Methods. In-depth interviews were undertaken with a purposive sample of twelve Black Caribbean women selected from a larger sample (n=101) to examine prevalence and psychosocial risks for perinatal depression among this ethnic group. The study also sought to explore women's models of help-seeking. During analysis, the context in which help-seeking/giving is mediated emerged as a key issue. We explore the nature of these encounters thereby opening up the possibility of finding common ground between service users and providers for enabling women to receive the care and support they need.
Findings. Whether or not women configure depressive feelings as ‘symptoms’ requiring external validation and intervention is a reflection both of the social embeddedness of those individuals and of how ‘help-givers’ perceive them and their particular needs. We suggest that the ways in which help-seeking/giving are commonly conceptualised might offer at least a partial explanation for apparently low levels of diagnosed perinatal depression among Black Caribbean women.
Conclusions. Popular approaches to health seeking behaviours within health promotion and practice focus on individuals as the fulcrum for change, tending to overlook their embeddedness within ‘reflexive communities’. This might serve to reinforce the invisibility of Black Caribbean women both in mainstream mental health services and associated research. Alternative approaches may be required to achieve government targets to reduce inequalities in access, care, and treatment and to deliver more responsive and culturally-appropriate mental health services. 相似文献
Design . Data is from two cross-sectional surveys, conducted in 1990 and 2000, that included 919 women and 774 men from a community sample, and 276 men from an agricultural labor camp sample (ages 18–64).
Results . Over the 10-year period, the prevalence of obesity increased by 48% among community women, 47% among community men, and 91% among labor camp men. Although consumption of fruits and vegetables remained low and consumption of fried foods remained high, other diet-related behaviors showed significant improvements (e.g. milk consumption shifted from whole-fat to lower-fat among women from the community and men from the labor camps, use of lard or meat fat when cooking decreased among women and men from the community). In addition, alcohol intake decreased among men from both samples, as did smoking among labor camp men. There were large improvements for annual pap and mammography screening (increases from 53 to 71% for pap testing, and from 15 to 53% for mammography screening) but annual blood stool testing remained infrequent and unchanged.
Conclusion . These findings highlight the need for interventions and policies that improve knowledge, preventive care, and social environments to sustain improvements and address areas of special need in cancer prevention for Latinos, especially related to obesity and colorectal screening. 相似文献
Aims: Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment.
Methods: Women (n?=?164) and men (n?=?160) with psychiatric disabilities completed self-report questionnaires.
Results: There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment.
Conclusion: Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered. 相似文献
Design: This cross-sectional study used data from 4971 Hispanic/Latinos, 18–74 years, who participated in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) baseline exam and the HCHS/SOL Sociocultural Ancillary Study. Three objectively measured cardiovascular disease risk factors (hypertension, hypercholesterolemia, and obesity) were included. Wealth was measured using an adapted version of the Home Affluence Scale, which included questions regarding the ownership of a home, cars, computers, and recent vacations.
Results: After adjusting for traditional socioeconomic indicators (income, employment, education), and other covariates, we found that wealth was not associated with hypertension, hypercholesterolemia or obesity. Analyses by sex showed that middle-wealth women were less likely to have hypercholesterolemia or obesity. Analyses by Hispanic/Latino background groups showed that while wealthier Central Americans were less likely to have obesity, wealthier Puerto Ricans were more likely to have obesity.
Conclusion: This is the first study to explore the relationship between wealth and health among Hispanic/Latinos of diverse backgrounds, finding only partial evidence of this association. Future studies should utilize more robust measures of wealth, and address mechanisms by which wealth may impact health status among Hispanic/Latinos of diverse backgrounds in longitudinal designs. 相似文献
Design. Data were collected as part of a longitudinal survey study of 9th and 10th grade Hispanic/Latino students in Southern California (n = 1167). The student bodies were at least 70% Hispanic/Latino with a range of socioeconomic characteristics represented. We used linear and logistic regression models to test hypothesized relationships between cultural and familial factors and depression and substance use. We used a mediational model to assess whether bullying victimization mediated these associations.
Results.Acculturative stress and family cohesion were significantly associated with bullying victimization. Family cohesion was associate d with depression and substance use. Social support was associated with alcohol use. Acculturative stress was associated with higher depression. The associations between acculturative stress and depression, family cohesion and depression, and family cohesion and cigarette use were mediated by bullying victimization.
Conclusion. These findings provide valuable information to the growing, but still limited, literature about the cultural barriers and strengths that are intrinsic to the transition from adolescence to emerging adulthood among Hispanic youth. Our findings are consistent with a mediational model in which cultural/familial factors influence the risk of peer victimization, which in turn influences depressive symptoms and smoking, suggesting the potential positive benefits of school-based programs that facilitate the development of coping skills for students experiencing cultural and familial stressors. 相似文献
Objectives: Identify factors determining implementation success of mentor mother support in family practice.
Methods: Individual interviews were conducted with 12 family physicians, 16 abused mothers and three mentor mothers. Four mentor mothers participated in a focus group. Qualitative content analysis was used to analyse the data.
Results: The identification and discussion of abuse is hindered by family physicians’ attitudes because they considered mothers experiencing IPV as a difficult target group with a responsibility of their own to break out of their violent situation. Some family physicians doubted the partner’s violence because he was known as a patient as well. Acceptance of mentor mother support is related to the readiness for change of mothers experiencing IPV. Mentor mothers facilitate acceptance and completion of their support by connecting as a friend who is equal and less threatening than professionals.
Conclusion: To improve successful implementation of mentor mother support in primary care, we should focus on family physicians’ attitudes towards IPV. To change these attitudes, we recommend continuous training of family physicians. By being paraprofessional friends, mentor mothers offer low threshold support that is complementary to professional support and should be embedded more widely in primary care.
We need to focus on family physicians’ attitudes towards IPV to improve the support for mothers experiencing IPV.
As ‘paraprofessional friends,’ mentor mothers offer low-threshold support that is complementary to professional support.
Aim/objective: The aim of this study was to examine potential associations between everyday occupations, perceived stress, and stress-related disorders as well as potential gender differences.
Material and methods: A survey was mailed to a random selection of 3481 employees in the public sector in Western Sweden. Cox regressions with constant time at risk were used, in order to calculate prevalence ratios (PR) and their 95% confidence intervals (CI).
Results: The results showed a clear association between reporting imbalance between different everyday occupations and both perceived stress and stress-related disorders among men and women.
Conclusion: Imbalance between different everyday occupations seems to be an important risk factor for perceived stress and stress-related disorder among both women and men.
Significance: To enable people to achieve balance between different everyday occupations may be a useful way to prevent stress, stress-related disorders, and sick leave, and to promote better health and well-being. 相似文献
Methods. This study used data from the 2007 Pew Hispanic Healthcare Survey, a nationally representative survey of 4013 Hispanic adults. Using the Behavioral Model of Health Service Use (BMHSU) model, we examined three levels of predictive factors: (1) predisposing characteristics (e.g., language proficiency), (2) enabling resources (e.g., health insurance status), and (3) need (e.g., self-perceived health status). Multivariate logistic regression analyses were conducted to predict odds of seeking health care services in Mexico or any other country in Latin America.
Results. As hypothesized, lack of continuous health insurance coverage, perceived lack of quality health care, and low English proficiency increased the likelihood of seeking health care in Mexico or any other Latin American country among US Hispanic adults. Self-reported health status and usual source of care, however, were not significant predictors.
Conclusions. Hispanic immigrants face critical access gaps to health care in the United States. Implications for closing the access gap for this population are discussed within the context of health care system reform and immigration reform in the United States. 相似文献
Method . Dutch natives (1,236) and Turkish migrants (438), age 18–28, completed the Young Adult Self-Report. Scores above the 90th percentile of the distribution of the Dutch sample were defined as deviant.
Results . Turkish migrants more often reported deviant scores than natives for internalising problems, especially for the Anxious/Depressed syndrome. For externalising problems, Turkish migrants less often had deviant scores for Intrusive Behaviour, whereas Turkish women more often had deviant scores for Aggressive and Delinquent Behaviour. Similar results were found for comparison between mean scores. After adjustment for socio-economic position, the disparities in men remained, whereas disparities in women largely disappeared.
Conclusion . Compared with Dutch young adults, Turkish migrant young adults reported more problems. Ethnic disparities were strongly associated with socio-economic disparities among women, but not among men. 相似文献
Design . Middle school student participants (n=519; median age 14) completed a self-report questionnaire on their risk behaviors, psychosocial antecedents, and socio-demographic factors. Latino (304) and non-Latino European American (215) students were surveyed through a large, urban, West Coast US school district.
Results . More bicultural stress was significantly related to reports of all risk behaviors (i.e. smoking, drinking, drug use, and violence) and depressive symptoms. Further, bicultural stress was a robust explanatory variable across sub-groups, and appears largely independent from depressive symptoms.
Conclusion . The hypotheses were supported. Bicultural stress appears to be an important underlying factor for health disparities among US adolescents. Future research may consider promoting well-being in majority, as well as minority adolescents, through targeting sources of bicultural stressors or examining ways to moderate their effects on adolescent risk behaviors. 相似文献
Design. Women's experiences of depressive symptoms were elicited through a series of longitudinal ethnographic interviews, including an explanatory models interview specifically designed to elicit their beliefs about the causes, symptomatology and help-seeking behavior and management of depressive symptoms.
Results. A content analysis of interview data indicated that most women (11 African-Americans and 15 Whites) reported having depressive symptoms currently or in the past. Both African-American and White women perceived the main causes of these symptoms as being relationship problems with a spouse, a partner, or a family member; lack of finances; and parenting stresses. There were no differences in the depressive symptoms African-American and White women reported, but there were differences in how they managed these symptoms and where they sought help. Most of the African-American women sought no formal treatment (i.e., pharmacotherapy and/or psychotherapy), but instead turned to their religious faith to deal with their feelings. White women were more likely to seek formal treatment.
Conclusion. These findings provide insights into the ways in which women in one nonurban area in the USA explained and experienced depressive symptoms and demonstrate differences in help-seeking behaviors that can be linked to beliefs about depression and perceptions of societal responses to those who have it, as well as to perceptions of and experiences with the health-care system. Results have implications for the implementation of education, intervention, and treatment programs in more culturally sensitive ways. 相似文献
Objective. To determine the prevalence, characteristics and health outcomes related to consanguineous marriage.
Design. A cross-sectional survey was carried out using a cluster sampling technique to select the respondents. A total of 400 women aged 15–49 years were interviewed from September 2011 to February 2012. A structured questionnaire was administered through face-to-face meetings. Adjusted odds ratios (AOR) were estimated by a stepwise likelihood ratio method with binary logistic regression.
Results. The overall prevalence of consanguinity was 36.7%. The median age at marriage and age at first childbirth was 15 and 18 years, respectively. The association of being in a consanguineous marriage among women whose husband's education level were secondary or higher was 3.35 (95% CI 1.56, 7.12) times greater than among those whose husbands were unable to read and write.
Woman who have consanguineous marriage were less likely to have (AOR 0.46, 95% CI 0.26, 0.82) used contraceptive than those who have non-consanguineous marriage. Women who have consanguineous marriage were more (AOR 1.80; 95% CI 0.90, 3.61) likely to have birth defect in their children than those who have non-consanguineous marriage. The association of having a history of death after live birth among women who experienced emotional violence was 2.60 (95% CI 1.36, 5.00) and physical violence 2.15 (95% CI 1.16, 3.93) times greater than among those who did not experience violence.
Conclusions. Several factors like husband's education and dowry practices are associated with consanguineous marriage. Further, these factors including consanguineous marriage and marital violence are also accountable for negative health consequences. Thus, multicomponent interventions are needed in order to improve the health condition of Nepalese Muslim community in rural area. 相似文献
Design. Data were drawn from the 2003 National Survey of Children's Health, restricted to Hispanic adolescents aged 10–17 (n=4704). Acculturation was assessed by proxy measures (generation status and language spoken at home). Adolescents who were not reported to engage in physical activity lasting at least 20 minutes, that was vigorous enough to cause sweating and hard breathing, for at least three days per week were defined as failing to meet physical activity requirements. Obesity was defined as gender and age-specific body mass index values at or above the 95th percentile of the reference population. Multiple logistic regressions were performed to adjust for confounders.
Results. Of the Hispanic adolescents studied, 25.2%, 43.8%, and 31.1% were first, second, and third generation or more, respectively. English was the primary language in the home for 42.8% of these adolescents. Compared with adolescents in the third generation, adolescents from immigrant families had higher odds for not obtaining recommended physical activity (first generation: adjusted odds ratio [AOR] = 1.50, 95% conference intervals [CI]: 1.09, 2.05; second generation: AOR = 1.29, 95% CI: 0.99, 1.69). Living in homes where English was not the primary language, vs. English-speaking homes, was also associated with not obtaining recommended physical activity (AOR = 1.36, 95% CI: 1.06, 1.75). The unadjusted prevalence of obesity was higher in homes where English was not the primary language (22.5% vs. 16.1%; p<0.01), but this difference disappeared after adjusting for family socioeconomic status. Generational status was not a significant correlate of obesity.
Conclusions. Findings suggest that future public health interventions that aim to increasing physical activity among Hispanic adolescents should be tailored based on generational status and English-language use. 相似文献
Design: Secondary data analyses of a longitudinal survey examined self-reports of Hispanic adolescents in 9th grade (the first year of high school) and 11th grade at seven high schools in Los Angeles.
Results: (1) Perceiving discrimination in 9th grade significantly predicted depressive symptoms (β=0.23, p<0.01) and drug use (β=0.12, p<0.01) in 11th grade, even after controlling for socioeconomic status, gender, acculturation, and GS in the USA. The third GS group reported significantly higher perceptions of discrimination compared to newer immigrants. (2) Neighborhoods' ethnic composition was included as a moderator of the association between perceived discrimination and the outcomes, but did not moderate the relation.
Conclusion: Teaching Hispanic adolescents effective strategies for coping with discrimination, such as increasing their sense of belongingness in the American mainstream, may prove useful in preventing drug use and depressive symptoms. 相似文献
Design . Cross-sectional study using data from a large, nationally representative sample collected in 1999 in the US.
Results . Older age groups tend to exhibit larger racial/ethnic disparities in child health. Except for some age groups of Asian youths, minority children and adolescents generally show higher risks of fair or poor parent-rated health and limiting health condition relative to Whites. Family SES partly explains the effects of Black, Hispanic, and Native American groups, but significant amount of residual effects remain. Family structure explains some Black effects, but not for other minority groups. Healthcare factors do not contribute much to the racial/ethnic differences. Both family structure and healthcare factors are important factors of child health in their own right. None of the social factors examined can explain the effects of the Asian group. Data also show that economic resources play a more salient role in child health than parental education, especially in young children. In addition, healthcare factors, to some extent, can explain why children from higher SES families fare better in health.
Conclusion . Racial/ethnic disparities in health start early in life. Except for Asians, class explains a substantial amount, but not all, of these disparities. Healthcare factors play some role in explaining health disparities by class. Structural solution seems to be needed to reduce disparities by race/ethnicity among youths. 相似文献
Methods . The cross-sectional survey was based on interviewer-administered questionnaires on socio-demographic variables, lifestyle and health status. In the study 100–120 persons were recruited from Serbian, Croatian, Romanian, German minorities and the Hungarian population. Univariate and multivariate logistic regression models were used.
Results . In the univariate analyses, poor self-rated health correlated with all the factors examined except marital status. In the multivariate logistic regression model, poor health was found to be significantly associated with age, educational level, ethnicity, body mass index and chronic diseases. Poor self-rated health was observed in the Croatians and in the Hungarian control group.
Conclusion . In South-East Hungary, demographic parameters, especially being a member of a minority, and objective health status are highly important determinants of self-rated health. Several of the parameters studied in our survey indicated no effect or no special differences within the population of the region as concerns of self-rated health; certain other factors, however, proved to be special features for the studied ethnic minority, justifying the launching of target group-oriented health intervention programmes. 相似文献
Method: Longitudinal data on 2223 employees in a public organization in Sweden were collected by surveys, and analyzed by logistic regression.
Results: Occupational imbalance predicted stress-related disorders among both women and men. However, what aspects of occupational imbalance which predicted stress-related disorders differ by gender. Perceived stress was not a mediator in these associations.
Conclusion and significance: How women and men perceived their occupational balance affected the risk of stress-related disorders. The results may be used to develop effective strategies to decrease stress-related disorders. 相似文献
Methods. The population‐based Connecticut Tumor Registry (CTR) routinely obtains only limited information on Hispanic origin and maiden name. In this study, surnames of CTR breast cancer patients diagnosed in 1989–1991 were matched with a list of Spanish surnames. To assess misclassification, both surnames and maiden names (from death certificates) of female Connecticut residents who had died in 1989–1991 from any cause of death at 20 years of age and older were matched with the Spanish‐surname list.
Results. Age‐specific incidence rates (1989–1991) for ‘Hispanic’ women (with Spanish surname) were lower than those for ‘non‐Hispanic’ white women (with non‐Spanish surname) for age 35–39 years and older. Errors in these estimated rates were probably small because among decedents the number with a Spanish surname differed by only 9% from the number with a Spanish maiden name; false positives were almost balanced by false negatives.
Conclusion. Matching of surnames in the cancer registry with a Spanish surname list provided reasonably accurate estimates of cancer incidence rates in Hispanic women, although individual women were misclassified as ‘Hispanic’ or ‘non‐Hispanic’. 相似文献
Methods. Ethnographic in-depth interviews and focus groups were conducted in London, Manchester and Glasgow, with a total of 58 (n?=?58) Irish and 57 (n?=?57) white British participants. The study samples were broadly similar in socio-demographic characteristics.
Results. We explored explanatory models (lay beliefs) used by the Irish and white British to understand their cancer-related beliefs and behaviours. Among both groups there was confusion about causation, poor knowledge of signs and symptoms, and a general pessimism about cancer prevention and treatments. The narratives of the Irish were, however, qualitatively different from those of the white British. Historical, cultural, social and economic circumstances, both in the UK and in the past in Ireland, appeared to influence views of cancer and health-seeking behaviours. Recollections of negative family experiences of cancers linked to ‘stigma’ and ‘secrecy’, poor outcomes and medical practices in rural Ireland, particularly among the older Irish, influenced Irish understanding of cancers and help-seeking behaviours. The second generation also appeared to retain some beliefs that were common amongst the first generation migrants. The context of migration was also felt by the Irish group to have exposed them to living and working environments that made them susceptible to cancers.
Conclusion. The Irish frame of reference was firmly embedded in a specific historical, social and economic context which may contribute to cultural constraints on discussions about cancers and to the lack of engagement with preventative behaviours and health care services. 相似文献