First name
Katherine
Last name
Yun

Title

Acceptance of COVID-19 Vaccine Among Refugees in the United States.

Year of Publication

2021

Number of Pages

333549211045838

Date Published

2021 Sep 21

ISSN Number

1468-2877

Abstract

<p><strong>OBJECTIVE: </strong>Little is known about COVID-19 vaccination intentions among refugee communities in the United States. The objective of this study was to measure COVID-19 vaccination intentions among a sample of refugees in the United States and the reasons for their vaccine acceptance or hesitancy.</p>

<p><strong>METHODS: </strong>From December 2020 through January 2021, we emailed or text messaged anonymous online surveys to 12 bilingual leaders in the Afghan, Bhutanese, Somali, South Sudanese, and Burmese refugee communities in the United States. We asked community leaders to complete the survey and share the link with community members who met the inclusion criteria (arrived in the United States as refugees, were aged ≥18, and currently lived in the United States). We compared the characteristics of respondents who intended to receive the COVID-19 vaccine with those of respondents who did not intend to receive the vaccine or were unsure. We then conducted crude and adjusted logistic regression analysis to measure the association between employment as an essential worker and COVID-19 vaccine acceptance.</p>

<p><strong>RESULTS: </strong>Of 435 respondents, 306 (70.3%) indicated that they planned to receive a COVID-19 vaccine. Being an essential worker (adjusted odds ratio [aOR] = 2.37; 95% CI, 1.44-3.90) and male sex (aOR = 1.87; 95% CI, 1.12-3.12) were significantly associated with higher odds of intending to receive a COVID-19 vaccine. Among respondents who intended to receive a COVID-19 vaccine, wanting to protect themselves (68.6%), family members (65.0%), and other people (54.3%) were the main reasons.</p>

<p><strong>CONCLUSION: </strong>Many refugees who responded to the survey, especially those who worked in essential industries, intended to receive a COVID-19 vaccine. Community organizations, health care providers, and public health agencies should work together to ensure that vaccine registration and vaccination sites are accessible to refugees.</p>

DOI

10.1177/00333549211045838

Alternate Title

Public Health Rep

PMID

34546812

Title

Association between Preferred Language and Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Children in the United States.

Year of Publication

2021

Date Published

2021 Sep 01

ISSN Number

1476-1645

Abstract

<p>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a disproportionate impact on Black, Hispanic, and other individuals of color, although data on the effect of a person's language on SARS-CoV-2 infection are limited. Considering the barriers suffered by immigrants and non-English-speaking families, we tested whether children with a preferred language other than English was associated with SARS-CoV-2 infection. Children from families with a preferred language other than English had a higher predicted probability of SARS-CoV-2 test positivity (adjusted odds ratio, 3.76; 95% CI, 2.07-6.67) during the first wave of the pandemic. This discrepancy continued into the second wave (adjusted odds ratio, 1.64; 95% CI, 1.10-2.41), although the difference compared with families who prefer to speak English decreased over time. These findings suggest that children from non-English-speaking families are at increased risk of SARS-CoV-2 infection, and efforts to reverse systemic inequities causing this increased risk are needed.</p>

DOI

10.4269/ajtmh.21-0779

Alternate Title

Am J Trop Med Hyg

PMID

34469330

Title

A Content Analysis Of US Sanctuary Immigration Policies: Implications For Research In Social Determinants Of Health.

Year of Publication

2021

Number of Pages

1145-1153

Date Published

2021 Jul

ISSN Number

1544-5208

Abstract

<p>Restrictive immigration policies are important social determinants of health, but less is known about the health implications and health-related content of protective immigration policies, which may also represent critical determinants of health. We conducted a content analysis of types, themes, and health-related language in 328 "sanctuary" policies enacted between 2009 and 2017 in the United States. Sanctuary policies were introduced in thirty-two states and Washington, D.C., most frequently in 2014 and 2017. More than two-thirds of policies (67.6&nbsp;percent) contained language related to health, including direct references to access to services. Health-related themes commonly co-occurred with language related to supporting immigrants in communities, including themes of antidiscrimination, inclusion, trust, and privacy. Our work provides foundational, nuanced data about the scope and nature of sanctuary policies that can inform future research exploring the impacts of these policies on health and health care.</p>

DOI

10.1377/hlthaff.2021.00097

Alternate Title

Health Aff (Millwood)

PMID

34228526

Title

Caring for Children in Immigrant Families: Are United States Pediatricians Prepared?

Year of Publication

2020

Number of Pages

391-398

Date Published

2020 04

ISSN Number

1876-2867

Abstract

<p><strong>OBJECTIVE: </strong>A growing number of children in the United States are from immigrant families. We conducted a national survey to examine pediatricians' self-rated preparedness to care for children in immigrant families.</p>

<p><strong>METHODS: </strong>A 2017 survey of American Academy of Pediatrics members assessed respondent characteristics, formal training in and experience with global, public, or immigrant health, and preparedness to care for children in immigrant families. Descriptive statistics and a multivariable logistic regression model examined associations between characteristics, formal training, experience, and preparedness.</p>

<p><strong>RESULTS: </strong>The survey response rate was 47% (n = 758/1628). One third of respondents (33.6%) reported being unprepared to care for children in immigrant families. In bivariate analyses, respondents who had graduated from medical school outside of the United States, had previous education on immigrant health care, or had recent international global health experience were most likely to report feeling prepared to care for children in immigrant families. Multivariable regression model results indicated that prior education on immigrant health (adjusted odds ratio [AOR] 4.07; 95% confidence interval [CI] 2.68, 6.32), graduation from medical school outside the United States (AOR 2.35; 95% CI 1.22, 4.67), and proficiency in a language other than English (AOR 1.78; 95% CI 1.14, 2.80) were independently associated with preparedness.</p>

<p><strong>CONCLUSIONS: </strong>One in 3 US pediatricians report being unprepared to care for children in immigrant families. Wider implementation of graduate and continuing medical education on immigrant child health is needed to ensure that practicing pediatricians have the appropriate skills and knowledge to care for this patient population.</p>

DOI

10.1016/j.acap.2019.11.015

Alternate Title

Acad Pediatr

PMID

31790799

Title

Discrimination and Stress Among Asian Refugee Populations During the COVID-19 Pandemic: Evidence from Bhutanese and Burmese Refugees in the USA.

Year of Publication

2021

Date Published

2021 Mar 02

ISSN Number

2196-8837

Abstract

<p><strong>OBJECTIVES: </strong>To measure COVID-19 pandemic-related discrimination and stress among Bhutanese and Burmese refugees in the USA and to identify characteristics associated with these two measures.</p>

<p><strong>METHODS: </strong>From 5/15-6/1/2020, Bhutanese and Burmese refugee community leaders were invited to complete an anonymous, online survey and shared the link with other community members who were English-proficient, ≥18 years old, and currently living in the USA. We identified characteristics associated with pandemic-related discrimination and stress applying ordinal logistic regression models.</p>

<p><strong>RESULTS: </strong>Among 218 refugees from 23 states, nearly one third of participants reported experiencing at least one type of discrimination, and more than two-thirds experienced at least one type of pandemic-related stress. Having had COVID-19, having a family member with COVID-19, and being an essential worker were associated with discrimination. Discrimination, financial crisis, and female gender were associated with stress.</p>

<p><strong>CONCLUSIONS: </strong>Reducing pandemic-related discrimination should remain a priority, as should the promotion of social support and coping strategies. Noting that this is a nonrepresentative sample, we recommend that larger national studies tracking experiences with pandemic-related discrimination and stress include Asian American subgroups with limited English proficiency.</p>

DOI

10.1007/s40615-021-00992-y

Alternate Title

J Racial Ethn Health Disparities

PMID

33651371

Title

COVID-19 and Immigrant Essential Workers: Bhutanese and Burmese Refugees in the United States.

Year of Publication

2021

Number of Pages

117-123

Date Published

2021 Jan/Feb

ISSN Number

1468-2877

Abstract

<p><strong>OBJECTIVES: </strong>Immigrants are believed to be at high risk of infection with severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019 (COVID-19). A leading suspected risk factor is their role in the essential workforce. We aimed to describe COVID-19-related risk factors among Bhutanese and Burmese refugees in the United States.</p>

<p><strong>METHODS: </strong>We administered an anonymous online survey in May 2020 among community leaders of Bhutanese and Burmese refugees. Using a snowball sampling strategy, we invited community leaders to complete the survey and share the link with others who met inclusion criteria (English proficient, aged ≥18, currently living in the United States). We compared respondents with and without recent COVID-19 and identified risk factors for infection.</p>

<p><strong>RESULTS: </strong>Of 218 refugees in 23 states who completed the survey from May 15 through June 1, 2020, fifteen (6.9%) reported infection with COVID-19. Being an essential worker during the pandemic (odds ratio [OR] = 5.25; 95% CI, 1.21-22.78), having an infected family member (OR = 26.92; 95% CI, 5.19-139.75), and being female (OR = 5.63; 95% CI, 1.14-27.82) were risk factors for infection. Among 33 infected family members, 23 (69.7%) were essential workers.</p>

<p><strong>CONCLUSION: </strong>Although we had a small snowball sample, we found that working in essential industries was associated with an increased risk of COVID-19 infection among Bhutanese and Burmese refugees. We call for larger studies that include Asian immigrant subgroups, as well as immediate attention to protecting immigrant essential workers during the COVID-19 pandemic.</p>

DOI

10.1177/0033354920971720

Alternate Title

Public Health Rep

PMID

33207130

Title

Hepatitis B Evaluation and Linkage to Care for Newly Arrived Refugees: A Multisite Quality Improvement Initiative.

Year of Publication

2020

Date Published

2020 Jul 25

ISSN Number

1557-1920

Abstract

<p>A quality improvement collaborative evaluated Hepatitis B virus (HBV) care for resettled refugees and identified strategies to enhance care. 682 of the 12,934 refugees from five refugee health clinics in Colorado, Minnesota, and Pennsylvania had chronic HBV. Timely care was defined relative to a HBsAg + result: staging (HBV DNA, hepatitis Be antigen, hepatitis Be antibody, alanine transaminase testing) within 14&nbsp;days, comorbid infection screening (hepatitis C virus and HIV) within 14&nbsp;days, and linkage to care (HBV specialist referral within 30&nbsp;days and visit within 6&nbsp;months). Completed labs included: HBV DNA (93%), hepatitis Be antigen (94%), hepatitis Be antibody (92%), alanine transaminase (92%), hepatitis C screening (86%), HIV screening (97%). 20% had HBV specialist referrals within 30&nbsp;days; 36% were seen within 6&nbsp;months. Standardized reflex HBV testing and specialist referral should be prioritized at the initial screening due to the association with timely care.</p>

DOI

10.1007/s10903-020-01058-7

Alternate Title

J Immigr Minor Health

PMID

32712852

Title

Disparities in Mental and Behavioral Health Treatment for Children and Youth in Immigrant Families.

Year of Publication

2020

Date Published

2020 Jun 26

ISSN Number

1876-2867

Abstract

<p><strong>BACKGROUND AND OBJECTIVES: </strong>Children and youth in immigrant families (CIF)-children and youth with at least one foreign-born parent-face unique psychosocial stressors. Yet little is known about access to mental/behavioral health (MBH) services for CIF. Among US CIF and non-CIF with MBH problems, we assessed access to MBH treatment.</p>

<p><strong>METHODS: </strong>We used the National Survey of Children's Health-2016, a nationally-representative survey of predominantly English- or Spanish-speaking US parents. The sample included 2-17 year-olds whose parent reported at least one MBH problem. The primary outcome was prior-year receipt of MBH treatment (counseling, medication, or both).</p>

<p><strong>RESULTS: </strong>Of 50,212 survey respondents, 7,164 reported a current MBH problem (809 CIF and 6,355 non-CIF). The majority of CIF were Hispanic/Latinx (56% CIF vs 13% non-CIF, p&lt;0.001). CIF were less likely than non-CIF to have an ADHD diagnosis (35% vs 59%, p&lt;0.001) and less likely to have received MBH medication and/or counseling (61% vs 71%, p = 0.02). This difference was pronounced for receiving medication (32% vs 50%, p&lt;0.001). When controlling for multiple covariates, differences in any MBH treatment were no longer statistically significant (AOR 0.76, 95% CI 0.52- 1.11), while the odds of receipt of medication remained significantly lower for CIF (AOR 0.61, 95% CI 0.42 - 0.88).</p>

<p><strong>CONCLUSIONS: </strong>Among children and youth with at least one parent-reported MBH problem, CIF, compared with non-CIF, were less likely to receive MBH treatment, specifically medication. This may be explained, in part, by differences in the proportion of CIF and non-CIF diagnosed with ADHD.</p>

DOI

10.1016/j.acap.2020.06.013

Alternate Title

Acad Pediatr

PMID

32599347

Title

Culturally-Appropriate Orientation Increases the Effectiveness of Mental Health First Aid Training for Bhutanese Refugees: Results from a Multi-state Program Evaluation.

Year of Publication

2020

Date Published

2020 Feb 22

ISSN Number

1557-1920

Abstract

<p>Poor mental health remains a significant source of morbidity and mortality in the Bhutanese refugee community. Mental Health First Aid (MHFA) is a promising intervention that has been used in other immigrant communities to prepare individuals to recognize and respond to mental health warning signs. This was a non-randomized program evaluation. Using pre- and post-training questionnaires developed for prior evaluations of MHFA, we examined the effectiveness of training offered with and without culturally-appropriate orientation to mental health terminology and concepts (N = 458). Pre- to post-training improvement in ability to recognize schizophrenia, ability to respond to schizophrenia and depression, and the overall mental health literacy was greater for Bhutanese refugees who attended orientation relative to other participants (P &lt; 0.05). In scaling up MHFA training for other immigrant communities, we recommend developing and systematically evaluating culturally-appropriate orientation materials that introduce mental health vocabulary and contextualize mental health concepts.</p>

DOI

10.1007/s10903-020-00986-8

Alternate Title

J Immigr Minor Health

PMID

32088846

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