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1.
Psychiatr Danub ; 32(Suppl 3): 386-395, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030459

RESUMO

The use of violence and aggression on civilians during the war has become one of the most prominent military events of the 20th and 21st centuries, resulting in an increasing number of refugees and displaced persons in the midst of regional and tribal conflicts. We are witnessing a daily increase in the number of migrants when people are fleeing from their homes because of human rights violations, persecution, poverty, and conflict. When found in "host" countries, they often encounter bad conditions, with uncertainty and instability. Many come to Europe in search of economic and personal opportunities for progress, where they face different types of process of acculturation. 'Place loss', acute and chronic trauma, family disorders, and family reunification issues became more and more important issues. Refugees, asylum seekers and irregular migrants have a higher risk for certain mental health disorders, including posttraumatic stress, depression and psychosis. In addition to being exposed to various risk factors for mental disorders, migrants often face barriers to access to adequate health care to address these issues. Some of the biggest challenges for migrant populations within "host" countries include: lack of knowledge of health care rights and health systems; poor knowledge of the language; different belief systems and cultural expectations of health care; and the general lack of trust in experts and in government. The rates of depressive and anxiety disorders usually increase over time, and poor mental health is associated with poor socioeconomic conditions - particularly with social isolation and unemployment. Acculturative stress often implies a high discrepancy in the acculturation between parents and their children. This dislocation of families in new conditions has been caused by the different degrees of acceptance of "new culture" by children and parents, which causes serious difficulties, especially in bilingual terms.


Assuntos
Aculturação , Saúde Mental/estatística & dados numéricos , Refugiados , Migrantes , Transtornos de Ansiedade/epidemiologia , Transtorno Depressivo/epidemiologia , Europa (Continente) , Humanos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos
2.
PLoS One ; 15(8): e0236326, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822363

RESUMO

This study aimed to test whether or not where people come from and move to impacts their method for dealing with stress. We investigated this research question among newcomers crossing between the rice and wheat farming regions in China-south and north China, respectively. New evidence suggests wheat-farming agriculture fosters a coping strategy of changing the environment (primary coping), while rice-farming regions foster the converse strategy of fitting into the environment (secondary coping). Using two longitudinal studies on newcomers at universities located in both the rice and wheat farming regions, we hypothesized that students from south China (rice region) at a university in north China (wheat region) would use more primary coping and it would lead to better adaptation (Study 1). In contrast, students from wheat-farming regions moving to a rice university would benefit from secondary coping as an effective strategy for buffering stress (Study 2). Results indicated that for students from rice-farming regions who were studying universities in wheat-farming regions, secondary coping was damaging and attenuated the stress-adaptation relationship. However, in study 2, the reverse was found, as secondary coping was found to buffer the negative effects of stress on sociocultural adaptation for students from wheat-farming regions who were studying at universities in rice-farming regions. This study lends further support to the theory that ecological factors impact how individuals cope with the acculturative stress of moving to a new environment.


Assuntos
Aculturação , Adaptação Psicológica , Produção Agrícola , Comparação Transcultural , Migração Humana , Adolescente , China , Produtos Agrícolas , Fazendas , Feminino , Geografia , Humanos , Estudos Longitudinais , Masculino , Oryza , Estudantes/psicologia , Triticum , Universidades , Adulto Jovem
3.
PLoS One ; 15(8): e0237113, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760157

RESUMO

OBJECTIVE: Adolescent migrants present psychological disorders more frequently than the corresponding host population but their access to care and to follow-up are less effective. The French method of transcultural psychotherapy (TPT) was conceived to respond to these problems. Our objective is to assess how these adolescents and their families perceive the experience and effectiveness of TPT. METHOD: We conducted semistructured interviews with the families of adolescents seen for TPT. The data were analyzed by a qualitative thematic methodology. RESULTS: We spoke to 21 participants in 8 families. The families came to TPT with a sense that the teen's current treatment was at an impasse. During the follow-up, they noted that family communication and relationships had improved, as had their connection to their culture of origin. Besides commenting on what they perceived as limitations, families identified specific elements of TPT as therapeutic. CONCLUSION: The pronounced diversity of the group and the use of both multiperspective narration and an interpreter were specific elements driving the construction of a good therapeutic alliance, despite the initial barriers. Pursuit of the evaluation of TPT is essential to advance the psychiatric care of adolescent migrants.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Psicoterapia/métodos , Migrantes/psicologia , Aculturação , Adolescente , Criança , Características Culturais , Família/psicologia , Feminino , Humanos , Masculino , Psicoterapia/normas , Inquéritos e Questionários , Adulto Jovem
4.
J Cross Cult Gerontol ; 35(3): 291-310, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32648075

RESUMO

After migrating to the United States, older Korean immigrants may increase their gambling participation and be at higher risk for problem gambling. However, not much is known about their experiences and beliefs on gambling. The purpose of the present study was to explore gambling behaviors and shared beliefs about gambling among older Korean immigrants residing in New York City. A total of 20 semi-structured in-depth interviews (10 men and 10 women) were conducted in Korean. Interviews were transcribed verbatim and analyzed using a thematic analysis approach. The findings revealed three major categories among older Korean immigrants. The first category, cultural beliefs, has three subcategories (i.e., gambling is unethical, fear of addiction, and losing everything) and refers to negative beliefs about gambling. The second category, adaptation, refers to positive attitudes they acquired as they adjusted to the new gambling environment (i.e., harmless leisure, coping strategies, and excitement in life). Last, they revealed ambivalence about gambling (i.e., changes in gambling environment, 'my gambling' is different, and gambling in secrecy). Overall, older Korean immigrants have retained their cultural beliefs about gambling, even as they have embraced the legalized gambling environment and changed social norms of the U.S. However, they have trouble reconciling the differences between their beliefs, behaviors, values, and newly acquired norms. Findings point to a need for healthy and affordable leisure pursuits, and for culturally appropriate intervention programs to help problem gamblers.


Assuntos
Americanos Asiáticos/psicologia , Emigrantes e Imigrantes/psicologia , Jogo de Azar/etnologia , Aculturação , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Feminino , Jogo de Azar/psicologia , Humanos , Atividades de Lazer , Masculino , Cidade de Nova Iorque , Pesquisa Qualitativa , República da Coreia/etnologia
5.
Stud Health Technol Inform ; 270: 1215-1216, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570586

RESUMO

Biostatistics is one of the transversal subjects that all future doctors must acquire and master. Nonetheless, it is a subject that has the reputation of being difficult, which has not been able to be corrected even with the application of new pedagogical methods such as blended learning. We address this problem with our acculturative and disruptive approach in the form of a serious game scenario in clinical research that integrates biostatistics with our R4Web adapted tools. Our approach was launched in 2008 for the second year of medical school. Here we describe this LOE scenario for serious game including the biostatistics disruptive acculturation task and present its new international version.


Assuntos
Bioestatística , Jogos de Vídeo , Aculturação , Biometria , Aprendizagem
6.
Ann Epidemiol ; 45: 32-39, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32340835

RESUMO

PURPOSE: The aim of the study was to quantify the association between perceived everyday discrimination and binge eating among Latinas in the United States. METHODS: Participants included 1014 Latinas from the 2002-2003 National Latino and Asian American Study. Modified Poisson models with robust standard errors were used to estimate sociodemographic-adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) of binge eating associated with overall and attribution-specific discrimination. RESULTS: Approximately 7% of Latinas reported binge eating. Increased frequency of discrimination was associated with a higher prevalence of binge eating (aPR, 1.59; 95% CI, 1.23-2.06), and Latinas reporting frequencies of discrimination in the top tertile had the greatest prevalence elevation (aPR, 3.63; 95% CI, 1.32-10.00). There were important differences by discrimination attribution: Latinas experiencing primarily height/weight-based or skin color-based discrimination had the greatest prevalence elevation relative to those reporting no discrimination (aPR, 10.24; 95% CI, 2.95-35.51; and aPR, 8.83; 95% CI, 2.08-37.54, respectively), whereas Latinas reporting primarily race-based discrimination had the lowest prevalence elevation (aPR, 1.64; 95% CI, 0.47-5.69). CONCLUSIONS: Discrimination may be an important social determinant of Latinas' binge eating. Future research should incorporate expanded conceptual models that account for Latinas' complex social environment, focusing on intersecting dimensions of identity.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia/psicologia , Hispano-Americanos/psicologia , Obesidade/psicologia , Racismo/psicologia , Discriminação Social/psicologia , Aculturação , Adulto , Transtorno da Compulsão Alimentar/complicações , Índice de Massa Corporal , Peso Corporal , Bulimia/etnologia , Feminino , Disparidades nos Níveis de Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Características de Residência , Discriminação Social/etnologia , Meio Social , Estados Unidos/epidemiologia
7.
PLoS One ; 15(4): e0231106, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32240255

RESUMO

OBJECTIVE: To investigate the influence of acculturation, demonstrated by age on arrival, length of residence, interpreter use and having an Australian-born partner, on disparities observed in the risk of stillbirth between migrant and Australian-born populations in Western Australia (WA). METHODS: A retrospective cohort study using linked administrative health data for all non-Indigenous births in WA from 2005-2013 was performed. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Adjusted odds ratios (aOR) for stillbirth in migrants from six ethnicities of white, Asian, Indian, African, Maori, and 'other', with different levels of acculturation, were compared with Australian-born women using multivariable logistic regression analysis and marital status, maternal age group, socioeconomic status, parity, plurality, previous stillbirth, any medical conditions, any pregnancy complications, sex of baby, and smoking during pregnancy as the covariates. RESULTS: From all births studied, 172,571 (66%) were to Australian-born women and 88,395 (34%) to migrant women. Women from African, Indian and Asian backgrounds who gave birth in the first two years after arrival in Australia experienced the highest risk of stillbirth (aOR 3.32; 95% CI 1.70-6.47, aOR 2.71; 95% CI 1.58-4.65, aOR 1.93; 95% CI 1.21-3.05 respectively) compared with Australian-born women. This association attenuated with an increase in the length of residence in Asian and Indian women, but the risk of stillbirth remained elevated in African women after five years of residence (aOR 1.96 [1.10-3.49]). Interpreter use and an Australian-born partner were associated with 56% and 20% lower odds of stillbirth in migrants (p<0.05), respectively. CONCLUSIONS: Acculturation is a multidimensional process and may lower the risk of stillbirth through better communication and service utilisation and elevate such risk through increase in prevalence of smoking in pregnancy; the final outcome depends on how these factors are in play in a population. It is noteworthy that in women of African background risk of stillbirth remained elevated for longer periods after immigrating to Australia extending beyond five years. For migrants from Asian and Indian backgrounds, access to services, in the first two years of residence, may be more relevant. Enhanced understanding of barriers to accessing health services and factors influencing and influenced by acculturation may help developing interventions to reduce the burden of stillbirth in identified at-risk groups.


Assuntos
Aculturação , Natimorto/epidemiologia , Migrantes , Adolescente , Adulto , Grupos Étnicos , Feminino , Humanos , Razão de Chances , Gravidez , Austrália Ocidental/epidemiologia
8.
PLoS One ; 15(4): e0230809, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32315345

RESUMO

Riverine populations are typical of the Amazon region that depend on nature for subsistence. These people are considered an intermediate population between the urban and indigenous, the original Amazon habitants. The aim of this cross-sectional study was to evaluate the relationship between tooth wear and age in a remote riverine population from the Amazon, located by the Tucumanduba River (n = 94), and to compare them to previous findings obtained from semi-isolated indigenous (n = 223) and urban populations (n = 40) from the Amazon region, which were examined using the same methodology. Using linear regression, tooth wear explained 54.5% of the variation in the ages of the riverine subjects (p<0.001). This coefficient is mid-way between those obtained in semi-isolated indigenous populations (65-86%) and urban subjects (12%) living in the Amazon. Our findings suggest that tooth wear, a direct evidence of what an individual ate in the past, may be an indicator of the acculturation process in remote populations.


Assuntos
Desgaste dos Dentes/epidemiologia , Aculturação , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Populacionais , Rios , População Urbana , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-32235711

RESUMO

With high levels of protein, fiber, folate, iron and other micronutrients, the Dietary Guidelines for Americans recommends eating beans for optimal nutrition. Low-income women are at greater risk of nutrition-related health disparities. Use of beans may change among Hispanic women (Latinas) during acculturation, but few studies exist that describe specific preferences of this important traditional food. Preserving or promoting beans in the diets of all low-income women could improve dietary quality. The study objectives were to describe consumption frequency, purchasing patterns, and attitudes toward dry and canned beans, by acculturation level among Latinas and by ethnicity with non-Hispanic White women. Survey data were collected from 356 women (µ 32 y ± 9 y; 81% Latina), who were enrolled in, or eligible for, a federal nutrition assistance, or unemployment, program in Phoenix, Arizona, USA. Participants had positive attitudes toward beans overall. Less acculturated and bicultural Latinas bought dry beans more often than their peers. Price was considered important in canned bean selection for Non-Hispanic White women, and less acculturated Latinas had poorer attitudes toward canned. Awareness of these attitudes and preferred traits of low-income women suggests ways to message populations to maintain or increase bean consumption. Negative views of canned beans by Latinas should be investigated further. Inclusion of canned beans in nutrition assistance programs may benefit those unfamiliar with preparing dry beans.


Assuntos
Aculturação , Grupos Étnicos , Disparidades nos Níveis de Saúde , Hispano-Americanos , Estado Nutricional , Arizona , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Estados Unidos
10.
Artigo em Inglês | MEDLINE | ID: mdl-32326523

RESUMO

The present study evaluated the application of the basic and extended (incorporated primary caregivers' levels of acculturation) Family Stress Model (FSM) to understand the effect of family financial stress and primary caregivers' levels of acculturation on children's emotional and behavioral problems among refugees in Australia. A total of 658 refugee children aged 5-17 and their primary caregivers (n = 410) from the third wave of a nationwide longitudinal project were included in this study. We used multilevel structural equation models with bootstrapping to test the indirect effects of family financial stress and caregivers' levels of acculturation (including English proficiency, self-sufficiency, social interaction, and self-identity) on children's emotional and behavioral problems through caregivers' psychological distress and parenting styles. The results showed that the extended FSM improved the model fit statistics, explaining 45.8% variation in children's emotional and behavioral problems. Family financial stress, caregivers' English proficiency, and self-identity had indirect effects on children's emotional and behavioral problems through caregivers' psychological distress and hostile parenting. The findings showed that interventions aimed at reducing caregivers' psychological distress and negative parenting could be effective in alleviating the adverse effects of family financial stress and caregivers' low levels of acculturation on refugee children's mental health.


Assuntos
Comportamento Infantil , Renda , Comportamento Problema , Refugiados , Estresse Psicológico , Aculturação , Adolescente , Austrália , Cuidadores , Criança , Pré-Escolar , Saúde da Família , Feminino , Humanos , Masculino , Refugiados/psicologia
11.
BMC Public Health ; 20(1): 292, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32138713

RESUMO

BACKGROUND: Over the last decades, due to high rates of immigration, many high-income countries have witnessed demographic shifts towards more cultural diversity in the population. Socio-economic deprivation and traumatic experiences pre-migration contribute to a high risk for mental health problems among immigrant background youth. Moreover, when adapting to the multi-cultural contexts of the resettlement countries they face several acculturation demands, which may also affect their mental health in adaptive or hazardous ways. One of these acculturation tasks involves developing the cultural competence necessary to thrive and participate socially within the heritage and the majority cultural domains. From a public mental health perspective, it is important to have thorough knowledge about acculturation-related risk and protective factors. However, this responsibility has been challenged by a lack of acculturation measures that are theoretically linked to mental health, and target the cultural competencies of immigrant background youth. Therefore, the current study aimed at examining if a construct of peer-related culture competence, operationalized in the Youth Culture Competence Scale (YCCS), captured the same competence-phenomenon across different language, age, and immigrant groups in two immigrant-receiving countries. The scale includes two dimensions: one of heritage, and one of majority peer-related culture competence. METHODS: Self-report questionnaire data were collected from 895 unaccompanied refugees and 591 immigrant background high school students in Norway, and from 321 immigrant university students in the United States. To examine if the measure assessed the same phenomenon of peer-related culture competence across these three multi-ethnic samples with an age range from 13 to 28, we examined its measurement equivalence. Additionally, we examined if the association between peer-related culture competence and depressive symptoms was similar in these groups. RESULTS: Confirmatory factor analyses supported the proposed two factor structure of the YCCS across the three samples. The structural equation model assessing the effects of heritage and majority culture competence on depressive symptoms confirmed that each culture competence dimension had a unique association with depressive symptoms across the samples. CONCLUSIONS: We conclude that the YCCS is a robust acculturation measure that may be included in public health studies of mental health among multi-ethnic refugee and immigrant samples of varied ages.


Assuntos
Criança Abandonada/psicologia , Competência Cultural , Depressão/epidemiologia , Emigrantes e Imigrantes/psicologia , Refugiados/psicologia , Aculturação , Adolescente , Adulto , Criança Abandonada/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Masculino , Noruega/epidemiologia , Refugiados/estatística & dados numéricos , Instituições Acadêmicas , Autorrelato , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Estados Unidos/epidemiologia , Universidades , Adulto Jovem
12.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32188643

RESUMO

BACKGROUND: Mexican-origin women breastfeed at similar rates as white women in the United States, yet they usually breastfeed for less time. In our study, we seek to identify differences in Mexican-origin women's breastfeeding intentions, initiation, continuation, and supplementation across nativity and country-of-education groups. METHODS: The data are from a prospective cohort study of postpartum women ages 18 to 44 recruited from 8 Texas hospitals. We included 1235 Mexican-origin women who were born and educated in either Texas or Mexico. Women were interviewed at delivery and at 3, 6, 12, 18, and 24 months post partum. Breastfeeding intentions and initiation were reported at baseline, continuation was collected at each interview, and weeks until supplementation was assessed for both solids and formula. Women were classified into 3 categories: born and educated in Mexico, born and educated in the United States, and born in Mexico and educated in the United States. RESULTS: Breastfeeding initiation and continuation varied by nativity and country of birth, although all women reported similar breastfeeding intentions. Women born and educated in Mexico initiated and continued breastfeeding in higher proportions than women born and educated in the United States. Mexican-born and US-educated women formed an intermediate group. Early supplementation with formula and solid foods was similar across groups, and early supplementation with formula negatively impacted duration across all groups. CONCLUSIONS: Nativity and country of education are important predictors of breastfeeding and should be assessed in pediatric and postpartum settings to tailor breastfeeding support. Support is especially warranted among US-born women, and additional educational interventions should be developed to forestall early supplementation with formula across all acculturation groups.


Assuntos
Aleitamento Materno/etnologia , Aculturação , Adulto , Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Escolaridade , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Fórmulas Infantis/estatística & dados numéricos , Recém-Nascido , Intenção , México/etnologia , Mães/educação , Estudos Prospectivos , Texas , Fatores de Tempo , Estados Unidos
13.
Nurs Educ Perspect ; 41(4): 235-240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32168091

RESUMO

BACKGROUND: This is a secondary data analysis of an original study describing the lived experiences of Hispanic/Latinx nursing students as they acculturate into the profession of nursing. METHOD: The original study described the experiences of 11 Hispanic/Latinx new graduates from three baccalaureate nursing programs in the southeastern United States. A secondary data analysis using a theoretical thematic analytical approach with data gathered in the original study was done to determine the utility of the theory of cultural marginality in understanding these student experiences. RESULTS: Findings support aspects of the theory, including marginal living, cross-cultural conflict recognition, and adjustment responses of poise and integration. Personal and contextual influences also impact the acculturation process for these nursing students. CONCLUSION: The theory of cultural marginality is valuable and provides important context for understanding the process that Hispanic/Latinx nursing students experience as they acculturate into nursing.


Assuntos
Aculturação , Bacharelado em Enfermagem/organização & administração , Hispano-Americanos/psicologia , Estudantes de Enfermagem/psicologia , Análise de Dados , Hispano-Americanos/estatística & dados numéricos , Humanos , Pesquisa em Educação de Enfermagem , Sudeste dos Estados Unidos , Estudantes de Enfermagem/estatística & dados numéricos
14.
Diabetes Res Clin Pract ; 161: 108052, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32113027

RESUMO

AIM: We investigated the association between acculturation strategies and cardiometabolic risk among South Asian (SA) immigrants in the US. METHODS: In this cross-sectional analysis of data from 849 SA participants in the Mediators of Atherosclerosis in SAs Living in America (MASALA), we performed multidimensional measures of acculturation to categorize the participants into three acculturation classes: separation (preference for SA culture), assimilation (preference for US culture), and integration (similar preference for both cultures). Differences in glycemic indices, blood pressure, lipid parameters and body composition by acculturation strategy were examined. RESULTS: Women in the integration class had the lowest prevalence of diabetes (16.4%), prediabetes (29.7%), fasting and 2-h glucose compared to women in the separation class with the highest prevalence of diabetes (29.3%), prediabetes (31.5%), fasting and 2-h glucose and 2-hr insulin (all p < 0.05). Women in the assimilation class had significantly lower triglycerides, BMI, and waist circumference and higher HDL compared to women in the separation class after adjusting for age, study site, and years in the US. After additionally accounting for socioeconomic/lifestyle factors, women in the assimilation class had significantly lower triglyceride and higher HDL levels compared to women in the separation class (p < 0.01). There was no significant association between acculturation strategies and cardiometabolic risk in SA men. CONCLUSION: SA women who employed an assimilation or integration strategy had a more favorable cardiometabolic profile compared to women using a separation strategy. Future research should investigate the behavioral and psychosocial pathways linking acculturation strategies with cardiometabolic health to inform preventive interventions among SAs living in America.


Assuntos
Aculturação , Doenças Cardiovasculares/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos
15.
Public Health ; 181: 151-157, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32036172

RESUMO

OBJECTIVES: Depression has been associated with numerous adverse health conditions. This study sought to determine the frequency of significant depressive symptoms and whether or not acculturative stress, discrimination, and reproductive health conditions were risk factors for significant depressive symptoms in migrant working women in China. STUDY DESIGN: The design of this study is cross-sectional. METHODS: Data were derived from a survey of female migrant workers at three employment sites in Changsha, China. The associations between acculturative stress, discrimination, reproductive health, and risk for significant depressive symptoms were obtained using F-tests for mean differences, correlations, ordinary least squares regression, and logistic regression analysis. RESULTS: Between March and June 2017, 232 eligible female participants completed the survey among whom the median age was 34.36 years (standard error 0.43) and 25.58% reported significant depressive symptoms. Significant depressive symptoms were associated with higher education (F-test, P = .006), all four acculturative stress factors (r = 0.15 to r = 0.29), both institutional and interpersonal discrimination (r = 0.29, r = 0.35), age (r = - 0.13), and self-rated health (r = - 0.19). In multivariate regression analysis of depression scale scores, interpersonal discrimination was the strongest predictor (beta = 0.238, P = .002) among the nine factors identified in bivariate analysis. None of the other predictors (age, self-rated health, education, acculturative stress, and institutional discrimination) showed significant associations with the depression scale. Similar results were obtained for a multivariate logistic regression analysis of a clinically important threshold for depression (<10 versus ≥ 10 on the depression scale). Only interpersonal discrimination significantly distinguished between clinical depression categories (odds ratio = 2.607 per unit change in the index, P = .001). CONCLUSIONS: Migrant women workers in China appear to be at risk for significant depressive symptoms, and interpersonal discrimination appears to be an important risk factor in this setting. Acculturative stress and institutional discrimination may also be relevant risk factors, as suggested in our bivariate analysis, but in our sample, the correlations between the stress and discrimination factors are high enough to compromise identification of unique associations between acculturation stress and depression. Government, community and workplace education, and psychosocial services for migrant women are recommended.


Assuntos
Aculturação , Depressão/etnologia , Transtorno Depressivo/etnologia , Discriminação Psicológica , Saúde Reprodutiva/etnologia , Estresse Psicológico/etnologia , Migrantes/psicologia , Adulto , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Fatores de Risco , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
16.
J Consult Clin Psychol ; 88(2): 149-159, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31894996

RESUMO

BACKGROUND: The Acculturative Process and Context Framework (Ward & Geeraert, 2016) proposes that acculturative stressors influence psychological well-being over time. In fact, extant literature has linked bicultural stress with psychological functioning; yet, no studies have explored the causal dominance of bicultural stress. The purpose of the present study was to evaluate the directionality of prospective relations among bicultural stress and psychosocial functioning (i.e., depressive symptoms, hopefulness, and self-esteem) in Latinx immigrant adolescents across 5 waves. METHOD: There were 303 Latinx adolescents who were recruited for this study from Los Angeles and Miami and were assessed across 5 waves at 6-month intervals. Adolescents were 14.50 years old on average (SD = .88) and 53.16% were male. Adolescents reported living in the United States for 2.07 years on average (SD = 1.87). A Random-Intercept Cross-Lagged Panel Model (RI-CLPM) was used to examine the between- and within-person relations among bicultural stress, depressive symptoms, hopefulness, and self-esteem in a comprehensive model. RESULTS: The comprehensive RI-CLPM including bicultural stress, depressive symptoms, hopefulness, and self-esteem exhibited excellent model fit. Between-person, trait-like relations among constructs ranged from small to large, as expected. Within-person, cross-lagged estimates among constructs were overall inconsistent, with some evidence that, within individuals, self-esteem influences later hopefulness. CONCLUSION: Findings from this study indicate that the RI-CLPM is an effective strategy to examine bicultural stress and well-being processes among adolescents. There is a need for further research examining bicultural stress among Latinx immigrant youth, particularly within prevention and intervention studies. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Assuntos
Aculturação , Emigrantes e Imigrantes/psicologia , Saúde Mental , Autoimagem , Estresse Psicológico/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Depressão/psicologia , Feminino , Esperança , Humanos , Masculino , Estados Unidos
17.
BMC Public Health ; 20(1): 111, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992248

RESUMO

BACKGROUND: Oral disease is a serious public health issue, and Hispanic children in the United States (US) are more likely than children of other racial/ethnic groups to experience dental caries. Although Hispanic children are a growing segment of the US population there is limited research on the association between acculturation and oral health outcomes in this population. This study examined the associations between household acculturation and pediatric oral health in the Hispanic population using a nationally representative sample of children. METHODS: Data from the 2011-2012 National Survey of Children's Health were analyzed; analyses included Hispanic children ages 1 to 17. Household acculturation was assessed with a combination of language and parental nativity, while oral health was assessed via parents'/guardians' reports of children's dental caries. Logistic regression was used to examine the association between acculturation and oral health, adjusting for other demographic and social determinants of pediatric oral health. We assessed significance at the p < 0.05 level, and all analyses accounted for the survey's complex sample design. RESULTS: Analyses included 9143 Hispanic children. In total, 24.9% (95% CI: 22.9-27.0%) experienced dental caries, and there were significant associations between household acculturation and oral health. In unadjusted analyses, 32.0% (95% CI: 28.9-35.4%) of children in low acculturation households, 20.3% (95% CI: 16.0-25.4%) of children in moderate acculturation households, and 16.9% (95% CI: 14.2-20.0%) of children in high acculturation households experienced dental caries (p < 0.001). In adjusted analyses, children in high acculturation households were significantly less likely than those in low acculturation households to experience dental caries (p < 0.001; OR = 0.50; 95% CI: 0.35-0.70). The difference between children in moderate and low acculturation households approached but did not reach statistical significance (p = 0.057; OR = 0.69; 95% CI: 0.48-1.01). CONCLUSIONS: A dose-response relationship was observed between household acculturation and the oral health of Hispanic children in the US. As acculturation increases, the likelihood of a child experiencing dental caries decreases. These findings suggest that public health and community-based interventions intended to reduce oral health disparities in Hispanic children would likely be most impactful if the acculturation levels of the children's households are considered during program development.


Assuntos
Aculturação , Cárie Dentária/etnologia , Disparidades nos Níveis de Saúde , Hispano-Americanos/estatística & dados numéricos , Saúde Bucal/etnologia , Adolescente , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Estados Unidos/epidemiologia
18.
BMC Public Health ; 20(1): 38, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924196

RESUMO

BACKGROUND: Families resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. These families must cope with experiences of armed conflict and forced migration while also assimilating to a new society. According to the 'immigrant paradox,' time spent in a new country can compound the effects of migration and assimilation challenges and lead to deteriorated mental health. This study aims to assess the psychosocial wellbeing of MENA-born or first-generation adolescents attending school in the Detroit metropolitan area (DMA) to understand how schools, families, and communities play a role in supporting these adolescents' wellbeing. METHODS: The quantitative component of this mixed methods study will involve a self-administered survey with a sample of students whose responses will be linked to academic records and behavioral assessments. The survey will utilize validated instruments to measure depressive and anxiety symptoms (Hopkins Symptom Checklist-37A), hope (Children's Hope Scale), resilience (Child and Youth Resilience Measure-12), externalizing and prosocial behavior (Hopkins Symptom Checklist-37A, Strengths and Difficulties Questionnaire), school belonging (Psychological Sense of School Membership), and peer relationships (Multidimensional Scale of Perceived Social Support). Differences in outcomes will be analyzed across two strata: students born in the MENA region and first-generation students whose parents immigrated to the US from the MENA region. The qualitative component will involve semi-structured key informant interviews with parents, school administrators, educators, and mental health providers, and focus group discussions (FGDs) with a purposive sample of adolescents born - or whose parents were born - in the MENA region. The FGDs will include a participatory ranking activity where participants will be asked to free-list and rank ideas about how schools can better support students like them. Thematic content analysis will be conducted to identify common themes. DISCUSSION: This study will contribute evidence about the wellbeing of adolescents who come from - or whose parents come from - conflict-affected countries currently living in the U.S. Findings can be used to inform program and policy development to enable schools and their community partners to serve this population more effectively.


Assuntos
Conflitos Armados/psicologia , Emigrantes e Imigrantes/psicologia , Transtornos Mentais/epidemiologia , Refugiados/psicologia , Apoio Social , Aculturação , Adaptação Psicológica , Adolescente , África do Norte/etnologia , Cidades , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Família/psicologia , Feminino , Humanos , Masculino , Michigan/epidemiologia , Oriente Médio/etnologia , Pesquisa Qualitativa , Refugiados/estatística & dados numéricos , Instituições Acadêmicas , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
19.
BMC Public Health ; 20(1): 42, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31924212

RESUMO

BACKGROUND: Overweight and obesity are important risk factors for chronic non-communicable diseases, and their prevalence is on the rise worldwide. This study seeks to describe the prevalence and predictors of overweight and obesity in Brazilian immigrants living in Massachusetts, United States of America (USA). METHODS: Modeled after a survey on behavioral risk factors for chronic disease conducted annually in Brazil (Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico: Vigitel), Brazilian immigrants aged 18+ (n = 361) were surveyed between December 2013 and March 2014. Information was obtained from consenting participants regarding their demographic characteristics, physical activity, dietary and lifestyle habits, and other behavioral risk factors. Weight status was estimated from body mass index (BMI), calculated from self-reported height and weight data. Participants were categorized as overweight/obese if their BMI was ≥25; overweight and obese categories were combined to ensure appropriate sample size. Prevalence of overweight/obesity was estimated using STATA, and significant predictors were identified via multi-variable logistic regression. Odds ratio (OR), 95% confidence intervals (95% CI) and p-values were determined. RESULTS: The overall prevalence of overweight/obesity in the sample was 47.6%. Significant predictors of overweight and obesity were gender (men OR 2.30, 95% CI: 1.10, 3.78; women are comparison group), working in the 3 months prior to the survey (OR 2.90, 95% CI: 1.01, 8.30), and longer duration living in the USA (OR per additional year 1.06, 95% CI: 1.02, 1.11). Significant dietary predictors of overweight/obesity included 5 or more days per week of consumption of red meat (OR red meat 3.70, 95% CI: 1.47, 9.26) or of sweetened beverages, like soft drinks also known as soda (OR soda 2.40, 95% CI: 1.00, 5.78) compared with less frequent consumption of these foods. CONCLUSIONS: This study suggests that long duration of time lived in the USA increases odds of overweight and obesity for Brazilian immigrants living in Massachusetts. Efforts to curb increases in overweight and obesity in this population should focus not only on the men and those who work but also the women. Possible intervention measures should target soda (soft drink) and red meat consumption in Brazilian immigrants.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Aculturação , Adolescente , Adulto , Idoso , Brasil/etnologia , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Feminino , Humanos , Masculino , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
20.
Obstet Gynecol ; 135(2): 301-309, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31923068

RESUMO

OBJECTIVE: To evaluate the relationship between acculturation and adverse pregnancy outcomes, and whether these relationships differ across racial or ethnic groups. METHODS: This is a planned secondary analysis of the nuMoM2b study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be), a prospective observational cohort study of 10,038 pregnant women at eight academic health care centers in the United States. Nulliparous pregnant women with singleton gestations were recruited between 6 0/7 and 13 6/7 weeks of gestation from October 2010-September 2013. Acculturation was defined by birthplace (United States vs non-United States), language used during study visits (English or Spanish), and self-rated English proficiency. The adverse pregnancy outcomes of interest were preterm birth (less than 37 weeks of gestation, both iatrogenic and spontaneous), preeclampsia or eclampsia, gestational hypertension, gestational diabetes, stillbirth, small for gestational age, and large for gestational age. Multivariable regression modeling was performed, as was an interaction analysis focusing on the relationship between acculturation and adverse pregnancy outcomes by maternal race or ethnicity. RESULTS: Of the 10,006 women eligible for this analysis, 8,100 (80.9%) were classified as more acculturated (eg, born in the United States with high English proficiency), and 1,906 (19.1%) were classified as having less acculturation (eg, born or not born in the United States with low proficiency in English or use of Spanish as the preferred language during study visits). In multivariable logistic regression modeling, more acculturation was significantly associated with higher frequency of preterm birth (odds ratio [OR] 1.46, adjusted odds ratio [aOR] 1.50, 95% CI 1.16-1.95); spontaneous preterm birth (OR 1.54, aOR 1.62, 95% CI 1.14-2.24); preeclampsia or eclampsia (OR 1.39, aOR 1.31, 95% CI 1.03-1.67); preeclampsia without severe features (OR 1.44, aOR 1.43, 95% CI 1.03-2.01); and gestational hypertension (OR 1.68, aOR 1.48, 95% CI 1.22-1.79). These associations did not differ by self-described race or ethnicity. CONCLUSION: In a large cohort of nulliparous women, more acculturation, regardless of self-described race or ethnicity, was associated with increased odds of several adverse pregnancy outcomes. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01322529.


Assuntos
Aculturação , Hipertensão Induzida pela Gravidez/etnologia , Complicações na Gravidez/etnologia , Resultado da Gravidez , Nascimento Prematuro/etnologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Idade Gestacional , Hispano-Americanos/estatística & dados numéricos , Humanos , Recém-Nascido , Modelos Logísticos , Análise Multivariada , Gravidez , Estudos Prospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
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