Voices of the community: Exploring the experiences of resettled refugee interpreters at a refugee clinic in a large multicultural city in Texas, United States of America.

Worldwide refugees numbered nearly 25.9 million in 2018 and, according to the United Nations High Commissioner for Refugees, the crisis grows each year. Research reports that refugees have a high prevalence of mental health conditions and are at increased risk for emotional and mental distress during resettlement. Furthermore, interpreters have been shown to be at increased risk for secondary re-traumatisation, a condition similar to Post Traumatic Stress Disorder, where client trauma shares commonalities with trauma experienced by the interpreter. The purpose of this study was to explore the experiences of resettled refugee interpreters. Based on previous data from this community, the research team determined that a qualitative methodology was best practice to explore the experiences of resettled refugee interpreters. In May of 2019, seven participants were recruited from a pool of resettled refugee interpreters who worked at a refugee health clinic in a large multicultural city in Texas. One-on-one interviews were conducted, and the data were analysed using content analysis. Five themes emerged that represented the experiences of these participants: speaking for others, developing interpretation strategies, advocating for the community, receiving social support and overcoming challenges specific to the healthcare setting. The findings from this study add to the current body of literature that addresses the experiences of resettled refugee interpreters. Furthermore, these data may be used to create additional resources for refugee interpreters who work at health clinics, such as training on medical terminology, access to mental health services and site-specific incentives.

Evolution of Experiential Learning Opportunities for Nursing Students After Natural Disaster.

BACKGROUND: Natural disasters, such as Hurricane Harvey, can provide unique hands-on learning experiences for nursing students. METHOD: The University of Texas Health Science Center at San Antonio School of Nursing deployed teams of faculty and students to Rockport, Texas, two to three times per week to provide post-disaster relief following Hurricane Harvey. Each team included a minimum of 10 students and two faculty to provide primary care, prevention, and door-to-door canvassing. Nursing students provided physical examinations, urgent care, vaccines, first aid training, and education. RESULTS: Across 6 months and more than 60 trips, over 200 students (supervised by 12 faculty) successfully delivered care to Rockport residents. This learning experience was invaluable for the nursing students, who expressed that "I felt like a real nurse" and "This is the best experience I have had since I decided to become a nurse." CONCLUSION: This intervention highlights the potential of disaster relief as a unique hands-on educational experience for nursing students. [J Nurs Educ. 2020;59(1):30-33.].

"We didn't forget" Utilizing a Community-Nurse Partnership to Promote Health in Rockport, Texas after Hurricane Harvey.

BACKGROUND: On August 25th 2017 Harvey, a category 4 hurricane, made landfall on the south coast of Texas with heavy winds and rain that severely damaged the seaside town of Rockport. The challenge facing healthcare providers following a natural disaster is timely assessments of community need and available resources. One week later, faculty at the University of Texas Health Science Center San Antonio, School of Nursing (SON) completed a community assessment and developed valuable partnerships. AIMS: Eighteen days after the initial assessment, faculty had secured support from The Children's Health Fund and operationalized strategies to provide disaster relief and experiential learning opportunities for the SON Population Focused Health undergraduate students. MATERIALS & METHODS: The community-as-partner model served as the framework to apply the nursing process to a community in crisis. As the focus shifted to recovery, the team prioritized the need to address long-term consequences for children after a natural disaster. RESULTS: Two educational sessions were designed using an interactive and instructional approach to discuss parental strategies to assess and support children as they navigated through loss after Harvey. DISCUSSION: This community-nurse partnership has endured, and the SON faculty and students continue to travel to Rockport to promote health and provide education to the community.

"You Are Not Alone" Strategies for Addressing Mental Health and Health Promotion with a Refugee Women's Sewing Group.

Resettlement can be an uncertain time for refugees as they have often suffered life-threatening circumstances prior to flight from their countries, yet few resettlement programs screen for mental health. The purpose of this study was to pilot the Refugee Health Screener-15 (RHS-15) to assess mental health and the Pathways to Wellness intervention to identify internal and structural barriers affecting resettlement with a refugee women's sewing group. Community collaborations that create healthy social and physical environments through access to resources, economic opportunities, and social support promote a holistic approach to health and can improve quality of life for this vulnerable population.

Exploring precarious employment and women's health within the context of U.S. microenterprise using focus groups.

OBJECTIVE: Nursing has been a leader in exploring social determinants of health within the context of U.S. microenterprise and women's health. The purpose of this study was to explore precarious employment within the context of microenterprise and women's health using focus groups with clientele from New Mexico (NM). The specific aims were to identify (1) the health concerns of low-income women who utilized resources from Women's Economic Self-Sufficiency Team (WESST), and (2) the meaning of precarious employment in low-income women's lives. DESIGN AND STRATEGY: Fourteen women, ranging in age from 21-65 years, who were affiliated with regional WESST sites around NM participated in focus groups and completed a demographic questionnaire. MEASURES: Focus group data were analyzed using content analysis. The degree of interrater agreement was determined by calculating the Cohen's kappa, percentage agreement, and prevalence-adjusted and bias-adjusted kappa (PABAK). RESULTS: Two broad themes emerged from these data: (1) Working for Yourself and (2) Strategies. Although the women identified concerns about participation in microenterprise, flexibility, freedom, and feeling purposeful were motivators to pursue a small business. The kappa statistics on the five transcripts revealed poor inter-rater agreement, yet PABAK, which is a more sophisticated inter-rater reliability index, indicated that inter-rater agreement between the two raters was satisfactory. CONCLUSION: Despite the challenges associated with microenterprise in the US, women found value in working for themselves.

Microcredit and the social determinants of health: a conceptual approach.

Social determinants of health, such as human behavior, environment, and socioeconomics, contribute to health disparities at the individual and population levels. The association between socioeconomics and health is established, and it is acknowledged that people with a lower socioeconomic status experience poorer health. The impetus of microcredit programs is to provide financial alternatives for low-income populations, the majority of whom are women with limited or no access to traditional lending, to start small businesses, generate income, and progress toward self-sufficiency. The income-health link within the context of microcredit has been internationally acknowledged; however, there is scarce research in this area in the United States. This article presents a review of the conceptual approach used to explore the microcredit and health link from a public health nursing perspective. Establishing conceptual foundations can enhance research focused on targeted interventions aimed at lasting change in social and health status. Exploring the link between microcredit and health can enrich research efforts and may offer innovative strategies and interventions to improve health-promoting capacity in impoverished groups.

Exploring women's participation in a U.S. Microcredit Program.

PURPOSE: The purpose of this ethnographic study was to explore and describe women's participation in a U.S. microcredit program in the Pacific Northwest and to examine the relationship between the participants' businesses and their health. DESIGN AND METHODOLOGY: In 2006, an ethnographic study was conducted with a microcredit organization in the Pacific Northwest using the following methods: (a) 10 audiotaped, semistructured interviews with clientele; (b) observation of microcredit groups four times a month for 6 months; (c) conversations with organization executive directors; and (d) review of organizational documents. The participants were women 32 to 64 years of age who had received one or more loans from the microcredit organization. FINDINGS: Four broad themes emerged from the data: (a) Microcredit: The introduction; (b) Microcredit: The place; (c) Stereotypes; and (d) Health. Despite the challenges associated with participation, all of the study participants were enthusiastic about the advantages of microcredit and would recommend it to others. CONCLUSIONS: Many international microcredit organizations have incorporated health care and health education into their programs and have reported successful economic and social outcomes for women. In the United States (US), reports are varied, and there is a lack of literature that explores the economic and health link that is addressed in some international microcredit literature. The findings from this study might be used to initiate discussions around conjoint health education programs and microcredit as a health intervention. CLINICAL RELEVANCE: Nurses, as a trusted presence in the community, are in a position to partner with microcredit organizations to improve the health of clientele.