Suchergebnisse

Abstract
Syrian refugees in Germany number around 700,000 and they are managing acculturation and mental health issues. In May–July 2018, we conducted a cross-sectional survey among 97 Syrian refugees in Germany using measures of acculturation, social support, depressive symptoms and wellbeing. We ran linear-regression models and created an interaction term of two aspects of acculturation, focused on the outcomes of depressive symptoms and wellbeing, along with the possible moderation of social support. Affiliation with German culture was positively associated with wellbeing. More acculturation to German culture may promote positive mental health. Higher levels of social support were associated with lower levels of wellbeing and higher levels of depressive symptoms; this could reflect reverse causality or more connections with those back home. This study provides insight into acculturation and mental health among a significant refugee population in Germany.

Objective: Cost-related nonadherence to health maintenance behaviors is common in the general population, yet we know little about these behaviors in Middle East and North African (MENA) Americans. We examined cost-related nonadherence (CRN) in the MENA community in SE Michigan to determine demographic predictors, and risk and protective factors.Design, Setting, and Participants: We used data from a cross-sectional convenience sample of MENA adults (N=398) conducted May-September 2019 to identify relevant demographic predictors, as well as the as­sociation between individual health, social, and clinical factors and the likelihood of reporting CRN.Methods and Measures: CRN was defined by whether respondents reported any of the following: that they took less medi­cine, skipped doses, or delayed getting a prescription filled. Other factors included patient/provider communication and racial concordance, mental health distress, food insecurity and insurance status. We used multivariable logistic regression models to determine association of these health and social factors with CRN.Results: Those with highest incomes were least likely to report CRN. Participants with private insurance and with no coverage were more likely to report CRN compared with those with Medicaid coverage. Risk factors for CRN included food insecurity and mental health distress, though strong patient/provider communication was pro­tective of CRN.Discussion: The risk factors for CRN in the MENA community align with risk factors in the general population. As provider commu­nication is protective of CRN, interventions focused on improving patient/provider com­munication may serve as a way to protect against financially motivated medication nonadherence. Ethn Dis. 2022;32(1):11-20; doi:10.18865/ed.32.1.11

Purpose: Examine association between emotional valence and intensity prompted by anti-tobacco advertising messages and perceived ad effectiveness among youth/young adults. Design: Online forced-exposure survey data from a nationally weighted, cross-sectional sample of youth/young adults, collected periodically over a 4-year period. Setting: National. Participants: Thirty-seven cross-sectional surveys conducted online from June 2015 to January 2018; total N = 9534. All participants, aged 15 to 21, were in the intervention; no control group. Intervention: Individuals participating in premarket testing of truth ads were forced exposed to one of 37 anti-tobacco ads. Measures: Emotional response, emotional intensity, and perceived ad effectiveness. Emotional response has been previously studied and measured. Including the discrete measure of "concerned" in positive emotions is unique to our study. It patterned with the other positive emotions when each ad was examined by each emotion. Intensity as measured in this study through the 5-point scale ("how much does this ad make you feel") is unique in the anti-tobacco ad literature. Although several past studies ranked the degree of emotion elicited by ads, they have not incorporated the intensity of emotion as reported by the participant themselves. The scale was used to determine whether perceived ad effectiveness is similar to those used in previous studies. Analysis: Linear regressions were estimated to assess type of emotional sentiment and level of intensity in relation to perceived effectiveness of the message. Results: All 9534 participants were exposed; no control group. The βs indicate how strongly the emotion variable influences the study outcome of perceived ad effectiveness. Positive emotions (β = .76) were more highly associated with perceived ad effectiveness (β = .06). Higher intensity with positive emotional sentiment and high-intensity negative produced the highest scores for perceived ad effectiveness (β = .30). Conclusion: Eliciting a positive, high-impact emotional response from viewers can help improve perceived effectiveness, and in turn, overall ad effectiveness.

<p class="Pa7"><strong>Objective: </strong>To examine the relationship between menthol perceptions and support for a national menthol ban.</p><p class="Pa7"><strong>Design: </strong>Descriptive cross-sectional study.</p><p class="Pa7"><strong>Participants: </strong>Data were collected from a nationally representative probability-based panel of adults aged ≥18 years during June 21, 2016 through July 18, 2016. A total of 1,303 respondents, including an oversample of 300 African Americans, completed the survey.</p><p class="Pa7"><strong>Main Outcome Measures: </strong>Weighted logistic regression models examined the relationship between menthol perceptions, specifically related to health and addiction, and the outcome measure: support for a menthol ban, by menthol smoking status. All models controlled for age, sex, education level, and race/ethnicity.</p><p class="Pa7"><strong>Results: </strong>The association between reporting accurate menthol health perceptions dif­fered by menthol preference. Among non-menthol smokers, there was no association between accurate menthol health percep­tions and support of a menthol ban while more accurate menthol perceptions of ad­diction were associated with greater support of a menthol ban (aOR=2.83, CI=1.19- 6.72). Among menthol smokers, more accurate health-related menthol percep­tions were associated with increased odds of supporting a menthol ban (aOR=3.90, CI=1.02-14.79) while more accurate men­thol addiction perceptions were not.</p><p><strong>Conclusions: </strong>Fewer current menthol smok­ers support a menthol ban than current non-menthol smokers given its effect on their preferred product. Given the large proportions of smokers who have misper­ceptions of the health consequences and addictive properties of menthol, there is a moral imperative to inform those who use these products. Findings suggest the need for tailored messaging strategies targeted to reach menthol smokers who will be most impacted by a ban, but also have the most to gain from such a policy change.</p><p><em>Ethn Dis. </em>2018;28(3):177-186; doi:10.18865/ ed.28.3.177.</p>

Abstract
Background
Southeast Michigan is home to the second largest Middle Eastern and North African (MENA) US population. There is increasing interest in understanding correlates of psychosocial outcomes and health behaviors in this growing population. One potentially important health correlate is ethnic identity (EI). This paper reports the development, validity, and initial correlates of a new measure of MENA identity named the MENA-IM.

Methods
We used convenience sampling at locations frequented by individuals of MENA descent in southeast Michigan. We also measured EI centrality, religiosity, cultural mistrust, substance use, and health status to assess convergent and divergent validity. Exloratory and Confirmatory Factor Analysis identified three subscales, which were valid for both Arab and Chaldean respondents and were named (1) MENA cultural affiliation, (2) MENA media use, and (3) multicultural affiliation. We also created and tested a 20-item, single-factor version.

Results
We obtained data from 378 adults, 73% of whom identified as Arab and 27% as Chaldean. MENA-IM scores were higher among older, lower-educated, lower-income, non-US born, and Arabic-speaking respondents. Arab respondents reported significantly higher scores than Chaldeans. MENA-IM scores were positively associated with EI centrality and religiosity. Higher MENA-IM scores were found among those not reporting use of marijuana, alcohol, and opiates. Higher MENA-IM scores were also found among those without a self-reported history of heart disease and among those with better mental health status.

Discussion
The MENA-IM has strong psychometric properties and demonstrated initial evidence of convergent and discriminant validity. In general, values on the measure were associated with better psychosocial and health status. How the measure performs with MENA populations outside of Michigan and how it may relate to other health outcomes merit investigation.