Ethnic Minority Persons Research Articles

Directional associations between posttraumatic stress disorder symptoms and cannabis use in young adults: Uncovering variation by sex, race, and ethnicity.

Prevalence rates of cannabis use and PTSD vary, with men reporting greater cannabis use than females, females reporting higher rates of PTSD than males, and race and ethnic minority persons reporting higher rates of both cannabis and PTSD compared to non-Hispanic White individuals. This study extends our understanding of directional associations between cannabis use and PTSD from early to late young adulthood (18-26 years old) using two theoretical models: symptom-driven pathway and substance-induced pathway. Participants provided yearly data for 14 years, and the present study utilized data from Waves 9 through 14. Those endorsing Criterion A in at least one wave of data collection (n = 1,454) were included in the analytic sample. We used autoregressive latent trajectory with structured residuals to understand reciprocal associations for the full sample, as well as by sex and race or ethnicity. For the full sample, we noted support for both symptom-driven and substance-induced pathways during early young adulthood (18-20) but only support for a symptom-driven pathway during late young adulthood (21-26). Males showed the same pattern as the full sample; however, for females, only a symptom-driven pathway during late young adulthood was found. For race and ethnic minority participants, we showed full cross-lagged effects during both early and late young adulthood and no associations for non-Hispanic White individuals. Results indicate that both men and individuals from minoritized racial and ethnic groups are more likely to report heightened PTSD symptomology, maladaptive coping, and worsening symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Informal caregiver and nurse perceptions of access to culturally appropriate health care for ethnic minority persons with dementia: A qualitative study.

This study explored what informal caregivers of ethnic minority (EM) persons with dementia in the Netherlands perceive as culturally accessible health care and nurses' perceptions of how cultural competence can be improved to facilitate access to health care for EM persons with dementia and their informal caregivers. Qualitative description research with semi-structured individual interviews and focus group discussions (FGDs). Semi-structured interviews with 15 nurses and 6 informal caregivers provided input for two FGDs with nurses about the need to strengthen their cultural competence to improve access to health care for EM persons with dementia and their informal caregivers. Interview data were collected between September 2020 and April 2021 in the Netherlands. Focus group discussion data were collected between June and September 2021 in the Netherlands. Nurses and informal caregivers experienced difficulty building and maintaining a relationship. Contrary to informal caregivers' experiences, nurses felt a shared cultural background with the persons with dementia and informal caregiver is necessary. Although nurses acknowledged the importance of cultural knowledge, cultural skills, in particular, were mentioned as needing improvement. Examples are mapping involved family members and their roles, asking the right questions and letting go of personal judgements. Nurses frequently mentioned stereotypical thinking and seeing 'the other' as different, and collaboration with(in) family proved difficult for informal caregivers and nurses. Strengthening cultural skills will contribute to facilitating better access to cultural appropriate health care for EM persons with dementia and their informal caregivers. No patient or public contribution. This study explores what is perceived as culturally accessible health care and what nurses need to improve their cultural competence. We show that strengthening nurses' cultural competence by addressing which skills should be improved can improve access to health care for EM persons with dementia and their informal caregivers.

The model of threat-infused intergroup feedback: Why, when, and how feedback to ethnic minority learners is positively biased

This article concerns the positive feedback bias, which occurs when White instructors supply selectively more praise and less criticism to ethnic minority learners relative to White learners. The positive bias is reliable and enduring and affects feedback to various ethnic groups in North America and in Europe. The model of threat-infused intergroup feedback (MOTIIF) is introduced to explain the positive bias. MOTIIF integrates research on feedback practices, interracial dynamics, self-image maintenance, and psychosocial resources to explain why and when the bias is expressed. According to MOTIIF the positive bias is driven mainly by racial anxiety, the concern of many White people that they will reveal self-compromising prejudices, to others or to themselves, when engaging with ethnic minority persons. Inflated praise and muted criticism to ethnic minority learners serve, per MOTIIF, to quell racial anxiety. The article reviews evidence of the positive bias and relates it to the MOTIIF framework. It also discusses how the positive bias can affect ethnic minority learners; how it diminishes their trust in feedback, erodes their self-esteem, increases their stress, and potentially, undermines their learning. The article draws on MOTIIF to consider potential solutions to the positive bias and to recommend future research.

Evaluating Differences in the Disease Experiences of Minority Adults With Cystic Fibrosis.

Extensive research has demonstrated disparities in health outcomes and survival between non-Hispanic Caucasian (NHC) and non-Caucasian or Hispanic (minority) persons with cystic fibrosis (CF) in the United States (US). However, very little research has been done to explore the disease experiences of racial and ethnic minority persons with CF. Adult subjects with CF were approached for study participation and to characterize their experiential disease perceptions. Survey data were analyzed using Chi-Square tests and Mann-Whitney U-test for basic categorical and continuous variables, and Kruskal-Wallis one-way ANOVA using ranks for Likert scales. Minority persons reported significantly lower scores (more negative experience) when comparing themselves to others with CF (15.18 ± 2.89 vs 18.40 ± 3.18, P < .01), particularly in the areas of representation in research, experience, and support. We were able to identify the unique experiences of minority persons with CF, including perceived lower disease understanding and poorer representation compared to most others with CF. Further large studies are needed to develop and assess interventions that may be useful for serving these diverse populations.

Psychological Distress and Physical Health Symptoms in the Latinx Population During the COVID-19 Pandemic: Exploring the Role of Anxiety Sensitivity.

ObjectiveThe outbreak of the novel 2019 SARS2-Coronavirus disease (COVID-19) has led to substantial physical and mental health consequences. Rates of mortality and hospitalization are highest among those of racial and ethnic minority persons, including Latinx persons. Further, Latinx persons have been experiencing elevated mental health problems in response to the pandemic compared to non-Latinx Whites. The current study examined whether individual differences in anxiety sensitivity (AS) related to more severe emotional distress associated with social distancing, financial strain, fear of COVID-19, and physical health symptoms stemming from the COVID-19 pandemic among Latinx adults.MethodsParticipants included 188 Latinx persons (31.4% female, Mage = 34.1 years, SD = 8.16) recruited via an online survey panel program.ResultsResults indicated that AS significantly contributed to increased severity of the emotional stress response associated with social distancing (ΔR2 = 0.15, p < 0.001), financial strain (ΔR2 = 0.15, p < 0.001), physical health symptoms (ΔR2 = 0.03, p = 0.006), and fear of COVID-19 (ΔR2 = 0.15, p < 0.001). These effects were evident over and above the variance accounted for by gender, years living in the United States, education, and work and home life COVID-19-related stress.ConclusionsThese cross-sectional findings suggest AS may be an important individual difference factor for better understanding mental health among Latinx persons in the context of the COVID-19 pandemic.

Factors Influencing Successful Recruitment of Racial and Ethnic Minority Patients for an Observational HIV Cohort Study in Washington, DC.

The process of recruiting racial and ethnic minority persons living with HIV (PLWH) is important for research studies to ensure inclusivity of underrepresented groups. To understand factors associated with recruitment of minority PLWH, this study examined the recruitment process of PLWH for an observational study of their routine medical care at 14 clinics in Washington, DC. Research assistant (RA) recruiters were interviewed to assess their consenting processes and strategies. Data were collected on clinic services, patient demographics, and recruitment logs of patient approaches for obtaining informed consent resulting in agreement or refusal. A median of 96% of eligible patients was approached to obtain consent, yielding a median consent rate of 78% across all sites. A total of 8438 patients consented and 1326 refused study participation. Clinical sites with more comprehensive services had higher consent rates. black/African American and Hispanic/Latinx PLWH consented or refused study participation in similar proportions, while significantly more white patients enrolled than refused. More men, compared with women, enrolled than refused study participation. The most frequent reasons for refusing study participation were the lack of interest in research (33.2%) and no specific reason provided (28%). RAs identified that effective recruitment strategies used culturally sensitive approaches, built rapport with patients, and obtained provider support for the study. Recruitment strategies that are gender sensitive to address the disparity of underrepresentation of women, address perceived barriers, and examine clinic-specific services are needed to maximize research participation for minority PLWH to improve prevention and health outcomes.

'Can you please hold my hand too, not only my breast?' The experiences of Muslim women from Turkish and Moroccan descent giving birth in maternity wards in Belgium.

To reach nuanced understanding of the perinatal experiences of ethnic minority women from Turkish and Moroccan descent giving birth in maternity wards in Belgium thereby gaining insight into the underlying challenges of providing intercultural care for ethnic minority persons in a hospital setting. A qualitative study design was used by conducting In-depth interviews with 24 women from Turkish and Moroccan descent who gave birth during the past three years in maternity wards in Flanders, Belgium. The interviews were analysed using a Grounded Theory Approach. This study shows that the women's care experiences were shaped by the care interactions with their caregivers, more specifically on the attention that was given by the caregivers towards two essential dimensions of the care relationship, viz. Ereignis (attention to what happens) and Erlebnis (attention to how it happens). These two dimensions were interrelated in four different ways, which defined the women's care experiences as being either 'uncaring', 'protocolized', 'embraced' or 'ambiguous'. Moreover, these experiences were fundamentally embedded within the women's cultural context, which has to be understood as a relational process in which an emotional and moral meaning was given to the women's care expectations, interactions and interpretations of care. The findings reveal that the quality of intercultural care depends on the nature and quality of care interactions between ethnic minority patients and caregivers much more than on the way in which cultural questions and tensions are being handled or dealt with in a practical way. As such, the importance of establishing a meaningful care relationship should be the priority when providing intercultural care. In this, a shift in perspective on 'culture' from being an 'individual culture-in-isolation' towards an understanding of culture as being inter-relational and emerging from within these care relationships is necessary.

Epidemiological study on disabilities among ethnic minorities in China

To explore the prevalence rates of disabilities among the ethnic minority people in China. Utilizing stratified, multiphase, and cluster probability sampling design, 2 526 145 persons were investigated and screened by trained interviewers, including 297 761 persons with ethnic minority backgrounds. Respondents scoring positive for potential problems were referred to physician for further diagnosis on disability and on scale measurement. The overall prevalence rate of disability for both ethnic minority and Han population were 6.24% (95%CI: 6.16% - 6.51%) and 6.41% (95%CI: 6.38% - 6.51%) respectively. The total aggregate age-adjusted prevalence rate of disability was 7.31% for persons with ethnic minority. The prevalence rate of disabilities in male was significantly higher than that in females (7.31% vs. 6.75%). The ranking of prevalence rates on different type of disabilities were: physical disability 1.90% (95%CI: 1.89% - 1.91%), hearing disability 1.34% (95%CI: 1.33% - 1.35%), multiple disability 1.14% (95%CI: 1.13% - 1.15%), vision disability 0.99% (95%CI: 0.97% - 1.01%), psychiatric disability 0.38% (95%CI: 0.37% - 0.40%), intellectual disability 0.38% (0.37% - 0.39%) and speech disability 0.12% (0.11% - 0.13%). Cerebral Palsy, genetic diseases, tympanitis, cerebral disease and mental retardation (not including unknown items) were the major causes for disabled children with ethnicity background. Degenerated diseases, including osteoarthropathy, cerebrovascular disease, elderly-related deafness or cataract were most important causes for ethnic minority persons aged 60 or over. Injury, including traffic accident was important disabled-related factor for persons with minority ethnicity aged 15 - 59. The main causes and ranking of causes for ethnical minority were similar with that for Han population. The prevalence rate of disability for ethnic minority persons was significantly higher than that for Han population in China. Prevention for different types of disability should be provided accordingly to persons with ethnic minority, in different age groups.

A cluster-randomized controlled trial evaluating the effect of culturally-appropriate hypertension education among Afro-Surinamese and Ghanaian patients in Dutch general practice: study protocol

BackgroundIndividuals of African descent living in western countries have increased rates of hypertension and hypertension-related complications. Poor adherence to hypertension treatment (medication and lifestyle changes) has been identified as one of the most important modifiable causes for the observed disparities in hypertension related complications, with patient education being recommended to improve adherence. Despite evidence that culturally-appropriate patient education may improve the overall quality of care for ethnic minority patients, few studies have focused on how hypertensive individuals of African descent respond to this approach. This paper describes the design of a study that compares the effectiveness of culturally-appropriate hypertension education with that of the standard approach among Surinamese and Ghanaian hypertensive patients with an elevated blood pressure in Dutch primary care practices.Methods/DesignA cluster-randomized controlled trial will be conducted in four primary care practices in Amsterdam, all offering hypertension care according to Dutch clinical guidelines. After randomization, patients in the usual care sites (n = 2) will receive standard hypertension education. Patients in the intervention sites (n = 2) will receive three culturally-appropriate hypertension education sessions, culturally-specific educational materials and targeted lifestyle support. The primary outcome will be the proportion of patients with a reduction in systolic blood pressure ≥ 10 mmHg at eight months after the start of the trial. The secondary outcomes will be the proportion of patients with self-reported adherence to (i) medication and (ii) lifestyle recommendations at eight months after the start of the trial. The study will enrol 148 patients (74 per condition, 37 per site). Eligibility criteria for patients of either sex will be: current diagnosis of hypertension, self-identified Afro-Surinamese or Ghanaian, ≥ 20 years, and baseline blood pressure ≥ 140/90 mmHg. Primary and secondary outcomes will be measured at baseline and at 3 1/2, 6 1/2, and eight months. Other measurements will be performed at baseline and eight months.DiscussionThe findings will provide new knowledge on how to improve blood pressure control and patient adherence in ethnic minority persons with a high risk of negative hypertension-related health outcomes.Trial registrationISRCTN35675524

ACT Tailored for Ethnocultural Communities of Metropolitan Toronto

ACT Tailored for Ethnocultural Communities of Metropolitan Toronto

Translating the Diabetes Prevention Program to Primary Care

Research on the translation of efficacious lifestyle change programs to prevent type 2 diabetes into community or clinical settings is needed. The objective of this study was to examine the reach, implementation, and efficacy of a 6-month lifestyle program implemented in primary care by nurse practitioners (NPs) for adults at risk of type 2 diabetes. The NP sites (n = 4) were randomized to an enhanced standard care program (one NP and one nutrition session) or a lifestyle program (enhanced standard care and six NP sessions). These NPs recruited adults at risk of diabetes from their practice (n = 58), with an acceptance rate of 70%. The program reached a diverse, obese, and moderately low income sample. The NPs were able to successfully implement the protocols. The average length of the program was 9.3 months. Attendance was high (98%), and attrition was low (12%). The NPs were able to adopt the educational, behavioral, and psychosocial strategies of the intervention easily. Motivational interviewing was more difficult for NPs. Mixed-model repeated-measures analysis indicated significant trends or improvement in both groups for nutrition and exercise behavior. Participants of the lifestyle program demonstrated trends for better high-density lipoprotein (HDL) and exercise behavior compared with the enhanced standard care participants. Twenty-five percent of lifestyle participants met treatment goals of 5% weight loss compared with 11% of standard care participants. A lifestyle program can be implemented in primary care by NPs, reach the targeted population, and be modestly successful. Further research is indicated.

Experience of dietary advice among Pakistani-born persons with type 2 diabetes in Oslo

Experience and implementation of dietary advice are influenced by various factors including ethnic, cultural and religious background. The aim is to explore how ethnic minority persons with diabetes experience dietary advice given by Norwegian health-workers, which strategies they have in response to the advice and how they explain their actions. In-depth interviews were performed with 15 Pakistani-born persons with type 2 diabetes living in Oslo. The analyses are based on the principles of Giorgi's interpretation of phenomenology. The participants expressed great concern to follow the advice. However, narratives about constraints were numerous. These concerned different life-situational factors, but more importantly they were related to communication problems arising from discontinuities between universalising medical knowledge and lay knowledge, as well as between different types of culturally defined lay knowledge. As a consequence, advice was generally experienced as inadequately based on the participant's food-cultural background, leaving the person with diabetes to do the translation between different levels of knowledge. In general health-workers would benefit from expanding their knowledge of the many positive aspects of their patients' cultural background, and apply their knowledge thereafter, whether it concerns (food)-culture or the impact of religion in everyday life.

Examining sexual health discourses in a racial/ethnic context.

Sexual health is a complex, multidimensional construct. In analyzing race and ethnicity in sexual health, this article examines 2 domains of discourse: (1) preventive sexual health, a public health oriented domain of discourse concerned with the prevention of disease, and (2) eudaemonic sexual health, a domain of discourse concerned with attainment of sexual pleasure within a moral context. Research on the sexual health of ethnic minority populations is typically focused on preventive sexual health. There is an underemphasis on eudaemonic discourses when applied to ethnic minority persons, particularly in the examination of ethnic variations in sexual dysfunction. Medicalization of sexual dysfunction, control of minority sexualities, and ethnically oriented cultural scenarios are cited as reasons for this underemphasis. Exploring racial/ethnic aspects of eudaemonic sexual health can deepen understanding of sexual health in multiple domains and strengthen the ability to promote sexual health for all.

Anxiety in ethnic minority youth. Methodological and conceptual issues and review of the literature.

Although current research has documented a relatively high prevalence of anxiety disorders in American youth, this research has been conducted mainly with nonminority samples. Fair treatment and increasing numbers of ethnic minority persons in the United States require that more should be known about minority youth. However, research with majority youth cannot be safely generalized to minority youth for several reasons, such as potential differences in the manifestation of anxiety, differences in style of response to assessment devices, and different life circumstances. This review is presented in two major sections. First, the authors address definition of terms and fully examine the significance of studying anxiety in ethnic minority youth. Also considered are methodological issues such as sampling and participation biases. Second, the authors review anxiety in ethnic minority children and adolescents in the United States including studies addressing fears, worries, trait anxiety, test anxiety, and anxiety disorders.

Partnering with families.

1.The numbers of ethnic minority persons in the United States are increasing faster than Caucasian populations. This means that nurse will be caring for an increasingly diverse patient pool. 2. Ethnic differences have been discovered to play a role in the efficacy of psychoactive medication. These differences result from a number of biological as well as non-biological factors. 3. Nurses have a professional obligation to be aware and sensitive to differential responses to treatment.

Cross-ethnic variations in the care of psychiatric patients: a review of contributing factors and practice considerations.

The number of ethnic minority persons in the United States is increasing faster than that of the Caucasian population. This means that nurses will be caring for an increasingly diverse patient pool. Ethnic differences have been discovered to play a role in the efficacy of psychoactive medication. These differences result from a number of biological as well as non biological factors. Nurses have a professional obligation to be aware and sensitive to differential response to treatment.

Deaths Related to Propoxyphene or Codeine or Both

Ninety-nine deaths involving propoxyphene or codeine or both were investigated through interviews with surviving relatives and associates. The criterion for admission to this study was the presence of propoxyphene or codeine in the body fluids or tissues, determined analytically. The codeine-related group included more ethnic minority persons, more histories of primary drug addiction, more users of street drugs, and more accidental deaths. In the propoxyphene-related group there were fewer histories of drug addiction and more persons with mental illness and more suicides. Most victims had considerable past experience with one or both of the drugs and other drugs as well. Propoxyphene was usually obtained by physician prescription. Codeine was often obtained illegally.