美国的拉丁裔人口不成比例地受到药物使用的影响,艾滋病毒/艾滋病,暴力,心理健康问题(SAVAME)。越来越多的证据证明了SAVAME的联合性质以及需要采取综合策略来减少其影响。这项研究旨在了解费城拉丁裔移民的SAVAME服务网络,以告知未来对SAVAME预防和缓解的干预措施。
与在提供SAVAME服务的拉丁裔服务组织中工作的提供者进行了关键线人访谈(N=30)。使用主题编码和扎根理论对访谈进行了分析。
拉丁裔服务提供商认为,以及可用性的重要限制,可访问性,以及为拉丁裔移民提供的SAVAME服务的充分性。差距被认为对精神健康和物质使用服务特别严重,部分原因是这些服务的资金不足。拉丁裔移民缺乏医疗保险,移民身份,有限的英语水平(LEP),围绕SAVAME问题的耻辱,以及对可用服务的有限知识被确定为阻碍获得服务的重大障碍。供应商指出,缺乏训练有素的人,文化能力强,种族和谐的提供者降低了为拉丁裔移民客户提供SAVAME服务的充分性。小尺寸,基础设施水平低,据报道,能力有限是限制许多拉丁裔服务组织在SAVAME服务的预防和治疗中采用联合方法的能力的其他因素。
结果要求改变资金流的结构和整个社区的战略,以促进与拉丁裔移民客户合作的SAVaME提供商之间的合作。
Latino populations in the United States are disproportionately affected by substance use, HIV/AIDS, violence, and mental health issues (SAVAME). A growing body of evidence demonstrates the syndemic nature of SAVAME and the need for integrated strategies to reduce their impact. This study sought to understand the network of SAVAME services for Latino immigrants in Philadelphia to inform future interventions for SAVAME prevention and mitigation.
Key informant interviews (N = 30) were conducted with providers working in Latino-serving organizations providing SAVAME services. Interviews were analyzed using thematic coding and grounded theory.
Latino-serving providers perceived a large need for, and important limitations in the availability, accessibility, and adequacy of SAVAME services for Latino immigrants. Gaps were seen as especially acute for mental health and substance use services, partly because of insufficient funding for these services. Latino immigrants\' lack of health insurance, immigration status, limited English proficiency (LEP), stigma surrounding SAVAME issues, and limited knowledge of available services were identified as significant barriers preventing access to services. Providers noted that scarcity of well-trained, culturally competent, and ethnically concordant providers reduced the adequacy of SAVAME services for Latino immigrant clients. The small size, low levels of infrastructure, and limited capacity were reported as additional factors limiting the ability of many Latino-serving organizations to adopt a syndemic approach in the prevention and treatment of SAVAME services.
The results call for changes in the structure of funding streams and communitywide strategies to foster collaboration across SAVAME providers working with Latino immigrant clients.