The impact of postresettlement stressors and access to health care on health outcomes in recently resettled refugees in the United States.

This mixed-methods study examines mechanisms connecting the deployment of economic, social, and health care resources to emotional distress and physical health outcomes. Examining such mechanisms is critical for informing strategies, policies, and other interventions for reducing health disparities and improving refugee health in the United States and other resettlement contexts. Data for this study were collected as part of a randomized control trial in a mid-sized city in the Southwestern United States. Two-hundred ninety recently resettled (< 3 years) refugee adults from 143 households were enrolled in the study (36.2% Afghan, 32.8% Iraqi/Syrian, and 31.0% Great Lakes African; 52% women). Qualitative interview data were collected via semistructured interviews. A longitudinal structural equation path model of quantitative data from three time points over 12 months tested hypotheses that emerged from qualitative findings. In semistructured interviews, refugees in the United States (a) attributed the development of worse or new physical health problems to postresettlement stressors related to financial instability and limited social support that contributed to their emotional distress and (b) reported several barriers to accessing health care in the United States, including insufficient knowledge of health care resources, inadequate patient-provider communication, and navigating complex American health insurance systems, all of which exacerbated their physical health problems. Guided by these qualitative findings, longitudinal quantitative data revealed that: (a) postmigration stressors were associated with emotional distress and poor self-reported physical health, (b) emotional distress mediated the association between postmigration stressors and global health satisfaction, and (c) emotional distress was negatively associated with global health satisfaction. Findings document stressors refugees experience in the context of the unique environment created by the American health care system and how these stressors contribute to poor physical health through increased emotional distress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Psychological sense of community, community civic participation, and ethnic identity on social justice orientation and psychological empowerment between LGBQ and Non-LGBQ youth of color.

For lesbian, gay, bisexual, and questioning (LGBQ) youth of color, the intersection of identifying as both LGBQ and a person of color results in not only managing racial stereotypes, but also heterosexism and genderism. Developing a critical understanding of oppressive social conditions and ways to engage in social action is a form of resistance for these youth. Research is needed among LGBQ youth of color that examines the range of predictors and outcomes related to civic engagement, development, and empowerment. Drawing on data derived from a sample of urban youth of color (N = 383; 53.1% Female; 75% Hispanic; Age range = 14 to 18 years; 15% identify as LGBQ), this study will: (1) examine the relationship between community-based perceptions (e.g., psychological sense of community), ethnic identity, behaviors (e.g., community civic participation) and awareness of social justice concerns with dimensions of psychological empowerment; and (2) assess differences that these relationships have between LGBQ and non-LGBQ youth of color. Findings indicate that main predictors have a positive impact on intrapersonal and cognitive dimensions of psychological empowerment through social justice orientation, with noted variations between LGBQ and non-LGBQ youth of color.

Social Vulnerabilities and Spatial Access to Primary Healthcare through Car and Public Transportation System in the Albuquerque, NM, Metropolitan Area: Assessing Disparities through GIS and Multilevel Modeling.

Primary healthcare (PHC) is a keystone component of population health. However, inequities in public transportation access hinder equitable usage of PHC services by minoritized populations. Using the multimodal enhanced 2-step floating catchment area method and data in 2018 and 2019 for spatial access to PHC providers (n = 1166) and social vulnerability markers through census block (n = 543) and tract data (n = 226), a generalized linear mixed-effect model (GLMEM) was constructed to test the effects of sociodemographic and community area correlates on both car and bus transit spatial access to PHC in the Albuquerque, New Mexico (NM) metropolitan area. Results for bus spatial access to PHC showed lower access for Hispanics (B = - 0.097 ± 0.029 [- 0.154, - 0.040]) and non-Hispanic Whites (B = - 0.106 ± 0.032 [- 0.169, - 0.043]) and a positive association between single-family households and bus spatial access (B = 1.573 ± 0.349 [0.866, 2.261]). Greater disability vulnerability (B = - 0.569 ± 0.173 [- 0.919, - 0.259]) and language vulnerability (B = - 0.569 ± 0.173 [- 0.919, - 0.259]) were associated with decreased bus spatial access. For car spatial access to PHC, greater SES vulnerability (B = - 0.338 ± 0.021 [- 1.568, -0.143]), disability (B = - 0.721 ± .092 [- 0.862, - 0.50 9]), and language vulnerability (B = - 0.686 ± 0.172 [- 1.044, - 0.362]) were associated with less car spatial access. Results indicate a disproportionate burden of low PHC access among disadvantaged population groups who rely heavily on public transportation. These results necessitate targeted interventions to reduce these disparities in access to PHC.

The Buffering Role of Community Self-Efficacy in the Links between Family Economic Stress and Young Adults' Prosocial Behaviors and Civic Engagement.

The goal of the current study was to examine the predictive role of economic stress and community self-efficacy on prosocial behaviors toward friends and strangers, and civic engagement. In addition, we considered the multiplicative effects of economic stress and community self-efficacy on these distinct types of prosocial behaviors (different targets of prosocial behaviors). The sample consisted of 202 young adults (M age = 20.94 years; 76.5% women; 67.5% reported identifying as racially White; 7.7% Black; 5.7% Asian; 5.5% Native; 13.6% other and included groups such as Mestizo, mixed race, and Mexican) who reported on their economic stress, community self-efficacy, and tendencies to engage in prosocial behaviors toward friends and strangers as well as civic engagement. The results demonstrated that economic stress was not directly associated with prosocial behaviors or civic engagement. Community self-efficacy was positively associated with civic engagement and prosocial behaviors toward both friends and strangers. The interaction term was positively associated with prosocial behaviors toward friends. Discussion focuses on the critical role of community self-efficacy as a buffer against stress and as a predictor of multiple forms of prosocial behaviors.

The brief sense of community scale: Testing dimensionality and measurement invariance by gender among Hispanic/Latinx youth.

Psychological sense of community is defined as feelings of belongingness and a shared belief that community members will meet one another's needs. Psychological sense of community has four dimensions: membership, influence, needs fulfillment, and emotional connection. In this study, multigroup confirmatory factor analysis was used to examine the first and second-order factor structure of the brief sense of community scale (BSCS) between male and female Hispanic/Latinx adolescents from an urban community (N = 947). To help validate the BSCS model, the second-order factor model was tested with regression to predict the measures of intrapersonal psychological empowerment and ethnic identity, as constructs conceptually related to psychological sense of community. Findings support that: (1) psychological sense of community can be measured through the BSCS and as a four-factor model among Hispanic/Latinx youth, supporting McMillan and Chavis's (1986) original theoretical discussions; (2) while no differences between genders were present at the model-level, there was path-specific variation; and (3) intrapersonal psychological empowerment and ethnic identity were associated with psychological sense of community.

The Mediating Role of Ethnic Identity and Social Justice Orientation Between Community Civic Participation, Psychological Sense of Community, and Dimensions of Psychological Empowerment Among Adolescents of Color.

There is an emerging interest in studying social action and civic engagement as a part of the developmental process. Studies among youth of color indicate that empowerment has been associated with well-being, a critical perspective, and in combating social oppression. These studies also show that civic involvement and awareness of social justice issues are associated with positive developmental outcomes including empowerment. The range of predictors and outcomes related to empowerment have been insufficiently explored. This study used structural equation modeling path analysis techniques to examine the association community civic participation and psychological sense of community have with intrapersonal and cognitive psychological empowerment, through both ethnic identity and social justice orientation among urban youth of color (N =383; 53.1% Female; 75% Hispanic; 50.6% were 13 and 15 years of age). Findings illustrate that greater community civic participation and psychological sense of community are associated with both intrapersonal and cognitive psychological empowerment, through both ethnic identity and a social justice orientation; however, with some noted variations. Ethnic identity and social justice orientation mediated community civic participation and psychological sense of community and both intrapersonal and cognitive psychological empowerment. Implications put forward for community youth-workers and community programming.

Mental Health Burden among Black Adolescents: The Need for Better Assessment, Diagnosis and Treatment Engagement.

This study examines mental health symptoms among Black adolescents who were currently in mental health treatment and those who were not in treatment. The study uses a sample of Black adolescents (N=154) and logistic regression was performed to determine which psychological factors were associated with exhibiting mental health symptoms. Both groups experienced high amounts of trauma exposure history, recent suicidality, substance use, and depressive symptoms. Nearly one in four adolescents in the out of treatment group met diagnostic criteria for anxiety disorders. Implications include better screening for mental health symptoms to ensure Black adolescent have access to mental health treatment.

Contextualizing negative sense of community and disconnection among urban youth of color: "Community We ain't got that".

We explore the experiences of urban youth of color, as well as perceptions, of feeling disconnected and having an overall negative sense of community (SOC). Drawing on data from 11 focus groups, youth (N = 59) describe their communities and lived experiences. We document several themes put forward through the lens of SOC and community connection that highlight perceived lack of membership, needs fulfillment, influence, and overall emotional connection to their community. Unpacking youth's perceptions of their community, we suggest that-in the face of such realities-community-based organizations, such as those the youth find themselves in, aid in creating connectedness and help heal youth from the effects of social conditions experienced daily.

Increasing Viral Hepatitis Knowledge Among Urban Ethnic Minority Youth: Findings from a Community Based Prevention Intervention.

Viral hepatitis (VH) knowledge among youth is understudied in the United States. There has been a rise in VH cases in the U.S. in the wake of the opioid epidemic. Innovative approaches to preventing the infection are needed especially in urban communities. This study presents preliminary findings from a community-based HIV/AIDS, substance abuse, and VH prevention education intervention for ethnic minority youth in a northeastern urban community. We aimed to evaluate VH knowledge and factors associated with knowledge. Participants in the study completed a baseline survey followed by an exit survey measuring VH knowledge after the intervention. The survey was completed by 691 individuals. Logistic regression analyses were conducted and indicated that there was a significant increase (82.3%) in VH knowledge among youth who participated in the intervention. The development and implementation of VH knowledge interventions can be crucial in alleviating the rise of VH infections in the U.S.

A latent class analysis of cognitive empowerment and ethnic identity: An examination of heterogeneity between profile groups on dimensions of emotional psychological empowerment and social justice orientation among urban youth of color.

Psychological empowerment (PE) encompasses key aspects of youth development and civic engagement. Empowerment scholarship has largely focused on the intrapersonal or emotional component of PE, which considers perceptions of control and self-efficacy, specifically in the sociopolitical sphere. Fewer studies have assessed the interactional or cognitive component of PE. Even less have examined the empirical association aspects of PE, including cognitive empowerment, with conceptually related variables, such as ethnic identity. Those studies that are present have shown that the association between aspects of PE and ethnic identity are complex. The current study of urban high school students of color (N = 383; 53.1% female; 75% Hispanic/Latinx) investigates the heterogeneity present between cognitive empowerment and ethnic identity. Latent class cluster analyses were conducted and five distinct profile groups emerged. Differences were observed on the basis of profile groups of cognitive empowerment and ethnic identity on self-reported dimensions of emotional PE (e.g., leadership and policy control) and social justice orientation. The majority of study participants were clustered in groups that identified moderate to high levels of both cognitive empowerment and ethnic identity. Results provide useful insights for theory and programming.

Community coalitions as spaces for collective voice, action, and the sharing of resources.

This study examined how a community coalition, focused on prevention efforts, can aid in bridging resources between community organizations in a resource-deprived area. We also explored how it may serve as a venue to support significant changes to the community, adults, and youth who live there. Drawing on 18 individual interviews with adult coalition members from various community organizations, in a large, underserved city in the northeastern United States, we examined these data for narrations of the coalition's place within the broader prevention community and how the coalition may be an organizational venue for collective voice. We were specifically interested in hearing if these adult community members saw the coalition as filling a gap within their community. Our data revealed that while organizations within the community have been decimated due to reduced funding, the present coalition aided in meeting a variety of needs. These needs included the facilitation of community voice while helping to bridge resources between organizations, which would otherwise work alone.

Critical Hopefulness Among Urban High School Students.

Psychological empowerment encompasses several key aspects of youth civic and sociopolitical development. Most research has focused on psychological empowerment's emotional component, which entails learned hopefulness about one's own ability to participate in and lead community change efforts. Fewer studies have assessed critical awareness of how social power operates-psychological empowerment's cognitive component. The confluence of these two components has been termed critical hopefulness. A complex relationship exists between these two components, and previous research has found relatively small proportions of participants reporting both high levels of critical awareness and simultaneously high levels of hopefulness about their ability to exert influence in the sociopolitical domain. The current study of urban high school students in the Northeastern U.S. (n = 389; 53.5% female) investigates heterogeneity according to these two components of psychological empowerment. Latent class cluster analyses were conducted and seven distinct groups of participants emerged. Students identifying as Hispanic/Latinx were more likely to be classified into a profile group exhibiting critical hopefulness. Differences were observed between psychological empowerment profile groups on self-reported levels of psychological sense of community, civic engagement, and social justice orientation. Furthermore, a larger proportion of this overall sample was classified into groups that exhibited critical hopefulness than in a previous study of adults. These findings provide useful insights for efforts to engage young people in civic life and to promote sociopolitical development.