Culturally competent health care from the immigrant lens: a qualitative interpretive meta-synthesis (QIMS).

Immigrant groups comprise a large segment of ethnic minorities in the United States. Although the literature is rich with strategies to deliver culturally and linguistically appropriate services to eliminate health inequities, studies addressing cultural competence from the immigrant's perspective are limited. Further research is needed to build knowledge of the predictors and needs of this population, and to influence health care policy and practice. Using qualitative interpretive meta-synthesis, this study describes the lived experience of immigrants accessing health care to understand the essence of cultural competence in health care through their lens. Findings provide insight on expanding the definition of culturally competent health care beyond language, behaviors, attitudes, and policies.

What leads non-U.S.-Born Latinos to access mental health care?

Latinos underutilize mental health care services. Of those who do, about 70% do not return after the initial visit. This study's purposes were: (1) to identify factors that led non-U.S.-born Latinos to utilize services from a nonprofit clinic in Texas and (2) to assess whether acculturation played a role in accessing mental health care. Data were collected over a 10-week period using an interview schedule and the Bidimensional Acculturation Scale for Latinos. Results indicate acculturation does not play a significant role in access, but patient knowledge of mental health care issues does. Specifically, the main barriers to access were: (1) lack of knowledge that there was a mental health issue; and (2) lack of knowledge of where to go for mental health services.

Reproductive attitudes and behaviors in people with sickle cell disease or sickle cell trait: a qualitative interpretive meta-synthesis.

Sickle cell disease (SCD) is a serious and life threatening disorder. The literature on informed reproductive decisions among people with SCD is limited, suggesting that there is a lack of awareness about SCD and Sickle cell trait status (SCT) among high-risk populations. The purpose of this qualitative interpretive meta-synthesis (QIMS) is to examine the reproductive attitudes and behaviors in people with SCD or SCT to create effective genetic counseling programs to inform reproductive decision making. Three studies were included in the QIMS for a total sample of 79 participants. The majority of the sample was African American, ages 16 to 63. Other demographic characteristics of the study populations and data collection methods used in these studies varied. Seven themes on reproductive attitudes and behaviors among people with SCD or SCT emerged: lack of awareness or education about SCD and SCT; men who deny having SCT; attitudes toward learning one's SCT status; rationales for learning a partner's SCT status prior to commencing a relationship; valuing relationships over SCD risk; learning one's own and partner's SCT status; and the consequences of not asking about partners' SCT status. Implications for prevention programming involving improved education and awareness about the disease and reproduction are discussed.

Suicide postvention as suicide prevention: improvement and expansion in the United States.

The authors asserted the need for increased postvention efforts for suicide survivors, individuals left behind to grieve the loss of a loved one by suicide, because they have an increased risk for suicide. Indeed, Shneidman (1972) asserted that suicide postvention efforts serve the dual purpose of assisting survivors through the grief process and preventing suicide for future generations. First, the authors briefly discussed the increased risk for suicide among survivors. Second, the authors overviewed the potential benefits of postvention programs and current strategies for suicide postvention in the United States. Finally, they recommended plans for suicide postvention program development such as states should include efforts to create or expand traditional postvention services as well as active survivor outreach to link survivors to these services.