Community perspectives on substance use among Bhutanese and Iraqi refugees resettled in the United States.

Premigration trauma and postmigration stressors put refugees at high risk for mental health concerns, including substance use. However, there is limited systematic research on substance use in refugee communities exists. We conducted exploratory qualitative research to examine Bhutanese and Iraqi refugee perspectives related to the use of recreational substances after resettlement in the United States. Data were collected through separate focus groups with 28 Bhutanese and 22 Iraqi adult men. Focus groups were facilitated by an experienced clinician with an in-person interpreter, audiorecorded, and transcribed. Transcripts were checked for accurate translation and then analyzed using a conventional content analysis approach. Findings revealed similarities and differences between the two refugee groups with regard to recognizing excessive use, triggers for use, and preferred modes of outreach and intervention. Findings also revealed postmigration changes in substance use behaviors stemming from issues related to access, cost, and perceived legal ramifications.

Acculturation and Psychological Adjustment of Vietnamese Refugees: An Ecological Acculturation Framework.

Acculturation to the culture of the host society as well as to one's heritage culture have been shown to impact immigrants' adjustment during the years following resettlement. While acculturation has been identified as an important factor in adjustment of Vietnamese immigrants (Birman and Tran in Am J Orthopsychiatr 78(1):109-120. doi: 10.1037/0002-9432.78.1.109 , 2008), no clear pattern of findings has emerged and too few studies have employed an ecological approach. The purpose of this paper is to contextualize the study of acculturation and adjustment by taking an ecological approach to exploring these relationships across several life domains, using a bilinear scale, and examining mediators of these relationships for adult Vietnamese refugees (N = 203) in the United States. We call this approach the Ecological Acculturation Framework (EAF). Results of a structural equation model (SEM) showed that job satisfaction fully mediated the relationship between American acculturation and psychological distress, demonstrating that this relationship was specific to an occupational domain. However, while Vietnamese acculturation predicted co-ethnic social support satisfaction, it did not predict reduced psychological distress. Implications for a life domains approach, including domain specificity, are discussed.