The Correlates of Collective and Individual Trauma on Mental Health Outcomes Among Afghan Refugees: A Study of Sociodemographic Differences.

Following the U.S. military's departure from Afghanistan, a significant number of Afghan refugees have resettled in the United States, presenting complex mental health challenges exacerbated by extensive traumatic exposure. This demographic is particularly affected by collective trauma due to war, genocide, and the loss of homeland. However, detailed investigations into the correlations between collective trauma and mental health outcomes among Afghan refugees are limited. This study sought to explore the relationship between collective trauma and mental health outcomes within the Afghan refugee population in the United States, paying particular attention to the influence of sociodemographic factors. Identifying subgroups at greater risk allows for the development of more targeted mental health interventions. The study surveyed 173 Afghan refugees employing snowball sampling, utilizing a cross-sectional design. Data collection was facilitated through online and in-person surveys in English, Dari, and Pashto. Key measures included the Harvard Trauma Questionnaire for individual trauma experiences, the Historical Loss Scale for collective trauma, the Historical Loss Associated Symptoms Scale for collective trauma symptoms, the Afghan Symptom Checklist-22 for mental health symptoms, and the Post-Migration Living Difficulties Scale for post-migration stressors. Statistical analyses involved Pearson's correlation for variable associations, with nonparametric Mann-Whitney U and Kruskal-Wallis tests conducted to assess sociodemographic impacts due to data's non-normal distribution. The analysis revealed significant variations in collective trauma and mental health outcomes across subgroups. Afghan women, minoritized ethnic groups, those who experienced extended displacement, and refugees with uncertain visa statuses reported higher collective trauma levels and worse mental health outcomes. Statistical significance was noted in the correlations between collective trauma and mental health symptoms (r = .53, p < .01) and between post-migration difficulties and mental health (r = .33, p < .01). The disparities in mental health outcomes based on sociodemographic characteristics were significant, with nonparametric tests showing clear distinctions across different groups (Kruskal-Wallis H = 14.76, p < .05 for trauma experience by visa status). This study emphasizes the critical need for mental health interventions that account for the complex experiences of collective trauma among Afghan refugees, especially among identified subgroups. Tailoring mental health services to address the specific needs highlighted through disaggregated data can enhance support for Afghan refugees in the United States. This research contributes to a deeper understanding of the relationship between collective trauma and refugee mental health, advocating for nuanced care strategies in resettlement environments.

Exploring the Digital Divide among the Bhutanese Refugee Community during COVID-19: Engaged Research in Action.

The digital divide proved a critical barrier to accessing information and healthcare during the COVID-19 pandemic and negatively impacted the Bhutanese refugee community. Moving beyond a technological model of the digital divide that highlights a lack of access to computers and the internet, we engaged the community to co-produce a dynamic approach that identifies the impact of socio-cultural and socio-environmental factors as well. Our paper reports on our community-academic research partnership and explores how the digital divide exacerbates health disparities in a midwestern Bhutanese refugee community. Combining the efforts of the community, anthropologists and social workers, this paper reports on the health disparities that confront the community as well as interventions designed to mitigate social inequities.

Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination.

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.

Just Research: Advancing Antiracist and Antioppressive Social Work Research.

The Society for Social Work and Research (SSWR) created its Research Capacity and Development Committee in 2017 to build research capacity across the careers of social work scholars. The committee has initiated multiple conferences and webinar sessions that have increasingly focused on antiracist and antioppressive (ARAO) research, including "Mentorship for Antiracist and Inclusive Research" and "Strategies for Supporting Antiracist Pedagogy & Scholarship: Reimagining Institutional Systems & Structures." This commentary integrates themes from these sessions and other discussions among committee members about strategies to advance ARAO research. Although SSWR board members reviewed and approved this submission, it is not an official statement of SSWR or its board of directors.

Conceptualizing Mental Health Through Bhutanese Refugee Lens: Findings from a Mixed Methods Study.

Despite the rapidly growing need to understand mental health challenges faced by refugee subpopulations, there is a dearth of literature exploring mental health conceptualization through the unique refugee lens. Guided by historical trauma theory, we gathered data using a two-phase explanatory sequential mixed-methods study (quantitative: n = 40; qualitative: n = 6) in a Midwestern U.S. region to understand mental health conceptualization from the Bhutanese refugee perspective by examining the cultural meaning and perception of mental health, describing experiences of mental health problems, and examining cultural protective factors and coping strategies. We argue that recognition of refugees' conceptualization of mental health and identification of cultural protective factors is paramount to healing. Findings emphasize the need to understand historical and cultural perspectives in cross-cultural contexts for the development and implementation of culturally responsive services. Our study also contributes to emerging knowledge on methodological rigor in research among understudied, hard-to-reach, small populations.

The hidden minority: Discrimination and mental health among international students in the US during the COVID-19 pandemic.

International students in the US occupy a precarious position at the intersection of immigration policy and global education mobility, one made more challenging by the disparate impact of COVID-19 on college students' mental health. Few studies, however, have explored the pandemic's effects on mental well-being among the international student population in the US. Our study aims to provide initial empirical evidence on the mental health status of these students, with a specific focus on discrimination, loneliness, anxiety, and depression. We propose a mediation framework and estimate the mediating effects of loneliness and anxiety in the relationships between discrimination and depression in a sample of US-based international students (N = 103). We collected cross-sectional data from July to August 2020, using a 50-item online survey instrument with three open-ended questions. Mediation analyses using PROCESS Macro were used to analyse quantitative data and thematic analysis was used to analyse qualitative data. Findings showed that higher levels of discrimination were significantly associated with higher levels of loneliness. Higher levels of loneliness were significantly associated with higher levels of anxiety, which in turn led to high levels of depressive symptoms. Our study contributes to understanding the needs and capacities of international students in the wake of COVID-19 and simultaneously provides pragmatic program and policy implications for inclusive higher education environments and the overall health and well-being of this crucial US student population.

A multidimensional examination of psychological distress among Latina mothers with and without HIV.

The Latino population is disproportionally affected by HIV in the United States. Latina women, in particular, have significantly higher rates of HIV diagnosis than their White counterparts. Latinas with HIV who are primary family caregivers face multidimensional challenges from caregiving demands to stressors related to chronic illness, acculturation, family functioning, and socioeconomic disparities, which may contribute to higher psychological distress than Latina mothers without HIV. However, to date, scant research has focused on the mental health needs of Latina mothers living with HIV (MLHs) and how these needs are similar or different to Latina mothers without HIV. Thus, using a multidimensional approach we: (a) examined the associations between HIV status, acculturation, family functioning, socioeconomic status, and psychological distress among Latina mothers and (b) identified how these associations differed between Latina mothers with and without HIV. Cross-sectional, self-reported data were obtained via face-to-face interviews from 221 Latina MLHs and 116 Latina neighborhood control mothers (NCMs) living without HIV in Los Angeles, California. Results from multivariate ordinary least square regressions showed that higher acculturation was associated with psychological distress among MLHs, whereas higher levels of family conflict and education were associated with psychological distress among NCMs. Findings highlight the differential mental health needs of Latina mothers based on HIV status. Our study findings provide social work implications for culturally responsive interventions that can address multidimensional stressors experienced by marginalized Latinas MLHs.

I Wanna help, but my Hands can be a Little Tied: The Challenges and Benefits of Formal Volunteering among Low-Income Diverse Older Adults.

Volunteering is often considered an important component of productive and active aging. Although there is a rich body of literature on the predictors and outcomes of volunteering among the general older adults in the United States (U.S.), few studies have explored the unique volunteering experiences of culturally and linguistically diverse older adults. Given the growing number of diverse older adults and the importance of optimizing their contributions to society, this study investigates the challenges and benefits of volunteering among low-income diverse older adults. We conducted eight 90-minute focus groups in six languages (English, Nepali, Khmer, Somali, Russian, and Chinese) with 70 older volunteers attending a Senior Companions monthly training in a U.S. Midwestern metropolitan area. Data analysis followed the Rapid and Rigorous Qualitative Data Analysis (RADaR) technique and thematic analysis through an interactive team approach. Three overarching themes highlighted the challenges of volunteering: (1) transportation, (2) community emergencies and workload, and (3) family caregiving; and three themes reflected the benefits of volunteering: (1) stress-relief, (2) training and information, and (3) peer support and socialization. Study findings shed light on diverse older adults' unique volunteering experiences with implications for recruitment and retention.

Substance Use, Service Provision, Access & Utilization among Foreign-Born Communities in the United States: A Mixed Methods Study.

BACKGROUND: The prevalence of substance use among the foreign-born has gained increasing attention. Cumulative migration stressors - including historical trauma, violence, family separation, and poverty - present challenges to human service systems wherein services may not adequately meet the needs of these groups. Objectives: This study explores the challenges and realities of substance use, substance use service provision, and delivery of services among the increasingly diverse immigrant population using multiple perspectives. This study is based on data from a larger mixed methods study that assessed the human service landscape pertaining to the immigrant population in a mid-western region of the United States. Methods: This transformative mixed methods study used a community based participatory research approach. Data were collected from human service providers (HSPs), informal service providers, and local community leaders through surveys (n = 64), in-depth interviews (n = 23), and six focus group discussions (n = 48). A weaving approach was used to integrate findings from quantitative and qualitative data. Results: Participants recognize substance use as an issue that needs immediate attention among increasingly diverse immigrant communities. Community members and human service organizations identified several emergent themes including patterns and occurrence of substance use, barriers to care, and proposed system changes. Conclusions: Given that only 28% of responding organizations list substance use as part of their core services, the need for organizational collaborations with a focus on culturally responsive evidence-based services is proposed.

Typologies of Peer Victimization, Depression, and Alcohol Use among High School Youth in the United States: Measuring Gender Differences.

Using the data from 2015 Youth Risk Behavior Surveillance System, our study explored gender differences in the typologies of peer victimization and alcohol use mediated by depression among adolescents. Results showed a significant association between peer victimization types with depression and alcohol use among both male and female students. Results also showed stark gender differences in school victimization, cyber-bullying victimization, sexual-dating violence, and depression on alcohol use. Findings provide implications for policies and programs that examine various forms of peer victimization, mental health, and alcohol use through a gendered lens, critical to acknowledging gendered differences in victimization and behavior of adolescents.

Pathways to age-friendly communities in diverse urban neighborhoods: Do social capital and social cohesion matter?

Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.

Women, war, and reproductive health in developing countries.

Globally, millions of people are affected by war and conflicts every year. However, women have increasingly suffered the greatest harm by war in more different ways than men. We conceptualize a reproductive rights approach toward examining the effects of war on women's reproductive health in developing countries. Given the rising concerns of exclusion to adequately address women's rights, sexual and gender-based violence, and post-conflict accountability, we specifically focus on the limitations of the Minimum Initial Service Package, a UN-sponsored reproductive health service program in conflict zones while offering a broad reproductive rights-based conceptual lens for examining reproductive health care services in war-torn areas. In addition, we discuss the roles social workers may play at both micro and macro levels in war-torn areas to bring about both short term and long term gains in women's reproductive health.

Antenatal Care in Nepal: A Socioecological Perspective.

Globally, millions of women die during pregnancy and childbirth due to preventable causes. In Nepal, although significant improvements have been made in the availability of routine antenatal care (ANC), the need for effective initiatives still persists. Using the 2011 Nepal Demographic and Health Survey data, we examine the relationship between ecological and socioeconomic variations on the effect of ANC services between three distinct ecological zones in Nepal. We make a case for the consideration of socioecological niches in designing effective policies and programs to achieve positive maternal health outcomes. Most importantly, we demonstrate how sociocultural perspective can be one alternative for examining the cultural and contextual effects on women's health, contributing to the methodological literature on women's health. Since geography and culture are components of human ecology and form the larger socioecological system, we highlight the importance of these contextual effects on women's health in general, and the conditions under which women from diverse backgrounds may experience similar health issues.

Culturally competent health care from the immigrant lens: a qualitative interpretive meta-synthesis (QIMS).

Immigrant groups comprise a large segment of ethnic minorities in the United States. Although the literature is rich with strategies to deliver culturally and linguistically appropriate services to eliminate health inequities, studies addressing cultural competence from the immigrant's perspective are limited. Further research is needed to build knowledge of the predictors and needs of this population, and to influence health care policy and practice. Using qualitative interpretive meta-synthesis, this study describes the lived experience of immigrants accessing health care to understand the essence of cultural competence in health care through their lens. Findings provide insight on expanding the definition of culturally competent health care beyond language, behaviors, attitudes, and policies.

The impact of family and parental education on adolescents' substance use: a study of U.S. high school seniors.

This study explores the impact of family structure and parental education on adolescents' substance use using a racially diverse sample of 14,268, 12th-grade high school adolescents. Findings reveal that family structure affects adolescents' substance use. In addition, racial differences are noted. African American adolescents report a relatively lower rate of substance use compared to White and Hispanic adolescents, yet they are gravely affected by substance use outcomes. The study lends further support that family structure and parental education variables may buffer adolescents from substance abuse influences. Implications for practice and policy are discussed.