Suchergebnisse

This case study describes the process of conducting research on the social and cultural factors that shape young adults' sexual and romantic partnerships, sexual decision making, and perceptions of sexual risk. The research was conducted among a predominantly White, middle-class sample of students attending a 4-year university in the northeastern region of the United States. We discuss the impetus for the research and describe the process and procedures of collecting and analyzing sexual health data. By drawing on diverse data sources, including self-report demographic surveys, focus-group discussions, sexual life history interviews, and coital diaries, we triangulated the data to provide a rich, contextualized understanding of the structural, social, and cultural factors that shape sexual and romantic partnerships and patterns of communication and negotiation surrounding sexual behavior and sexual risk prevention. We discuss the challenges and successes of conducting sex research from collecting data to analyzing and interpreting data to publishing data.

This theoretical treatise uses the scientific literature concerning help seeking for mental illness among those with a background in the U.S. military to posit a more complex definition of military culture. The help-seeking literature is used to illustrate how hegemonic masculinity, when situated in the military field, informs the decision to seek formal treatment for mental illness among those men with a background in the U.S. military. These analyses advocate for a nuanced, multidimensional, and situated definition of U.S. military culture that emphasizes the way in which institutional structures and social relations of power intersect with individual values, beliefs, and motivations to inform and structure health-related practices.

Thousands of Mexicans and Central Americans settle in communities along the borderlands between Mexico and the United States. Many live and work in rural communities characterized by poverty and limited access to basic resources. Drawing on qualitative research, this article reports on inequalities and health among foreign-born Latinos in rural borderland communities. From 2015 to 2016, the study team conducted research in Inland Southern California's Eastern Coachella Valley with Mexican farmworkers, farmworker advocates, community leaders, healthcare service providers, and local political leaders. The analysis of field notes and interviews demonstrates how situational and temporal factors position this foreign-born population as vulnerable to inequalities across multiple social systems resulting in low social status, lack of employment and housing stability, and limited access to healthcare services. Over time, the experience of both situational life events and persistent and daily chronic strain infringes on self-concept, including mastery or control over life and self-worth, and contributes to stress and subsequent poor mental health outcomes (e.g., depression). The research calls for local community action, healthcare policy change, and further in-depth research on structural inequalities in health among foreign-born Latinos.

In this article, we show that the Veterans Health Administration (VA), similar to military organizations, is a gendered organization where women Veterans' experiences are embedded in and shaped by gender inequalities and structures of power. Based on an in‐depth analysis of women Veterans' substance use histories and VA treatment seeking experiences, we illustrate how gender power dynamics are (re)produced and maintained through everyday social interactions and organizational practices and processes that render women Veterans both visible and invisible: visible as sexual objects and invisible as suffering subjects. By retelling the illness and treatment experiences of women Veterans with trauma histories and co‐occurring substance use and mental health disorders—a highly stigmatized population of Veterans—we highlight the importance of giving voice to their concerns when developing policies and programs to address the unique health care needs of women Veterans.

Background A novel coronavirus, SARS-CoV-2 (known as COVID-19), spread rapidly around the world, affecting all and creating an ongoing global pandemic. In the United States, Latinx, African American, and Indigenous populations across the country have been disproportionately affected by COVID-19 cases and death rates. An examination of the perceptions and beliefs about the spread of the virus, COVID-19 testing, and vaccination amongst racial/ethnic minority groups is needed in order to alleviate the widespread disparity in new cases and deaths. Methods From November to December 2020 the research team conducted focus groups with members of Latinx farm-working communities in the Eastern Coachella Valley, located in the inland southern California desert region. A total of seven focus groups, six in Spanish and one in Purépecha, with a total of 55 participants were conducted. Topics covered include knowledge of the coronavirus, COVID-19 testing and vaccination. Results Using theme identification techniques, the findings identify structural factors that underly perceptions held by immigrant, migrant, and indigenous Latinx community members about COVID-19, which, in turn, shape attitudes and behaviors related to COVID-19 testing and vaccination. Common themes that emerged across focus groups include misinformation, lack of trust in institutions, and insecurity around employment and residency. Conclusions This racial/ethnic minority population is structurally vulnerable to historical and present-day inequalities that put them at increased risk of COVID-19 exposure, morbidity, and mortality. Findings from the focus groups indicate a significant need for interventions that decrease structural vulnerabilities by addressing issues of (dis)trust in government and public health among this population.

This study qualitatively examines the religious and spiritual dimensions of cutting down and stopping cocaine use among African Americans in rural and urban areas of Arkansas. The analyses compare and contrast the narrative data of 28 current cocaine users living in communities where the Black church plays a fundamental role in the social and cultural lives of many African Americans, highlighting the ways that participants used religious symbols, idiomatic expression, and Biblical scriptures to interpret and make sense of their substance-use experiences. Participants drew on diverse religious and spiritual beliefs and practices, including participation in organized religion, reliance on a personal relationship with God, and God's will to cut down and stop cocaine use. Our findings suggest that culturally sensitive interventions addressing the influence of religion and spirituality in substance use are needed to reduce cocaine use and promote recovery in this at-risk, minority population.

BackgroundSome veterans face multiple barriers to VA mental healthcare service use. However, there is limited understanding of how veterans' experiences and meaning systems shape their perceptions of barriers to VA mental health service use. In 2015, a participatory, mixed-methods project was initiated to elicit veteran-centered barriers to using mental healthcare services among a diverse sample of US rural and urban veterans. We sought to identify veteran-centric barriers to mental healthcare to increase initial engagement and continuation with VA mental healthcare services.MethodsCultural Domain Analysis, incorporated in a mixed methods approach, generated a cognitive map of veterans' barriers to care. The method involved: 1) free lists of barriers categorized through participant pile sorting; 2) multi-dimensional scaling and cluster analysis for item clusters in spatial dimensions; and 3) participant review, explanation, and interpretation for dimensions of the cultural domain. Item relations were synthesized within and across domain dimensions to contextualize mental health help-seeking behavior.ResultsParticipants determined five dimensions of barriers to VA mental healthcare services: concern about what others think; financial, personal, and physical obstacles; confidence in the VA healthcare system; navigating VA benefits and healthcare services; and privacy, security, and abuse of services.ConclusionsThese findings demonstrate the value of participatory methods in eliciting meaningful cultural insight into barriers of mental health utilization informed by military veteran culture. They also reinforce the importance of collaborations between the VA and Department of Defense to address the role of military institutional norms and stigmatizing attitudes in veterans' mental health-seeking behaviors.

BackgroundSome veterans face multiple barriers to VA mental healthcare service use. However, there is limited understanding of how veterans' experiences and meaning systems shape their perceptions of barriers to VA mental health service use. In 2015, a participatory, mixed-methods project was initiated to elicit veteran-centered barriers to using mental healthcare services among a diverse sample of US rural and urban veterans. We sought to identify veteran-centric barriers to mental healthcare to increase initial engagement and continuation with VA mental healthcare services.MethodsCultural Domain Analysis, incorporated in a mixed methods approach, generated a cognitive map of veterans' barriers to care. The method involved: 1) free lists of barriers categorized through participant pile sorting; 2) multi-dimensional scaling and cluster analysis for item clusters in spatial dimensions; and 3) participant review, explanation, and interpretation for dimensions of the cultural domain. Item relations were synthesized within and across domain dimensions to contextualize mental health help-seeking behavior.ResultsParticipants determined five dimensions of barriers to VA mental healthcare services: concern about what others think; financial, personal, and physical obstacles; confidence in the VA healthcare system; navigating VA benefits and healthcare services; and privacy, security, and abuse of services.ConclusionsThese findings demonstrate the value of participatory methods in eliciting meaningful cultural insight into barriers of mental health utilization informed by military veteran culture. They also reinforce the importance of collaborations between the VA and Department of Defense to address the role of military institutional norms and stigmatizing attitudes in veterans' mental health-seeking behaviors.

Using anti-oppressive methodologies, the Chihuum Piiuywmk Inach/Gathering of Good Minds (CPI/GoGM) project reimagined inclusive pathways for data analysis in health equity Community Engaged Research (CER). Transformations in CER methodologies that decenter colonial and institutional systems of oppression and center Indigenous epistemologies are on the rise. There is, however, a paucity of guidance on data analysis in CER. The CPI/GoGM's historical trauma project is a grounded demonstration of inclusion and building relational research spaces that support Indigenous epistemologies. Community inclusion in data analysis is an intervention and next step for equity in CER and a call for epistemic justice.