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1.
Arch Psychiatr Nurs ; 49: 10-22, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38734444

ABSTRACT

The number of refugees and asylum seekers worldwide is increasing, and these populations often experience significant mental health challenges due to their difficult life experiences. This study aims to explore the perspectives of refugees and asylum seekers regarding their behavior when seeking mental healthcare. We conducted a meta-synthesis of thirteen articles published between January 2000 and January 2023. The study identified four main themes: understanding of mental health, utilization of health services, the role of society, and necessary interventions. Based on our findings, we provided recommendations for healthcare providers, governments, and researchers to improve the mental healthcare-seeking behavior of these populations in the future.


Subject(s)
Mental Health Services , Patient Acceptance of Health Care , Refugees , Refugees/psychology , Humans , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/ethnology
2.
Med Care ; 62(6): 404-415, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38728679

ABSTRACT

RESEARCH DESIGN: Community-engaged qualitative study using inductive thematic analysis of semistructured interviews. OBJECTIVE: To understand Latine immigrants' recent prenatal care experiences and develop community-informed strategies to mitigate policy-related chilling effects on prenatal care utilization. BACKGROUND: Decreased health care utilization among immigrants due to punitive immigration policies (ie, the "chilling effect") has been well-documented among Latine birthing people both pre and postnatally. PATIENTS AND METHODS: Currently or recently pregnant immigrant Latine people in greater Philadelphia were recruited from an obstetric clinic, 2 pediatric primary care clinics, and 2 community-based organization client pools. Thematic saturation was achieved with 24 people. Participants' pregnancy narratives and their perspectives on how health care providers and systems could make prenatal care feel safer and more comfortable for immigrants. RESULTS: Participants' recommendations for mitigating the chilling effect during the prenatal period included training prenatal health care providers to sensitively initiate discussions about immigrants' rights and reaffirm confidentiality around immigration status. Participants suggested that health care systems should expand sources of information for pregnant immigrants, either by partnering with community organizations to disseminate information or by increasing access to trusted individuals knowledgeable about immigrants' rights to health care. Participants also suggested training non-medical office staff in the use of interpreters. CONCLUSION: Immigrant Latine pregnant and birthing people in greater Philadelphia described ongoing fear and confusion regarding the utilization of prenatal care, as well as experiences of discrimination. Participants' suggestions for mitigating immigration-related chilling effects can be translated into potential policy and programmatic interventions which could be implemented locally and evaluated for broader applicability.


Subject(s)
Emigrants and Immigrants , Patient Acceptance of Health Care , Prenatal Care , Qualitative Research , Humans , Female , Prenatal Care/statistics & numerical data , Pregnancy , Philadelphia , Adult , Emigrants and Immigrants/psychology , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/psychology , Interviews as Topic , Health Services Accessibility , Young Adult
3.
J Health Care Poor Underserved ; 35(1): 316-340, 2024.
Article in English | MEDLINE | ID: mdl-38661873

ABSTRACT

Early in the COVID-19 pandemic, the Centers for Disease Control and Prevention identified Prince William County (PWC), Va. as a hotspot with a high disease rate among Latinos. This study uses spatial, survey, and qualitative data to understand attitudes towards vaccine uptake among PWC Latinos. A quantitative analysis (n=266) estimates the association for vaccine acceptance among Latinos. Next, qualitative interviews with Latinos (n=37) examine vaccine attitudes. Finally, a spatial analysis identifies clusters of social vulnerability and low vaccine uptake in PWC and adjacent counties. Our findings show that a substantial proportion of PWC Latinos had low vaccination rates as of December 2022, two years after the vaccine's release. Side effects and safety and approval concerns were cited in both the quantitative and qualitative studies. Persistent vaccine disparities are concerning given the high hospitalization and mortality rates that prevailed among Latinos early in the pandemic.


Subject(s)
COVID-19 , Hispanic or Latino , Humans , Hispanic or Latino/statistics & numerical data , Hispanic or Latino/psychology , COVID-19/prevention & control , COVID-19/ethnology , Male , Female , Adult , Middle Aged , COVID-19 Vaccines/administration & dosage , Health Knowledge, Attitudes, Practice/ethnology , Vaccination Hesitancy/statistics & numerical data , Vaccination Hesitancy/psychology , Aged , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/psychology , Young Adult , Qualitative Research
4.
J Health Care Poor Underserved ; 35(1): 341-358, 2024.
Article in English | MEDLINE | ID: mdl-38661874

ABSTRACT

This study examined mental health needs and risk factors associated with service use among Latinx high school students in two cities in the United States. We explored how socioeconomic characteristics, school location, youth and parental nativity, and self-perceived clinical needs were associated with the odds of youths seeing a mental health provider. Data were collected from 306 Latinx youths during the 2018-19 school year. Most youths (78%) self-reported symptoms of anxiety, trauma, or depression above the clinical range. None of these clinical needs predicted service utilization. Youth experiencing less economic hardship and having a mother from South America were almost five times more likely to use services than their counterparts. Similarly, males and older respondents were more likely to be underserved than females and younger respondents. Implications to ensure equitable access to services among older, low-income Latinx youth, particularly those from Central America, the Caribbean, and Mexico, are discussed.


Subject(s)
Hispanic or Latino , Mental Health Services , Socioeconomic Factors , Humans , Male , Female , Adolescent , Hispanic or Latino/statistics & numerical data , Hispanic or Latino/psychology , Mental Health Services/statistics & numerical data , United States , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Health Services Needs and Demand/statistics & numerical data , Mental Disorders/ethnology , Young Adult
5.
J Immigr Minor Health ; 26(3): 596-603, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38308798

ABSTRACT

Haitian immigrant women living in the U.S. have a higher rate of cervical cancer mortality than any other ethnic group, primarily due to lower rates of screening test utilization. Therefore, it is important to understand the issues affecting their pap smear screening behaviors. We conducted a narrative review of articles from PubMed, SCOPUS, Embase, CINAHL/Nursing, and Psych Info. Inclusion criteria: U.S. Haitian immigrant, screening, cervical cancer, health beliefs/perceptions. Exclusion criteria: HPV-vaccine. Primary barriers: (1) lack of knowledge of cervical cancer, HPV, and pap smears; (2) lack of culturally appropriate dissemination of information; and (3) difficulty obtaining the test. Primary facilitators: (1) provider recommendations, (2) Haitian media to disseminate health information, and (3) having health insurance. This review highlights the points for intervention by health professionals and policy makers to address this group's low pap smear utilization.


Subject(s)
Early Detection of Cancer , Emigrants and Immigrants , Health Knowledge, Attitudes, Practice , Papanicolaou Test , Uterine Cervical Neoplasms , Humans , Female , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/ethnology , Haiti/ethnology , Early Detection of Cancer/statistics & numerical data , United States , Vaginal Smears/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Adult , Health Services Accessibility
6.
J Immigr Minor Health ; 26(3): 527-538, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38334856

ABSTRACT

We conducted an analysis to identify factors influencing the use of traditional complementary and alternative medicine (TCAM), with a particular emphasis on ethnic variations. Using the 2015 Asian American Quality of Life survey (N = 2,609), logistic regression analyses were performed, considering acculturation, health status, healthcare accessibility/utilization, and socio-demographic factors. Ethnicity, specifically being Chinese or Korean Americans, having chronic medical conditions, experiencing unmet healthcare needs, and having regular check-ups were significant predictors of TCAM use among Asian Americans as a whole. However, when we delved into sub-ethnic groups, different patterns were found. Among Vietnamese and Filipino Americans, having unmet healthcare needs emerged as the most prominent predictor of TCAM use. Furthermore, acculturation level and English proficiency were significant in predicting Vietnamese and Filipino Americans' TCAM use, with the direction varying by sub-ethnicity. Being old emerged as a predictor of TCAM use for Chinese, Indian, Korean, and 'other' Americans. Our findings underscore the importance of adopting an ethnically sensitive approach when addressing the healthcare needs of diverse Asian American populations.


Subject(s)
Acculturation , Asian , Complementary Therapies , Humans , Asian/statistics & numerical data , Female , Male , Complementary Therapies/statistics & numerical data , Middle Aged , Adult , Aged , United States , Socioeconomic Factors , Health Status , Health Services Accessibility , Age Factors , Patient Acceptance of Health Care/ethnology , Sociodemographic Factors , Young Adult , Vietnam/ethnology , Philippines/ethnology , Quality of Life , Ethnicity/statistics & numerical data
8.
Cancer Causes Control ; 35(5): 825-837, 2024 May.
Article in English | MEDLINE | ID: mdl-38217760

ABSTRACT

PURPOSE: Screening history influences stage at detection, but regular preventive care may also influence breast tumor diagnostic characteristics. Few studies have evaluated healthcare utilization (both screening and primary care) in racially diverse screening-eligible populations. METHODS: This analysis included 2,058 women age 45-74 (49% Black) from the Carolina Breast Cancer Study, a population-based cohort of women diagnosed with invasive breast cancer between 2008 and 2013. Screening history (threshold 0.5 mammograms per year) and pre-diagnostic healthcare utilization (i.e. regular care, based on responses to "During the past ten years, who did you usually see when you were sick or needed advice about your health?") were assessed as binary exposures. The relationship between healthcare utilization and tumor characteristics were evaluated overall and race-stratified. RESULTS: Among those lacking screening, Black participants had larger tumors (5 + cm) (frequency 19.6% vs 11.5%, relative frequency difference (RFD) = 8.1%, 95% CI 2.8-13.5), but race differences were attenuated among screening-adherent participants (10.2% vs 7.0%, RFD = 3.2%, 0.2-6.2). Similar trends were observed for tumor stage and mode of detection (mammogram vs lump). Among all participants, those lacking both screening and regular care had larger tumors (21% vs 8%, RR = 2.51, 1.76-3.56) and advanced (3B +) stage (19% vs 6%, RR = 3.15, 2.15-4.63) compared to the referent category (screening-adherent and regular care). Under-use of regular care and screening was more prevalent in socioeconomically disadvantaged areas of North Carolina. CONCLUSIONS: Access to regular care is an important safeguard for earlier detection. Our data suggest that health equity interventions should prioritize both primary care and screening.


Subject(s)
Breast Neoplasms , Early Detection of Cancer , Healthcare Disparities , Humans , Female , Breast Neoplasms/diagnosis , Breast Neoplasms/ethnology , Middle Aged , Aged , Early Detection of Cancer/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Healthcare Disparities/ethnology , North Carolina/epidemiology , Mammography/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Black or African American/statistics & numerical data , Cohort Studies , White People/statistics & numerical data , Mass Screening/statistics & numerical data , Mass Screening/methods
9.
Med Care Res Rev ; 81(3): 209-222, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38235576

ABSTRACT

The intersection of social risk and race and ethnicity on mental health care utilization is understudied. This study examined disparities in health care treatment, adjusting for clinical need, among 25,780 Medicare Advantage beneficiaries with a diagnosis of a psychiatric disorder. We assessed contributions to disparities from racial and ethnic differences in the composition and returns of social risk variables. Black and Hispanic beneficiaries had lower rates of mental health outpatient visits than Whites. Assessing composition, Black and Hispanic beneficiaries experienced greater financial, food, and housing insecurity than White beneficiaries, factors associated with greater mental health treatment. Assessing returns, food insecurity was associated with an exacerbation of Hispanic-White disparities. Health care systems need to address the financial, food and housing insecurity of racial and ethnic minority groups with psychiatric disorder. Accounting for racial and ethnic differences in social risk adjustment-based payment reforms has significant implications for provider reimbursement and outcomes.


Subject(s)
Healthcare Disparities , Medicare Part C , Mental Disorders , Humans , United States , Female , Male , Mental Disorders/therapy , Mental Disorders/ethnology , Aged , Medicare Part C/statistics & numerical data , Healthcare Disparities/ethnology , Risk Factors , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Middle Aged , Aged, 80 and over , Ethnicity/statistics & numerical data , Hispanic or Latino/statistics & numerical data
10.
J Natl Cancer Inst ; 116(2): 258-263, 2024 Feb 08.
Article in English | MEDLINE | ID: mdl-37849350

ABSTRACT

BACKGROUND: Exposure to racial discrimination may exacerbate disparities throughout the cancer care continuum. Therefore, we explored how experiences of racial discrimination in the health-care setting manifest for Black cancer patients and how it contributes to racial disparities in cancer care. METHODS: This qualitative analysis used semistructured in-depth interviews with Black cancer survivors not on active treatment from May 2019 to March 2020. All interviews were audio recorded, professionally transcribed, and uploaded into Dedoose software for analysis. We identified major themes and subthemes that highlight exposure to racial discrimination and its consequences for Black cancer patients when receiving cancer care. RESULTS: Participants included 18 Black cancer survivors, aged 29-88 years. Most patients experienced racial discrimination when seeking care. Participants experienced racial discrimination from their interactions with health-care staff, medical assistants, front desk staff, and health insurance administrators. Exposure to overt racial discrimination in the health-care setting was rooted in racial stereotypes and manifested through verbal insults such as physicians using phrases such as "you people." These experiences impacted the ability of the health-care delivery system to demonstrate trustworthiness. Patients noted "walking out" of their visit and not having their health issues addressed. Despite experiences with racial discrimination, patients still sought care out of necessity believing it was an inevitable part of the Black individual experience. CONCLUSION: We identified that exposure to racial discrimination in the health-care setting is pervasive, affects health-seeking behaviors, and degrades the patient-clinician relationship, which may likely contribute to racial disparities in cancer care.


Subject(s)
Black or African American , Delivery of Health Care , Healthcare Disparities , Neoplasms , Patient Acceptance of Health Care , Racism , Humans , Black People , Continuity of Patient Care , Delivery of Health Care/ethnology , Neoplasms/ethnology , Neoplasms/therapy , Racial Groups , Racism/ethnology , Healthcare Disparities/ethnology , Qualitative Research , Health Inequities , Adult , Middle Aged , Aged , Aged, 80 and over , Patient Acceptance of Health Care/ethnology , Physician-Patient Relations
11.
J Adv Nurs ; 80(3): 1018-1029, 2024 Mar.
Article in English | MEDLINE | ID: mdl-37828729

ABSTRACT

AIM: To explain the process taken by Chinese family care partners of older adults in the Greater Toronto Area, Canada, to access health and social services in their communities. The research question was: What mechanisms and structures impact the agency of Chinese family care partners of older adults, in the process of assisting them to access health and social services? DESIGN: This qualitative study was informed by critical realism. METHODS: Chinese family care partners of older adults in the Greater Toronto Area, Canada, were interviewed from August 2020 to June 2021. Transcripts underwent thematic analysis. FINDINGS: Twenty-eight Chinese family care partners expressed a firm commitment to maintain caregiving conditions and to judiciously access health and social services. Their commitment was made up of three parts: (a) legislative and cultural norms of family, work, and society; (b) their perseverance to fill gaps with limited social and financial resources; (c) the quality of their relationship to, and illness trajectory of the older adults. The social structures created tension in how Chinese family care partners made decisions, negotiated resources, and ultimately monitored and coordinated timely access with older adults. CONCLUSION: Participants' commitment and perseverance were conceptualized as "grit," central to their agency to conform to legislative and cultural norms. Moreover, findings support grit's power to motivate and sustain family caregiving, in order for older adults to age in place as long as possible with finite resources. IMPLICATIONS FOR THE PROFESSION: This study highlights the importance of cultural awareness education for nurses, enabling continuity of care at a systems level and for a more resilient healthcare system. IMPACT: Family care partners' grit may be crucial for nurses to harness when together, they face limited access to culturally appropriate health and social services in a system grounded in values of equity and inclusion, as in Canada. REPORTING METHOD: When writing this manuscript, we adhered to relevant EQUATOR guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC INVOLVEMENT AND ENGAGEMENT: No patient or public involvement.


Subject(s)
Asian People , Caregivers , Health Services Accessibility , Patient Acceptance of Health Care , Aged , Humans , Asian People/psychology , Canada/epidemiology , Caregivers/psychology , China/ethnology , Qualitative Research , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology , Intention , Ontario/epidemiology , Health Services Accessibility/statistics & numerical data
12.
J Womens Health (Larchmt) ; 33(4): 453-466, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38112561

ABSTRACT

Purpose: Pregnant women are vulnerable to Coronavirus Disease 2019 (COVID-19) complications, yet may hesitate to get vaccinated. It is important to identify racial/ethnic and other individual characteristics associated with COVID-19 vaccine acceptance in the United States during pregnancy. Methods: We searched PubMed, Embase, and Web of Science for articles published through January 2023 for keywords/terms related to immunization, COVID-19, and pregnancy, and performed a systematic review and meta-analysis to examine characteristics associated with vaccine acceptance. Results: Of 1,592 articles, 23 met inclusion criteria (focused on pregnant women in the United States, and their willingness or hesitation to vaccinate). Twenty-two of the studies examined receipt of ≥1 COVID-19 vaccine dose and/or intention to vaccinate, while one examined vaccine hesitancy. Vaccine acceptance rates ranged from 7% to 78.3%. Meta-analyses demonstrated that compared with Whites, Hispanics (odds ratios [OR] 0.72; 95% confidence interval [CI] 0.58-0.91) and Blacks (OR 0.44; 95% CI 0.30-0.63) had less COVID-19 vaccine acceptance, while Asians (OR 1.78; 95% CI 1.10-2.88) had greater vaccine acceptance. College graduation or more (OR 3.25; 95% CI 2.53-4.17), receipt or intention to receive the influenza vaccine (OR 3.46; 95% CI 2.22-5.41), and at least part-time employment (OR 2.12; 95% CI 1.66-2.72) were significantly associated with vaccine acceptance. Conclusions: COVID-19 vaccine nonacceptance in pregnant women is associated with Hispanic ethnicity and Black race, while acceptance is associated with Asian race, college education or more, at least part-time employment, and acceptance of the influenza vaccine. Future COVID-19 vaccination campaigns can target identified subgroups of pregnant women who are less likely to accept vaccination.


Subject(s)
COVID-19 Vaccines , COVID-19 , Pregnant Women , Vaccination Hesitancy , Humans , Pregnancy , Female , COVID-19 Vaccines/administration & dosage , United States , COVID-19/prevention & control , Pregnant Women/psychology , Pregnant Women/ethnology , Vaccination Hesitancy/statistics & numerical data , Vaccination Hesitancy/psychology , Vaccination/statistics & numerical data , Vaccination/psychology , SARS-CoV-2 , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/psychology , Pregnancy Complications, Infectious/prevention & control , Adult
13.
J Med Internet Res ; 25: e50191, 2023 12 29.
Article in English | MEDLINE | ID: mdl-38157241

ABSTRACT

BACKGROUND: While breastfeeding rates have increased in the United States in recent years, racial and ethnic disparities persist. Telelactation may help reduce disparities by increasing access to lactation consultants, but there is limited research on acceptability among minoritized individuals. OBJECTIVE: We aimed to explore experiences with telelactation among Black parents and identify strategies to make services more culturally appropriate. METHODS: We selected 20 Black parents who were given access to telelactation services from an ongoing National Institutes of Health-funded randomized controlled trial (the Tele-MILC trial) to participate in semistructured interviews. Interviews addressed birth experiences, use and opinions about telelactation, comparison of telelactation to in-person lactation support, and recommendations to improve telelactation services. The thematic analysis was informed by a previously reported theoretical framework of acceptability and RAND Corporation's equity-centered model. RESULTS: Users appreciated the convenience of telelactation and reported that lactation consultants were knowledgeable and helpful. Participants wanted more options to engage with lactation consultants outside of video visits (eg, SMS text messaging and asynchronous resources). Users who had a lactation consultant of color mentioned that racial concordance improved the experience; however, few felt that racial concordance was needed for high-quality telelactation support. CONCLUSIONS: While Black parents in our sample found telelactation services to be acceptable, telelactation could not, in isolation, address the myriad barriers to long-duration breastfeeding. Several changes could be made to telelactation services to increase their use by minoritized populations.


Subject(s)
Black or African American , Breast Feeding , Patient Acceptance of Health Care , Telemedicine , Female , Humans , Consultants , Postnatal Care , Qualitative Research , United States , Black or African American/psychology , Randomized Controlled Trials as Topic , Patient Acceptance of Health Care/ethnology
14.
Front Public Health ; 11: 1192748, 2023.
Article in English | MEDLINE | ID: mdl-37900019

ABSTRACT

Background: County-level vaccination barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, history of low vaccination) may partially explain COVID-19 vaccination intentions among U.S. adults. This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S. and were associated with willingness to receive the COVID-19 vaccine. In addition, this study assessed whether these associations differed across racial/ethnic groups. Methods: This study used data from the REACH-US study, a large online survey of U.S. adults (N = 5,475) completed from January 2021-March 2021. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Ordinal logistic regression estimated associations between race/ethnicity and county-level vaccination barriers and between county-level vaccination barriers and willingness to receive the COVID-19 vaccine. Models adjusted for covariates (age, gender, income, education, political ideology, health insurance, high-risk chronic health condition). Multigroup analysis estimated whether associations between barriers and willingness to receive the COVID-19 vaccine differed across racial/ethnic groups. Results: American Indian/Alaska Native, Black/African American, Hispanic/Latino ELP [English Language Preference (ELP); Spanish Language Preference (SLP)], and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers [Adjusted Odd Ratios (AORs):1.63-3.81]. Higher county-level vaccination barriers were generally associated with less willingness to receive the COVID-19 vaccine, yet associations were attenuated after adjusting for covariates. Trends differed across barriers and racial/ethnic groups. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine (AOR:0.78, 95% CI:0.64-0.94), whereas higher irregular care-seeking behavior was associated with greater willingness to receive the vaccine (AOR:1.20, 95% CI:1.04-1.39). Greater history of low vaccination was associated with less willingness to receive the COVID-19 vaccine among Black/African American adults (AOR:0.55, 95% CI:0.37-0.84), but greater willingness to receive the vaccine among American Indian/Alaska Native and Hispanic/Latino ELP adults (AOR:1.90, 95% CI:1.10-3.28; AOR:1.85, 95% CI:1.14-3.01). Discussion: Future public health emergency vaccination programs should include planning and coverage efforts that account for structural barriers to preventive healthcare and their intersection with sociodemographic factors. Addressing structural barriers to COVID-19 treatment and preventive services is essential for reducing morbidity and mortality in future infectious disease outbreaks.


Subject(s)
COVID-19 Vaccines , COVID-19 , Health Services Accessibility , Adult , Humans , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/prevention & control , COVID-19 Drug Treatment , COVID-19 Vaccines/therapeutic use , Ethnicity/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Vaccination Coverage/statistics & numerical data , Vaccination Hesitancy/psychology , Vaccination Hesitancy/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Race Factors , American Indian or Alaska Native/statistics & numerical data , Black or African American/statistics & numerical data , Racial Groups/ethnology , Racial Groups/statistics & numerical data , White/statistics & numerical data
16.
Afr J Reprod Health ; 27(7): 32-42, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37742332

ABSTRACT

Cervical cancer (CC) is the second leading cause of cancer morbidity and mortality among Nigerian women. Although screening is a cost-effective strategy for reducing its burden, uptake remains sub-optimal. A descriptive cross-sectional study was conducted among 514 sexually active women aged ≥25 years in Gwagwalada Area Council, Abuja, Nigeria using a semi-structured interviewer administered questionnaire. Mean age of respondents was 38.4±11.6years. 246(46.9%) had good knowledge of CC screening while 268(51.2%) had poor knowledge. Religion (aOR:1.8 [95% CI: 1.1 - 3.1]), location (aOR:1.2 [95% CI: 1.2 - 3.4) and number of children (aOR:2.3 [95% CI: 1.3 - 3.9]) were predictors for screening. Poor access routes to health facilities (aOR:0.5 [95% CI: 0.2 - 0.9]), high cost of screening (aOR:0.4 [95% CI: 0.2 - 0.9]), unaware of screening centers (aOR:0.4 [95% CI: 0.2 - 0.9]) and long waiting hours (aOR:0.5 [95% CI: 0.2 - 0.9) were identified environmental predictors. Fear of positive diagnosis/stigma (aOR:0.3 [95% CI: 0.1 - 0.9]), unacceptable touch (aOR:0.2 [95% CI: 0.1 - 0.8), deficiency in awareness programs (aOR:0.3 [95% CI: 0.2 - 0.7]), and not aware of appropriate screening age (aOR:0.1 [95% CI: 0.1 - 0.4]) were identified psychosocial predictors. This study highlights the need to intensify enlightenment programs, subsidize screening services, and encourage community screening.


Subject(s)
Black People , Early Detection of Cancer , Uterine Cervical Neoplasms , Adult , Female , Humans , Middle Aged , Black People/ethnology , Black People/psychology , Black People/statistics & numerical data , Cross-Sectional Studies , Early Detection of Cancer/economics , Early Detection of Cancer/methods , Early Detection of Cancer/psychology , Early Detection of Cancer/statistics & numerical data , Nigeria/epidemiology , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/economics , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/psychology , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/statistics & numerical data , Health Services Accessibility/economics , Health Services Accessibility/statistics & numerical data
17.
Oncol Nurs Forum ; 50(5): 589-598, 2023 08 17.
Article in English | MEDLINE | ID: mdl-37677761

ABSTRACT

PURPOSE: To explore the formation of stigma toward lung cancer and its social consequences for Chinese patients living with this diagnosis. PARTICIPANTS & SETTING: A purposive sample of 19 patients with lung cancer were recruited in the outpatient clinic of a tertiary cancer center in southern China. METHODOLOGIC APPROACH: This is a descriptive qualitative study. Semistructured interviews were conducted to explore the formation of stigma toward lung cancer and its social consequences. Audio recordings were transcribed verbatim and coded by the thematic analysis approach. FINDINGS: The following three themes emerged from interviews: (a) sources of stigma, (b) stigma manifestations, and (c) social consequences of stigma. IMPLICATIONS FOR NURSING: Considering that the formation of lung cancer stigma is socioculturally specific, existing stereotypes and prejudice in Chinese society should be the focus of antistigma interventions at the population level. At the individual level, cancer concealment, resistance to cancer identity, and feelings of no longer being a normal person were three common manifestations that may be indicators for stigma screening among people with lung cancer. In addition, stigmas profoundly affected patients' social lives and their help-seeking behaviors, and medical staff should use effective strategies to alleviate stigma toward lung cancer and its effects.


Subject(s)
East Asian People , Lung Neoplasms , Patient Acceptance of Health Care , Social Behavior , Social Stigma , Humans , Ambulatory Care Facilities , Asian People , East Asian People/psychology , Lung Neoplasms/psychology , Qualitative Research , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology
18.
J Immigr Minor Health ; 25(5): 1008-1015, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37261646

ABSTRACT

Asian Americans are less likely than Whites to seek mental care and when they do, there is a substantial delay in help-seeking. Stigma associated with mental health service use is one of the major barriers to help-seeking among Asian Americans. However, few studies have examined multi-layered contextual predictors of stigma to examine joint as well as unique contributions of each predictor. Using a cross-sectional study of 376 Filipino and 412 Korean American parents from the Midwestern U.S., we investigated how individual, familial, ethnic cultural, and macro level factors were associated with stigma among immigrant parents. The findings from hierarchical regressions suggest that familial and ethnic cultural factors are prominent predictors of stigma among Korean Americans, whereas macro level factors are particularly pertinent to Filipino Americans. This study highlights the significance of subgroup specific interventions to be effective in addressing unmet mental care needs in distinct subgroups of Asian Americans.


Subject(s)
Asian , Mental Health Services , Patient Acceptance of Health Care , Social Stigma , Humans , Asian/ethnology , Asian/psychology , Cross-Sectional Studies , Parents/psychology , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology , Emigrants and Immigrants/psychology
19.
Article in English | MEDLINE | ID: mdl-37372738

ABSTRACT

Ensuring a healthy lifestyle for the increasing number of Vietnamese migrants living in Japan is a key public health issue, including infectious disease responses such as tuberculosis (TB). To develop risk communication in relation to the TB response, this study aimed to explore the health issues and health-related behaviors of Vietnamese migrants living in Japan using a mixed method. A survey was conducted on Vietnam-born migrants, aged 18 years and over, in Tokyo. The survey consisted of questions on the following components: (1) demographics; (2) health-related issues and behavior; and (3) health-seeking behavior, information, and communication. A total 165 participants participated in the survey. The majority of the participants were young adults. 13% of the participants responded that they were concerned about their health. Moreover, 22% and 7% of the participants reported weight loss and respiratory symptoms, respectively. 44% of the participants answered they had no one to consult about their health in Japan when they needed it, and 58% answered they had no awareness of any Vietnamese-language health consultation services. Logistic regression analysis revealed that people who contact family members living in Vietnam or overseas using social networking services (SNSs) when they needed to consult someone about their health (adjusted odds ratio (AOR) = 6.09, 95% confidence interval (CI) 1.52-24.43) were more likely to present with one or more of the typical TB symptoms, compared to those who did not consult someone in this manner. Current smokers (OR = 3.08, 95% CI 1.15-8.23) were more likely to have health problems compared to non-smokers. The key informant interviews revealed that individual factors, the health system, and socio-environmental factors may hinder Vietnamese migrants' health-seeking and health-information-seeking behaviors in Japan. TB risk communication approaches for migrants need to be developed considering their health-related behaviors while addressing their health needs.


Subject(s)
Health Services Accessibility , Southeast Asian People , Transients and Migrants , Tuberculosis , Adolescent , Adult , Humans , Young Adult , Japan/epidemiology , Language , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/statistics & numerical data , Social Determinants of Health/ethnology , Social Determinants of Health/statistics & numerical data , Southeast Asian People/statistics & numerical data , Transients and Migrants/statistics & numerical data , Tuberculosis/epidemiology , Tuberculosis/therapy , Vietnam/ethnology , Health Services Accessibility/statistics & numerical data
20.
J Prim Care Community Health ; 14: 21501319231171440, 2023.
Article in English | MEDLINE | ID: mdl-37191303

ABSTRACT

INTRODUCTION/OBJECTIVES: New variants of the SARS-CoV-2 virus that causes COVID-19 will continue to develop and spread globally. The Omicron variant identified in November 2021 has many lineages. Variants spread quickly and can infect previously vaccinated individuals, prompting the Centers for Disease Control and Prevention to update vaccination recommendations. While ~230 million Americans received the initially-recommended vaccine sequence, booster uptake has been much lower; less than half of fully vaccinated individuals report receiving a booster. Racial disparities also mark patterns of COVID-19 vaccination booster uptake. This study explored willingness and motivations to get a COVID-19 booster among a diverse sample of participants. METHODS: We used convenience sampling to recruit participants 18 years of age or older who attended a community vaccine event. We conducted informal interviews during the recommended 15-min post-vaccination wait time with 55 participants who attended vaccine events at Marshallese and Hispanic community locations and comprised the recruitment pool for individual interviews. Using a qualitative descriptive design, we conducted in-depth follow-up interviews with 9 participants (Marshallese n = 5, Hispanic n = 4) to explore willingness and motivations to get boosted. We used rapid thematic template analysis to review informal interview summaries and formal interviews. The research team resolved data discrepancies by consensus. RESULTS: Participants reported high willingness to get boosted, especially if boosters were recommended in the future to protect against serious illness and mitigate the spread of COVID-19. This finding underscores how essential including recommendations to get a COVID-19 booster from trusted sources in health messaging and educational campaigns may be for increasing booster uptake. Participants described their preference for receiving future COVID-19 boosters, reporting that they would attend similar vaccine events, especially those held at faith-based organizations and facilitated by the same community partners, community health workers, and research staff. This finding shows how community engagement can overcome barriers to vaccination (ie, transportation, language, and fear of discrimination) by providing services in preferred community locations with trusted community partners. CONCLUSIONS: Findings document high willingness to get a COVID-19 booster, emphasize the role of recommendations from trusted sources in motivating booster uptake, and highlight the importance of community engagement to address disparities in vaccination coverage and reach.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , Humans , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Hispanic or Latino , Language , SARS-CoV-2 , United States/epidemiology , Vaccination , Patient Acceptance of Health Care/ethnology , Immunization, Secondary
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