Hardship and Survival: The Impact of Migration-Related Trauma, Communal Coping, and Social Stressors on the Suicide and Mental Health Outcomes of Latina Immigrant Women

困难与生存：与移民相关的创伤、共同应对和社会压力因素对拉丁裔移民妇女自杀和心理健康结果的影响

• 批准号: 10750613
• 负责人: Laura Rebeca Mata Lopez
• 金额: $ 4.77万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-10-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10750613
• 关键词: Address; Adopted; Adult; Anxiety; Area; Baltimore; Cause of Death; Cessation of life; Chronic; Chronic Disease; Chronic stress; Collaborations; Communities; Complex; Conflict (Psychology); Country; Cross-Sectional Studies; Development; Discipline of Nursing; Disease Management; Disparity; Dissemination and Implementation; Documentation; Economics; Exposure to; Face; Family member; Feedback; Feeling suicidal; Focus Groups; Funding; Future; Gender; Growth; Health; Immigrant; Immigrant community; Individual; International; Interview; Kidnappings; Knowledge; Language; Latin America; Latina; Latina Population; Latino; Legal; Length; Life Cycle Stages; Literature; Mental Depression; Mental Health; Mentorship; Methods; National Institute on Minority Health and Health Disparities; Natural Disasters; Nurses; Outcome; Pattern; Personal Satisfaction; Politics; Population; Positioning Attribute; Post-Traumatic Stress Disorders; Provider; Religiosity; Research; Research Personnel; Resources; Review Literature; Risk; Risk Factors; Ritual compulsion; Science; Self Efficacy; Severities; Shapes; Social isolation; Social support; Spirituality; Strategic Planning; Stress; Suicide; Suicide attempt; Suicide prevention; Survey Methodology; Symptoms; Time; Trauma; United States; United States National Institutes of Health; Violence; Well in self; Woman; Work; aged; commune; community based participatory research; community engagement; coping; deprivation; experience; healing; health equity promotion; innovation; member; metropolitan; migration; minority health; minority health disparity; novel; outcome disparities; poor health outcome; pre-doctoral; preventive intervention; promote resilience; protective factors; psychological distress; psychosocial; racism; resilience; resilience factor; sexual assault; social determinants; social health determinants; social stressor; suicidal risk; systematic review; trauma exposure

PROPOSAL SUMMARY Migration is a social determinant of health which has profound and long-lasting health consequences, and contributes to the significant disparities in mental health outcomes experienced by Latina immigrants. Shifts in migration patterns from Latin America over the last decades – driven in part by sociopolitical conflict, organized violence, and evolving gender norms – have contributed to unprecedented growth in the population of Latinas in the US. Latina immigrants face cumulative exposure to an array of traumatic experiences before, during, and after migration – including sexual assault, natural disasters, kidnapping, separation from/and death of family members, and deprivation of basic needs. These are deeply traumatic experiences which are associated with poor mental health outcomes (posttraumatic stress disorder, depression and anxiety). Presently, suicide is a leading cause of death among Latinas in the U.S., but there is limited research seeking to identify the distinct factors that heighten the risk of suicide and that promote resilience among Latina immigrants. Furthermore, there is a significant gap in knowledge regarding Latina immigrant’s lived experiences with suicide and migration- related trauma and understanding how these women utilize communal and cultural resources – such as communal coping, collective rituals, and traditional gatherings – to cope with the collective impact of migration- related trauma and chronic stress. This exploratory sequential mixed-methods study aims to generate a rich understanding of the experiences of Latina immigrants with migration-related trauma, suicide and suicidal ideation, and social stressors, and to identify salient cultural and communal factors that shape these experiences. This will be accomplished through the following aims: 1a) explore how exposure to migration-related trauma, communal coping, and social stressors influence the risk of suicidal ideation and mental health symptoms among adult Latina immigrants (n=20) using individual interviews and focus groups; 1b) understand community providers’ and team members’ (promotoras, nurses, and clinicians) (n=16-20) perspectives of how migration- related trauma, communal coping, and social stressors impact the mental health outcomes of Latina immigrants using focus groups; 2) examine how migration-related trauma, social stressors, communal coping and other salient cultural, migratory, and communal factors impact suicidal ideation and mental health symptoms among Latina immigrants using a cross-sectional survey; and 3) collaborate with community partners and the community advisory board to interpret and integrate findings and identify risk and resilience factors that shape experiences with suicide and the mental health outcomes of Latina immigrants. This innovative study builds on over a year of preliminary work, including community engagement efforts, a systematic review of the literature and concept analysis, and conceptual framework development. We center the cultivation of collaborations between the PI, mentorship team, our community partners at Centro SOL, and the Latino(a) immigrant community in the Baltimore Metropolitan Area. To our knowledge, this innovative proposal will be the first to explore the impact of migration-related trauma (across the stages of migration), social stressors, communal coping, and other salient cultural and communal factors on the mental health outcomes of Latina immigrants.

提案摘要 移徙是健康的一个社会决定因素，对健康产生深远和持久的影响， 导致了拉丁裔移民在心理健康方面的显著差异。变化 过去几十年来，拉丁美洲的移民模式-部分是由社会政治冲突驱动的， 暴力和不断演变的性别规范-促成了拉丁美洲人口的前所未有的增长， 美方拉丁裔移民面临着累积暴露于一系列的创伤经历之前，期间， 移徙后-包括性攻击、自然灾害、绑架、与家人分离/和家人死亡 成员，以及剥夺基本需求。这些都是深深的创伤经历， 心理健康状况不佳（创伤后应激障碍、抑郁和焦虑）。目前，自杀是一种 是美国拉丁裔的主要死因但目前的研究有限， 这些因素增加了自杀的风险，并促进了拉丁美洲移民的恢复力。而且 是关于拉丁裔移民自杀和移民的生活经历的知识的一个重大差距- 相关的创伤和了解这些妇女如何利用社区和文化资源-如 社区应对、集体仪式和传统集会-以科普移民的集体影响- 相关的创伤和慢性压力。这种探索性的顺序混合方法研究旨在产生丰富的 了解拉丁裔移民与移民有关的创伤，自杀和自杀的经历 构思，和社会压力，并确定突出的文化和社区因素，塑造这些经验。 这将通过以下目标来实现：1a）探索如何暴露于与移民有关的创伤， 社区应对和社会压力因素影响自杀意念和精神健康症状的风险， 成年拉丁裔移民（n=20）使用个人访谈和焦点小组; 1b）了解社区 提供者和团队成员（发起人、护士和临床医生）（n=16-20）对迁移方式的看法- 相关的创伤，社区应对和社会压力影响拉丁美洲移民的心理健康结果 2）研究与移徙有关的创伤、社会压力源、社区应对和其他 突出的文化，迁移和社区因素影响自杀意念和心理健康症状， 拉丁裔移民使用横断面调查;和3）与社区合作伙伴和社区合作 一个咨询委员会，负责解释和整合调查结果，并确定影响经验的风险和复原力因素 拉丁裔移民的自杀和心理健康结果。这项创新的研究建立在一年多的时间里 初步工作，包括社区参与工作，对文献和概念的系统审查 分析和概念框架的发展。我们的中心是培养私家侦探， 导师团队，我们在Centro SOL的社区合作伙伴，以及拉丁美洲（a）移民社区， 巴尔的摩都会区。据我们所知，这一创新提案将首次探讨 与移徙有关的创伤（跨越移徙的各个阶段）、社会压力源、社区应对和其他突出问题 文化和社区因素对拉丁裔移民心理健康的影响。