Perceptions of Resettled Refugee Congolese Women: Maintaining Cultural Traditions during Resettlement.

Conflict-displaced refugees have increased significantly globally. The Democratic Republic of Congo is the leading country with refugees in the United States, where many resettle in Ohio. Women refugees are highly vulnerable, yet little literature has focused on them. Furthermore, maintaining cultural traditions can provide comfort during the tumultuous resettlement process. Therefore, this study used mixed methods to understand the perceptions of Congolese refugee women on maintaining cultural traditions during resettlement in Ohio. Translator-assisted, orally administered demographic survey and face-to-face interviews were conducted among resettled Congolese refugee women (n = 20) 18 and older, who arrived in the United States from 2011 to 2018, and were currently receiving Ohio resettlement agency assistance. Researchers applied descriptive coding and thematic analysis to identify themes and subthemes. Three themes were identified among the resettled Congolese refugee women regarding maintaining cultural traditions in the United States. The three themes comprised (1) clothing and dressing, (2) food, and (3) parenting style. Our work examined resettled refugee Congolese women's perceptions of maintaining their culture after resettling in Ohio. These study findings could assist community engagers with insights and practical recommendations on supportive services for resettled Congolese women and a deeper understanding of complex acculturative situations facing them during resettlement.

Path Model Validation of Breastfeeding Intention Among Pregnant Women.

OBJECTIVE: To validate a blended health belief model and integrated behavioral model of selected modifiable psychosocial constructs during pregnancy to seek the best-fit path model for breastfeeding intention. DESIGN: A nonexperimental, cross-sectional study. SETTING: A virtual online market research sample aggregator. PARTICIPANTS: Women (N = 300) between 18 and 45 years of age in their second or third trimesters of pregnancy participated in the study in February 2018. METHODS: Based on the health belief model and the integrated behavioral model, we proposed a theoretical framework, including self-efficacy for breastfeeding, knowledge, perceived benefits, perceived barriers, attitude toward breastfeeding, patient-provider interaction, and motivation to breastfeed, to predict breastfeeding intention. We administered a 98-item questionnaire modified from preexisting instruments. We conducted descriptive, bivariate, and regression analyses to help with the formation of the path model. RESULTS: The best-fit path model with all significant paths and effect directions showed that intention to breastfeed is directly influenced by motivation to breastfeed, attitudes toward breastfeeding, and self-efficacy for breastfeeding, which together accounted for 56% (R2) of the variance in intention. We also identified indirect effects from knowledge about breastfeeding, patient-provider interaction, perceived benefits, and perceived barriers and their interrelationships with effect directions. CONCLUSION: Through our findings, we contribute to the emerging body of evidence that shows the significant variables and their effect directions for breastfeeding intention. Incorporating these findings may provide support and evidence for clinical and community interventions focusing on modifiable psychosocial constructs during pregnancy to promote breastfeeding and further investigations using health behavior theories.

Validating a path model of adherence to prenatal care recommendations among pregnant women.

OBJECTIVE: To date, no study has reported a diagrammatic path model that involves patient-provider communication on pregnant women's adherence to prenatal care recommendations. To bridge this gap, this study aimed to validate a path model to display the direct and indirect influences on adherence to prenatal care recommendations. METHODS: A cross-sectional study founded on an evidence-based proposed theoretical framework was conducted among pregnant women (18-45 years) in their second or third trimester (n = 401) in the Midwestern United States. The proposed theoretical framework examined multiple levels of influences. Previously validated instruments were pilot tested and modified. Path analysis was conducted to validate the best-fit path model. RESULTS: The path model showed shared decision-making and motivation significantly predicted adherence to prenatal care recommendations and accounted for 10% (R2) of the variance. Cultural competency, interaction, perceived discrimination, and satisfaction accounted for 30% (R2) of the variance of shared decision-making. Patient's trust, distrust, and self-efficacy accounted for 5% (R2) of motivation's variance. CONCLUSION: Our work identified the best-fit path model for adherence to prenatal care recommendations. PRACTICE IMPLICATIONS: Incorporating findings from this study could assist prenatal care providers in understanding many complex variables affecting prenatal care, ultimately reducing infant mortality.

The Relationships Between Perceived Discrimination and Utilization of Mental Health Services Among African Americans and Caribbean Blacks.

Although all ethnic/racial groups underutilize mental health services, only about one-third of African Americans and Caribbean Blacks in need utilize mental health services. An extensive literature review led us to examine if an association between perceived discrimination and mental health utilization exists. The National Survey of American Life 2001-2003 nationally representative dataset was analyzed. Variables including utilization of mental health services, perceived discrimination, and socio-demographic variables were assessed for their relationships. The study found that each of the following predictors statistically significant: being male, being employed, having household income higher than 100,000, perceiving no discrimination, being African American, or being Caribbean Black are less likely to utilize mental health services than their counterparts. This study contributes to the emerging body of evidence demonstrating that perceived discrimination has a strong connection with the utilization of mental health services.

Influences of Socio-Demographic Factors and Health Utilization Factors on Patient-Centered Provider Communication.

Patient-centered care has been documented as a measure of quality of health care and has been associated with positive health outcomes. However, the effect of health utilization on improving patient-centered communication has not been investigated. This study examined the effect of three important kinds of health utilization: routine check-up, frequency of provider visits in the last year, and quality of health care to patient-centered provider communication. Cross-sectional data from 3,608 respondents to Health Information National Trends Survey-Cycle 4 2014 were analyzed. Multiple regressions were used to examine the association of sociodemographic factors and health utilization to patient-centered provider communication. Results showed that adults above 50 years and women reported higher patient-centered provider communication. Hispanic and Asian versus White respondents reported poorer patient-centered provider communication. Respondents with routine checkups between 1 and 2 years, 2 and 5 years, 5 or more years and none were all negatively associated with patient-centered provider communication in comparison with routine checkup within 1 year. Respondents who didn't visit health provider within past year had poorer patient-centered provider communication when compared to those who visited once. Finally, higher quality of healthcare experience was associated with higher patient-centered provider communication. Thus, this study highlights that race and ethnicity, age, and gender are significant factors that influence patient-centered provider communication; and specifically higher quality of healthcare experience, one provider visit within past year, and annual routine checkup as measures of health utilization predicts improved patient-centered provider communication.