 391). We describe barriers that researchers may face in their pursuit of cultural and linguistic adaptation and offset these challenges with tangible solutions. We discuss lessons learned through our application to a research study. This approach holds promise for reducing barriers to participation in research and health disparities in predominantly Spanish-speaking Latinx individuals, who represent a population that is growing in size in the United States yet is still underrepresented as research participants and in the research workforce.

A Systematic Review of Physical Health Consequences and Acculturation Stress Among Latinx Individuals in the United States.

The health of Latinx immigrants decays over time and across generations. Acculturation stress influences decays in behavioral and mental health in this population, but the effect on physical health outcomes is less understood. This systematic review synthesizes findings from 22 studies that examined the influence of acculturation stress on physical health outcomes among Latinx populations in the United States. The Society-to-Cell Resilience Framework was used to synthesize findings according to individual, physiological, and cellular levels. There is mounting evidence identifying acculturation stress as an important social contributor to negative physical health outcomes, especially at the individual level. More research is needed to identify the physiological and cellular mechanisms involved. Interventions are also needed to address the damaging effects of acculturation stress on a variety of physical health conditions in this population.