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 移徙是健康的社会决定因素，对健康产生深远而持久的影响， 造成拉丁裔移民心理健康结果的显着差异。 过去几十年拉丁美洲的移民模式——部分是由社会政治冲突驱动的，有组织的 暴力和不断演变的性别规范——导致拉丁美洲人口空前增长 美国的拉丁裔移民在之前、期间和期间都面临着一系列痛苦的经历。 移民后——包括性侵犯、自然灾害、绑架、与家人分离/和家人死亡 成员，以及基本需求被剥夺，这些都是与此相关的深刻创伤经历。 心理健康状况不佳（创伤后应激障碍、抑郁和焦虑）。 是美国拉丁裔死亡的主要原因，但试图找出不同原因的研究有限 此外，还有一些因素会增加拉丁裔移民的自杀风险并提高其适应能力。 关于拉丁裔移民的自杀和移民生活经历的知识存在重大差距- 相关的创伤并了解这些妇女如何利用公共和文化资源——例如 公共应对、集体仪式和传统聚会——以应对移民的集体影响—— 这项探索性序贯混合方法研究旨在产生丰富的内容。 了解拉丁裔移民的移民相关创伤、自杀和自杀经历 观念和社会压力源，并确定塑造这些经历的显着文化和社区因素。 这将通过以下目标来实现：1a）探索如何暴露于移民相关的创伤， 公共应对和社会压力会影响自杀意念和心理健康症状的风险 成年拉丁裔移民 (n=20) 通过个人访谈和焦点小组了解社区； 提供者和团队成员（促销员、护士和主教）（n=16-20）对移民如何 相关的创伤、公共应对和社会压力会影响拉丁裔移民的心理健康结果 利用焦点小组；2) 研究与移民有关的创伤、社会压力、社区应对和其他问题 显着的文化、移民和社区因素影响自杀意念和心理健康症状 使用横断面调查的拉丁裔移民；3) 与社区合作伙伴和社区合作； 咨询委员会解释和整合调查结果并确定塑造体验的风险和复原力因素 这项创新研究以一年多的时间为基础，研究了拉丁裔移民的自杀和心理健康状况。 初步工作，包括社区参与工作、对文献和概念的系统回顾 我们重点培养 PI 之间的合作， 导师团队、Centro SOL 的社区合作伙伴以及拉丁美洲 (a) 移民社区 据我们所知，这项创新提案将是第一个探讨巴尔的摩都会区影响的提案。 与移徙相关的创伤（跨越移徙阶段）、社会压力、共同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结果的影响。