The Social Readjustment Rating Questionnaire: a study of Cuban exiles

¡Mi Vida Saludable! A randomized, controlled, 2 × 2 factorial trial of a diet and physical activity intervention among Latina breast cancer survivors: Study design and methods

BACKGROUND

Most Latina breast cancer survivors do not meet diet and physical activity (PA) guidelines for cancer survivors and effective lifestyle interventions to adopt and maintain these recommendations are limited, especially among underserved populations. Here we describe the design, methods and enrollment of a 2 × 2 factorial-designed trial testing the separate effects of the ¡Mi Vida Saludable! (My Healthy Life!) intervention program on changes in diet and PA behaviors among Latina breast cancer survivors.

METHODS

Latinas with a history of stage 0-III breast cancer, no evidence of recurrent/metastatic disease, and > 90 days post-treatment were primarily identified via cancer registries and physician referral. Participants were randomized to four arms: 1) 4 weeks of in-person group sessions plus 11 months of eHealth communication, 2) in-person group sessions alone, 3) eHealth alone, or 4) control. All participants received a Fitbit to self-monitor PA. Assessments at baseline, 6 and 12 months include diet, PA, anthropometrics, predictors and mediators of behavior change, psychosocial and quality of life outcomes, and blood draw.

RESULTS

Of 884 women screened between January 2016 and September 2018, 27% were eligible. Primary reasons for ineligibility included not being willing/able to participate due to work/life responsibilities, health reasons, or transportation. Of 241 eligible women, 167 completed baseline assessment and enrolled.

CONCLUSIONS

We successfully enrolled a diverse group of breast cancer survivors representing more than 15 Latin American nationalities to a diet and physical activity trial. If effective, the ¡Mi Vida Saludable! program can be implemented by community groups and medical centers.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02780271, registered May 2016.

Defining Adjustment to Address the Missing Link between Refugees and Their Resettlement Communities

Background: data from the United Nations High Commissioner for Refugees (UNHCR) show that, in 2020, among 82.4 million refugees, only 251,000 returned to their home countries, indicating the desire for refugees to stay, for the long-term, in their new homelands. The paper contributes to the scientific–psychological debate on the social representation of refugee populations, by studying this population, not simply as “foreigners”, traumatized and resourceless people, but rather focusing on the factors that lead to their positive adjustments within local communities. Method: a scoping review was carried out to explore the phenomenon of adjustment (RQ1) and to identify the factors that foster adjustment among refugees and their resettlement communities (RQ2). A research protocol and eligibility criteria were defined prior to conducting the literature research through the Scopus database. Afterwards, data charting and items were conducted to organize the results. Results: a process of data mapping outlined three dimensions of adjustment—psychological, social, and scholastic. In addition, six macro factors emerged that ease refugee adjustments—context characteristics, time, social integration markers, acculturation, social support, and psychological capital. Results show that adjustment is the result of the inter-relations among sociological and psychological factors. Conclusions: the lack of studies addressing the inner resources of refugees and community participation confirms that research in this field needs a change of paradigm, to identify the resources that refugees use to adjust to their new communities and promote their development.

Moderators of Stress in Salvadoran Refugees: The Role of Social and Personal Resources

Refugee research has tended to focus exclusively on the mental health consequences of migration with little attention being devoted to factors that facilitate adjustment. Recently, several cross-cultural researchers have suggested that the growing literature on moderators of stress may elucidate why some migrants experience adverse effects whereas others remain relatively unscathed. This study examines the moderating effects of social and personal resources on the relationship between stress and subjective well-being in 60 recently-arrived and 60 established Salvadoran refugees in Canada. The participants completed a questionnaire that included scales pertaining to stress (life events, hassles, migration-related events), resources (social support, locus of control, self-esteem) and well-being (quality of life, life satisfaction). Varying results were found for both groups. For Recent Refugees, personal resources were found to moderate migration stress. In particular, locus of control buffered the relationships between migration stress and quality of life and life satisfaction, whereas self-esteem buffered the migration stress-quality of life relation. For Established Refugees, social support and self-esteem moderated the relationship between life events and life satisfaction. In addition, social support buffered the effects of hassles on quality of life. The findings underscore the relevance of integrating more firmly the study of refugee adjustment with current developments in stress research.

Stress and Distress

Frequency and intensity of stressful life events (SLE) and distress (neurotic symptom formation and anxiety) were compared in groups of Chinese students at the University of Hong Kong, Chinese student sojourners at a Canadian University, and Euro-Canadian students. The results are dominated by a strong Gender X Culture interaction for the total symptom score such that Chinese females, especially female sojourners, are most at risk. There were no cultural or gender differences in SLE frequency. However, the possible differential utility of the SLE measures as predictors of psychological distress was highlighted by the fact that SLE frequency was positively related to symptoms for Canadians and University of Hong Kong students but not for student sojourners for whom the best predictor of symptoms was SLE impact; furthermore, the relationship was negative. Female sojourners appear to have a different stress-symptom structure than male sojourners or female Chinese at the University of Hong Kong.

Vulnerability to stress in migratory contexts: a study with Eastern European immigrants residing in Portugal

The assessment of individual vulnerability to stress emerges as a predictive factor of a higher risk of developing stress-related disorders. In the last decade, the geography of immigration in Portugal experienced intense transformations in terms of recruitment and patterns of geographic settlement, with an increasing and exponential inflow of new and diversified migratory groups. The immigrant populations coming from Eastern European countries are a recent migratory flow, with linguistic, cultural and socio-demographic specificities which are very different from the general Portuguese population. This makes them a paradigmatic group in potential transcultural studies on mental health issues. The primary aim of the study was to describe the characteristics of vulnerability to stress and determine their impact on the mental health status of Russian-speaking immigrants residing in Portugal. The relationship between vulnerability to stress, sociodemographic variables, mental health status and social support were analyzed, using the SSQ6, GHQ28, 23QVS and a socio-demographic questionnaire. A comparative analysis was carried out, using a control group of 110 Portuguese subjects without previous migratory experiences, matched by sex, age group and academic qualifications. The eastern European immigrants reported high levels of vulnerability to stress assessed by the cut-off point of the 23QVS. Immigrants also reported higher percentage of vulnerability to stress and lower social support levels of social support versus the control group. Several factors inherent to the dynamics of the migratory process were related to the presence of vulnerability to stress. The findings suggest that vulnerability to stress is positively correlated with worse mental health outcomes and negatively correlated with the social support perceived as available--number of supporters and satisfaction with social support.

Family stress and the precipitation of psychiatric disorder. A comparative study among immigrant West Indian and native British patients in Birmingham

A study of family data among immigrant West Indian and Native British patients in Birmingham is described. Predisposing factors--unhappy childhood and a family history of mental disorder--were associated with psychiatric illness but not with ethnic origin. Behaviour disorder among children and broken marriages among family members were not associated with psychiatric illness, but are more prevalent among immigrants. These patients did not admit to a greater prevalence of stress (obtained from 11 factors) but it is noteworthy that family stresses predominated among them rather than other stresses which were more prevalent among natives. Inter-personal conflicts within the family were often believed to have been of aetiological significance among immigrants rather than natives who instead reacted to normal life events. Neurotic syndromes resulting from migration-related separation experiences between parents and children are described.