Exploring acculturative stress and family dynamics in African immigrant students in the US: implications for mental health.

OBJECTIVES: African immigrants represent a rapidly growing immigrant group in the US, yet relatively little is known about influences on the health of this group. This is a particularly important oversight since adaptation to life in the United States can have deleterious effects on health due to the stress associated with immigrant and minority status as well as separation from family abroad. The present study explores how African immigrants experience acculturative stress - the stress-inducing elements of life as an immigrant - and the mental health implications of these experiences in light of home country values and conceptions of health. DESIGN: Semi-structured, in-depth interviews were conducted with a purposive sample of sub-Saharan African immigrant students attending a metropolitan university in the northeastern United States (N = 26). Data were analyzed thematically using NVivo 12. RESULTS: African immigrant students first experience acculturative stress through schools and neighborhoods where they encounter othering processes, including discrimination and racism. Family responsibilities to loved ones in the US and Africa also represent a source of stress that contributes to feelings of isolation and depression experienced while managing college responsibilities. Since these emotional and mental states are not within the purview of how health is viewed in their home countries, many suffer and may not get the care they need to effectively manage their mental health. CONCLUSION: Findings emphasize shared experiences of navigating cultural dynamics, family pressures, and discrimination that contribute to the stress experienced by African immigrants. Findings also underscore the need for the development of culturally sensitive interventions in university settings so that African immigrant students can be upwardly mobile and healthy in the long-term.

Depressive symptoms among mothers with young children-the role of family migration and social networks in Mexico.

BACKGROUND: Women who remain in migratory sending communities as their family members migrate internationally are at risk for depression. Limited research examines the association between the number of absent household members and a woman's mental health. AIMS: This study examines the association between residing in a migrant household and depressive symptoms for women in Mexico while accounting for social networks and social support. METHODS: Logistic regression analysis was employed using the Social Networks and Health Information Survey (SNHIS) (n = 320), a random household survey conducted in a medium-sized municipality in Guanajuato, Mexico. RESULTS: Multivariate results suggest that residing in a household with two or more migrants was associated with increased odds of depressive symptoms, while having immediate kin in the community reduced the odds of depressive symptoms. Social relationships in the community and social support were associated with reduced odds of depressive symptoms. Their inclusion in the models reduced the significance of but did not significantly mediate the association between residing in a household with multiple migrants and depressive symptoms. CONCLUSIONS: Services aimed at improving women's health should target women who reside in households with multiple migrants and focus on reducing the stress and mental health impacts associated with these relationships.

Father Absence, Social Networks, and Maternal Ratings of Child Health: Evidence from the 2013 Social Networks and Health Information Survey in Mexico.

Objectives To bridge the literature on the effect of father absence, international migration, and social networks on child health, we assess the association between father absence and maternal ratings of child poor health (MCPH). Next we test whether social networks of immediate and extended kin mediate the relationship between fathers' absence and MCPH. Methods Nested logistic regression models predicting MCPH are estimated using the 2013 Social Networks and Health Information Survey, collected in a migrant-sending community in Guanajuato, Mexico. These unique data distinguish among father absence due to migration versus other reasons and between immediate and extended kin ties. Results Descriptive results indicate that 25% of children with migrant fathers are assessed as having poor health, more often than children with present (15.5%) or otherwise absent fathers (17.5%). In the multivariate models, fathers' absence is not predictive of MCPH. However, the presence of extended kin ties for the mother was associated with approximately a 50% reduction in the odds of MCPH. Additionally, mother's poor self-assessed health was associated with increased odds of MCPH while the presence of a co-resident adult lowered the odds of MCPH. In sensitivity analysis among children with migrant fathers, the receipt of paternal remittances lowered the odds of MCPH. Conclusions for Practice Social networks have a direct and positive association with MCPH rather than mediating the father absence-MCPH relationship. The presence of extended kin ties in the local community is salient for more favorable child health and should be considered in public health interventions aimed at improving child health.

Using COVID-19 online learning modules to examine concerns of university students returning to in-person learning: a mixed-methods study.

OBJECTIVE: Understand student concerns with returning to in-person instruction during the COVID-19 pandemic using an e-learning module. PARTICIPANTS: 925 undergraduate and graduate students returning to in-person instruction in Fall 2021. METHODS: Five modules educated students about COVID and the transition to in-person learning and collected quantitative and qualitative data related to concerns about COVID and in-person learning. RESULTS: 65% of students expressed comfort in returning to in-person learning and almost all students answered the scenario questions correctly. Identifying as female and African-American as well as living off campus were connected to a decrease in comfort level associated with the return to in-person learning. Six major themes emerged from the qualitative data analysis. CONCLUSIONS: Students were well-informed about the COVID-19 pandemic protection measures. These findings suggest that universities can do more to address concerns students have about in-person settings during the COVID-19 pandemic.

The Interaction and Impact of Social Support and Father Absence on Breastfeeding.

Background: Behaviors related to early childhood nutrition are influenced by a mother's social environment. In many low- and middle-income countries, breastfeeding rates have steadily declined. At the same time, many communities have a history of domestic or international migration that affects the family support systems for women and children remaining in these communities. While social support has been shown to be important to health behaviors conducive to maternal and child health, scant research examines whether social support moderates the impact of an absent father on breastfeeding. Objective: We aim to assess the relationship between father absence and breastfeeding duration and test whether social support moderates the impact of father absence on breastfeeding duration. Methods: We use data from the Social Networks and Health Information Survey (n = 292), a random household survey conducted in a municipality in Guanajuato, Mexico, to estimate Poisson regression models of breastfeeding duration. Results: In multivariate models, an absent father is negatively associated with breastfeeding, whereas social support is positively associated. A significant and positive interaction between father absence and social support suggests that at high levels of support, breastfeeding duration for women with absent fathers does not appear to be meaningfully different from women with present fathers. This suggests that receiving high levels of social support during pregnancy may mitigate the absence of the child's father. Conclusions: Social support interventions for mothers of infants should target mothers and children in households without a father. More research should also be directed at understanding how social support processes during pregnancy can affect breastfeeding in other low- and middle-income countries with high rates of emigration.

Using "clinical trial diaries" to track patterns of participation for serial healthy volunteers in U.S. phase I studies.

Phase I testing of investigational drugs relies on healthy volunteers as research participants. Many U.S. healthy volunteers enroll repeatedly in clinical trials for the financial compensation. Serial participants are incentivized to ignore restrictions on their participation, and no centralized clinical trial registry prevents dual enrollment. Little is currently known about how healthy volunteers participate in studies over time, hampering the development of policies to protect this group. We detail a methodology developed as part of a longitudinal study to track in real-time healthy volunteers' Phase I participation. Illustrating these data through three case studies, we document how healthy volunteers use strategies, such as qualifying for studies at more than one clinic and traveling significant distances, to maximize their participation. Our findings suggest that "clinical trial diaries" can generate critical information about serial research participation and point to ethical issues unique to healthy volunteers' involvement in Phase I clinical trials.

Promotoras across the border: a pilot study addressing depression in Mexican women impacted by migration.

The migration of working-aged men from Mexico to the United States fractures the family-centered support structures typical of Latin America and contributes to high levels of depression in women left behind in migratory sending communities in Mexico. Mujeres en Solidaridad Apoyandose (MESA) was developed to improve depression in women through social support in a resource poor setting. MESA is a promotora intervention that trains women in the community to lead social support groups over a five-week period. The MESA curriculum uses a combination of cognitive behavioral theory techniques, psychoeducation, and social support activities aimed at alleviating or preventing depression in women. Results from this pilot efficacy study (n = 39) show that depressed participants at baseline experienced declines in depression as measured by the Center for Epidemiologic Studies Depression Scale at follow-up. Other findings demonstrate the complexity behind addressing social support and depression for women impacted by migration in different ways.