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1.
BMJ Case Rep ; 14(1)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509855

RESUMO

Infection by human T-lymphotropic virus 1 (HTLV-1) is often seen as the cause of chronic infection or lymphoproliferative disorders, but many clinicians do not recognise its association with severe immunosuppression. We report the case of a woman in her 70s from the Caribbean who sought care at the emergency department for weakness, fatigue and weight loss. Further work-up showed atypical lymphocytosis with floral lymphocytes and smudge cells in the peripheral blood smear and hypercalcaemia. Chest CT demonstrated a moderate right pleural effusion. Results of HIV testing were negative, and screening and confirmatory tests for HTLV-1 were positive. Empiric antibiotic therapy was administered, and the patient was discharged home. Five days later, she was readmitted with shortness of breath and severe abdominal pain. A disseminated infection with Cryptococcus neoformans was diagnosed. Despite aggressive intravenous antifungal therapy, the patient died on day 7 of hospitalisation.


Assuntos
Criptococose/diagnóstico , Infecções por HTLV-I/diagnóstico , Infecções Fúngicas Invasivas/diagnóstico , Leucemia-Linfoma de Células T do Adulto/diagnóstico , Idoso , Antifúngicos/uso terapêutico , Ascite/diagnóstico por imagem , Criptococose/complicações , Criptococose/tratamento farmacológico , Emigrantes e Imigrantes , Evolução Fatal , Feminino , Infecções por HTLV-I/complicações , Haiti/etnologia , Vírus Linfotrópico T Tipo 1 Humano , Humanos , Infecções Fúngicas Invasivas/complicações , Infecções Fúngicas Invasivas/tratamento farmacológico , Leucemia-Linfoma de Células T do Adulto/complicações , Linfadenopatia/diagnóstico por imagem , Derrame Pleural/diagnóstico por imagem
2.
Rev. enferm. UERJ ; 28: e53194, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1146674

RESUMO

Objetivo: compreender as percepções dos imigrantes haitianos sobre os Determinantes Sociais da Saúde que impactam a vivência da imigração. Método: pesquisa qualitativa, do tipo pesquisa ação participante, fundamentada no Itinerário de Pesquisa de Paulo Freire, que constitui três fases: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Realizou-se Círculo de Cultura, no segundo semestre de 2019, com a participação de 12 imigrantes haitianos, estudantes universitários, residentes no oeste de Santa Catarina, Brasil, após aprovação pelo Comitê de Ética em pesquisa. Resultados: nos diálogos emergiram duas temáticas para discussão como determinação social da saúde e doença: saúde do imigrante no Brasil; desafios de estudar e trabalhar. Conclusão: A iniquidade de acesso aos direitos, escasso tempo para dormir e praticar exercícios físicos, saudade do Haiti, dificuldade financeira, adaptação à cultura brasileira e discriminação foram apontados como fatores determinantes que afetam a saúde. Urge a necessidade da construção de políticas públicas que garantam os direitos dos imigrantes no Brasil.


Objective: to understand the perceptions of Haitian immigrants about the social determinants of health that impact on the experience of immigration. Method: this qualitative, participant action study was based on Paulo Freire's research itinerary, which consists of three phases: thematic research; encoding and decoding; and critical unveiling. A "culture circle" was held, after ethics committee approval, in the second half of 2019, with the participation of 12 immigrant Haitian university students residing in western Santa Catarina, Brazil. Results: in the dialogues, two themes emerged for discussion as representing the social determination of health and disease: immigrants' health in Brazil; and challenges of studying and working. Conclusion: inequity in access to rights, lack of time to sleep and exercise, homesickness for Haiti, financial difficulties, adaptation to Brazilian culture, and discrimination were identified as determinant factors that affect health. There is an urgent need to build public policies to guarantee immigrants' rights in Brazil.


Objetivo: comprender las percepciones de los inmigrantes haitianos sobre los determinantes sociales de la salud que impactan en la experiencia de la inmigración. Método: este estudio cualitativo de acción participante se basó en el itinerario de investigación de Paulo Freire, que consta de tres fases: investigación temática; codificación y decodificación; y revelación crítica. Se realizó un "círculo cultural", luego de la aprobación del comité de ética, en el segundo semestre de 2019, con la participación de 12 estudiantes universitarios haitianos inmigrantes residentes en el occidente de Santa Catarina, Brasil. Resultados: en los diálogos surgieron dos temas de discusión que representan la determinación social de la salud y la enfermedad: la salud de los inmigrantes en Brasil; y desafíos de estudiar y trabajar. Conclusión: la inequidad en el acceso a los derechos, la falta de tiempo para dormir y hacer ejercicio, la nostalgia por Haití, las dificultades económicas, la adaptación a la cultura brasileña y la discriminación fueron identificadas como factores determinantes que afectan la salud. Urge construir políticas públicas para garantizar los derechos de los inmigrantes en Brasil.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Estudantes , Universidades , Emigrantes e Imigrantes , Determinantes Sociais da Saúde , Brasil , Coleta de Dados , Pesquisa Qualitativa , Haiti/etnologia
3.
Int J Equity Health ; 19(1): 209, 2020 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-33228706

RESUMO

BACKGROUND: The province of Quebec (Canada) has implemented a breast cancer screening program to diagnose this cancer at an early stage. The strategy is to refer women 50 to 69 years old for a mammogram every two years by sending an invitation letter that acts as a prescription. Ninety per cent (90%) of deaths due to breast cancer occur in women aged 50 and over. Numerous studies have shown social inequalities in health for most diseases. With breast cancer, a significant paradox arises: its incidence is lower among disadvantaged women and yet, more of them die from this disease. The health care system might play a role in this inequality. The scientific literature documents the potential for creating such inequalities when prevention does not consider equity among social groups. Immigrant women are often disadvantaged. They die of breast cancer more than non-immigrants. Studies attribute this to late-stage diagnosis due to poor adherence to mammography screening programs. PURPOSE OF THE STUDY: The main objective of our research is to assess how Haitian immigrant women in Montreal are reached by the Quebec Breast Cancer Screening Program, and specifically how they perceive the mammogram referral letter sent by the program. METHODS: The study uses a two-step qualitative method: i) In-depth interviews with influential community workers to identify the most relevant issues; ii) Focus groups with disadvantaged women from Montreal's Haitian community. RESULTS: A mammogram referral letter from the Breast Cancer Screening Program may be a barrier to compliance with mammography by underprivileged Haitian women in Montreal. This might be attributable to a low level of literacy, poor knowledge of the disease, and lack of financial resources. CONCLUSION: Barriers may be underestimated in underprivileged immigrant and non-immigrant communities. A preventive strategy must be adapted to different sub-groups and must also take into account lower literacy levels. To increase mammography uptake, it is crucial that the benefits of prevention be clearly identified and described in understandable terms. Finally, economic access to follow-up measures should be considered.


Assuntos
Neoplasias da Mama/diagnóstico , Comunicação , Detecção Precoce de Câncer/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Mamografia/estatística & dados numéricos , Idoso , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Grupos Focais , Haiti/etnologia , Humanos , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , Quebeque , Fatores Socioeconômicos
4.
Neurology ; 95(19): e2605-e2609, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33004606

RESUMO

OBJECTIVE: Asylum seekers experience a high burden of physical and psychological trauma, yet there is a scarcity of literature regarding the epidemiology and sequelae of head injury (HI) in asylum seekers. We examined HI prevalence and association with neuropsychiatric comorbidities in asylum seekers. METHODS: A retrospective cross-sectional study was performed through review of 139 medical affidavits from an affidavit database. Affidavits written from 2010 to 2018 were included. Demographic and case-related data were collected and classified based on the presence of HI. For neuropsychiatric sequelae, the primary study outcome was headache and the secondary outcomes were depression, posttraumatic stress disorder, and anxiety. Multivariable logistic regression was performed to examine the association between HI and neuropsychiatric sequelae, adjusted for demographic and clinical characteristics. RESULTS: A total of 139 medical affidavits of asylum seekers were included. The mean age was 27.4 ± 12.1 years, 56.8% were female, and 38.8% were <19 years. Almost half (42.5%) explicitly self-reported history of HI. Compared to clients who did not report HI, clients with HI were older and more likely to report a history of headache, physical abuse, physical trauma, concussion, and loss of consciousness. After adjustment for demographic and clinical characteristics, clients with HI had greater odds for neuropsychological sequelae such as headache (odds ratio [OR] 4.2, 95% confidence interval [CI] 2.0-8.7) and depression (OR 2.5, 95% CI 1.1-5.7). CONCLUSIONS: We observed a high prevalence of HI in asylum seekers. Comprehensive screening for HI and neuropsychiatric comorbidities is encouraged when evaluating asylum seekers.


Assuntos
Ansiedade/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Depressão/epidemiologia , Cefaleia/epidemiologia , Refugiados/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Ansiedade/psicologia , Concussão Encefálica/epidemiologia , Concussão Encefálica/psicologia , Traumatismos Craniocerebrais/psicologia , Estudos Transversais , Depressão/psicologia , El Salvador/etnologia , Feminino , Guatemala/etnologia , Haiti/etnologia , Cefaleia/psicologia , Honduras/etnologia , Humanos , Masculino , Transtornos da Memória/epidemiologia , Transtornos da Memória/psicologia , México/etnologia , Nicarágua/etnologia , Razão de Chances , Questionário de Saúde do Paciente , Prevalência , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Refugiados/psicologia , Estudos Retrospectivos , Distribuição por Sexo , Delitos Sexuais/psicologia , Delitos Sexuais/estatística & dados numéricos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inconsciência/epidemiologia , Inconsciência/psicologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia , Ferimentos e Lesões/psicologia , Adulto Jovem
5.
AIDS ; 34 Suppl 1: S43-S51, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32881793

RESUMO

OBJECTIVE(S): To describe stigma among seropositive MSM, female sex workers (FSWs), and Haitian-descent individuals in the Dominican Republic, and to assess whether stigma is associated with HIV treatment outcomes. DESIGN: Cross-sectional survey using Stigma Index 2.0. METHODS: People living with HIV (PLHIV) interviewed seropositive adult MSM, FSWs, Haitian-descent persons, and other PLHIV who did not identify with these communities about experiences of social exclusion, harassment, stigma in healthcare settings, and internalized stigma. Bivariate analyses were conducted to compare experiences between FSWs and other women; MSM and other men; and Haitian-descent participants and non-Haitian PLHIV. Within each community, separate multivariate logistic regression analyses were conducted to examine the association between stigma experiences with viral suppression and with missed antiretroviral doses. RESULTS: The 891 participants consisted of 154 MSM, 216 FSWs, 90 Haitian-descent persons, and 447 who did not identify with any of these three communities. Compared with other women, FSWs reported significantly higher levels of harassment due to their HIV status, and those of Haitian descent reported significantly lower levels of social exclusion compared with non-Haitian PLHIV. In adjusted analyses, MSM who experienced more stigma in HIV-specific services had a significantly lower odds of knowing they had undetectable viral load (adjusted odds ratio 0.37, P < 0.05). Higher internalized stigma scores were significantly associated with missing an antiretroviral treatment dose among FSWs (adjusted odds ratio 1.26, P < 0.05). CONCLUSION: For FSWs and MSM, efforts to mitigate HIV-related stigma are necessary to improve treatment adherence and viral suppression. For Haitian-descent PLHIV, interventions must address not only their HIV-specific needs, but also the broader social and legal barriers to care.


Assuntos
Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Profissionais do Sexo/psicologia , Estigma Social , Adulto , Estudos Transversais , República Dominicana/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Haiti/etnologia , Humanos , Masculino , Prevalência
7.
J Natl Black Nurses Assoc ; 31(1): 32-40, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32853494

RESUMO

The prevalence of type 2 diabetes mellitus (T2DM) is 19.7% in Haiti (DeGennaro et al., 2018). Haitian American women (HAW) experience difficulties with adherence to T2DM treatment and management (Bivins, 2016; Magny-Normilus et al., 2019; Vimalananda et al., 2011; Huffman et al., 2013); however, no previous study was found that focused exclusively on Haitian American women with T2DM. Van Manen's six research activities guided this phenomenological qualitative inquiry. Recruitment included 25 Haitian American women (N = 25) with T2DM from three South Florida counties. Data were collected using a vignette and audio-recorded semi-structured interviews with open-ended questions. Recordings were then transcribed and analyzed to identify thematic concepts and patterns. Themes of spiritualizing and shifting cultural norms with the subtheme of dietary restrictions were found. In conclusion, to promote health outcomes nurses must incorporate these salient factors in the care of Haitian American women with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/etnologia , Assistência à Saúde Culturalmente Competente/organização & administração , Diabetes Mellitus Tipo 2/enfermagem , Feminino , Haiti/etnologia , Humanos , Pesquisa Qualitativa , Estados Unidos
8.
Matern Child Health J ; 24(9): 1130-1137, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32632842

RESUMO

OBJECTIVES: Previous obesity prevention studies in preschool-age children have included non-Hispanic Black (NHB) children, but few have investigated between-subgroup differences even though there may be cultural risk and protective practice differences, challenging the generalizability of findings. The purpose of this study was to examine differences in early childhood obesity-related factors in NHB subgroups (Haitian, other Caribbean Islander and African-American [AA]) children. METHODS: Baseline data from two randomized controlled trials in 52 childcare centers of which 35 had data to test a preschool-based obesity prevention intervention was analyzed. The sub-sample included 370 caregiver-child dyads; 209 self-identified as AA, 120 as Haitian and 41 as Caribbean Islander/West Indian or mixed race. Multilevel regression models generated outcome estimates for group differences in body mass index (BMI) percentile, birthweight, breastfeeding initiation and duration, bottle feeding duration and age when solid foods were introduced. RESULTS: Mean BMI percentile was similar for AA, Haitian and Caribbean Islander/West Indian/Multiracial (60.1th percentile, 60.8th percentile, 62.8th percentile, respectively) as was birthweight (6.3, 6.8, and 6.6 lb, respectively). Children of US-born caregivers had significantly lower BMI percentiles (9.13 percentile points) versus foreign-born caregivers. Haitian women were significantly more likely to initiate breastfeeding (64.9%) versus AA (47.6%) and Caribbean Islander/West Indian/Multiracial (62.2%) (p < .01). No significant group differences were found in breastfeeding or bottle feeding duration or age solid foods were introduced. CONCLUSIONS: Findings here suggest that NHB race classification can identify important subgroup behavioral similarities which in turn may inform culturally sensitive strategies to promote early childhood healthy weight. Foreign-born caregivers may benefit from healthy weight promotion information, and as early as possible in their child's development.


Assuntos
Peso Corporal/etnologia , Grupos Étnicos/estatística & dados numéricos , Obesidade/etnologia , Ganho de Peso/etnologia , Adulto , Afro-Americanos/estatística & dados numéricos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Índice de Massa Corporal , Criança , Cuidado da Criança , Pré-Escolar , Estudos Transversais , Feminino , Haiti/etnologia , Humanos , Masculino , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Índias Ocidentais/etnologia
9.
Ann Glob Health ; 86(1): 69, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32676298

RESUMO

Several characteristics of refugee and migrant populations make them susceptible to acquire COVID-19. To fully understand the impact of COVID-19 on refugees and migrants in the Americas, it is important to consider the broader geopolitical context and appreciate the differences among migratory groups. There are three migrant groups in the Americas that are particularly susceptible to COVID-19: Central American migrants at the northern Mexico border, Venezuelans within South America, and Haitians in the Dominican Republic. Refugees and displaced migrants are the world's collective responsibility, and thus, it would be imprudent to displace their care to resource constrained developing nations.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Refugiados , Migrantes , Betacoronavirus , COVID-19 , América Central/etnologia , Países em Desenvolvimento , República Dominicana/epidemiologia , Haiti/etnologia , Humanos , México/epidemiologia , Pandemias , SARS-CoV-2 , América do Sul/epidemiologia , Venezuela/etnologia , Populações Vulneráveis
10.
Medwave ; 20(4): e7904, 2020 May 25.
Artigo em Espanhol | MEDLINE | ID: mdl-32469856

RESUMO

Introduction: This study aims to describe the psychomotor development of children, the offspring of Chilean and Haitian parents, and who attend the local kindergartens. Methods: The design of this study was a descriptive and cross-sectional study. The study population was children 3 to 24 months-old, belonging to kindergartens, evaluated with the Psychomotor Development Assessment Scale (EEDP) regarding psychomotor development profile for the domains of language, socialization, coordination, and motor skills. A questionnaire was administered to the parents to determine the socioeconomic level, educational level, and parenting skills. Results: Twenty-four infants, 12 children of Chilean parents, and 12 children of Haitian parents were evaluated. The EEDP classification (p = 0.299) did not show significant differences between both groups. In children of Chilean parents, 25% (3/12) classified as delay, while 75% (9/12) as normal. On the other hand, for children of Haitian parents, 8.3% (1/12) classified as risk, while 91.7% (11/12) as normal. There are significant differences in coordination (p = 0.006), in which Haitian children achieved better performance compared to the Chilean. Conclusions: It is necessary to emphasize every domain of infant psychomotor development and the multiple sociocultural variables that can influence this. Current evaluation methods do not presently have an intercultural character.


Assuntos
Desenvolvimento Infantil/fisiologia , Comparação Transcultural , Pais , Desempenho Psicomotor/fisiologia , Pré-Escolar , Chile , Estudos Transversais , Feminino , Haiti/etnologia , Humanos , Lactente , Masculino , Inquéritos e Questionários
11.
Trials ; 21(1): 368, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32349789

RESUMO

BACKGROUND: Underserved ethnic minority populations experience significant disparities in HIV, hepatitis C virus (HCV), colorectal cancer (CRC), and cervical cancer incidence and mortality. Much of the excess burden of these diseases among underserved communities is due to lack of preventive care, including screening. Barriers to disease screening include low awareness, lack of access to care and health insurance, and cultural beliefs regarding disease prevention. Our current trial aims to examine community health worker (CHW)-delivered, home-based multi-modality screening for HIV, HCV, CRC, and cervical cancer simultaneously. DESIGN: We are conducting a randomized pragmatic trial among 900 Haitian, Hispanic, and African-American participants from diverse underserved communities in South Florida. People between the ages of 50 and 65 who have not had appropriate HIV, HCV, CRC, and cervical cancer screening per United States Preventive Services Task Force (USPSTF) recommendations are eligible for the study. Participants are recruited by CHWs and complete a structured interview to assess multilevel determinants of disease risk. Participants are then randomized to receive HIV, HCV, CRC, and cervical cancer screening via navigation to care by a CHW (Group 1) or via CHW-delivered home-based screening (Group 2). The primary outcome is completion of screening for each of these diseases within 6 months post-enrollment. DISCUSSION: Our trial is among the first to examine the effectiveness of a CHW-delivered, multimodality, home-based disease-screening approach. If found to be effective, this approach may represent a cost-effective strategy for disease screening within underserved and underscreened minority groups. TRIAL REGISTRATION: Clinical Trials.gov # NCT02970136, registered November 21, 2016.


Assuntos
Neoplasias Colorretais/diagnóstico , Agentes Comunitários de Saúde , Infecções por HIV/diagnóstico , HIV/imunologia , Hepacivirus/imunologia , Hepatite C/diagnóstico , Programas de Rastreamento/métodos , Grupos Minoritários , Neoplasias do Colo do Útero/diagnóstico , Afro-Americanos , Idoso , Conscientização , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etnologia , Feminino , Florida/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Infecções por HIV/virologia , Haiti/etnologia , Acesso aos Serviços de Saúde , Disparidades em Assistência à Saúde , Hepatite C/epidemiologia , Hepatite C/etnologia , Hispano-Americanos , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Pragmáticos como Assunto , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etnologia
12.
Health Soc Care Community ; 28(5): 1795-1806, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32323900

RESUMO

Our global communities are becoming increasingly more diverse and interwoven; thus, research that enhances our understanding of the multidimensional relationship between depression and migration among distinct ethnic groups is imperative. This study examined the relationship between migration-related stress and depression and the extent to which that relationship is modified by other factors, through the lens of the stress process model. This cross-sectional pilot study used purposive sampling methods to recruit 76 first-generation Haitian immigrants living in South and West Florida from February 2018-May 2018. Descriptive statistics, bivariate and multiple regressions were utilized to assess associations among migration-related stress (Demands of Immigration Scale), depression (Center for Epidemiological Studies Depression (CESD), Zanmi Lasante Depression Symptom Inventory (ZLDSI)), and key demographic variables. Findings showed a strong positive correlation between migration-related stress and depression (CESD (ß =.606, 95% CI [.296, .556]) and ZLDSI (ß = .624, 95% CI [.242, .440]). Relative to the standardized coefficient, migration-related stress was the strongest predictor of depression after controlling for other predictors. Presence at the 2010 earthquake was the only significant moderator, showing an amplifying effect between migration-related stress and depression (ZLDSI) for those in Haiti during the 2010 earthquake. Consideration of pre-migration factors and the degree of migration-related stress encountered while adapting to life post-migration is critical because they play a significant role in shaping immigrants' depression realities. Community-based services that incorporate or partner with established immigrants to strengthen support for the most vulnerable immigrants early on after migration could serve to mitigate migration-related stressors and facilitate mental health promotion and prevention.


Assuntos
Depressão/etnologia , Emigrantes e Imigrantes/psicologia , Estresse Psicológico/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Terremotos , Emigração e Imigração , Feminino , Florida/epidemiologia , Haiti/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
13.
Prog Community Health Partnersh ; 14(1): 55-62, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32280123

RESUMO

BACKGROUND: Haitian and Hispanic immigrant women experience substantial disparities in cervical cancer screening. Recently, our team completed two randomized trials of human papillomavirus (HPV) self-sampling as a cervical cancer screening strategy among Haitian and Hispanic women, using a community-based participatory research (CBPR) approach. OBJECTIVE: To reflect on lessons learned in the process of completing two large randomized cancer screening trials within underserved communities. METHODS: Haitian and Hispanic women were randomized to HPV self-sampling versus navigation to Pap smear versus standard cervical cancer screening education in the first trial, and HPV self-sampling delivered in-person versus via mail in the second trial. LESSONS LEARNED: During the two trials, our team encountered several challenges. The lessons learned from these challenges allowed for the strengthening of our community partnerships, study procedures, and our ability to conduct CBPR within an academic setting. CONCLUSIONS: Lessons learned from our trials may be useful to other researchers engaging in CBPR within underserved communities.


Assuntos
Pesquisa Participativa Baseada na Comunidade/organização & administração , Detecção Precoce de Câncer/métodos , Emigrantes e Imigrantes , Hispano-Americanos , Provedores de Redes de Segurança/organização & administração , Feminino , Haiti/etnologia , Humanos , Teste de Papanicolaou/métodos , Seleção de Pacientes , Avaliação de Programas e Projetos de Saúde , Estados Unidos/epidemiologia
14.
Ann Glob Health ; 86(1): 24, 2020 02 27.
Artigo em Inglês | MEDLINE | ID: mdl-32140433

RESUMO

Background: Some specific groups, such as immigrants, are considered at significantly high risk of developing poor sexual health (SH), specifically in relation to sexually transmitted infections (STIs). However, despite the high number of Haitian immigrants living in southern Brazil, a study that assessed the SH of these immigrants has not been conducted yet. Objective: This study aimed to assess the sexual health of Haitian immigrants in southern Brazil. Methods: This was a cross-sectional study conducted in 201 adult Haitian immigrants of both sexes, living in southern Brazil. A self-applied questionnaire containing sociodemographic questions and SH and behaviors was used to collect data. Data were collected on paper or through online form. Findings: Of the 201 immigrants included in the study, the majority were men (58.06%). There was no difference in the mean age (30 years) between both sexes. More than half were married with a partner (a) (53.29%), and 69.89% had an average educational level. Although an association between the reported STIs and the variables considered as risk factors or behaviors for STIs was not reported, women reported a frequency of 33.80% for self-declared active STIs and a frequency of 66.20% for lifelong STIs; these frequencies are highly superior in women compared to men. Additionally, 55.33% of women also reported not using a condom in their last sexual intercourse, and 35.10% reported changing their sexual behaviors after immigrating. Conclusions: The high frequency of STIs reported by Haitian immigrant women indicates the need to implement STI tracking strategies in that population. This study can assist in the development of comprehensive healthcare policies for Haitian immigrants.


Assuntos
Comportamento Contraceptivo/estatística & dados numéricos , Emigrantes e Imigrantes/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Saúde Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Preservativos , Estudos Transversais , Escolaridade , Feminino , Haiti/etnologia , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Parceiros Sexuais , Adulto Jovem
15.
Ann Glob Health ; 86(1): 12, 2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-32064230

RESUMO

Background: Obesity prevention and its associated co-morbidities such as diabetes require a multi-tiered, culturally sensitive, population-based approach. South Florida's tri-county area is home to approximately 75% of Florida's total Caribbean immigrant population. This project is the first Caribbean-focused intervention using the Go-Slow-Whoa or GSW format which designates whether a food or beverage should be chosen frequently (Go - green), less often (Slow - yellow), or rarely (Whoa - red) based on the content of nutrients, sodium, fat, and sugar. Specific Aims: 1. To create and evaluate culturally appropriate nutrition materials for the Caribbean diaspora population in Broward County (i.e. tailor existing GSW evidence-based materials for this population). 2. To quantify which social determinants of health are most relevant to this population. Methods: Mixed methods were utilized in this study. The qualitative, exploratory arm consisted of semi-structured focus groups that included 38 subjects from five Caribbean countries most represented in South Florida: Jamaica, Haiti, Trinidad and Tobago, Cuba and Dominican Republic. The quantitative arm employed descriptive and inferential statistics to analyze social determinants of health (SDOH) obtained from a modified National Association of Community Health Centers' PRAPARE survey. Intercept survey data was also collected from a convenience sample of 24 Caribbean immigrants in Broward County. Findings: Analysis revealed a lack of culturally appropriate foods and exercise examples in the current GSW materials. At 92% and 82% respectively, an overwhelming majority of our intercept surveys indicated that our revised, culturally appropriate materials were helpful in making positive food and beverage choices. Further study is required to determine which SDOH variables are relevant to this population. Conclusions: Health disparities and inequity in the healthy living education of our Caribbean subpopulation are best addressed using an inclusive research frame that captures the cultural essence and preferences of this understudied community.


Assuntos
Assistência à Saúde Culturalmente Competente , Dieta Saudável , Emigrantes e Imigrantes , Exercício Físico , Promoção da Saúde , Obesidade/prevenção & controle , Determinantes Sociais da Saúde , Adulto , Região do Caribe/etnologia , Cuba/etnologia , República Dominicana/etnologia , Feminino , Florida , Grupos Focais , Haiti/etnologia , Migração Humana , Humanos , Jamaica/etnologia , Masculino , Pessoa de Meia-Idade , Política Nutricional , Obesidade/terapia , Pesquisa Qualitativa , Trinidad e Tobago/etnologia
16.
Esc. Anna Nery Rev. Enferm ; 24(spe): :e20200242, 20200000. mapas
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1129217

RESUMO

Objetivo: compreender a vivência do enfrentamento e repercussões da COVID-19 na perspectiva das famílias de imigrantes haitianos no Brasil. Método: estudo qualitativo, do tipo ação-participante, fundamentado no Itinerário de Pesquisa de Paulo Freire, que possui três fases: Investigação Temática; Codificação e Descodificação; Desvelamento Crítico. Foi realizado Círculo de Cultura Virtual em maio de 2020, com 10 famílias de imigrantes haitianos, residentes no oeste de Santa Catarina. Resultados: os participantes discutiram preocupações geradas no enfrentamento da pandemia: trabalho e subsistência da família no Brasil e no Haiti; incerteza do futuro; risco de contaminação e de morrer no Brasil; cancelamento das aulas dos filhos; desânimo e solidão. Desvelaram oportunidades na vivência da pandemia: ajuda recebida; força pessoal e familiar; repensar a vida; confiança em Deus e esperança. Conclusões e implicações para a prática: os imigrantes haitianos se encontram em situação de vulnerabilidade social, econômica e de saúde mental no enfrentamento da COVID-19. A identificação dessa vulnerabilidade, considerando fatores sociais, econômicos e culturais é fundamental à proposição de políticas públicas e adoção de estratégias efetivas de enfrentamento da situação. O Círculo de Cultura Virtual amplia possibilidades para a enfermagem, pois possibilita as interações necessárias à promoção da saúde, mesmo diante da pandemia


Objective: to understand the experience of coping and repercussions of COVID-19 from the perspective of Haitian immigrant families in Brazil. Method: qualitative, action-participant study, based on Paulo Freire's Research Itinerary, which has three phases: Thematic Research; Encoding and Decoding; Critical Unveiling. A Virtual Culture Circle was held in May 2020, with 10 families of Haitian immigrants residing in western Santa Catarina. Results: the participants discussed concerns generated in facing the pandemic: work and family subsistence in Brazil and Haiti; uncertainty of the future; risk of contamination and dying in Brazil; cancellation of children's classes; discouragement and loneliness. They revealed opportunities in experiencing the pandemic: help received; personal and family strength; rethinking life; trust in God and hope. Conclusions and implications for practice: Haitian immigrants are in a situation of social, economic and mental health vulnerability when facing COVID-19. The identification of this vulnerability considering social, economic and cultural factors is fundamental to the proposition of public policies and the adoption of effective strategies to face the situation. The Virtual Culture Circle expands possibilities for nursing, as it enables the interactions necessary for health promotion, even in the face of the pandemic


Objetivo: comprender la experiencia de afrontamiento y las repercusiones de COVID-19 desde la perspectiva de las familias de inmigrantes haitianos en Brasil. Método: estudio cualitativo, de tipo acción-participante, basado en el Itinerario de Investigación de Paulo Freire, que tiene tres fases: Investigación temática; Codificación y decodificación; Revelación crítica. En mayo de 2020 se realizó un Círculo de Cultura Virtual, con 10 familias de inmigrantes haitianos que residen en el oeste de Santa Catarina. Resultados: los participantes discutieron las preocupaciones generadas al enfrentar la pandemia: el trabajo y la subsistencia familiar en Brasil y Haití; la incertidumbre del futuro; el riesgo de contaminación y muerte en Brasil; la cancelación de las clases infantiles; el desánimo y la soledad. Revelaron oportunidades en la experiencia de la pandemia: la ayuda recibida; fortaleza personal y familiar; el repensar la vida; la confianza en Dios y la esperanza. Conclusiones e implicaciones para la práctica: los inmigrantes haitianos se encuentran en una situación de vulnerabilidad social, económica y de salud mental en la confrontación de COVID-19. La identificación de esta vulnerabilidad, considerando los factores sociales, económicos y culturales es fundamental para la propuesta de políticas públicas y la adopción de estrategias efectivas para enfrentar la situación. El Círculo de Cultura Virtual amplía las posibilidades de la enfermería, ya que permite las interacciones necesarias para la promoción de la salud, incluso ante la pandemia


Assuntos
Humanos , Masculino , Feminino , Adulto , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/prevenção & controle , Emigração e Imigração , Pandemias/prevenção & controle , Betacoronavirus , Fatores Socioeconômicos , Brasil , Saúde Mental/etnologia , Vulnerabilidade Social , Haiti/etnologia
17.
Acad Pediatr ; 20(2): 234-240, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31857250

RESUMO

OBJECTIVE: Incorporating culturally sensitive care into well-child visits may help address pediatric preventive care disparities faced by racial and ethnic minorities, families with limited English proficiency, and immigrants. We explored parents' perspectives about the extent to which their children's pediatric care is culturally sensitive and potential associations between culturally sensitive care and well-child visit quality. METHODS: We conducted cross-sectional surveys with parents attending a well-child visit for a child ages 3 to 48 months. To measure culturally sensitive care, we created a composite score by averaging 8 subscales from an adapted version of the Clinicians' Cultural Sensitivity Survey. We assessed well-child visit quality through the Promoting Healthy Development Survey. Multivariate linear regression was used to understand associations between demographic characteristics and parent-reported culturally sensitive care. We used multivariate logistic regression to examine associations between culturally sensitive care and well-child visit quality. RESULTS: Two hundred twelve parents (71% of those approached) completed the survey. Parents born abroad, compared with those born in the United States, reported significantly higher culturally sensitive care scores (+0.21; confidence interval [CI]: 0.004, 0.43). Haitian parents reported significantly lower culturally sensitive care scores compared with non-Hispanic white parents (-0.49; CI: -0.89, -0.09). Parent-reported culturally sensitive care was significantly associated with higher odds of well-child visit quality including receipt of anticipatory guidance (adjusted odds ratio: 2.68; CI: 1.62, 4.62) and overall well-child visit quality (adjusted odds ratio: 2.54; CI: 1.59, 4.22). CONCLUSIONS: Consistent with prior research of adult patients, this study demonstrates an association between parent-reported culturally sensitive care and well-child visit quality. Future research should explore best practices to integrating culturally sensitive care in pediatric preventive health care settings.


Assuntos
Atitude Frente a Saúde , Assistência à Saúde Culturalmente Competente/estatística & dados numéricos , Pais , Pediatria/normas , Medicina Preventiva/normas , Qualidade da Assistência à Saúde , Adulto , Afro-Americanos , Grupo com Ancestrais do Continente Africano , Grupo com Ancestrais do Continente Asiático , Pré-Escolar , Grupos Étnicos , Grupo com Ancestrais do Continente Europeu , Feminino , Haiti/etnologia , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos , Humanos , Lactente , Proficiência Limitada em Inglês , Modelos Lineares , Modelos Logísticos , Masculino , Análise Multivariada , Adulto Jovem
18.
J Transcult Nurs ; 31(1): 51-58, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30957666

RESUMO

Introduction: A large body of literature exists on self-management of type 2 diabetes (T2D) in a variety of populations. However, research is limited on how Haitian immigrants self-manage their T2D despite a prevalence of 6.9% in Haiti. The purpose of this study was to explore and describe the lived experience of adult Haitian immigrants managing T2D living in the United States. Methodology: Moustakas's phenomenological approach guided this qualitative study. Adult Haitian immigrants diagnosed with T2D for at least 1 year were interviewed. Individual interviews were audio-recorded, transcribed verbatim, uploaded into NVivo, and analyzed using Moustakas's existential data analysis process. Results: We interviewed 16 participants (mean age 56;12 females; an average of 11 years living in the United States; mean hemoglobin A1c 8.1%). Four themes emerged: self-reliance, spirituality, nostalgia for home, and a desire for positive patient-provider relationships. Cultural influences and health beliefs may affect individual self-management of T2D in this population. Conclusions: These results may assist clinicians in identifying factors that contribute to suboptimal self-management in Haitian immigrants and help patients reach glycemic control. Culturally competent assessment and interventions for Haitian immigrants with T2D may not be provided without considering these four themes.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Emigrantes e Imigrantes/psicologia , Autogestão/psicologia , Adulto , Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Haiti/etnologia , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Autogestão/métodos
19.
J Immigr Minor Health ; 22(2): 399-409, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31227973

RESUMO

Type 2 diabetes (T2D) is a complex, lifelong condition that is disproportionately prevalent among minority populations. Haitian immigrants (HIs) living in the US with T2D have unique factors that influence diagnosis, treatment, and self-management. The purpose of this integrative review was to provide a synthesis of the research on T2D in the HI population. In a systematic literature search, 14 studies met the inclusion criteria. Three themes were identified: risk factors for less self-management and/or worse metabolic control; protective factors for better self-management and/or metabolic control; and mixed results. HIs had higher HbA1c, yet better self-management, different genetic profiles, and lower levels of vitamin D and hemoglobin concentration compared to other ethnic groups. HIs also reported better dietary quality, less healthcare utilization, and higher perceived emotional/psychological stress compared to other ethnic groups. This study has implications for practice for integrating the unique cultural factors when assessing and intervening with HIs.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Emigrantes e Imigrantes , Feminino , Haiti/etnologia , Humanos , Masculino , Grupos Minoritários , Prevalência , Estados Unidos/epidemiologia
20.
Medwave ; 20(4): e7904, 2020.
Artigo em Inglês, Espanhol | LILACS | ID: biblio-1103950

RESUMO

INTRODUCCIÓN: El objetivo de este estudio es describir el desarrollo psicomotor en niños y niñas de padres chilenos y haitianos de tres a 24 meses, pertenecientes a jardines infantiles. MÉTODO: El diseño del estudio fue descriptivo y transversal. Se evaluaron niños y niñas de tres a 24 meses de edad pertenecientes a jardines infantiles, mediante la Escala de Evaluación del Desarrollo Psicomotor (EEDP) y su perfil de desarrollo psicomotor para las áreas de lenguaje, social, coordinación y motor. Además, se administró un cuestionario dirigido a los padres para conocer su nivel socioeconómico, nivel educacional y aspectos de crianza. RESULTADOS: Se evaluaron un total de 24 infantes, 12 niños y niñas de padres chilenos y 12 de padres haitianos. La clasificación Escala de Evaluación del Desarrollo Psicomotor no mostró diferencias significativas entre ambos grupos (p = 0,299). En los párvulos de padres chilenos, 25% (3/12) clasificó como retraso, mientras que 75% (9/12) lo resultó normal. Por otro lado, en niños y niñas de padres haitianos, 8,3% (1/12) clasificó como riesgo, mientras que 91,7% (11/12) como normal. Existen diferencias significativas en el área de coordinación (p = 0,006), en la cual las y los menores de etnia haitiana lograron un mejor desempeño. CONCLUSIONES: Es necesario reforzar en cada una de las áreas del desarrollo psicomotor del infante y las múltiples variables socioculturales que pueden influir en este, debido a que los métodos de evaluación que se utilizan actualmente no presentan un carácter intercultural.


INTRODUCTION: This study aims to describe the psychomotor development of children, the offspring of Chilean and Haitian parents, and who attend the local kindergartens. METHODS: The design of this study was a descriptive and cross-sectional study. The study population was children 3 to 24 months-old, belonging to kindergartens, evaluated with the Psychomotor Development Assessment Scale (EEDP) regarding psychomotor development profile for the domains of language, socialization, coordination, and motor skills. A questionnaire was administered to the parents to determine the socioeconomic level, educational level, and parenting skills. RESULTS: Twenty-four infants, 12 children of Chilean parents, and 12 children of Haitian parents were evaluated. The EEDP classification (p = 0.299) did not show significant differences between both groups. In children of Chilean parents, 25% (3/12) classified as delay, while 75% (9/12) as normal. On the other hand, for children of Haitian parents, 8.3% (1/12) classified as risk, while 91.7% (11/12) as normal. There are significant differences in coordination (p = 0.006), in which Haitian children achieved better performance compared to the Chilean. CONCLUSIONS: It is necessary to emphasize every domain of infant psychomotor development and the multiple sociocultural variables that can influence this. Current evaluation methods do not presently have an intercultural character.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Pais , Desempenho Psicomotor/fisiologia , Desenvolvimento Infantil/fisiologia , Comparação Transcultural , Chile , Estudos Transversais , Inquéritos e Questionários , Haiti/etnologia
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