Tracy Chu

Intimate Partner Violence among West African Immigrants

Although the number of African immigrants arriving to the United States has increased significantly, there has been little investigation regarding their experiences of intimate partner violence or coping strategies. This study used focus groups and individual interviews to explore intimate partner violence among 32 heterosexual West African immigrants. Results suggest that although cultural expectations influence their coping strategies, West African–born men and women face different realities, with women reporting multiple instances of abuse and a sense of frustration with the existing options for assistance. Although participants discussed multilevel support structures within the immediate West African community to address intimate partner violence, all of these options maintained a gender hierarchy, leaving women dissatisfied. Challenges and barriers to partner violence resolution and coping strategies are identified. Results are examined in terms of their implications for addressing the needs of this underserved population. Implications for future research and services are discussed and highlighted.

Effects of Post-migration Factors on PTSD Outcomes Among Immigrant Survivors of Political Violence

This study examined the predictors of posttraumatic stress disorder (PTSD) in a clinical sample of 875 immigrant survivors of political violence resettled in the United States, with a specific aim of comparing the relative predictive power of pre-migration and post-migration experiences. Results from a hierarchical OLS regression indicated that pre-migration experiences such as rape/sexual assault were significantly associated with worse PTSD outcomes, as were post-migration factors such as measures of financial and legal insecurity. Post-migration variables, which included immigration status in the US, explained significantly more variance in PTSD outcomes than premigration variables alone. Discussion focused on the importance of looking at postmigration living conditions when treating trauma in this population.

Exploring Female Genital Cutting Among Survivors of Torture.

Though the practice of female genital cutting (FGC) has been framed as a form of gender-based torture, few studies have examined the prevalence and impact of the practice among documented survivors of torture. This article presents a secondary analysis of data from 514 African-born women at an interdisciplinary clinic for survivors of torture. Results indicate few demographic differences between those who experienced FGC and those who had not, though a larger proportion of the FGC group were West African and identified as Muslim. Many with FGC were in the process of applying for asylum, reported sexual and psychological torture, and cited gender as a basis for their persecution. The FGC group evidenced unique correlates related to immigration status and psychological and sexual torture experiences that the non-FGC group did not. Findings indicate that female survivors of torture with FGC represent a distinct group with specific mental health needs.

Forced Migration and Psychotic Symptoms: An Analysis of the National Latino and Asian American Study

Immigrants report more psychotic symptoms than native-born populations. This study used data from the U.S.-based, nationally representative and culturally validated National Latino and Asian American Study to investigate whether refugees are at higher risk of psychotic symptoms than voluntary migrants. In this study, refugee status predicted more psychotic symptoms. Effects remained significant in most models after controlling for demographic covariates and traumatic experiences, however the direction of the effect differed for pre- versus post-migration periods. The study concludes that refugees are at higher risk for developing psychotic symptoms, which arise among refugees more often in the pre-migration period and less often post-migration.

The Social Ecology of Resolving Family Conflict Among West African Immigrants in New York: A Grounded Theory Approach

The current study employs a grounded theory approach to examine West African immigrants’ resolution of parent–child conflict and intimate partner conflict. Data from 59 participants present an interactive social ecological framework, where a lack of resolution at one level results in attempts to resolve problems at higher levels. Four levels are identified within West African immigrants’ problem solving ecology, each with specific actors in positions of authority: individual/dyadic (parents and spouses), extended family (which includes distant relatives and relatives living in home countries), community leadership (non-family elders and religious leaders), and state authorities. From participants’ descriptions of family challenges emerged a picture of a social ecology in flux, with traditional, socially conservative modes of resolving family conflict transposed across migration into the more liberal and state-oriented familial context of the United States. This transposition results in a loss spiral for the traditional social ecology, differentially affecting individual actors within families. Implications for helping professionals working with new immigrant communities include identifying variability in openness to adapting structures that are not working well (e.g., patriarchal protection of abusive husbands) and supporting structures known to be associated with well being (e.g., collective monitoring of youth).

Exploring Caregiver Behavior and Knowledge About Unsafe Sleep Surfaces in Infant Injury Death Cases

Objectives. In the United States, infant deaths due to sleep-related injuries have quadrupled over the past two decades. One of the major risk factors is the placement of an infant to sleep on a surface other than a crib or bassinet. This study examines contextual circumstances and knowledge and behaviors that may contribute to the placement of infants on an unsafe sleep surface in infant injury death cases. Method. This study employed a retrospective review of 255 sleep-related injury death cases in New York City from 2004 to 2010 where an infant was found sleeping on an unsafe sleep surface. Mixed-methods analyses, employing both quantitative analysis of vital statistics data and risk variables extracted from the medical examiner files and qualitative analysis of the narrative content of the files, were conducted. Results. In 48% of cases, a crib or bassinet was identified in the home. Quantitative analysis revealed no significant differences in demographic or risk factor characteristics between infants who had a crib or bassinet and those who did not. Qualitative analysis highlighted factors in caregivers’ decision making related to situational convenience, preference, and misconceptions concerning safe infant sleep. The health belief model (HBM), specifically the constructs of perceived susceptibility, severity, benefits, and barriers, was used as a lens to understand factors associated with caregiver behavior. Conclusions. This study provides evidence that infants are at risk of sleep-related injury death even when a crib or bassinet is present. Understanding the factors that may influence safe sleep behaviors can help produce more appropriate interventions.

Health Outcomes and Attitudes Toward Female Genital Cutting in a Community-Based Sample of West African Immigrant Women from High-Prevalence Countries in New York City

ABSTRACT Female genital cutting (FGC), a deeply rooted cultural practice with high prevalence rates in many West African countries, is considered by many to represent systematic gender-based violence and human rights violation. Although short- and long-term health consequences of FGC have been examined in studies in Africa, the experiences of women who have immigrated to the Western countries such as the United States have remained largely unexplored. We sought to examine prevalence rates of FGC, as well as differences in demographic characteristics, health outcomes, and knowledge, attitudes, and beliefs among West African immigrants. This study employed audio computer-assisted self-interviewing with a community-based sample of 68 women from Gambia, Guinea, Mali, and Sierra Leone living in New York City. The rate of FGC was 68% overall and varied significantly by country, tribe or ethnicity, and marital status. Women with FGC had a significantly higher number of live births and were more likely to report a history of vaginal pain and decreased sexual arousal, but there were no other significant differences in gynecological and obstetric outcomes, sexual functioning, or psychological outcomes. Participants also had similar rates of opposition to FGC, although women with FGC were less likely to assert human rights as a reason to end the practice. Women reported a high level of surprise and unpreparedness for the FGC procedure, and 22% reported that it was done without their parents’ consent. Long-term health consequences of FGC among women who have immigrated remain unclear, although resistance to the practice is overwhelming.

Maternal nativity and sleep-related infant injury deaths in New York City.

BACKGROUND Half of all births in New York City are to women born outside of the United States whose infant care practices may differ from official recommendations from the American Academy of Pediatrics. These infants have an overall lower infant mortality rate than those of their US-born counterparts. AIMS The aims of this study were to examine sleep-related infant injury death, a leading cause of infant mortality, and its risk factors among infants of US-born and foreign-born women in a large, diverse urban area. STUDY DESIGN Data for 344 infant death cases from medical examiner and vital statistics records were analyzed. Rate ratios and 95% CIs, calculated with Poisson regression models, were used to quantify differences in death rates by maternal and infant characteristics. Bivariate and logistic regression analyses were used to examine differences within the sample of sleep-related infant injury deaths. OUTCOME MEASURES The outcome measures were rate of sleep-related injury death, and behavioral risk factors associated with these deaths: unsafe sleep positioning, bed-sharing, and excess bedding. RESULTS US-born mothers had a sleep-related infant injury death rate that was over three times that of foreign-born mothers, even when controlling for maternal race/ethnicity, education, and age. However, adverse sleep-related practices were not consistently more prevalent among US-born infants in the sample of deaths, even when controlling for those same demographic factors. CONCLUSIONS The higher rate of sleep-related infant injury death among infants of US-born mothers may be explained by more complex socio-demographic factors, or factors outside of infant sleep practices.

Trait emotional intelligence, coping, and occupational distress among resettlement workers.

Objective: Trait emotional intelligence has recently emerged as a negative predictor of work-related distress. However, research that considers the mechanisms underlying the relationship between trait emotional intelligence and distress is lacking, in particular among workers with emotionally intensive occupations. The purpose of this study was to analyze the mediating pathway of coping behaviors in the relations between trait emotional intelligence, and work-related distress outcomes, namely secondary traumatic stress and job burnout in a sample of refugee resettlement workers. Method: Participants were 210 resettlement workers from six organizations in the United States who completed a questionnaire. Questions included self-reported measures of secondary traumatic stress, burnout, trait emotional intelligence, coping behaviors, and history of trauma. The majority of participants identified as White (64.9%) and female (73.6%). The average participant was 32.96 years old (SD = 10.22) and was employed in the same position for 2.64 years (SD = 4.67). Results: Unhealthy coping (e.g., substance use and denial), emerged as a significant mediator of the relations between trait emotional intelligence and the outcomes, with 43% and 64% of the total effects for secondary traumatic stress and burnout mediated. Specifically, trait emotional intelligence negatively related to secondary traumatic stress and burnout via a reduction in unhealthy coping behaviors, rather than an increase in healthy coping ones. Conclusions: Training programs promoting the psychological well-being of employees often focus on the promotion of healthy coping practices. These results suggest the potential value of including trait emotional intelligence training in the development of such programs.

Secondary Traumatic Stress and Burnout Among Refugee Resettlement Workers: The Role of Coping and Emotional Intelligence: Secondary Traumatic Stress and Burnout Among Refugee Resettlement Workers

To promote a better understanding of the impact of refugee resettlement work on refugee resettlement workers, this study examined the prevalence rates of deleterious mental health and occupational outcomes, such as secondary traumatic stress and burnout, among a sample of 210 refugee resettlement workers at six refugee resettlement agencies in the United States. The study also explored coping mechanisms used by service providers to manage work-related stress and the influence of such strategies and emotional intelligence on secondary traumatic stress and burnout. Our findings show that certain coping strategies, including self-distraction, humor, venting, substance use, behavioral disengagement, and self-blame, were strongly related to deleterious outcomes, βs = .18 to .38, ps = .023 to < .001. Emotional intelligence was a negative correlate for all outcomes, βs = -.25 to -.30, ps < .001, above and beyond the effects of trauma, coping styles, job, and demographic characteristics. These findings have potential implications for clinical training and organizational policy regarding refugee mental health.