Gendered racism, anxiety, and depression: the mediating roles of gendered racialized stress and social isolation.

OBJECTIVE: Black women experience unique stressors linked to the intersection of racism and sexism (i.e. gendered racism). While the negative effects of gendered racism are associated with Black women's health, less is known about factors that describe these relationships. DESIGN: Using data from 263 Black women, we used path analysis to examine direct and indirect effects of gendered racism on anxiety and depression through gendered racialized stress. We also examined the direct and indirect effects of gendered racialized stress on anxiety and depression through social isolation. RESULTS: After adjusting for covariates, gendered racism, and gendered racialized stress were not statistically significant predictors of anxiety and depression. However, gendered racism was a statistically significant predictor of gendered racialized stress. Also, social isolation mediated the relationships between gendered racism, gendered racialized stress, and anxiety, as well as depression. CONCLUSIONS: Stress from gendered racism is associated with loneliness, which can negatively impact Black women's mental health. Findings suggest that gendered racialized stress and social isolation is important for understanding the relationship between gendered racism and mental health outcomes, such as anxiety and depression.

Non-Latinx Healthcare Provider's Knowledge and Awareness of Latinx Geriatric Clinical Health Needs.

OBJECTIVES: Due to the exponential growth in the Latinx older adult population, culturally responsive services are needed, especially since most healthcare providers are non-Latinx with limited Spanish or bilingual skills. One place to start is by drawing a formative assessment of the healthcare providers' knowledge and awareness of the healthcare needs of Latinx older adults. METHODS: Focus groups were conducted to explore the healthcare providers' knowledge and awareness of cultural and structural barriers and facilitators to accessing health care services for Latinx older adults. RESULTS: Results note that healthcare providers perceived the healthcare needs for Latinx older adults to be underutilized for healthcare services, preventive interventions for healthy diet/lifestyle, and healthcare knowledge. Providers reported Latinx family over-involvement, religiosity, immigration, and language/lack of interpreters as barriers to seeking timely healthcare. Finally, healthcare providers said that family support, the location of healthcare services, and community-based partnerships were all facilitators for seeking healthcare. CONCLUSIONS: Findings suggest providers' conflicting perspectives toward the Latinx communities. CLINICAL IMPLICATIONS: Healthcare services can consider implementing trainings for non-Latinx providers to recognize conflicting perspectives and reduce implicit bias toward the Latinx communities.

Culturally enhancing a group-based motivational interviewing substance use prevention program for Latine youth.

Background: Group Motivational Interviewing for Teens (GMIT) has been effective in reducing youth substance use in diverse communities, yet more research is needed to determine its efficacy in reducing tobacco and alternative tobacco products (ATP) use among Latine adolescents. This study modified GMIT to include a focus on ATPs (GMIT-ATP). GMIT was also linguistically translated so it could be offered in English and Spanish, culturally enhanced, and parent sessions were added (GMIT-ATP + P). Methods: The study's aims were to 1) Develop a model of how cultural context, family relationships, and adolescent tobacco-related skills/beliefs are associated with smoking and ATP use; 2) Examine the impact of the GMIT-ATP intervention on adolescent tobacco use; 3) Examine whether the GMIT-ATP + P intervention improves family/parenting factors associated with reduced adolescent tobacco use; 4) Examine whether GMIT-ATP + P is more effective than GMIT-ATP in improving adolescent tobacco use; 5) Explore whether essential components of our behavior change model mediate the impact on tobacco use, and 6) Explore whether cultural factors influence the impacts of our intervention. Latine adolescents (ages 10-16) and their parents/guardians were recruited throughout Virginia. Parents and adolescents completed three surveys: before and immediately after the program ends and at 3-months post-intervention. Families attended 3 GMIT-ATP or GMIT-ATP + P sessions. Conclusion: Findings from this study will be disseminated in Latine communities and with providers working with Latine youth and can serve as a community-based model to reduce substance and tobacco use (e.g., ATP) in these Latine communities.

Spanish Translation and Psychometric Validation of a Measure of Acculturative Stress among Latinx Immigrants in the USA.

BACKGROUND: In the United States, the Latinx community is growing at a faster rate than any other racial or ethnic minority group. Members of this community have been found to experience a number of acculturative stressors after immigrating, including xenophobia, racism, and discrimination. Although several scales have been created in recent years to measure acculturative stress in Spanish-speaking immigrants, they are long, do not have nuanced subscales, or have not been validated in an extremely diverse sample of Latinx immigrants. OBJECTIVE: The purpose of the current study was to translate and psychometrically validate the Riverside Acculturative Stress Inventory (RASI) in a diverse sample of Spanish-speaking immigrants. METHODS: A sample of 202 Latinx immigrants in the United States completed the RASI as well as measures of depression and anxiety. RESULTS: An initial confirmatory factor analysis suggested that the overall subscale factor structure was not an ideal fit for the data. An exploratory factor analysis suggested the retention of four subscales, each with three items, forming a 12-item Spanish RASI short form. As indices of convergent validity, the RASI total score was positively associated with depression and anxiety. CONCLUSIONS: The findings from the study contribute to the literature a brief and valid assessment of acculturative stress in Spanish-speaking immigrants. The RASI Spanish short form holds promise to stimulate research on the unique adversities experienced by Latinx immigrants.

The Hispanic Paradox: A Moderated Mediation Analysis of Health Conditions, Self-Rated Health, and Mental Health among Mexicans and Mexican Americans.

This study investigates how mediating (e.g. history of health conditions) and moderating (e.g. self-rated health) factors are associated with nativity status on depression and anxiety in Mexican immigrants. Using data from the 2019 National Health Interview Survey (NHIS), results found a significant direct association between nativity status and anxiety and depression. Additionally, the association between nativity status and mental health was mediated by the history of health conditions, and self-rated health was a significant moderator in both mediation models. Study findings are discussed within the context of barriers to care, current literature, and strengths-based interventions. Future research can expand upon these findings by examining the specific types of physical and mental health conditions that may support the Hispanic Paradox, as well as how self-efficacy and internal locus of control are associated with the paradox within this population.

Continuing Education for Haitian Nurses: Evidence from Qualitative and Quantitative Inquiry.

BACKGROUND: There is increasing evidence that to improve nursing practice, nurses must embrace lifelong learning. Research indicates that engagement in lifelong learning positively affects the quality of nursing care, improves patient outcomes, and increases nurses' job satisfaction. Both lack of standardized initial education and nurses' limited opportunities for lifelong learning are challenges in Haiti. It is crucial to ensure adequate continuing education in order to support the professional growth and development of Haiti's existing nursing workforce. OBJECTIVES: The objectives of this study were to: 1) assess the continuing education nursing needs and desires of practicing Haitian nurses and 2) contribute to the body of knowledge about nursing in Haiti to help inform practice and policy. METHODS: A multimodal needs assessment approach was used, with semi-structured focus groups and written surveys. The results were analyzed, and common themes were identified. FINDINGS: The results were analyzed from 100 surveys and four focus groups (n = 33). Overwhelmingly, Haitian nurses desire continuing nursing education. Major themes include: recognition that continuing education is necessary to provide high quality patient care, continuing education saves lives, and more consistent and standardized initial nursing education is needed. Barriers to participation in continuing education opportunities were also identified. CONCLUSIONS: This study was one of the first formal studies that addressed continuing education needs of Haitian nurses. By identifying the barriers to important resources, we hope to continue to collaborate with our Haitian nursing colleagues to build curriculum and improve education programs. We also hope that this research will ensure that Haitian nurses voices are heard and will serve to foster change within the Haitian nursing education system. These results were shared with our nurse colleagues in Haiti.