Provider Perspectives on Latino Immigrants’ Access to Resources for Syndemic Health Issues

2021 ◽  
pp. 154041532098559
Author(s):  
Kristin R. Giordano ◽  
Nishita Dsouza ◽  
Elizabeth McGhee-Hassrick ◽  
Omar Martinez ◽  
Ana P. Martinez-Donate
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
The United States ◽  
Latino Immigrants ◽  
Cross Sectional Survey ◽  
Optimal Domain ◽  
Cross Sectional ◽  
Provider Perspectives ◽  
States Experience ◽  
Hiv Aids

Introduction: Latino immigrants to the United States experience disproportionate impacts from the syndemic formed by substance abuse, violence victimization, HIV/AIDS, and mental health (SAVAME). This study characterizes resource access for Latino immigrants living in Philadelphia, as perceived by staff at Latino-serving organizations. Methods: An online cross-sectional survey of staff at key Latino-serving Philadelphia organizations assessed access to their organization and citywide access to each type of service (substance use, HIV/AIDS, domestic violence [DV], and mental health) for Latino immigrants. Descriptive statistics for organizational access indicators and citywide access scores across four syndemic domains (availability, accessibility, adequacy, and quality) and by syndemic condition were computed. Results: Organizational access and citywide access across HIV/AIDS (mean = 1.94, SD = 0.83), mental health (mean = 1.37, SD = 0.95), substance use (mean = 1.11, SD = 0.74), and DV (mean = 1.49, SD = 0.97) services were perceived as far from optimal. Domain scores were highest for accessibility (mean = 1.66, SD = 1.03), followed by quality (mean = 1.44, SD = 0.79), availability (mean = 1.41, SD = .81), and adequacy (mean = 1.24, SD = .75). Conclusion: Based on findings from a survey of staff working at Latino-serving organizations, this study highlights the lack of support and resources for Latino immigrants, in particular those related to mental health and substance use. Programs and interventions are needed to improve service delivery in Latino immigrant communities.

scholarly journals Home Infusions for Inflammatory Bowel Disease are Safe: United States Experience and Patient Perspectives

2021 ◽  
Author(s):  
Bharati Kochar ◽  
Yue Jiang ◽  
Wenli Chen ◽  
Yuting Bu ◽  
Edward L Barnes ◽  
...  
Keyword(s):  
United States ◽  
Inflammatory Bowel Disease ◽  
Patient Experience ◽  
Bowel Disease ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Increased Risk ◽  
Inflammatory Bowel ◽  
States Experience

Abstract Background Home-infusions (HI) for biologic medications are an option for inflammatory bowel disease (IBD) patients in the United States (US). We aimed to describe the population receiving HI and report patient experience with HI. Methods We conducted a retrospective cohort study in the Quintiles-IMSLegacy PharMetrics Adjudicated Claims Database from 2010-2016 to describe the population receiving infliximab and vedolizumab HI and determine predictors for an urgent/emergent visit post-HI. We then administered a cross-sectional survey to IBD-Partners Internet-based cohort participants to assess knowledge and experience with infusions. Results We identified claims for 11,892 conventional infliximab patients, 1,573 home infliximab patients, 438 conventional vedolizumab patients and 138 home vedolizumab patients. There were no differences in demographics or median charges with infliximab home and conventional infusions. Home vedolizumab infusions had a greater median charge than conventional vedolizumab infusion. Less than 4% of patients had an urgent/emergent visit post-HI. Charlson comorbidity index >0 (OR:1.95, 95% CI:1.01-3.77) and Medicaid (OR:3.01, 95%CI:1.53-5.94) conferred significantly higher odds of urgent/emergent visit post-HI. In IBD-Partners, 644 IBD patients responded; 56 received HI. The majority chose HI to save time and preferred HI to conventional infusions. Only 2 patients reported an urgent/emergent visit for HI-related problems. Conclusions HI appears to be safe in IBD patients receiving infliximab and vedolizumab. However, patients with fewer resources and more co-morbidities are at increased risk for an urgent/emergent visit post-HI. The overall patient experience with HI is positive. Expansion of HI may result in decreased therapy-related logistic burden for carefully selected patients.

scholarly journals Adversity, Mental Health, and Substance Use Disorders as Predictors and Mediators of Rule Violations in U.S. Prisons

2019 ◽  
Vol 47 (3) ◽  
pp. 271-289 ◽  
Author(s):  
Brandy F. Henry
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Structural Equation ◽  
Equation Modeling ◽  
Correctional Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Adverse Experiences ◽  
History Of

This study explores how typologies of adversity and mental health/substance use disorders impact rule violations during incarceration. Data come from the 2004 cross-sectional Survey of Inmates in State and Federal Correctional Facilities (SI-SFCF). Logistic regression and structural equation modeling were used for analysis. Results link history of adverse experiences to rule violations during incarceration and demonstrate how mental health and substance use disorders mediate this relationship. Incarcerated people with severe histories of adverse experiences had the highest odds of rule violations, relative to people with low adversity, for all typologies. More severe adversity typologies predicted mental health and substance use disorders. Alcohol and substance use disorders predicted drug violations, whereas substance use and mental health disorders predicted major violations. Serious mental illness did not predict rule violations when accounting for adversity. Findings suggest that addressing adverse experiences, mental health, and substance use disorders may prevent rule violations.

Resilience and anxiety or depression among resettled Bhutanese adults in the United States

2019 ◽  
Vol 65 (6) ◽  
pp. 496-506 ◽  
Author(s):  
Kalpana Poudel-Tandukar ◽  
Genevieve E Chandler ◽  
Cynthia S Jacelon ◽  
Bhuwan Gautam ◽  
Elizabeth R Bertone-Johnson ◽  
...  
Keyword(s):  
Mental Health ◽  
Stressful Life Events ◽  
The United States ◽  
Poor Mental Health ◽  
Anxiety And Depression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Personal Competence ◽  
Hopkins Symptom Checklist ◽  
Resilience Scale

Background: Resilience, or an individual’s positive response in managing life’s adversities, is of increasing interest in addressing the mental health disparities in refugees. Although the link between stressful life events and poor mental health is established, research on the role of resilience on the mental health of refugees is limited. Aims: This study assessed the association between resilience and anxiety or depression in resettled Bhutanese adults in Western Massachusetts. Methods: A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20–65 residing in Massachusetts. Resilience was measured with the 25-item Wagnild and Young’s Resilience Scale including two constructs as follows: a 17-item ‘personal competence’ that measures self-reliance, independence, determination, resourcefulness, mastery and perseverance and an 8-item ‘acceptance of self and life’ that measures adaptability, flexibility and a balanced perspective of life. Higher total scores indicate greater resilience. The Hopkins Symptom Checklist-25 was used to measure anxiety (10-item) and depression (15-item) with a cutoff mean score of ⩾1.75 for moderate to severe symptoms. Associations of resilience with anxiety or depression scores were assessed using multiple-linear and logistic regression analyses. Results: The proportion of participants with above threshold anxiety and depression were 34.2% and 24%, respectively. Resilience was inversely associated with both anxiety (beta for 1 unit change in resilience scores: β = −0.026; p = .037) and depression (β = −0.036, p = .041). ‘Personal competence’ resilience was inversely associated with both anxiety (β = −0.041 p = .017) and depression (β = −0.058, p = .019), but ‘acceptance of self and life’ resilience was not. Participants with the highest tertile of resilience scores had a significantly decreased risk of anxiety (ORs (95% CI): 0.13 (0.04–0.40)) and depression (0.16 (0.04–0.60)). Conclusion: Higher resilience was associated with reduced anxiety and depression among Bhutanese with personal competence resilience accounting for most of the effects. These findings suggest the potential targets for mental-health intervention to improve resilience in refugees.

scholarly journals Differential Effects of Personal-Level vs Group-Level Racial Discrimination on Health among Black Americans

2016 ◽  
Vol 26 (3) ◽  
pp. 453 ◽  
Author(s):  
Nao Hagiwara ◽  
Courtney J. Alderson ◽  
Briana Mezuk
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Racial Discrimination ◽  
Black Americans ◽  
The United States ◽  
Group Level ◽  
Physical And Mental Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Personal Level

<p><strong>Objective: </strong>Racial/ethnic minorities in the United States not only experience discrimination personally but also witness or hear about fellow in-group members experiencing discrimination (ie, group-level discrimination). The objective of our study was to examine whether the effects of group-level discrimination on mental and physical health are different from those of personal level discrimination among Black Americans by drawing upon social psychology research of the Personal/Group Discrimination Discrepancy. <strong></strong></p><p><strong>Design and Setting: </strong>We conducted a secondary analysis of cross-sectional survey data from a larger study. <strong></strong></p><p><strong>Participants: </strong>One hundred and twenty participants, who self-identified as Black/ African Americans during the laboratory sessions (57.5% women, mean age = 48.97, standard deviation = 8.58) in the parent study, were included in our analyses. <strong></strong></p><p><strong>Main Predictor Measures: </strong>Perceived personal- level discrimination was assessed with five items that were taken from two existing measures, and group-level racial discrimination was assessed with three items. <strong></strong></p><p><strong>Main Outcome Measures: </strong>Self-reported physical and mental health were assessed with a modified version of SF-8. <strong></strong></p><p><strong>Results: </strong>Perceived personal-level racial discrimination was associated with worse mental health. In contrast, perceived group-level racial discrimination was associated with better mental as well as physical health. <strong></strong></p><p><strong>Conclusions: </strong>Perceived group-level racial discrimination may serve as one of several health protective factors even when individuals perceive personal-level racial discrimination. The present findings demonstrate the importance of examining both personal- and group-level experiences of racial discrimination as they independently relate to health outcomes for Black Americans. <em>Ethn Dis. </em>2016;26:453-460; doi:10.18865/ ed.26.3.453 </p>

scholarly journals Custodial Grandparent’s Job Loss During the COVID-19 Pandemic and Its Relationship With Parenting Stress and Mental Health

2021 ◽  
pp. 073346482110062
Author(s):  
Qi Wu ◽  
Yanfeng Xu ◽  
Merav Jedwab
Keyword(s):  
Mental Health ◽  
Parenting Stress ◽  
Job Loss ◽  
The United States ◽  
Ordinary Least Squares ◽  
Least Squares Regression ◽  
Cross Sectional Survey ◽  
Custodial Grandparents ◽  
Cross Sectional ◽  
The Relationship

Involuntary job loss during the COVID-19 pandemic adds challenges, especially for custodial grandparents that are taking care of grandchildren. Grandparents are relatively vulnerable, and they need more attention and support when facing the negative impacts of COVID-19. This study analyzed cross-sectional survey data collected from 234 custodial grandparents via Qualtrics Panels in June 2020 in the United States. After using the propensity score weighting adjustment, results from logistic and ordinary least squares regression showed that compared with grandparents that did not lose their job during the pandemic, grandparents that did had more parenting stress and worse mental health. Moderation analysis also showed that social support was a significant moderator of the relationship between job loss and mental health, but not the relationship between job loss and parenting stress. The findings and implications are discussed.

scholarly journals Depression and loneliness during COVID-19 restrictions in the United States, and their associations with frequency of social and sexual connections

2020 ◽  
Author(s):  
Molly Rosenberg ◽  
Maya Luetke ◽  
Devon Hensel ◽  
Sina Kianersi ◽  
Debby Herbenick
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Low Income ◽  
The United States ◽  
Social Connections ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Us ◽  
Prevalence Of Depression ◽  
Nationally Representative

Purpose: To estimate the prevalence of depression and loneliness during the US COVID-19 response, and examine their associations with frequency of social and sexual connections. Methods: We conducted an online cross-sectional survey of a nationally representative sample of American adults (n=1010), aged 18-94, running from April 10-20, 2020. We assessed depressive symptoms (CES-D-10 scale), loneliness (UCLA 3-Item Loneliness scale), and frequency of in-person and remote social connections (4 items, e.g. hugging family member, video chats) and sexual connections (4 items, e.g. partnered sexual activity, dating app use). Results: One-third of participants (32%) reported depressive symptoms, and loneliness was high [mean (SD): 4.4 (1.7)]. Those with depressive symptoms were more likely to be women, age 20-29, unmarried, and low-income. Frequent in-person connections were associated with lower depression and loneliness; frequent remote connections were not. Conclusions: Depression and loneliness were elevated during the early US COVID-19 response. Those who maintained frequent in-person, but not remote, social and sexual connections had better mental health outcomes. While COVID-19 social restrictions remain necessary, it will be critical to expand mental health services to serve those most at-risk and identify effective ways of maintaining social and sexual connections from a distance.

Parents’ Perceptions of Their Children’s Engagement in a Consumer-Based Meditation Mobile App: Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Megan Puzia ◽  
Breanne Laird ◽  
Jeni Green ◽  
Jennifer Huberty
Keyword(s):  
Mental Health ◽  
Mindfulness Meditation ◽  
Mobile Apps ◽  
The United States ◽  
Mobile App ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Breathing Exercises ◽  
Children’S Sleep

BACKGROUND In the United States, nearly half (48%) of school-aged children experience sleep disturbance that results in less than the recommended sleep duration, which may negatively impact mental health and behavior. Mindfulness interventions may improve sleep and mental health in youth. However, there are gaps in the literature regarding how children (2-12 years) and adolescents (13-17 years) practice mindfulness and the extent to which they benefit from these practices. OBJECTIVE The purpose of this study was to determine parents’ perceptions of their children’s engagement with a consumer-based mindfulness meditation app and the extent to which they believe their children have benefitted from using the app, particularly with regard to sleep. METHODS This study is a secondary analysis of a cross-sectional survey in adult subscribers (N=11,108) to the mindfulness meditation mobile app Calm. Participants who indicated that they had a child or children younger than 18 years (2944/11,108) who used the Calm app were asked additional questions related to their perceptions of their children’s engagement with Calm. Descriptive statistics were used to assess children’s app engagement, and chi-square tests and binary logistic regression models were used to assess differences in children’s usage based on gender and age. RESULTS Among the survey respondents, approximately half of the parents (1537/2944, 52.21%) reported that their children used Calm. Children used Calm mostly for (1) sleep (1168/1537, 75.99%), (2) stress (491/1537, 31.95%), (3) depression or anxiety (430/1537, 27.98%), and (4) improvement of overall health (215/1537,13.99%). Older children were more likely to begin using Calm to reduce stress, depression, or anxiety, whereas younger children were more likely begin using Calm to improve sleep. Most children used Calm when lying down to go to bed (1113/1529, 72.79%). Children were most likely to use sleep stories at night (1144/1207, 94.78%), followed by music and soundscapes (749/1114, 67.24%), meditations (736/1120, 65.71%), and breathing exercises (610/1092, 55.86%). Nearly all parents believed that using sleep stories was helpful for their children’s sleep (1090/1128, 96.63%), and the majority of parents felt that the other components were also helpful for their children’s sleep (music and soundscapes [570/728, 78.30%], meditations [445/696, 63.94%], and breathing exercises [610/1092, 55.86%]). CONCLUSIONS To our knowledge, this is the first study to explore parents’ perceptions of how their children or adolescents use a popular consumer-based mindfulness mobile app (ie, Calm). As the majority of children use the app for sleep, mindfulness meditation mobile apps should consider incorporating age-appropriate sleep content to meet the needs of this audience. More research is needed to confirm the feasibility and effectiveness of mindfulness meditation apps for improving sleep and mental health in children and adolescents.

Multi-informant perspective on psychological distress among Ghanaian orphans and vulnerable children within the context of HIV/AIDS

2016 ◽  
Vol 46 (11) ◽  
pp. 2329-2336 ◽  
Author(s):  
P. N. Doku ◽  
H. Minnis
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Mental Health Problems ◽  
Significant Proportion ◽  
Health Problems ◽  
Cross Sectional Survey ◽  
Vulnerable Children ◽  
Cross Sectional ◽  
Self Reports ◽  
Hiv Aids

BackgroundThere is little knowledge about the psychosocial distress of children affected by human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) in Ghana, to aid the planning of services. This study investigated mental health problems among children affected by HIV/AIDS, compared with control groups of children orphaned by other causes, and non-orphans.MethodThe study employed a cross-sectional survey that interviewed 291 children and their caregivers. Both children and caregivers completed the Strengths and Difficulties Questionnaire that measured children's psychosocial wellbeing. Verbal autopsy was used to identify whether children lost one or both parents from AIDS.ResultsThe results indicated that controlling for relevant sociodemographic factors, both children's self-reports and caregivers’ reports indicate that both children living with HIV/AIDS-infected caregivers and children orphaned by AIDS were at heightened risk for mental health problems than both children orphaned by other causes and non-orphans. The findings further indicated that a significant proportion of orphaned and vulnerable children exhibited symptoms for depression and other psychiatric disorders (approximately 63%) compared with 7% among the non-orphaned group. Caregivers gave higher ratings for children on externalizing problems and lower on internalizing problems, and vice versa when the children's self-reports were analysed.ConclusionsThe findings suggest that both children and their informants have diverse yet complementary perspectives on psychological outcomes. The study discusses the theoretical and practical implications of these findings and urgently calls for necessary intervention programmes that target all children affected by HIV/AIDS to effectively alleviate psychological distress and enhance the mental health of these children.

scholarly journals Material Hardship, Mental Health, and Parenting Stress among Grandparent Kinship Providers in COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 952-952
Author(s):  
Yanfeng Xu ◽  
Qi Wu ◽  
Sue Levkoff ◽  
Merav Jedwab
Keyword(s):  
Mental Health ◽  
United States ◽  
Parenting Stress ◽  
Binary Logistic Regression ◽  
The United States ◽  
Material Hardship ◽  
Cross Sectional Survey ◽  
School Closures ◽  
Cross Sectional ◽  
Mediation Analyses

Abstract The COVID 19 pandemic has exposed the vulnerability of many families, including grandparent kinship families, to deal with a health/economic crisis. The fear of COVID-19 plus stay-at-home orders have increased individuals’ psychological distress. Moreover, school closures and homeschooling further increased parenting stress among caregivers. This study examined the relationship between material hardship and parenting stress among grandparent kinship providers and assessed grandparents’ mental health as a potential mediator to this relationship during the COVID-19 pandemic in the United States. Grandparent kinship providers (N=362) that took primary care of their grandchildren participated in a cross-sectional survey via Qualtrics Panels in June 2020 in the United States. Descriptive and bivariate analyses, binary logistic regression, and mediation analyses were conducted using STATA 15.0. Experiencing material hardship (OR = 1.67, p &lt; 0.001) was significantly associated with higher odds of parenting stress among grandparent kinship providers, and grandparents’ mental health (indirect effect = 0.11, 95% CI [0.01, 0.25]) partially mediated this association. Addressing material and mental health needs among grandparent kinship providers is critical to decreasing their parenting stress.

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