ABSTRACT
OBJECTIVE: Despite increases in the US foreign-born population, medical education opportunities in immigrant and refugee health (IRH) remain limited. We summarize findings for published IRH curricula and offer recommendations for integrating IRH into pediatric residency programs. METHODS: We performed a literature review of articles describing the design, implementation, or assessment of IRH curricula for US-based undergraduate and graduate medical trainees. RESULTS: The literature review identified 36 articles from 21 institutions describing 37 unique curricula. Three curricula included pediatric residency programs. Commonly taught topics included cultural humility, interpreter use, and immigration status as a social determinant of health. Immigrant-focused training experiences existed at continuity clinics, clinics for refugees or asylum seekers, and dedicated electives/rotations. Curricula were most frequently described as stand-alone electives/rotations. CONCLUSIONS: IRH curricula provide opportunities to develop skills in clinical care, advocacy, and community partnerships with immigrant populations. Pediatric residency programs should align the IRH curriculum with existing learning priorities, support and hire faculty with expertise in IRH, and partner with community organizations with expertise. Programs can also consider how to best support learners interested in careers focusing on immigrant populations. Further work is needed to establish competencies and validated tools measuring trainee satisfaction and clinical competency for IRH curricula.
Subject(s)
Curriculum , Emigrants and Immigrants , Internship and Residency , Pediatrics , Refugees , Humans , Refugees/education , Pediatrics/education , United States , Emigrants and Immigrants/education , Cultural Competency/education , Social Determinants of Health , Education, Medical, Graduate/methodsABSTRACT
Pregnant people who are recent immigrants often face barriers navigating the health care system and establishing a support network to sustain them through pregnancy and new parenthood. The Cultivando una Nueva Alianza (CUNA) program from the Children's Home Society of New Jersey was created to address these obstacles. For over 20 years, CUNA has collaborated with local midwives to develop a program for newly immigrated, Spanish-speaking Latinx pregnant people. The curriculum, facilitated by trained members of the community, provides education around pregnancy, birth, and early parenting and connects participants with prenatal care and community resources while cultivating a social support network. The program's success is seen in improved clinical outcomes, ongoing involvement by graduates, and strong continued support from community stakeholders. The CUNA program has been replicated in nearby communities and offers a blueprint for a low-tech intervention to improve the health and wellness of this population.
Subject(s)
Delivery of Health Care , Emigrants and Immigrants , Hispanic or Latino , Prenatal Care , Social Support , Child , Female , Humans , Pregnancy , Delivery of Health Care/ethnology , Delivery of Health Care/methods , Midwifery , Prenatal Care/methods , Health Education , Group Processes , Emigrants and Immigrants/education , Time Factors , Health Services Accessibility , United States , New Jersey , Education, Nonprofessional , Parenting/ethnology , Culturally Competent Care/ethnologySubject(s)
Education, Graduate , Emigration and Immigration , Foreign Professional Personnel , Career Choice , Surveys and Questionnaires , Emigrants and Immigrants/education , Emigrants and Immigrants/legislation & jurisprudence , Emigration and Immigration/legislation & jurisprudence , Foreign Professional Personnel/education , Foreign Professional Personnel/legislation & jurisprudence , InternationalityABSTRACT
The COVID-19 pandemic disrupted schooling for children worldwide. Most vulnerable are non-citizen children without access to public education. This study aims to explore challenges faced in achieving education access for children of refugee and asylum-seekers, migrant workers, stateless and undocumented persons in Malaysia during the pandemic. In-depth interviews of 33 stakeholders were conducted from June 2020 to March 2021. Data were thematically analysed. Our findings suggest that lockdowns disproportionately impacted non-citizen households as employment, food and housing insecurity were compounded by xenophobia, exacerbating pre-existing inequities. School closures disrupted school meals and deprived children of social interaction needed for mental wellbeing. Many non-citizen children were unable to participate in online learning due to the scarcity of digital devices, and poor internet connectivity, parental support, and home learning environments. Teachers were forced to adapt to online learning and adopt alternative arrangements to ensure continuity of learning and prevent school dropouts. The lack of government oversight over learning centres meant that measures taken were not uniform. The COVID-19 pandemic presents an opportunity for the design of more inclusive national educational policies, by recognising and supporting informal learning centres, to ensure that no child is left behind.
Subject(s)
COVID-19 , Education , Emigrants and Immigrants/education , Refugees/education , COVID-19/epidemiology , Child , Education/methods , Education/organization & administration , Education, Distance , Female , Humans , Interviews as Topic , Malaysia/epidemiology , Male , Qualitative Research , Schools/organization & administrationSubject(s)
Emigrants and Immigrants/education , Emigrants and Immigrants/psychology , Foreign Professional Personnel/psychology , Language , Research Personnel/psychology , Science/education , Teaching , Child , Community-Institutional Relations , Female , Germany , Humans , Internet , London , Paris , Portugal , Research Personnel/organization & administration , VolunteersABSTRACT
Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. We outline vulnerabilities refugee newcomers face in the context of COVID-19, including barriers to accessing health care services, disproportionate rates of mental health concerns, financial constraints, racism, and higher likelihoods of living in relatively higher density and multigenerational dwellings. In addition, we describe the response to COVID-19 by a community-based refugee primary health center in Ontario, Canada. This includes how the clinic has initially responded to the crisis as well as recommendations for providing services to refugee newcomers as the COVID-19 crisis evolves. Recommendations include the following actions: (1) consider social determinants of health in the new context of COVID-19; (2) provide services through a trauma-informed lens; (3) increase focus on continuity of health and mental health care; (4) mobilize International Medical Graduates for triaging patients based on COVID-19 symptoms; and (5) diversify communication efforts to educate refugees about COVID-19.
Subject(s)
Emigrants and Immigrants , Family Practice/organization & administration , Health Services Accessibility/organization & administration , Refugees , COVID-19/epidemiology , Emigrants and Immigrants/education , Emigrants and Immigrants/psychology , Emigrants and Immigrants/statistics & numerical data , Female , Health Services Accessibility/economics , Humans , Male , Ontario/epidemiology , Pandemics , Refugees/education , Refugees/psychology , Refugees/statistics & numerical data , SARS-CoV-2 , Social Determinants of Health/economicsABSTRACT
Nonnative English speakers may hesitate or avoid accessing healthcare in the United States due to cultural and communication barriers. Role-play is effective as a method of reducing healthcare access due to inadequate communication skills. A role-play activity used with female Muslim immigrants to the United States enabled participants to develop communication skills and gain confidence for future interactions with a healthcare provider.
Subject(s)
Christianity , Cultural Competency/education , Cultural Competency/psychology , Emigrants and Immigrants/education , Emigrants and Immigrants/psychology , Health Personnel/psychology , Health Services Accessibility , Islam/psychology , Adult , Aged , Aged, 80 and over , Communication , Female , Humans , Male , Middle AgedABSTRACT
This study examined longitudinal relations between emotion knowledge (EK) in pre-kindergarten (pre-K; Mage = 4.8 years) and math and reading achievement 1 and 3 years later in a sample of 1,050 primarily Black children (over half from immigrant families) living in historically disinvested neighborhoods. Participants were part of a follow-up study of a cluster randomized controlled trial. Controlling for pre-academic skills, other social-emotional skills, sociodemographic characteristics, and school intervention status, higher EK at the end of pre-K predicted higher math and reading achievement test scores in kindergarten and second grade. Moderation analyses suggest that relations were attenuated among children from immigrant families. Findings suggest the importance of enriching pre-K programs for children of color with EK-promotive interventions and strategies.
Subject(s)
Academic Success , Child Development/physiology , Emotions/physiology , Knowledge , Minority Groups , Poverty Areas , Black or African American/education , Black or African American/statistics & numerical data , Age Factors , Child , Child, Preschool , Cultural Deprivation , Educational Status , Emigrants and Immigrants/education , Emigrants and Immigrants/statistics & numerical data , Female , Follow-Up Studies , History, 20th Century , History, 21st Century , Humans , Longitudinal Studies , Male , Mathematics/education , Mathematics/history , Minority Groups/education , Minority Groups/psychology , Reading , Residence Characteristics/history , Schools/economics , Schools/history , Social Skills , Vulnerable Populations/ethnology , Vulnerable Populations/psychologyABSTRACT
Academics in non-tenure-track positions encounter a unique set of challenges on the road toward tenure. Institutionalized policies and lack of mentors are additional burdens for foreign scientists, resulting in representation differences. Becoming a scientist has been a personal and moving journey in which my multiple selves intersect and clash every now and again. My identity as a scientist is a life project and has intersected with my other identities: a young Latina immigrant in Western Europe. This crossroad has molded, and at times, challenged my participation in science.
Subject(s)
Emigrants and Immigrants/education , Laboratory Personnel , Europe , Female , Hispanic or Latino , Humans , MentorsABSTRACT
Parents and friends can help facilitate the academic engagement of newcomer immigrant youth during the early post-migration years. Using an accelerated longitudinal design and the integrative risk and resilience framework, we examined how parent home involvement and friendships were directly and indirectly associated with the development of newcomer immigrant youths' academic engagement. We used data from three waves (Years 3-5) of the Longitudinal Immigrant Student Adaptation study where a culturally diverse group of immigrant youth (N = 354, ages 10-17, MtimeinUS = 3.98 years, SD = 1.39) in the United States reported on their perceptions of parent home involvement (educational values and communication) and friendship (educational values and academic support) in Year 3 and on their academic engagement (behavioural and emotional) across 3 years. Findings showed high-stable behavioural and emotional engagement and direct positive associations between perceptions of parent home involvement and initial levels of behavioural and emotional engagement and between perceptions of friend educational values and initial levels of emotional engagement. Additionally, perceptions of parents' educational values indirectly contributed to initial levels of emotional engagement through positive associations with perceptions of friends' educational values. These findings can inform family-school partnerships and school-interventions targeting newcomer immigrant youths' engagement.
Subject(s)
Academic Performance/psychology , Emigrants and Immigrants/education , Friends/psychology , Parents/psychology , Students/psychology , Adolescent , Child , Female , Humans , Longitudinal Studies , Male , Negotiating , United StatesABSTRACT
Intensive lifestyle interventions targeting diet and physical activity are recommended for reducing atherosclerotic cardiovascular disease (ASCVD) risk in adults. However, existing interventions often do not reach immigrant populations because of a mismatch between the social, cultural, and environmental context of immigrants and Western bio behavioral models which underpin evidence-based lifestyle interventions. The South Asian Healthy Lifestyle Intervention (SAHELI) study is a type 1 hybrid design randomized controlled trial aimed at reducing ASCVD risk in South Asian Americans, a group at higher ASCVD risk than whites and other Asian Americans. The objective is to evaluate the clinical effectiveness and implementation potential of a community-based, culturally-adapted lifestyle intervention for South Asian adults. Participants (nâ¯=â¯550) will be randomized to printed healthy lifestyle education materials or SAHELI, a group-based lifestyle change program that includes weekly classes for 16â¯weeks and 4 booster classes though month 11. SAHELI integrates evidence-based behavior change strategies with culturally-adapted strategies and group motivational interviewing to improve diet, physical activity, and stress management. Follow-up assessments will occur at 6 and 12â¯months. We hypothesize that the SAHELI intervention group will have greater improvements in clinical ASCVD risk factors (weight, blood pressure, glycated hemoglobin, and lipids), physical activity, and psychosocial outcomes than the print material group at 6- and 12- months. We will use mixed-methods to examine SAHELI's potential for reach, adoption, implementation, and maintenance from the perspective of multiple stakeholders. This study offers the potential to increase the reach and effectiveness of evidence-based lifestyle interventions for South Asian adults at increased risk for ASCVD.
Subject(s)
Asian/education , Cardiovascular Diseases/ethnology , Cardiovascular Diseases/prevention & control , Emigrants and Immigrants/education , Health Education/organization & administration , Healthy Lifestyle , Asia, Western/ethnology , Blood Pressure , Body Weight , Cultural Competency , Diet , Exercise , Glycated Hemoglobin , Heart Disease Risk Factors , Humans , Lipids/blood , Research Design , Stress, Psychological/psychology , Stress, Psychological/therapy , United States/epidemiologySubject(s)
Awards and Prizes , Education, Graduate/statistics & numerical data , Emigrants and Immigrants/statistics & numerical data , Fellowships and Scholarships/statistics & numerical data , Foreign Professional Personnel/statistics & numerical data , Research Personnel/statistics & numerical data , Universities/statistics & numerical data , China/ethnology , Emigrants and Immigrants/education , Fellowships and Scholarships/economics , Foreign Professional Personnel/education , Foreign Professional Personnel/standards , Research Personnel/economics , Research Personnel/education , Research Personnel/standards , Time Factors , Universities/standardsABSTRACT
Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.
Subject(s)
Community Health Workers/organization & administration , Emigrants and Immigrants/education , Health Promotion/organization & administration , Hispanic or Latino/education , Motivational Interviewing/organization & administration , Preventive Health Services/organization & administration , Early Detection of Cancer , Health Behavior , Health Status Disparities , Humans , Medically Underserved Area , Viral Vaccines/administration & dosageABSTRACT
BACKGROUND AND OBJECTIVES: Latino children in immigrant families experience health care disparities. Text messaging interventions for this population may address disparities. The objective of this study was to evaluate the impact of a Spanish-language text messaging intervention on infant emergency department use and well care and vaccine adherence. METHODS: The Salud al Día intervention, an educational video and interactive text messages throughout the child's first year of life, was evaluated via randomized controlled trial conducted in an urban, academic pediatric primary care practice from February 2016 to December 2017. Inclusion criteria were publicly insured singleton infant <2 months of age; parent age >18, with Spanish as the preferred health care language; and at least 1 household cellular phone. Primary outcomes were abstracted from the electronic medical record at age 15 months. Intention-to-treat analyses were used. RESULTS: A total of 157 parent-child dyads were randomly assigned to Salud al Día (n = 79) or control groups (n = 78). Among all participants, mean parent age was 29.3 years (SD: 6.2 years), mean years in the United States was 7.3 (SD: 5.3 years), and 87% of parents had limited or marginal health literacy. The incidence rate ratio for emergency department use for the control versus intervention group was 1.48 (95% confidence interval: 1.04-2.12). A greater proportion of intervention infants received 2 flu vaccine doses compared with controls (81% vs 67%; P = .04). CONCLUSIONS: This Spanish-language text messaging intervention reduced emergency department use and increased flu vaccine receipt among a population at high risk for health care disparities. Tailored text message interventions are a promising method for addressing disparities.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Emigrants and Immigrants/education , Health Services Misuse/prevention & control , Hispanic or Latino/education , Text Messaging , Adult , Confidence Intervals , Emigrants and Immigrants/statistics & numerical data , Health Literacy/statistics & numerical data , Healthcare Disparities/ethnology , Healthcare Disparities/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Humans , Infant , Influenza Vaccines/administration & dosage , LanguageABSTRACT
Somali American women have low rates of breast and cervical screening. This research aimed to test the feasibility and impact of religiously tailored workshops involving Somali American Muslim women and male imams to improve intention to undergo breast or cervical cancer screening. Religiously tailored workshops addressing cancer screening (each approximately 3 h in length) were conducted with 30 Somali American women and 11 imams. Pre- and post-test surveys measured attitudes toward screening, screening intention, and workshop experience. The workshops were feasible, and both the women and the imams found the workshops enjoyable as well as informative. The discussions of religiously tailored messages had a positive impact on attitudes toward cancer screening, and, for the women, a positive impact on intention to screen. Religiously tailored messages can be an important community asset for engaging Somali American Muslim women around the value of breast and cervical cancer screening.
Subject(s)
Breast Neoplasms/prevention & control , Early Detection of Cancer/statistics & numerical data , Emigrants and Immigrants/education , Health Education/organization & administration , Patient Acceptance of Health Care/ethnology , Uterine Cervical Neoplasms/prevention & control , Adult , Aged , Clergy/education , Cultural Competency , Female , Health Knowledge, Attitudes, Practice , Humans , Intention , Islam , Mammography , Middle Aged , Qualitative Research , Socioeconomic Factors , Somalia/ethnology , United States/epidemiologyABSTRACT
Latina immigrants living in farmworker communities are a population in need of HIV risk reduction interventions due to their high risk for HIV and their limited access to health care and prevention services. The present study is the first to evaluate the efficacy of SEPA intervention on a cohort of 234 pre-established Latina immigrants living in farmworker communities in South Florida. SEPA is a CDC evidenced-based and Latinx culturally tailored HIV risk reduction intervention. Data were collected through structured interviews at baseline and 6-months post intervention and were analyzed using generalized linear mixed modeling. Results showed that SEPA was effective on increasing condom use during vaginal and anal sex with male partners, self-efficacy for condom use, intentions to negotiate safe sex and HIV-related knowledge from baseline to 6-months post intervention. These findings contribute to the evidence supporting the efficacy of SEPA by confirming previous results and demonstrating the efficacy of this intervention for Latinas of diverse backgrounds.
Subject(s)
Emigrants and Immigrants/education , Farmers , HIV Infections/prevention & control , Health Education/organization & administration , Health Knowledge, Attitudes, Practice/ethnology , Hispanic or Latino/education , Adolescent , Adult , Condoms/statistics & numerical data , Cultural Competency , Female , Florida , Humans , Middle Aged , Self Efficacy , Sexual Behavior/ethnology , Socioeconomic Factors , Young AdultABSTRACT
Scholars have proposed that immigrant optimism explains why some immigrant students outperform their United States-born peers academically. Yet, immigrant optimism has not been directly measured. This study aims to test the immigrant optimism hypothesis by operationalizing it using the Children's Hope Scale. Using structural equation modeling, the author examined the associations between hope, immigrant generation, citizenship status, and academic outcomes among a sample of 2,369 Latino 14- to 17-year-old students. Though no difference by immigrant generation was found, undocumented students were more hopeful than their documented peers. This finding suggests that the documentation status has an indirect relative effect on academic outcomes via hope. This article reexamines the immigrant optimism as a resource that could be fostered among Latino youth, regardless of immigrant status.
Subject(s)
Emigrants and Immigrants/psychology , Hispanic or Latino , Hope/physiology , Optimism , Students , Adolescent , Educational Status , Emigrants and Immigrants/education , Emigrants and Immigrants/statistics & numerical data , Female , Hispanic or Latino/education , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Humans , Latent Class Analysis , Male , Optimism/psychology , Students/psychology , Students/statistics & numerical data , United States/epidemiology , Universities/statistics & numerical dataABSTRACT
OBJECTIVES: The aim was to assess the effects of a parental sex education program on knowledge, attitudes, self-efficacy, and practices among immigrant parents. METHODS: A cluster randomized trial was conducted at immigrant activity centers in northern Taiwan. Recruited participants were randomly assigned to an experimental (four centers, nâ¯=â¯86) or control (four centers, nâ¯=â¯67) group. A practical booklet and a booster session were delivered. In total, 132 participants' knowledge, attitudes, self-efficacy, and practice of parenting sexual education were examined at the baseline and 6 weeks after the intervention. RESULTS: After controlling for possible confounders, the posttest scores of self-efficacy of the experimental group were higher than those of the control group. The Johnson-Neyman procedure indicated that the intervention was effective for participants who had pretest knowledge, attitude, and practice scores of <14.62, <110.27, and <41.5, respectively. CONCLUSIONS: An intervention with both practical booklet and booster session can improve knowledge, attitudes, self-efficacy and practices of parental sex education among immigrant parents. PRACTICE IMPLICATIONS: In addition to practical booklets, health care professionals should provide booster sessions that meet the needs of immigrant parents to prevent sexual problems among children and adolescents at an early age.