Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees

基于社区的多层次心理健康干预措施，以解决结构性不平等以及 COVID-19 疫情对拉丁裔移民和非洲难民造成的不同不利后果

• 批准号: 10674390
• 负责人: JESSICA R GOODKIND
• 金额: $ 6.03万
• 依托单位: UNIVERSITY OF NEW MEXICO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-16 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10674390
• 关键词: Address; Advocacy; Affect; African; Awareness; Behavioral; Black Populations; Black race; COVID-19; COVID-19 pandemic effects; Collaborations; Communities; Complex; Control Groups; Data; Disasters; Discrimination; Economics; Education; Effectiveness of Interventions; Enrollment; Essential worker; Exposure to; Face; Family; Goals; Grief reaction; Health Insurance; Housing; Immigrant; Immigration; Incidence; Individual; Insurance Coverage; Intervention; Interview; Language; Latinx; Latinx population; Learning; Legal; Low income; Mediating; Mental Health; Mental Health Services; Methods; Modeling; Occupations; Participant; Pathway interactions; Personal Satisfaction; Persons; Plant Roots; Policies; Probability Samples; Prognosis; Randomized; Refugees; Research; Research Design; Resources; Sampling; Science; Site; Social Change; Social support; Stress; System; Testing; Time; United States; Waiting Lists; Work; Youth; adverse outcome; barrier to care; base; community based participatory research; comparison group; comparison intervention; design; disparity reduction; economic impact; effectiveness testing; experience; food insecurity; health care availability; health care economics; health disparity; health economics; health service use; improved; innovation; intervention effect; marginalized population; mental health education; mutual learning; pandemic disease; peer; physical conditioning; primary outcome; protective factors; psychological distress; recruit; research study; response; secondary outcome; social; social determinants; socioeconomics; stressor; trauma exposure; treatment as usual; university student

PROJECT SUMMARY Graduate student Alejandra Lemus’ long-term goal is to become a NIH-funded researcher engaged in high impact, innovative research that examines the effects of multilevel interventions (including policy change) on reducing social inequities and mental health disparities experienced by Latinx immigrants. Almost 14% of the U.S. population are immigrants (28% of the population when including U.S.-born children of immigrants), with Latinx immigrants comprising 40% of the immigrant population. Due to long-standing structural inequities, the COVID-19 pandemic has disparately impacted immigrants, particularly those who are Latinx and low-income. The parent grant aims to test a multilevel approach to reduce adverse consequences of the COVID-19 pandemic with disparate impacts on Latinx and Black immigrants and refugees by observing and implementing three nested levels of intervention. This Diversity Supplement will further advance mental health disparities research through intersectional analyses of the mental health, daily stressors, and economic distress of Latina immigrant mothers, which is critical because recent research that has shown that women have experienced more severe mental health, daily stressor, and economic impacts of the pandemic. These disparities are likely due to multiple factors, such as higher caregiving responsibilities and lower income compared to men, and high rates of exposure to political, structural, and intimate partner violence. These gendered experiences highlight the importance of intersectional approaches which focus on gender and caregiving responsibilities, in addition to immigration status, SES, and race/ethnicity, to understand the pathways and intersecting positionalities that are contributing to mental health disparities. The longitudinal mixed methods data collected from 1140 Latinx immigrants for the parent study will be leveraged to conduct a mixed methods study with an innovative sequential design, in which initial quantitative analyses to describe gender disparities in mental health, daily stressors, and economic precarity among Latinx immigrants (Aim 1) will be followed by qualitative analyses of interviews conducted with a subsample of participants to provide explanation and elaboration on differences in these outcomes (Aim 2), and then subsequent quantitative analyses to test potential moderators and mechanisms suggested by the qualitative findings that may be contributing to gendered disparities (Aim 3). In addition to the proposed research activities, Ms. Lemus will engage in a comprehensive training plan that advances her expertise in 4 key areas: mixed methods and advanced qualitative and quantitative analyses; policy and structural analyses; community-engaged research; and intersectional transnational gender analyses. Guided by a primary mentor and 4 co-mentors, her training includes directed readings, coursework, mentored research activities, and writing and submission of 3 conference abstracts, 4 first-authored papers, a bilingual policy brief and community report, and a F32 application. In sum, the proposed research and training experiences will provide critical opportunities for Ms. Lemus and enhance the impact of the parent grant.

项目摘要 研究生Alejandra Lemus的长期目标是成为一名NIH资助的研究人员， 影响，创新研究，审查多层次干预措施（包括政策变化）对 减少拉丁裔移民所经历的社会不平等和心理健康差异。近14%的 美国人口是移民（28%的人口，包括美国-出生的移民子女）， 拉丁裔移民占移民人口的40%。由于长期存在的结构性不平等， COVID-19疫情严重影响移民，尤其是拉丁裔及低收入人士。 家长补助金旨在测试一种多层次的方法，以减少COVID-19的不良后果 通过观察和实施对拉丁裔和黑人移民和难民产生不同影响的流行病 三级干预。这一多样性补充将进一步推动心理健康差距 通过对拉丁裔美国人的心理健康、日常压力源和经济困境的交叉分析进行研究。 移民母亲，这是至关重要的，因为最近的研究表明，妇女经历了 更严重的心理健康、日常压力和大流行病的经济影响。这些差异很可能 由于多种因素，如与男子相比，妇女承担的责任更大，收入更低， 暴露于政治、结构性和亲密伴侣暴力的比率。这些性别化的经历凸显了 强调必须采取注重性别和分担责任的跨部门办法， 移民身份，社会经济地位和种族/民族，以了解途径和交叉位置， 导致了心理健康的差异。1140例Latinx样本的纵向混合方法数据 父母研究的移民将被利用来进行一项混合方法的研究， 序贯设计，其中每天进行初步定量分析，以描述心理健康方面的性别差异 压力，和经济不稳定拉丁移民（目标1）将随后进行定性分析， 对参与者进行了一次抽样访谈，以解释和阐述 这些结果（目标2），然后进行定量分析，以测试潜在的调节剂， 定性调查结果表明可能造成性别差异的机制（目标3）。在 除了拟议的研究活动外，莱穆斯女士还将参与一项全面的培训计划， 她在4个关键领域的专业知识：混合方法和先进的定性和定量分析; 政策和结构分析;社区参与的研究;跨部门跨国性别 分析。在一位初级导师和4位共同导师的指导下，她的培训包括定向阅读，课程作业， 指导研究活动，撰写并提交3份会议摘要，4篇第一作者论文，a 双语政策简报和社区报告，以及F32申请表。总而言之，拟议的研究和培训 这些经验将为Lemus女士提供重要的机会，并增强父母补助金的影响。