Identifying Structural Vulnerability Latent Classes Associated with the Health Outcomes of Latino Immigrant Men in Baltimore

最近的公共卫生事件突出了有色人种社区的不成比例的负担 在美国，由于长期的健康差距，外国出生的拉丁裔移民 (LM)被发现特别有可能从事危险行为（物质使用， 性风险），与拉丁裔移民相比，寻求医疗保健服务的可能性较小 妇女越来越多的研究记录了移民相关压力的影响 对LM的心理健康和物质使用有影响。然而，在知识方面存在差距， 社会心理脆弱性，以种族之间复杂的动态形式， 歧视、耻辱、暴力受害和社会孤立， 差距。在结构脆弱性理论的指导下，我们将使用一个顺序的解释性混合模型， 方法：首先进行潜在类别分析，以确定心理社会脆弱性 LM亚组（N=300）和与健康结果的相关性。接下来，我们将向更深层次发展 通过定性表征亚组对已识别的潜在类别的病因学理解 根据参与者的生活经验（n=40）。具体而言，本研究旨在1。识别 潜在的明显的心理社会脆弱性（种族歧视耻辱、暴力、社会孤立） 类（例如，假设高、中、低等级）在巴尔的摩LM中; 2.检查 个人（社会人口统计学、法律的地位、英语能力）和社会背景 决定因素（社会支持、家庭联系、生活和工作条件） 每个心理社会脆弱性潜在类别（例如，高、中、低）及其关联 与健康结果（药物和酒精相关的问题，感染风险，心理健康）;和3. 素质表征社会文化语境因素对不同的 目标1和2中确定的心理社会脆弱性潜在类别。拟定的研究将 通过阐明系统性疾病对社会心理和健康的影响， 一个弱势群体和严重缺乏服务的移民男性之间的压迫。 这个R21项目的成功完成有很高的承诺，以告知和测试新的目标 公共卫生预防干预措施，以减少未来LM之间的健康差异负担 R 01应用程序。

Recent public health events have highlighted the disproportionate burden communities of color face in the U.S. as a result of chronic health disparities. Foreign-born immigrant Latino men (LM) have been found to be particularly likely to engage in risky behaviors (substance use, sexual risks) and less likely to seek out health care services when compared to Latina immigrant women. A growing body of research has documented the impact immigration-related stressors have on the mental health and substance use of LM. However, there is a gap in knowledge of how psychosocial vulnerability, in the form of a complex dynamic between racial discrimination, stigma, violence victimization and social isolation, contribute to health disparities. Guided by structural vulnerability theory, we will use a sequential explanatory mixed methods approach to first conduct latent class analyses to identify psychosocial vulnerability subgroups of LM (N=300) and associations with health outcomes. Next, we will develop deeper etiological understanding of identified latent classes by qualitatively characterizing subgroups based on the lived experience of participants (n=40). Specifically, this study aims to 1. Identify distinct psychosocial vulnerability (racial discrimination stigma, v iolence, social isolation) latent classes (e.g., hypothesized high, moderate, low classes) among LM in Baltimore; 2. Examine the individual (socio-demographics, legal status, English proficiency), and socio-contextual determinants (social support, family contact, living and working conditions) associated with each psychosocial vulnerability latent class (e.g., high, moderate, low), and their associations with health outcomes (drug and alcohol related problems, infection risk, mental health); and 3. Qualitatively characterize the influence socio-cultural contextual factors have on the distinct psychosocial vulnerability latent classes identified in Aims 1 & 2. The proposed study will advance scientific knowledge by elucidating the lived psychosocial and health effects of systemic oppression among a vulnerable and significantly underserved group of immigrant men. Successful completion of this R21 project has high promise to inform and test novel targeted public health prevention interventions to reduce health disparity burdens among LM in a future R01 application.