620 research outputs found

    LIVING UNDOCUMENTED: AN ETHNOGRAPHIC STUDY OF THE MENTAL HEALTH AND WELLBEING OF UNDOCUMENTED MEXICAN MIGRANT MEN

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    Background: Documentation status is a social determinant of migrants’ health, although existing research is limited. Migrant health research has utilized cultural frameworks, such as acculturation and assimilation, to explain the health effects of restrictive migration policies. This dissertation aimed to explore the lived experiences of migrant Mexican men that lived undocumented in the US and understand how living undocumented affected their mental health and well-being. Methods: I conducted a transnational ethnographic and phenomenological study including in-depth interviews with Mexican men in North Carolina and Mexican who were living or had lived undocumented, their family members, and service providers. I also analyzed existing oral histories and engaged in participant observation at a workers’ center for day laborers. Analysis entailed writing analytical summaries, coding, memoing, and generating matrices to summarize and interpret data. Results: Living undocumented for Mexican men meant feeling like nobody, enacting pride to protect themselves from constant abuses, living surveilled and criminalized, and feeling socially disabled by the multiple everyday challenges. Living undocumented affected their mental and physical health. Men expressed that their undocumentedness was always present in their minds, and generated negative feelings, depression and anxiety. Undocumentedness was embodied through somatic symptoms, experiences of injury at work, chronic diseases, and disability. Men implemented coping strategies to deal with the effects of their migration status on their mental and physical health, mainly avoidance. Other ways of coping and getting some control back in their lives included reaching out for community services and resources, and preparing to return to Mexico in case of deportation. Conclusion: Undocumentedness is a complex phenomenon that affects the lives and health of Mexican men in multiple ways. The multiple challenges they experience in their everyday activities and the effects of living undocumented on their bodies make avoidance difficult to sustain. Interventions need to help men living undocumented deal with daily stressors, connect men to local community resources, develop strategies to deal with daily challenges related to be undocumented, and develop a plan in case the case of voluntary or forced return to their countries of origin. Community and structural interventions are also needed.Doctor of Philosoph

    Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice to describe the assets and barriers to sexual and reproductive health among Latinos in North Carolina

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    Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a viable strategy to address disparities

    Ensuring Youth's Right to Participation and Promotion of Youth Leadership in the Development of Sexual and Reproductive Health Policies and Programs

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    AbstractThe purpose of this article was to reflect on the concepts of adolescence and youth, summarize models and frameworks developed to conceptualize youth participation, and assess research that has attempted to evaluate the implementation and impact of youth participation in the field of sexual and reproductive health and rights (SRHR). We searched and critically reviewed relevant published reports and "gray literature" from the period 2000–2013. "Young people" are commonly defined as those between the ages of 10 and 24 years, but what it means to be a young person varies largely across cultures and depends on a range of socioeconomic factors. Several conceptual frameworks have been developed to better understand youth participation, and some frameworks are designed to monitor youth development programs that have youth participation as a key component. Although none of them are SRHR specific, they have the potential to be adapted and applied also for adolescents' SRHR programs. The most monitored and evaluated intervention type is peer education programs, but the effectiveness of the approach is questioned. There are few attempts to systematically evaluate youth participation, and clear indicators and better methodologies still need to be developed. More research and documentation as well as the adoption of innovative practices for involving youth in sexual and reproductive health programs are needed. Participation is a right and should not only be evaluated in terms of effectiveness and impact. Youth participation in program and policy development should still be a priority

    Marginalisation, discrimination and the health of Latino immigrant day labourers in a central North Carolina community

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    The morbidity and mortality of Latino immigrants in the United States (US) stem from a complex mix of policy, culture, discrimination, and economics. Immigrants working as day labourers may be particularly vulnerable to the negative influences of these social factors due to limited access to social, financial, and legal resources. We aimed to understand how the health of male Latino day labourers in North Carolina, US is influenced by their experiences interacting with their community and perceptions of their social environment. To respond to our research questions, we conducted three focus groups (n=9, n =10, n=10) and a photovoice project (n=5) with Latino male immigrants between October 2013 and March 2014. We conducted a thematic analysis of transcripts from the discussions in the focus groups and the group of Photovoice participants. We found that men's health and well-being were primarily shaped by their experiences and feelings of discrimination and marginalization. We identified three main links between discrimination/marginalization and poor health: (1) dangerous work resulted in workplace injuries or illnesses, (2) unsteady employment caused stress, anxiety and insufficient funds for health care, and (3) exclusionary policies and treatment resulted in limited healthcare accessibility. Health promotion with Latino immigrant men in new settlement areas could benefit from community-building activities, addressing discrimination, augmenting the reach of formal health care, and building upon the informal mechanisms that immigrants rely on to meet their health needs. Reforms to immigration and labour policies are also essential to addressing these structural barriers to health for these men

    Framing Young Childrens Oral Health: A Participatory Action Research Project

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    Despite the widespread acknowledgement of the importance of childhood oral health, little progress has been made in preventing early childhood caries. Limited information exists regarding specific daily-life and community-related factors that impede optimal oral hygiene, diet, care, and ultimately oral health for children. We sought to understand what parents of young children consider important and potentially modifiable factors and resources influencing their children’s oral health, within the contexts of the family and the community

    Engaging Men as Promotores de Salud: Perceptions of Community Health Workers Among Latino Men in North Carolina

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    The promotor de salud, or community health worker (CHW) role, is highly feminized and little is known about how men view their participation in CHW programs. We conducted in-depth interviews with Latino men in North Carolina to explore this gap. We used systematic coding and display procedures informed by Grounded Theory to analyze the data. Men described their communities as lacking cohesion, making integration of Latino immigrants difficult. Most did not consider themselves leaders or feel they had leaders in their communities. Their perceptions of the feminized CHW role as well as the volunteer or low-paid nature of CHW work conflicted with men’s provider role. They also did not think they could perform the CHW role because they lacked education, skills, and broad networks. Efforts to increase male participation in CHW programs in new Latino immigrant destinations will need to understand and address these gender and migration-related dynamics in order to engage both women and men in improving the health of their communities

    Extracurricular Factors Influence Perceived Stress in a Large Cohort of Colombian Dental Students

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    The aim of this study was to investigate the association of extracurricular factors including socioeconomic status and career choice with perceived stress in dental school in a large cohort of Colombian dental students. Participants in the study were 5,700 students enrolled in seventeen Colombian dental schools. The study employed a Spanish adaptation of the Dental Environment Stressors (DES30-Sp) questionnaire and recorded an array of demographic, socioeconomic, career choice, and dental studies-related information. Data analyses relied on descriptive, bivariate, and multivariate methods based on multi-level mixed-effects linear regression and post hoc estimation of predictive margins. "Fear of failing a course or year" emerged as the highest ranked item. Male students consistently reported less perceived stress than females, and stress scores were higher among seniors. Independent of gender, age, and study year, having dentistry as one's first career choice, relying on financial support, and belonging to higher socioeconomic strata were associated with lower stress levels. Academic environment interventions aimed to improve students' educational well-being will need to account for the individual heterogeneity among them. These data from a robust cohort of predoctoral dental students underscore the importance of considering students' educational experiences in a broader social and economic context

    Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools

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    Abstract Background Links between the demanding nature of studies in the health sciences, students’ personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates. Methods The Spanish version of the Derogatis’ Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants’ socio-demographic information and first career choice, as well as school’s characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics. Results A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress. Conclusions Levels of psychological distress correlated with students’ socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions
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