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1.
JMIR Public Health Surveill ; 10: e44616, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38952026

RESUMO

Background: Behavioral differences exist between countries, regions, and religions. With rapid development in recent decades, an increasing number of international immigrants from different regions with different religions have settled in China. The degrees to which sexual behaviors-particularly risky sexual behaviors-differ by religion and geographical areas are not known. Objective: We aim to estimate the associations of religion and geographical areas with sexual behaviors of international immigrants and provide evidence for promoting the sexual health of international immigrants. Methods: A cross-sectional study was conducted via the internet with a snowball sampling method among international immigrants in China. In our study, risky sexual behaviors included having multiple sexual partners and engaging in unprotected sex. Descriptive analysis was used to analyze the basic characteristics of international immigrants as well as their sexual behaviors, religious affiliations, and geographical regions of origin. Multivariate binary logistic regression analyses with multiplicative and additive interactions were used to identify aspects of religion and geography that were associated with risky sexual behaviors among international immigrants. Results: A total of 1433 international immigrants were included in the study. South Americans and nonreligious immigrants were more likely to engage in risky sexual behaviors, and Asian and Buddhist immigrants were less likely to engage in risky sexual behaviors. The majority of the Muslims had sexually transmitted infection and HIV testing experiences; however, Muslims had a low willingness to do these tests in the future. The multivariate analysis showed that Muslim (adjusted odds ratio [AOR] 0.453, 95% CI 0.228-0.897), Hindu (AOR 0.280, 95% CI 0.082-0.961), and Buddhist (AOR 0.097, 95% CI 0.012-0.811) immigrants were less likely to report engaging in unprotected sexual behaviors. Buddhist immigrants (AOR 0.292, 95% CI 0.086-0.990) were also less likely to have multiple sexual partners. With regard to geography, compared to Asians, South Americans (AOR 2.642, 95% CI 1.034-6.755), Europeans (AOR 2.310, 95% CI 1.022-5.221), and North Africans (AOR 3.524, 95% CI 1.104-11.248) had a higher probability of having multiple sexual partners. Conclusions: The rates of risky sexual behaviors among international immigrants living in China differed depending on their religions and geographical areas of origin. South Americans and nonreligious immigrants were more likely to engage in risky sexual behaviors. It is necessary to promote measures, including HIV self-testing, pre-exposure prophylaxis implementation, and targeted sexual health education, among international immigrants in China.


Assuntos
Emigrantes e Imigrantes , Assunção de Riscos , Comportamento Sexual , Humanos , Estudos Transversais , China/etnologia , China/epidemiologia , Masculino , Feminino , Adulto , Emigrantes e Imigrantes/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Comportamento Sexual/estatística & dados numéricos , Comportamento Sexual/etnologia , Comportamento Sexual/psicologia , Religião , Geografia , Pessoa de Meia-Idade , Adolescente , Adulto Jovem
2.
Am J Gastroenterol ; 119(7): 1346-1354, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38985980

RESUMO

INTRODUCTION: Immigrants with inflammatory bowel disease (IBD) may have increased healthcare utilization during pregnancy compared with non-immigrants, although this remains to be confirmed. We aimed to characterize this between these groups. METHODS: We accessed administrative databases to identify women (aged 18-55 years) with IBD with a singleton pregnancy between 2003 and 2018. Immigration status was defined as recent (<5 years of the date of conception), remote (≥5 years since the date of conception), and none. Differences in ambulatory, emergency department, hospitalization, endoscopic, and prenatal visits during 12 months preconception, pregnancy, and 12 months postpartum were characterized. Region of immigration origin was ascertained. Multivariable negative binomial regression was performed for adjusted incidence rate ratios (aIRRs) with 95% confidence intervals (CIs). RESULTS: A total of 8,880 pregnancies were included, 8,304 in non-immigrants, 96 in recent immigrants, 480 in remote immigrants. Compared with non-immigrants, recent immigrants had the highest rates of IBD-specific ambulatory visits during preconception (aIRR 3.06, 95% CI 1.93-4.85), pregnancy (aIRR 2.15, 95% CI 1.35-3.42), and postpartum (aIRR 2.21, 1.37-3.57) and the highest rates of endoscopy visits during preconception (aIRR 2.69, 95% CI 1.64-4.41) and postpartum (aIRR 2.01, 95% CI 1.09-3.70). There were no differences in emergency department and hospitalization visits between groups, although those arriving from the Americas were the most likely to be hospitalized for any reason. All immigrants with IBD were less likely to have a first trimester prenatal visit. DISCUSSION: Recent immigrants were more likely to have IBD-specific ambulatory care but less likely to receive adequate prenatal care during pregnancy.


Assuntos
Emigrantes e Imigrantes , Doenças Inflamatórias Intestinais , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Feminino , Adulto , Gravidez , Emigrantes e Imigrantes/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Adulto Jovem , Adolescente , Pessoa de Meia-Idade , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/etnologia , Doenças Inflamatórias Intestinais/terapia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/etnologia , Hospitalização/estatística & dados numéricos , Cuidado Pré-Concepcional/estatística & dados numéricos , Estudos de Coortes , Serviço Hospitalar de Emergência/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Período Pós-Parto , Assistência Ambulatorial/estatística & dados numéricos
3.
S D Med ; 77(2): 54-61, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38986158

RESUMO

Chagas disease is a chronic, systemic parasitic infection caused by the protozoan Trypanosoma cruzi. The primary mode of transmission to humans is by the Reduviid insect, endemic to South America. Recent migration of the vector has led to increased cases in the southern United States and has prompted increased surveillance and blood donation screening. It is unusual to diagnose and treat individuals with Chagas disease in the northern United States. This case describes an immigrant female from El Salvador that was informed she had Chagas disease from a blood bank screening. Confirmation and treatment of the disease were performed by her South Dakota primary care provider thus demonstrating the importance of identifying Chagas disease in the immigrant population in regions where Chagas disease infection is uncommon.


Assuntos
Doença de Chagas , Humanos , Feminino , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Doença de Chagas/terapia , Doença de Chagas/tratamento farmacológico , South Dakota , Tripanossomicidas/uso terapêutico , El Salvador , Adulto , Emigrantes e Imigrantes , Nifurtimox/uso terapêutico
5.
Front Public Health ; 12: 1359145, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39022416

RESUMO

In the early months of the COVID-19 pandemic The National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) was established. NRC-RIM initially sought to rapidly identify promising case investigation and contact tracing (CICT) practices within refugee, immigrant, and migrant communities. Between September 2020 and April 2021, the team conducted 60 interviews with individuals from cross-sector organizations (i.e., public health, health systems, community experts/organizations) working with refugee, immigrant and migrant communities in health and public health capacities related to COVID-19. The overarching aim was to identify and amplify innovative promising and best practices for CICT with refugee, immigrant, and migrant communities, including an exploration of barriers and facilitators. We utilized layered methods to rapidly assess, summarize and disseminate promising practices while simultaneously completing four thematic analyses including: (1) public health organizations; (2) health system organizations; (3) community leaders and organizations; and (4) vaccine planning and access across the three sectors. The primary objective of this article is to describe the project design, applied methods, and team science approach we utilized. We found that rapid identification and dissemination of promising practices, and barriers and facilitators for CICT with refugee, immigrant and migrant communities was feasible during a public health emergency. This approach was essential for identifying and widely sharing culturally and linguistically concordant public health practices.


Assuntos
COVID-19 , Busca de Comunicante , Emigrantes e Imigrantes , Refugiados , Migrantes , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Busca de Comunicante/métodos , Migrantes/estatística & dados numéricos , Pesquisa Qualitativa , SARS-CoV-2 , Saúde Pública
6.
BMC Psychiatry ; 24(1): 483, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956511

RESUMO

OBJECTIVE: The overall aim of this study was to understand the experiences and perspectives of immigrant Muslim women in Quebec living with mental illness, who have recently used formal mental health services such as an accredited therapist, psychologist, or clinician. Specific objectives included (i) eliciting and examining their self-identified barriers and facilitators to recovery; (ii) exploring links between religion and mental health; and (iii) self-reported satisfaction with mental health services received. METHODS: We adopted a qualitative approach, facilitating the prioritization of participant perspectives. This involved semi-structured interviews with 20 women who (i) identified as Muslim; (ii) had used mental health services in the last three years; and (iii) were 18 + years of age. Interviews were transcribed and analyzed using thematic analysis techniques. RESULTS: Three prominent themes emerged from the analysis. These themes were (i) stigma and misunderstandings in families (especially parents) and sometimes in the ethno-religious community, both acting as barriers to health service utilization and recovery; (ii) frustrating clinical experiences within formal mental health care settings, in particular a perceived lack of cultural and religious competence, which negatively affected service utilization and the development of a therapeutic alliance; and (iii) deeply-held religious beliefs, practices and trust in God imparting a rhythm, purpose and meaning, which were strong facilitators to recovery. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: These findings suggest that recovery from mental illness can be advanced by a three-pronged approach in this population. First, anti-stigma mental health literacy interventions could be held in collaboration with Muslim community groups. Second, there is a need for further religious and cultural competence interventions, resources and trainings for mental health professionals working with Muslims. Third, self-care resources should be developed that harness aspects of religious practices that can give structure, meaning, purpose and hope. All this could ultimately foster recovery in this population.


Assuntos
Emigrantes e Imigrantes , Islamismo , Transtornos Mentais , Serviços de Saúde Mental , Satisfação do Paciente , Humanos , Feminino , Islamismo/psicologia , Adulto , Quebeque , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Transtornos Mentais/etnologia , Emigrantes e Imigrantes/psicologia , Satisfação do Paciente/etnologia , Adulto Jovem , Pesquisa Qualitativa , Estigma Social
7.
BMC Public Health ; 24(1): 1757, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956532

RESUMO

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.


Assuntos
Emigrantes e Imigrantes , Emigração e Imigração , Humanos , Feminino , Adulto , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Emigração e Imigração/legislação & jurisprudência , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Michigan , Acessibilidade aos Serviços de Saúde , Política Pública , Racismo , Teoria Fundamentada , Pesquisa Qualitativa , Promoção da Saúde/métodos , Adulto Jovem
8.
BMC Public Health ; 24(1): 1911, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014369

RESUMO

BACKGROUND: After settling in the United States (US), immigrants often accumulate obesity and cardiovascular risk factors. As mood is often associated with health behaviors in the US population, mood may be an important mediating factor in immigrant populations. METHODS: The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention designed to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered "negative", while ratings of good, very good, or excellent were considered "positive". RESULTS: Hispanic/Latino (n = 268) and Somali (n = 181) adults enrolled in HIC completed baseline measures and were included in this analysis. Participants endorsing negative mood compared to positive mood had lower healthy eating scores (p = 0.02), lower physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood reported receiving less social support to eat healthy (p = < 0.001) and be physically active (p = 0.01). They also accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) less frequently than participants endorsing positive mood. CONCLUSIONS: On self-report, negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions to reduce obesity and cardiovascular risk among immigrants who report negative mood. TRIAL REGISTRATION: ClinicalTrials.gov registration: NCT05136339; April 23, 2022.


Assuntos
Afeto , Doenças Cardiovasculares , Emigrantes e Imigrantes , Exercício Físico , Fatores de Risco de Doenças Cardíacas , Humanos , Feminino , Masculino , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , Minnesota , Exercício Físico/psicologia , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Doenças Cardiovasculares/etnologia , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Somália/etnologia , Apoio Social , Autoeficácia , Inquéritos e Questionários , Comportamentos Relacionados com a Saúde
9.
BMC Public Health ; 24(1): 1912, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014412

RESUMO

INTRODUCTION: A peer support intervention using 'Mentor Mothers' was implemented for mothers who had migrated to Sweden, living in socially disadvantaged communities. The Mentor Mothers had a high degree of freedom to develop strategies for facilitating empowerment of their clients according to perceived needs. This study aimed to investigate which empowerment facilitation strategies that Mentor Mothers perceived to be relevant, feasible and effective. METHODS: Photovoice was used to generate qualitative data. Participants took photographs of their work which were then discussed during a focus group discussion and six individual semi-structured interviews. Data were analysed using thematic analysis. RESULTS: Four overarching strategies to facilitate empowerment were identified, corresponding to distinctive perceived needs in the target group: (1) Informative support responded to a need for making sense of the external context, by helping mothers navigate society, the process of parenthood and cultural parenting norms. (2) Practical support addressed a need for managing challenges in daily life, by facilitating contacts with welfare services and authorities and to enhance parenting practices. (3) Psychosocial support addressed a need for improved mental wellbeing, by instilling feelings of safety and security in daily life, relationships and in contacts with public institutions. (4) Motivational support responded to a need for finding fulfilling purpose, by promoting social interaction, encouraging civic engagement and sharing the challenges and successes of others to inspire hope. CONCLUSIONS: These results highlight various aspects of peer support for empowerment facilitation that future interventions targeting immigrant parents can use in their intervention design.


Assuntos
Empoderamento , Grupos Focais , Mães , Grupo Associado , Pesquisa Qualitativa , Humanos , Suécia , Feminino , Mães/psicologia , Adulto , Mentores/psicologia , Fotografação , Apoio Social , Emigrantes e Imigrantes/psicologia
10.
BMC Public Health ; 24(1): 1801, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38971760

RESUMO

BACKGROUND: This study aims to explore the varied experiences of patients with drug-resistant tuberculosis in Norway. The study emphasizes challenges and implications of being diagnosed with drug-resistant tuberculosis, including the impact on psychosocial health during the diagnosis, disease, treatment, isolation and recovery phases. Norway is a low endemic country of tuberculosis. Most patients are immigrants, and some of them have recently arrived in the country. Patients undergoing treatment for drug-resistant tuberculosis endure prolonged and demanding treatment that could affect their psychosocial health. METHODS: This qualitative study conducted 16 in-depth interviews with individuals aged 18 years and above who were diagnosed with drug-resistant tuberculosis. All participants completed the treatment between 2008 and 2020. Fourteen participants were immigrants, and eight of them had resided in Norway for less than four years before diagnosis. Data analysis followed the six-phase reflexive thematic analysis framework, focusing on identifying patterns in participants' experiences, thoughts, expectations and attitudes. RESULTS: The narratives of the participants highlighted the complexities of navigating the diagnosis of drug-resistant tuberculosis, treatment, side effects and life after treatment. Immigrants encountered additional challenges, including language barriers and adapting to new social environments. All participants reported experiencing physical health issues that additionally affected their mental health and social activity. Several participants had a delayed or prolonged diagnosis that complicated their disease trajectory. Participants with suspected or confirmed contagious pulmonary tuberculosis underwent hospital isolation for periods ranging from weeks to six months. The participants reported mental health issues, social isolation and stigma, however few were offered follow-up by a psychologist. Many participants had persistent problems at the time of the interviews. Three main themes emerged from the analysis: Delayed and prolonged diagnosis; Psychosocial impact of isolation during treatment; The life after tuberculosis. CONCLUSION: This study highlights the enduring impact of drug-resistant tuberculosis on patients and the significance of timely diagnosis, psychosocial support and post-treatment follow-up. The participants universally faced serious implications of the disease, including stigma and isolation. Participants who experienced delayed diagnosis, reflected on missed early intervention opportunities. We recommend further research in low endemic countries to evaluate the international and local recommendations on psychosocial support.


Assuntos
Pesquisa Qualitativa , Tuberculose Resistente a Múltiplos Medicamentos , Humanos , Noruega/epidemiologia , Masculino , Feminino , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/psicologia , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Adulto , Pessoa de Meia-Idade , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto Jovem , Entrevistas como Assunto , Antituberculosos/uso terapêutico
11.
Ethn Dis ; 34(2): 66-74, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38973803

RESUMO

Background: Social support is associated with improved clinical outcomes but is understudied among US immigrants. We examined two types of social support, perceived health provider support and community support, and characterized perceptions of social support among US immigrants compared with nonimmigrants. Methods: We conducted cross-sectional data analysis on self-reported data from Health Information National Trends Survey 5, Cycle 2. Population-level estimates were obtained using jack-knife replicate weights. Results: Immigrant status was not associated with perceived health care provider support or community support. However, compared with nonimmigrants, US immigrants were more likely to report rarely (adjusted odds ratio [aOR]=3.07) or never (aOR=3.18) having access to emotional support. Conclusions: Further research that incorporates nuanced factors (eg, time since arrival) that may influence social support in diverse US immigrant groups is needed to determine the impact of social support on health outcomes in an underserved and often overlooked population.


Assuntos
Emigrantes e Imigrantes , Apoio Social , Humanos , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Masculino , Estudos Transversais , Adulto , Estados Unidos , Pessoa de Meia-Idade , Área Carente de Assistência Médica , Idoso , Adulto Jovem , Adolescente , Acessibilidade aos Serviços de Saúde
12.
Ethn Dis ; 34(2): 60-65, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38973804

RESUMO

Background: Although small, the African immigrant population is one of the fastest growing immigrant populations in the United States. Emerging research indicates a high prevalence of noncommunicable preventable chronic conditions in this population. Like other African Americans, African immigrants are mistrustful of the health care system, hampering efforts for prevention and intervention research. Purpose: To describe our experiences conducting 2 studies in an African immigrant community, discuss the lessons learned, and provide advice to researchers interested in conducting research in similar populations. Design: The 2 published studies for which we derive lessons learned for this paper were a cross-sectional study and a qualitative study using focus group interviews. Participants included Zimbabwean immigrants in the Eastern United States recruited at religious festivals and community events. The 2 studies enrolled a total of 135 participants. Results: Of our recruitment goal of 120 in the first study, we enrolled only 98 despite numerous efforts. However, after strategically partnering with a community advisory board (CAB), in the second study, we met our recruitment goal within 4 months. With the CAB, we recruited a larger proportion of men (38% versus 24%). Without the CAB, 350 individuals agreed to participate, but only 98 (28%) returned the questionnaire, whereas with the CAB, 40 agreed to participate, and 37 (93%) successfully completed the study. Conclusion: Conducting health-related research in immigrants requires strategic partnerships with the community to build strong relationships between the research team and the target community. By nurturing these relationships, research teams can effectively access this hard-to-reach population and achieve high participation.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Emigrantes e Imigrantes , Grupos Focais , Humanos , Masculino , Estudos Transversais , Feminino , Adulto , Zimbábue/etnologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estados Unidos
13.
Acad Pediatr ; 24(5S): 100-102, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991794

RESUMO

Pathways programs are critical to promoting access and success for careers in healthcare for students from immigrant backgrounds. Three cases are presented that demonstrate the successful elements of pathways programs. Excellence in pediatrics requires the inclusion of talent from immigrant communities. Community capacity building and systems level change can be achieved through coliberatory practice of mutual action, investment, and benefit. Navigation, mentorship, and structural support for educational, social, and monetary capital are key components of pathways programs.


Assuntos
Emigrantes e Imigrantes , Mentores , Pediatria , Humanos , Pediatria/educação , Estudantes de Medicina/psicologia , Escolha da Profissão , Masculino , Feminino , Estados Unidos
15.
Acad Pediatr ; 24(5S): 103-111, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991795

RESUMO

OBJECTIVE: Despite increases in the US foreign-born population, medical education opportunities in immigrant and refugee health (IRH) remain limited. We summarize findings for published IRH curricula and offer recommendations for integrating IRH into pediatric residency programs. METHODS: We performed a literature review of articles describing the design, implementation, or assessment of IRH curricula for US-based undergraduate and graduate medical trainees. RESULTS: The literature review identified 36 articles from 21 institutions describing 37 unique curricula. Three curricula included pediatric residency programs. Commonly taught topics included cultural humility, interpreter use, and immigration status as a social determinant of health. Immigrant-focused training experiences existed at continuity clinics, clinics for refugees or asylum seekers, and dedicated electives/rotations. Curricula were most frequently described as stand-alone electives/rotations. CONCLUSIONS: IRH curricula provide opportunities to develop skills in clinical care, advocacy, and community partnerships with immigrant populations. Pediatric residency programs should align the IRH curriculum with existing learning priorities, support and hire faculty with expertise in IRH, and partner with community organizations with expertise. Programs can also consider how to best support learners interested in careers focusing on immigrant populations. Further work is needed to establish competencies and validated tools measuring trainee satisfaction and clinical competency for IRH curricula.


Assuntos
Currículo , Emigrantes e Imigrantes , Internato e Residência , Pediatria , Refugiados , Humanos , Refugiados/educação , Pediatria/educação , Estados Unidos , Emigrantes e Imigrantes/educação , Competência Cultural/educação , Determinantes Sociais da Saúde , Educação de Pós-Graduação em Medicina/métodos
18.
Acad Pediatr ; 24(5S): 46-47, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991802

RESUMO

Structural racism is historically rooted, and has been a foundation for United States immigration policy. This injustice has intergenerational effects that cost society greatly - with impacts on social cohesion, individual and collective health, and well-being, and ultimately our ability to function as a civil society. Limited pathways to citizenship and major restrictions to resources that promote integration have adverse consequences for immigrants and, their families. Research shows that children experience toxic stress that negatively impacts their long-term health and development from heightened immigration enforcement, regardless of any personal impact. In embracing the next generation of children, we will not succeed unless we support sound integration policies that promote the health and well-being of immigrant families across this nation. We must recognize how intricately our fates and our health are tied to each other; we all depend on immigrants being well. We must advance new a social contract, one that counters the 'othering' of immigrants" and recognizes that we must invest in the health and well-being of all families.


Assuntos
Emigrantes e Imigrantes , Humanos , Estados Unidos , Criança , Relação entre Gerações , Racismo Sistêmico , Emigração e Imigração/legislação & jurisprudência , Racismo
19.
Acad Pediatr ; 24(5S): 32-41, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991799

RESUMO

Immigrant students and families experience disproportionate exposure to trauma, immigration-related stress, structural inequities, and poor access to mental health and social services which can lead to mental health inequities. Immigrant students and their families also have many strengths that can buffer potential negative mental health outcomes. Schools, which address social and emotional development in addition to academic achievement, are critical institutions that can play a unique role in enhancing the strengths and responding to the needs of immigrant students and families. In this review, we adapt the Behavioral Model for Vulnerable Populations to acknowledge the contextual and macro-level factors (e.g., relevant policies, environmental influences, and structural factors) and the predisposing, enabling, and need factors that immigrant students and families experience and impact access to school mental health and social services. We discuss school-based interventions that show efficacy for improving mental health outcomes and focus on addressing acculturative stress among immigrant students. We also discuss models to address social determinants of health need among immigrant students and families within schools, including the community schools model applied to immigrant students and families. We conclude this review by providing recommendations and strategies for pediatricians and schools to transform school-based supports for immigrant students and families and promote equitable outcomes. Our recommendations include incorporating multi-level school supports for addressing mental health, social need, and acculturative stress among immigrant students, along with reinforcing the strengths of immigrant students, and promoting school collaborations with pediatricians, school-based health centers, and trusted community partners.


Assuntos
Emigrantes e Imigrantes , Humanos , Emigrantes e Imigrantes/psicologia , Criança , Determinantes Sociais da Saúde , Aculturação , Serviços de Saúde Escolar , Estresse Psicológico , Apoio Social , Serviços de Saúde Mental Escolar , Saúde Mental , Adolescente , Estudantes/psicologia , Instituições Acadêmicas , Estados Unidos
20.
Acad Pediatr ; 24(5S): 19-24, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38991797

RESUMO

The ability to exercise autonomy in achieving reproductive health goals necessitates access to contraceptive and reproductive health information and medical care. Finding trusted, comprehensive, consistent and affordable reproductive care is particularly challenging for immigrants living in the United States, especially for those without legal immigration status and for those who prefer a language other than English. In immigrant communities, sexual and reproductive health (SRH) knowledge, contraceptive choice, and family planning are influenced by many factors including tension between traditional and adopted cultural norms, limited English proficiency, restricted health care access, and structural racism. The family-centered model and longitudinal nature of relationships in pediatric primary care pose a unique opportunity to support immigrant families across the lifespan in obtaining SRH information and achieving reproductive health goals. Here, we present the unique vulnerabilities faced by immigrants seeking SRH services in the United States including both the upstream and downstream health effects of immigration status on family health. We then describe four time points across the lifespan where pediatricians can support SRH, including examples of existing SRH programming designed or adapted for immigrant families. Finally, we discuss opportunities to advance research, policy, education, and clinical care related to SRH equity for immigrant families.


Assuntos
Emigrantes e Imigrantes , Saúde Reprodutiva , Saúde Sexual , Humanos , Estados Unidos , Feminino , Acessibilidade aos Serviços de Saúde , Masculino , Serviços de Saúde Reprodutiva , Pediatras , Adolescente , Criança , Adulto
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