Exploring the Usability of a Community Resiliency Model Approach in a High Need/Low Resourced Traumatized Community.

This study tested the usability of a non-stigmatizing community-based trauma intervention delivered by trained community members. The Community Resiliency Model (CRM) was taught to a high-crime, low-income community designated as a Mental Health Provider Shortage Area (19 MPSA score). Five groups of Latino, African-American, LGBTQ, Asian Pacific Islander, and Veteran participants (N-57) with a history of complex/cumulative traumas and untreated posttraumatic stress undertook a five-day 40-h CRM training with master trainers. Measures included Treatment Relevance, Use and Satisfaction (TRUSS), Brief CRM Questionnaire (Brief CRM), and Symptom Questionnaire (SQ). Participant preparedness to teach CRM to others was high (98%) and sustained at the 3-6 months follow-up with 93% reporting a daily use. Pre-to post comparison analyses showed a significant decrease in distress indicators and increase in wellbeing indicators. CRM's high usability holds promise for a broader, low cost and sustainable implementation in traumatized and under-resourced communities.

Effect of Perceived Discrimination on Depressive Symptoms in 1st- and 2nd-Generation Afghan-Americans.

While it is well established that Afghan refugees are disproportionately affected by mental health problems, limited evidence exists concerning the psychosocial needs of their children who are transitioning to adulthood in the United States; that is, of 1st- and 2nd-generation Afghan-Americans. The purpose of this study was to examine the effect of perceived discrimination on depressive symptoms in this population, and to determine whether discrimination is buffered by ethnic identity and social support. A convenience sample of 133 1st- and 2nd-generation Afghan-Americans participated in this study by completing a brief survey. We used OLS regression methods to control for covariates, and to sequentially test study hypotheses. The results show that perceived discrimination was significantly associated with high levels of depression. Furthermore, the effect of discrimination on depression was not buffered by ethnic identity or social support. We found that perceived discrimination was a significant source of stress and a risk-factor for negative mental health outcomes among 1st- and 2nd-generation Afghan-Americans. Future research should examine additional pre-dispositional and protective factors for discriminatory experiences and associated health outcomes.

Determinants of Health Care Services Utilization among First Generation Afghan Migrants in Istanbul.

There is insufficient empirical evidence on the correlates of health care utilization of irregular migrants currently living in Turkey. The aim of this study was to identify individual level determinants associated with health service and medication use. One hundred and fifty-five Afghans completed surveys assessing service utilization including encounters with primary care physicians and outpatient specialists in addition to the use of prescription and nonprescription medicines. Multivariate logistic regression analyses were employed to examine associations between service use and a range of predisposing, enabling, and perceived need factors. Health services utilization was lowest for outpatient specialists (20%) and highest for nonprescription medications (37%). Female gender and higher income predicted encounters with primary care physicians. Income, and other enabling factors such as family presence in Turkey predicted encounters with outpatient specialists. Perceived illness-related need factors had little to no influence on use of services; however, asylum difficulties increased the likelihood for encounters with primary care physicians, outpatient services, and the use of prescription medications. This study suggests that health services use among Afghan migrants in Turkey is low considering the extent of their perceived illness-related needs, which may be further exacerbated by the precarious conditions in which they live.