Health Literacy among Korean American Immigrant Women in the USA: Role of Social Support.

Health literacy is associated with health behaviors and outcomes. Using Andersen's Behavioral Model of Health Services Use, this study examined the role of limited English proficiency (LEP) and social support for the health literacy of Korean American immigrant women, one of the most affected groups by LEP. Researchers surveyed 232 Korean American immigrant women in a metro area in a Southeastern state, U.S. Health literacy was measured by the CDC Behavioral Risk Factor Surveillance System Questionnaire and the California Health Interview Survey. Participants with better English proficiency and larger social support had higher health literacy. LEP and social support interaction was significantly associated with health literacy, illustrating social support as a buffer that mitigates the negative impact of LEP on health literacy. Community programs that enhance social support through community health advocates or peer educators may increase health literacy and reduce health disparities among Korean American immigrant women with LEP.

"They Knew They Were Still Safe with Us": Experiences of Domestic Violence Shelter Staff on Survivors' Experiences in Shelter in the Early COVID-19 Pandemic.

Background: Domestic violence (DV) shelters are an essential service for survivors and their children. While research has demonstrated global increases in DV during COVID-19, little is known about the experiences of DV shelter staff. This study aimed to understand DV shelter staff's experiences and how they navigated the early stages of the pandemic. Methods: Researchers disseminated a cross-sectional online survey, first to state DV coalitions and then directly to DV shelters. Univariate and bivariate analyses were used for multiple-choice items, and patterns were identified using thematic analysis for open-ended responses. Results: Survey participants included 368 DV staff (180 leadership, 167 direct services, and 21 other roles) from 48 states. They reported little change to their schedules and mixed feelings of shelter preparedness for the pandemic. Participants described shelter methods for preventing the spread of COVID-19, changes in shelter policies and satisfaction with such policies, and the impacts of the pandemic on themselves and survivors. Balancing survivor autonomy with the health and safety of staff and other residents proved to be one of the most consistently challenging tasks. Participants also described how programs adapted to changing regulations and continued to serve survivors throughout this challenging time. Conclusion: Several innovative practices were implemented by staff throughout the pandemic, including expansions in technology use and non-residential services. Most reported feeling prepared for a similar crisis in the future. We offer five recommendations for DV shelters and their funders, including increased mental health support for staff and greater transparency in policies for both shelter residents and staff.

Off the beaten path: A scoping review of how 'rural' is defined by the U.S. government for rural health promotion.

Background: Given the recognition that the U.S. government lacks a consensus definition of the word rural, the purpose of this scoping review was to uncover how the federal government defines the term and to establish a nuanced understanding of what criterion is used to designate an area as rural. Methods: Arksey and O'Malley's framework was used to synthesize, analyze, and summarize the existing literature. A multi-system search was conducted, and articles were screened for eligibility by two independent reviewers using pretested forms. Results: Initially, 929 articles were screened that used the search terms rural and some variation of the word definition. After eliminating all ineligble studies, 49 documents were included in the final analysis. These documents revealed 33 federal definitions of rural. The majority of definitions centered on either population, population density, or urban integration provisions. Additionally, the analysis showed that the literature could be separated into two categories: how rural was defined in a particular industry or for a specific population and the multiple adverse effects of having multiple definitions of rural. Conclusion: The discrepancies found in current classification systems reveal the need for a standardized definition of rural. Ultimately, policies centered on securing health care services for rural populations are impacted by whatever definition of rural is used. Failing to establish a gold standard definition of rural could have harmful consequences to the health and wellbeing of the many people living in rural communities across the U.S.