Children In Immigrant Families Research Articles

Barriers to Service Access for Immigrant Families of Children With Developmental Disabilities: A Scoping Review.

This scoping review explores (a) barriers faced by immigrant families of children with intellectual and developmental disabilities (IDD) when accessing healthcare-related services in the United States, (b) where research stands based on the health disparity research framework, and (c) implications for future health disparities research with this population. Our scoping review found 26 empirical studies published between 2000 and 2020 that met our inclusion criteria. Data were extracted and synthesized based on the stages of research outlined in the health disparity research framework. Overall, immigrant families experienced barriers on multiple levels including patient, provider, and healthcare system levels. Studies focusing on detecting and reducing disparities are emerging. We conclude with recommendations for future research and practice with immigrant families of children with IDD.

Group well-child care model for Latino children in immigrant families: Adapting to and learning from the coronavirus disease 2019 (COVID-19) context.

Group well-child care (GWCC) is an alternative to traditional pediatric well-child care designed to increase parental social support and peer learning. This mixed methods study explored the adaptation and implementation of GWCC to a virtual format during coronavirus disease 2019 (COVID-19 pandemic) among Spanish-speaking Latino immigrant families. Interviews were conducted with eight providers and 10 mothers from May through September 2020. Qualitative analyses used a priori codes based on an implementation science framework. Quantitative data included demographics, the COVID-19 Impact Scale, and virtual group attendance. Bivariate analyses identified correlates of virtual visit attendance. Eighty percent of mothers reported the pandemic had moderately or extremely impacted at least one major life domain such as daily life, food security, or family conflict. Of 27 mothers offered virtual groups, 67% attended. Mothers who attended virtual groups reported lower English proficiency (p = .087) and fewer friends and family members with COVID-19 (M = 1.0 vs. 5.1, p < .05) than those who did not attend. Women described virtual GWCC as acceptable and a source of social support. Some described differences in group dynamics compared with in-person groups and had privacy concerns. Providers noted scheduling and billing challenges affecting feasibility and sustainability. They reported that visits with good attendance were productive. Mothers and pediatric providers offered recommendations to improve feasibility and privacy and address sustainability. Competing demands for those most impacted by COVID-19 may outweigh benefits of attendance. Virtual Spanish language GWCC appears acceptable and feasible for Spanish speaking Latina mothers. Thematic analysis and recommendations identify areas of improvement. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Clinician's commentary to accompany "group well-child care model for Latino children in immigrant families: Adapting to and learning from the COVID-19 context".

Comments on an article by Nomi S. Weiss-Laxer et al. (see record 2022-71815-001). Providing virtual services takes time for many providers and families to get familiar with and many prefer in-person contact over telehealth; however, many of the challenges of doing telehealth can be overcome with creativity and flexibility. As clinicians, they agree with the authors that using the features of the technology to our advantage was helpful and that confirming with each person that they had privacy was vital to effective communication. Problem-solving was often needed, and most times parents had the best ideas for working around the limitations of their home environment. The article highlighted the possibility of hybrid models of care considering the needs and wants of both patients and providers. Such a hybrid approach can increase connection to clinics through in-person visits which can jump-start the establishment of therapeutic relationships and build trust (confianza) with clinicians and clinic staff. As the pandemic becomes more controlled, giving parents a choice and flexibility to change modalities can help them stay engaged and reduce drop out. Clinics will need to assess the language preferences of the families they serve to ensure they have enough staff and providers who are bilingual or multilingual to deliver such programs or use trained interpreters. These concerns would need to be addressed if implementation were increased on a large scale. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"The First Step to Changing Something": Addressing Latinx Childhood Obesity through Photovoice.

Latinx children in immigrant families have disproportionately high obesity rates; effective obesity treatment for this subset of Latinx children is critically needed. To inform the development of weight management interventions we explored: 1) community facilitators and barriers to achieving childhood healthy weight through photovoice; and 2) participant reflections on the photovoice process. Photovoice was conducted using established methods in a local church. After photovoice, participants completed semi-structured interviews to reflect on their experience. Transcripts were analyzed using a general thematic analysis approach to arrive at preliminary themes, which were presented to participants for validation. Participant input was used to finalize the themes. Six adults and two youth Latinx immigrants identified photograph themes over seven sessions. Four themes emerged regarding community barriers and facilitators to achieving childhood healthy weight: 1) family habits, 2) cultural influences on food, 3) built environment, and 4) food marketing. Participant reflections revealed they were motivated to participate in photovoice to learn more about health, recognized personal growth as a result of group sharing, valued representation as a community, and felt empowered to be role models. Findings from both photovoice and participant reflections reinforced the need for multi-level approaches to treating childhood obesity. Though participant reflections were gathered to inform continued engagement of Latinx families, they ultimately had a significant impact on our conclusions about priority intervention components.

Insurance and Health Care Outcomes in Regions Where Undocumented Children Are Medicaid-Eligible.

Expansion of insurance eligibility is associated with positive health outcomes. We compared uninsurance and health care utilization for (1) all children, and (2) children in immigrant families (CIF) and non-CIF who resided inside and outside of the seven US states/territories offering public health insurance to children regardless of documentation status ("extended-eligibility states/territories"). Using the cross-sectional, nationally representative National Survey of Children's Health-2019, we used survey-weighted, multivariable Poisson regression to assess the association of residence in nonextended- versus extended-eligibility states/territories with uninsurance and with health care utilization measures for (1) all children, and (2) CIF versus non-CIF, adjusting for demographic covariates. Of the 29 433 respondents, the 4035 (weighted 27.2%) children in extended- versus nonextended-eligibility states/territories were more likely to be CIF (27.4% vs 20.5%, P < .001), 12 to 17 years old (37.2% vs 33.2%, P = .048), non-White (60.1% vs 45.9%, P < .001), and have a non-English primary language (20.6% vs 11.1%, P < .001).The relative risk of uninsurance for children in nonextended- versus extended-eligibility states/territories was 2.0 (95% confidence interval 1.4-3.0), after adjusting for covariates. Fewer children in extended- versus nonextended-eligibility states/territories were uninsured (adjusted prevalence 3.7% vs 7.5%, P < .001), had forgone medical (2.2% vs 3.1%, P = .07) or dental care (17.1% vs 20.5%, P = .02), and had no preventive visit (14.3% vs 17.0%, P = .04). More CIF than non-CIF were uninsured, regardless of residence in nonextended- versus extended-eligibility states/territories: CIF 11.2% vs 5.7%, P < .001; non-CIF 6.1% vs 3.1% P < .001. Residence in nonextended-eligibility states/territories, compared with in extended-eligibility states/territories, was associated with higher uninsurance and less preventive health care utilization.

Do state laws reduce uptake of Medicaid/CHIP by U.S. citizen children in immigrant families: evaluating evidence for a chilling effect

BackgroundRestrictive state laws aimed at immigrants can have unintended consequences for health insurance coverage of United States citizens in immigrant families due to both actual barriers created by the laws and perceived barriers among immigrants. Increasing numbers of children in the U.S. are part of immigrant families, and these children are more likely to be living in poverty than their counterparts in native families. Immigrant restrictive policies could lead to reduced access to Medicaid and CHIP even for citizen children in immigrant families.MethodsUsing data from the Current Population Survey's (CPS) March Supplement, linear probability models with difference-in-differences (DD) estimates compare probability of enrollment in Medicaid/CHIP among low-income U.S. citizen children in immigrant families and low-income children in native families and U.S. citizen children in immigrant families in states that did not adopt restrictive legislation, in order to estimate the impact of restrictive state laws aimed at immigrants. An additional model explores the effect of mother’s citizenship on enrollment among all immigrant families in states with and without restrictive legislation.ResultsResults suggest a significant chilling effect where the magnitude of the effect varies according to family demographics and by the types of laws being passed. Immigrant restrictive social welfare laws being adopted have a strong negative effect on U.S. citizen children in immigrant families’ enrollment in Medicaid/CHIP, a 5.5 percentage point reduction in coverage. Among the subsample of only immigrant families, results point toward a global chilling effect created by an overall restrictive policy environment. All immigrant restrictive related laws, including those aimed at education, job restriction, identification access, and social welfare restrictions have a significant and negative impact on access to public insurance for U.S. citizen children with non-citizen mothers.ConclusionsThis research shows that the unintended consequence of restrictive state legislation aimed at immigrants is the reduction in access to Medicaid and CHIP by low-income U.S. citizen children living in immigrant families. Reduced access to health insurance can increase unmet medical needs for an already vulnerable group.

Legal Relief for Children in Immigrant Families: A Mixed-Methods Study.

Objective: Immigration status is a known social driver of health. Little research exists on addressing concerns about immigration status in primary care. The objective of this study is to understand the experiences of immigrant families that received a clinical-community intervention to address immigration-related concerns. Methods: We conducted a mixed-methods study: an embedded experimental design study. We implemented an immigration-focused legal needs screening tool and referral intervention at one academic primary care clinic in January 2018. Caregivers who screened positive for immigration-related concerns and were referred to a local immigration law firm were invited to participate in a semi-structured interview. Interviews were recorded, de-identified, transcribed, and systematically coded using an inductive content analysis approach. A modified constant comparative method was used to iteratively review codes, identify emerging themes, and resolve differences through consensus. Results: Nineteen caregivers reported immigration-related legal concerns, seven of whom were interviewed. Most (84.2%) were mothers, identified as Hispanic (94.7%), were from Mexico (52.6%), and reported persecution and fear of returning to their country of origin (57.9%). In interviews, we identified three major themes: (1) families were motivated to immigrate due to mental health trauma and persecution; (2) families sought legal services for several immigration-related concerns; and (3) families experienced challenges in navigating the legal system, with which clinics may assist. Conclusion: This study demonstrates the need for immigration-related services in primary care settings and the feasibility and potential benefits of implementing a legal screening and referral intervention.

Subtractive Bilingualism among Children in Immigrant Families, Family Cohesion and Acculturation

Subtractive bilingualism is a phenomenon that is common among children of immigrants, and refers to a process in which the acquisition of a second language results in the deterioration of the heritage language. This article is a critical overview of some of the literature surrounding this phenomenon in immigrant families residing in English speaking countries, as well as how it can affect family relationships. It is concluded that heritage language proficiency, as well as the simultaneous mastery of the heritage language and the dominant language, typically leads to improved relationships, while subtractive bilingualism often is associated with intergenerational conflict. However, many immigrant families navigate issues of communication brought about by subtractive bilingualism in a multitude of different ways, thus illustrating that the families do not necessarily become dysfunctional due to linguistic barriers, rather they employ strategies to minimize miscommunication.

“We’ve got to fight; that’s the story of our lives”: advocacy experience of immigrant families of children with autism spectrum disorder

ABSTRACT Advocating for a child’s rights and needs is an experience shared by most families of children with autism spectrum disorder (ASD). This qualitative study is an in-depth secondary content analysis of the discourse of 13 immigrant families on their advocacy experience during the early childhood period. Results revealed that, from very early on, parents engage in an adaptive process as advocates to ensure an inclusive future for their children and call on support during key transition periods. In light of these findings, from immigrant families in a Canadian province, implications for practice, policy and research are discussed.

Stories beyond Books: Teacher Storytelling Supports Children’s Literacy Skills

ABSTRACT Given the changing demographics of young children served by U.S. schools, educational equity practices must include ways of sustaining cultural heritage practices of children from ethno-linguistic, minoritized, and under-resourced communities. In the present study, we partnered with a bilingual Head Start serving mostly children of immigrant families from Latin American backgrounds to explore the effectiveness of a classroom-based oral storytelling program grounded in the cultural heritage practices of Spanish-speaking communities. We trained lead teachers (n = 12) in either an oral storytelling program or a storybook reading program. Research Findings: Analyses were conducted at the child level (n = 185) and provided initial evidence for the benefits of integrating oral storytelling in preschool classrooms to enhance the quality of teacher language input and support the development of children’s narrative skills. Practice or Policy: Findings contribute to our knowledge base on the differential effects of story sharing modality and have implications for the education of young Latine children.

The process of acquiring the heritage or home language by children in immigrant families (A case study of Iranian migrant families to Georgia)

In this study, we are researching the impact of immigration on acquiring the heritage language in Iranian immigrant families to Georgia whose children age was between 3 to 15 years. The methodology used in this research is a survey study in the Iranian community, and the results methodology is questionnaires. According to the answers and the independent variable which is immigration, the result has shown that Iranian immigrant families to Georgia try to keep their heritage language even though some families were multinational. People are immigrating in the 21st century more than ever. This result is that people are being separated from their mother tongue and joining a new world and language. One of the challenges people face is how to preserve their heritage language while it faces a variety of obstacles that may be lost by its speakers. In this research, we study the effects of immigration on language knowledge from each side in addition to find out how the immigrant family’s children acquire languages.

Including Children in Immigrant Families in Policy Approaches to Reduce Child Poverty

Although they are an increasing share of the US child population (26% in 2020) and have much higher poverty rates than children in nonimmigrant families (20.9% vs 9.9%), children in immigrant families have much more restricted access to the social safety net, which can lead to increased economic hardship and health and developmental risks. More than 90% of children in immigrant families are US citizens, but they are excluded from the safety net due to restrictions that affect their parents and other family members. Exclusions that affect children in immigrant families include restricted categorical eligibility based on immigrant status, stricter income eligibility, reduced benefit levels, high administrative burden, and interactions with immigration policy such as public charge. These exclusions limit the ability of both existing and enhanced social programs to reduce child poverty among this population. Results derived from the Transfer Income Model simulations for the National Academy of Sciences, Engineering and Medicine's 2019 report A Roadmap to Reducing Child Poverty show that the poverty-reducing effects of potential enhancements to three main antipoverty programs result in unequal poverty reduction effects by family citizenship/immigration status with disproportionate negative effects on Hispanic children, 54% of whom live in immigrant families. Policy principles to improve equitable access and poverty-reduction effects of social programs for children in immigrant families include basing eligibility and benefit levels on the developmental, health and nutrition needs of the child instead of the immigration status of other family members, reducing administrative burden, and eliminating the link between immigration policy and access to the safety net.

Child Poverty and Health in the United States: Introduction and Executive Summary.

Child Poverty and Health in the United States: Introduction and Executive Summary.

Information and Communication Technology Access and Use Among Low-Income Latino Immigrant Parents.

Development of mHealth interventions to address health disparities for Latino children in immigrant families requires understanding access to and use of information and communication technology. We examined access to information and communication technology and use of common applications/programs by low-income immigrant Latino parents of infants to inform development of mHealth interventions for this population. Latino immigrant parents reported technology use and access of common applications/software via survey. Of the 157 participants, we found nearly all parents owned a smartphone and that 60% accessed the internet only via their smartphone. Around one-quarter of participants had access to unlimited data. Frequent use of text messaging was common, but frequent email use was less common. Less than 10% of participants frequently used health-oriented applications. Our findings suggest that mHealth interventions that use data, email, or an application interface may not have the intended reach or effectiveness among low-income immigrant Latino parents. Consideration of these findings is important in guiding the development of future mHealth programs for the low-income Latino population. This study was registered at clinicaltrials.gov (NCT02647814).

“Children's time use in immigrant and native families: National evidence from Australia”

Although numerous studies have looked closely at determinants of developmental outcomes for children of immigrants, few studies have examined these children's time use at the national level, and even fewer have focused on early childhood. This study investigates the role of familial immigration background on children's time use using three waves of large-scale data (from age 4–9) from the Longitudinal Study of Australian Children. Results showed that children in immigrant families spent more time reading than children in native families, whereas children in native families spent more time in non-structured social and other activities. Importantly, the differences found between children in immigrant and native families were similar on weekdays and weekends when children are free from institutionalized routines. Furthermore, the differences in time use between children in immigrant and native families were found mostly for children of immigrants from non-Anglophone countries. Finally, differences in time use between children in immigrant and native families did not change as children aged. Policy and theoretical implications are discussed.

31.3 GROUP WELL-CHILD CARE MODEL FOR LATINO CHILDREN IN IMMIGRANT FAMILIES: ADAPTING TO AND LEARNING FROM THE COVID-19 CONTEXT

Well-child care (WCC) is an opportunity to promote optimal child development and family functioning but may not adequately meet the needs of the most vulnerable families as currently structured. Therefore, experts have called for a redesign of WCC. One form of WCC redesign is group well-child care (GWCC). In this mixed-methods study embedded in a parent study of in-person GWCC, we examined adaptation of GWCC to the COVID-19 context in a clinic serving Latino children in immigrant families.

Adverse Childhood Experiences Among Low-Income, Latinx Children in Immigrant Families: Comparison of Children in Rural Farmworker and Urban Non-Farmworker Communities

Adverse childhood experiences (ACEs) are stressors that can have lifelong detrimental health effects. ACEs are a concern for children of immigrant parents. The low-income mothers of 75 rural farmworker and 63 urban non-farmworker 8-year old Latinx children in immigrant families completed a standardized ACEs inventory. 47.1% of mothers reported no ACEs, 33.3% reported 1, 8.7% reported 2, and 10.9% reported 3 or more. A logistic regression model indicated that urban versus rural children had a higher odds (OR = 2.35, 95% CI = 1.01, 5.48) of at least one ACE. Children living in families with 2 versus 1 adults (OR = 0.10, 95% CI = 0.02, 0.49) and 3 versus 1 adults (OR = 0.12, 95% CI = 0.02, 0.78) had a lower odds of at least one ACE. ACEs prevalence was similar to other children in immigrant families, with children living in urban communities having twice the likelihood of experiencing an ACE. Detailed research is needed on locality-based ACEs prevalence.

How does neighborhood affect child maltreatment among immigrant families?

Background: Child maltreatment in immigrant families is understudied, although research suggests that they are at higher risk of child abuse and neglect. While the limited studies on the etiology of child maltreatment among immigrant families have mainly focused on children and their caregivers, this study breaks new ground by examining the neighborhood as an environmental context for child maltreatment among immigrant families. Methods: Following social disorganization theory, this study explores the mechanisms by which neighborhood structural characteristics and social processes affect the maltreatment of children in immigrant families, using the Fragile Families and Child Wellbeing Study (N = 372). Results: Structural equation modeling revealed that negative neighborhood structural characteristics were positively associated with higher physical assault (β = 0.42, p < .001), higher psychological aggression (β = 0.29, p < .001), and higher neglect (β = 0.19, p < .001) among immigrant families. Conversely, positive neighborhood social processes were associated with lower physical assault (β = −0.37, p < .001) and lower psychological aggression (β = −0.31, p < .001) among immigrant families. In addition, neighborhood social processes mediated the relationship between neighborhood structural characteristics and child physical assault (β = −0.09, p < .001) among immigrant families. Conclusions: The findings of this study highlighted the positive role of neighborhood social processes in reducing child physical assault among immigrant families, even in neighborhoods with negative structural characteristics.

Longitudinal relations among school context, school-based parent involvement, and academic achievement of Chinese American children in immigrant families

Immigrant families face multiple barriers to engaging with children's schools. Yet, school-based parent involvement has been associated with academic and behavioral benefits for children of immigrant families. Although past research has examined links between family contextual factors and parent involvement, less is known about the links between school contextual factors and parent involvement in immigrant families. Identifying socio-cultural barriers to parent involvement across home and school contexts can inform culturally competent family engagement interventions serving immigrant families. In a two-wave (1.5 years apart) longitudinal study of a community-based sample of Chinese American children (N = 210, beginning age = 5.8–9.1 years) attending over 80 schools in a metropolitan area, we assessed school-based parent involvement behaviors and parent involvement-related psychological processes (i.e., parent-teacher relationship quality, parents' endorsement of schools, teachers' perceptions of parents) using parent and teacher report. First, results indicated that significant positive associations were found between school-based parent involvement behaviors and parent involvement-related psychological processes (rs = 0.36–0.53). Next, multi-level modeling was conducted to test concurrent relations of Wave 1 school contextual factors to all four parent involvement constructs (controlling for family-level factors), as well as testing the prospective relations of parent involvement at Wave 1 to children's academic achievement at Wave 2. Student body diversity of schools was negatively associated with school-based parent involvement (rs = −0.18, −0.17), parent-rated parent-teacher relationship quality (r = −0.18), and parents' endorsement of schools (r = −0.36). The concentration of Asian students at schools and schoolwide achievement were negatively associated with teachers' perceptions of parents (rs = −0.18, −0.20). However, neither school contextual factors nor school-based parent involvement at Wave 1 uniquely predicted children's academic achievement at Wave 2. Implications of findings for understanding and addressing barriers to engaging Chinese American immigrant families in their children's schools are discussed.

Restoring An Inclusionary Safety Net For Children In Immigrant Families: A Review Of Three Social Policies

Since the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act, known as "welfare reform," in 1996, US social policy has increasingly stratified immigrants by legality, extending eligibility exclusions, benefit limitations, and administrative burdens not only to undocumented immigrants but also to lawful permanent residents and US citizens in immigrant families. This stratification is a form of structural discrimination, which is a social determinant of health. Children in immigrant families, most of whom are US citizens, have not been able to fully realize the benefits from social safety-net programs-including the 2020 Coronavirus Aid, Relief, and Economic Security Act stimulus payments. Policy deliberations over pandemic recovery, the equity focus of the Biden administration, and proposals to address child poverty provide an opportunity to reexamine immigrant exclusions, restrictions, and administrative burdens in public programs. We discuss immigrant stratification by legal status in social policy and review how it affects citizen children in mixed-status families in three safety-net programs: the Earned Income Tax Credit, Supplemental Nutrition Assistance Program, and Child Care and Development Block Grant. We provide eight policy recommendations to restore equity to the social safety net for children in immigrant families.