The impact of adolescents' racial and ethnic self-identity on hope.

The two components of hope (i.e., hope-agency defined as the ability to envision and believe in one's ability to achieve goals; hope-pathway defined as belief in one's ability to devise strategies to achieve one's goals) propel adolescents toward well-being, academic achievement and personal fulfillment. This study compares levels of hope and its components, for different groups of immigrant and ethnic non-immigrant youths, while adjusting for and measuring the impact of racism, school and family characteristics, and the youth's unique individual attributes. Using a community-based participatory research approach and a cross-sectional study design, data were collected from immigrant and non-immigrant youth (n = 567) between May 2015 and December 2015 at three Israeli public high schools. The study included five groups of youth based on their self-descriptions: Ethiopian immigrant (n = 48), Russian immigrant (n = 145), Israeli-born Mizrachi/Sephardi (n = 59), Israeli-born Ashkenazi (n = 49), or Israeli-born Unspecified (n = 266). Linear regression models showed that Ethiopian immigrant youth, compared to Russian immigrant youth and all Israeli-born groups of youth, had significantly lower hope-agency, hope-pathway and overall hope. However, an interaction effect between racism and ethnicity indicated that adolescents who perceived racism and self-identified as Ethiopian had higher hope-agency, hope-pathway and overall hope. This effect was not found with Russian immigrant or Israeli-born youth. Immigrants of color compared to other immigrants and ethnicities have less overall hope; but those who acknowledge racism feel more control over their future (hope-agency), able to devise strategies to surmount barriers blocking goals (hope-pathway), and have greater overall hope.

Health indicators and social gradient in adolescent immigrants' health risk and healthcare experiences.

Few studies have assessed healthcare experiences in apparently healthy adolescents, or whether healthcare attitudes are linked to the two leading adolescent health indicators, smoking and obesity. Even fewer have examined these relationships in adolescent immigrant groups or made comparisons to adolescent non-immigrants. Using a cross-sectional study, healthcare experiences were compared among three groups of adolescents (n = 589) including Russian immigrants (n = 154), Ethiopian immigrants (n = 54), and non-immigrants (n = 381). Bootstrap estimates indicated positive healthcare experiences were less common among Russian adolescent immigrants (OR = 0.38, CI = 0.17, 0.86) compared to non-immigrants, unless the Russian adolescent immigrants reported above average socioeconomic status, in which case they were more likely than non-immigrant adolescents to report positive healthcare experiences (OR = 3.22, CI = 1.05, 9.85). Positive healthcare experiences were less likely among adolescents who were smokers (OR = 0.50, CI = 0.27, 0.91), and more likely for adolescents with a normal or low BMI (OR = 3.16, CI = 1.56, 6.40) and for those relying on parents for health information (OR = 1.97, CI = 1.05, 3.70). CONCLUSION: Findings suggest a social gradient in which positive healthcare experiences were more common among adolescence with higher socioeconomic status for some immigrants (Russian adolescents) but not for others. The two leading health indicators were related to healthcare experiences, but as adolescent smokers were less likely to have positive healthcare experiences, proactive efforts are needed to engage this group. What is Known: • Health indicators (such as obesity) and healthcare attitudes are linked to healthcare service use among adolescents sampled from outpatient and inpatient populations. What is New: • A social gradient involving socioeconomic status and being an adolescent immigrant was found regarding risky health indicators (i.e., smoking, use of internet as the primary source of health information). • Problematic health indicators, such as smoking, is linked to less positive healthcare attitudes in apparently healthy adolescents (both immigrants and non-immigrants).

Adolescent immigrants, the impact of gender on health status.

Background: : Although studies have described the 'healthy immigrant effect' in adults, far fewer have examined the 'healthy immigrant effect' for adolescents living in immigrant families. Those few studies that did, noted conflicting results, and also differed on whether gender confounds the results. : This cross-sectional study was informed by the community-based participatory research (CBPR) approach in which researchers obtained the expertise and guidance on instrument design and study implementation. Data collection of self-administered surveys was completed between May 2015 and December 2015 on adolescents. Comparisons were made among six groups based on gender and immigrant status. : Of the total sample ( n = 618), more than a third were first or second generation immigrant adolescents ( n = 239). Comparisons among six groups, categorized by gender and immigrant status (i.e. first generation immigrants, second generation immigrants, native born), indicated many differences. However, when the differences were taken into account using logistic regression models, excellent health status was least likely to be reported by second generation immigrant males (versus native born adolescent females) ( P < 0.01), even after adjusting for the independent associations found for psychological symptoms ( P < 0.0001), not smoking ( P < 0.05) and having normal BMI ( P < 0.05). : This study demonstrates the relative disadvantage of second generation immigrant boys, but not first generation boys or first and second generation immigrant girls relative to their native counterparts. Reasons for the gap may be differences in support services and/or parental expectations; however further studies are needed to confirm these possibilities.

A qualitative study assessing cardiovascular risk factors: the accumulative stressors influencing societal integration of teenage African immigrants.

BACKGROUND: This study examines the nature of disparities in cardiovascular risk by exploring chronic stressors and other cardiovascular risk factors on youth of African descent who are integrating into an industrialized society. METHODS: Qualitative data on cardiovascular risk and acclimation to the dominant society were collected from three groups of key informants: (1) community leaders; (2) youth; and (3) a community advisory group. RESULTS: Youth of Ethiopian descent engaged in the same western diets, computerized social networking, and habits in smoking and alcohol use as did youth from the dominant society. However, informants of Ethiopian descent encountered and witnessed racism, institutional discrimination and evidence of devaluing Ethiopian culture, influencing youths' ability to integrate into the society. CONCLUSION: Immigrant youth of Ethiopian descent face an accumulation of conflicting social support, psychosocial factors, and stressors, including: living in low-income, high-crime areas; encountering pervasive discrimination; acclimating to a new and industrialized culture; and navigating within an often unhospitable society. Contributing to these factors are changes in health behaviors such as adding processed foods and sugary drinks to the diet, increasing heavy alcohol use and substituting screen use for physical activity. The accumulative impact of these factors contributes to the marginalization of youth of Ethiopian descent in the dominant society and perpetuates a cycle of increasing cardiovascular risk.