The chronic load carried by minority status, including anti-Muslim prejudice.
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401 to 425 of 599Choi SE (2020)MEDLINE-indexed journal, not yet read by usJournal of health and social behavior16 citations Grandparenting and Mortality: How Does Race-Ethnicity Matter?
Little is known about whether and how intergenerational relationships influence older adult mortality. This study examines the association between caring for grandchildren (i.e., grandparenting) and mortality and how the link differs by race-ethnicity. Drawing from the Health and Retirement Study (1998-2014, N = 13,705), I found different racial-ethnic patterns in the effects of grandparenting on mortality risk. White grandparents who provide intensive noncoresident grandparenting (i.e., over 500 hours of babysitting per two years) and multigenerational household grandparenting have a lower risk of mortality compared to noncaregiving grandparents. In contrast, black grandparents have a higher mortality risk than their noncaregiving counterparts when providing intensive noncoresident, multigenerational household, and skipped-generation household (i.e., grandparent-headed family) grandpare…
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Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States.
Importance: An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space.
Objectives: To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois.
Design, setting, and participants: In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n = 71 901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsu…
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Fletcher FE, Sherwood NR, Rice WS, Yigit I, Ross SN, Wilson TE, Weiser SD, Johnson MO, Kempf MC, Konkle-Parker D, Wingood G, Turan JM, Turan B (2020)MEDLINE-indexed journal, not yet read by usAIDS patient care and STDs39 citations Resilience and HIV Treatment Outcomes Among Women Living with HIV in the United States: A Mixed-Methods Analysis.
Resilience is defined as the ability and process to transform adversity into opportunities for growth and adaptation. Resilience may be especially important for people living with HIV (PLWH), who are susceptible to anxiety and depressive disorders, which are commonly linked to risk behaviors (i.e., alcohol and drug abuse), poor adherence to medical regimens, increased risk of morbidity and mortality, and related stigma and discrimination. To date, few studies have examined the impact of resilience on health-related behaviors and outcomes among PLWH, particularly among minority women living with HIV (WLWH) who are dealing with multiple stressors impacting their health. This study used a convergent parallel mixed-methods design to collect, analyze, and integrate qualitative and quantitative data from a subsample of WLWH enrolled in the Women's Interagency HIV Study (WIHS). The aims of the …
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Can School Diversity Policies Reduce Belonging and Achievement Gaps Between Minority and Majority Youth? Multiculturalism, Colorblindness, and Assimilationism Assessed.
European societies and schools face the challenge of accommodating immigrant minorities from increasingly diverse cultural backgrounds. In view of significant belonging and achievement gaps between minority and majority groups in school, we examine which diversity approaches are communicated by actual school policies and which approaches predict smaller ethnic gaps in student outcomes over time. To derive diversity approaches, we content-analyzed diversity policies from (n = 66) randomly sampled Belgian middle schools. Cluster analysis yielded different approaches valuing, ignoring, or rejecting cultural diversity in line with multiculturalism, colorblindness, and assimilationism, respectively. We estimated multilevel path models that longitudinally related diversity approaches to (N = 1,747) minority and (N = 1,384) majority students' school belonging and achievement (self-reported grad…
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Daeem R, Mansbach-Kleinfeld I, Farbstein I, Goodman R, Elias R, Ifrah A, Chodick G, Khamaisi R, Fennig S, Apter A (2019)MEDLINE-indexed journal, not yet read by usIsrael journal of health policy research6 citations Correlates of mental disorders among minority Arab adolescents in Israel: results from the Galilee Study.
Background: The Galilee Study is the first large epidemiological study to compare correlates of mental disorders between two Arab Palestinian minority groups of adolescents in Israel.
Methods: A two-stage cross-sectional study, carried out between 2012 and 2014, included all 9th grade students from 5 Arab localities, representative of 77% of the Muslim and 100% of Druze citizens in Israel. During the screening stage, 1639 students completed the Strengths and Difficulties Questionnaire in the classroom (response rate = 69.3%). During the follow-up stage, 704 adolescent-mother dyads were interviewed at home; using the Development and Well-Being Assessment, the General Health Questionnaire (GHQ)-12, the Subjective Feeling of Discrimination Index (FDI), and socio-demographic questions (response rate = 84.4%).
Results: Prevalence of any disorder, internalizing or externalizing disorders among…
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Allostatic Load: Importance, Markers, and Score Determination in Minority and Disparity Populations.
Allostatic load is a physiological measure of the cumulative burden of stress on the body assessed by markers of physiological dysregulation. It is a multisystem construct that quantifies biological risk which leads to poor health and maladaptive trajectories. In this overview, which is based on a presentation made at the Flip the Script: Understanding African American Women's Resilience in the Face of Allostatic Load meeting at Ohio State University in August 2018, we build upon previous reviews by discussing four key aspects of allostatic load, specifically its: (1) importance, (2) operationalization, (3) use in minority health and health disparities research, and (4) value in such research. Operationalized in various ways, allostatic load is composed of 10 original markers and additional markers deriving from research among minority and disparity populations. The markers represent fou…
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Perceived barriers to accessing Female Community Health Volunteers' (FCHV) services among ethnic minority women in Nepal: A qualitative study.
Despite the efforts of community health workers to increase access to healthcare among ethnic minority groups in low- and -middle income countries, members of ethnic minorities are less likely than women from other ethnic groups to use maternal and child healthcare services. However, much less is known about the factors that limit access of ethnic minorities to healthcare services, including the services of community health workers in Nepal, who are known as Female Community Health Volunteers (FCHVs). To address this issue, we conducted a qualitative study to explore perceived barriers to accessing maternal and child healthcare services among ethnic minority groups in two different geographical locations (the hill and Terai regions- flatland bordering south India) with varying degrees of access to local healthcare centres. Between April 2014 and September 2014, semi-structured interviews…
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Reappraising academic and social adversity improves middle school students' academic achievement, behavior, and well-being.
The period of early adolescence is characterized by dramatic changes, simultaneously affecting physiological, psychological, social, and cognitive development. The physical transition from elementary to middle school can exacerbate the stress and adversity experienced during this critical life stage. Middle school students often struggle to find social and emotional support, and many students experience a decreased sense of belonging in school, diverting students from promising academic and career trajectories. Drawing on psychological insights for promoting belonging, we fielded a brief intervention designed to help students reappraise concerns about fitting in at the start of middle school as both temporary and normal. We conducted a district-wide double-blind experimental study of this approach with middle school students (n = 1,304). Compared with the control condition activities, th…
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Ethnic-racial typicality and its relation to ethnic identity and psychological functioning.
Objectives: Ethnic identity development is considered a central task of adolescence and emerging adulthood for ethnic minority individuals. Although the process of developing a coherent ethnic identity has received attention from researchers, there has been little work done to elucidate the content of ethnic identity. This study uses an inductive mixed-methods approach to address 1 aspect of ethnic identity content: typicality, or the degree of perceived similarity individuals feel to their ethnic-racial group.
Method: Participants included 974 college students at 3 universities-66% women, average age 20.4 years, 5% Black, 30% Asian, 10% Latinx, 40% White, 11% Multiracial, 1% American Indian, and 4% Other race-ethnicity. Thematic analysis was used to code qualitative categories on what makes individuals typical of and atypical of their ethnic group. Codes were used to quantitatively asse…
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Population-level factors predicting variation in influenza vaccine uptake among adults and young children in England, 2015/16 and 2016/17.
England's influenza vaccination programme targets persons with clinical risk factors, pregnant women, those aged 65 years and older and children. Low vaccine uptake amongst primary school children was previously found to be significantly associated with increasing deprivation, Black or Minority Ethnic (BME) and certain religions. It is unknown whether these population predictors are associated with vaccine uptake in other groups. GP level data for target groups during the 2015/16 and 2016/17 seasons were linearly regressed against various factors to determine potential predictors associated with variation in uptake. Adjusted uptake for 2-4 year olds during both seasons was more than 11% lower in the most deprived decile and more than 3% lower in 34%+ BME populations compared to the least deprived and non-BME populations. Pregnant women in deprived areas had significantly lower vaccine up…
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Peer status in relation to psychotic experiences and psychosocial problems in adolescents: a longitudinal school-based study.
Social exclusion is related to many adverse mental health outcomes and may be particularly harmful for mental health in adolescence when peer relations become very important. This study examined associations between low peer status and psychotic experiences, psychosocial problems and short-term courses of these symptoms. A school-based sample of adolescents (N = 1171) was investigated in 2 consecutive years using the 16-item Prodromal Questionnaire and the self-report and teacher-report version of the Strengths and Difficulties Questionnaire (SDQ). Peer status was measured in the second year with positive and negative peer nominations of classmates. Low peer status was, after adjusting for gender, ethnic minority status and level of education, associated with more psychosocial difficulties with a persistent course and a higher level of psychotic experiences. Of all peer status groups, be…
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Best Practices for Partnering with Ethnic Minority-Serving Religious Organizations on Health Promotion and Prevention.
Faith-based organizations (FBOs) serve as effective sites for community-based health promotion, but there is a lack of research on this work in ethnic minority-serving religious institutions such as mosques, temples, and gurdwaras. This article will share best practices, challenges, and special considerations in engaging these sites through two projects: Racial and Ethnic Approaches to Community Health for Asian Americans (REACH FAR) and Muslim Americans Reaching for Health and Building Alliances (MARHABA). We also discuss the Consolidated Framework for Implementation Research and how we used this framework in the two projects to facilitate implementation of health promotion initiatives within ethnic minority-serving religious institutions. To successfully implement such initiatives within these sites, efforts should leverage trusted internal and external relationships through iterative …
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Stability of Attachment Style in Adolescence: An Empirical Test of Alternative Developmental Processes.
Few studies have examined stability and change in attachment during adolescence. This 5-year longitudinal study (a) examined whether prototype or revisionist developmental dynamics better characterized patterns of stability and change in adolescent attachment (at T1, N = 176; Mage = 14.0 years, SD = 0.9), (b) tested potential moderators of prototype-like attachment stability, and (c) compared attachment stability in adolescence to stability in adulthood. The results supported the prototype model, which assumes that there is a stable, enduring factor underlying stability and change in attachment. Exploratory moderation analyses revealed that family conflict, parental separation or divorce, minority status, and male sex might undermine the prototype-like stability of adolescent attachment. Stability of attachment was lower in adolescence relative to adulthood.
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Hatchel T, Marx R (2018)MEDLINE-indexed journal, not yet read by usInternational journal of environmental research and public health43 citations Understanding Intersectionality and Resiliency among Transgender Adolescents: Exploring Pathways among Peer Victimization, School Belonging, and Drug Use.
Transgender youth experience elevated levels of victimization and may therefore report greater drug use than their cisgender peers, yet little is known about protective factors like school belonging that may mediate this relationship. Further, scant research has explored the experiences of youth at the intersection of transgender identity and youth of color status or low socioeconomic status, especially with respect to these multiple minority statuses’ associations with peer victimization, drug use, and school belonging. Using data from the California Healthy Kids Survey, the current study employs structural equation modeling to explore the relationships among school belonging, peer victimization, and drug use for transgender youth. Findings indicate that school belonging does mediate the pathway between peer victimization and drug use for transgender youth and that although youth of col…
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Culture as a Double-Edged Sword: The Posttraumatic Experience of Indigenous Ethnic Minority Veterans.
The applicability of Western concepts regarding the treatment of trauma in soldiers from indigenous ethnic minority backgrounds has scarcely been researched. This study explored the subjective meaning of living with chronic posttraumatic stress disorder (PTSD) among indigenous Bedouin veterans of the Israel Defense Forces (IDF), who are of Arab ethnicity and Muslim faith. In-depth, semistructured qualitative interviews were conducted with 10 Bedouin veterans suffering from PTSD and three Bedouin mental health clinicians working with this population. Two themes emerged: "I wanted to be like everyone else," referring to participants' experiences during their military service, and "Fluctuating between belonging and abandonment," referring to veterans' experiences of living with mental health problems in a traditional minority community. These findings highlight the importance of conducting …
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Availability, use of, and satisfaction with green space, and children's mental wellbeing at age 4 years in a multicultural, deprived, urban area: results from the Born in Bradford cohort study.
Background: It is unknown whether the quantity or quality of green space is more important for mental wellbeing. We aimed to explore associations between availability of, satisfaction with, and use of green space and mental wellbeing among children aged 4 years in a multi-ethnic sample.
Methods: We did a 4-year follow-up assessment of participants in the Born in Bradford longitudinal cohort study, which recruited children and mothers at the city's main maternity unit from 2007 to 2011. The primary outcome was parent-reported mental wellbeing for children aged 4 years, assessed with the standardised Strengths and Difficulties Questionnaire. Total, internalising, and externalising behavioural difficulties and prosocial behaviour scales were computed (with higher scores indicating greater difficulties or more prosocial behaviour). Residential green space around participants' home addresses …
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Using a co-production prioritization exercise involving South Asian children, young people and their families to identify health priorities requiring further research and public awareness.
Objectives: To facilitate South Asian (SA) families and health-care professionals (HCPs) participation in a prioritization exercise to co-produce child health research and public awareness agendas.
Design: A three-stage process was adopted involving the following: (i) systematic literature review, (ii) HCP scoping survey and (iii) focus groups of SA adolescents and families. A Punjabi- and Urdu-speaking community facilitator moderated focus groups. A British Sign Language interpreter assisted in the hard of hearing group. Concordant and discordant themes between HCPs and SAs were identified.
Setting: National survey of HCPs. Leicestershire for SA families.
Participants: A total of 27 HCPs and 35 SAs. SAs varied by descent, age (16-74), UK stay length (3-57 years) religion and disability.
Results: Ranked by submission frequency in the survey, HCPs prioritized (i) public awareness on obesi…
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Enhancing Diversity in Undergraduate Science: Self-Efficacy Drives Performance Gains with Active Learning.
Efforts to retain underrepresented minority (URM) students in science, technology, engineering, and mathematics (STEM) have shown only limited success in higher education, due in part to a persistent achievement gap between students from historically underrepresented and well-represented backgrounds. To test the hypothesis that active learning disproportionately benefits URM students, we quantified the effects of traditional versus active learning on student academic performance, science self-efficacy, and sense of social belonging in a large (more than 250 students) introductory STEM course. A transition to active learning closed the gap in learning gains between non-URM and URM students and led to an increase in science self-efficacy for all students. Sense of social belonging also increased significantly with active learning, but only for non-URM students. Through structural equation …
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The concomitants of conspiracy concerns.
Purpose: A conspiracy world view may be a form of mistrust that is typically corrosive to individual and societal well-being. Our aim was to establish the correlates of conspiracy thinking in an epidemiologically representative sample.
Methods: US National Comorbidity Survey-Replication (NCS-R) data were analysed from 5645 people who had completed the item "I am convinced there is a conspiracy behind many things in the world." Results were weighted to be representative of the US adult English speaking household population.
Results: 1618 people (weighted 26.7%) endorsed the conspiracy belief item. These individuals were more likely to be: male; currently unmarried; less educated; in a lower income household; outside the labour force; from an ethnic minority group; not attending religious services; taking a weapon outside; and perceiving themselves as of lower social standing compared to o…
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Mantovani N, Pizzolati M, Edge D (2017)MEDLINE-indexed journal, not yet read by usHealth expectations : an international journal of public participation in health care and health policy58 citations Exploring the relationship between stigma and help-seeking for mental illness in African-descended faith communities in the UK.
Background: Stigma related to mental illness affects all ethnic groups, contributing to the production and maintenance of mental illness and restricting access to care and support. However, stigma is especially prevalent in minority communities, thus potentially increasing ethnically based disparities. Little is known of the links between stigma and help-seeking for mental illness in African-descended populations in the UK.
Objective and study design: Building on the evidence that faith-based organizations (FBOs) can aid the development of effective public health strategies, this qualitative study used semi-structured interviews with faith groups to explore the complex ways in which stigma influences help-seeking for mental illness in African-descended communities. A thematic approach to data analysis was applied to the entire data set.
Setting and participants: Twenty-six men and women …
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U.S. Minority Homeless Youth's Access to and Use of Mobile Phones: Implications for mHealth Intervention Design.
Few interventions for homeless youth have leveraged the potential of mHealth technologies, in part because of the limited data on phone behaviors, perceptions, and intervention preferences among youth experiencing homelessness. We conducted 9 focus groups (n = 52 homeless youth) and 41 individual structured interviews also with homeless youth in underserved communities in Baltimore and Washington, DC, to ascertain how youth perceived their mobile phone, acquired and maintained mobile services over time, and thought mHealth programs for this population should be designed. We also measured phone use, functionality, source, duration of ownership, and reasons for changing phones or numbers. Results showed that mobile coverage was high, as most youth self-purchased phones or received gift payments from others. Maintaining mobile connectivity was often challenging because of financial constrai…
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"Where are all the lonely people?" A population-based study of high-risk groups across the life span.
Background: Loneliness is a prevalent and urgent public health issue. Optimal planning of community approaches to loneliness requires a differentiated understanding of loneliness across the life span. We identified groups at high risk of loneliness by exploring the relationship between loneliness and socio-demographic and health-related factors across multiple age groups.
Methods: This was a combined population-based questionnaire survey and register data study based on a representative sample, including 33,285 Danish individuals aged 16-102 years. Loneliness was measured using the Three-Item Loneliness Scale.
Results: The relation between loneliness and age took a shallow U-shaped distribution. Ethnic minority status, receiving disability pensions or being unemployed, living alone, prolonged mental disorder, and psychiatric treatment were strongly associated with severe loneliness. Soci…
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Help seeking in school by Israeli Arab minority adolescents with emotional and behavioral problems: results from the Galilee Study.
Background: Many distressed minority adolescents with little access to professional mental health services use teachers and school counselors as their main consultation sources. This paper presents data from the Galilee study on factors that may increase the probability of adolescents' help-seeking in school and discusses the needed linkage between the school mental health services and those provided by other agencies, in the framework of the Mental Health Reform in Israel.
Methods: This cross-sectional survey included 1639, 9th grade students living in 5 Arab localities in the Galilee in northern Israel, representative of the Muslim and Druze populations. The study was carried out in two stages: in the screening stage, the Strengths and Difficulties Questionnaire (SDQ) was completed in the classroom. During the follow-up stage 704 students were selected and interviewed at home regarding…
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Predictors of Delayed Healthcare Seeking Among American Muslim Women.
Background: Delayed care seeking is associated with adverse health outcomes. For Muslim women, delayed care seeking might include religion-related motivations, such as a preference for female clinicians, concerns about preserving modesty, and fatalistic beliefs. Our study assesses associations between religion-related factors and delayed care seeking due to a perceived lack of female clinicians.
Materials and methods: Surveys were distributed to Muslim women attending mosque and community events in Chicago. Survey items included measures of religiosity, religious fatalism, discrimination, modesty, and alternative medicine utilization and worship practices. The outcome measure asked for levels of agreement to the statement "I have delayed seeking medical care when no woman doctor is available to see me."
Results: Two hundred fifty-four women completed the survey with nearly equal numbers …
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Muslim immigrant women's views on cervical cancer screening and HPV self-sampling in Ontario, Canada.
Background: Canada has observed significant decreases in incidence and mortality of cervical cancer in recent decades, and this has been attributed to appropriate screening (i.e., the Pap test). However, certain subgroups including Muslim immigrants show higher rates of cervical cancer mortality despite their lower incidence. Low levels of screening have been attributed to such barriers as lack of a family physician, inconvenient clinic hours, having a male physician, and cultural barriers (e.g., modesty, language). HPV self -sampling helps to alleviate many of these barriers. However, little is known about the acceptability of this evidence-based strategy among Muslim women. This study explored Muslim immigrant women's views on cervical cancer screening and the acceptability of HPV self-sampling.
Methods: An exploratory community-based mixed methods design was used. A convenience sample…
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