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1.
MMWR Morb Mortal Wkly Rep ; 69(41): 1485-1491, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33056951

RESUMO

Frequent hand hygiene, including handwashing with soap and water or using a hand sanitizer containing ≥60% alcohol when soap and water are not readily available, is one of several critical prevention measures recommended to reduce the spread of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19).* Previous studies identified demographic factors associated with handwashing among U.S. adults during the COVID-19 pandemic (1,2); however, demographic factors associated with hand sanitizing and experiences and beliefs associated with hand hygiene have not been well characterized. To evaluate these factors, an Internet-based survey was conducted among U.S. adults aged ≥18 years during June 24-30, 2020. Overall, 85.2% of respondents reported always or often engaging in hand hygiene following contact with high-touch public surfaces such as shopping carts, gas pumps, and automatic teller machines (ATMs).† Respondents who were male (versus female) and of younger age reported lower handwashing and hand sanitizing rates, as did respondents who reported lower concern about their own infection with SARS-CoV-2§ and respondents without personal experience with COVID-19. Focused health promotion efforts to increase hand hygiene adherence should include increasing visibility and accessibility of handwashing and hand sanitizing materials in public settings, along with targeted communication to males and younger adults with focused messages that address COVID-19 risk perception.


Assuntos
Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Fatores Etários , Idoso , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/etnologia , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/etnologia , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
2.
J Anxiety Disord ; 75: 102291, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32827869

RESUMO

OBJECTIVE: COVID-19 is rearranging our society with fear and worry about the novel coronavirus impacting the mental health of Americans. The current study examines the intersection of COVID-19 fear, worries and perceived threat with social vulnerabilities and mental health consequences, namely anxiety and depressive symptomatology. METHODS: Using an online platform, a national sample (n = 10, 368) of U.S. adults was surveyed during the week of March 23, 2020. The sample was post-strata weighted to ensure adequate representation of the U.S. population based on population estimates for gender, race/ethnicity, income, age, and geography. RESULTS: Fear and worry are not distributed equally across the country; rather they are concentrated in places where the largest number of confirmed COVID-19 cases is found. Additionally, data highlight significant differences in the subjective perception of distress across groups with varying social vulnerabilities. Women, Hispanics, Asians, families with children under 18, and foreign-born respondents reported higher levels of subjective fear and worry compared to their counterparts. Finally, even after controlling for social vulnerability, subjective assessments of distress were positive, and significantly related to anxiety and depressive symptomatology; prior mental health research from China and Europe confirm what others have begun to document in the United States. CONCLUSIONS: This preliminary work provides practitioners with a glimpse of what lies ahead, which individuals and communities may be the most vulnerable, and what types of strategic interventions might help to address a wide range of mental health consequences for Americans in the months and years ahead.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Medo , Inquéritos Epidemiológicos , Saúde Mental/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , Betacoronavirus , Criança , Depressão/epidemiologia , Grupos Étnicos/psicologia , Medo/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Masculino , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Mulheres/psicologia , Adulto Jovem
3.
Womens Health (Lond) ; 16: 1745506520953348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32856564

RESUMO

BACKGROUND: On account of their racial/ethnic minority status, class, and gender, African-American women of low socioeconomic status are among the least privileged, underserved, and most marginalized groups in the United States. Generally, African Americans continue to experience poorer health outcomes, in which disparities have been attributed to socioeconomic inequities and structural racism. This objective of this study was to explore the lived experiences of low-income African-American women in interacting with the healthcare system and healthcare providers. METHODS: Twenty-two in-depth one-on-one interviews were conducted with low-income African-American women. The audio-recorded interviews were transcribed verbatim. An inductive content analysis was performed, using an analytical software, Dedoose® to enabled hierarchical coding. Codes were grouped into categories which were further analyzed for similarities that led to the emergence of themes. RESULTS: A key finding was the experience of discriminatory treatment. The three themes that emerged relevant to this category were (1) perceived discrimination based on race/ethnicity, (2) perceived discrimination based on socioeconomic status, and (3) stereotypical assumptions such as drug-seeking and having sexually transmitted diseases. CONCLUSION AND RECOMMENDATIONS: Low-income African-American women experience less than satisfactory patient care, where participants attribute to their experience of being stereotyped and their perception of discrimination in the healthcare system and from providers. Patients' experiences within the healthcare system have implications for their healthcare-seeking behaviors and treatment outcomes. Healthcare personnel and providers need to be more aware of the potential for implicit bias toward this population. Healthcare workforce training on culturally responsive patient care approaches and more community engagement will help providers better understand the context of patients from this population and more effectively meet their healthcare needs.


Assuntos
Afro-Americanos/psicologia , Assistência à Saúde Culturalmente Competente , Assistência à Saúde , Racismo/psicologia , Adulto , Grupos Étnicos/psicologia , Feminino , Disparidades em Assistência à Saúde , Humanos , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Aceitação pelo Paciente de Cuidados de Saúde , Percepção , Pobreza , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
4.
PLoS One ; 15(7): e0236008, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726359

RESUMO

OBJECTIVES: To reach nuanced understanding of the perinatal experiences of ethnic minority women from Turkish and Moroccan descent giving birth in maternity wards in Belgium thereby gaining insight into the underlying challenges of providing intercultural care for ethnic minority persons in a hospital setting. METHODS: A qualitative study design was used by conducting In-depth interviews with 24 women from Turkish and Moroccan descent who gave birth during the past three years in maternity wards in Flanders, Belgium. The interviews were analysed using a Grounded Theory Approach. RESULTS: This study shows that the women's care experiences were shaped by the care interactions with their caregivers, more specifically on the attention that was given by the caregivers towards two essential dimensions of the care relationship, viz. Ereignis (attention to what happens) and Erlebnis (attention to how it happens). These two dimensions were interrelated in four different ways, which defined the women's care experiences as being either 'uncaring', 'protocolized', 'embraced' or 'ambiguous'. Moreover, these experiences were fundamentally embedded within the women's cultural context, which has to be understood as a relational process in which an emotional and moral meaning was given to the women's care expectations, interactions and interpretations of care. CONCLUSIONS: The findings reveal that the quality of intercultural care depends on the nature and quality of care interactions between ethnic minority patients and caregivers much more than on the way in which cultural questions and tensions are being handled or dealt with in a practical way. As such, the importance of establishing a meaningful care relationship should be the priority when providing intercultural care. In this, a shift in perspective on 'culture' from being an 'individual culture-in-isolation' towards an understanding of culture as being inter-relational and emerging from within these care relationships is necessary.


Assuntos
Cuidadores/normas , Assistência à Saúde/normas , Grupos Étnicos/psicologia , Hospitais/normas , Islamismo , Serviços de Saúde Materna/normas , Parto/psicologia , Bélgica , Criança , Pré-Escolar , Barreiras de Comunicação , Emigrantes e Imigrantes , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Lactente , Marrocos , Satisfação do Paciente , Gravidez , Pesquisa Qualitativa , Turquia
5.
PLoS One ; 15(7): e0236733, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32722707

RESUMO

Studies on wife abuse in Bangladesh predominantly include the mainstream Bengali population, although there are at least 27 ethnic minority communities including a few 'female-centered' matrilineal groups living in the country. This study explored ethnic differences in the attitudinal acceptance of wife abuse among matrilineal ethnic minority Garo, patrilineal ethnic minority Santal, and mainstream patriarchal Bengali communities in rural Bangladesh. Adopting a cross-sectional design, the study included 1,929 women and men randomly selected from 24 Garo, Santal, and Bengali villages. Multivariate Poisson regression was performed to predict the number of contextual events, where the respondents attitudinally endorsed wife abuse. Of the sample, 33.2% were from Garo, 33.2% from Santal, and 33.6% from the Bengali communities. The acceptance of wife abuse was high in the sample; specifically, 34.1% of the respondents accepted physical wife abuse, 67.5% accepted emotional abuse, and 71.6% accepted any abuse (either physical or emotional) at least on one contextual reason provided in a 10-item scale. The mean for accepting any abuse was 3.0 (SD = 2.8), emotional abuse 2.3 (SD = 2.2), and physical abuse 0.8 (SD = 1.4). The study showed that the rates of accepting any abuse and physical abuse were respectively 16% and 56% lower among Garo as well as 14% and 33% lower among Santal than that of the Bengali community. Data also revealed that individual level factors like younger age, higher education, prestigious occupation as well as family level factors such as higher income, female mobility, and female family authority were inversely associated with the acceptance of wife abuse in the sample. It appears that the gender regime of a society has a great influence on the attitudes toward wife abuse. We argue that a comprehensive socio-cultural transformation of the patriarchal societies into a gender equal order is imperative for the prevention of widespread wife abuse in the country.


Assuntos
Mulheres Maltratadas/estatística & dados numéricos , Grupos Étnicos/psicologia , Grupos Minoritários/estatística & dados numéricos , Maus-Tratos Conjugais/estatística & dados numéricos , Adolescente , Adulto , Bangladesh , Mulheres Maltratadas/psicologia , Estudos Transversais , Características Culturais , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , Fatores Socioeconômicos , Maus-Tratos Conjugais/psicologia , Inquéritos e Questionários , Adulto Jovem
6.
PLoS One ; 15(6): e0234540, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584831

RESUMO

The importance of social connection to well-being is underscored by individuals' reactivity to events highlighting the potential for rejection and exclusion, which extends even to observing the social exclusion of others ("vicarious ostracism"). Because responses to vicarious ostracism depend at least in part on empathy with the target, and individuals tend to empathize less readily with outgroup than ingroup members, the question arises as to whether there is a boundary condition on vicarious ostracism effects whereby individuals are relatively immune to observing ingroup-on-outgroup ostracism. Of particular interest is the case where members of a dominant ethnic group observe fellow ingroup members ostracize a member of a disadvantaged ethnic minority group, as here there is a compelling potential alternative: Perceived violation of contemporary social norms condemning prejudice and discrimination might instead lead dominant group members to be especially upset by "dominant-on-disadvantaged" ostracism. Accordingly, the present research examines, across four studies and 4413 participants, individuals' affective reactions to observing dominant-on-disadvantaged versus dominant-on-dominant ostracism. In each study, dominant group members (White/Europeans) observed dominant group members include or ostracize a fellow dominant group member or a disadvantaged ethnic minority group member (a Black individual) in an online Cyberball game. Results revealed that dominant group members felt more guilt, anger, and sadness after observing severe ostracism of a disadvantaged as opposed to dominant group member. Although no direct effects emerged on behavioral outcomes, exploratory analyses suggested that observing ostracism of a disadvantaged (versus dominant) group member had indirect effects on behavior via increased feelings of anger. These results suggest that observing ostracism may be a sufficiently potent and relatable experience that when it occurs across group boundaries it awakens individuals' sensitivity to injustice and discrimination.


Assuntos
Grupos Étnicos/psicologia , Grupos Minoritários/psicologia , Comportamento Social , Distância Social , Adolescente , Adulto , Ira/fisiologia , Emoções/fisiologia , Empatia/fisiologia , Feminino , Humanos , Masculino , Preconceito , Identificação Social , Adulto Jovem
8.
Soins Pediatr Pueric ; 41(313): 23-25, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32446552

RESUMO

In a transcultural therapy session, an auxiliary therapist brings in play dough to the children. This medium will allow the youngs to anchor in the here and now of the session and will ease the therapeutic alliance.


Assuntos
Argila , Grupos Étnicos/psicologia , Jogos e Brinquedos , Psicoterapia/métodos , Criança , Humanos , Relações Profissional-Paciente
9.
PLoS One ; 15(5): e0232944, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32392247

RESUMO

OBJECTIVES: Autopsy rates worldwide have dropped significantly over the last five decades. Imaging based autopsies are increasingly used as alternatives to conventional autopsy (CA). The aim of this study was to investigate the effect of the introduction of minimally invasive autopsy, consisting of CT, MRI and tissue biopsies on the overall autopsy rate (of CA and minimally invasive autopsy) and the autopsy rate among different ethnicities. METHODS: We performed a prospective single center before-after study. The intervention was the introduction of minimally invasive autopsy as an alternative to CA. Minimally invasive autopsy consisted of MRI, CT, and CT-guided tissue biopsies. Autopsy rates over time and the effect of introducing minimally invasive autopsy were analyzed with a linear regression model. We performed a subgroup analysis comparing the autopsy rates of two groups: a group of western-European ethnicity versus a group of other ethnicities. RESULTS: Autopsy rates declined from 14.0% in 2010 to 8.3% in 2019. The linear regression model showed a significant effect of both time and availability of minimally invasive autopsy on the overall autopsy rate. The predicted autopsy rate in the model started at 15.1% in 2010 and dropped approximately 0.1% per month (ß = -0.001, p < 0.001). Availability of minimally invasive autopsy increased the overall autopsy rate by 2.4% (ß = 0.024, p < 0.001). The overall autopsy rate of people with an ethnic background other than western-European was significantly higher in years when minimally invasive autopsy was available compared to when it was not (22/176 = 12.5% vs. 81/1014 (8.0%), p = 0.049). CONCLUSIONS: The introduction of the minimally invasive autopsy had a small, but significant effect on the overall autopsy rate. Furthermore, the minimally invasive autopsy appears to be more acceptable than CA among people with an ethnicity other than western-European.


Assuntos
Autopsia/métodos , Autopsia/tendências , Adulto , Causas de Morte , Grupos Étnicos/psicologia , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos
10.
BMC Public Health ; 20(1): 712, 2020 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-32423390

RESUMO

BACKGROUND: To evaluate the association between weight misperception and psychological symptoms in the Determinants of young Adults Social well-being and Health (DASH) longitudinal study. METHODS: A longitudinal sample of 3227 adolescents, in 49 secondary schools in London, aged 11-16 years participated in 2002/2003 and were followed up in 2005/2006. A sub-sample (N = 595) was followed up again at ages 21-23 years in 2012/2013. An index of weight misperception was derived from weight perception and measured weight. Psychological well- being was measured using the Strengths and Difficulties Questionnaire at 11-16 years and the General Health Questionnaire at 21-23 years. Associations with weight misperception was assessed using regression models, adjusted for socio-economic and lifestyle factors. RESULTS: White British males and females were more likely than ethnic minority peers to report accurate perceptions of measured weight. At 11-13y, 46% females and 38% males did not have an accurate perception of their measured weight. The comparable figures at 14-16y were 42 and 40%. Compared with male adolescents, more females perceived themselves as overweight or were unsure of their weight but measured normal weight, and this was more pronounced among Indians, Pakistanis and Bangladeshis. At 14-16y, more males perceived themselves as underweight but measured normal weight, and this was more pronounced among Indians. Compared with those who had an accurate perception of their normal weight, a higher likelihood of probable clinically-relevant psychological symptoms was observed among those who measured normal weight but perceived themselves to be underweight (females Odds Ratio (OR) = 1.87 95% CI 1.03-3.40; males OR = 2.34 95% CI 1.47-3.71), overweight (females only OR = 2.06 95% CI 1.10-3.87), or unsure of their weight (males only OR = 1.61 95% CI 1.04-2.49). Among females, the association was driven by internalising rather than externalising symptoms. An accurate perception of overweight was associated with higher psychological symptoms in adolescence and early 20s. Ethnic specific effects were not evident. CONCLUSION: Weight misperception may be an important determinant of psychological symptoms in young people, with an accurate perception of normal weight status being protective. Culturally targeted interventions should be considered to promote healthy perceptions of body image.


Assuntos
Imagem Corporal/psicologia , Grupos Étnicos/psicologia , Obesidade/psicologia , Percepção de Peso , Adolescente , Peso Corporal , Feminino , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , Grupos Minoritários/psicologia , Sobrepeso/psicologia , Magreza/psicologia , Reino Unido , Adulto Jovem
11.
BMC Public Health ; 20(1): 723, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429947

RESUMO

BACKGROUND: Human Immunodeficiency Virus (HIV) disproportionately affects the Southern United States, accounting for approximately 46% of people living with HIV. HIV-related stigma is recognized as a barrier to testing, treatment, and prevention efforts. However, little is known about HIV-related stigma experiences in Florida. Using data collected from the Florida Medical Monitoring Project, we sought to examine individual characteristics associated with HIV-related stigma. METHODS: We analyzed secondary data from the 2015-2016 Medical Monitoring Project in Florida (n = 603). Stigma was measured using the 10-item HIV Stigma Scale. Exploratory factor analysis of the HIV Stigma Scale revealed three subscales: negative self-image, anticipated, and personalized stigma. Bivariate and multivariate regression models were used to determine the individual characteristics associated with the HIV Stigma Scale. RESULTS: Multivariate analysis indicated that people with severe depression scores (OR: 3.13; CI: 1.38-7.13) and persons with disability (OR: 1.64; CI: 1.03-2.61) had significantly increased odds of higher overall stigma. In the subscale analyses, negative self-image was significantly associated with alcohol misuse (OR: 2.02; CI: 1.15-3.56) depression (OR: 2.81; CI: 1.38-5.72) and/or those who identify as homosexual (OR: 0.54; CI: 0.31-0.93). Anticipated stigma was significantly associated with people who had mild-moderate depression (OR: 3.03; CI: 1.20-7.65), severe depression (OR: 2.87; CI: 1.38-5.98), identified as Black (OR: 0.60; CI: 0.37-0.98), non-injection drug use (OR: 0.55; CI: 0.33-0.91), and/or people aged 50 years and older (OR: 0.28; CI: 0.09-0.82). Personalized stigma was not associated with any of the variables examined. CONCLUSIONS: The implications of these findings reveal that certain individuals are more vulnerable to stigma. Researchers could consider distinct stigma interventions strategies based on the characteristics of specific individuals (i.e., targeting depression, disability, sexual orientation, avoidant coping, racial/ethnic groups, and youth) in Florida.


Assuntos
Depressão/psicologia , Infecções por HIV/psicologia , Autoimagem , Minorias Sexuais e de Gênero/psicologia , Estigma Social , Adolescente , Adulto , Afro-Americanos/psicologia , Idoso , Depressão/epidemiologia , Depressão/virologia , Grupos Étnicos/psicologia , Análise Fatorial , Feminino , Florida/epidemiologia , HIV , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Análise de Regressão , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-32384717

RESUMO

Suicide-related behavior (SRB) is a mental health disparity experienced by the alternative sexuality community. We assessed mental health, relationship orientation, marginalized identities (i.e., sexual orientation minority, gender minority, racial minority, ethnic minority, and lower education), and preferences in information processing (PIP) as factors differentiating lifetime SRB groups. An online cross-sectional survey study was conducted in 2018. Members of the National Coalition for Sexual Freedom (NCSF; n = 334) took part. Bivariate analyses identified the following SRB risk factors: female and transgender/gender non-binary identity, sexual orientation minority identity, lower education, suicide attempt/death exposure, Need for Affect (NFA) Avoidance, depression, and anxiety. Monogamous relationship orientation was a protective factor. Multi-nomial regression revealed the following: (1) monogamous relationship orientation was a protective factor for suicidal ideation and attempt; (2) lower education was a risk factor for suicide attempt; (3) anxiety was a risk factor for suicide attempt; and (4) depression was a risk factor for suicidal ideation. A two-way interaction showed that elevated NFA Approach buffered the negative impacts of depression. Relationship orientation, several marginalized identities (i.e., based on gender, sexual orientation, and educational level), and PIP all contributed uniquely to SRB. Further study is necessary to understand the role of relationship orientation with suicide. Health education and suicide prevention efforts with NCSF should be tailored to account for marginalized identity, mental health, and NFA factors.


Assuntos
Grupos Étnicos/psicologia , Identidade de Gênero , Comportamento Sexual , Minorias Sexuais e de Gênero/psicologia , Sexualidade , Ideação Suicida , Cognição , Estudos Transversais , Feminino , Humanos , Masculino , Grupos Minoritários , Fatores de Risco , Comportamento Sexual/etnologia , Comportamento Sexual/psicologia , Sexualidade/etnologia , Sexualidade/psicologia , Sexualidade/estatística & dados numéricos , Tentativa de Suicídio/psicologia
13.
Plast Reconstr Surg ; 145(5): 932e-939e, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32332533

RESUMO

BACKGROUND: Aesthetic surgery is a personal choice that appeals to a wide population of individuals. The authors investigated how race and ethnicity, age, gender, income, and education level affect patient motivation to pursue cosmetic surgery and selection of a plastic surgeon. METHODS: One hundred seventy-two consecutive patients from two surgeons (an African American man and a Caucasian woman) completed surveys from 2016 to 2017 that assessed their decision to pursue cosmetic surgery. Univariable cumulative logit models with odds ratios and 95 percent confidence intervals were calculated with the survey data. RESULTS: African American patients were more likely to be willing to travel greater than 100 miles for a surgeon who shared the same ethnicity or race, to consider international surgery, to report that social standards did not influence their decision for surgery, and to view the buttocks as the female feature that best defines attractiveness within their race or ethnicity. Patients with incomes over $125,000 and those over the age of 50 years were more likely to seek a surgeon of the same gender, think a same-gender surgeon could provide better results, be influenced by societal standards to pursue surgery, and view the face as the defining attractive female feature within their race or ethnicity. Patients with college or graduate degrees were more likely to believe a gender- and racially concordant surgeon would provide them with better a result and believed societal standards were unrealistic to obtain with diet and exercise. CONCLUSIONS: Plastic surgeons encounter patients of varying demographics, all of whom have differing perspectives about cosmetic surgery and motivations for its pursuit. Recognizing and defining these differences could enable surgeons to provide a more individualized cosmetic experience and inform future marketing strategies to attract a diverse patient population.


Assuntos
Centros Médicos Acadêmicos/estatística & dados numéricos , Motivação , Preferência do Paciente/psicologia , Procedimentos Cirúrgicos Reconstrutivos/psicologia , Fatores Etários , Comportamento de Escolha , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Escolaridade , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Preferência do Paciente/estatística & dados numéricos , Satisfação do Paciente , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Fatores Sexuais , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
14.
PLoS One ; 15(4): e0230303, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32240202

RESUMO

The current paper presents three studies, which suggest that perceiving one's nation as transgenerational (TG) is related to a differentiation in the evaluation of ethnically German diaspora migrants and ethnically non-German ('foreign') migrants. First, we find that unlike 'classical' concepts such as right-wing authoritarianism (RWA), social dominance orientation (SDO), and hierarchic self-interest (HSI), TG explains differences in derogatory sentiments expressed towards diaspora and 'foreign' migrants. Second, TG is differentially related to positive emotions and behavioral intentions expressed towards these two groups of migrants. Lastly, results indicate that people who perceive the ingroup as TG require 'foreign' migrants to fulfill more criteria that make them eligible for citizenship and are thereby more exclusionist than people who include only the current generation into their concept of national identity. The social implications of these findings in face of the so-called refugee crisis in Germany and the wider European Union are discussed.


Assuntos
Autoritarismo , Grupos Étnicos/psicologia , Relação entre Gerações/etnologia , Percepção Social , Migrantes/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha/etnologia , História do Século XIX , História do Século XX , História do Século XXI , Migração Humana/história , Humanos , Internacionalidade/história , Israel/etnologia , Masculino , Pessoa de Meia-Idade
15.
PLoS One ; 15(4): e0231154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32251431

RESUMO

BACKGROUND: Cultural competency describes interventions that aim to improve accessibility and effectiveness of health services for people from ethnic minority backgrounds. Interventions include interpreter services, migrant peer educators and health worker training to provide culturally competent care. Very few studies have focussed on cultural competency for migrant service use in Low- and Middle-Income Countries (LMIC). Migrants and refugees in Thailand and Malaysia report difficulties in accessing health systems and discrimination by service providers. In this paper we describe stakeholder perceptions of migrants' and health workers' language and cultural competency, and how this affects migrant workers' health, especially in Malaysia where an interpreter system has not yet been formalised. METHOD: We conducted in-depth interviews with stakeholders in Malaysia (N = 44) and Thailand (N = 50), alongside policy document review in both countries. Data were analysed thematically. Results informed development of Systems Thinking diagrams hypothesizing potential intervention points to improve cultural competency, namely via addressing language barriers. RESULTS: Language ability was a core tenet of cultural competency as described by participants in both countries. Malay was perceived to be an easy language that migrants could learn quickly, with perceived proficiency differing by source country and length of stay in Malaysia. Language barriers were a source of frustration for both migrants and health workers, which compounded communication of complex conditions including mental health as well as obtaining informed consent from migrant patients. Health workers in Malaysia used strategies including google translate and hand gestures to communicate, while migrant patients were encouraged to bring friends to act as informal interpreters during consultations. Current health services are not migrant friendly, which deters use. Concerns around overuse of services by non-citizens among the domestic population may partly explain the lack of policy support for cultural competency in Malaysia. Service provision for migrants in Thailand was more culturally sensitive as formal interpreters, known as Migrant Health Workers (MHW), could be hired in public facilities, as well as Migrant Health Volunteers (MHV) who provide basic health education in communities. CONCLUSION: Perceptions of overuse by migrants in a health system acts as a barrier against system or institutional level improvements for cultural competency, in an already stretched health system. At the micro-level, language interventions with migrant workers appear to be the most feasible leverage point but raises the question of who should bear responsibility for cost and provision-employers, the government, or migrants themselves.


Assuntos
Competência Cultural/psicologia , Assistência à Saúde Culturalmente Competente , Acesso aos Serviços de Saúde , Refugiados/psicologia , Migrantes/psicologia , Adulto , Criança , Barreiras de Comunicação , Grupos Étnicos/psicologia , Feminino , Pessoal de Saúde/psicologia , Humanos , Entrevistas como Assunto , Malásia , Masculino , Grupos Minoritários/psicologia , Pesquisa Qualitativa , Participação dos Interessados/psicologia , Análise de Sistemas , Tailândia , Tradução
16.
Health Psychol ; 39(7): 622-631, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32281823

RESUMO

Objective: The objective of the study was to evaluate a novel measure of HIV care engagement in a large sample of non-Latino White, Latino, and African American patients. The Index of Engagement in HIV care (the Index) measures the degree to which a patient feels engaged/disengaged from HIV care. However, its measurement invariance, or the degree to which observed scores can be meaningfully compared across racial/ethnic groups, has not been established. Methods: The 10-item Index is a self-report measure initially validated in the Center for AIDS Research Network of Integrated Systems cohort study. Using Center for AIDS Research Network of Integrated Systems survey data, Index scores were linked to patients' electronic medical records, which included viral load (VL) and appointment attendance data. We conducted measurement invariance analyses to test the Index's performance in the 3 racial/ethnic groups and its cross-sectional association with VL and retention in HIV care (2 primary outcomes). Results: A total of 3,127 patients completed the Index, which showed good reliability across the 3 groups (alphas >.84). Confirmatory factor analysis model fit statistics showed that the Index demonstrated configural, metric, and scalar invariance, supporting the conclusion that the Index is a single factor construct. Lastly, lower Index scores associated with a concurrent detectable VL and poor retention in HIV care for all 3 groups. Conclusion: Having demonstrated invariance, the Index scores can be used to compare engagement levels across non-Latino Whites, Latinos, and African Americans in HIV care settings. Improving HIV care retention requires tools that can accurately identify people struggling to stay engaged in HIV care, especially racial/ethnic minorities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Grupos Étnicos/psicologia , Infecções por HIV/etnologia , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
17.
Adv Cancer Res ; 146: 115-137, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32241386

RESUMO

Human papillomavirus (HPV) infection is the primary risk factor for cervical cancer. While the HPV vaccine significantly reduces the risk of HPV infection and subsequent cervical cancer diagnosis, underuse is linked to lack of knowledge of its effectiveness in preventing cervical cancer. The purpose of this study was to evaluate a cancer educational intervention (titled "MOVENUP") to improve knowledge of cervical cancer, HPV, and the HPV vaccine among predominantly African American communities in South Carolina. The MOVENUP cancer educational intervention was conducted among participants residing in nine South Carolina counties who were recruited by community partners. The 4.5-h MOVENUP cancer educational intervention included a 30-min module on cervical cancer, HPV, and HPV vaccination. A six-item investigator-developed instrument was used to evaluate pre- and post-intervention changes in knowledge related to these content areas. Ninety-three percent of the 276 participants were African American. Most participants reporting age and gender were 50+ years (73%) and female (91%). Nearly half of participants (46%) reported an annual household income <$40,000 and 49% had not graduated from college. Statistically significant changes were observed at post-test for four of six items on the knowledge scale (P<0.05), as compared to pre-test scores. For the two items on the scale in which statistically significant changes were not observed, this was due primarily due to a baseline ceiling effect.


Assuntos
Intervenção Educacional Precoce/métodos , Grupos Étnicos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/psicologia , Feminino , Educação em Saúde , Humanos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia
18.
Adv Cancer Res ; 146: 83-102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32241393

RESUMO

Higher BMI, lower rates of physical activity (PA), and hormone receptor-negative breast cancer (BC) subtype are associated with poorer BC treatment outcomes. We evaluated the prevalence of high BMI, low PA level, and BC subtype among survivors with white/European American (EA) and African American (AA) ancestry, as well as a distinct subset of AAs with Sea Island/Gullah ancestry (SI). We used the South Carolina Central Cancer Registry to identify 137 (42 EAs, 66 AAs, and 29 SIs) women diagnosed with BC and who were within 6-21 months of diagnosis. We employed linear and logistic regression to investigate associations between BMI, PA, and age at diagnosis by racial/ethnic group. Most participants (82%) were overweight/obese (P=0.46). BMI was highest in younger AAs (P=0.02). CDC PA guidelines (≥150min/week) were met by only 28% of participants. The frequency of estrogen receptor (ER)-negative BC subtype was lower in EAs and SIs than in AAs (P<0.05). This is the first study to identify differences in obesity and PA rates, and BC subtype in EAs, AAs, and SIs. BMI was higher, PA rates were lower, and frequency of ER-negative BC was higher in AAs as compared to EAs and SIs. This study highlights the need to promote lifestyle interventions among BC survivors, with the goal of reducing the likelihood of a BC recurrence. Integrating dietary and PA interventions into ongoing survivorship care is essential. Future research could evaluate potential differential immune responses linked to the frequency of triple negative BC in AAs.


Assuntos
Índice de Massa Corporal , Neoplasias da Mama/etnologia , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Grupos Étnicos/psicologia , Exercício Físico , Afro-Americanos/psicologia , Neoplasias da Mama/reabilitação , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Humanos , Receptores Estrogênicos/metabolismo
19.
N C Med J ; 81(2): 126-129, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32132258

RESUMO

Racial and ethnic disparities in health care occur within broader contexts impacting the youth who present for behavioral health treatment. Clinician bias and clinical uncertainty can influence diagnostic and treatment outcomes. Behavioral health professionals should strive toward effectiveness in the delivery of culturally sensitive interventions to assist in health promotion with youth of color.


Assuntos
Disparidades em Assistência à Saúde/etnologia , Transtornos Mentais/diagnóstico , Transtornos Mentais/etnologia , Adolescente , Grupos de Populações Continentais/psicologia , Grupos de Populações Continentais/estatística & dados numéricos , Grupos Étnicos/psicologia , Grupos Étnicos/estatística & dados numéricos , Humanos
20.
PLoS One ; 15(3): e0229529, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163429

RESUMO

Knowledge, attitude and willingness of ethnic minorities in China towards cadaver donation programs were assessed. Questionnaire and interviews were conducted to investigate Yi, Bai, Hani, Dai and Han ethnicities. Educational level and per capita income of ethnic minorities were lesser than those of Han ethnicity (p<0.01). Agriculture was the primary occupation and proportions of technical personnel and public officials was lesser among ethnic minorities (p<0.01). Surveyed ethnic minorities universally practice religious traditions, Bai and Dai ethnicities practice Buddhist beliefs also (p<0.01). Knowledge of Yi, Bai, Hani and Dai ethnic respondents was lesser than those of Han ethnicity (p<0.01). Over 83.8% of Yi, Bai, Hani and Dai ethnicity residents were unwilling to register for body donation programs with receiving a driver's license (p<0.01). Less than 46.9% of ethnic minorities supported use of honorary certificates (p<0.01). Ethnic minorities were supportive of financial compensation for body donations and denied that financial compensation led to the commercialization of cadaver donation (p<0.01, p<0.01). Willingness of ethnic minorities to participate in cadaver donation programs was primarily related to religious beliefs (p<0.01), economic status (p<0.01). Knowledge, attitude and willingness of ethnic minorities to participate in cadaver donation programs were markedly different from those of Han ethnicity, and the religious belief and economic status played a decisive role. To increase participation, programs based on respecting religious belief should be developed to support improvements in economy, education, medical care and social security system.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos/tendências , Adulto , Idoso , Cadáver , China , Tomada de Decisões , Grupos Étnicos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/psicologia , Religião , Religião e Psicologia , Fatores Socioeconômicos , Inquéritos e Questionários , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/métodos
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