Search Results (147)

This article focuses on how rising nativism, manifested through immigrants’ experiences of everyday discrimination, and Florida’s legal context (ascertained through immigrants’ fears of deportation), are related to immigrants’ hesitation when seeking healthcare services. Hesitation to seek healthcare, or healthcare hesitancy, is examined in the context of Florida’s SB1718, a law passed in 2023 that criminalized many aspects of being an immigrant. Based on a survey of 466 Florida immigrants and U.S. citizen adult children of immigrants, logistic regression analysis reveals that everyday experiences with discrimination are associated with a reluctance to seek healthcare services among this population. In particular, those with insecure legal immigrant status (i.e., undocumented and temporary statuses), those with financial hardship, and women demonstrate reluctance to engage with healthcare systems when controlling for other sociodemographic factors. Findings from this study exemplify how immigration policies that restrict access to healthcare and social services not only create logistical barriers to seeking care but also foster a climate of fear and exclusion that deters even those with legal status from seeking medical attention. Full article

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States (U.S.) and a major contributor to several cancers, including cervical, anal, penile, and oropharyngeal cancers. Although a safe and effective vaccine is available, HPV vaccination rates remain suboptimal, particularly among racial, ethnic, and immigrant minority groups. This study explored multiple factors, such as cultural, social, and structural influences, influencing HPV vaccine decision-making among Cape Verdean immigrant parents in the U.S., a population currently underrepresented in HPV research. Methods: Qualitative study using individual, in-depth interviews with Cape Verdean immigrant parents of children aged 11 to 17 years living in the U.S. Interviews were transcribed verbatim and analyzed thematically using the social ecological model (SEM) to identify barriers and facilitators at the intrapersonal, interpersonal, organizational, community, and policy levels. Results: Forty-five Cape Verdean parents (27 mothers, 18 fathers) participated. Fathers were significantly older than mothers (50.0 vs. 41.1 years, p = 0.05). Most were married or partnered (60%), had at least a high school education (84.4%), and reported annual household incomes of US$50,000 or more (66.7%), with no significant gender differences. Nearly all spoke Creole at home (95.6%). Fathers had lower acculturation than mothers (p = 0.05), reflecting less adaptation to U.S. norms and language use. Most parents had limited knowledge of HPV and the vaccine, with gendered beliefs and misconceptions about risk. Only seven mothers (25.9%) reported receiving a provider recommendation; all indicated that their children had initiated vaccination (1 dose or more). Mothers were the primary decision-makers, though joint decision-making was common. Trust in providers was high, but poor communication and the lack of culturally and linguistically appropriate materials limited informed decision-making. Stigma, misinformation, and cultural taboos restricted open dialogue. Trusted sources of information included schools, churches, and Cape Verdean organizations. While parents valued the U.S. healthcare system, they noted gaps in public health messaging and provider engagement. Conclusions: Findings revealed that HPV vaccine uptake and hesitancy among Cape Verdean immigrant parents in the U.S. were influenced by individual beliefs, family dynamics, healthcare provider interactions, cultural norms, and structural barriers. These findings highlight the need for multilevel strategies such as culturally tailored education, community engagement, and improved provider communication to support informed vaccination decisions in this population. Full article

Background/Objectives: Hispanic immigrants (HIs) in the U.S.A. are disproportionately affected by cervical cancer compared to other groups, at least partly due to low HPV vaccination rates. The aim of this study was to investigate strategies to improve HPV vaccine attitudes and intent of HIs in the U.S.A. by developing and testing the effectiveness of video-based interventions. Methods: This study employed a two-phase mixed-methods approach. In the first phase, focus groups with new and established HIs explored perspectives, concerns about HPV vaccination, types of information to include in a video intervention, and how an effective intervention should be designed. Findings from the focus groups guided the creation of seven short educational videos, including a summary video and a testimonial-based video, addressing key questions about HPV and its vaccine. The second phase, which involved a nationwide survey of 1500 Spanish-speaking HIs, revealed a significant change in overall HPV vaccine attitude generally, and a significant increase in both HPV vaccine intent and attitudes among parents of unvaccinated children. Results: Regression analysis revealed general vaccine attitudes (β = 0.620, p < 0.001), English proficiency (β = 0.066, p = 0.01), and gender (β = −0.072, p = 0.002), as significant predictors of attitudinal changes. Notably, females exhibited less favorable post-intervention attitudes compared to males. Additionally, perceived care from video creators was a strong predictor of normalized gains in vaccine attitudes (β = 0.270, p < 0.001). Video content effectiveness varied; the video addressing vaccine side effects demonstrated the highest impact on attitude improvement. Testimonials and the summary video were also effective in fostering positive changes in attitudes. Despite differences in trust levels between new and established immigrants, both groups valued culturally tailored, Spanish-language information from credible sources. Conclusion: Addressing language and cultural barriers can improve trust in healthcare interventions among Hispanic immigrants in the U.S.A. Public health initiatives should consider these factors to more effectively reduce HPV vaccine hesitancy in this population. Full article

This article examines the risk factors for hypertension among migrants in South Africa, a critical public health concern. We explore the connection between acculturation, lifestyle changes, obesity, diet, urbanization, and socioeconomic status in contributing to hypertension risk. Our analysis highlights the unique challenges faced by African migrants, including acculturative stress, limited healthcare access, and lifestyle changes. The findings have significant implications for health promotion, disease prevention, and policy development. We emphasize the need for targeted interventions and updated immigration policies prioritizing hypertension awareness, screening, and management among African migrant populations. Full article

Background: Maternal and child health (MCH) is a critical public health issue affecting individuals, families, and communities worldwide. Immigrant populations, including Brazilian mothers and children in the United States (U.S.), face unique challenges, such as language barriers, limited healthcare access, and socioeconomic disparities that exacerbate health risks. Despite their growing numbers, Brazilian immigrants in the U.S. are an understudied group in MCH research. Objective: This systematic review and qualitative meta-synthesis aims to identify, appraise, and synthesize qualitative and mixed-methods research focused on the MCH experiences of Brazilian immigrants in the U.S. Methods: This review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with PROSPERO, an international prospective registry of systematic reviews. Qualitative and mixed-methods research published between 2004 and 2024 that explicitly report qualitative methodology, analysis, and findings related to MCH experiences among Brazilians in the U.S. will be eligible to be included. Studies will be identified through a comprehensive search of seven databases (CINAHL, MEDLINE, PubMed, PsycINFO, Web of Science, Scopus, SocINDEX), and selected according to predefined inclusion/exclusion criteria. Only studies available in English, Portuguese, or Spanish and reporting original qualitative data will be included. Data extraction will be conducted using the Joanna Briggs Institute (JBI) Data Extraction Tool for Qualitative Research. Findings will be synthesized using the JBI meta-aggregation approach in MAXQDA software and evaluated for confidence using the JBI Confidence in Qualitative Research (ConQual) tool. Conclusions: By synthesizing qualitative findings, this review aims to inform the development of culturally responsive healthcare policies, community-based interventions, and future research tailored to the unique needs and experiences of Brazilian immigrant mothers and children in the U.S. Full article

The COVID-19 pandemic greatly impacted care aides in long-term care facilities (LTCFs), exacerbating existing challenges and introducing new stressors that profoundly affected their job satisfaction, mental health, and overall well-being. This study investigates these multifaceted effects by conducting a comprehensive literature review of 18 studies from 2020 to 2023 across multiple countries. The findings reveal that care aides, mostly older and female and often immigrants with limited formal education, faced increased workloads, emotional exhaustion, physical fatigue, anxiety, and heightened stress levels during the pandemic. These factors led to decreased job satisfaction, higher burnout rates, and further pressure on LTCFs. The review emphasizes the need for strong support systems and targeted interventions, including mental health resources, counseling, adequate personal protective equipment (PPE), effective workload management, professional development opportunities, fair compensation, and supportive work environments. Addressing these issues is crucial for maintaining a stable and effective LTC workforce, improving care outcomes for residents, and enhancing the healthcare system’s resilience against future challenges. Full article

African immigrants in the UK, especially in places such as London, Birmingham, and Manchester, contend with institutional racism, xenophobia, and socio-economic marginalisation. This study analyses how first- and second-generation African diaspora communities understand Jeremiah 29: 4–7 to create resilience and belonging. This study uses desktop research from African diasporic churches and analyses the UK’s Inclusive Britain Strategy (2023) to contend that biblical tales are reinterpreted to confront modern issues, including the Windrush Scandal and racial inequalities in NHS maternal care. The document emphasises the influence of African-led churches in formulating integration plans and promoting policy reforms in the UK. The findings indicate that African diaspora churches reinterpret Jeremiah 29: 4–5 to promote resilience and structural involvement in combating systemic racism and socio-economic disadvantage in the UK. The paper concludes by reinterpreting biblical tales to connect spiritual resilience with systemic activism, promoting hybrid identities, and integrating legislative reforms with community-driven initiatives for equity. The paper recommends the decolonisation of curricula, the enhancement of culturally competent healthcare training, the expansion of church–state collaborations, and the modification of legislation such as the Hostile Environment to foster inclusiveness. This study enhances academic discourse by merging diaspora theology with policy analysis, presenting an innovative framework for the theological examination of migration and elevating African agency within UK socio-political environments through decolonial hermeneutics and hybrid identity paradigms. Full article

Background/Objectives: The surge in migration from the Middle East and North Africa due to conflicts has significantly impacted healthcare systems, particularly in Greece. This study investigates how the sharp increase in refugees and migrants after July 2015 has strained the surgical departments of the Greek National Health System (NHS). Methods: A retrospective analysis was conducted on 229 patients treated at the emergency department of a public hospital in Athens, Greece. Data were compared between two periods: January 2012–July 2015 (pre-July 2015) and July 2015–December 2018 (post-July 2015), with July 2015 chosen as the cutoff due to a significant influx of immigrants during that time. Results: Patients’ demographic details, diagnoses, and surgical interventions were analyzed. Results indicated a significant rise in surgical cases, with 72.5% of patients requiring procedures, notably for appendicitis (23.6%), cholecystitis (10.9%), lower extremity thrombophlebitis (9.6%), perianal abscess (8.3%), and inguinal hernia (5.7%). Post-July 2015, there was a notable increase in perianal abscess (12.2%), inguinal hernia (8.4%), and cholelithiasis (6.1%). However, the average hospital stay of 3.9 days remained unchanged. Conclusions: The findings reveal the profound economic and operational pressures on the NHS during the refugee crisis, highlighting the urgent need for resource optimization and policy reforms. Future studies should address long-term healthcare impacts to support more sustainable healthcare models amidst ongoing and future migration challenges. Full article

In the United States (U.S.), Latina transgender women (LTW) are highly burdened by HIV and are prioritized for pre-exposure prophylaxis (PrEP). This study explored intersectional barriers and facilitators to PrEP uptake among LTW. Between February–November 2022, in-depth interviews were conducted with 27 LTW in the LITE Study. Participants were purposively sampled from 196 LTW in the cohort based on PrEP uptake (PrEP-naïve n = 8, PrEP-eligible and not user n = 5, current PrEP user n = 6, previous PrEP user n = 8). We conducted content analysis guided by a Modified Social Ecological Model and Intersectionality Framework. The mean age of participants was 32.3 (SD = 12.9). Themes were: (1) Intrapersonal: Medical distrust, acceptability of PrEP modalities, and concerns about long-term health; (2) Interpersonal: Mistreatment in healthcare, discrimination-related healthcare avoidance, difficulty finding trans-competent providers, language barriers, and shame and stigma; and (3) Structural: PrEP in the context of limited access to gender-affirming care and widespread silicone use, immigration status, economic marginalization, lack of community outreach, transphobia and anti-transgender legislative contexts, and xenophobia. This study found multilevel intersectional barriers influence PrEP uptake and persistence. Culturally tailored HIV prevention efforts are needed to address LTW-specific barriers, provide information on programs subsidizing PrEP, and implement policy change to ensure equitable PrEP access. Full article

Objective: This study examines the barriers and facilitators to COVID-19 vaccination among immigrant and refugee populations, with a focus on informing primary healthcare stakeholders on effective strategies to address the health needs of these groups. Although conducted in Canada, the findings are relevant to countries facing similar challenges in promoting vaccine uptake among migrant communities. Methods: As part of an evaluation of best practices in COVID-19 vaccination promotion and provision, data were collected using in-depth key informant interviews with a cross-section of primary care stakeholders (n = 11). Main findings: Key barriers to vaccine promotion and provision included distrust of health and government services, misinformation, lack of vaccine confidence, and access or systems-level barriers. Effective facilitators were relationship-building and equity-driven approaches, such as community engagement and development, culturally and linguistically effective communication, one-on-one supports, and collaboration with community members as valued partners and staff. These strategies were identified as best practices that enhanced vaccine confidence and uptake. Conclusion: The risk and impacts of COVID-19 are disproportionately distributed worldwide, affecting migrant populations in many countries. Primary healthcare stakeholders must understand the barriers and facilitators to vaccine promotion to effectively address health inequalities. Increasing vaccine uptake and confidence among immigrant and refugee populations requires targeted and tailored approaches that are culturally responsive and equity-informed. These findings provide valuable insights for health systems globally, supporting efforts to reduce health inequities by using inclusive vaccination strategies. Full article

Italy’s immigrant population has risen in the last two decades. Integration into society, including access to healthcare, is critical for the well-being of this population. Objectives: We compared regular immigrants and Italians to determine whether the groups received different care. Methods: Inpatient and outpatient medical records were collected from January 2017 to December 2021. We abstracted the identification code, nationality, sex, age, ICD-9 codes, date of the first and additional visits, and surgical intervention. Pathologies were categorized with ICD-9 codes. Patients were grouped according to geographical origin: European Union (EU), Central and Eastern Europe, Asia, North Africa, Central and South Africa, North America, and Central and South America. Results: More patients from Asia and Africa presented to inpatient than outpatient clinics (p-value: 0.001). The median age was lower for patients from Asia and Eastern Europe than from the EU. More patients presented with acute spine pain (26.4% versus 19.6%, p-value: 0.001) as inpatients, while patients presented as outpatients more for degenerative spine issues (77.1% versus 69.0%, p-value: <0.001) but less for brain neoplasms (p-value: 0.009). Additional visit rates were higher for immigrants than for Italians (IRR 1.32 visits/year, 95% CI 0.99–1.77 visits/year, p-value: 0.06), especially for patients with spinal issues (spinal versus cranial: 1.27 visits/year, 95% CI 1.14–1.43 visits/year, p-value: <0.001) and younger patients (<65 years old: 1.52 visits/year, 95% CI 1.39–1.71 visits per year, p-value: <0.001). There was no difference in the incidence of new visits when stratified by sex. Conclusions: Access to emergency care and additional visits were more prevalent in the recent immigrant population, especially from Asia, reflecting unconsolidated health habits. Immigrants from Central and Eastern Europe or North Africa seemed fully integrated. A healthcare policy tailored to the needs of immigrants—taking into account their cultural and social backgrounds and ensuring effective communication—can be highly beneficial. Specifically, it is essential to reintegrate general practitioners and guide individuals toward the most appropriate services. Full article

Background: Vast spatial mobility changes happened globally during the COVID-19 pandemic, profoundly affecting older adults’ well-being and active aging experience. This study aims to examine how the virtual environment and cyberspace, in conjunction with the physical and social neighbourhood environments, influence outdoor activities and spatial mobility for older immigrants. Methods: Four online focus groups were conducted with 25 older Chinese immigrants aged 65 and over in the Greater Toronto Area, Canada. The focus groups explored coping strategies during the pandemic and spatial mobility patterns related to different activity types such as grocery shopping, leisure activities and physical exercises, social and familial activities, and healthcare. Qualitative thematic analysis was conducted guided by the neighbourhood and health theoretical framework. Results: The overall engagement of older Chinese immigrants in various types of outdoor activities declined drastically and the spatial mobility pattern was complex. This change was shaped largely by the intersecting physical/built (e.g., residential conditions, access to public spaces), social (e.g., social support, interpersonal cohesion) and virtual (e.g., online communities and internet-based resources) environmental factors, as well as individual risk perceptions towards COVID-19 and public health interventions during the pandemic. Conclusions: Virtual environment emerged as an important domain that compensates for the heavily reduced spatial mobility of the group during the pandemic. It functioned as a vital channel for older Chinese immigrants to sustain the necessary leisure, social, and healthcare-related activities and maintain well-being during the pandemic. The study provides implications for addressing neighbourhood-level factors in policymaking and implementing initiatives to enhance active ageing experience of older Chinese immigrants. Full article

Background: Increasing evidence shows that the COVID-19 pandemic has disproportionately impacted certain populations, particularly those facing structural marginalization, such as immigrants and refugees. Additionally, research highlights that structurally marginalized populations living with chronic conditions, such as cancer and/or mental health and addiction (MH&A) disorders, are more vulnerable to the adverse effects of COVID-19. These individuals face higher susceptibility to infection and worse health outcomes, including increased rates of hospitalization, severe illness, and death. To better understand the challenges faced by people living at the intersection of social and clinical disadvantages, we organized a series of Think Tank sessions to engage stakeholders in exploring barriers and identifying community-based solutions for immigrants and refugees living with cancer and/or MH&A disorders during the current and future pandemics. Objectives: Our main objectives were to gauge how earlier findings resonated with stakeholders, to identify any gaps in the work, and to co-develop actionable solutions to safeguard health and well-being during COVID-19 and future crises. Methods: Two virtual Think Tank sessions were held in September 2023 as integrative knowledge exchange forums. The Cancer Think Tank was attended by 40 participants, while the MH&A disorders Think Tank included 41 participants. Each group comprised immigrants and refugees living with or affected by cancer (in the Cancer Think Tank) or MH&A disorders (in the MH&A disorders Think Tank), alongside service providers, policymakers, and researchers from Ontario. This paper presents the key discussions and outcomes of these sessions. Results: Participants identified and prioritized actionable strategies during the Think Tank sessions. In the Cancer Think Tank, participants emphasized the importance of leveraging foreign-trained healthcare providers to address workforce shortages, creating clinical health ambassadors to bridge gaps in care, and connecting immigrants with healthcare providers immediately upon their arrival in Canada. In the MH&A disorders Think Tank, participants highlighted the need to remove silos by fostering intersectoral collaboration, empowering communities and building capacity to support mental health, and moving away from one-size-fits-all approaches to develop tailored interventions that better address diverse needs. Conclusions: The Think Tank sessions enhanced our understanding of how the COVID-19 pandemic has impacted immigrants and refugees living with cancer and/or MH&A disorders. The insights gained informed a series of actionable recommendations to address the unique needs of these populations during the current pandemic and in future public health crises. Full article

Vulnerable groups, including certain immigrant populations, have faced higher COVID-19 incidence rates in several countries. This study addresses the gap in knowledge regarding disease severity and readmission odds among refugees, other immigrant groups, and native Danes. Using clinical data from 159 COVID-19-positive patients admitted to hospitals in the Central Denmark Region in 2020, this cross-sectional analysis compared clinical parameters at admission and 30-day readmission odds. The findings revealed no significant differences in clinical status upon admission between groups. Refugees (51.8%) and Others (41.7%) had fewer comorbidities than native Danes (61.2%). Native Danes were more frequently categorized with the highest Charlson Comorbidity Index (CCI) scores. Readmission prevalence was highest among Refugees (23.1%), followed by native Danes (17.0%) and Others (8.3%). After adjusting for age, sex, and CCI, Refugees had a readmission odds ratio (OR) of 1.88 (95% CI, 0.61–5.74) and Others had an OR of 0.61 (95% CI, 0.07–5.41) for readmission compared to native Danes, although this was not statistically significant. This study’s significance lies in highlighting the distinct healthcare challenges faced by refugees during the pandemic. Its findings are beneficial for public health policymakers and healthcare professionals seeking to reduce readmission risks and improve COVID-19 outcomes for immigrant populations. Full article

Objective: The objective is to synthesize the literature on culturally sensitive approaches in psychosocial interventions to enhance the well-being of immigrant adults diagnosed with breast cancer. Methods: We conducted a systematic review following the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and reporting literature searches, and a multi-database search strategy of qualitative research studies and reports published in academic journals and grey literature within a 20-year duration. Results: We extracted data from twenty-two studies that met the inclusion criteria. Content analysis revealed experiences of cultural considerations in the care and psychosocial well-being of immigrants such as the development of culturally responsive care models; barriers and gaps in culturally responsive care in rural communities; patient information, education, and culturally responsive care; cultural stigma, and self-perception of the access, use, and role of healthcare providers, the impact of cancer and linguistically appropriate care; and challenges with psychosocial well-being and culturally responsive care. Conclusions: Concerns relating to psychosocial well-being of immigrant adults diagnosed with breast cancer are consistently described in the literature. Interventions exist to address psychosocial well-being; however, none have been developed or tested in immigrant adults diagnosed with breast cancer. Addressing the psychosocial well-being of immigrant adults will require the integration of culturally appropriate considerations in care to attitudes impacting patient care and reported outcomes. Full article