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Punjani NS, Okeke-Ihejirika PE, Salami BO, Yohani S, Olukotun M. "The Children Are Not Controllable Because They Follow Western Values" - Narratives of the Parenting Experiences of African Immigrants in Alberta, Canada. J Immigr Minor Health 2024:10.1007/s10903-024-01598-2. [PMID: 38647630 DOI: 10.1007/s10903-024-01598-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
African immigrants are moving to high-income nations such as Canada in greater numbers in search of a better life. These immigrants frequently struggle with several issues, including limited social support, shifts in gender roles/status, cultural conflicts with their children, and language barriers. We used participatory action research (PAR) to gather data about Sub-Saharan African immigrants residing in Alberta, Canada, with a focus on their viewpoints, difficulties, and experiences of parenting children in Canada. We contextualized our study and its findings using both postcolonial feminism and transnationalism approaches. Study findings show African immigrant parents place a high priority on respect between generations. The absence of assistance, conflicts caused by culture, and language barriers are notable difficulties they encountered in parenting. An additional factor is a lack of acquaintance with and comprehension of the culture of their new home nation. Several implications stem from our findings, including the need for interventional research that explores effective, culturally relevant strategies for enhancing parenting among African immigrants. Our findings demonstrate the need for culturally sensitive policies and practices that support the transition and integration of African immigrant families into Canadian society. It is imperative for health care providers and policy makers to develop and revise culturally appropriate policies that take into consideration the importance of African immigrants in destination countries. Adopting culturally relevant policies and practices will improve the wellbeing of this growing but underprivileged minority of Canadians.
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Affiliation(s)
- Neelam Saleem Punjani
- Faculty of Nursing, University of Alberta, 5-172 Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada.
| | - Philomina E Okeke-Ihejirika
- Pan African Collaboration for Excellence (PACE), University of Alberta, 1-13 Assiniboia Hall, Edmonton, AB, T6G 2E7, Canada
| | | | - Sophie Yohani
- Counselling Psychology, Faculty of Education, School of Social Sciences and Humanities, University of Alberta, 6-107D Education North, 11210 87 Avenue, Alberta, Canada
| | - Mary Olukotun
- Faculty of Nursing, University of Alberta, 5-172 Edmonton Clinic Health Academy, Edmonton, AB, T6G 1C9, Canada
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Akingbule O, Teran-Garcia M, Alston R. Exploring the dietary practices and perceptions of African immigrants in Illinois- a qualitative study of immigrants from Nigeria and Congo. Ethn Health 2024; 29:353-370. [PMID: 38515253 DOI: 10.1080/13557858.2024.2311418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 01/23/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE Previous studies suggest an increased prevalence of diet-related chronic diseases among African immigrants with increased length of stay in the U.S. The objective of the current study is to understand the dietary practices and perceptions of recent African immigrant families. DESIGN Focus group sessions were conducted with Nigerian and Congolese immigrant parents residing in Illinois. Participants were recruited using convenience sampling methods and focus group sessions were conducted via videoconference. Participants discussed dietary practices, meal preparation, and family mealtimes for their families. They also discussed experiences with eating different kinds of foods since arrival in the U.S. Verbatim transcription of focus group sessions were completed and deductive thematic analysis of transcribed data was conducted using NVivo (QSR International Pty Ltd. [2020] NVivo [version 12]). RESULTS Twenty African immigrant parents (Mean age: 42 years, Female: 95%) residing in Northern and Central Illinois participated in a total of five focus group sessions. Seven themes were derived from the analysis. Participants had a positive attitude toward healthy diet and had a high level of interest in receiving educational resources to make healthier food choices. Participants preferred and mostly consumed foods they were familiar with before migration. A majority of the participants perceived 'American foods' as unhealthy, characterizing them as containing a high amount of sugar and salt. Parents reported that their school-aged children often preferred a western diet over traditional African meals. CONCLUSION This study helps to understand unique diet-related practices and perceptions of recent Nigerian and Congolese African immigrants in Illinois. Findings could help to inform cultural adaptation of evidence-based nutrition education programs for these groups of African immigrants.
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Affiliation(s)
- Oluwatosin Akingbule
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Department of Biomedical and Translational Sciences, Carle Illinois College of Medicine, Urbana-Champaign, Champaign, IL, USA
- University of Illinois Extension, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Reginald Alston
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Koku EF, Johnson-Yengbeh N, Muhr A. Addressing COVID-19 Vaccine Hesitancy and Uptake Among African Immigrants: Lessons from a Community-Based Outreach Program. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01947-9. [PMID: 38443740 DOI: 10.1007/s40615-024-01947-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
In 2021, the African Cultural Alliance of North America (ACANA) implemented a community-based vaccine education and outreach program to decrease hesitancy and increase COVID-19 vaccine uptake among African immigrants in Philadelphia. The program had three components: (1) tailored messaging on the benefits of vaccines by trusted community health navigators in familiar languages/dialects, (2) use of educational/tabling events, and (3) establishment of a vaccine clinic in community settings. Using secondary data analysis, in-depth interviews, focus group discussions and a self-administered survey, we explored (i) the impact and effectiveness of the outreach program and extent of vaccine uptake, (ii) African immigrants' beliefs about the COVID-19 pandemic and the vaccine, and (iii) barriers and facilitators of vaccine knowledge, uptake, and hesitancy. Our analysis showed that ACANA's outreach program was effective in addressing several cultural, logistic, and systematic barriers to vaccine uptake. The program distributed 2000 educational/informational flyers, reached 3000 community members via social media campaigns, and an additional 2320 through other person-to-person outreach events. The program was effective and resulted in the vaccination of 1265 community members over the course of the outreach. The impact of this outreach underscores the critical role of community-based organizations in addressing COVID-19 vaccine hesitancy and increasing vaccine uptake in underserved and minority communities. The paper concludes with suggestions and recommendations for using community-based outreach programs to increase COVID-19 vaccine uptake and decrease hesitancy.
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Affiliation(s)
- Emmanuel F Koku
- Department of Sociology, Drexel University, 3201 Arch Street, Room 288, Philadelphia, PA, 19104, USA.
| | - Nettie Johnson-Yengbeh
- Health Department, African Cultural Alliance of North America (ACANA), 5530 Chester Ave, Philadelphia, PA, 19143, USA
| | - Ava Muhr
- Health Department, African Cultural Alliance of North America (ACANA), 5530 Chester Ave, Philadelphia, PA, 19143, USA
- School of Social and Political Science, University of Edinburgh, 15a George Square, EH8 9LD, Edinburgh, UK
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Aidoo-Frimpong G, Agbemenu K, Adzrago D, Akyirem S, Boateng S, Nelson LE. The Promise of Pre-Exposure Prophylaxis - Examining Awareness, Knowledge, and Willingness to use Different Modalities Among US-Based African Immigrants. J Immigr Minor Health 2023; 25:1331-1338. [PMID: 37378713 DOI: 10.1007/s10903-023-01515-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
This study aims to describe and understand the relationship between sociodemographic factors and PrEP awareness, and willingness to use a PrEP modality (oral or injectable).Despite the availability of effective prevention tools such as HIV preexposure prophylaxis (PrEP), African immigrants in the United States are disproportionately affected by HIV. Although PrEP can significantly reduce HIV infection in this population, research evidence on PrEP outcomes, such as awareness, knowledge, and willingness to use, is extremely limited. Between April and May 2022, 92 participants completed an online survey assessing their awareness, knowledge, and willingness to use oral or injectable PrEP. The association between sociodemographic characteristics and PrEP-related measures was examined using descriptive and Pearson's chi-squared or Fisher's exact tests. Participants (N = 92) were born between 1990 and 1999 (46.7%), female (70.76%) and highly educated (59.6%). About 52.2% were unaware of PrEP, and 65.6% were willing to use a PrEP modality. Findings indicate that individuals who reported being aware of PrEP demonstrated a high level of knowledge regarding the medication. Having a healthcare provider was associated with PrEP awareness and willingness to use, while educational status was associated with PrEP awareness. 51.1% of participants were willing to use an oral pill for prevention and 47.8% were willing to use injectable PrEP. Our findings highlight the need for PrEP-related research and interventions for African immigrants to increase awareness and provide options for HIV prevention, as African immigrants are currently not well-represented in PrEP delivery systems in the US.
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Affiliation(s)
- Gloria Aidoo-Frimpong
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, Connecticut, CT, 06510, USA.
| | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - David Adzrago
- CDC Prevention Research Center, School of Public Health, Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Samuel Akyirem
- School of Nursing, Yale University, New Haven, Connecticut, USA
| | - Sarpong Boateng
- Bridgeport Hospital/ Yale New Haven Health, Department of Medicine, Bridgeport, CT, USA
| | - LaRon E Nelson
- School of Nursing, Yale University, New Haven, Connecticut, USA
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Boukpessi TB, Kpanake L, Gagnier JP. Why are African immigrants in Montreal reluctant to use mental health services?: a systematic inventory of reasons. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02566-1. [PMID: 37805584 DOI: 10.1007/s00127-023-02566-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE Previous research has shown that non-Caucasian immigrants in Western countries are less likely than native-born people to use mental health services. This study examined the reasons underlying reluctance to use mental health services among African immigrants in Montreal, Canada. METHODS The study participants were 280 African immigrants who had experienced symptoms suggesting depression but did not use formal mental health services. They were presented with a questionnaire that contained 65 statements referring to reasons for not using formal mental health services while experiencing those symptoms and were asked to indicate their degree of agreement with each of the statements on a scale of 0-10. Responses were then analyzed using factor analysis. RESULTS An eight-factor structure of reasons was found: "Minimizing symptoms and perceived self-efficacy" (61% of the sample), "Relying on spiritual care" (56% of the sample), "Cost and waiting time" (45% of the sample), "Influence of significant others" (34% of the sample), "Lack of cultural competence" (32% of the sample), "Fear of stigmatization" (23% of the sample), "Nature of the consultation" (10% of the sample) and "Social models" (8% of the sample). Scores on these factors were related to participants' demographics. CONCLUSION Effectively addressing the underutilization of mental health services among African immigrants requires a multifaceted approach rather than one focused on a single barrier. Our findings suggest critical points that could help develop tailored interventions to address the various barriers to care.
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Corra M. Immigration from Africa to the United States: key insights from recent research. Front Sociol 2023; 8:1171818. [PMID: 37359213 PMCID: PMC10285403 DOI: 10.3389/fsoc.2023.1171818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/09/2023] [Indexed: 06/28/2023]
Abstract
Immigration from Africa to the United States has increased dramatically in the past three decades. This paper summarizes recent findings on the growth of African immigration to the United States in recent years. In doing so, it highlights shifting sociodemographic profiles of these "new African Americans" or "new Americans," profiling the increasing diversity, yet also racialized portrait of this group. Key patterns of immigration shown include the changing racial and gender composition of immigrants, as well as rising immigration from a wider range of African countries. Some key theoretical and practical implications are outlined.
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Aidoo-Frimpong G, Turner D, Collins RL, Ajiboye W, Agbemenu K, Nelson LE. WhatsApp-propriate? Exploring "WhatsApp" as a Tool for Research Among Ghanaian Immigrants in the United States. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01664-9. [PMID: 37285049 PMCID: PMC10246539 DOI: 10.1007/s40615-023-01664-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023]
Abstract
African immigrants remain underrepresented in research due to challenges in recruitment. Mobile instant messaging applications, such as WhatsApp, present novel, and cost-effective opportunities for conducting health research across geographic and temporal distances, potentially mitigating the challenges of maintaining contact and engagement in research with migrant populations. Moreover, WhatsApp has been found to be commonly used by African immigrant communities. However, little is known about the acceptability and use of WhatsApp as a tool for health research among African immigrants in the US. In this study, we examine the acceptability and feasibility of WhatsApp as a tool for research among Ghanaian immigrants- a subset of the African immigrant population group. We used WhatsApp to recruit 40 participants for a qualitative interview about their use of the mobile messaging application. Three distinct themes related to the acceptability and feasibility of WhatsApp emerged from the interviews: (1) preference for using WhatsApp as a medium of communication; (2) positive perception of WhatsApp; and (3) preference for using WhatsApp for research. The findings indicate that for African immigrants in the US, WhatsApp is a preferred method for recruiting and collecting data. It remains a promising strategy to utilize in future research involving this population.
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Affiliation(s)
- Gloria Aidoo-Frimpong
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA.
| | - DeAnne Turner
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - R Lorraine Collins
- School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Wale Ajiboye
- MAP Center for Urban Health Solution, Unity Health Toronto - St Michael's Hospital, Ontario, Canada
| | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, State University of New York, Buffalo, NY, USA
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Puplampu VA, Silversides HP, Phillips KLR. A Scoping Review on Older Adults from Africa Social Connectedness Experiences in North America. J Cross Cult Gerontol 2023:10.1007/s10823-023-09479-1. [PMID: 37209245 DOI: 10.1007/s10823-023-09479-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
The percentage of older adult immigrants in Canada and the United States is increasing with older adult immigrants from Africa forming a small proportion of the population, but one of the fastest growing groups in the area. Depending on the circumstances leading to the move, migration can be very stressful, especially for older adults. The purpose of this scoping review is to summarize the evidence on the social connectedness of older African immigrants in Canada and the United States. The researchers searched databases including Cochrane Library, BMJ Online, CINAHL, Medline (Ovid), PsycInfo (Ovid), PsycArticles (Ovid), Web of Science, SpringerLINK, CBCA Canadian Business and Current Affairs Database, Academic Search Complete, Sage Journals Online, ABI/Inform, Emerald Fulltext, Expanded Academic ASAP, General OneFile, Joanna Briggs Institute EBP Database, Journals@Ovid, JSTOR, Oxford Journals Online, Taylor & Francis Journals, Wiley Online Library, ProQuest Dissertations and Thesis Global, and Google Scholar from 2000-2020. Four manuscripts met the search inclusion criteria of published peer-reviewed and unpublished research studies in the English language on aging, older adult, social connectedness, African immigrants, Canada, and the United States. The authors found limited studies on African older adult immigrants' social connectedness in Canada and the United States with dearth of research on the older adults' access to health care, use of smart technology and social media to promote their health and social connectedness which are gaps in the literature that should be researched in the future.
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Affiliation(s)
- Vivian A Puplampu
- Faculty of Nursing, University of Regina, Saskatoon Campus, 111-116 Research Drive, Saskatoon, SK, S7N 3R3, Canada.
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Ivande SK, Ryabichenko T. The Relationship Between Perceived Discrimination, Acculturation Attitudes, and Adaptation among Anglophone African Immigrants in Russia: The Moderating Role of Neuroticism. Psychol Russ 2023; 16:77-98. [PMID: 37383924 PMCID: PMC10294273 DOI: 10.11621/pir.2023.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 01/25/2023] [Indexed: 06/30/2023] Open
Abstract
Background Perceived discrimination is an acculturative stressor that negatively predicts psychological and socio-cultural adaptation, partially mediated by the individual's acculturation attitudes. However, despite being under similar conditions of high perceived discrimination, some African immigrants in Russia appear to adapt more successfully than others. Why the individual differences? Neuroticism is a trait that intensifies the experience of negative emotions and sensitivity to stress. Perhaps it amplifies the reaction to acculturative stressors (e.g., perceived discrimination) in terms of acculturation attitudes, with significant implications for adaptation. Objective This study sought to determine whether the personality trait of neuroticism influences how African immigrants in Russia react to perceived discrimination in terms of their acculturation attitudes and how this may relate to adaptation. Design A moderated mediation analysis was carried out, investigating neuroticism as a moderator in the relationship between perceived discrimination, acculturation attitudes, and adaptation of African immigrants in Russia (N = 157). Results Perceived discrimination was found to be strongly associated with poor psychological and sociocultural adaptation, which was partially mediated by the integration attitude; neuroticism strengthened this indirect negative association. Conclusion When highly neurotic African immigrants perceived elevated levels of discrimination, they were more averse to adopting a positive attitude toward integration, and as a result, were more maladapted. This result suggests that the differences in the levels of adaptation among African immigrants in Russia under similar conditions of high perceived discrimination may be partially due to their levels of neuroticism.
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Affiliation(s)
- Sepase K. Ivande
- Motivation and Intercultural Relations Lab, Department of Psychology, University of Victoria, BC, Canada
- School of Psychology, HSE University, Moscow, Russia
| | - Tatiana Ryabichenko
- School of Psychology, HSE University, Moscow, Russia
- International Laboratory for Social Integration Research, HSE University, Moscow, Russia
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Azugbene EA. Maternal Health Experiences and Health Care Utilization of African Immigrant Women: A Review of The Literature. Matern Child Health J 2023:10.1007/s10995-023-03644-1. [PMID: 36988796 DOI: 10.1007/s10995-023-03644-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION This systematic review summarizes the maternal health experiences and healthcare utilization of African immigrant women who have immigrated to the United States using an adapted version of the healthcare utilization model. METHODS Published journal articles from the year 2000 to 2022 were identified from seven large databases; 13 studies satisfied the inclusion criteria. RESULTS The results of the study are reported according to the individual and contextual factors for healthcare utilization for African immigrant women in the United States. Individual factors that facilitated the use of maternal healthcare were having transportation, higher health literacy levels, insurance, and family support. Contextual factors that facilitated maternal health utilization included access to interpreters and female doctors. DISCUSSION Facilitators and barriers to maternal health utilization were impacted by cultural and environmental factors. First, African immigrant women included in the studies, believe pregnancy and childbirth are safe and normal, therefore prenatal care is unnecessary. Second, the fear of obstetrical interventions, especially from women who have had female genital mutilation. Third, the misconceptions regarding pain medications and the roles of hospital staff. Further research is necessary for addressing the facilitators and barriers to healthcare utilization in African immigrant women.
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Affiliation(s)
- Ehiremen Adesua Azugbene
- Maternal and Child Health Translational Research Team (MCHTRT), College of Public Health Solutions, Arizona State University, Phoenix, AZ, United States.
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Byiringiro S, Koirala B, Ajibewa T, Broni EK, Liu X, Adeleye K, Turkson-Ocran RAN, Baptiste D, Ogungbe O, Himmelfarb CD, Gbaba S, Commodore-Mensah Y. Migration-Related Weight Changes among African Immigrants in the United States. Int J Environ Res Public Health 2022; 19:15501. [PMID: 36497575 PMCID: PMC9735855 DOI: 10.3390/ijerph192315501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
(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.
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Affiliation(s)
- Samuel Byiringiro
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Binu Koirala
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Tiwaloluwa Ajibewa
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Eric K. Broni
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD 21093, USA
| | - Xiaoyue Liu
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Khadijat Adeleye
- Elaine Marieb College of Nursing, University of Massachusetts, Amherst, MA 01003, USA
| | | | - Diana Baptiste
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
| | | | | | - Serina Gbaba
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA
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Min M, Wong T, Akinsulure-Smith AM. Exploring Beliefs and Attitudes Toward Female Genital Mutilation/Cutting Among Healthcare Providers in New York City. Violence Against Women 2022; 28:3174-3193. [PMID: 34817265 PMCID: PMC9423936 DOI: 10.1177/10778012211045710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Given the increase of African immigrants from countries with high female genital cutting (FGC) prevalence, this study explored U.S. healthcare providers' beliefs and attitudes regarding FGC. A total of 31 professionals who have provided services to FGC-experienced women in New York City were interviewed; data were analyzed using grounded theory. Results indicated that, although a majority of respondents emphasized maintaining a nonjudgmental and open-minded attitude toward clients' experiences, some only focused on the negative aspects of FGC. Also, multifaceted efforts by providers to understand the cultural meanings of FGC and resolve their own cultural dissonance were identified. The implications for practice were discussed.
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Affiliation(s)
- Moonkyung Min
- The City College of New York, 14770NY, USA
- 2129University of Calgary, AB, Canada
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Yusuf KK, Madu E, Kutchava S, Liu SK. The Coronavirus (COVID-19) Pandemic and Mental Health of African Immigrants in the United States. Int J Environ Res Public Health 2022; 19:10095. [PMID: 36011724 PMCID: PMC9407718 DOI: 10.3390/ijerph191610095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/05/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The impact of the COVID-19 pandemic on immigrants in the United States is understudied. We investigated the effect of the pandemic on the mental health of African immigrants in the United States and if subjective religiosity was a protective factor. We analyzed primary data collected using an online survey (n = 260). The study's outcome variable was incident mental health disorder associated with the pandemic, and the primary independent variable was religiosity. Chi-squared and Mann-Whitney U tests were used to compare the distribution of variables by incident mental health disorders. Logistic regression models were used to quantify the association between predictors and the outcome. There were 39 (15.0%) new cases of mental health disorders related to the pandemic. The median scores in the three domains of religiosity of those who developed a mental health disorder and those who did not were not significantly different. Significant predictors of this outcome included having a strong religious support network and loss of household employment income. African immigrants experienced an increased rate of mental health disorders during the pandemic. Implementing community-based strategies to provide social support during a disaster may be essential in promoting mental health in the African immigrant community.
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Ogungbe O, Turkson-Ocran RA, Nkimbeng M, Cudjoe J, Miller HN, Baptiste D, Himmelfarb CD, Davidson P, Cooper LA, Commodore-Mensah Y. Social determinants of hypertension and diabetes among African immigrants: the African immigrants health study. Ethn Health 2022; 27:1345-1357. [PMID: 33550838 DOI: 10.1080/13557858.2021.1879026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 01/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To examine the association between social determinants of health, hypertension, and diabetes among African immigrants. METHODS The African Immigrant Health Study was a cross-sectional study of the health of African immigrants in the Baltimore-Washington Metropolitan Area. The outcomes of interest were self-reported diagnoses of hypertension and diabetes. Logistic regression was used to examine the relationship between educational status, employment, income, social support, health insurance, and self-reported diagnoses of hypertension and diabetes, adjusting for age, sex, and length of stay in the U.S. RESULTS A total of 465 participants with mean (±SD) age 47 (±11.5) years were included. Sixty percent were women, 64% had a college degree or higher, 83% were employed, 67% had health insurance, and 70% were married/cohabitating. Over half (60%) of the participants had lived in the United States for ≥ 10 years, and 84% were overweight/obese. The overall prevalence of hypertension and diabetes was 32% and 13%, respectively. The odds of diabetes was higher (aOR: 5.00, 95% CI: 2.13, 11.11) among those who were unemployed than among those who were employed, and the odds of hypertension was higher among those who had health insurance (aOR:1.73, 95% CI: 1.00, 3.00) than among those who did not. CONCLUSIONS Among African immigrants, those who were unemployed had a higher likelihood of a self-reported diagnosis of diabetes than those who were employed. Also, people who had health insurance were more likely to self-report a diagnosis of hypertension. Additional studies are needed to further understand the influence of social determinants of health on hypertension and diabetes to develop health policies and interventions to improve the cardiovascular health of African immigrants.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lisa A Cooper
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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15
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Wenham K, Sebar B, Lee P, Harris N, Campbell G. Intimate Partner Violence in the Sub-Saharan African Immigrant Community in Chicago: A Changing Landscape. Epidemiologia (Basel) 2022; 3:337-52. [PMID: 36417242 DOI: 10.3390/epidemiologia3030026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 07/01/2022] [Indexed: 12/14/2022]
Abstract
The challenges of conducting research on intimate partner violence (IPV) in immigrant communities means little is known about the occurrence of various forms of IPV, making it difficult to address in these populations. This research draws on data gathered in Chicago's large and varied African immigrant communities. This research used a mixed methods approach: collection of quantitative survey data on occurrence, followed by qualitative interviews to explain the results. Missing quantitative data and contradicting qualitative responses made it difficult to draw definite conclusions on physical IPV; however, verbal abuse and controlling behaviours appear to be relatively widespread and normalised, and not always viewed as violence. Particularly with the probability of future pandemics and natural disasters, which are known to increase prevalence, it is important to raise awareness of less visible controlling behaviours and verbal abuse as forms of violence, and to implement appropriate prevention programs to minimise a concomitant rise in IPV within African immigrant communities.
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16
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Aidoo-Frimpong G, Collins RL, Agbemenu K, Orom H, Morse GD, Nelson LE. Barriers to HIV Pre-Exposure Prophylaxis Uptake and Ways to Mitigate Them: Perspectives of Ghanaian Immigrants in the United States. AIDS Educ Prev 2022; 34:209-225. [PMID: 35647865 DOI: 10.1521/aeap.2022.34.3.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
African immigrants in the United States experience disparities in HIV incidence. Pre-exposure prophylaxis (PrEP) effectively prevents HIV infection, yet uptake is low among racial and ethnic minorities. To better understand PrEP adoption among African immigrants, in March 2020, we conducted interviews with Ghanaian immigrants (N = 40) to explore the barriers and ways to overcome these barriers to PrEP adoption. Participants described several barriers (e.g., low HIV knowledge and risk perception, fear of social judgment, cultural values, and norms), which may impede PrEP adoption. We categorized these barriers according to the levels of the socioecological model (individual, interpersonal, community, and organizational/structural factors). Participants also identified strategies to overcome the barriers, such as providing comprehensive education on HIV and PrEP. Our research provides foundational knowledge that can inform future PrEP research with Ghanaian and other African immigrants and offers important insights into factors that may impact PrEP adoption in this population.
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Affiliation(s)
- Gloria Aidoo-Frimpong
- School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - R Lorraine Collins
- School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, State University of New York, Buffalo, New York
| | - Heather Orom
- School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - Gene D Morse
- School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, and the Center for Integrated Global Biomedical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - LaRon E Nelson
- Yale School of Nursing, Yale University, New Haven, Connecticut
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17
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Mukaz DK, Melby MK, Papas MA, Setiloane K, Nmezi NA, Commodore-Mensah Y. Diabetes and acculturation in African immigrants to the United States: analysis of the 2010-2017 National Health Interview Survey (NHIS). Ethn Health 2022; 27:770-780. [PMID: 32977725 DOI: 10.1080/13557858.2020.1820958] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/22/2020] [Indexed: 06/11/2023]
Abstract
Objective: This study sought to assess the association between unidimensional acculturation and diabetes, and analyze mediating pathways of the association in African immigrants to the United States (U.S.).Hypothesis: Acculturation would be positively associated with diabetes and that BMI (Body mass index), physical activity, and psychological distress would mediate this association.Methods: An analysis of cross-sectional data from the 2010-2017 National Health Interview Surveys was performed. Adults aged ≥ 18 years who were born in Africa (African immigrants) and residing in the U.S. were considered. The outcome was self-reported diabetes, and acculturation was defined by percent of life spent in the U.S. and citizenship. Multivariable logistic regression analysis was used to assess the association between acculturation and diabetes, and mediation analysis was used to examine the mediating effects of BMI, physical activity, and psychological distress on this association.Results: The analytic sample included 1648 African immigrants with mean (SD) age of 41.3 ± 0.45 years; 56.4% male. Additionally, 46% had ≥ college education, and 21.4% lived below the poverty threshold. About two-thirds were overweight/obese. Less than 50% exercised at adequate levels of physical activity levels. A small percentage (1.8%) reported psychological distress. The prevalence of self-reported diabetes was 6.1%, and 76.5% reported being acculturated. In the multivariate logistic regression analysis, higher levels of acculturation were associated with higher odds of diabetes diagnosis (Odds Ratio (OR) = 2.2; 95% CI = 1.1-4.4). Although BMI mediated the association between acculturation and diabetes (ZMediation = 2.11, p = 0.036), only 18.9% of the total effect of acculturation on diabetes was explained by BMI.Conclusions: Acculturation increased the odds of diabetes diagnosis, and BMI mediated the association. Thus, tailoring culturally-appropriate interventions to control BMI may contribute to preventing diabetes within African immigrant communities to the U.S.
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Affiliation(s)
- Debora Kamin Mukaz
- Department of Medical and Molecular Sciences, University of Delaware, Newark, DE, USA
| | - Melissa K Melby
- Department of Anthropology, University of Delaware, Newark, DE, USA
| | - Mia A Papas
- Value Institute, Christiana Care Research, Newark, DE, USA
| | - Kelebogile Setiloane
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | | | - Yvonne Commodore-Mensah
- Department of Community-Public Health Nursing, Johns Hopkins University School of Nursing, Baltimore, MD, USA
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18
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Nkimbeng M, Rosebush CE, Akosah KO, Yam H, Russell WN, Bustamante G, Albers EA, Shippee TP, Sasikumar AP, Gaugler JE. The Immigrant Memory Collaborative: A Community-University Partnership to Assess African Immigrant Families' Experiences with Dementia. Int J Environ Res Public Health 2022; 19:ijerph19074075. [PMID: 35409758 PMCID: PMC8997896 DOI: 10.3390/ijerph19074075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/07/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022]
Abstract
Research suggests a disparity in the prevalence of dementia, with Black older adults having double the risk compared to their White counterparts. African immigrants are a fast-growing segment of the U.S. Black population, but the dementia care needs and resources of this population are not fully understood. In this paper, we describe the process of working collaboratively with a community partner and project advisory board to conduct a culturally informed project. Specifically, we describe the process of developing culturally informed instruments to collect data on dementia care needs and resources among African immigrants. Working together with a diverse project advisory board, a guide was developed and used to conduct community conversations about experiences with dementia/memory loss. Transcripts from six conversations with 24 total participants were transcribed and analyzed thematically by two independent coders in Nvivo. These qualitative findings were used to inform the development of a survey for quantitative data collection that is currently ongoing. Themes (e.g., cultural attitudes, challenges, and current resources) from the community conversations that informed the survey are described briefly. Despite the challenges of conducting research during a global pandemic, having trusting relationships with a partnering community organization and project advisory board facilitated the successful development of instruments to conduct preliminary dementia care research in an underserved population. We anticipate that survey results will inform interventions that increase education, outreach, and access to dementia care and caregiving resources for this population. It may serve as a model for community–university partnerships for similar public health efforts in dementia as well as other chronic disease contexts.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
- Correspondence:
| | - Christina E. Rosebush
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Kwame O. Akosah
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Hawking Yam
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Wynfred N. Russell
- African Career Education and Resources Inc., Brooklyn Park, MN 55445, USA; (W.N.R.); (A.P.S.)
| | - Gabriela Bustamante
- Program in Health Disparities Research, Department of Family Medicine & Community Health, University of Minnesota Medical School, Minneapolis, MN 55455, USA;
- School of Public Health, Universidad San Francisco de Quito, Quito 170901, Ecuador
| | - Elizabeth A. Albers
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Tetyana P. Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
| | - Arundhathi P. Sasikumar
- African Career Education and Resources Inc., Brooklyn Park, MN 55445, USA; (W.N.R.); (A.P.S.)
| | - Joseph E. Gaugler
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA; (C.E.R.); (K.O.A.); (H.Y.); (E.A.A.); (T.P.S.); (J.E.G.)
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Abstract
This cross-sectional study aims to describe the self-care of adult African immigrants in the US with chronic illness and explore the relationship between acculturation and self-care. A total of 88 African immigrants with chronic illness were enrolled. Self-care was measured with the Self Care of Chronic Illness Inventory v3 and the Self-Care Self-Efficacy scale. Scores are standardized 0 to 100 with scores >70 considered adequate. Acculturation was measured using a modified standardized acculturation instrument and predefined acculturation proxies. The self-care scores showed adequate self-care, with the mean scores of 78.6, 77.9, and 75.6 for self-care maintenance, monitoring, and management. Self-care self-efficacy mean score was 81.3. Acculturation was not significantly associated with self-care. Self-care self-efficacy was a strong determinant of self-care maintenance (p < .0001), monitoring (p < .0001), and management (p < .0001). The perception of inadequate income was a significant determinant of poor self-care management (p = .03). Self-care self-efficacy and perceived income adequacy were better determinants of self-care than acculturation.
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Affiliation(s)
- Onome H. Osokpo
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Lisa M. Lewis
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Uchechukwu Ikeaba
- West Chester University of Pennsylvania, 25 University Avenue, West Chester, PA 19383
| | - Jesse Chittams
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
| | - Frances K. Barg
- University of Pennsylvania Perelman School of Medicine, 915 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
| | - Barbara J. Riegel
- University of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USA
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20
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Waldman ZC, Schenk BR, Duhuze Karera MG, Patterson AC, Hormenu T, Mabundo LS, DuBose CW, Jagannathan R, Whitesell PL, Wentzel A, Horlyck-Romanovsky MF, Sumner AE. Sleep and Economic Status Are Linked to Daily Life Stress in African-Born Blacks Living in America. Int J Environ Res Public Health 2022; 19:ijerph19052562. [PMID: 35270258 PMCID: PMC8909882 DOI: 10.3390/ijerph19052562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023]
Abstract
To identify determinants of daily life stress in Africans in America, 156 African-born Blacks (Age: 40 ± 10 years (mean ± SD), range 22–65 years) who came to the United States as adults (age ≥ 18 years) were asked about stress, sleep, behavior and socioeconomic status. Daily life stress and sleep quality were assessed with the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. High-stress was defined by the threshold of the upper quartile of population distribution of PSS (≥16) and low-stress as PSS < 16. Poor sleep quality required PSQI > 5. Low income was defined as <40 k yearly. In the high and low-stress groups, PSS were: 21 ± 4 versus 9 ± 4, p < 0.001 and PSQI were: 6 ± 3 versus 4 ± 3, p < 0.001, respectively. PSS and PSQI were correlated (r = 0.38, p < 0.001). The odds of high-stress were higher among those with poor sleep quality (OR 5.11, 95% CI: 2.07, 12.62), low income (OR 5.03, 95% CI: 1.75, 14.47), and no health insurance (OR 3.01, 95% CI: 1.19, 8.56). Overall, in African-born Blacks living in America, daily life stress appears to be linked to poor quality sleep and exacerbated by low income and lack of health insurance.
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Affiliation(s)
- Zoe C. Waldman
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
| | - Blayne R. Schenk
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
| | - Marie Grace Duhuze Karera
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
- National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
- Institute of Global Health Equity Research, University of Global Health Equity, Kigali 6955, Rwanda
| | - Arielle C. Patterson
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
| | - Thomas Hormenu
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
- Department of Health, Physical Education, University of Cape Coast, Cape Coast P.O. Box 5007, Ghana
| | - Lilian S. Mabundo
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
| | - Christopher W. DuBose
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
| | - Ram Jagannathan
- Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Peter L. Whitesell
- Howard University Hospital Sleep Disorders Center, Howard University, 2041 Georgia Ave, NW, Washington, DC 20060, USA;
| | - Annemarie Wentzel
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
| | - Margrethe F. Horlyck-Romanovsky
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
- Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, New York, NY 11210, USA
| | - Anne E. Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (Z.C.W.); (B.R.S.); (M.G.D.K.); (A.C.P.); (T.H.); (L.S.M.); (C.W.D.); (A.W.); (M.F.H.-R.)
- National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
- Correspondence:
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21
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Ogungbe O, Turkson-Ocran RA, Koirala B, Byiringiro S, Liu X, Elias S, Mensah D, Turkson-Ocran E, Nkimbeng M, Cudjoe J, Baptiste D, Commodore-Mensah Y. Acculturation and Cardiovascular Risk Screening among African Immigrants: The African Immigrant Health Study. Int J Environ Res Public Health 2022; 19:2556. [PMID: 35270252 PMCID: PMC8909198 DOI: 10.3390/ijerph19052556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 01/12/2023]
Abstract
Acculturation and immigration-related factors may impact preventive, routine cardiovascular risk (CV) screening among African immigrants. We examined the associations between length of stay, percent of life spent in the U.S. (proxy for acculturation), and CV screening. Outcomes were recent screening for hypertension, diabetes, and dyslipidemia. Multivariable logistic regression analyses were used to examine these relationships. Among 437 African immigrants, 60% were males, mean age was 47 years, 61% had lived in the U.S. for ≥10 years, mean length of stay was 15 years, and 81% were employed. Only 67% were insured. In the 12 months prior, 85% had screened for hypertension, 45% for diabetes, and 63% for dyslipidemia. African immigrants with a ≥10-year length of U.S. stay had 2.20 (95%Confidence Intervals: 1.31−3.67), and those with >25% years of life spent in the U.S. had 3.62 (95%CI: 1.96−6.68) higher odds of dyslipidemia screening compared to those with a <10-year length of stay and ≤25% years of life spent in the U.S., respectively. Overall, screening for CV risk higher in African immigrants who have lived longer (≥10 years) in the U.S. Recent African immigrants may experience challenges in accessing healthcare. Health policies targeting recent and uninsured African immigrants may improve access to CV screening services.
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Affiliation(s)
- Oluwabunmi Ogungbe
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
| | - Ruth-Alma Turkson-Ocran
- Beth Israel Deaconess Medical Center, Division of General Medicine, Section for Research, Boston, MA 02215, USA;
| | - Binu Koirala
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
| | - Samuel Byiringiro
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
| | - Xiaoyue Liu
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
| | - Sabrina Elias
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
| | - Danielle Mensah
- Drexel University College of Medicine, Philadelphia, PA 19129, USA;
| | | | - Manka Nkimbeng
- School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA;
| | | | - Diana Baptiste
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
| | - Yvonne Commodore-Mensah
- Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA; (B.K.); (S.B.); (X.L.); (S.E.); (D.B.); (Y.C.-M.)
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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22
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Nkimbeng M, Akumbom A, Granbom M, Szanton SL, Shippee TP, Thorpe RJ Jr, Gaugler JE. Where to Retire? Experiences of Older African Immigrants in the United States. Int J Environ Res Public Health 2022; 19:1040. [PMID: 35162063 DOI: 10.3390/ijerph19031040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 12/28/2022]
Abstract
Doubling in size since the 1970s, the aging needs of the African immigrant population are not fully understood. This qualitative study examined experiences of aging and retirement planning for African immigrant older adults in the United States (U.S.). Specifically, it explored the factors, processes, and ultimate decision of where these older adults planned to retire. Secondary analysis of semi-structured interviews with 15 older African immigrants in the Baltimore–Washington Metropolitan area was conducted. Data was analyzed using thematic analyses in NVivo. The majority of participants were women, with a mean age of 64. Three overarching themes with ten sub-themes were identified. The themes included: (1) cultural identity, which indicated the participant’s comfort with the U.S. society and culture; (2) decision making, meaning factors that impact participants’ choice of retirement location; and (3) decision made, meaning the final choice of where participants would like to retire. Age-friendliness for immigrant older adults in the U.S. is complex and it includes traditional domains such as physical and sociocultural environment (e.g., housing, transportation, and income). However, immigrant age-friendliness also needs to include wider contextual aspects such as political climate of their country of origin, immigrant status, family responsibilities, and acculturation in the U.S. More research is needed to better understand and facilitate age-friendly environments and transnational aging of immigrant older adults.
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Daniel NA, Hassan SA, Mohamed F, Sheikh N, Basualdo G, Schwartz R, Gebreselassie BT, Beyene YK, Gabreselassie L, Bayru K, Tadesse B, Libneh HA, Shidane M, Benalfew S, Ali A, Rao D, Kerani RP, Patel RC. Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington. AIDS Behav 2022; 26:149-164. [PMID: 34368910 PMCID: PMC8349708 DOI: 10.1007/s10461-021-03396-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 02/07/2023]
Abstract
African immigrants are disproportionately affected by HIV compared to U.S.-born individuals, and early HIV testing is the key challenge in ending the HIV epidemic in these communities. HIV-related stigma appears to be the most significant barrier to testing for HIV among African communities in King County, WA. In this formative study, we conducted thirty key informant interviews and five focus group discussions (n = total 72 participants) with Ethiopian, Somali, and Eritrean people living with HIV, health professionals, religious and other community leaders, and lay community members in King County to better understand HIV-related and intersectional stigmas' impact on HIV testing behaviors. We used inductive coding and thematic analysis. Participants from all communities reported similar themes for HIV-related and intersectional stigmas' influences on HIV testing behaviors. Misconceptions or poor messaging, e.g., regarding treatability of HIV, as well as normative or religious/moral beliefs around pre/extramarital sex contributed to HIV-related stigma. Intersecting identities such as immigrant status, race/ethnicity, and having a non-English language preference, all intermingle to further influence access to the U.S. healthcare system, including for HIV testing. These findings can be used to inform future research on community-led approaches to addressing early HIV testing amongst African immigrant communities.
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Affiliation(s)
| | - Shukri A Hassan
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Farah Mohamed
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
- Somali Health Board, Tukwila, WA, USA
| | - Najma Sheikh
- Department of Global Health, UW, Seattle, WA, USA
| | | | - Rahel Schwartz
- Ethiopian Community in Seattle, Seattle, WA, USA
- Ethiopian Health Board, Seattle, WA, USA
| | | | | | | | | | | | | | | | | | - Ahmed Ali
- Somali Health Board, Tukwila, WA, USA
- Department of Global Health, UW, Seattle, WA, USA
| | - Deepa Rao
- Department of Global Health, UW, Seattle, WA, USA
| | - Roxanne P Kerani
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Rena C Patel
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA.
- Department of Global Health, UW, Seattle, WA, USA.
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Aidoo-Frimpong G, Orom H, Agbemenu K, Collins RL, Morse GD, Nelson LE. Exploring Awareness, Perceptions, and Willingness to Use HIV Pre-Exposure Prophylaxis: A Qualitative Study of Ghanaian Immigrants in the United States. AIDS Patient Care STDS 2022; 36:8-16. [PMID: 34910883 PMCID: PMC8905245 DOI: 10.1089/apc.2021.0156] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
HIV/AIDS disproportionately burdens African immigrants in the United States. Oral pre-exposure prophylaxis (PrEP) is an effective prevention tool for people at high HIV risk, yet uptake is low among racial and ethnic minorities-particularly immigrants. This study explores the awareness, perception, and willingness to use PrEP among Ghanaian immigrants in the United States. WhatsApp, a social media platform, was used to recruit and conduct semi-structured oral interviews with 40 Ghanaian immigrants in March 2020. Interview questions explored awareness of PrEP (whether the participants knew or had knowledge of PrEP before the study), perceptions of PrEP and PrEP users, and willingness to use PrEP. Interviews were audiorecorded, and transcribed. We used NVivo-12 Plus to analyze transcripts for emergent themes. Our sample consisted of Ghanaian adult immigrants (N = 40, 57% male, 71% college educated, age = 32.8 ± 5.7 years, 68% had lived in the United States between 1 and 10 years) residing in 12 US cities. Four major themes emerged: (1) low awareness of PrEP; (2) positive perception of PrEP for HIV prevention; (3) divergent views on PrEP users; and (4) mixed views on willingness to use PrEP. This study presents formative qualitative work, which suggests that Ghanaian immigrants, despite having low awareness of PrEP, may be willing to use PrEP. A key study implication was that stigma reduction interventions might facilitate PrEP scale-up in this population.
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Affiliation(s)
- Gloria Aidoo-Frimpong
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, USA.,Address correspondence to: Gloria Aidoo-Frimpong, MA, MPH, Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, 3435 Main Street, 321 Kimball Tower, Buffalo, NY 14214-8028, USA
| | - Heather Orom
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Kafuli Agbemenu
- School of Nursing, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - R. Lorraine Collins
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Gene D. Morse
- Pharmacy Practice (Medicine, Pediatrics), University at Buffalo, State University of New York, Buffalo, New York, USA
| | - LaRon E. Nelson
- Yale School of Nursing, MAP Center for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto—St. Michael's Hospital, Toronto, Canada
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25
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Saasa S, Miller S. Biopsychosocial Predictors of Depression and Anxiety Symptoms among First-Generation Black African Immigrants. Soc Work 2021; 66:329-338. [PMID: 34410429 DOI: 10.1093/sw/swab038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 06/13/2023]
Abstract
Few studies examine factors associated with mental health distress among immigrants from African countries. Using cross-sectional data from first-generation Black African immigrants across the United States (N = 180), this study examined biopsychosocial factors that influence depression and anxiety symptoms among African immigrants in the United States. Ordinary least squares regression was conducted to analyze the data. Approximately 22 percent of the sample reported depression and anxiety symptoms in the moderate to severe range. Results indicated that being male, substance use, discrimination, and loneliness were significantly associated with worse depression and anxiety symptoms. In addition, worries about safety and financial strain were associated with increased mental health distress. Loneliness also moderated the association between discrimination and depression and anxiety symptoms. Findings imply that relational interventions in direct practice settings may play a critical role in helping African immigrants ameliorate depression and anxiety symptoms. This study supports the use of the biopsychosocial approach in assessment and intervention of mental health symptoms as well as a systems approach when understanding the experiences of African immigrants.
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Affiliation(s)
- Sherinah Saasa
- School of Social Work, Brigham Young University, 2190 JFSB, Provo, UT 84062
| | - Selina Miller
- School of Social Work, Washington University in St. Louis
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26
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Boukpessi TB, Kpanake L, Gagnier JP. Willingness to Use Mental Health Services for Depression Among African Immigrants and White Canadian-Born People in the Province of Quebec, Canada. J Immigr Minor Health 2021; 23:320-328. [PMID: 32740883 DOI: 10.1007/s10903-020-01061-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Studies suggest that non-Caucasian immigrants to Canada are less likely than Canadian-born people to use mental health services. To meet the mental health needs of ethnocultural minorities, insights into their help-seeking attitudes are of great concern. This study examined the willingness of African immigrants and White Canadian-born to seek care for depression from conventional mental health services. African immigrants (N = 262) and White Canadian-born people (N = 250) living in Montreal, Canada, indicated their willingness to use mental health services under different conditions varying as a function of four factors: the severity of symptoms, the waiting time for first consultation, the type of care offered in the mental health service, and whether informal sources of help were available. Seven qualitatively different positions were identified: Never Consult (18% of the African immigrants and 1% of the White Canadian-born people); Hesitant (18% of the African immigrants and 7% of the White Canadian-born people); Depends on Waiting Time (16% of the African immigrants); Depends on Waiting Time and Symptoms (22% of the African immigrants); Depends on Symptoms (36% of the White Canadian-born people and 6% of the African immigrants); Willing to consult (33% of the White Canadian-born people and 2% of the African immigrants); Certain to Consult (9% of the White Canadian-born people and 4% of the African immigrants), while 14% of participants in each group did not express any position. African immigrants were more likely to underuse mental health services, compared with White Canadian-born people. The above diversity of positions strongly suggests that the design and implementation of interventions to reduce disparities in African immigrants' use of mental health care must not be "one size fits all" but must be tailored to address these immigrants' differing attitudes and needs.
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Affiliation(s)
| | - Lonzozou Kpanake
- University of Québec - TELUQ, 5800, Rue Saint-Denis, Bureau 1105, Montréal, QC, H2S 3L5, Canada
| | - Jean-Pierre Gagnier
- Université du Québec à Trois-Rivières, 3351, Boulevard des Forges, Trois-Rivières, QC, G8Z 4M3, Canada
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Saasa SK, Rai A, Malazarte N, Yirenya-Tawiah AE. Mental health service utilization among African immigrants in the United States. J Community Psychol 2021; 49:2144-2161. [PMID: 34033683 DOI: 10.1002/jcop.22602] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/12/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
This study utilized Andersen's model of health behavior to explore factors associated with mental health service utilization. We also examine rates for mental health service use, treatment preferences, and barriers to care. Data were collected utilizing web-based surveys. The sample consisted of first and second-generation African immigrants who had struggled with emotional or behavioral problems in the past 12 months (N = 323). Hierarchical logistic regression analyses were conducted to examine predictors of mental health service utilization. The majority of participants (79.5%) met criteria for probable major depression, and 63% sought mental health services. Findings showed that mental health service utilization was more significantly predicted by enabling and need factors. Age (odds ratio [OR] = 1.03), religiosity (OR = 1.11), acculturative stress (OR = 1.68), neighborhood risk (OR = 0.54), and work-productivity loss (OR = 2.93) were associated with increased likelihood of mental health service use (p < 0.05). Most common barriers to service use were hopes of self-healing (56.3%) followed by financial barriers (46.2%). Findings highlight the need for public health initiatives to increase mental health literacy and financial accessibility to mental health services in response to the high mental health need and identified barriers to care in this population.
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Affiliation(s)
- Sherinah K Saasa
- School of Social Work, Brigham Young University, Provo, Utah, USA
| | - Abha Rai
- School of Social Work, Loyola University Chicago, Chicago, Illinois, USA
| | - Nikki Malazarte
- School of Social Work, Loyola University Chicago, Chicago, Illinois, USA
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Cudjoe J, Nkimbeng M, Turkson-Ocran RA, Commodore-Mensah Y, Han HR. Understanding the Pap Testing Behaviors of African Immigrant Women in Developed Countries: A Systematic Review. J Immigr Minor Health 2021; 23:840-856. [PMID: 33165711 PMCID: PMC8747177 DOI: 10.1007/s10903-020-01119-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND African immigrant (AI) women remain burdened by cervical cancer, but the prevalence and correlates of Pap testing remains unclear in this population. OBJECTIVE To review studies on the prevalence and determinants of Pap testing among AI women living in developed countries. METHODS PubMed, CINAHL, Embase, and Scopus were searched for relevant articles that included African-born immigrant participants; were published in English; addressed the prevalence of Pap testing; conducted in a developed country; and identified correlates of Pap testing behavior. The Andersen Behavioral Model guided synthesis of the key findings. RESULTS Sixteen studies met the inclusion criteria. The prevalence of Pap testing ranged from 4.6% to 73.0%. Having a female provider and access to primary care facilitated Pap testing. Barriers to Pap testing included low income, male healthcare providers, and no history of gynecological exam. CONCLUSIONS Healthcare providers and social determinants-particularly income and healthcare access, play an important role in improving Pap testing among AI women. Larger qualitative and mixed methods studies are needed to explore other important determinants of Pap testing such as disease knowledge, self-efficacy, health literacy to reduce the burden of cervical cancer among AI women.
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Affiliation(s)
- Joycelyn Cudjoe
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
- Inova Health System, 8110 Gatehouse Road, Falls Church, VA, 22042, USA.
| | - Manka Nkimbeng
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN, 55444, USA
| | - Ruth-Alma Turkson-Ocran
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Yvonne Commodore-Mensah
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Community Innovation and Scholarship, The Johns Hopkins School of Nursing, 855 N Wolfe Street, Baltimore, MD, 21205, USA
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Abstract
Although researchers have found an inverse relationship between length of U.S. residence and health, research on this issue among African-born immigrants is limited. Data from the 2011-2015 National Health Interview Surveys were pooled for African-born immigrants (N = 1137) and used to estimate weighted ordinary least squares regression models on self-reported health, adjusting for common immigrant health predictors. Length of U.S. residence was associated with significant health status declines only among those that had lived in the U.S. for 10 to less than 15 years (b = - 0.235, p < 0.05), net of covariates. African-born immigrants may have both different selection processes than other immigrants and not follow common integration patterns. These findings suggest that existing immigrant health frameworks may need modification to fully apply to this growing U.S. immigrant population.
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Affiliation(s)
- Ezinne M Nwankwo
- Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E Young Dr. S., Box 951772, Los Angeles, CA, 90095, USA.
| | - Steven P Wallace
- Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 Charles E Young Dr. S., Box 951772, Los Angeles, CA, 90095, USA
- Center for Health Policy Research, UCLA Fielding School of Public Health, Los Angeles, CA, 90095, USA
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Nwoke CN, Awosoga O, Leung BM. Recruitment Strategies Used in a Survey of African Immigrant Maternal Mental Health in Alberta, Canada. J Racial Ethn Health Disparities 2021; 9:1415-1421. [PMID: 34100262 PMCID: PMC8184054 DOI: 10.1007/s40615-021-01078-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/03/2022]
Abstract
African immigrant women are underrepresented in health research on maternal mental health. Thus, there is a need to highlight successful recruitment strategies to engage African women in health-oriented research. This paper offers insights on recruitment strategies utilized in recruiting African immigrant women in Alberta (Canada) with infants 2 years of age or under for a survey study on maternal mental health. We recruited 136 African immigrant women. Most participants were recruited by using already established social networks in the community. Other successful strategies included referral from community partners (i.e., immigrant organizations, cultural association, religious institutions), participants, utilizing an online survey tool (i.e., Qualtrics), and through family and friend networks (i.e., word-of-mouth). This study evidently highlights the importance of utilizing multiple recruitment strategies to successfully meet the desired sample size for a survey study. We believe the lessons learned during the process of recruitment will be helpful for others working with other African immigrant women populations in Canada and in other Western societies.
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Affiliation(s)
- Chinenye Nmanma Nwoke
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Oluwagbohunmi Awosoga
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
| | - Brenda My Leung
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada
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31
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Carr J, Cha DE, Shaltiel T, Zheng S, Siderides C, Golas B, Labow D, Magge D, Cohen N, Branch A, Sarpel U. African Immigrants in New York City with Hepatitis B-Related Hepatocellular Carcinoma Demonstrate High Morbidity and Mortality. J Immigr Minor Health 2021. [PMID: 33907933 DOI: 10.1007/s10903-021-01205-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/09/2022]
Abstract
Guidelines recommend hepatitis B (HBV) testing in individuals from endemic areas, and if positive, screening for hepatocellular carcinoma (HCC). While screening programs are well established in the Asian immigrant population in New York City (NYC), less is known about the characteristics of HBV/HCC among the African immigrant community. A retrospective review was performed of HCC cases from 2005 to 2018 at our institution. Country of origin was not documented in the electronic medical record; therefore, African immigrant status was approximated using self-identified race/ethnicity, positive HBV status, and an online registry to determine country of origin based on last name. Surnames with the greatest prevalence or density in an African country were considered. Among 4400 patients with HCC, 472 identified as non-Hispanic Black; of these, 86 were HBV+. Based on surname, it was estimated that 33 individuals were likely immigrants from Africa. In this group, median age of HCC diagnosis was 48 years (IQR 43-55). In patients with an available date of HBV diagnosis (n = 24), 17 (71%) were unaware of their HBV status when they presented with HCC. Zero patients were diagnosed with HCC through routine screening, most patients (66%) were diagnosed upon imaging evaluation of symptoms. Twelve patients (36%) underwent resection or transplantation; the remaining 64% were ineligible for surgical treatment. Of the 26 patients with follow-up data, 18 (69%) died of disease or were critically ill at last encounter, and of these, 14 (77%) died within 1 year of HCC diagnosis. In conclusion, African immigrants in NYC with HBV/HCC are at high risk of HCC related mortality at a young age. Most were unaware of their hepatitis status at the time of HCC diagnosis. No patients were enrolled in routine HCC screening; the majority were diagnosed based on imaging obtained for symptoms. Most individuals presented with inoperable disease, and the majority died within months of diagnosis. Awareness of these findings may help healthcare providers improve patient outcomes.
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Ekwonye AU, Ezumah BA, Nwosisi N. Meaning in life and impact of COVID-19 pandemic on African immigrants in the United States. Wellbeing Space Soc 2021; 2:100033. [PMID: 34746894 PMCID: PMC8562864 DOI: 10.1016/j.wss.2021.100033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/15/2021] [Accepted: 03/16/2021] [Indexed: 05/03/2023]
Abstract
This study explored the 2020 COVID-19 pandemic impact, with its unprecedented isolation norm and social distancing requirements, on African immigrants in the United States. We focused on the sources of meaning in their daily lives, how they navigated their meaning-making process, and cultural proclivities amidst the official and unofficial mandates for social distancing. Additionally, we investigated the role technologies play in the entire process. A qualitative inquiry conducted virtually generated data from a sample of 20 participants. Results show that African immigrants derive meaning from social relationships, personal life goals, religious faith, service, and good health. The COVID-19 pandemic undoubtedly threatened participants' core meaning sources, which they rely on for life satisfaction, personal growth, and healing. Various emergent technologies helped in ameliorating the situation by providing conduits for participants to engage, albeit virtually, in most activities that positively impact their lives. This study highlights clinicians' need to integrate meaning in life discussions in their African immigrant patients' care and incorporate congruent technologies as needed.
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Affiliation(s)
- Angela U Ekwonye
- St. Catherine University, 2004 Randolph Ave, #4203, St. Paul, MN 55105, United States
| | | | - Ngozi Nwosisi
- Program in Public Health, College of Health Sciences, University of California, 653 E. Peltason Drive, Suite 2040K, Irvine CA 92617, USA
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Tiwari T, Rai N. Oral Health of African Immigrants: A participatory approach to needs assessment. Community Dent Health 2021; 38:48-52. [PMID: 33507651 DOI: 10.1922/cdh_00087tiwari05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Dental care service use is lower in the immigrant population in the US, with the African immigrant population increasing at a much higher rate. We aimed to evaluate the barriers faced by the African immigrant community through a participatory needs assessment approach. METHODS Photovoice, a qualitative research method was used to collect the data. Thirty participants were recruited from community events, churches, and African community-serving organizations. Participants took photographs related to oral health research questions. Focus groups were conducted with the participants to discuss the clicked pictures. The focus group data were transcribed and analyzed using an inductive and thematic approach using Atlas Ti®. RESULTS The response rate was 90% and six focus groups were conducted. Focus group data demonstrated participants' knowledge of good oral health and preventive oral behaviors; physical, financial and psychosocial barriers to accessing dental care; and cultural and social beliefs of the community. The participants had good knowledge about oral hygiene habits and dietary factors impacting the oral health of their community. Several barriers including, lack of perceived oral health needs, transportation, time, insurance, fear, and trust were identified that prevent them to access dental care. CONCLUSION Further research is warranted to understand the cultural norms and perceived needs of the African immigrant community. Increasing our understanding of such knowledge can support in improving the cultural competency of the oral health workforce.
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Affiliation(s)
- T Tiwari
- Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado, United States
| | - N Rai
- Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado, United States
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Henry Osokpo O, James R, Riegel B. Maintaining cultural identity: A systematic mixed studies review of cultural influences on the self-care of African immigrants living with non-communicable disease. J Adv Nurs 2021; 77:3600-3617. [PMID: 33619819 DOI: 10.1111/jan.14804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Abstract
AIM To understand and identify cultural factors influencing the self-care practices of African immigrants living with chronic illness in countries outside Africa. BACKGROUND The influence of cultural factors on self-care is relatively unexplored in African immigrants with non-communicable diseases (NCDs). DESIGN Systematic Mixed Studies review. DATA SOURCES PubMed, Psych Info, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Anthropology Plus and Sociological Abstract computerized databases. No limit was placed on publication date. REVIEW METHODS Results-based convergent design was used. The Mixed Method Appraisal Tool was used to evaluate the studies. Quantitative studies were synthesized narratively while qualitative studies were synthesized using thematic synthesis. RESULTS We identified 251 articles and nine fulfilled our inclusion criteria. The studies were published between 2006 and 2019, with six qualitative and three quantitative studies. Studies were conducted in the United States, Australia, Sweden, the Netherlands and the United Kingdom. Most studies examined the influence of culture on self-care of diabetes (n = 6), while the rest focused on hypertension (n = 3). Findings highlight that cultural norms and practices, non-Western approaches to interpreting and managing illness, cultural connotations of health behaviours and structural challenges influencing self-care. Cultural food preferences made adherence to prescribed diets challenging. Family support facilitated self-care. Maintaining cultural identity was both a driver and constraint to engaging in self-care. CONCLUSION The complex interplay of cultural and structural factors influences the willingness of Africans who have immigrated to a developed country to follow recommended self-care practices. Considering these cultural norms and structural barriers can help to explain the self-care behaviours of African immigrant populations. IMPACT Clinicians and policymakers who account for structural factors and integrate cultural factors into care facilities, treatment protocols and policy can be influential in promoting self-care in African immigrant populations.
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Affiliation(s)
- Onome Henry Osokpo
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Richard James
- Biomedical library, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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35
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Aidoo-Frimpong G, Agbemenu K, Orom H. A Review of Cultural Influences on Risk for HIV and Culturally-Responsive Risk Mitigation Strategies Among African Immigrants in the US. J Immigr Minor Health 2021. [PMID: 33428074 DOI: 10.1007/s10903-020-01138-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
There is a paucity of research on HIV risk factors and risk reduction among African immigrants living in the US. This is despite the fact that the literature on HIV prevention and treatment continues to grow. We conducted a focused review to identify cultural factors contributing to the high incidence of HIV among African immigrants and best practices to increase engagement in HIV prevention services in this population. We conducted a search for empirical research published between 2009 and 2019, yielding 17 relevant studies with 16 unique samples. Inadequate knowledge about HIV transmission, low HIV risk perception, and stigma may be barriers to engaging in HIV prevention. Targeted interventions included bundled HIV testing, flexible scheduling, and involvement of community leaders in intervention planning and implementation. Implications for practice and directions for future research among this population are discussed.
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36
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Nkimbeng M, Commodore-Mensah Y, Angel JL, Bandeen-Roche K, Thorpe RJ, Han HR, Winch PJ, Szanton SL. Longer Residence in the United States is Associated With More Physical Function Limitations in African Immigrant Older Adults. J Appl Gerontol 2020; 41:411-420. [PMID: 33353456 DOI: 10.1177/0733464820977608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Acculturation and racial discrimination have been independently associated with physical function limitations in immigrant and United States (U.S.)-born populations. This study examined the relationships among acculturation, racial discrimination, and physical function limitations in N = 165 African immigrant older adults using multiple linear regression. The mean age was 62 years (SD = 8 years), and 61% were female. Older adults who resided in the United States for 10 years or more had more physical function limitations compared with those who resided here for less than 10 years (b = -2.62, 95% confidence interval [CI] = [-5.01, -0.23]). Compared to lower discrimination, those with high discrimination had more physical function limitations (b = -2.51, 95% CI = [-4.91, -0.17]), but this was no longer significant after controlling for length of residence and acculturation strategy. Residing in the United States for more than 10 years is associated with poorer physical function. Longitudinal studies with large, diverse samples of African immigrants are needed to confirm these associations.
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Affiliation(s)
- Manka Nkimbeng
- Johns Hopkins School of Nursing, Baltimore, MD, USA.,Univeristy of Minnesota School of Public Health, Minneapolis, MN, USA
| | | | - Jacqueline L Angel
- The Univeristy of Texas at Austin School of Public Affairs, Austin, TX, USA
| | | | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Peter J Winch
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Shoup EM, Hormenu T, Osei-Tutu NH, Ishimwe MCS, Patterson AC, DuBose CW, Wentzel A, Horlyck-Romanovsky MF, Sumner AE. Africans Who Arrive in the United States before 20 Years of Age Maintain Both Cardiometabolic Health and Cultural Identity: Insight from the Africans in America Study. Int J Environ Res Public Health 2020; 17:ijerph17249405. [PMID: 33333954 PMCID: PMC7765413 DOI: 10.3390/ijerph17249405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/02/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022]
Abstract
The overall consensus is that foreign-born adults who come to America age < 20 y achieve economic success but develop adverse behaviors (smoking and drinking) that lead to worse cardiometabolic health than immigrants who arrive age ≥ 20 y. Whether age of immigration affects the health of African-born Blacks living in America is unknown. Our goals were to examine cultural identity, behavior, and socioeconomic factors and determine if differences exist in the cardiometabolic health of Africans who immigrated to America before and after age 20 y. Of the 482 enrollees (age: 38 ± 1 (mean ± SE), range: 20–65 y) in the Africans in America cohort, 23% (111/482) arrived age < 20 y, and 77% (371/482) arrived age ≥ 20 y. Independent of francophone status or African region of origin, Africans who immigrated age < 20 y had similar or better cardiometabolic health than Africans who immigrated age ≥ 20 y. The majority of Africans who immigrated age < 20 y identified as African, had African-born spouses, exercised, did not adopt adverse health behaviors, and actualized early life migration advantages, such as an American university education. Due to maintenance of cultural identity and actualization of opportunities in America, cardiometabolic health may be protected in Africans who immigrate before age 20. In short, immigrant health research must be cognizant of the diversity within the foreign-born community and age of immigration.
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Affiliation(s)
- Elyssa M. Shoup
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Thomas Hormenu
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Nana H. Osei-Tutu
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - M. C. Sage Ishimwe
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
- National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
- Institute of Global Health Equity Research, University of Global Health Equity, Kigali 6955, Rwanda
| | - Arielle C. Patterson
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Christopher W. DuBose
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | - Annemarie Wentzel
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
| | | | - Anne E. Sumner
- Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20892, USA; (E.M.S.); (T.H.); (N.H.O.-T.); (M.C.S.I.); (A.C.P.); (C.W.D.); (A.W.)
- National Institute of Minority Health and Health Disparities, Bethesda, MD 20892, USA
- Correspondence:
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Nkimbeng M, Taylor JL, Roberts L, Winch PJ, Commodore-Mensah Y, Thorpe RJ, Han HR, Szanton SL. "All I know is that there is a lot of discrimination": Older African immigrants' experiences of discrimination in the United States. Geriatr Nurs 2020; 42:196-204. [PMID: 33283756 DOI: 10.1016/j.gerinurse.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022]
Abstract
Discrimination is implicated in the disproportionate burden of disease and health disparities in racial/ethnic minorities. This qualitative descriptive study explored the experiences of discrimination and its impact on the health of older African immigrants. Semi-structured interviews were conducted with 15 participants. Three main themes and six sub-themes were identified. These included: (1) types of discrimination which were: (a) accent-based, (b) unfair treatment during routine activities, (c) experience with systems; (2) consequences of discrimination; and (3) surviving and thriving with discrimination: (a) "blind eye to it", (b) reacting to it, (c) avoiding it. These themes described common experiences of discrimination, current strategies used to deal with discrimination, and the impact of discrimination on this sample. Health care providers should be aware of discrimination experiences, how to assess for it, and identify when to refer patients to appropriate community resources that include mental health, employment, cultural groups and legal services.
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Affiliation(s)
- Manka Nkimbeng
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America.
| | - Janiece L Taylor
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America
| | - Laken Roberts
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America
| | - Peter J Winch
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America; Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Roland J Thorpe
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America; Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
| | - Sarah L Szanton
- Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205, United States of America; Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States of America
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Odunitan-Wayas FA, Alaba OA, Lambert EV. Food insecurity and social injustice: The plight of urban poor African immigrants in South Africa during the COVID-19 crisis. Glob Public Health 2020; 16:149-152. [PMID: 33275870 DOI: 10.1080/17441692.2020.1854325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We discuss the plight of urban poor African immigrants from the perspective of the right to food (food availability, accessibility and adequacy) for everyone during the COVID-19 in South Africa. Despite their disrupted sources of livelihood, the majority of the African immigrants are without a social welfare safety net and have little hope of benefiting from the Government relief packages. Consequently, it seems that the increase in the triple burden of food insecurity, poverty and malnutrition compounded with social injustice and income inequality is inevitable for the urban poor African immigrants in South Africa. Even though the Government may not have the capacity to address food insecurity by itself, the Government should endeavour to make the limited resources to access food equally available to all with no social injustice. By working hand in hand with foreign national associations, township councillors and other stakeholders, such as the food banks and faith-based organisations, that have stepped forward to try and bridge the widening incapacity of the Government to feed the food insecure, the nexus of food insecurity and social injustice of African immigrants will be alleviated.
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Affiliation(s)
- Feyisayo A Odunitan-Wayas
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Olufunke A Alaba
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Estelle V Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Mugeni R, Hormenu T, Hobabagabo A, Shoup EM, DuBose CW, Sumner AE, Horlyck-Romanovsky MF. Identifying Africans with undiagnosed diabetes: Fasting plasma glucose is similar to the hemoglobin A1C updated Atherosclerosis Risk in Communities diabetes prediction equation. Prim Care Diabetes 2020; 14:501-507. [PMID: 32173292 DOI: 10.1016/j.pcd.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/24/2020] [Indexed: 12/15/2022]
Abstract
AIMS Seventy percent of Africans living with diabetes are undiagnosed. Identifying who should be referred for testing is critical. Therefore we evaluated the ability of the Atherosclerosis Risk in Communities (ARIC) diabetes prediction equation with A1C added (ARIC + A1C) to identify diabetes in 451 African-born blacks living in America (66% male; age 38 ± 10y (mean ± SD); BMI 27.5 ± 4.4 kg/m2). METHODS All participants denied a history of diabetes. OGTTs were performed. Diabetes diagnosis required 2-h glucose ≥200 mg/dL. The five non-invasive (Age, parent history of diabetes, waist circumference, height, systolic blood pressure) and four invasive variables (Fasting glucose (FPG), A1C, triglycerides (TG), HDL) were obtained. Four models were tested: Model-1: Full ARIC + A1C equation; Model-2: All five non-invasive variables with one invasive variable excluded at a time; Model-3: All five non-invasive variables with one invasive variable included at a time; Model-4: Each invasive variable singly. Area under the receiver operator characteristic curve (AROC) predicted diabetes. Youden Index identified optimal cut-points. RESULTS Diabetes occurred in 7% (30/451). Model-1, the full ARIC + A1C equation, AROC = 0.83. Model-2: With FPG excluded, AROC = 0.77 (P = 0.038), but when A1C, HDL or TG were excluded AROC remained unchanged. Model-3 with all non-invasive variables and FPG alone, AROC=0.87; but with A1C, TG or HDL included AROC declined to ≤0.76. Model-4: FPG as a single predictor, AROC = 0.87. A1C, TG, or HDL as single predictors all had AROC ≤ 0.74. Optimal cut-point for FPG was 100 mg/dL. CONCLUSIONS To detect diabetes, FPG performed as well as the nine-variable updated ARIC + A1C equation.
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Affiliation(s)
- Regine Mugeni
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States; National Institute of Minority Health and Health Disparities (NIMHD), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States
| | - Thomas Hormenu
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States
| | - Arsène Hobabagabo
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States; National Institute of Minority Health and Health Disparities (NIMHD), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States
| | - Elyssa M Shoup
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States
| | - Christopher W DuBose
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States
| | - Anne E Sumner
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States; National Institute of Minority Health and Health Disparities (NIMHD), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States
| | - Margrethe F Horlyck-Romanovsky
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, United States; City University of New York, Brooklyn College, 2900 Bedford Avenue, Brooklyn, NY, United States.
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Abstract
PURPOSE This study sought to examine gendered variations in determinants of depression and anxiety symptoms among African immigrants in the United States. METHODS Data were drawn from a cross-sectional survey of first and second-generation immigrants from African countries living in the United States (N = 409). RESULTS Ordinary Least Squares (OLS) regression results revealed gendered differences in factors that influence depression and anxiety symptoms. Second-generation immigrants showed decreased depression and anxiety symptoms among men, while income and marital status showed significant effects on depression and anxiety symptoms for women. Loneliness and discrimination were found to negatively impact the mental health of both female and male immigrants. Additionally, we found that gender did not moderate the effects of loneliness on depression and anxiety symptoms. CONCLUSION Findings highlight the need for practitioners to better understand the unique risk and protective factors affecting female and male African immigrants in their efforts to provide effective mental health services to members of this population.
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Affiliation(s)
| | - Sherinah Saasa
- School of Social Work, Brigham Young University , Provo, UT, USA
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Hormenu T, Shoup EM, Osei-Tutu NH, Hobabagabo AF, DuBose CW, Mabundo LS, Chung ST, Horlyck-Romanovsky MF, Sumner AE. Stress Measured by Allostatic Load Varies by Reason for Immigration, Age at Immigration, and Number of Children: The Africans in America Study. Int J Environ Res Public Health 2020; 17:E4533. [PMID: 32599711 DOI: 10.3390/ijerph17124533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/17/2020] [Accepted: 06/20/2020] [Indexed: 12/18/2022]
Abstract
Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22–65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.
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Juon HS, Ha E, Kim F, Trang A, Pan J, Blanchard J. Prevalence of Viral Hepatitis in Foreign-Born Populations in the Baltimore-Washington Metropolitan Area, 2009-2015. J Community Health 2019; 44:203-7. [PMID: 30259234 DOI: 10.1007/s10900-018-0573-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While the majority of viral hepatitis is experienced in the developing world, migration of people from high prevalence countries contributes to health outcomes in the United States. The purpose of this study was to estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in foreign-born immigrants living in the Baltimore-Washington metropolitan area. This study used cross-sectional data from 5982 individuals screened at community events held from 2009 to 2015. Descriptive statistics were generated to describe the screening results. Positive results for HBV infection (HBsAg+) and HCV infection (HCVAb+) were analyzed according to age, gender, and country of birth. Of 5982, the majority of participants were born in Asia (77.8%). The prevalence of infection was 6.1% for HBV and 3.8% for HCV in Asia-born immigrants compared to 3.7% for HBV and 2.8% for HCV in Africa-born immigrants. Among participants who were Asia-born, prevalence of HBV infection was highest for those from Cambodia (11.9%) compared to Vietnam (8.2%), China (8.1%), Laos (6.1%), and Korea (4.6%). Among participants who were Africa-born, prevalence of HBV was highest for those from Liberia (6.7%) and Sierra Leone (6.7%), followed by Cameroon (4.4%) and Nigeria (4.2%). The highest HCV prevalence occurred among those from Cambodia (10.8%) and Myanmar (4.9%) in Asia and those from Cameroon (11.4%) and Nigeria (4.8%) in Africa. This study suggests that screening data are disaggregated by country of birth, then improvements can be made to programs for prevention, earlier diagnosis, and linkage to care.
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Cudjoe J, Turkson-Ocran RA, Ezeigwe AK, Commodore-Mensah Y, Nkimbeng M, Han HR. Recruiting African Immigrant Women for Community-Based Cancer Prevention Studies: Lessons Learned from the AfroPap Study. J Community Health 2019; 44:1019-1026. [PMID: 31102117 PMCID: PMC6708449 DOI: 10.1007/s10900-019-00677-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Recruitment in research can be challenging, particularly for racial/ethnic minorities and immigrants. There remains a dearth of research identifying the health and sociocultural needs of these populations related to recruitment. To describe our experiences and lessons learned in recruiting African immigrant (AI) women for the AfroPap study, a community-based study examining correlates of cervical cancer screening behaviors. We developed several recruitment strategies in collaboration with key informants and considered published recruitment methods proven effective in immigrant populations. We also evaluated the various recruitment strategies using recruitment records and study team meeting logs. We enrolled 167 AI women in the AfroPap study. We used the following recruitment strategies: (1) mobilizing African churches; (2) utilizing word of mouth through family and friends; (3) maximizing research team's cultural competence and gender concordance; (4) promoting altruism through health education; (5) ensuring confidentiality through the consenting and data collection processes; and (6) providing options for data collection. Online recruitment via WhatsApp was an effective recruitment strategy because it built on existing information sharing norms within the community. Fear of confidentiality breaches and time constraints were the most common barriers to recruitment. We were successful in recruiting a "hard-to-reach" immigrant population in a study to understand the correlates of cervical cancer screening behaviors among AI women by using a variety of recruitment strategies. For future research involving African immigrants, using the internet and social media to recruit participants is a promising strategy to consider.
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Affiliation(s)
- Joycelyn Cudjoe
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Ruth-Alma Turkson-Ocran
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Angelica K Ezeigwe
- School of Medicine, The Johns Hopkins University, 733 N. Broadway, Baltimore, MD, 21205, USA
| | - Yvonne Commodore-Mensah
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Manka Nkimbeng
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Hae-Ra Han
- School of Nursing, The Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Cardiovascular and Chronic Care, The Johns Hopkins School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
- Center for Community Innovation and Scholarship, The Johns Hopkins School of Nursing, 855 N Wolfe Street, Baltimore, MD, 21205, USA
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Saasa SK. Discrimination, Coping, and Social Exclusion among African Immigrants in the United States: A Moderation Analysis. Soc Work 2019; 64:198-206. [PMID: 31190061 DOI: 10.1093/sw/swz018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/01/2018] [Accepted: 08/16/2018] [Indexed: 06/09/2023]
Abstract
This cross-sectional study examined coping strategies as moderators of the relationship between perceived discrimination and social exclusion among African immigrants in the United States (N = 409). Moderation models using path analyses were conducted to examine the moderating effects of three coping strategies (active coping, use of instrumental support, and religious coping) on the relationship between discrimination and four dimensions of social exclusion: (1) material deprivation, (2) limited access to basic social rights, (3) limited social participation, and (4) insufficient cultural integration. Increases in perceived discrimination were associated with increased social exclusion on all four dimensions. Increased use of active coping was found to weaken the positive relationship between perceived discrimination and material deprivation and between discrimination and limited social participation. Use of instrumental support also buffered the negative effects of discrimination on limited social participation. Recommendations for practice and future research are presented.
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Affiliation(s)
- Sherinah K Saasa
- School of Social Work, Brigham Young University, JFSB, Provo, UT
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Ross J, Akiyama MJ, Slawek D, Stella J, Nichols K, Bekele M, Cunningham CO, Blackstock OJ. Undocumented African Immigrants' Experiences of HIV Testing and Linkage to Care. AIDS Patient Care STDS 2019; 33:336-341. [PMID: 31194578 DOI: 10.1089/apc.2019.0036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the United States, undocumented African immigrants living with HIV enter care late, potentially leading to adverse individual and population health outcomes, yet little is known about the specific experiences of HIV diagnosis and linkage to care among this population. We conducted individual, semi-structured interviews with adults who were undocumented African immigrants living with HIV in New York City. Interviews explored perspectives regarding individual, social, institutional, and societal barriers and facilitators of HIV testing and linkage to care. Of 14 participants from 9 different African countries, 9 were women and the median age was 44 years (interquartile range: 42-50). Participants described fear of discovery by immigration authorities as a substantial barrier to HIV testing and linking to initial medical appointments. Actual and perceived structural barriers to both testing and care linkage included difficulty obtaining health insurance and a belief that undocumented immigrants are ineligible for any health services. Participants also expressed reluctance to be tested because of HIV-related stigma within the immigrant communities that they heavily relied on. After diagnosis, however, participants overwhelmingly described a positive role of health and social service providers in facilitating linkage to HIV care. Concerns about immigration status and HIV-related stigma are significant barriers to HIV testing and linkage to care among undocumented African immigrants. Multilevel efforts to reduce stigma and increase awareness of available services could enhance rates of HIV testing and care linkage in this population.
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Affiliation(s)
- Jonathan Ross
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Matthew J. Akiyama
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Deepika Slawek
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Jennifer Stella
- Division of Hospital Medicine, Zuckerberg San Francisco General/University of California, San Francisco, San Francisco, California
| | - Kim Nichols
- African Services Committee, New York, New York
| | | | - Chinazo O. Cunningham
- Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Oni J. Blackstock
- New York City Department of Health and Mental Hygiene, New York, New York
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Mehta PK, Saia K, Mody D, Crosby SS, Raj A, Maru S, Piwowarczyk L. Learning from UJAMBO: Perspectives on Gynecologic Care in African Immigrant and Refugee Women in Boston, Massachusetts. J Immigr Minor Health 2019; 20:380-387. [PMID: 29032521 DOI: 10.1007/s10903-017-0659-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
African-born immigrant women, and particularly refugees and asylum seekers, are at risk for reproductive health disparities but inadequately use relevant gynecologic services. We sought to elucidate perspectives on gynecologic care in a population of Congolese and Somali immigrants. We conducted a secondary qualitative analysis of focus group data using a grounded theory approach and the Integrated Behavioral Model as our theoretical framework. Thirty one women participated in six focus groups. Participant beliefs included the states of pregnancy and/or pain as triggers for care, preferences included having female providers and those with familiarity with female genital cutting. Barriers included stigma, lack of partner support, and lack of resources to access care. Experiential attitudes, normative beliefs, and environmental constraints significantly mediated care preferences for/barriers to gynecologic health service utilization in this population. Centering of patient perspectives to adapt delivery of gynecologic care to immigrants and refugees may improve utilization and reduce disparities.
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Affiliation(s)
- P K Mehta
- Department of Obstetrics and Gynecology, Boston University Medical Center & Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA. .,Department of Obstetrics & Gynecology, School of Medicine, Program in Health Policy and Systems Management, School of Public Health, Maternal & Womens Health Policy, LSU Consortium for Health Transformation, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
| | - K Saia
- Department of Obstetrics and Gynecology, Boston University Medical Center & Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA
| | - D Mody
- Boston University School of Medicine, Boston, MA, USA
| | - S S Crosby
- Department of Internal Medicine/Immigrant and Refugee Health Program, Boston University Medical Center, Boston University School of Public Health & Boston University School of Medicine, Boston, MA, USA
| | - A Raj
- Center on Gender Equity and Health/Division of Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - S Maru
- Department of Obstetrics and Gynecology, Boston University Medical Center & Boston University School of Medicine, 85 East Concord Street, Boston, MA, 02118, USA
| | - L Piwowarczyk
- Department of Psychiatry/Boston Center for Refugee Health and Human Rights, Boston University Medical Center & Boston University School of Medicine, Boston, MA, USA
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Agbemenu K, Hannan M, Kitutu J, Terry MA, Doswell W. "Sex Will Make Your Fingers Grow Thin and Then You Die": The Interplay of Culture, Myths, and Taboos on African Immigrant Mothers' Perceptions of Reproductive Health Education with Their Daughters Aged 10-14 Years. J Immigr Minor Health 2018; 20:697-704. [PMID: 29204725 DOI: 10.1007/s10903-017-0675-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This paper examines the convergence of culture, myths, and taboos surrounding reproductive health issues African immigrant women, living in the United States, learned during childhood in their countries of origin. We also discuss how mothers' perceptions of reproductive health education (RHE) influenced the education of their own daughters aged 10-14 years. This was a qualitative descriptive study. Data were collected via interviews and demographic survey. The sample size was 20 African immigrant mothers living in a mid-sized city in the U.S. Interviews were transcribed verbatim. Qualitative data was analyzed using qualitative content analysis. Myths and taboos related to menstruation, sexual intercourse, pregnancy, and HIV/AIDS were reported by the women interviewed. Discussion of these issues was largely taboo, and most myths the mothers learned growing up pertained to sexual intercourse, pregnancy prevention, and pregnancy termination using non-hormonal ingested substances. Myths and taboos about sexual issues are widespread in Africa and are propagated to control sexual behavior, especially that of unmarried people, particularly women. By examining these myths and taboos, we are able to somewhat contextualize the mothers' immigrant experience regarding RHE. Although myths were reported, the majority of mothers did not appear to believe them. The most significant taboo reported was sexual intercourse. This in turn led to mothers' overemphasis on abstinence for their daughters. It is also noteworthy that this sample contained mainly African women who overall were highly educated, spoke English, and could adequately navigate life in the U.S. It is unclear what the results would be if we were to examine African immigrant women with less achievements in these areas.
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Alaazi DA, Salami B, Yohani S, Vallianatos H, Okeke-Ihejirika P, Nsaliwa C. Transnationalism, parenting, and child disciplinary practices of African immigrants in Alberta, Canada. Child Abuse Negl 2018; 86:147-157. [PMID: 30292095 DOI: 10.1016/j.chiabu.2018.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/02/2018] [Accepted: 09/16/2018] [Indexed: 06/08/2023]
Abstract
Child discipline remains a topic of public health interest across the globe. Despite this enduring interest, very little is known about the child disciplinary practices of African immigrants in Canada. This paper explores the disciplinary practices of African immigrant parents in Alberta, a Canadian province with a recent surge in the population of African immigrants. Employing a critical ethnographic methodology, informed by transnational theory, we collected data through in-depth qualitative interviews with a purposive sample of African community leaders (n = 14), African immigrant parents (n = 32), policymakers (n = 2), and health and immigrant settlement workers (n = 10). As members of the African immigrant community, we were deeply immersed in the research settings, which afforded us the opportunity to collect pertinent observational data in the form of reflexive notes. Thematic analysis of the data revealed child disciplinary approaches that incorporate Canadian and African parenting practices, as well as practices that appear somewhat unique to this demographic. We found that African immigrant parents used corporal discipline, persuasive discipline, and a hybrid of the two, as well as emerging practices involving transnational fostering and emotional isolation of children who persistently misbehaved. These practices, in their totality, appeared to be influenced by the transnational experiences of parents and precepts that are traceable to Canada's legal and educational systems. We present theoretical, policy, and service implications of our findings, including a recommendation to incorporate sociocultural dimensions of child discipline into Canadian child welfare policies and practices.
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Affiliation(s)
- Dominic A Alaazi
- School of Public Health, University of Alberta, Edmonton, Canada.
| | - Bukola Salami
- Faculty of Nursing, University of Alberta, Edmonton, Canada.
| | - Sophie Yohani
- Department of Educational Psychology, University of Alberta, Edmonton, Canada.
| | - Helen Vallianatos
- Department of Anthropology, University of Alberta, Edmonton, Canada.
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Agbemenu K, Volpe EM, Dyer E. Reproductive health decision-making among US-dwelling Somali Bantu refugee women: A qualitative study. J Clin Nurs 2018; 27:3355-3362. [PMID: 29121429 DOI: 10.1111/jocn.14162] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To explore Somali Bantu refugee women's reproductive health decision-making, as influenced by their resettlement in the USA. BACKGROUND Available literature on reproductive health of refugee women is mostly from the healthcare provider perspective, neglecting the lived experience of the population. DESIGN Qualitative descriptive. METHODS A purposive sample of 30 women was recruited for five focus groups. Data were collected via demographic survey and semi-structured focus group discussion. Content analysis was used to analyse the data. RESULTS Our study revealed that Somali Bantu women considered children as wealth. Reproductive health decision-making was influenced by three main factors: family influence, cultural/religious ideas and experience with various hormonal birth control methods. CONCLUSIONS Nurses and other healthcare providers would better serve refugee women if equipped with a more nuanced understanding of factors in their reproductive healthcare decision-making. This study can inform tailored and cultural relevant interventions to improve reproductive health among those at greatest need. RELEVANCE TO CLINICAL PRACTICE Our findings can serve to guide nurses and other healthcare providers' clinical approach to a subset of the population whose cultural beliefs and practices regarding reproductive health may be unfamiliar. Incorporating the perspective of the Somali Bantu women will facilitate the provision of person-centred care and ensure women receive appropriate, efficient and quality care that meets their needs, which may potentially reduce financial costs to the healthcare system.
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Affiliation(s)
- Kafuli Agbemenu
- Department of Family, Community & Health Systems Sciences, State University of New York, School of Nursing, University at Buffalo, Buffalo, NY, USA
| | - Ellen M Volpe
- Department of Family, Community & Health Systems Sciences, State University of New York, School of Nursing, University at Buffalo, Buffalo, NY, USA
| | - Ervin Dyer
- College of General Studies, University of Pittsburgh, Pittsburgh, PA, USA
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