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

识别与巴尔的摩拉丁裔移民男性健康状况相关的结构性脆弱性潜在类别

• 批准号: 10810511
• 负责人: Nalini Negi
• 金额: $ 23.18万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-24 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10810511
• 关键词: Acquired Immunodeficiency Syndrome; Address; Baltimore; Behavioral; Black race; Chronic; Cities; Color; Complex; Economic Policy; Environment; Ethnography; Etiology; Event; Exposure to; Face; Family; Future; HIV; HIV diagnosis; Health; Health Services; Health Services Accessibility; Heterogeneity; Immigrant; Immigration; Individual; Inequity; Intervention; Knowledge; Latina; Latino; Latino Population; Legal; Legal Status; Literature; Mental Health; Mental Health Services; Methods; Migrant; Not Hispanic or Latino; Outcome; Participant; Pharmaceutical Preparations; Policies; Population; Poverty; Predisposition; Prevention; Public Health; Reduce health disparities; Research; Risk; Risk Behaviors; Risk Factors; Role; Scientific Advances and Accomplishments; Shapes; Social Hierarchy; Social Policies; Social isolation; Social support; Subgroup; Testing; Underserved Population; Variant; Violence; Woman; alcohol related problem; behavior influence; community burden; contextual factors; experience; health care service; health disparity; health equity; health service use; high risk; infection risk; male health; men; novel; preventive intervention; psychosocial; racial discrimination; residence; social; social culture; social stigma; sociodemographics; stressor; structural determinants; substance use; theories; violence victimization

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.

最近的公共卫生事件突显了有色人种社区不成比例的负担 由于长期的健康差距，美国人面临着严重的健康问题。外国出生的拉美裔移民男子 (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更小 女人。越来越多的研究记录了移民相关压力源的影响 对心理健康和物质使用的影响。然而，对……的认识存在差距。 心理社会脆弱性，以种族之间复杂动态的形式 歧视、耻辱、暴力受害和社会孤立有助于健康 差距。在结构脆弱性理论的指导下，我们将采用顺序解释混合的方法 首先进行潜在类别分析以识别心理社会脆弱性的方法 肌萎缩侧索硬化症亚型(N=300)及其与健康结局的关系。接下来，我们将更深入地开发 通过定性刻画亚群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)。具体地说，这项研究的目的是1.确定 明显的心理社会脆弱性(种族歧视污名、情感、社会孤立)潜伏 在巴尔的摩的LM之间的类别(例如，假设的高、中、低类别)；2.检查 个人(社会人口统计、法律地位、英语水平)和社会背景 决定因素(社会支持、家庭联系、生活和工作条件) 每一心理社会脆弱性潜在类别(例如，高、中、低)及其关联 与健康结果有关(与药物和酒精有关的问题、感染风险、精神健康)； 定性地描述社会文化背景因素对不同 目标1和目标2中确定的心理社会脆弱性潜在类别。拟议的研究将 通过阐明系统性肺炎对生活、心理、社会和健康的影响来推进科学知识 在弱势和服务严重不足的移民男性群体中的压迫。 该R21项目的成功完成对通知和测试有针对性的小说具有很高的前景 公共卫生预防干预措施在未来减轻农村居民健康差距中的作用 R01应用程序。