The American College Health Association (ACHA) has declared international students a campus population disproportionately affected by the novel coronavirus (COVID-19) in the United States (US; ACHA, 2020). More than a million international students study at US colleges and universities -5.5% of all US college students (IIE, 2020) -and occupy a precarious space at the intersection of immigration policy and global education mobility. As a group of temporary migrants, international students play a unique and complex role and cannot simply be defined in contrast to local students (Maleku et al., 2021). They participate in multiple economic systems as

Using a resilience framework, the current cross-sectional study examined indicators of behavioral health risk and resilience among U.S. international students (N=322) across key socio-demographic characteristics. A multimethod approach was used to collect data with both an online platform and paper-based survey instrument. Results showed that higher levels of acculturative stress were reported by older students, females, undergraduates, students who lived with their families, and those who had resided in the US longer than 2 years. Findings underscore the importance of culturally-relevant screening and prevention strategies that target resilience and other protective factors to reduce health risk and encourage well-being and academic success among international students.

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Immigrant groups comprise a large segment of ethnic minorities in the United States. Although the literature is rich with strategies to deliver culturally and linguistically appropriate services to eliminate health inequities, studies addressing cultural competence from the immigrant's perspective are limited. Further research is needed to build knowledge of the predictors and needs of this population, and to influence health care policy and practice. Using qualitative interpretive meta-synthesis, this study describes the lived experience of immigrants accessing health care to understand the essence of cultural competence in health care through their lens. Findings provide insight on expanding the definition of culturally competent health care beyond language, behaviors, attitudes, and policies.

Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.

Purpose While social cohesion is important for the promotion of immigrant health, language is a core component through which immigrant groups establish social connections. Since language is a vehicle through which immigrant groups establish social linkages and that English language proficiency has been established as a virtual requirement for full participation in US society, the purpose of this paper is to examine the role of language in establishing social cohesion affecting immigrant health. Design/methodology/approach Using the 2012 California Health Interview Survey, the authors investigated the role of language efficacy in the relationship between social cohesion and utilization of healthcare among immigrant groups with good and poor health statuses (n=11,134). Mediation analyses were conducted using PROCESS Macro. Findings The direct effect of social cohesion on healthcare utilization and the effect of English language efficacy on healthcare utilization were significant for both groups. English language efficacy was a significant mediator between social cohesion and healthcare utilization among immigrants with good health statuses. Research limitations/implications Limitations include generalizability issues across immigrant sub-populations, limited measures in terms of English language efficacy and limitations with measures variables such as length of stay. Social implications This study highlights that language is the channel that plays a crucial role not only to establish and maintain social cohesion for positive health outcomes, but also the ripple effects of promoting trust, belonging, opportunity of upward mobility and inclusion. Originality/value The findings of the study add value to other pertinent issues of linguistic diversity, positive social relationships and well-being of diverse communities.

Background. The gross longitudinal relationship between female literacy and maternal mortality ratios has not been adequately investigated even though the knowledge of the relationship is crucial for designing maternal mortality reduction programs through female literacy campaigns and improvements. The objective of the study was to examine the dynamic relationship between female literacy and mortality ratios. A longitudinal study design spanning three decades, 1970-2000, was used. Country level data on 143 nations belonging to six geographical regions for the duration 1970-2000 were secured from websites hosted by global agencies such as World Bank and the United Nations were utilized. Maternal mortality ratios ranged from 147 to 271 across the six regions. The longitudinal relationship between female literacy rates and maternal mortality ratios was examined using a latent growth curve approach. The study found that rates of change in female literacy and maternal mortality ratios are negatively related. Steady rates of increase in female literacy were associated with declining maternal mortality ratios as well. We find that female literacy programs are of immense value in reducing maternal mortality ratios given their ability to yield sustained reductions in mortality levels in developing countries.

Transformative sequential mixed methods design in a cross-cultural context is seldom straightforward. Using a community-based participatory research approach as the transformative lens in an African refugee context in the southern United Status, we explored: (a) the intersection of culture, financial stress, and financial self-efficacy and (b) tested the efficacy of financial literacy as the focus of a culturally responsive solution grounded in community-identified priorities. Through a three-phased explanatory sequential mixed methods design, we demonstrate how the addition of a third phase of analysis that focuses on convergence and expansion of quantitative and qualitative data integration and cyclical processes of dissemination and action can strengthen the utility of transformative mixed methods research in a cross-cultural context. Our study offers a unique contribution to the long-standing methodological dialogue between the design elements of mixed methods research, community-based participatory research, and migration studies by expanding the transformative explanatory sequential design archetype in a cross-cultural context.