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强调了颜色的不成比例负担社区 由于慢性健康差异，在美国面临。外国出生的移民拉丁裔男人 （LM）已发现（LM）特别可能从事风险行为（使用物质， 性风险），与拉丁裔移民相比，寻求医疗服务的可能性较小 女性。越来越多的研究记录了与移民相关的压力源的影响 具有LM的心理健康和药物使用。但是，了解 种族之间的复杂动态形式的社会心理脆弱性如何 歧视，污名，暴力受害和社会隔离，有助于健康 差异。在结构脆弱性理论的指导下，我们将使用连续的解释性混合 首先进行潜在类别分析以识别社会心理脆弱性的方法 LM的亚组（n = 300）和与健康结果的关联。接下来，我们将更深入地发展 通过定性表征亚组对已识别潜在类别的病因理解 根据参与者的生活经验（n = 40）。具体来说，这项研究的目的是确定1。 独特的社会心理脆弱性（种族歧视污名，V iolence，社会隔离）潜在 巴尔的摩LM中的LM中的类（例如，假设的高，中，低等的阶级）； 2。检查 个人（社会人口统计学，法律地位，英语能力）和社会上下文 决定因素（社会支持，家庭联系，生活和工作条件） 每个社会心理脆弱性潜伏类别（例如，高，中，低）及其关联 与健康结果（毒品和酒精有关的问题，感染风险，心理健康）；和3。 定性地描述了社会文化上下文因素对独特的影响的影响 AIMS 1和2中确定的社会心理脆弱性潜在类别。拟议的研究将 通过阐明系统性的生活心理和健康影响来提高科学知识 在一群脆弱且服务不足的移民人群中的压迫。 这个R21项目的成功完成具有很高的希望，可以为目标提供信息和测试 预防公共卫生的干预措施，以减轻LM之间的健康差异负担 R01应用程序。