A scoping review of neuropsychological assessment for Asian Indians in the United States - research and clinical recommendations.

Objective: There is an increasing focus on understanding health disparities among various cultural groups in the United States. The need for heterogeneity in norms and test stimuli across ethnically diverse individuals are being increasingly recognized. However, to date it remains unknown whether and to what extent differences in cognitive norms and tests exist in Asian Indians, a fast-growing population in the U.S. It is essential to understand these differences to improve diagnostic accuracy and provide timely and appropriate clinical care. Method: In this study, we conducted a scoping review of available cognitive tests that were normed, developed, or adapted for Asian Indians living in the U.S. Results: The results suggested a paucity of norms and tests specifically examining cognition in this community. Conclusions: Based on the findings, we provide suggestions for research directions focusing on the development of culturally sensitive neuropsychological tools, normative data representative of this demographic, and interventions addressing healthcare access barriers. Overall, this review provides readers with relevant clinical information to immediately enhance patient care as well as provide actionable items in research to improve the future utility of neuropsychology for Asian Indians in the United States.

Prevalence and social determinants of depression: A cross-sectional survey of Myanmar migrant workers in Chiang Mai, Northern Thailand.

BACKGROUND: Depression is a common mental disorder and the sixth leading cause of disability in Thailand. Chiang Mai has historically been a city of attraction for labour migration for Shan migrants from the adjacent Southern Shan State of Myanmar. Currently, only infectious diseases are screened during the pre-employment period. Prevention and early detection of noncommunicable diseases can improve a healthy workforce and reduce the healthcare burden on the host country. Therefore, we aimed to determine the prevalence of depression and associated factors. METHODS: A cross-sectional survey was done among Myanmar migrant adults legally working in Chiang Mai, Thailand. RESULTS: The final analysis included 360 participants and the prevalence of depression was 14.4%. Being female, duration of stay in Thailand of more than 10 years, co-residence with co-workers, and marginalisation pattern of acculturation were significant associated factors affecting depression in a multivariate regression analysis model. CONCLUSION: Although the culture and dialect were not different between the host and country of origin, Myanmar migrant workers of Shan ethnicity suffered from depression. Our findings highlighted the importance of social determinants beyond common predictors of depression among migrants and the need for public health measures to promote migrants' integration into the host culture.

Roe v. Wade Overturned: The Association of Acculturation with Interest in and Awareness of Hospital Services for Family Planning Among Hispanic Women.

Introduction: The overturning of Roe v. Wade impacted family planning services in many areas of the United States (US). Our study investigates the association of acculturation with interest in and awareness of family planning hospital services of contraception and elective termination of pregnancy among Hispanic women. Methods: We surveyed 306 Hispanic women at a public hospital in a Long Island suburb of New York City. Predictor variables were acculturation (language, media, ethnic social relations) measured by the Short Acculturation Scale for Hispanics and years lived in the US. Outcome variables were interest in and awareness of hospital services of family planning for elective abortion and non-elective non-abortion family planning methods. Results: For interest in hospital services, both language and ethnic social relations acculturation were significantly positively associated with almost all family planning methods whether abortion or non-abortion. However, media acculturation and years lived in the US were significantly positively associated with abortion but not the non-abortion methods. For awareness of hospital services, only language acculturation was significantly positively associated with abortion and some nonelective non-abortion family planning methods. Conclusion: We recommend that healthcare providers and hospitals should be aware of acculturation levels when providing counseling and information about family planning methods to Hispanic women.

A Qualitative Study of Adolescents from Refugee Backgrounds Living in Australia: Identity and Resettlement.

Identity formation among young people from refugee backgrounds is complex, as it occurs while they are both integrating into a novel cultural landscape and navigating the intricacies of adolescence. The present study explored sense of identity and experiences among refugee youth in the context of resettlement. Nineteen young people (15-18 years) from refugee backgrounds, settled in Brisbane, Australia, took part in the study. An individual semi-structured interview, drawing upon the Tree of Life method, was used. The thematic analysis (TA) methodology was adopted, and several themes emerged: experiencing changes in family roles; experience of belonging; experience of bonds with lost loved ones; dealing with emotions in a new context; experience of self in the context of change. There was one emergent overarching theme of meaning-making in the context of change. These themes were explicated within the framework of social identity and sociocultural theories, which emphasises the dynamic co-construction of identity through the interplay of belonging and meaning-making within specific contextual settings. This study highlights the fundamental role of social context, particularly the fostering of school belonging, in the multifaceted process of identity construction. The findings identify the importance of integrating multiple identities and experiences to develop a comprehensive and resilient sense of personal cohesion and selfhood.

Exploring the dietary practices and perceptions of African immigrants in Illinois- a qualitative study of immigrants from Nigeria and Congo.

OBJECTIVE: Previous studies suggest an increased prevalence of diet-related chronic diseases among African immigrants with increased length of stay in the U.S. The objective of the current study is to understand the dietary practices and perceptions of recent African immigrant families. DESIGN: Focus group sessions were conducted with Nigerian and Congolese immigrant parents residing in Illinois. Participants were recruited using convenience sampling methods and focus group sessions were conducted via videoconference. Participants discussed dietary practices, meal preparation, and family mealtimes for their families. They also discussed experiences with eating different kinds of foods since arrival in the U.S. Verbatim transcription of focus group sessions were completed and deductive thematic analysis of transcribed data was conducted using NVivo (QSR International Pty Ltd. [2020] NVivo [version 12]). RESULTS: Twenty African immigrant parents (Mean age: 42 years, Female: 95%) residing in Northern and Central Illinois participated in a total of five focus group sessions. Seven themes were derived from the analysis. Participants had a positive attitude toward healthy diet and had a high level of interest in receiving educational resources to make healthier food choices. Participants preferred and mostly consumed foods they were familiar with before migration. A majority of the participants perceived 'American foods' as unhealthy, characterizing them as containing a high amount of sugar and salt. Parents reported that their school-aged children often preferred a western diet over traditional African meals. CONCLUSION: This study helps to understand unique diet-related practices and perceptions of recent Nigerian and Congolese African immigrants in Illinois. Findings could help to inform cultural adaptation of evidence-based nutrition education programs for these groups of African immigrants.

Understanding the relationships between acculturation, food insecurity, and food parenting practices among socioeconomically/racially diverse parents.

Research suggests that acculturation and food insecurity are factors that are separately associated with the use of specific food parenting practices among United States (US) families. Certain food parenting practices, such as coercive control and unstructured food parenting practices, are related to negative health consequences in children, such as disordered eating behaviors. The current study aimed to explore associations between acculturation strategies and food parenting practices in a sample of 577 Latinx, Hmong, Somali/Ethiopian, and Multiracial families. A secondary objective was to understand whether food security status significantly modified the relationships between acculturation strategies and food parenting practices. Results showed that acculturation strategies were significantly related to food parenting practices, and patterns in these relationships differed across race and ethnicity. Further, food security status significantly modified the relationship between acculturation strategies and food parenting practices for Latinx, Hmong, and Somali/Ethiopian families, but not for Multiracial families. These results point to the complex relationships among acculturation strategies, food security status, and food parenting practices in immigrant populations in the US. Longitudinal studies exploring the temporal relationships between acculturation strategies, food security status, and food parenting practices would help tease apart how food parenting practices may evolve upon migrating to the US.

Caught between two worlds: mental health literacy and stigma among bicultural youth.

PURPOSE: Bicultural youths are at higher risk of mental health problems and are less likely to utilize mental health services, yet our knowledge of their mental health literacy and help-seeking behaviours remains limited. METHODS: To fill this gap, the current study explored bicultural youths' mental health literacy and stigma by conducting semi-structured interviews with 14 Canadian university students in 2021. RESULTS: Our analysis revealed that bicultural youths may be torn between two worlds: intergenerational tensions between participants assimilated into individualistic Canadian culture and their more collectivist parents meant that they had different cultural perceptions of mental health literacy and stigma. While being caught between these two worlds may be detrimental for bicultural youth, our results also suggested that a trans-cultural factor-celebrities' mental health journeys-may promote help-seeking behaviour across participants. Furthermore, our study speaks to the ways that unprecedented events such as the COVID-19 pandemic impact mental health literacy among bicultural youth. Our findings might be used by university mental health services to encourage help-seeking among bicultural students. CONCLUSION: The acculturation of mental health literacy, stigma, and associated intergenerational differences needs to be considered by university wellness services.

Translation and validation of the East Asian Acculturation Measure (EAAM) among Myanmar migrants in Thailand.

Background: Acculturation provides a framework for exploring the health behaviors of ethnic minority or cultural groups. Research on the acculturation level and patterns of Myanmar migrants is crucial since there is ample evidence that acculturation promotes health-promoting behaviors. However, no Myanmar version has undergone cross-cultural validation. Objective: This study aimed to translate the original East Asian Acculturation Measure (EAAM) into the Myanmar version (EAAM-M) and investigate its psychometric properties. Methods: The validation study was conducted on a sample of 200 Myanmar migrants in three factories in Bangkok, Thailand, by a multistage random sampling method from August to September 2023. Brislin's back translation technique was applied to convert the original EAAM into its modified version, EAAM-M. The reliability, content validity, and construct validity of the EAAM-M were examined, and confirmatory factor analysis (CFA) was employed to test the appropriateness of the model that underpins the EAAM-M structure. Results: The average age of the participants was 38.39 years (SD = 5.56), and 68% of participants reported they earned less than 9000 baht. In terms of how long they stayed in Thailand, slightly over half (52.5%) did so for 1-5 years. Nearly half of them (46%) cannot communicate at all regarding their proficiency in speaking Thai. The score regarding the comparability of language and similarity of interpretability between the original EAAM and the EAAM-M was satisfactory. The overall alpha reliability of the EAAM-M was 0.76. Based on the CFA, the measurement model was well fit, with acceptable goodness-of-fit values (Chi-square test of model fit (p = 0.05), CMIN/df = 1.70 (χ2 = 624.931, df = 366), RMSEA = 0.02, CFI = 0.98, and SRMR = 0.06). The validity and reliability of the factors were affirmed through appropriate factor loadings and satisfactory levels of composite reliability (0.942) and average variance extracted (0.538). Conclusion: The EAAM-M is a reliable and valid instrument to measure the acculturation patterns of Myanmar migrants. It is beneficial for scholars across various disciplines, including health professionals and nurses, to deliver culturally tailored care for migrants.

Anxiety among Asian international college students in the US: a systematic literature review.

OBJECTIVE: The current systematic literature review explores the factors contributing to anxiety among Asian international college students in the United States. METHODS: A search of multiple electronic databases yielded seven relevant peer-reviewed articles published since 2018. RESULTS: Findings indicated that academic stressors, lack of social support, and cultural barriers significantly contributed to anxiety among Asian international students. Additionally, demographic factors such as gender, age, and English proficiency may also influence anxiety levels. DISCUSSION: Mindfulness-based interventions, peer support groups, and culturally sensitive counseling may reduce anxiety among Asian international students. Further research is needed to understand more thoroughly the complex interactions between these factors and anxiety in this population.

Lived experiences of Sri Lankan Tamil refugees in the UK: Migration and identity.

Sri Lankan Tamil refugees (SLTRs) have lived in the United Kingdom in substantial numbers for about three decades. However, they remain under-represented in academic and public discourse, and little is known about their migration experiences. This study examined first-hand accounts of such experiences, with special attention paid to identity and acculturation. Data were collected through four semi-structured interviews and analysed using interpretative phenomenological analysis (IPA). The results suggest that SLTRs' experience of conflict as an imposed life disruption continues to shape their adaptation, identity, and meaning-making ("Afflicted life"). Changing social identities mediate protection from, as well as risk of, trauma. SLTRs try to remedy the socio-economic and emotional losses suffered in the conflict, but achieve only a partial compensation. Consequently their repair efforts are a source not only of positive emotions but also of dissatisfaction ("Living past"). Finally, participants' sense of belonging and quest for home represent a challenging socio-emotional process in which they continue to engage even decades after migration ("Continuing quest for home"). This nuanced analysis of how the past continues to shape lived experience, contributes to the under-developed literature on qualitative psychological investigations of acculturation, research on forced migration, and the establishment of IPA in social psychology.

Global migration and factors influencing retention of Asian internationally educated nurses: a systematic review.

BACKGROUND: Given nurses' increasing international mobility, Asian internationally educated nurses (IENs) represent a critical human resource highly sought after within the global healthcare workforce. Developed countries have grown excessively reliant on them, leading to heightened competition among these countries. Hence, this review aims to uncover factors underlying the retention of Asian IENs in host countries to facilitate the development of more effective staff retention strategies. METHODS: A mixed-methods systematic review was conducted using the Joanna Briggs Institute methodology for mixed-method systematic review. A search was undertaken across the following electronic databases for studies published in English during 2013-2022: CINAHL, Embase, PubMed, Scopus, Web of Science and PsycINFO. Two of the researchers critically appraised included articles independently using the Joanna Briggs Critical Appraisal Tools and Mixed Methods Appraisal Tool (version 2018). A data-based convergent integrated approach was adopted for data synthesis. RESULTS: Of the 27 included articles (19 qualitative and eight quantitative), five each were conducted in Asia (Japan, Taiwan, Singapore and Malaysia), Australia and Europe (Italy, Norway and the United Kingdom); four each in the United States and the Middle East (Saudi Arabia and Kuwait); two in Canada; and one each in New Zealand and South Africa. Five themes emerged from the data synthesis: (1) desire for better career prospects, (2) occupational downward mobility, (3) inequality in career advancement, (4) acculturation and (5) support system. CONCLUSION: This systematic review investigated the factors influencing AMN retention and identified several promising retention strategies: granting them permanent residency, ensuring transparency in credentialing assessment, providing equal opportunities for career advancement, instituting induction programmes for newly employed Asian IENs, enabling families to be with them and building workplace social support. Retention strategies that embrace the Asian IENs' perspectives and experiences are envisioned to ensure a sustainable nursing workforce.

Acculturation and Mental Health: A Scoping Review.

Background: Acculturative stress theory and the healthy immigrant paradox provide conflicting frameworks from which to study the mental health of immigrant groups. This scoping review aims to provide clarity on the mental health effects of acculturation. Review Question: How are anxiety, depression, and stress expressed in the adolescent and adult children of immigrants? Method: Considering various generational classifications, 1333 articles were screened and 25 articles were selected. This review highlights the presentation of cultural stress and its mental health effects in the children of immigrants ranging from 13 to 28 years of age. Conclusions: Social support is necessary as these children and young adults work to reconcile different worldviews. There is a need for a multifaceted approach to health care that incorporates the development of culturally appropriate responses to stressors. Collaboration among health practitioners growing in cultural competency can assist this population not only in the development of coping strategies, but also in self-actualization. The conflicting results found in this review suggest a need for more work in the area of acculturation stress, to grow the understanding of health practitioners within various cultural groups in order to transform mental health clinical practice.

Body image and physical activity in Latinas.

Women with negative body image engage in less physical activity. The purpose of this study is to examine the relationship between body image and physical activity in Latinas participating in a lifestyle program. Participants (age 43.8 ± 10.1 years and BMI 30.4 ± 5.2 kg/m2) were enrolled in a 12-month culturally and linguistically adapted, individually tailored, intervention focused on increasing moderate-to-vigorous intensity physical activity (MVPA). Longitudinal assessments were conducted on body image dissatisfaction (BID) using the Figure Rating Scale, MVPA using the 7-day PAR interview, and objectively measured body weight. Pre-intervention BID did not significantly predict MVPA change. Participants experienced considerable reduction in BID. Greater MVPA engagement and weight loss were independently related to BID reduction. Acculturation did not moderate these relationships. Body image improved in Latinas participating in a cognitive and behavioral physical activity intervention regardless of weight loss and acculturation level.

Relationship Between Acculturation and Mental Health in Korean American Family Caregivers of Community-Dwelling Persons Living with Dementia.

Despite the growing number of Korean American (KA) family caregivers for persons with dementia, little is known about how acculturation might affect caregiving stress in this population. Acculturation is a variable of considerable interest in caregiving research due to its significance in understanding the impact of cultural perceptions and expectations on the caregiving role and its relation to mental health outcomes. A cross-sectional descriptive study using baseline data from an ongoing randomized controlled trial of dementia caregiver intervention was performed to examine the association between acculturation and mental health outcomes among KA caregivers (n = 32) for persons with dementia. Self-report survey questionnaires including a bidirectional acculturation scale, Center for Epidemiologic Studies Depression Scale, the Perceived Stress Scale, and the Zarit Burden Interview were administered in person in English or Korean by trained bilingual community health workers. The primary independent variable, acculturation, was assessed using a 24-item inventory. It measured two sets of cultural orientation: Korean orientation and American orientation. The mean age was 67 years (SD = 11.8) and 87% were women. Half of the caregivers were spouses of persons with dementia, while the other half were offspring caregivers. In the multiple linear regression model, caregiver acculturation toward Korean cultural orientation had a significant and positive association with depressive symptoms (ß = .62; SE = 0.25; p-value = .02) and perceived stress (ß = .29; SE = 0.13; p-value = .03) after adjusting for age and self-efficacy. No significant effect of American cultural orientation was found for caregiver burden, perceived stress, or depressive symptoms. Our findings suggest that exploring the role of acculturation in caregiving and its relation to outcomes, particularly caregiver distress, may be valuable for future studies aiming to understand specific elements of cultural values and practices in the acculturation process related to mental health outcomes among immigrant Korean American caregivers.

Effects of sociocultural stressors on maternal responsivity and the infant behavioral and neuroendocrine response to stress in families of Mexican descent.

Maternal stress is consistently linked to alterations in maternal behavior and infant neurodevelopmental outcomes. As the Latino population grows in the U.S., it is increasingly important to understand how culturally relevant factors affect this relationship. This study aimed to address the role of sociocultural stressors on maternal sensitivity and markers of infant emotional regulation and the neuroendocrine response to stress in mother/infant dyads of Mexican descent. Pregnant women of Mexican descent (n = 115) were recruited during early pregnancy and followed until their infants were 6 months old. Mothers completed measures of sociocultural stressors (acculturative stress and discrimination) at pre and postnatal time points. At 6 months, dyads underwent the Still Face procedure. Mothers were observed for behaviors exhibiting maternal responsivity, while negative vocalizations were observed in infants. Salivary cortisol was also collected from infants. Maternal responsivity was a salient risk factor for alterations in infant emotional regulation and cortisol activity. Postnatal experiences of discrimination were also negatively associated with infant negative affect. This work highlights maternal responsivity and points to a potential role for experiences of discrimination in the response to stress in the mother/child dyad that may have consequences for the development of emotional regulation in infants of Mexican descent.

Acculturation and clinical symptoms of schizophrenia among Latine adults in the United States.

BACKGROUND: Research on acculturation and schizophrenia spectrum disorders has yielded inconsistent findings. This study aimed to clarify the influence of acculturation on symptomatology in Latine individuals with schizophrenia in the United States. METHODS: The analysis involved cross-sectional data from Latine (n = 120) and non-Latine White (n = 60) adults with schizophrenia in San Diego, California. Participants completed the Short Acculturation Scale for Hispanics (SASH), Positive and Negative Symptom Scale, and Hamilton Depression Rating Scale in their preferred language. Univariate linear regressions were implemented to identify proxy measures as predictors of acculturation scores. Analyses of variance were conducted to analyze the relationship of SASH scores and proxy measures of acculturation to symptom severity. RESULTS: Latine participants presented more symptom severity than non-Latine Whites. When categorized by acculturation status (Spanish-preferring, bicultural, and English-preferring), Spanish-preferring participants presented similar psychiatric symptoms to the non-Latine group and less severe symptoms than both other Latine groups. Analyses identified study language as the strongest proxy measure for the SASH. Latine participants assessed in English had significantly worse positive and depressive symptoms than those assessed in Spanish. Nativity status moderated the relationship between study language and symptomatology. CONCLUSIONS: Findings support an association between acculturation and symptom severity among Latine individuals with schizophrenia. The use of proxy measures of acculturation may be useful in settings where time is constrained. Future research should continue to explore acculturation and symptomatology in Latine communities.

Acculturating Systems of Care to Ensure Healthy Futures for Latine Migrant Youth.

Migration across the Americas is an ever-changing process with current trends including increased migration into the United States of Latine youth. Experiences before, during, and after migration can increase the risk of psychiatric illness, including discriminatory and exclusionary experiences when accessing care. Acculturation typically focuses on the process that the immigrant group experiences when coming into contact with a host culture. Members of the host culture and systems of care can take intentional steps to acculturate themselves in an integrative manner in an effort to reduce host-immigrant friction and better coordinate care across systems.

African Immigrants' perceptions and attitudes toward cardiovascular health.

AIM: To explore perceptions and attitudes of African immigrants (Ghanaians, Nigerians, Liberians, and Sierra Leoneans) in the Baltimore-Washington, DC, metropolitan area toward cardiovascular health. METHODS: This was a qualitative study among African immigrants recruited from religious and community-based organizations in the Baltimore-Washington metro area. A purposive sample of 66 African immigrants originally from Ghana, Nigeria, Liberia, and Sierra Leone completed a sociodemographic survey and participated in focus group discussions. Focus group data were analysed using qualitative description to develop emergent themes. RESULTS: A total of 66 African immigrants with a mean (±standard deviation) age of 51 (±11.8) years participated in the focus group discussions. Fifty percent were women, 91% had at least a bachelor's degree, 84% were employed, 80% had health insurance, and 75% were married/cohabitating. The majority of the participants (74%) had lived in the US for 10 years or more, 44% of them had hypertension, and 12% had diabetes. Findings from the focus group discussions revealed: gender differences in descriptions of cardiovascular health and healthiness, an emotional response associated with cardiovascular disease (evoking fear and anxiety and associated with family secrecy), positive and negative lifestyle changes after migration, cardiovascular screening behaviours, and facilitators and barriers to cardiovascular disease prevention practices and heart-healthy lifestyle. CONCLUSIONS: Participants understood health to be a holistic state of well-being. Secrecy in disclosing their cardiovascular disease diagnoses informed by historical socio-cultural belief systems, perceived racial discrimination by healthcare providers, communication and health literacy barriers, economic barriers of holding multiple jobs and the exorbitant cost of heart-healthy foods were identified as some barriers to achieving optimal cardiovascular health in this immigrant population. IMPACT: Our study expanded on the body of knowledge on African immigrants' perceptions and attitudes toward cardiovascular health. Addressing this knowledge gap will provide important intervention opportunities targeted at improving cardiovascular health outcomes in this population. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Research on the formation mechanism of brand identification in cross-border e-commerce platforms - Based on the perspective of perceived brand globalness/localness.

With the advent of the digital economy, enterprises have been engaging in brand management activities through cross-border e-commerce platforms to secure brand identification (BI) and capture market share. However, scant attention has been given to the impact of perceived brand globalness (PBG) and perceived brand localness (PBL) on brand identification in cross-border e-commerce platforms. This study delves into the underlying mechanisms governing the formation of brand identification in the context of cross-border e-commerce platforms. In this end, we employed the AMOS26.0 software to conduct structural equation analysis on a corpus of 300 survey questionnaires. The results show that: (1) PBG and PBL can exert a positive influence on BI through customer perceived value; (2) acculturation (AC) assumes a positive moderating role in the influence of PBG and PBL on emotional value (EV) and functional value (FV) respectively, (3) and that platform reputation (PR) plays a constructive moderating role in the impact of PBG on FV.

Utilization of Traditional Complementary and Alternative Medicine Across Ethnically Diverse Asian Americans.

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.