Ethnicity & Health最新文献

ABSTRACTRacial-ethnic socialization (RES) is a critical parenting practice among Asian American parents, yet little is known about its impact on parental mental health. Drawing on Lazarus and Folkman's (1984) transactional model of stress and coping, this longitudinal study examined trajectories of three RES domains (awareness of discrimination, avoidance of outgroups, minimization of race) and their associations with depressive symptoms among 209 Asian American parents (mean age 41.68; 79.43% female) over 12 months. Using growth mixture modeling, three distinct trajectory classes emerged for each domain: Moderate-Stable (35% for awareness of discrimination; 17% for avoidance of outgroups; 15% for minimization of race), High-Increasing (12% for awareness of discrimination; 8% for avoidance of outgroups; 13% for minimization of race), and Low-Decreasing (53% for awareness of discrimination; 76% for avoidance of outgroups; 72% for minimization of race). For awareness of discrimination, parents in the Moderate-Stable class showed significantly higher depressive symptoms levels compared to the High-Increasing and Low-Decreasing classes. For avoidance of outgroups, High-Increasing class parents reported higher depressive symptoms levels than the Moderate-Stable class, while the Low-Decreasing class demonstrated the highest depressive symptoms levels overall. For minimization of race, parents in the High-Increasing class exhibited significantly higher depressive symptoms levels compared to other classes. Results highlight the psychological challenges of engaging in RES and suggest the need for culturally competent mental health services supporting Asian American parents in these conversations.

Objectives: Despite an effective human papillomavirus (HPV) vaccine, uptake among sexual and gender minority (SGM) young adults remains suboptimal, including among Hispanic/Latino SGM. This study aimed to describe awareness/knowledge, health beliefs, attitudes, clinician recommendation receipt, and HPV vaccine intentions among unvaccinated Spanish-speaking Hispanic/Latino SGM young adults assigned male at birth in Florida and Puerto Rico.

Design: Participants completed a cross-sectional online survey between August 2021 and August 2022. Eligibility criteria included being 18-26 years old, male sex assigned at birth, identifying as Hispanic/Latino, identifying as gay, bisexual, or queer, speaking Spanish, living in Florida or Puerto Rico, and having access to the internet. Survey items assessed previous healthcare experiences, HPV vaccine awareness, knowledge, beliefs, attitudes, discussions, clinician recommendation receipt, and vaccine intentions. Descriptive analyses were performed.

Results: Among the 102 unvaccinated participants, all (100%) identified as gay and/or bisexual. Most participants self-reported male gender (96%), being of Puerto Rican descent (92%), and living in Puerto Rico (86%). Only 18.6% of participants reported having received a clinician recommendation for the HPV vaccine. HPV vaccine knowledge was low (Mean=3.2; Standard Deviation [SD] = 2.6; Range: 0-9), attitudes were neutral (Mean=2.5; SD = 0.7; range=1.0-4.3), and perceived barriers were moderate (Mean=2.4; SD = 1.0; range=1.0-4.7). Approximately 35% reported being very likely to seek additional HPV vaccination information in the next year. Approximately one-in-nine (11.8%) reported being very likely to receive the HPV vaccine in the next year, whereas approximately one-third (30.4%) reported being very likely to receive the vaccine at some point in the future.

Conclusion: Findings suggest potential modifiable and multilevel targets for future interventions to promote HPV vaccination among Spanish-speaking Hispanic/Latino SGM young adults assigned male at birth. Such multilevel interventions could address specific knowledge gaps, beliefs, and attitudes among patients and promote clinician recommendations in order to improve HPV vaccination rates among Hispanic/Latino SGM young adults.

Objectives: Africans who migrate to the US are initially leaner than US-born Black Americans of the same age. However, over time, they become affected by obesity, possibly due to exposure to the obesogenic food environment and sedentary lifestyle in the US. We aimed to understand barriers and facilitators to healthy diet and physical activity among African immigrants in the US.

Methods: Using qualitative methods, we conducted eight focus groups remotely with 31 African immigrants (BMI ≥ 27 kg/m²) living in the US. We recruited African immigrants born in Ghana, Nigeria, Kenya, Uganda, Botswana, Ethiopia, South Africa, Sudan, and Zimbabwe. Participants completed a 5-minute screening survey to assess their eligibility. In focus groups, participants were queried about barriers and facilitators to the consumption of vegetable, lean proteins, and less sugary beverage consumption, physical activity. Data were recorded and fully transcribed. We analyzed the data using inductive qualitative content analysis, achieving inter-rater reliability of 81.8%.

Results: We identified 11 barriers to a healthy diet, including differences in the taste of fruits and vegetables in the US compared to their home African countries, difficulty finding traditional African fruits and vegetables in the US, and not being accustomed to consuming raw vegetables. We identified 5 healthy diet facilitators, including making smoothies to obtain fruit servings and buying in bulk. We identified 4 barriers to physical activity, including a lack of time and paying for gym memberships. We also identified 5 physical activity facilitators, including weight gain and having friends and family with whom to exercise.

Conclusions: African immigrants share similar barriers and facilitators to healthy diet and physical activity as others but also have unique barriers and facilitators that need to be addressed in tailored lifestyle interventions. Incorporating these in future lifestyle interventions may enhance relevance, engagement, and more sustainable behavior change.

Objectives: To examine the individual- and systemic-level barriers and facilitators that influence cervical cancer screening behaviors among African and African American women, and to highlight both shared and unique factors through the lens of the Social Determinants of Health (SDH) framework.

Design: A qualitative systematic review was conducted in accordance with PRISMA 2020 standards. Twelve peer-reviewed qualitative studies published between January 2020 and May 2025 were included. Data were analyzed thematically to classify barriers and facilitators at both individual and systemic levels, using the SDH framework.

Results: Across both populations, common barriers included limited awareness, cultural and religious stigma, and financial concerns. African women frequently reported infrastructural and logistical barriers such as distance and shortages of trained providers, while African American women emphasized institutional mistrust, racial discrimination, and inconsistent communication with providers. However, factors such as community-based education, peer and partner support, and personal motivation facilitated screening uptake in both groups.

Conclusion: The study shows that even though African women and African American women share similar barriers and facilitators to cervical cancer screening, the underlying causes differ. Among African women, poor screening uptake is largely due to inadequate health infrastructure, whereas African American women's barriers are rooted in historical medical mistrust. These findings highlight the need for culturally tailored interventions, such as community-driven awareness and culturally trained providers, that respond to the lived experiences of each population rather than adopting a monolithic approach.

Objective: It has been well established that racial discrimination has detrimental consequences for well-being. However, less is known about this relationship in non-Western settings, and there is limited research examining factors that may moderate it. This study investigates the association between perceived racial discrimination and life satisfaction across four non-Western countries, as well as the role of migration as a potential moderator.

Design: A total of 3,600 respondents living in Ghana, Indonesia, Kenya, and Ukraine participated in an online survey on racial discrimination and its association with life satisfaction. Participants also reported their migration status, including whether they had migrated and the duration of their residence outside their country of origin.

Results: We found a negative association between perceived racial discrimination and life satisfaction across the four countries, although the strength of this relationship varied by context. Importantly, we found that years since migration attenuate the negative association between perceived racial discrimination and life satisfaction, potentially reflecting coping strategies and adaptation processes developed over time.

Conclusion: While a negative association between perceived racial discrimination and life satisfaction is observed in these non-Western contexts, the strength of this relationship varies across countries and is moderated by individuals' migration experiences. These findings open new avenues for research on how discrimination and migration jointly shape well-being across diverse national and individual contexts.

Background: People from culturally and linguistically diverse (CALD) backgrounds are disproportionately impacted by chronic pain. To inform the design of culturally responsive pain care that can reduce health disparities and improve health outcomes, this scoping review examined the perspectives and experiences of pain and pain care of people from CALD backgrounds in Australia.

Methods: Scoping review design based on Arksey and O'Malley's framework. Six databases (MEDLINE, EMBASE, APA PsychInfo, CINAHL, SCOPUS, Social Sciences Abstract - Proquest) were searched from inception to July 2023 and repeated in February 2024 using the keywords 'chronic pain', 'CALD' and 'Australia'. Inclusion criteria were qualitative or mixed-methods studies exploring the perceptions and experiences of adults aged ≥18 years with non-cancer pain of ≥3 months duration from CALD backgrounds (born in a non-English speaking country and/or speak a language other than English at home). Qualitative data were analysed using thematic analysis.

Results: Of 546 studies screened, five met the inclusion criteria. These studies involved 167 participants from Assyrian (Iraq), Mandaean (Iraq), Vietnamese and Indian communities. Whilst perspectives and experiences unique to each community were observed, three major themes characterised the CALD communities' chronic pain experiences: holistic beliefs about pain including physical, mental, cultural and spiritual aspects; the importance of social support networks; and barriers to accessing the healthcare system such as cost and lack of trust.

Conclusion: To improve access, uptake, and outcomes for people from CALD backgrounds, future research is needed to co-design a multidisciplinary pain programme that is widely accessible through primary care, adopts a strengths-based approach, and is delivered by trusted healthcare professionals with the support of the wider community. The findings of this study give rise to recommendations at the clinician, health service, and broader health system levels, including the hiring of culturally diverse staff who reflect the community.

Background: Black women in the United States continue to experience inequitable preventive health care shaped by racism, gender discrimination, and medical mistrust. While prior research has examined historical foundations of mistrust or individual attitudes, less attention has focused on how Black women interpret and navigate bias as it unfolds in everyday clinical encounters.

Objective: To examine how Black women understand their health care interactions, how they experience bias in preventive care, and the strategies they use to protect their well-being and sustain engagement in care.

Methods: Seventeen self-identified Black women, including both U.S. born and immigrant participants aged 21-65 years, completed in-depth semi structured interviews between February and April 2023. Interviews explored participants' interpretations of clinical interactions, perceptions of being unheard or dismissed, and the responses they enacted to preserve their dignity and health. A thematic analytic approach guided the interpretation of the data.

Results: Three major themes emerged: (1) participants described biased encounters ranging from subtle dismissive cues to overt discrimination connected to race, gender, class, immigration, and religion; (2) these experiences carried emotional and psychological demands, contributing to constant self-monitoring during care; and (3) women employed strategies such as modifying their behavior, selectively choosing providers, and self-advocacy, while acknowledging the personal limits and emotional toll of continually having to protect themselves in clinical spaces. These findings illustrate how mistrust is not only historically rooted but continually reinforced through routine interactions that communicate who is valued within health care systems.

Conclusions: Black women's accounts demonstrate that mistrust emerges from lived experiences within health care, not only historical memory. Improving preventive care requires meaningful change in provider communication, institutional responsiveness to bias, and system level commitments that demonstrate trustworthiness. Strengthening trust will depend on whether health systems can consistently honor Black women's dignity, voice, and safety in care.

Objectives: Evidence has highlighted that the COVID-19 pandemic worsened ongoing mental health inequity among population groups, such as those with pre-existing mental health problems. This is further compounded for ethnic minority communities. Research emphasises the importance of coping strategies in lessening the negative impacts of the pandemic; however, there is a scarcity of research among ethnic minority communities.

Design: To explore the experiences of coping during the COVID-19 pandemic among ethnic minority individuals with existing mental health difficulties and to identify changes and continuity in coping strategies across two different timepoints. A secondary thematic analysis was conducted of interviews with ethnic minority individuals with mental health conditions, using a cross case comparison approach to analyse interviews conducted at two timepoints during the COVID-19 pandemic.

Results: Seeking social support, implementing new habits, and self-care approaches to mental health, as well as access to and experience of mental health services, were adaptive coping strategies used, further highlighting the importance of these strategies being culturally sensitive. Several expressed difficulties with access to mental health services.

Conclusions: Whilst the pandemic has ended, this research highlights that there is still a need for future studies exploring the experiences of ethnic minority groups, and focus should be placed on developing solutions that facilitate uptake among people with mental health problems from these communities. This should involve adaptive, culturally appropriate coping strategies and implementing modifications for effective mental health care for future public health crises or other social stressors.

Objectives: This longitudinal study investigated how theorized cultural-, interpersonal/familial-, and individual-level experiences during initial years after immigrating to the United States may relate to changes in psychological distress over time among young adult Latina women in Miami-Dade County, Florida, United States (U.S.).

Methods: Using latent growth curve modeling, we examined trajectories of psychological distress reported by 530 Latina women (aged 18-23 years) during their initial years in the U.S. The sample's mean length of time in the United States since immigration was 11.52 months (SD = 9.94) at baseline assessment. Trajectories of distress were measured over a three-year time period. We investigated whether cultural- (immersion to dominant society/assimilation, immersion to ethnic society/enculturation, acculturative stress, marianismo), interpersonal/familial- (trust and communication with parents, peers, partner), and individual- (immigration authorization status, education level, relationship status) level determinants experienced soon after immigration predicted changes in participants' distress over a subsequent two-year time period.

Results: At baseline assessment, participants' psychological distress was associated with higher levels of acculturative stress (β = .63, p < .001). Over time, the average level of women's distress significantly declined (b = -.10, p = .001). Steeper declines in distress over time were reported by women who reported more baseline acculturative stress (β = -.80, p < .001) and less baseline trust and communication with their parents, peers, and partners (β = .52, p = .002).

Conclusions: Findings inform theoretical and empirical knowledge bases concerning determinants of psychological distress during initial years after immigration among foreign-born young Latina women in the U.S. The study provides a longitudinal examination of psychological distress during the rarely studied time period of initial years in the U.S. Results elucidate the substantive influence of acculturative stress and interpersonal/familial relationship dynamics soon after immigration. Mental health interventions should attend to these modifiable factors during young Latina women's early years in the U.S. to reduce psychological distress and promote well-being soon after immigration and subsequent years.

Objective: This study aims to investigate how the components of social cognitive theory (SCT), namely personal, behavioral, and environmental factors, mediate the relationship between barriers to regular glucose monitoring and the frequency of blood sugar testing in Black/African American men with type 2 diabetes (T2D).

Design: This cross-sectional observational survey study utilized an internet-based survey to assess barriers to glucose monitoring, SCT components, and monitoring frequency among 1,225 Black/African American men with T2D. Data were analyzed using Structural Equation Modeling (SEM) to examine direct and indirect relationships between these factors.

Results: Outcome expectations had a significant positive direct effect (path estimate) on the frequency of glucose testing (β = 0.02, p = 0.005), although they did not mediate the relationship between barriers and testing (β = -0.01, p = 0.183). Observational learning exhibited a significant positive direct effect on testing frequency (β = 0.19, p < 0.001), with barriers partially mediating monitoring frequency through observational learning (β = 0.01, p < 0.001). Self-efficacy showed a significant positive direct effect on testing frequency (β = 0.02, p < 0.001), with the relationship between barriers and testing frequency fully mediated by self-efficacy (β = -0.01, p < 0.001).

Conclusion: Both observational learning and self-efficacy partially or fully mediate the relationship between barriers and testing. These findings underscore the importance of interventions aimed at enhancing social support and observational learning to overcome barriers and improve adherence to glucose monitoring among Black/African American men with T2D.