Understanding Signs and Sources of Anxiety in Urban Elementary Schools Serving Predominately Ethnically/Racially Minoritized Children

OBJECTIVE

This mixed-methods study examined teachers' perceptions of student anxiety in urban elementary schools serving predominantly low-income and ethnically/racially minoritized youth.

METHOD

Most participating teachers were female (87.7%) and from minoritized backgrounds themselves (89.2%), teaching in schools serving predominantly Black/African American (40%) or Hispanic (60%) students, and in which > 70% of students are eligible for free meals. Teachers were asked in surveys (N = 82) and interviews (n = 12) about the nature of student anxiety, and cultural/contextual considerations that influence anxiety.

RESULTS

Overall, teachers reported prevalence and signs of student anxiety that were consistent with the literature, but they reported higher levels of impairment than in previous community samples. Regressions revealed that greater levels of student exposure to community violence and higher proportions of Black students were associated with higher teacher-perceived prevalence and concern about student anxiety, respectively. Moreover, greater emotional exhaustion in teachers was associated with higher reports of anxiety-related impairment in students. Thematic coding of interviews emphasized how teachers perceived 1) most student anxieties to be proportional responses to realistic threats and stress in students' lives (e.g. resource insecurity), 2) systems-level problems (e.g. pressure to perform on standardized tests) contribute to student anxiety, and 3) school-based anxiety sources often interact with traumas and stressors students experience outside of school (e.g. immigration experiences).

CONCLUSIONS

Relative to the predominant literature that has focused on biological, cognitive, and other intraindividual factors as sources of anxiety, the present work underscores the importance of considering how broader economic and systems-level influences exacerbate anxiety in marginalized youth.

Trajectories of physiological stress markers over time among Latinx immigrants in the United States: Influences of acculturative stressors and psychosocial resilience

AIMS

Latinx immigrants are exposed to acculturative stressors as they adapt to the U.S. However, little is known about the impact of acculturative stressors and psychosocial resilience on physiological responses and health over time. The purpose of this study was to examine trajectories of physiological stress markers among Latinx adults over time and examine the influence of acculturative stressors and psychosocial resilience factors on these different trajectories.

METHODS

A community-based, longitudinal study was conducted with adult Latinx immigrants in North Carolina (N = 391) over a two-year period. Self-reported measures of ten different types of acculturative stressors (e.g., occupational, family, healthcare, discrimination) and psychosocial resilience factors (individual resilience, coping, ethnic pride, familism, and social support) along with urine samples were taken at baseline and 12- and 24-month follow-up periods. Biomarkers of physiological stress (inflammatory cytokines interleukin-6 (IL-6), IL-8 and IL-18 and C-Reactive Protein (CRP)) were measured in urine. Multivariate latent class growth analysis, linear mixed models, and unadjusted bivariate analyses were conducted to address the study aims.

RESULTS

Participants were an average of 39 years of age (SD = 6.94) and mostly women (68.8%) and Spanish speakers (83%). Three latent classes of physiological stress marker trajectories were identified: resilient, rapidly increasing stress, and chronic elevated stress. These latent classes had significant differences in gender, race, coping styles, ethnic pride, and parental acculturative stressors.

CONCLUSIONS

The findings from this study identify specific types of acculturative stressors and psychosocial resilience factors that are important targets for health promotion and disease prevention programs for Latinx immigrants.

Disentangling the directionality among cultural stressors and psychosocial outcomes in recently immigrated Hispanic families: A random intercept cross-lagged panel model approach

Research shows the impact of cultural stressors (e.g. perceived discrimination, bicultural stressors, negative context of reception) on adolescents' psychosocial outcomes. Given the presence of multiple cultural stressors in many Hispanic adolescents' lives, it is essential to examine the (a) developmental sequencing of cultural stressors among recent immigrant youth and (b) predictive effects of cultural stressors on adolescents' psychosocial outcomes. We employed a random intercept cross-lagged panel model to examine the longitudinal interplay among cultural stressors and their effects on youth outcomes using longitudinal data with six waves among 302 recently immigrated Hispanic adolescents (47% girls, Mage = 14.51, SD = .88). We observed bidirectional within-person relations and between-person associations among cultural stressors. At the within-person level, bidirectional cross-lagged effects emerged between perceived discrimination and bicultural stress, between perceived discrimination and negative context of reception, and between negative context of reception and bicultural stress. At the between-person level, bidirectional cross-lagged effects emerged only between perceived discrimination and bicultural stressors. Our findings indicate that cultural stressors explain heterogeneity in psychosocial outcomes: self-esteem was inversely predicted by all cultural stressors, whereas depressive symptoms were predicted only by perceived discrimination. In addition, optimism was predicted only by bicultural stressors, and externalizing behavior was predicted by both bicultural stressors and perceived discrimination. These results suggest that the longitudinal relationships among cultural stressors are (partly) bidirectional. Additionally, cultural stressors demonstrated differential predictive effects on psychosocial outcomes, indicating the added value of considering multiple cultural stressors and their longitudinal effects on adolescents' psychosocial outcomes.

Determining the role of acculturative stress in predicting mental health service use among Latinx immigrants

OBJECTIVES

Acculturative stress is an important factor that affects health for Latinx immigrants in the US, with multiple studies identifying a link between depression and acculturative stress in this population. However, far fewer studies have examined the specific role and relationship of acculturative stress on mental health service use in this population. Through the lens of Yang's 2016 Model of Immigrant Health Service Use, this study aimed to examine the role of acculturative stress in predicting mental health service use in a sample of Latinx immigrants in the Southeast US.

DESIGN

We conducted a secondary data analysis from a longitudinal study of Latinx immigrant health (n = 391).

RESULTS

Our study found that while total acculturative stress was not significantly associated with mental health service use in this sample, parenting stress was a significant predictor of mental health service use in the past six months when controlling for covariates (OR: 1.043, 95% CI [1.009, 1.078]). Additionally, important Predisposing and Need for Healthcare factors were significantly associated with mental health service use, specifically: males were less likely to utilize mental health services than females (OR: 0.401, 95% CI [0.166-0.968]), English language acculturation was positively associated with mental health service use (OR: 1.953, 95% CI [1.130, 3.377]), and depression was positively associated with mental health service use (OR: 1.107, 95% CI [1.027, 1.194]).

CONCLUSION

These findings support the need for more culturally sensitive mental health services, and the need to develop strategies to engage males and less acculturated individuals in mental health services to promote health equity among Latinx immigrants.

Association Between High-Sensitivity C-Reactive Protein and Metabolic Syndrome Among Hispanic/Latino Participants of the Hispanic Community Health Study/Study of Latinos

Purpose: To determine whether high-sensitivity C-reactive protein (hsCRP) is associated with incident Metabolic Syndrome (MetS) among U.S. Hispanic/Latino adults. Patients and Methods: The Hispanic Community Health Study/Study of Latinos is a longitudinal observational cohort assessing cardiovascular health among diverse U.S. Hispanic/Latino adults. hsCRP was measured at visit 1 (2008-2011) and classified as low, moderate, or high, based on the Centers for Disease Control and Prevention and American Heart Association (CDC/AHA) guidelines. All MetS components [abdominal obesity, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure, and fasting glucose] were measured at visit 1 and visit 2 (2014-2017). MetS was defined as the presence of three or more components based on the 2005 definition from the modified Third Report of the National Cholesterol Education Program Adult Treatment Panel (modified NCEP ATP III). Participants free of MetS at visit 1 and with complete data on hsCRP and all MetS components were included (n = 6121 participants). We used Poisson regression analysis to determine whether hsCRP was associated with incident MetS after adjusting for demographic, behavioral, and clinical factors. All analyses accounted for the complex survey design of the study. Results: In fully adjusted models, moderate versus low hsCRP was associated with a 33% increased risk of MetS [incidence rate ratio (IRR): 1.33, 95% confidence interval (CI): 1.10-1.61], while high versus low hsCRP was associated with a 89% increased risk of MetS (IRR: 1.89, 95% CI: 1.58-2.25). Conclusions: Greater levels of hsCRP were associated with new onset of MetS in a diverse sample of U.S. Hispanic/Latino adults. Results suggest that hsCRP may be an independent risk factor for MetS.

Evaluating the psychometric properties of the Hispanic Stress Inventory-2 Simplified version among a diverse sample of Latinos who smoke

OBJECTIVE

Acculturation stress can negatively impact Latinos immigrant mental and physical health related behaviors such as smoking. It is essential to have validated and updated instruments that allow the evaluation of acculturation stress on this population. This study aims to evaluate the psychometric properties of an abbreviated version of the Hispanic Stress Inventory Version 2 (HSI2) immigration scale among Latinos who smoke.

METHODS

The study consisted of a secondary data analysis from a baseline assessment of Decídetexto, a mobile health (mHealth) smoking cessation randomized clinical trial. Of 457 Latinos included in the parent study, 352 immigrants who smoke were included. Construct validity was analyzed by completing a Pearson correlation coefficient matrix. Structural validity was analyzed using an Exploratory Factor Analysis (EFA). Cronbach alpha analysis was used to estimate the internal consistency of the items constituting a factor.

RESULTS

The results included an abbreviated version of the HSI2 including 52 items. From the Pearson correlation coefficient matrix with a cutoff point of 0.4, 22 of the 52 items were excluded. From the Pearson correlation coefficient matrix with a cutoff point of 0.4, 22 items were excluded. Exploratory Factor Analysis (EFA) results in six factors extracted, explaining 69.1% of the variance. According to the EFA, two items were relocated in different factors from the original scale. The HSI2 30 items scale reflected excellent reliability with a Cronbach's alpha coefficient of 0.93. The six factors reflect acceptable to excellent reliability, ranging from 0.77-0.93 across factors. The median for the HSI2 total score was 34.00 (25-45) out of a possible total score of 150.

CONCLUSION

Results confirmed acceptable psychometric properties of the HSI2 simplified 30-item version and provided a reliable and shorter measure of acculturation stress for Latinos groups. Having a valid and reduced measure of acculturation stress is the first step in understanding diverse ethnic groups of Latinos that are at higher risk of presenting health risk behaviors such as smoking. The present results provided the possibility of assessing the impact of acculturation stress among adults who smoke.

Cross-Sectional and Descriptive Study on the Challenges and Awareness of Hispanic Parents Regarding Their Adolescents' Mental Health during the COVID-19 Pandemic

Research has shown that during the COVID-19 pandemic, approximately 20% of children and adolescents in the United States experienced mental health issues that became a significant social concern. However, recent studies have demonstrated that the majority of adolescents maintain positive emotions despite the crisis. This cross-sectional and descriptive study delves into the emotional states of adolescents during the pandemic, considering the viewpoints of both adolescents and their parents, with a specific focus on Hispanic adolescents. Survey results revealed that most adolescents reported positive and happy moods. However, a percentage of adolescents experienced worry, significant changes in feelings, and loneliness as a result of the physical and social isolation associated with virtual learning. Unfortunately, most surveyed Hispanic parents did not adequately recognize their adolescents' mood changes well. This lack of awareness, caused by factors such as an insufficient understanding about the importance of adolescent mental health, cultural reasons, language barriers, low education, unstable jobs, and more, could lead to missed opportunities for timely mental health interventions. This study seeks to provide a comprehensive discussion on the mental health of adolescents, while also advocating for the emotional wellbeing of Hispanic adolescents.

The spiral of disadvantage: Ethnolinguistic discrimination, acculturative stress and health in Nahua indigenous communities in Mexico

OBJECTIVES

The aim of this study was to test the hypothesis that ethnic and ethnolinguistic discrimination, and Post-Traumatic Stress Disorder (PTSD) related to being Indigenous as well as different aspects of acculturative stress, are associated with poorer health and higher levels of depression among the Nahua Indigenous communities.

MATERIALS AND METHODS

Our quantitative survey was carried out in four different regions inhabited by the Nahua people in Mexico. Self-rated health and depression, the symptoms of PTSD, two facets of acculturative stress and ethnolinguistic discrimination were assessed by questionnaires. The data were analyzed using binary logistic regression models.

RESULTS

The symptoms of PTSD and acculturative stress experienced in the workplace were significantly associated with a higher risk of poor self-rated health, adjusted for various socio-demographic characteristics. Acculturative stress, discouragement of language use, language avoidance and ethnolinguistic discrimination were related to a higher risk of depression and PTSD.

DISCUSSION

Our research implies that ethnic and linguistic discrimination, acculturative stress and the memory of harm linked to being Indigenous reflected in the symptoms of PTSD, are important predictors of poorer health and depression among Nahua groups in Mexico. These adverse effects could be significantly counteracted by effective dealing with stigmatization and discrimination against Indigenous people in Mexico and by replacing strong assimilation pressures with integrational approaches that respect ethnolinguistic diversity and reduce socioeconomic marginalization.

Migration-Related Weight Changes among African Immigrants in the United States

(1) Background: people who migrate from low-to high-income countries are at an increased risk of weight gain, and excess weight is a risk factor for cardiovascular disease. Few studies have quantified the changes in body mass index (BMI) pre- and post-migration among African immigrants. We assessed changes in BMI pre- and post-migration from Africa to the United States (US) and its associated risk factors. (2) Methods: we performed a cross-sectional analysis of the African Immigrant Health Study, which included African immigrants in the Baltimore-Washington District of the Columbia metropolitan area. BMI category change was the outcome of interest, categorized as healthy BMI change or maintenance, unhealthy BMI maintenance, and unhealthy BMI change. We explored the following potential factors of BMI change: sex, age at migration, percentage of life in the US, perceived stress, and reasons for migration. We performed multinomial logistic regression adjusting for employment, education, income, and marital status. (3) Results: we included 300 participants with a mean (±SD) current age of 47 (±11.4) years, and 56% were female. Overall, 14% of the participants had a healthy BMI change or maintenance, 22% had an unhealthy BMI maintenance, and 64% had an unhealthy BMI change. Each year of age at immigration was associated with a 7% higher relative risk of maintaining an unhealthy BMI (relative risk ratio [RRR]: 1.07; 95% CI 1.01, 1.14), and compared to men, females had two times the relative risk of unhealthy BMI maintenance (RRR: 2.67; 95% CI 1.02, 7.02). Spending 25% or more of life in the US was associated with a 3-fold higher risk of unhealthy BMI change (RRR: 2.78; 95% CI 1.1, 6.97). (4) Conclusions: the age at immigration, the reason for migration, and length of residence in the US could inform health promotion interventions that are targeted at preventing unhealthy weight gain among African immigrants.