"We could see our real selves:" The COVID-19 syndemic and the transition to telehealth for a school-based prevention program for newcomer Latinx immigrant youth.

Newcomer Latinx immigrant youths in the United States are currently in a syndemic of increased risk of behavioral health concerns, disparities in access to related services, and are disproportionately impacted by the COVID-19 pandemic. This study used qualitative inquiry to examine the impact that the transition to telehealth had on a school-based group prevention program for immigrant youth, Fuerte, within the context of this syndemic. Data included semi-structured interviews with group leaders, and focus groups with youth program participants. Themes indicated both positive and negative impacts of the transition to telehealth on program component implementation, youth participant engagement, and youth participant social connectedness. Despite the telehealth model, youth participants reported that they felt socially connected to each other through the program. This study's results provide implications for the potential value and drawbacks of a telehealth prevention model for newcomer immigrant youth, as well as deepening understanding of how virtual behavioral health programs may operate in socially isolating contexts around the world.

Psychometric Properties of the Brazilian Version of GOHAI among Community-Dwelling Elderly People.

This study assessed the psychometric properties of the Brazilian version of the Geriatric Oral Health Assessment Index (GOHAI). A representative sample of 613 community-dwelling elderly people aged from 65 to 74 years was selected. Sociodemographic data, GOHAI and self-perceived oral health measures were collected. Dental clinical measures were obtained through oral examinations. The dimensional structure and adequacy of components were assessed using Confirmatory Factor Analysis (CFA), inter-item correlations and item-scale correlations. Reliability was evaluated by internal consistency and Intraclass Correlation Coefficients. Correlations between GOHAI scores and self-reported oral health measures were conducted to assess convergent validity. The relationship between dental clinical measures and GOHAI was tested through Poisson Regression to examine discriminant validity. The link between GOHAI items and dimensions was supported by CFA. Item 12 showed a poor factor loading. The inter-item correlations varied from 0.047 to 0.442, and item-scale correlations ranged from 0.305 to 0.612. Cronbach's alpha was 0.704. The test-retest correlation for GOHAI was 0.882. GOHAI scores were correlated by self-rated oral health measures. Poor dental clinical measures were associated with GOHAI. The Brazilian version of GOHAI showed adequate psychometric properties. However, the weak dimensional structure of GOHAI suggests the need to perform cross-cultural adaptation of GOHAI for Brazilian elderly people.

Understanding the migration experience of unaccompanied youth: A review of the literature.

Migration of unaccompanied immigrant and refugee youth has increased around the world in the last decade, peaking in 2014 in the United States and in 2015 in Europe. Youth are pushed to migrate without parents or guardians to escape war, persecution, gang violence, and extreme poverty in their country of origin. Youth are vulnerable to violence and abuse at the hands of smugglers during their journeys but show great courage and strength as they embark on their journey to a better life. The goal of this literature review is to provide a synthesis of empirical literature concerning this population. Thirty-one studies were included: 13 used qualitative methods, 13 quantitative, four mixed methods, and one used participatory methods. This body of research documents the stages of youths' immigration journeys from the decision to leave, to the migration process, to arriving in the new country and the resettlement experience. The migration journey was the overarching model in this review, and it describes the youth's complete journey, which continues after resettlement. We describe the four stages in the migration process identified in the experience of unaccompanied youth and their journey in this review: making the decision to migrate the experience during migration; psychological distress and coping upon arrival; and adaptation, acculturation upon arrival in the resettlement country, and impact of social support and social networks in the resettlement country. We end by offering recommendations for future research and immigration policy based on what is known and not yet known about the experiences of these courageous young people. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of psychologists in international migration research: Complementing other expertise and an interdisciplinary way forward.

This research note addresses the current and potential future role of psychologists in the study of international migration. We review ways in which psychologists have contributed to the study of migration, as well as ways in which psychological scholarship could be integrated with work from other social science fields. Broadly, we discuss four major contributions that psychology brings to the study of international migration-studying migrants' internal psychological experiences, incorporating a developmental perspective, conducting experimental studies, and integrating across levels of analysis. Given the position of psychology as a 'hub science' connecting more traditional social sciences with health and medical sciences, we argue for a more prominent role for psychologists within the study of international migration. Such a role is intended to complement the roles of other social scientists and to create a more interdisciplinary way forward for the field of migration studies. The research note concludes with an agenda for further scholarship on migration.

Construção de um indicador multidimensional de saúde bucal para a população idosa da cidade de Manaus, AM / Construction of a multidimensional oral health indicator for the older population in the city of Manaus-Amazonas

Resumo Objetivo Produzir um indicador multidimensional de saúde bucal, a partir de variáveis dentárias e não dentárias, para a pessoa idosa da zona urbana do município de Manaus, AM, Brasil. Método Os dados utilizados são oriundos de um estudo transversal de base populacional conduzido no ano de 2008, com indivíduos de 65 a 74 anos de idade, aleatoriamente selecionados, residentes na cidade de Manaus. Para a produção do indicador proposto, consideraram-se as variáveis dentárias (CPO-D - Índice de Dentes Perdidos, Cariados e Obturados; CPI - Índice Periodontal Comunitário; PIP- Índice de Perda de Inserção Periodontal) e não dentárias (socioeconômicas e índice GOHAI - General Oral Health Assessment Index). Uma Análise Fatorial Exploratória sintetizou essas variáveis, facilitando a construção do indicador multidimensional. Resultados A análise gerou três fatores que, em conjunto, explicaram 72,9% da variância do modelo (KMO = 0,749 e p< 0,001 para o teste de esfericidade de Bartlett). Esses três fatores foram reduzidos à variável "soma", calculada a partir da soma dos escores fatoriais por indivíduo. A mediana dessa nova variável foi o valor de referência para categorização da condição de saúde bucal do indivíduo em "favorável" ou "desfavorável". Conclusão O indicador foi capaz de agregar diversas dimensões da saúde bucal em uma única medida, além de possibilitar sua reprodutibilidade para construção de outros indicadores de saúde.

Abstract Objective Produce a multidimensional indicator of oral health, based on dental and non-dental variables, for the older adult in the urban area of the city of Manaus-AM. Method The data used are from a cross-sectional population-based study conducted in 2008 with randomly selected individuals aged 65 to 74 years, residing in the city of Manaus. To produce the proposed indicator, the dental variables (DMFT- Decayed, Missing and Filled Teeth; CPI- Community Periodontal Index; PIP- Periodontal Insertion Loss Index) and non-dental (socioeconomic and index GOHAI- General Oral Health Assessment Index) were considered. An exploratory factor analysis synthesized these variables, facilitating the construction of the multidimensional indicator Results The analysis generated three factors that, together, explained 72.9% of the model's variance (KMO = 0.749 and p<0.001 for Bartlett's test of sphericity). These three factors were reduced to the "sum" variable, calculated from the sum of the factor scores per individual. The median of this new variable was the reference value for categorizing the individual's oral health condition into "favorable" or "unfavorable". Conclusion The indicator was able to aggregate several dimensions of oral health into a single measure, in addition to enabling its reproducibility for the construction of other health status indicators.

COVID-19 and refugee and immigrant youth: A community-based mental health perspective.

In this article, we comment on the experience of the Kovler Center Child Trauma Program (KCCTP) following the March 21, 2020, shelter at home order in Chicago due to COVID-19. The KCCTP is a program of Heartland Alliance International that was founded in 2018 to provide community-based mental health and social services to immigrant and refugee youth and families who have experienced trauma. COVID-19 temporarily closed the doors of the center, suspending provision of in-person services in the community, and the program was forced to become remote overnight. The KCCTP rapidly transitioned to providing accessible information, active outreach, extensive case management, and flexible delivery of teletherapy and online psychosocial support, finding that attending to structural barriers and basic needs was crucial to family engagement and therapeutic success. Ongoing challenges include technological proficiency and access to computers, Internet, and private spaces. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Community perspectives on substance use among Bhutanese and Iraqi refugees resettled in the United States.

Premigration trauma and postmigration stressors put refugees at high risk for mental health concerns, including substance use. However, there is limited systematic research on substance use in refugee communities exists. We conducted exploratory qualitative research to examine Bhutanese and Iraqi refugee perspectives related to the use of recreational substances after resettlement in the United States. Data were collected through separate focus groups with 28 Bhutanese and 22 Iraqi adult men. Focus groups were facilitated by an experienced clinician with an in-person interpreter, audiorecorded, and transcribed. Transcripts were checked for accurate translation and then analyzed using a conventional content analysis approach. Findings revealed similarities and differences between the two refugee groups with regard to recognizing excessive use, triggers for use, and preferred modes of outreach and intervention. Findings also revealed postmigration changes in substance use behaviors stemming from issues related to access, cost, and perceived legal ramifications.

Inside-Out: Representational Ethics and Diverse Communities.

The purpose of this paper is to write about insights and special considerations for researchers who are, to some degree, "insiders" to the communities they study by expanding on the concept of representational ethics as applied to research in community psychology with diverse and marginalized groups. Representational ethics refers to the ways that researchers, artists, or corporations represent the identities of the people they portray in their communications. As community psychologists we generate and disseminate knowledge about the communities we work with, and in that process, create narratives about the people who participate in our studies. In preparing a report on psychological issues among Evangelical Christian refugees from the former Soviet Union, Dina Birman struggled with her portrayal of this group and her own status of being both an insider and an outsider to this community. When investigating academic aspirations and psychological distress among Muslim high school students, Ashmeet Oberoi was forced to acknowledge the one-sidedness of the discourse on autonomy and cultural socialization of Muslim adolescents. In her research with Cuban-educated doctors in Miami, Florida, Wendy Moore encountered similar issues as she considered how to represent gender dynamics among her participants.

Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and U.S.-Origin Children.

Most mental health services for trauma-exposed children and adolescents were not originally developed for refugees. Information is needed to help clinicians design services to address the consequences of trauma in refugee populations. We compared trauma exposure, psychological distress, and mental health service utilization among children and adolescents of refugee-origin, immigrant-origin, and U.S.-origin referred for assessment and treatment by U.S. providers in the National Child Traumatic Stress Network (NCTSN). We used propensity score matching to compare trauma profiles, mental health needs, and service use across three groups. Our sample comprised refugee-origin youth (n = 60, 48.3% female, mean age = 13.07 years) and propensity-matched samples of immigrant-origin youth (n = 143, 60.8% female, mean age = 13.26 years), and U.S.-origin youth (n = 140, 56.1% female, mean age = 12.11 years). On average, there were significantly more types of trauma exposure among refugee youth than either U.S.-origin youth (p < .001) or immigrant youth (p ≤ .001). Compared with U.S.-origin youth, refugee youth had higher rates of community violence exposure, dissociative symptoms, traumatic grief, somatization, and phobic disorder.  In contrast, the refugee group had comparably lower rates of substance abuse and oppositional defiant disorder (ps ranging from .030 to < .001).This clinic-referred sample of refugee-origin youth presented with distinct patterns of trauma exposure, distress symptoms, and service needs that merit consideration in services planning.

The Acculturation of Community Psychology: Is There a Best Way?

In this paper I describe a community psychology perspective on acculturation and adjustment of immigrants and refugees and suggest that this field of acculturation research has in turn something to offer heuristically as we consider our identity and training for future generations of community psychologists over the next 50 years. I suggest that honoring our heritage, maintaining our disciplinary identity as community psychologists, and sustaining doctoral programs that offer training specific to community psychology are crucial for our survival as a field and is not antithetical to, and is indeed necessary for, interdisciplinary collaborations.

Acculturation and Psychological Adjustment of Vietnamese Refugees: An Ecological Acculturation Framework.

Acculturation to the culture of the host society as well as to one's heritage culture have been shown to impact immigrants' adjustment during the years following resettlement. While acculturation has been identified as an important factor in adjustment of Vietnamese immigrants (Birman and Tran in Am J Orthopsychiatr 78(1):109-120. doi: 10.1037/0002-9432.78.1.109 , 2008), no clear pattern of findings has emerged and too few studies have employed an ecological approach. The purpose of this paper is to contextualize the study of acculturation and adjustment by taking an ecological approach to exploring these relationships across several life domains, using a bilinear scale, and examining mediators of these relationships for adult Vietnamese refugees (N = 203) in the United States. We call this approach the Ecological Acculturation Framework (EAF). Results of a structural equation model (SEM) showed that job satisfaction fully mediated the relationship between American acculturation and psychological distress, demonstrating that this relationship was specific to an occupational domain. However, while Vietnamese acculturation predicted co-ethnic social support satisfaction, it did not predict reduced psychological distress. Implications for a life domains approach, including domain specificity, are discussed.

Acculturation and adjustment of elderly émigrés from the former Soviet Union: A life domains perspective / Aculturación y adaptación de personas mayores exiliadas de la antigua Unión Soviética: Una perspectiva desde las facetas de la vida

Former Soviet émigrés in the United States are on average older than other immigrant groups, with adults over 65 comprising a large portion of the Russian-speaking population. Despite known risks associated with old-age migration, however, researchers and providers have underestimated adjustment difficulties for Russian-speaking elderly in U.S. These older adults tend to acquire a new culture with difficulty and remain highly oriented towards their heritage culture. However, limited research examines how acculturation to both the culture of origin and the host culture contributes to wellbeing for this immigrant group. This study assesses the adaptive value of host and heritage acculturation across several domains in the lives of older émigrés from the former Soviet Union resettled in the Baltimore and Washington, DC areas in the United States. Acculturation level with respect to both host and heritage culture was measured with the Language, Identity, and Behavior Scale (LIB; Birman & Trickett, 2001) and used to predict psychological, family, social, and medical care adjustment outcomes. Results suggest that acculturation to the host or heritage culture has different functions depending on life domain. Particularly, high American acculturation contributed to better adjustment in the psychological, family, and social domains. Heritage acculturation was associated with better outcomes in the social domain and had mixed effects for psychological adjustment. Theoretical implications highlight the importance of evaluating multiple life domains of adapting through a bilinear acculturation model for the understudied population of elderly immigrants

Las personas ex-soviéticas que se exiliaron a los EE.UU. tienen una media de edad superior a la de otros grupos de inmigrantes; entre ellas, los adultos que superan los 65 años suponen un gran porcentaje de la población ruso parlante. A pesar de que se conocen los riesgos asociados con la inmigración de personas mayores, los investigadores y agentes que prestan servicios han subestimado las dificultades de adaptación de las per sonas mayores ruso parlantes en los EE.UU. A estas personas les cuesta adquirir una nueva cultura y siguen muy orientados hacia su cultura de origen. No obstante, no abunda la investigación que analice de qué manera contribuye al bienestar de este grupo de inmigrantes la aculturación tanto en la cultura de origen como en la cultura de acogida. Este estudio analiza el valor adaptativo de la aculturación de origen y de acogida en diversas facetas de la vida de las personas de más edad que se exiliaron de la antigua Unión Soviética y se establecieron en EE.UU. en zonas de Baltimore y Washington DC. El nivel de aculturación tanto en la cultura de acogida como en la de origen se ha medido con la Escala de Idioma, Identidad y Comportamiento (LIB; Birman& Trickett, 2001), que se utilizó para predecir el grado de ajuste psicológico, familiar, social y sanitario.Los resultados indican que la asimilación de la cultura de acogida o de origen tiene funciones diferentes dependiendode la faceta de la vida. En concreto una elevada aculturación estadounidense contribuía a una mejoradaptación en las facetas psicológica, familiar y social. La aculturación de origen se asociaba a mejores resultadosen la faceta social aunque eran contradictorios en el ajuste psicológico. Las implicaciones teóricasdestacan la importancia de evaluar las distintas facetas de la vida en la adaptación a un modelo de aculturaciónbilineal en el caso de la población de inmigrantes mayores, escasamente estudiada

A life domains perspective on acculturation and psychological adjustment: a study of refugees from the former Soviet Union.

The study articulates a contextual approach to research on acculturation of immigrants, suggesting that the relationship between acculturation and adjustment is dependent on the cultural demands of the life domains considered. Specifically, the study investigated the mediating effects of adjustment in occupational and social life domains on the relationship between acculturation and psychological adjustment for 391 refugees from the former Soviet Union. The study used bilinear measures of acculturation to the host (American) and heritage (Russian) cultures. Using Structural Equation Modeling, the study confirmed the hypothesized relationships, such that the positive effects of American acculturation on psychological adjustment were mediated by occupational adjustment, and the effects of Russian acculturation on psychological adjustment were mediated by satisfaction with co-ethnic social support. Psychological adjustment was measured in two ways, as psychological well-being, using a measure of life satisfaction, and as symptoms of depression and anxiety, using the Hopkins symptom checklist (HSCL). Life satisfaction served as a mediator between adjustment in occupational and social domains and HSCL, suggesting that it may be an intervening variable through which environmental stress associated with immigration contributes to the development of symptoms of mental disorder.

Trauma history and psychopathology in war-affected refugee children referred for trauma-related mental health services in the United States.

There is an increasing need to deliver effective mental health services to refugee children and adolescents across the United States; however, the evidence base needed to guide the design and delivery of services is nascent. We investigated the trauma history profiles, psychopathology, and associated behavioral and functional indicators among war-affected refugee children presenting for psychological treatment. From the National Child Traumatic Stress Network's Core Data Set, 60 war-affected refugee children were identified (51.7% males, mean age = 13.1 years, SD = 4.13). Clinical assessments indicated high rates of probable posttraumatic stress disorder (30.4%), generalized anxiety (26.8%), somatization (26.8%), traumatic grief (21.4%), and general behavioral problems (21.4%). Exposure to war or political violence frequently co-occurred with forced displacement; traumatic loss; bereavement or separation; exposure to community violence; and exposure to domestic violence. Academic problems and behavioral difficulties were prevalent (53.6% and 44.6%, respectively); however, criminal activity, alcohol/drug use, and self-harm were rare (all < 5.45%). These findings highlight the complex trauma profiles, comorbid conditions, and functional problems that are important to consider in providing mental health interventions for refugee children and adolescents. Given the difficulties associated with access to mental health services for refugees, both preventive and community-based interventions within family, school, and peer systems hold particular promise.

Determinants and consequences of child culture brokering in families from the former Soviet Union.

Child culture brokering occurs when immigrant children help their families navigate the new culture and language. The present study develops a model of the child culture broker role that situates it within the family and community economic and acculturative contexts of 328 families from the former Soviet Union. Path analysis was utilized to explore the relationships of community and family economic and cultural contexts with child culture brokering, child emotional distress, and family disagreements. All children reported some culture brokering for their parents. Less English proficient parents with lower status jobs, and living in areas with more Russian speaking families tended to utilize their children as brokers more often. Further, community economic conditions also predicted brokering indirectly, mediated by parent job social status. Brokering was related to child emotional distress and family disagreements. Further, culture brokering was a mediator of the impact of parent job social status on both child emotional distress and family disagreements. These results add to our understanding of the culture broker role and emphasize the utility of approaching research on it from an ecological perspective.

The Effectiveness of Cultural Adjustment and Trauma Services (CATS): generating practice-based evidence on a comprehensive, school-based mental health intervention for immigrant youth.

A collaborative study of Cultural Adjustment and Trauma Services (CATS), a comprehensive, school-based mental health program for traumatized immigrant children and adolescents, was conducted to generate practice-based evidence on the service delivery model across two school districts. Program effectiveness was assessed by testing whether client functioning and PTSD symptoms improved as a result of 7 separate service elements. An array of clinical services including CBT, supportive therapy, and coordinating services were provided to all students, and an evidence-based intervention for trauma, TF-CBT, was implemented with a subset of students. Greater quantities of CBT and supportive therapy increased functioning, while greater quantities of coordinating services decreased symptoms of PTSD. TF-CBT services were associated with both improved functioning and PTSD symptoms, although TF-CBT was implemented with fidelity to the overall comprehensive service model rather than the structured intervention model. Results suggest the comprehensive school-based model was effective, though different service components affected different student outcomes. Implications of these findings for immigrant mental health interventions and implementing structured evidence-based practices into community mental health programs are discussed. Suggestions are made for future research on existing mental health practices with immigrants.

Migration and well-being: Beyond the macrosystem / Migración y Bienestar: Más allá del Macrosistema

This commentary reviews the contributions of the 6 papers to the emerging focus on migration within community psychology. This collection of articles on migration and community represents a growing interest in the field in immigration issues in general, and a community psychology focus on these issues in particular. The papers span a range of issues raised by migration in a variety of different contexts. The papers reflect principles of community psychology by articulating a perspective on migration and its outcomes within national and global contexts. Taken together, these articles demonstrate the increasing mutual enrichment of immigration and community research. The articles suggest the need to continue to articulate psychological constructs as transactional and contextual across multiple levels of analysis (AU)

Este comentario revisa los seis artículos de este monográfico sobre el emergente enfoque de la psicología comunitaria de las migraciones y en su conjunto, constituyen un ejemplo representativo del interés creciente de esta disciplina. Los artículos abarcan un amplio rango de los tópicos en una importante diversidad de contextos, y muestran cómo los principios de la psicología comunitaria permiten articular una visión de las migraciones y sus resultados, tanto en el ámbito nacional como global. Tomados en su conjunto, muestran el enriquecimiento que las migraciones suponen para la investigación comunitaria y sugieren la necesidad de continuar articulando los constructos psicológicos como transaccionales y contextuales través de múltiples niveles de análisis (AU)

Acculturation gaps in Vietnamese immigrant families: Impact on family relationships.

Vietnamese immigrants in the United States face acculturation challenges involving the individual, family, and community. Experts suggest that immigrant family members acculturate at different rates resulting in an acculturation gap, which negatively influences family adjustment. In this study we examined the degree and patterns of acculturation differences between 104 first generation immigrant Vietnamese adolescents and their parents, and whether acculturation gap affected family relationships. Operationalizing the "gap" as both absolute value of differences in acculturation and interactions of parent and adolescent acculturation levels, we examined the impact of such gaps in Vietnamese and American language, identity, and behavioral acculturation on family relationships. Results revealed that family cohesion and satisfaction were predicted by gaps in Vietnamese identity acculturation, but not by gaps in other acculturation domains.

NEIGHBORHOOD IMMIGRANT CONCENTRATION, ACCULTURATION, AND CULTURAL ALIENATION IN FORMER SOVIET IMMIGRANT WOMEN.

Several acculturation theories note the importance of surrounding context, but few studies describe neighborhood influences on immigrant adaptation. The purpose of this study was to examine relationships among neighborhood immigrant concentration, acculturation, and alienation for 151 women aged 44-80 from the former Soviet Union who lived in the US fewer than 13 years. Participants resided in 65 census tracts in the Chicago area with varying concentrations of Russian-speaking and diverse immigrants. Results from self-report questionnaires suggest that the effect of acculturation on alienation varies depending on neighborhood characteristics. The study also demonstrates the complexity of individual and contextual influences on immigrant adoption. Understanding these relationships is important for developing community-based and neighborhood-level interventions to enhance the mental health of immigrants.