Mothers and Babies Virtual Group (MBVG) for perinatal Latina women: study protocol for a hybrid type-1 effectiveness-implementation randomized controlled trial.

BACKGROUND: Immigrant Latinas (who are foreign-born but now reside in the USA) are at greater risk for developing postpartum depression than the general perinatal population, but many face barriers to treatment. To address these barriers, we adapted the Mothers and Babies Course-an evidence-based intervention for postpartum depression prevention-to a virtual group format. Additional adaptations are inclusion of tailored supplemental child health content and nutrition benefit assistance. We are partnering with Early Learning Centers (ELC) across the state of Maryland to deliver and test the adapted intervention. METHODS: The design is a Hybrid Type I Effectiveness-Implementation Trial. A total of 300 participants will be individually randomized to immediate (N = 150) versus delayed (N = 150) receipt of the intervention, Mothers and Babies Virtual Group (MB-VG). The intervention will be delivered by trained Early Learning Center staff. The primary outcomes are depressive symptoms (measured via the Center for Epidemiologic Studies-Depression Scale), parenting self-efficacy (measured via the Parental Cognition and Conduct Towards the Infant Scale (PACOTIS) Parenting Self-Efficacy subscale), and parenting responsiveness (measured via the Maternal Infant Responsiveness Instrument) at 1-week, 3-month, and 6-month post-intervention. Depressive episodes (Structured Clinical Interview for DSM-V- Disorders Research Version) at 3-month and 6-month post-intervention will also be assessed. Secondary outcomes include social support, mood management, anxiety symptoms, perceived stress, food insecurity, and mental health stigma at 1-week, 3-month, and 6-month post-intervention. Exploratory child outcomes are dysregulation and school readiness at 6-month post-intervention. Intervention fidelity, feasibility, acceptability, and appropriateness will also be assessed guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. DISCUSSION: This study will be one of the first to test the efficacy of a group-based virtual perinatal depression intervention with Latina immigrants, for whom stark disparities exist in access to health services. The hybrid effectiveness-implementation design will allow rigorous examination of barriers and facilitators to delivery of the intervention package (including supplemental components) which will provide important information on factors influencing intervention effectiveness and the scalability of intervention components in Early Learning Centers and other child-serving settings. REGISTRATION: ClinicalTrials.gov NCT05873569.

A qualitative study exploring the perinatal experiences of social stress among first- and second-generation immigrant parents in Quebec, Canada.

BACKGROUND: Perinatal psychological distress adversely impacts the well-being and social adjustment of parents and their children. Expectant parents who have migrated may be at higher risk for perinatal psychological distress due to various migration-specific stressors and healthcare service barriers. Limited studies have examined the perceived determinants of perinatal distress in immigrant parents, particularly men. This study explored first and second-generation immigrant parents' lived experiences of social stressors and facilitators of perinatal psychological well-being. METHODS: Participants were recruited by convenience and purposive sampling as part of a larger study. Semi-structured interviews were conducted virtually with first and second-generation immigrant women and men in Quebec, Canada. An inductive thematic analysis was performed. RESULTS: Sixteen women (age = 34.8 ± 3.7 years) and ten men (age = 35.1 ± 4.9 years) from various ethnic backgrounds participated in the study at 7.4 ± 0.73 and 7.5 ± 0.72 months postpartum, respectively. Three themes were identified: (1) cultural pressures (cultural differences in parenting, gender-related cultural pressures, health and baby-related practices), (2) health and social service access (social benefits and resources, and systemic barriers in health care), and (3) discrimination (physical appearance or parental-related discrimination, gender-related discrimination, ethnic-related discrimination). First-generation immigrant parents reported greater acculturative stress (i.e. mental health stigma, health care access) and ethnic discrimination concerns related to their distress. Among men, barriers include feeling as though the paternal role was devalued by society and not receiving consideration by health care. CONCLUSIONS: Our results highlight different social factors of perinatal well-being perceived by men and women from various ethnic and immigration backgrounds during the perinatal period. Perceived factors include macro-level factors, such as a country's social climate, health and social policies and services, and social aspects of acculturative stress. Our findings suggest the need for continued efforts to challenge and eliminate discriminatory practices. Interventions and resources directed at first-generation immigrant parents should be bolstered. Understanding what parents perceive to facilitate or hinder their psychological well-being can help inform the development of tailored evidence-based programs and policies to better meet the mental health needs of Canadians and reduce gender disparities in the treatment of perinatal distress.

Oral health-related quality of life and its association with sense of coherence and social support among Yemeni immigrants in Malaysia.

Oral health problems prove to be a significant public health issue due to their high prevalence and their impacts on people's self-confidence and basic physical functions such as talking, chewing and smiling, all of which affect an individual's social role. For that, this study aims to determine oral health-related quality of life (OHRQoL) and its association with a sense of coherence (SOC) and perceived social support among Yemeni adults residing in Malaysia. Data was collected from 223 Yemeni adults residing in Malaysia for over a year. The data collection instruments used were: a short version of the sense of coherence Scale (SOC-13), a new short version of the oral health impact profile (OHIP-5) questionnaire, the multidimensional scale of perceived social support (MSPSS), and a questionnaire containing socio-demographic and oral health behaviours information. Simple and adjusted binary logistic regression analyses with the level of significance p < 0.05 were used to determine the association between the independent factors and OHRQoL. Negative impacts on quality of life due to oral health issues were reported by (57.8%) of the participants, and a statistically significant association between SOC and OHRQoL was found; participants with weak SOC were more likely to have a negative impact on their OHRQol than individuals with strong SOC (AOR = 2.8, 95% CI 1.4-5.5). Additionally, self-assessment of oral health as poor (AOR = 4.6, 95% CI 1.5-14.1) were also associated with a negative impact OHRQoL. On the other hand, this study found that a longer period since the last dentist visit was a protective factor against negative impacts on quality of life (p < 0.05). In terms of perceived social support, no association was found between any categories of perceived social support and OHRQoL. In Conclusion, sense of coherence showed a statistically significant association with OHRQoL, emphasizing psychological factors' potential role in oral health. The findings support the hypothesis that SOC is a psychosocial determinant that could act as a protective factor against negative impact on OHRQoL.

The associations between social support and mental health among Chinese immigrant pregnant and parenting women.

BACKGROUND: While it is recognized that social support can alleviate mental health symptoms, this relationship is not well-understood among Chinese pregnant and parenting immigrants in the United States. This study aims to bridge this gap by exploring the relationships between different types of social support and women's anxiety and depression, and examining how these associations vary with pregnancy status. METHODS: Data were obtained from a cross-sectional survey conducted in Simplified Chinese or Mandarin between March-June 2021 among 526 women who were pregnant and/or parenting a child under five years. The Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, and Social Support scales were used to measure anxiety, depression, and social support levels. Descriptive statistics, t-tests, chi-square tests, and Pearson's correlations were employed for analysis. Hierarchical regression was conducted to investigate the main and interaction effects of social support types and pregnancy status on mental health outcomes. RESULTS: Compared to non-pregnant women, pregnant women reported higher mean scores for anxiety (non-pregnant: 55, pregnant: 59, p < 0.01) and depression (non-pregnant: 54, pregnant: 56, p = 0.02). Instrumental support displayed a significant main effect in relation to anxiety (ß=-0.13, p = 0.01) and depression (ß=-0.16, p < 0.01); emotional support exhibited a significant main effect solely on depression (ß=-0.13, p = 0.01). Notably, the interaction effects between pregnancy status and both instrumental (ß=-0.28, p = 0.01) and emotional support (ß=-0.42, p < 0.01) were significant for anxiety. In contrast, informational support did not exhibit a significant impact on either anxiety or depression. CONCLUSIONS: The findings indicate that tailoring support to the cultural context is crucial, especially for pregnant women in this Chinese immigrant community, with instrumental and emotional support being particularly beneficial in mitigating maternal anxiety.

Use and perception of risk: traditional medicines of Pakistani immigrants in Norway.

BACKGROUND: Pakistani immigrants are the largest non-Western ethnic minority group in Norway. Traditional medicines (TM) are extensively used in Pakistan, and studies show that ethnic minorities also use them to recover from illness after migration to the Western world. This study aims to explore Pakistani immigrants' experiences and perceptions of risk regarding the use of TM to treat illnesses. METHODS: A qualitative study was conducted through in-depth interviews (n = 24) with Pakistani immigrants in Norway from February to March 2023. Participants were recruited through purposive and snowball sampling methods. The data was analyzed using Braun & Clarke's reflexive thematic analysis (RTA) using Nvivo. RESULTS: RTA revealed three main themes and six sub-themes. The main themes were: (a) House of knowledge, (b) Choosing the best possible approach for health restoration, and (c) Adverse effects of TM used. A total of 96 different TM were identified, including herbs, food items, animal products, minerals, herbal products, and ritual remedies. All participants used TM to restore health in acute and chronic diseases, and many used TM along with conventional medicines. The participants' mothers were the primary source of knowledge about TM, and they passed it on to the next generation. They also frequently used religious knowledge to recover from illness. Although TM is considered safe because of its natural origin, some participants experienced adverse effects of TM, but none of them reported it to the health authorities. CONCLUSION: The study helps to understand the experiences and perceptions of risk of Pakistani immigrants in Norway regarding traditional practices for treating health complaints. Public health policies to improve the health of these immigrants should consider the importance of TM in their lives. Further research is necessary to explore the safety and toxicity of those TM that are common in Pakistani households in Norway.

[Address implicit bias and cultural misinterpretation in health care: improve the quality of care for patients with a migration background]. / Pak onbewuste bias en culturele misinterpretatie aan.

Dutch physicians are increasingly encountering patients with a migration background. Research indicates that this group is more likely to receive suboptimal quality of care than those without a migration background. Despite the intention to treat all their patients equally, the behaviour and professional decisions of physicians can sometimes contribute to this inequality. Various factors play a role in this. This paper addresses some factors that have been insufficiently highlighted in the Netherlands to date: implicit biases and cultural misinterpretation. These factors can contribute to discrimination, misunderstanding, medication non-adherence, and negatively impact healthcare outcomes. We conclude with practical tips and the prerequisites for a multidimensional, long-term approach to addressing these issues.

A Randomized Controlled Trial of Two Parent-Child Parallel Interventions to Enhance Positive Adaptation of Immigrant Families in Hong Kong: The Moderating Role of Depressive Symptoms.

Parents and children who have recently immigrated from the Chinese mainland to Hong Kong face various challenges, including psychological and sociocultural adaptation difficulties. In collaboration with community partners, our research team has developed and implemented culturally sensitive and preventive parent-child parallel interventions to enhance positive adaptation among immigrant parents and children. Two interventions were conducted in this randomized controlled trial: an emotion regulation (ER) arm, which addressed psychological adaptation by reducing parent-child conflicts and improving emotions, and an information provision (IP) arm targeting sociocultural adaptation by increasing participants' knowledge about Hong Kong. The study randomly assigned 113 and 73 parent-child pairs (allocation ratio 3:2) into the ER and IP arms, respectively. Parents and children attended four two-hour weekly sessions of their assigned intervention and completed assessments before, immediately after, and one month following the intervention. The results showed that in the ER arm, parents showed improved positive affect, and children reported decreases in parent-child conflicts more than their counterparts in the IP arm. In the IP arm, parents and children increased their knowledge, and parents decreased sociocultural adaptation difficulties more than their counterparts in the ER arm. In addition, the moderation analyses showed that in both interventions, parents and children with elevated baseline depressive symptoms obtained greater benefits relative to their counterparts with fewer symptoms. Such marked improvements were seen among parents in negative affect and adaptation difficulties and among children in parent-child conflict, positive and negative affect in the ER arm. More improvements were noted among parents in negative affect and sociocultural adaptation difficulties and among children in negative affect in the IP arm. Future studies are suggested to develop and provide parent-child parallel interventions targeting both psychological and sociocultural adaptations to parents and children with heightened baseline depressive symptoms to facilitate their positive adaptation in Hong Kong.

Perceptions of breast cancer screening programs and breast health among immigrant women: Qualitative study in Alberta.

OBJECTIVE: To examine how women who have emigrated from the Middle East and North Africa (MENA) region perceive breast cancer risk and screening in Canada and how they approach breast health, and to explore barriers to breast cancer screening in this population. DESIGN: Focused ethnography. SETTING: Edmonton, Alta. PARTICIPANTS: Women who were born in MENA countries (eg, Egypt, Iraq, Lebanon, Libya, Saudi Arabia, Somalia, Sudan, and Syria) and had immigrated to Canada less than 5 years prior to study recruitment and lived in Edmonton, Alta. METHODS: Six focus groups were conducted over a 6-week period in July and August 2018 with 6 participants in each group (N=36); results were analyzed thematically. MAIN FINDINGS: Three broad themes were identified: knowledge about breast health, cancer risk, and screening services; barriers to maintaining breast health and to screening; and potential solutions for overcoming these barriers. Findings indicated participants have limited knowledge about breast cancer screening practices in Alberta and that multiple barriers to screening remain. CONCLUSION: This study can help inform the development of culturally appropriate interventions to overcome barriers and to motivate women from MENA countries to use breast cancer screening.

The role of culturally appropriate interpersonal communication strategies to reduce hepatitis B and liver cancer disparities.

Introduction: Asian and Pacific Islander (API), African, and Caribbean immigrant groups in the U.S. are disproportionately impacted by chronic hepatitis B and hepatocellular carcinoma (primary liver cancer). Creating educational communication campaigns about hepatitis B and liver cancer for these communities is necessary to increase disease-related awareness and prompt health-promoting behaviors. Identifying interpersonal communication (IPC) preferences within diverse communities for integration into an educational campaign that emphasizes the link between hepatitis B and liver cancer can ultimately promote uptake of screening, vaccination and linkage to appropriate care. Methods: Fifteen focus groups and two key informant interviews were conducted with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Data were analyzed using thematic coding and analysis. Results: Findings demonstrate that all communities preferred that materials be offered in both English and native languages and emphasized that campaigns highlight the connection between hepatitis B and liver cancer. Educational sessions should take place in settings where communities feel safe, including community-based organizations, religious establishments, and healthcare offices, and should be facilitated by trusted messengers, including patient navigators, doctors and faith leaders. Presenting accurate information and dispelling myths and misconceptions around hepatitis B, liver cancer, and their connection were the biggest needs identified across all focus groups. Discussion: This study provides insight into community-specific preferences for learning about hepatitis B and liver cancer through IPC methods. The findings from this study can be used to design multi-platform, culturally and linguistically appropriate health education campaigns to facilitate improved diagnosis, prevention, and management of hepatitis B and liver cancer among heavily impacted communities in the U.S.

Application of the Social Cognitive Theory amid food parenting practices of Black immigrant mothers in the US: A qualitative study.

BACKGROUND: Children of Black immigrant parents living in the US are at elevated risk of being overweight or obese, thus increasing their risks of morbidity and mortality as they age. Parents play a crucial role in shaping their children's nutrition through their food parenting practices. The Social Cognitive Theory (SCT) can explain Black immigrant mother's FPP and their children's dietary behavior. This study aimed to assess SCT's constructs, personal (maternal knowledge, attitudes, beliefs) and environmental factors (acculturation) in relation to the behavioral factor (food parenting practices) among a sample of Black immigrant mothers living in Metro Atlanta, Georgia. METHODS: Convenience sampling was employed to recruit 30 Black immigrant mothers who lived in seven Metro Atlanta, Georgia counties in the summer of 2022. Four focus group interviews were conducted over two weeks. The qualitative data analysis was thematic. RESULTS: Focus group data analysis revealed seven major themes: knowledge, attitude, belief, modeling, acculturation, coercive control, and structure, and six subthemes. Mothers discussed being intentional about encouraging healthy foods and limiting unhealthy foods for their children. Overall, acculturation influenced mothers' food parenting practices. Since migrating to the US, some mothers' nutrition changed in positive (e.g., eating more fruits) and negative ways (e.g., snacking more) because of schedules, cost, and access. Children ate a mixed diet, the mother's native diet and the American diet, and the former was considered healthier and affordable by most. CONCLUSION: This is the first study to look at the food parenting practices of Black immigrants in the US. By identifying key factors that influence the food parenting practices of this population and their children's dietary habits, this study's findings are useful to practitioners or researchers who work with this population on nutrition.

Breast Cancer Screening among African Immigrants in the United States: An Integrative Review of Barriers, Facilitators, and Interventions.

The purpose of this review was to synthesize the available literature on breast cancer-screening barriers, facilitators, and interventions among U.S. African immigrants. Following the integrative review framework and PRISMA guidelines for reporting systemic reviews, five electronic databases were searched: PubMed, CINAHL, PsycINFO, Medline, and Google Scholar. Studies were included if they were published in English language journals after 1 January 2000 and reported data on breast cancer-screening barriers, facilitators, or interventions among U.S. African immigrants. Barriers and facilitators reported by studies were descriptively examined and synthesized by two authors and classified as aligning with one of the three levels of influences based on the social-ecological model (intrapersonal, interpersonal, and community). Interventions promoting breast cancer screening were narratively summarized. Search procedures retrieved 1011 articles, with 12 meeting the criteria for inclusion in the review (6 qualitative and 6 quantitative). Intrapersonal barriers included limited awareness, fear of pain, language barriers, health concerns, transportation issues, costs, and negative past experiences. Interpersonal barriers involved modesty, spiritual beliefs, and lack of support, while community-level barriers included provider and healthcare-system challenges. Regarding facilitators, past screening experiences and health insurance were the most commonly reported intrapersonal facilitators. The only interpersonal facilitator identified was observing other women experience a breast cancer diagnosis and undergo treatment. Community-level facilitators included appointment reminders, scheduling assistance, culturally congruent interpreters, transportation to screening facilities, and patient navigators. Three articles reported outcomes of breast cancer-screening interventions. All three were pilot studies and reported increased knowledge and attitudes regarding breast cancer screening following the respective interventions. One study examined the uptake of breast cancer screening following the intervention, with results indicating an increase in screening. Findings provide a comprehensive synthesis of factors influencing breast cancer screening among African immigrants and highlight the need for future research on the topic. This review was registered with Prospero (CRD42024502826) before the initiation of search procedures.

Myanmar immigrant women's perceptions, beliefs, and information-seeking behaviors with nutrition and food practices during pregnancy in Thailand: a qualitative study.

BACKGROUND: Although nutrition is an essential contributor to the quality of pregnancy outcomes, little is known about the experiences and influences affecting dietary behaviors during pregnancy among migrant women, particularly those from Myanmar, the largest immigrant population in Thailand. To fill this gap, we conducted a descriptive qualitative study to explore Myanmar immigrant women's perceptions, beliefs, and information-seeking behaviors concerning nutrition and food practices during pregnancy. METHODS: We conducted focus group discussions (FGDs) with fifty Myanmar immigrant pregnant women aged 18-45 years across all trimesters, who were recruited using purposive sampling from a public tertiary hospital. The FGDs were conducted in Thai or Myanmar using semi-structured guides that probed women's pregnancy perceptions and experiences about nutrition and food patterns during pregnancy. The FGDs were audio-recorded, translated, and transcribed. Direct content analysis was used to guide the analysis through an ecological perspective framework. RESULTS: The seven FGDs with fifty women revealed four major themes involving perceptions, beliefs, and information-seeking behaviors. The qualitative results consisted of (1) a positive attitude toward better changes under difficult conditions (setting goals for infant health; uncertainty about changes); (2) beliefs about eating patterns and dietary practices during pregnancy (taboos aimed at protecting women's health and ensuring safe childbirth; taboos aimed at guaranteeing infant safety); (3) limited access to appropriate information about nutrition (unclear dietary information from healthcare providers; ease of learning from experiences in informal social networks); and (4) difficult living conditions in a non-native setting (work-related influences on dietary behaviors; lack of comprehensible language to gain food literacy). In addition, the results were highlighted across four levels of ecological perspectives. CONCLUSIONS: Immigrant pregnant women are a vulnerable population that should be treated with equity to ensure quality of life through optimal nutrition throughout pregnancy. Respectful care requires that healthcare providers develop culturally sensitive nutrition interventions to increase nutrition literacy, accessibility, and pregnancy outcomes.

Breast Health Perceptions and Screening Behaviors Among Myanmar American Immigrant Women.

OBJECTIVES: To understand and describe attitudes toward general health checkups, breast health knowledge, cultural beliefs, and health-promoting behaviors among Myanmar American immigrant women in the United States. SAMPLE & SETTING: 267 women participated in the study. 10 women were excluded because of missing data, so the total sample size was 257 participants. METHODS & VARIABLES: A descriptive, cross-sectional survey design was used to describe and investigate breast health perceptions and behaviors. RESULTS: Nearly 75% of the study sample reported having negative attitudes toward general health checkups and were found to have less accurate breast health knowledge and more fatalistic views about breast cancer. Only 29% of older women adhered to mammogram recommendations. Younger women reported more barriers to mammograms, and older women reported fewer barriers to mammograms. IMPLICATIONS FOR NURSING: This study demonstrated the need for additional research focusing on unique perspectives when investigating breast health practices among Myanmar American immigrant women. The findings highlight the essential need to build a strong partnership with stakeholders to combat breast health disparities and address the complex nature of acculturation.

Vaccine hesitancy throughout the COVID-19 vaccination trajectory among immigrant and non-immigrant older adults: a cohort study.

OBJECTIVES: The aims of this study were to examine vaccine hesitancy for COVID-19 vaccinations, comparing immigrant and non-immigrant older adults (aged ≥60 years), after accounting for group-level and individual-level characteristics, and the interaction between immigrant and socio-economic status. STUDY DESIGN: This study used a retrospective cohort design. METHODS: Analyses were conducted using R version 4.3.2. Logistic regression models had the dependent variables of obtained any COVID-19 vaccinations vs not and obtained all four required COVID-19 vaccinations vs not. The linear regression model's dependent variable was the interval in days between the COVID-19 vaccination availability and the date of obtaining the first COVID-19 vaccination. RESULTS: In the cohort of older adults (n = 35,109), immigrants were less likely than non-immigrants to obtain a single COVID-19 vaccination (P < 0.001) or the full series of required COVID-19 vaccinations (P < 0.001); however, immigrants vs non-immigrants delayed only in obtaining the first vaccination (P < 0.001) but not the remaining required COVID-19 vaccinations. In the linear regression model, a longer interval before obtaining the first COVID-19 vaccination was associated with immigrant status (P < 0.001), lower socio-economic status (SES; P < 0.001), and the interaction between immigrant status and low SES (P < 0.001), while a shorter interval was associated with preventive behaviours of obtaining seasonal influenza (P < 0.001) or pneumococcal (P < 0.001) vaccinations previously. CONCLUSIONS: Immigrant status in general, and especially when combined with low SES, is a major risk factor for vaccination hesitancy. Reorienting immigrants to embrace preventive healthcare behaviours is key. Culturally appropriate communication campaigns may improve the dissemination of effective vaccination-related information to immigrant communities.

Intergroup evaluative bias in facial representations of immigrants and citizens in the United States.

We used a reverse-correlation image-classification paradigm to visualize facial representations of immigrants and citizens in the United States. Visualizations of immigrants' faces were judged by independent raters as less trustworthy and less competent and were more likely to be categorized as a non-White race/ethnicity than were visualizations of citizens' faces. Additionally, image generators' personal characteristics (e.g., implicit and explicit evaluations of immigrants, nativity status) did not reliably track with independent judges' ratings of image generators' representations of immigrants. These findings suggest that anti-immigrant sentiment and racial/ethnic assumptions characterize facial representations of immigrants in the United States, even among people who harbor positivity toward immigrants.

Childhood vaccination among Polish immigrants in Norway: a qualitative study.

BACKGROUND: Confidence in childhood vaccination is high in Norway and the Norwegian Childhood Immunization Programme (NCIP) achieves high overall coverage rates. However, lower coverage has been observed for some immigrant groups, including Polish immigrants who represent the largest immigrant group in Norway. Anti-vaccine sentiments and increased refusal of mandatory childhood vaccination has been on the rise in Poland, but it is unknown whether such attitudes also apply to Polish immigrants in Norway, as they experience a different vaccination policy and perhaps also different attitudes to vaccines. This qualitative study aims to explore attitudes towards childhood vaccination in Norway among Polish immigrants. METHODS: We interviewed 15 Polish parents living in Norway in 2022. We recruited the participants by purposive sampling and analyzed the interviews by reflexive thematic analysis. RESULTS: Three themes were identified: views of childhood vaccination, vaccine hesitancy, and differences in childhood vaccination between Poland and Norway. Overall, the participants favored childhood vaccination and viewed most of the vaccines included in the NCIP as safe and reliable. Human papilloma virus, meningococcal and pneumococcal vaccines were declined by some of the parents. Comparisons of childhood vaccination in Poland and Norway was evident in many of the interviews, especially among parents whose children had received vaccines in both countries. The participants were well acquainted with the NCIP, favored voluntary childhood vaccination, and the majority expressed a high level of trust in Norwegian health authorities. CONCLUSIONS: Polish immigrants to Norway generally expressed positive views about childhood vaccination. Non-vaccination was related to lack of knowledge and/or unfamiliarity with certain vaccines and not with anti-vaccine sentiments or conspiracy theories. The study highlights how parents' knowledge, in combination with norms and trends from both birth country and country of residence, influence parents' decision making about vaccination.

Dignity of Work and at Work: The Relationship between Workplace Dignity and Health among Latino Immigrants during the COVID-19 Pandemic.

Latino immigrants living in the United States were highly vulnerable to the health and economic consequences brought on by the COVID-19 pandemic. We use the conceptual framing of workplace dignity, worth that is acknowledged based on performance of job responsibilities, to explore Latino immigrants' experiences during the early months of the pandemic. A qualitative study was conducted with La Clínica del Pueblo (La Clínica), a community health center serving low-income Latino immigrants. From June to December 2020, we conducted in-depth video interviews with 29 Latino immigrant clients to explore pandemic-related challenges, including workplace changes, discriminatory experiences, and effects on health. We conducted thematic analysis using Dedoose software. Nearly half of participants were undocumented immigrants. Most participants were unemployed or underemployed due to the pandemic and 26-49 years of age; one-third were still working, and one-quarter were 50 years or older. About half were cisgender women and two were transgender women. Employed participants experienced a lack of dignity through being socially isolated and stigmatized at work; receiving no compensation for their extra labor or for sick leave; and experiencing discriminatory labor practices. Unemployed participants experienced a lack of dignity in being the first to lose their jobs without government support; losing self-esteem; and not being rehired. Participants associated denial of dignity with worsening health conditions and increased anxiety and depression. Our study suggests that denial of workplace dignity-through job loss, underemployment, and poor working conditions-is linked to adverse health outcomes for Latino immigrants. More research should recognize workplace dignity as an important social determinant of health.

Immigrant Older Adults' Experiences of Aging in Place and Their Neighborhoods: A Qualitative Systematic Review.

Engaging in one's neighborhood fosters independence, promotes social connectedness, improves quality of life, and increases life expectancy in older adults. There is a lack of evidence synthesis on immigrant older adults' neighborhood perceptions and experiences, essential for addressing neighborhood-level influences on aging in place. This study systematically synthesizes qualitative evidence on immigrant older adults' perceptions and experiences of their neighborhoods. A comprehensive search was conducted from inception to 5 April 2023, in multiple databases. This review considered studies including immigrant older adults aged ≥60 years, included studies from any country where the neighborhood was the focus, and only considered qualitative data while excluding review studies, theoretical publications, and protocols. Eligible studies were appraised using the JBI critical appraisal checklist for qualitative research. The Joanna Briggs Institute meta-aggregation approach was used to synthesize findings, and the ConQual approach established confidence in the synthesis. A total of 30 studies were included. Most studies were conducted in North America and explored phenomena such as aging in place, social capital, social cohesion, sense of community, and life satisfaction. Key contextual factors were walkable safe access to social spaces, accessible transportation to amenities, social cohesion with neighbors, and pre-migration neighborhood experiences. Immigrant older adults have varied experiences related to their sense of belonging and social cohesion. Factors such as racial discrimination, feeling unsafe, and social isolation contributed to negative perceptions. This review highlights the need for inclusive neighborhoods that align with the needs and values of immigrant older adults aging in place.

Impacts of COVID-19 shelter in place across key life domains among immigrant farmworker Latina mothers and young adults.

OBJECTIVE: Individuals and families from racial and ethnic groups experience social and economic disadvantage making them vulnerable to the disproportionate impact of the COVID-19 pandemic. This study sought to capture the impacts of Shelter in Place (SIP) across key life domains including family life, education, work, mental health, and coping strategies among a sample of Mexican-origin mothers who were currently engaged in agricultural work, or whose spouses were engaged in agricultural work, and young adults who had a parent working in agriculture. METHOD: During the summer of 2020, while California was under SIP orders, we conducted three virtual focus groups using Zoom(r). We recruited focus group participants from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), an ongoing, 20-year, longitudinal cohort study of Mexican-origin families in a predominantly agricultural area of California. Three focus groups were conducted with mothers (n = 9), mean age = 48 years, young adult women (n = 8) and young adult men (n = 5), mean age = 18 years, respectively. RESULTS: Mothers reported high levels of stress stemming from fear of Covid-19 infection, work instability and financial concerns, children's schooling, anxiety about an uncertain future, and the demands of caretaking for dependents. Adverse mental health impacts were particularly pronounced among participants experiencing multiple adversities pre-dating the pandemic, including unemployment, single motherhood, and having undocumented family members. For young adults, work instability and varying work hours were also a source of stress because they made it difficult to make decisions about the future, such as whether to attend college or how many classes to take. Families used coping strategies including expressing gratitude, focusing on what's under one's control, familismo, and community engagement to manage mental health challenges during SIP. CONCLUSION: In the event of future pandemics or disasters, particular attention is needed to those who experience unemployment, are undocumented and/or have undocumented family members, and/or are single parents facing economic adversity. During public health emergencies, action at the local, state, and national level is needed to support farmworkers and other vulnerable groups' secondary major stressors stemming from inequities in access to affordable housing, childcare, living wages, healthcare, and other benefits.

Raising awareness about physical activity's role in reducing cancer risk: qualitative interviews with immigrant women and community agency managers.

OBJECTIVES: To explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk. STUDY DESIGN: Qualitative description. METHODS: We conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis. RESULTS: Participants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada's PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes). CONCLUSIONS: We generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings.