ABSTRACT
OBJECTIVES: Following Hurricane Maria, scores of Puerto Rican "Maria migrants" fled the island with thousands permanently resettling on the United States (U.S.) mainland. Emerging evidence suggests that many Maria migrants are exposed to migration-related cultural stressors, including discrimination, negative context of reception, and language stress. The present study examines the associations of premigration hurricane trauma and postmigration cultural stress with posttraumatic stress disorder (PTSD) symptom severity and positive PTSD screens. METHOD: Participants were 319 adult (age 18+, 71% female) Puerto Rican Hurricane Maria survivors on the U.S. mainland. Data were collected virtually between August 2020 and October 2021. Participants completed Spanish-language measures of hurricane-related trauma, postmigration cultural stress exposure, PTSD symptoms, and positive screens. RESULTS: One in five (20.5%) Maria migrants reported PTSD scores in the range indicating a likely PTSD diagnosis (i.e., positive screen of 50+). Both hurricane trauma and migration-related cultural stressors independently predicted posttraumatic stress and positive PTSD screens. Additionally, controlling for the effect of hurricane trauma, discrimination and language stress were strongly linked with PTSD. Further, hurricane trauma and cultural stressors interact such that cultural stress predicts PTSD-positive screens at low-to-moderate levels of hurricane trauma exposure but not at high-to-very-high levels. CONCLUSION: Findings underscore the importance of providing mental health and other psychosocial supports to hurricane survivors and evacuees beyond the immediate aftermath of the disaster, and the need to consider both premigration trauma and postmigration experiences in terms of the mental health of crisis migrant populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
ABSTRACT
In the aftermath of Hurricane María's devastating impact on Puerto Rico in September 2017, a wave of migration to the continental United States followed. Despite Puerto Rico's territorial association with the United States, its distinct culture and language often render its migrants as cultural minorities who are often treated as foreigners. Prior research has indicated that natural disasters can have a profound effect on the family unit, so examining the experiences of displacement and resettlement of Puerto Rican parents can shed light on the challenges faced by these families. Using cultural stress theory and psychological sense of community as guiding frameworks, this qualitative study aimed to explore the experience of Puerto Rican parents displaced to the United States following Hurricane María. A total of 42 Puerto Rican Hurricane María migrant parents agreed to participate in semistructured interviews. Our findings illuminate a trade-off in the lives of Puerto Rican migrants: As they departed their homeland, they exchanged social connections, support networks, and the vibrant social fabric of Puerto Rico for the promise of economic stability, reduced crime, and enhanced prospects for themselves and their children in the United States. This study represents a crucial contribution to the understanding of Puerto Ricans who have embarked on the challenging journey of relocating in the aftermath of Hurricane María. It underscores how they grapple with the multifaceted challenges and benefits inherent in their roles as cross-cultural climate migrants, transitioning from the predominantly Spanish-speaking, Latin American context of Puerto Rico to the diverse landscape of the United States. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
ABSTRACT
BACKGROUND: Tuberculosis (TB) is global health concern and a leading infectious cause of mortality. Reversing TB incidence and disease-related mortality is a major global health priority. Infectious disease mortality is directly linked to failure to adhere to treatments. Using technology to send reminders by short message services have been shown to improve treatment adherence. However, few studies have examined tuberculosis patient perceptions and attitudes towards using SMS technology to increase treatment adherence. In this study, we sought to investigate perceptions related to feasibility and acceptability of using text messaging to improve treatment adherence among adults who were receiving treatment for TB in Callao, Peru. METHODS: We conducted focus group qualitative interviews with current TB positive and non-contagious participants to understand the attitudes, perceptions, and feasibility of using short message service (SMS) reminders to improve TB treatment adherence. Subjects receiving care through the National TB Program were recruited through public health centers in Ventanilla, Callao, Peru. In four focus groups, we interviewed 16 patients. All interviews were recorded and transcribed verbatim. Thematic network analysis and codebook techniques were used to analyze data. RESULTS: Three major themes emerged from the data: limits on health literacy and information posed challenges to successful TB treatment adherence, treatment motivation at times facilitated adherence to TB treatment, and acceptability of SMS including positive perceptions of SMS to improve TB treatment adherence. The majority of patients shared considerations about how to effectively and confidentially administer an SMS intervention with TB positive participants. CONCLUSION: The overall perceptions of the use of SMS were positive and indicated that SMS technology may be an efficient way to transmit motivational texts on treatment, health education information, and simple reminders to increase treatment adherence for low-income TB patients living in Peru.