Utilizing rapid qualitative assessment and thematic analysis methods to identify and share promising case investigation and contact tracing practices with people in refugee, immigrant, and migrant communities during COVID-19.

In the early months of the COVID-19 pandemic The National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) was established. NRC-RIM initially sought to rapidly identify promising case investigation and contact tracing (CICT) practices within refugee, immigrant, and migrant communities. Between September 2020 and April 2021, the team conducted 60 interviews with individuals from cross-sector organizations (i.e., public health, health systems, community experts/organizations) working with refugee, immigrant and migrant communities in health and public health capacities related to COVID-19. The overarching aim was to identify and amplify innovative promising and best practices for CICT with refugee, immigrant, and migrant communities, including an exploration of barriers and facilitators. We utilized layered methods to rapidly assess, summarize and disseminate promising practices while simultaneously completing four thematic analyses including: (1) public health organizations; (2) health system organizations; (3) community leaders and organizations; and (4) vaccine planning and access across the three sectors. The primary objective of this article is to describe the project design, applied methods, and team science approach we utilized. We found that rapid identification and dissemination of promising practices, and barriers and facilitators for CICT with refugee, immigrant and migrant communities was feasible during a public health emergency. This approach was essential for identifying and widely sharing culturally and linguistically concordant public health practices.

The Community Health Response Team: a culturally and linguistically tailored community response to COVID-19 addressing barriers to testing and vaccinations for refugee, immigrant and migrant communities in Atlanta, Georgia.

The International Rescue Committee (IRC) in Atlanta and Community Organized Relief Effort (CORE) established a Community Health Response Team in May 2020. The team members represented refugee, immigrant and migrant populations and had expertise in health care and public health. These 18 individuals were recruited from IRC Atlanta's Career Development program, had a variety of backgrounds and spoke 20 languages. They implemented a community-centered COVID-response intervention model of pairing education and outreach efforts with testing and vaccination clinics. Due to their team makeup, the Community Health Response Team conducted tailored outreach and education that was culturally and linguistically congruent with their target communities. They administered over 16,000 COVID-19 tests at mobile community sites within the first 6 months. Once COVID-19 vaccinations were available, the Community Health Response Team coordinated a total of 834 vaccination events in communities with a high number of refugees and in partnership with refugee- and immigrant-trusted community-based organizations, resulting in 31,888 vaccinations. Hiring staff from refugee, immigrant and migrant populations created a sustainable staffing model. Also, embedding culturally specific strategies in their model of pairing education and outreach led to long-term relationships and greater trust with community members. This approach of engaging and empowering community members to create tailored public health responses should serve as guidance for future public health campaigns.

Perspectives of public health organizations partnering with refugee, immigrant, and migrant communities for comprehensive COVID-19 case investigation and contact tracing.

Objectives: To understand public health organizations' experiences providing comprehensive COVID-19 case investigation and contact tracing, and related promising practices with refugee, immigrant and migrant communities. Methods: We interviewed public health professionals (September 2020 to February 2021) from local and state health departments using a geographically stratified, purposive sampling approach. A multidisciplinary team at the National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) conducted a thematic analysis of the data. Results: Six themes were identified: understanding community and public health context, cultivating relationships, ensuring linguistic and cultural concordance, communicating intentionally, evolving response, and implementing equity. The interconnection of themes and promising practices is explored. Conclusion: As public health continues to learn from and build upon COVID-19 response experiences, the thematic findings and potential promising practices identified in this project may foster proactive, community-engaged solutions for public health, and other organizations working and partnering with refugee, immigrant, and migrant communities. Implementing these findings with COVID-19 into current and future public health crisis responses may improve public health, collaborations with refugee, immigrant, and migrant communities, and staff wellbeing.

Experiences of American Health Departments, Health Systems, and Community Organizations in COVID-19 Vaccine Provision for Refugee, Immigrant, and Migrant Communities.

Effective provision of COVID-19 vaccines could mitigate the disproportionate impact of the COVID-19 pandemic experienced by many immigrant communities. To describe organizational experiences in using COVID-19 vaccination programs, qualitative interviews were conducted from September 2020 to April 2021 with representatives from public health, health system, and community organizations responding to the COVID-19 pandemic among immigrant communities across the United States. Interviews followed a semistructured interview guide and were audio recorded, transcribed, and coded. A latent thematic analysis was facilitated by Dedoose software. Interviews representative of 18 public health departments, 20 healthcare systems, and 18 community organizations were included in the analysis. Five identified themes referenced the importance of 1) appreciating community and individual heterogeneity in health priorities and attitudes; 2) addressing vaccine fears with trustworthy messages; 3) ensuring equitable access to vaccine opportunities; 4) making substantive investments in community partnerships and outreach; and 5) adapting to meet new needs. It is essential that vaccine efforts consider community heterogeneity, communicate in a trustworthy and culturally and linguistically appropriate manner, strive for equitable provision of care, build partnerships, and learn from prior experiences.

"Beyond just the four walls of the clinic": The roles of health systems caring for refugee, immigrant and migrant communities in the United States.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Introduction: Refugee, immigrant and migrant (hereafter referred to as "immigrant") communities have been inequitably affected by the COVID-19 pandemic. There is little data to help us understand the perspectives of health systems on their role, in collaboration with public health and community-based organizations, in addressing inequities for immigrant populations. This study will address that knowledge gap. Methods: This qualitative study used semi-structured video interviews of 20 leaders and providers from health systems who cared for immigrant communities during the pandemic. Interviewees were from across the US with interviews conducted between November 2020-March 2021. Data was analyzed using thematic analysis methods. Results: Twenty individuals representing health systems participated with 14 (70%) community health centers, three (15%) county hospitals and three (15%) academic systems represented. The majority [16 health systems (80%)] cared specifically for immigrant communities while 14 (70%) partnered with refugee communities, and two (10%) partnered with migrant farm workers. We identified six themes (with subthemes) that represent roles health systems performed with clinical and public health implications. Two foundational themes were the roles health systems had building and maintaining trust and establishing intentionality in working with communities. On the patient-facing side, health systems played a role in developing communication strategies and reducing barriers to care and support. On the organizational side, health systems collaborated with public health and community-based organizations, in optimizing pre-existing systems and adapting roles to evolving needs throughout the pandemic. Conclusion: Health systems should focus on building trusting relationships, acting intentionally, and partnering with community-based organizations and public health to handle COVID-19 and future pandemics in effective and impactful ways that center disparately affected communities. These findings have implications to mitigate disparities in current and future infectious disease outbreaks for immigrant communities who remain an essential and growing population in the US.

Validity and reliability of the Body-Esteem Scale among a diverse sample of preadolescent youth.

Researchers have called for more psychometric research on body image assessment measures in children. The Body-Esteem Scale (BES) is a commonly used 24-item measure of self-evaluation of body image in youth, yet only one study has evaluated the psychometric properties of this measure in preadolescent children. The goal of the present study was to replicate and extend the original psychometric work on the BES by examining the factor structure, reliability, and convergent validity in a diverse sample of children ages 9-11 years old. Teachers who taught 4th- and 5th-grade students in the United States were invited to participate. A total of 556 students completed an online survey in their classrooms. Findings indicate a one-factor model best fits the data after eliminating three BES items. The BES had strong scale score consistency. Supporting the convergent validity of the BES, body-esteem scores were positively correlated with general self-esteem and body satisfaction scores, while negatively correlated with body dissatisfaction, engagement in appearance conversations, and social comparison scores. There were no significant group differences on mean BES scores between gender and grade level. Overall, the BES is suitable to assess the body esteem of preadolescent children. Future research needs to replicate these findings and examine the BES's ability to detect a change in body-esteem scores across time in youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"How can you advocate for something that is nonexistent?" (CM16-17) Power of community in a pandemic and the evolution of community-led response within a COVID-19 CICT and testing context.

Formal and informal bilingual/bicultural organizations and networks form the backbone of support for refugee, immigrant, and migrant (RIM) communities in the United States. They are pivotal in mitigating barriers and inequities in social and structural determinants of health. These organizations and networks are situated within the communities they serve, and often are established and run by members of a community, to serve the community. In the United States, the COVID-19 pandemic surfaced and widened existing health inequities for some racial and ethnic communities. Our primary objectives were to: (1) describe the processes that underpinned the pivotal role of immigrant-serving community structures in developing and implementing culturally sustaining programming in the context of pandemic response, and (2) amplify the voices of community experts, as they shared experiences and perspectives around these humanistic and community-centered approaches. We applied a community case study approach to a national sample of RIM-serving community structures representing broad country/region-of-origin, cultural, and linguistic identities. Community engagement strategies utilized in the project period included engaging community partners to identify and facilitate connections, and consult on analysis and dissemination. The project team conducted 20 in-depth, semi-structured interviews with a purposive sample of community experts/community organizations. Sampling strategy was further informed by immigrant identity (i.e., characterization of status) and geography (i.e., United States Department of Health & Human Services, Office of Intergovernmental and External Affairs Regions). Through thematic analysis, results identified key contextual, process-, and impact-oriented themes inherent to community-led COVID-19 responses, that were situated within and around the public and health system response to the pandemic. As public health and health systems scrambled to address acute and unprecedented barriers to access, distribution of COVID-19-related health resources and services, and disparate health outcomes, community structures diligently and intentionally reimagined and reconceptualized their response to COVID-19, frequently in the setting of scarce resources. The grassroots response evolved as a counter-narrative to top-down equity processes, historically defined by systems and applied to the community.

Examination of hair experiences among girls with Black/African American identities.

Negative hair experiences can impact psychological well-being and are an integral part of development through childhood, adolescence, and beyond. The current study utilized a mixed-methods approach to capture the lived experiences of girls relating to their hair. Participants were 105 girls between the ages of 10-15 years old recruited via social media, email, and social organizations with Black/African American, or biracial communities. Satisfaction with natural hair, perceived bullying and teasing relating to hair, social comparisons, and pressure from family and friends were assessed. Approximately, 22% of 10-year olds, 14% of 11-year olds, 54% of 12-year olds, 35% of 13-year olds, and 32% of 14-year olds reported experiencing hair related teasing. Engaging in hair comparison with models/celebrities in the media and peers was significantly associated with less hair satisfaction. Similarly, girls that reported greater frequency of hair-related teasing also had significantly lower scores on hair satisfaction. Finally, having friends who like one's natural hair was significantly associated with higher hair satisfaction scores. Black/African American girls and their experiences around hair have been largely neglected in psychology and body image research, and more research on this topic is required to gain a better understanding of the role it plays in developing young girls.

Psychodynamic Psychiatry in the Philippines.

The authors describe the practice of psychodynamic psychiatry in the Philippines. They review features of contemporary psychodynamic psychiatry, the state of psychodynamic psychiatry in training programs, and its integration in national professional societies. Despite psychodynamic psychiatry's wide acceptance in the professional community in the Philippines and neighboring Southeast Asian countries, delivery of care to over 110 million residents of the archipelago requires creativity given the small number of psychiatrists. The authors discuss how psychodynamic psychiatry impacts the national mental health scene and propose future directions involving forging international linkages.

Identifying central symptoms of eating disorders among ethnic and racial minority women.

Experiencing eating disorder symptoms is associated with maladaptive outcomes and impairment in functioning. A paucity of research exists examining eating disorder symptoms among ethnic/racial minority women. Using a network analysis, we evaluated core symptoms of eating disorder psychopathology and the degree of association between eating disorder symptoms in a sample of ethnic/racial minority women. Participants were 296 Black, 261 Hispanic, and 261 Asian American women recruited across the United States to complete an online survey. Inclusionary criteria yielded a sample with high eating disorder psychopathology. The Network Comparison Test was used to identify differences in networks between groups and yielded no significant differences between the three ethnic/racial groups. Thus, one network analysis on the entire sample was conducted in the main analyses. However, separate group analyses are presented in the online supplemental materials. Consistent with the transdiagnostic theory of eating disorders, weight concerns (i.e., strong desire to lose weight and fear of weight gain) emerged as central symptoms. Discrepant from findings with predominantly White samples, purging emerged as a central symptom as well, while shape concerns did not. Interestingly, having to weigh oneself weekly, having a flat stomach, fasting, and compulsive exercising were on the periphery of the network. Findings are discussed in terms of clinical implications and comparative similarities and differences when addressing the existing literature. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The influence of temperament on stress-induced emotional eating in children.

BACKGROUND: Stress-induced emotional eating is a risk factor for overweight and obesity. Previous research proposes both the human serotonin transporter gene (5-HTTLPR) and child's reactive temperament are promising candidates to help explain individual differences in stress-induced emotional eating and weight. Understanding the association between specific genotypes, reactive temperament factors, and stress-induced emotional eating may inform the development of personalized and effective treatment for children who may be at risk for overweight and obesity. OBJECTIVE: The current study explored the conditional indirect effect of genetic and environmental susceptibility (i.e., the interaction between 5-HTTLPR and reactive temperament) on weight (as measured by percent body fat) mediated by stress-induced emotional eating. METHOD: One hundred and forty-seven children (4 to 6 years old; 50.3% female; 22.4% Hispanic), along with their primary caregiver, completed laboratory tasks and questionnaires that assessed the child's reactive temperament, stress-induced emotional eating, and percent body fat. RESULTS: The interaction between 5-HTTLPR and impulsivity as well as with negative affectivity significantly predicted percent body fat. The interaction between 5-HTTLPR and impulsivity as well as with negative affectivity significantly predicted both total calorie consumption and rate of total calorie consumption. However, the mediation aspect of this statistical model was not supported. CONCLUSIONS: Child reactive temperament is an important indicator of how children approach eating when stressed. Mental health providers may consider prescribing strategies to reduce emotional eating among children with the SL variant and moderate to high impulsivity as well as children with the LL variant and high negative affectivity.

The association between maternal criticism and body dissatisfaction on disordered eating pathology across racial and ethnic groups.

OBJECTIVES: Limited research exists examining the association of maternal weight-, shape-, and size-related criticism with disordered eating pathology across racial and ethnic groups. METHOD: The sample consisted of 392 undergraduate females and 368 undergraduate males for a total of 760 individuals. Disordered eating pathology, body dissatisfaction, and maternal criticism were assessed in 484 White, 134 Latinx, and 142 Asian American undergraduates. Hierarchical regression, correlation, and t-test analyses were conducted for each ethnic group. RESULTS: Among all three groups, body dissatisfaction, maternal criticism, and gender were significantly associated with disordered eating pathology. In addition, disordered eating and maternal criticism were greater among female undergraduates than among male undergraduates across all groups. However, body dissatisfaction did not differ significantly between female and male undergraduates in any of the three racial and ethnic groups. Findings from this study suggest that individual body dissatisfaction and maternal criticism may be differentially linked with disordered eating pathology across racial and ethnic groups. Among Whites and Latinx, body dissatisfaction was more strongly associated with disordered eating pathology than was perceived maternal criticism. However, among Asian Americans, perceived maternal criticism was more strongly associated with disordered eating pathology than was body dissatisfaction. CONCLUSIONS: Maternal criticism was the most saliently linked with disordered eating pathology among Asian Americans. Findings from this study speak to individual and familial factors impacting disordered eating across racial and ethnic groups. Additionally, this study highlights the potential role of culture on disordered eating, particularly self-construal and collectivistic and individualistic orientations. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Sexual orientation and salivary alpha-amylase diurnal rhythms in a cohort of U.S. young adults.

Sexual minorities in the United States are at elevated risk of prejudice, discrimination, and violence victimization due to stigma associated with their sexual orientation. These stressors may contribute to physiological stress responses and changes in the regulation of the sympathetic nervous system (SNS). To date, no studies have examined the associations among minority sexual orientation, recent stressful events, and diurnal salivary alpha-amylase (sAA) patterns. The present study included 1663 young adults ages 18-32 years (31% men, 69% women) from the Growing Up Today Study, a prospective cohort of U.S. youth. Participants provided five saliva samples over the course of one day to estimate diurnal sAA patterns. Sexual orientation groups included completely heterosexual with no same-sex partners (CH; referent), mostly heterosexual/completely heterosexual with same-sex partners, and gay/lesbian/bisexual (LB or GB). Sex-stratified multilevel models were fit to evaluate the association of sexual orientation with diurnal patterns of log sAA. The association of recent stressful events was also evaluated. Among women, sexual minorities scored significantly higher than CH on perceived stress and number of stressful events in the past month (p < 0.05). Among men, sexual minorities scored higher than CH on perceived stress but not recent stressful events. In multivariable models, recent stressful events were not associated with sAA patterns, but significant sexual orientation group differences in sAA diurnal rhythm were observed among women though not among men. Compared to CH women, LB showed a blunted awakening response and elevated sAA levels across the day, both indicators consistent with SNS dysregulation. Findings suggest dysregulation of stress physiology in LB women, but not other sexual minority women or men, relative to same-sex heterosexuals. Observed dysregulation may relate to exposure among LB women to chronic stressors associated with sexual orientation stigma, although these relations and differences by sex warrant further study.

Sex of sexual partners and disordered weight control behaviors in a nationally representative sample of South Korean adolescents.

Eating disorders are a serious and life-threatening health issue associated with physical and mental health problems. Stigma associated with sexual orientation is thought to be one contributor to eating disorders symptoms in U.S. adolescents. Additional research on disordered weight control behaviors in diverse populations is needed to better understand their etiology. To examine the association of sex of sexual partners with disordered weight control behaviors among South Korean adolescents, we analyzed survey data from 67,266 adolescents, ages 12-18 years, from the 2015 Korea Youth Risk Behavior Web-based Survey. Adolescents were grouped based on self-reported sex of sexual partners. Disordered weight control behaviors included fasting, vomiting, or use of unprescribed diet pills for weight control in the past month. Among both girls and boys, those reporting partners of both sexes had higher odds and those with no sexual partners had lower odds of disordered weight control behaviors. Those with same-sex partners only were not significantly different in disordered weight control behaviors from those with other-sex partners only for girls or boys. Our findings demonstrate the need for further research identifying ways to mitigate risk for this vulnerable group.

Household expenditures on dietary supplements sold for weight loss, muscle building, and sexual function: Disproportionate burden by gender and income.

Dietary supplements sold for weight loss (WL), muscle building (MB), and sexual function (SF) are not medically recommended. They have been shown to be ineffective in many cases and pose serious health risks to consumers due to adulteration with banned substances, prescription pharmaceuticals, and other dangerous chemicals. Yet no prior research has investigated how these products may disproportionately burden individuals and families by gender and socioeconomic position across households. We investigated household (HH) cost burden of dietary supplements sold for WL, MB, and SF in a cross-sectional study using data from 60,538 U.S. households (HH) in 2012 Nielsen/IRi National Consumer Panel, calculating annual HH expenditures on WL, MB, and SF supplements and expenditures as proportions of total annual HH income. We examined sociodemographic patterns in HH expenditures using Wald tests of mean differences across subgroups. Among HH with any expenditures on WL, MB, or SF supplements, annual HH first and ninth expenditure deciles were, respectively: WL $5.99, $145.36; MB $6.99, $141.93; and SF $4.98, $88.52. Conditional on any purchases of the products, female-male-headed HH spent more on WL supplements and male-headed HH spend more on MB and SF supplements compared to other HH types (p-values < 0.01). High-income ($30,000 < annual income < $100,000), compared to low-income (annual income < $30,000) HH, spent more on all three supplements types (p-values < 0.01); however, proportional to income, low-income HH spent 2-4 times more than high-income HH on WL and MB supplements (p-values < 0.01). Dietary supplements sold for WL, MB, and SF disproportionately burden HH by income and gender.

Results of a strategic science study to inform policies targeting extreme thinness standards in the fashion industry.

The appearance pressures experienced by fashion models have been criticized as harmful to their health, as well as increasing eating disorder risk among youth by promoting ideals of extreme thinness. Given recent legislation to protect models, we undertook a strategic science study to assess professional fashion models' perceptions of the potential impact and feasibility of seven policy proposals. A sample of 85 female fashion models, mean age = 22.7 years (SD 3.7) completed an online survey assessing unhealthy weight control behaviors (UWCB), perceived pressure from agencies to lose weight, as well as the perceived impact and feasibility of seven potential policy actions. Chi-squared analyses and multivariable logistic regressions compared UWCB among models who were asked to lose weight and those who were not. Friedman and Kendall's W tests were conducted to examine differences in impact and feasibility ratings across the seven policy proposals. Models reported high levels of pressure to lose weight, which was associated with higher odds of engaging in UWCB. The policy approaches rated as most impactful were those to increase worker protections, though they were rated as only moderately feasible. Requiring employers to provide food and a 30-min break for jobs longer than 6 h was rated as both impactful and feasible. Imposing restrictions on minimum BMI was rated as the least impactful. Approaches providing employment protections and healthier working conditions are most supported by professional models. These findings help to illuminate viable policy approaches from the perspective of key stakeholders.

Research-to-policy translation for prevention of disordered weight and shape control behaviors: A case example targeting dietary supplements sold for weight loss and muscle building.

New approaches to universal eating disorders prevention and interventions targeting macro-environmental change are greatly needed, and research-to-policy translation efforts hold promise for advancing both of these goals. This paper describes as a policy-translation case example an academic-community-government partnership of the Strategic Training Initiative for the Prevention of Eating Disorders, Multi-Service Eating Disorders Association, and the office of Massachusetts Representative Kay Khan, all based in Massachusetts, USA. The partnership's research-to-policy translation project focused on dietary supplements sold for weight loss and muscle building, which have been linked with serious injury and death in consumers. Youth and people of all ages with eating disorders and body dysmorphic disorder may be especially vulnerable to use these products due to deceptive promises of fast and safe weight loss and muscle gain. The research-to-policy translation project was informed by a triggers-to-action framework to establish the evidentiary base of harm to consumers, operationalize policy solutions to mitigate harm through legislation, and generate political will to support action through legislation introduced in the Massachusetts legislature to restrict sales of weight-loss and muscle-building dietary supplements. The paper concludes with lessons learned from this unique policy translation effort for the prevention of disordered weight and shape control behaviors and offers recommendations for next steps for the field to advance research and practice for universal, macro-environmentally targeted prevention.

Osteochondroma of the femoral neck: a rare cause of sciatic nerve compression.

A 39-year-old man presented with weakness and a nonmobile mass in the buttock of 5 months' duration. Hip flexion was limited to 70 degrees. Strength was diminished for both ankle/foot plantar and dorsiflexion. Sensation was decreased on the plantar and dorsal foot. A pedunculated osseous mass measuring 6x4 cm on the posterior femoral neck was seen on plain radiographs and magnetic resonance imaging. Electromyography showed moderate sciatic neuropathy of the peroneal and tibial branches. The patient underwent excision of the tumor through a posterior approach. Due to the risk of weakening the neck, two 7.3-mm cannulated screws were passed percutaneously into the head with fluoroscopic guidance. The final pathological report indicated the tumor was an osteochondroma. At 22-month follow-up, he had full resolution of the neurologic findings. Postoperatively, the patient reported improvement in numbness and tingling in the leg but continued to have moderate buttock pain. Left hip flexion increased to 115 degrees at last follow-up.The importance of protecting the medial femoral circumflex artery during approaches to the hip is paramount. In this case, the tumor arose from the central aspect of the quadratus femoris, with the superior muscle protecting the medial femoral circumflex artery from harm. Although osteochondromas are a rare cause of mass effect, they should be considered in the differential diagnosis of sciatic nerve compression in this anatomical location.