Although a large number of Muslim refugees have resettled in the United States for the last decades, few studies have looked into maternal healthcare access and utilization among Muslim refugee women in the country. This qualitative study was conducted to explore the factors influencing maternal healthcare access and utilization among Muslim refugee women resettled in the United States. In-depth interviews were conducted among Afghan, Iraqi, and Syrian refugee women (n = 17) using an interview guide informed by Social Cognitive Theory and its key constructs. The interviews were recorded and transcribed verbatim, imported into MAXQDA 2020 (VERBI Software), and analyzed based on qualitative content analysis. Data analysis revealed several themes at the micro, meso, and macro-levels. Micro-level factors included women\'s attitudes toward hospitals and prenatal care, as well as their life skills and language proficiency. Meso-level factors, such as cultural norms and practices, social support and network, as well as health care provider characteristics, were also identified. Macro-level factors, such as the complex healthcare system and access to insurance, also appeared to influence maternal healthcare access and utilization. This study revealed the complex contextual factors that refugee populations face. Given the population\'s heterogeneity, a more nuanced understanding of refugee maternal health is required, as are more tailored programs for the most vulnerable groups of refugee women.

BACKGROUND: Colombia has high numbers of internally displaced people, forced to migrate due to the conflict. 1 in 3 displaced women undergo pregnancy during adolescence, compared to around 1 in 5 in the non-displaced population, alongside health and resource inequalities between these groups. There is limited qualitative information available from the perspectives of displaced women experiencing adolescent pregnancy. This research explores how structural violence may feature in their experiences.
METHODS: Qualitative methods were used. Participants were recruited with purposive sampling, using key informants and snowball sampling technique. 14 semi-structured interviews were conducted in Ciudad Bolívar, Bogotá, involving 11 displaced women who began childbearing age 15-19 in the past 10 years, and 4 participants\' mothers. Data was analysed using the theoretical framework of structural violence, and emergent themes categorised using thematic analysis.
RESULTS: Pregnancy was considered advantageous in many ways, but this was contradicted by resulting disadvantages that ensued. Structural violence was embedded in life stories, manifesting in poverty and difficulties accessing reliable income, poor access to healthcare and education following pregnancy. Institutional and interpersonal discrimination confounded these challenges.
CONCLUSIONS: Pregnancy during adolescence was a contradictory experience, representing both a safety net and a trap due to a complex interplay of structural and cultural violence in everyday survival. Policymakers must consider the importance of the context surrounding adolescent pregnancy and address systematic disadvantages affecting women in these positions.
The violent conflict in Colombia has left many people forced to leave their homes and become ‘internally displaced’. Internally displaced women are more likely to become pregnant during their adolescence than non-displaced women. This work tries to understand more about the everyday lives of displaced women who experience adolescent pregnancy, through interviews. The interviews were analysed and results interpreted using the theory of ‘structural violence’. Structural violence describes how social structures such as racism, sexism, war and poverty determine life choices, leading to suffering and inequality. The work found that pregnancy and motherhood in adolescence for displaced women was positive in many ways by bringing purpose, status and companionship. However, these women also experienced many challenges after pregnancy, such as exclusion from education and secure employment and difficulty accessing healthcare. This demonstrated that structural violence features in multiple interconnected forms in the daily lives of displaced adolescent mothers. The work urges policymakers to appreciate the complexity of context surrounding adolescent pregnancy and motherhood, and to address the structural disadvantages facing women in these situations.

OBJECTIVE: The issue of oral health problems among refugees, not only during their journey but also once they arrive at their destination, is a current one. This study aimed to evaluate the oral health-related quality of life (OHRQoL) of refugees, with the intention of highlighting a potential need for improved education and easier access to dental care.
METHODS: A questionnaire based on the Oral Health Impact Profile (OHIP-14) was distributed via hyperlink on social media, targeting individuals with a refugee background to collect data on their OHRQoL.
RESULTS: A total of 401 participants completed the questionnaire. The median OHIP score for all participants was 8 (IQR 2-17) out of a maximum of 56, with 0 representing the best possible OHRQoL. The median OHIP score was 6 (IQR 2-16) for male and 8 (IQR 2-18) for female participants.
CONCLUSIONS: A comparison of the OHIP score from this study with reference values from non-refugee populations shows an elevated score and, thus, a lower oral quality of life.
CONCLUSIONS: The findings of this study indicate a clear need for enhanced access to dental care for refugees, coupled with an educational initiative aimed at fostering an appreciation of the importance of daily dental hygiene.

Community-led, shared book reading programs may help improve refugee children\'s reading abilities and attitudes towards reading. We Love Reading (WLR)-a light-touch, community-led, shared book reading program-was evaluated in a pre-registered, wait-listed, randomised controlled trial (AEARCTR-0006523). 322 Syrian refugee mother-child dyads (children: 4-8-year-olds, 50.0% female) in Jordan were tested at two timepoints, 15 weeks apart. WLR did not significantly affect child literacy or child-reported child attitudes toward reading (ps > 0.05). Mothers did report improved child attitudes toward reading from WLR (p = 0.046, η2 = 0.013). The intervention did not lead to improvements in family relationships (ps > 0.05). WLR may have promise in improving attitudes toward reading in forcibly displaced children but did not affect literacy or child-reported attitudes toward reading; these results provide insight into what changes are needed for effective shared book reading interventions in this population.

BACKGROUND: Contraceptive use is known to have a positive impact on maternal and child health outcomes; however, its use is still low in low-income countries, especially among people in humanitarian situations. This study explored decision-making processes towards the use of contraceptives by people in humanitarian situations to inform program design and uptake.
METHODS: A qualitative exploratory study was conducted among women of reproductive age (15-49 years) and men (15-60 years) living in three refugee settlements of Pagirinya, Nyumanzi, and Mirieyi and the surrounding host communities in Adjumani district, Uganda. Data were collected using 49 in-depth interviews (IDIs), 11 Key Informant Interviews (KIIs,) and 20 Focus Group Discussions (FGDs). Inductive thematic analysis was done with the aid of Atlas ti. Version 14.
RESULTS: We found that the decision-making processes entailed linear and nonlinear internalized cognitive and contextual processes involving four dynamic pathways. In the linear pathway, participants reported starting with 1) idea inception, 2) followed by cognitive processing, 3) consultation, and 4) decision-making for contraceptive use. The complex linear pathway happened when participants did not go through consultation but went straight to decision-making. However, participants who followed the non-linear pathway repeatedly went back to cognitive processing. Some women after consultation, or those already using and those not using contraceptives, decided to go back to cognitive processing to reconsider their current positions. This study found that some women who were not using contraceptives ended up using, while some who were using contraception ended up dropping out.
CONCLUSIONS: This study showed dynamic decision-making processes involving both internal and external environments as triggers to decision-making for contraceptive use. Interventions to increase contraceptive use should target both users and significant others who influence the decision to use particularly among refugees.
BACKGROUND: This study was registered by Makerere University School of Public Health Higher Degrees Research and Ethic Committee (HDREC) #188 and approved by Uganda National Council of Science and Technology on 15th/7/2021, Registration number-SS809ES.

UNASSIGNED: Despite established vaccination programs, vaccine-preventable diseases persist among about 900,000 Forcibly Displaced Myanmar Nationals (FDMN)/Rohingya refugees in the world\'s largest refugee settlement in Bangladesh. Health service providers (HSPs) play a key role in the delivery of childhood vaccination programs. This study explored their views on individual and context barriers and drivers to childhood vaccination in this setting.
UNASSIGNED: Informed by the theoretical framework of the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavior change, this qualitative study collected data through eight focus group discussions (FGDs) with community health workers (CHWs) and vaccinators in selected camps with high or low vaccination coverage rates, and through 11 in-depth interviews (IDIs) with key informants working in strategic, management, and administrative roles.
UNASSIGNED: Barriers and drivers were evident across all COM factors for HSPs and caregivers. Among HSPs, knowledge around vaccination acted both as a barrier and driver, while communication skills and confidence in vaccination served as drivers. Caregivers\' lack of awareness of vaccination, concerns and mistrust were described as main barriers. Context barriers included information system deficiencies, family dynamics, HSPs\' working conditions, and vaccination site accessibility. Context drivers included effective communication, mobilization, and incentives. Differences between high and low coverage camps in Cox\'s Bazar included variations in HSPs\' knowledge, communication strategies, incentive use, and stakeholder collaboration.
UNASSIGNED: For better vaccination coverage in the camps, context-related changes regarding collaboration, health workforce and the use of incentives seem necessary. Caregivers\' mistrust toward vaccination needs to be considered under the social and historical background of the Rohingya community, and further addressed with targeted communication and campaigning.

BACKGROUND: Germany played a key role as receiving country during the so-called refugee and displacement crisis with about 5 million asylum seekers arriving in the EU between 2014 and 2020. It is well known that asylum seekers and refugees (ASRs) have a high burden of disease and are particularly prone to mental disorders such as trauma, stress-related and affective disorders. Not much is known about the determinants of health-related quality of life (HrQoL) among ASRs, especially in the context of the flight. Therefore, the aim of this study was to analyze the associations between flight-related characteristics and HrQoL of ASRs in Germany.
METHODS: The sample of this study was based on five consecutive waves of the Survey of Refugees samples of the German Socio-Economic Panel (n = 8015; 14,314 observations). Mental and physical HrQoL was measured using the mental (MCS) and physical (PCS) component summary scores of the SF-12v2. Associations between flight-related characteristics and HrQoL were examined using multilevel mixed-effects linear regressions.
RESULTS: The different countries of birth were associated with varying MCS and PCS scores. The MCS and PCS scores were lower among ASRs with an economic situation below average in their countries of origin. Persecution, discrimination, and poor living conditions as reasons for leaving the county were associated with lower MCS scores. ASRs who were dissatisfied with their own living situation and who were discriminated often due to their origin had both lower MCS and PCS scores. Not feeling welcome in Germany and missing people from one\'s country of origin were both associated with lower MCS scores. No worries about not being able to stay in Germany or not being able to return to one\'s country of origin were both associated with higher MCS scores.
CONCLUSIONS: The economic situation in the country of origin and the presence of persecution, discrimination, and/or poor living conditions as reason for flight may be pre-flight-related determinants of HrQoL of ASRs in Germany. Possible post-flight-related determinants can be the residence status, the satisfaction with one\'s living situation, discrimination due to one\'s origin and a feeling of missing people from one\'s country of origin. With regard to those determinants, the clarity about the residence status, reducing racial discrimination and the mourning of flight-related circumstances must be ensured.

UNASSIGNED: There is a dearth of research on cognitive aging and dementia in Asian Americans, particularly in Vietnamese Americans, the fourth largest Asian subgroup in the United States.
UNASSIGNED: The Vietnamese Insights into Cognitive Aging Program (VIP) investigates early life adversity and war-related trauma and their associations with cognitive health in a community-based sample of older Vietnamese Americans in Northern California (i.e., Sacramento and Santa Clara counties). Baseline measurements include a comprehensive neuropsychological battery, including measures of global cognition along with executive function, semantic memory, and episodic memory. Data also include measures of functioning, early life adversity and trauma exposure, and psychosocial and traditional cardiovascular disease risk factors. Cognitive assessments will be repeated twice over the course of the data collection period, approximately 12- and 24- months post-baseline. Blood samples collected during Wave 2 will be assayed for biochemical risk factors.
UNASSIGNED: Baseline assessments were conducted from January 2022 to November 2023, with N = 548 Vietnamese Americans; mean age ± SD was 73 ± 5.31 years and 55% of participants were women. There were significant differences in social factors by site, with Santa Clara participants having higher education (some college or higher: Sacramento, ≈25%; Santa Clara: ≈48%) and marginally higher incomes compared to Sacramento participants. A higher percentage of Santa Clara participants reported speaking English well or very well (24%) compared to Sacramento participants (13%), although the majority of the entire sample (81%) reported speaking some to no English (response options: not at all; some/a little bit; well/very well).
UNASSIGNED: This longitudinal study providea a unique opportunity to more fully delineate psychosocial factors that contribute to dementia disparities in diverse and under-engaged populations. Future work will examine cognition, the prevalence of mild cognitive impairment and dementia, and other health outcomes, while controlling for site differences in all analyses.
UNASSIGNED: Vietnamese Insights into Cognitive Aging Program (VIP) is a new study.VIP has detailed early life and health data on 548 older Vietnamese Americans.History of war and trauma may contribute to Alzheimer\'s disease and related dementias (ADRD)-related burden.VIP may provide insight into ADRD burden in other understudied groups.

BACKGROUND: Younger age of migration is associated with higher risk of psychotic disorders but the relationship between age of migration and common mental disorders is less clear. This study investigates the association between age of migration and diagnosed common mental disorders among migrants living in Norway.
METHODS: Using national Norwegian register data from 2008 to 2019, we compared the odds of a common mental disorder diagnosis in healthcare services during early adulthood among non-migrants, descendants and migrants with different ages of migration and lengths of stay. We also investigated differences in the relationship for different migrant groups and for men and women.
RESULTS: Descendants and childhood migrants with ≥ 19 years in Norway had higher odds of common mental disorders than non-migrants, while those migrating during adolescence with ≥ 19 years in Norway had similar odds. Those migrating during emerging and early adulthood had lower odds. Overall among migrants, the relationship between age of migration and common mental disorders was more pronounced for migrants < 19 years in Norway than ≥ 19 years and for non-refugees compared with refugees, especially men.
CONCLUSIONS: Descendants and childhood migrants with long stays may have higher odds of common mental disorders due to the associated stress of growing up in a bicultural context compared with non-migrants. Age of migration has a negative association with diagnosed common mental disorders but much of this effect may attenuate over time. The effect appears weaker for refugees, and particularly refugee men, which may reflect higher levels of pre-migration trauma and stress associated with the asylum-seeking period for those arriving as adults. At the same time, migrants, especially those arriving as adults, experience barriers to care. This could also explain the particularly low odds of diagnosed common mental disorders among adult migrants, especially those with shorter stays.

BackgroundRecent migration trends have shown a notable entry of Latin American asylum seekers to Madrid, Spain.AimTo characterise the profile of asylum-seeking Latin American migrants who are living with HIV in Spain and to outline the barriers they face in accessing HIV treatment.MethodsA prospective cohort study was conducted between 2022 and 2023 with a 6-month follow-up period. Latin American asylum seekers living with HIV were recruited mainly from non-governmental organisations and received care at an HIV clinic in a public hospital in Madrid.ResultsWe included 631 asylum seekers. The primary countries of origin were Colombia (30%), Venezuela (30%) and Peru (18%). The median age was 32 years (interquartile range (IQR): 28-37), and 553 (88%) were cis men of which 94% were men who have sex with men. Upon their arrival, 49% (n = 309) lacked social support, and 74% (n = 464) faced barriers when attempting to access the healthcare system. Upon entry in Europe, 500 (77%) participants were taking antiretroviral therapy (ART). At their first evaluation at the HIV clinic, only 386 (61%) had continued taking ART and 33% (n = 209) had detectable plasma HIV-1 RNA levels. Six months later, 99% took ART and 98% had achieved an undetectable viral load.ConclusionsLatin American asylum seekers living with HIV in Madrid, Spain encountered barriers to healthcare and to ART. One-third of these individuals presented detectable HIV viral load when assessed in the HIV clinic, highlighting this as an important public health issue.