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Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice.

ABSTRACT: Latina immigrant women are vulnerable to traumatic stress and sexual health disparities. Without autonomy over their reproductive health and related decision-making, reproductive justice is elusive. We analyzed behavioral health data from 175 Latina immigrant participants (M age = 35; range = 18-64) of the International Latino Research Partnership (ILRP) study. We used descriptive and inferential statistics to compare immigrant mothers of minor children to those without, regarding their psychological and reproductive health, and correlates of past exposure to sexual trauma. Over one third (38%) of ILRP participants had minor children, and 58% had citizenship in their host country. The rate for sexual assault was 30 and 61%, respectively, for physical assault; these rates were similarly high for women with and without minor children. Women who reported sexual assault scored significantly higher for depression, posttraumatic stress disorder, and substance-abuse screens. Odds of experiencing sexual assault was highest for women who experienced physical assault (odds ratio = 10.74), and for those from the Northern Triangle (odds ratio = 8.41). Subgroups of Latina migrant mothers are vulnerable to traumatic stress and related sexual and mental health risks. Given these findings, we frame the implications in a reproductive justice framework and consider consequences for caregiver-child well-being.

SUBMITTER: Fortuna LR

PROVIDER: S-EPMC6972560 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice.

Fortuna Lisa R LR Noroña Carmen Rosa CR Porche Michelle V MV Tillman Cathi C Patil Pratima A PA Wang Ye Y Markle Sheri Lapatin SL Alegría Margarita M

Infant mental health journal 20190723 5

Latina immigrant women are vulnerable to traumatic stress and sexual health disparities. Without autonomy over their reproductive health and related decision-making, reproductive justice is elusive. We analyzed behavioral health data from 175 Latina immigrant participants (M age = 35; range = 18-64) of the International Latino Research Partnership (ILRP) study. We used descriptive and inferential statistics to compare immigrant mothers of minor children to those without, regarding their psycholo ...[more]

PMID: 31335984

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Project description:BackgroundAn estimated 70.8 million people are forcibly displaced worldwide, 75% of whom are women and children. Prioritizing a global research agenda to inform guidance, service delivery, access to and quality of services is essential to improve the survival and health of women, children and adolescents in humanitarian settings.MethodA mixed-methods design was adapted from the Child Health and Nutrition Research Initiative (CHNRI) methodology to solicit priority research questions across the sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) domains in humanitarian settings. The first step (CHNRI) involved data collection and scoring of perceived priority questions, using a web-based survey over two rounds (first, to generate the questions and secondly, to score them). Over 1000 stakeholders from across the globe were approached; 177 took part in the first survey and 69 took part in the second. These research questions were prioritized by generating a research prioritization score (RPP) across four dimensions: answerability, program feasibility, public health relevance and equity. A Delphi process of 29 experts followed, where the 50 scored and prioritized CHRNI research questions were shortlisted. The top five questions from the CHNRI scored list for each SRMNCAH domain were voted on, rendering a final list per domain.ResultsA total of 280 questions were generated. Generated questions covered sexual and reproductive health (SRH) (n = 90, 32.1%), maternal health (n = 75, 26.8%), newborn health (n = 42, 15.0%), child health (n = 43, 15.4%), and non-SRH aspects of adolescent health (n = 31, 11.1%). A shortlist of the top ten prioritized questions for each domain were generated on the basis of the computed RPPs. During the Delphi process, the prioritized questions, based on the CHNRI process, were further refined. Five questions from the shortlist of each of the SRMNCAH domain were formulated, resulting in 25 priority questions across SRMNCAH. For example, one of the prioritized SRH shortlisted and prioritized research question included: "What are effective strategies to implement good quality comprehensive contraceptive services (long-acting, short-acting and EC) for women and girls in humanitarian settings?"ConclusionData needs, effective intervention strategies and approaches, as well as greater efficiency and quality during delivery of care in humanitarian settings were prioritized. The findings from this research provide guidance for researchers, program implementers, as well as donor agencies on SRMNCAH research priorities in humanitarian settings. A global research agenda could save the lives of those who are at greatest risk and vulnerability as well as increase opportunities for translation and innovation for SRMNCAH in humanitarian settings.

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Project description:BackgroundInformation about design, implementation, monitoring and evaluation is central to understand the impact of programmes within the field of sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH). Existing reporting guidelines do not orient on reporting of contextual and implementation issues in sufficient detail. We therefore developed Programme Reporting Standards (PRS) to be used by SRMNCAH programme implementers and researchers.MethodsBuilding on the first step of the PRS development (a systematic review to identify reporting items), we conducted a three-round online Delphi consensus survey with experts. Consensus was defined a-priori as 80% agreement of items as essential. This was followed by a technical consultation with a group of experts to refine the items, definitions and their structuring. The revised PRS was piloted to assess its relevance to current SRMNCAH programme reports and identify key issues regarding the use of the PRS.ResultsOf the 81 participants invited to the Delphi survey, 20 responded to all three rounds. In the final round, 27 items received consensus as essential; three items were ranked as "borderline" essential; 20 items as supplementary. The items were subsequently revised, followed by a technical consultation with 29 experts to further review and refine the PRS. The feedback resulted in substantial changes to the structure and content of the PRS into 24 items across five domains: Programme overview; Programme components and implementation; Monitoring of Implementation; Evaluation and Results; and Synthesis. This version was used in a piloting exercise, where questions regarding how much information to report and how to comment on the quality of the information reported were addressed. All items were kept in the PRS following the pilot although minor changes were made to the flow and description of items.ConclusionsThe PRS 1.0 is the result of a structured, collaborative process, including methods to incorporate input from SRMNCAH stakeholders. The World Health Organization will develop a document that explains the items in greater detail, and will also apply the PRS to on-going initiatives. We welcome continuous input from the field, while it is being used, to improve its relevance and usefulness.

Project description:Human well-being is often an overarching goal in environmental decision-making, yet assessments are often limited to economic, health, or ecological endpoints that are more tangible to measure. Composite indices provide a comprehensive approach to measuring well-being in terms of multi-dimensional components, such as living standards, health, education, safety, and culture. For example, the Human Well-Being Index (HWBI) framework, initially developed for the U.S. fifty states, was recently applied to quantify human well-being for Puerto Rico. However, the paucity of data at spatial scales finer than state or county levels, particularly for social metrics, poses a major limitation to quantifying well-being at neighborhood-scales relevant to decision-making. Here we demonstrate a spatial interpolation method to fill in missing fine-scale data where coarser-scale data is available. Downscaling from municipio (i.e., county-equivalent) to census-tract revealed a greater range of variability in well-being scores across Puerto Rico, in particular, a larger proportion of low well-being scores. Furthermore, while some components of wellbeing (e.g., Education, Health, Leisure Time, Safety and Security, Social Cohesion) showed consistent improvement over time from 2000-2017 across Puerto Rico, others (e.g., Connection to Nature, Cultural Fulfillment, Living Standards) were variable among census tracts, increasing for some but declining for others. We use a case study in the San Juan Bay estuary watershed to illustrate how approaches to quantify baseline levels of well-being can be used to explore potential impacts of management actions on communities, including to identify environmental justice inequalities among neighborhoods. Spatial clustering analysis was used to identify statistically significant cold or hot spots in well-being. This study demonstrates how indicators of well-being, coupled with interpolation methods to overcome limitations of data availability, can help to monitor long-term changes over time and to better communicate the potential value of ecosystem restoration or resource management.

Dataset Information

Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice.

Publications

Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice.

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