Diabetes Among Refugee Populations: What Newly Arriving Refugees Can Learn From Resettled Cambodians

Wagner, Julie; Berthold, S. Megan; Buckley, Thomas; Kong, Sengly; Kuoch, Theanvy; Scully, Mary

doi:10.1007/s11892-015-0618-1

Cited by 25 publications

(14 citation statements)

References 107 publications

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“…In some regions the healthcare workforce is also inadequately trained to meet the unique needs of racial, ethnic, and linguistic minorities. For example, In North America, Europe, and Australia the rising number of immigrants, refugees, and racial/ethnic minority citizens with diabetes creates challenges for provision of quality healthcare [2]. In these settings, task shifting of some healthcare functions from professionals to community health workers (CHWs) is considered to be an efficient means of improving the health of these communities [3].…”

Section: 1 Community Health Workers and Diabetes Carementioning

confidence: 99%

A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol

Wagner

Bermúdez‐Millán

Damio

et al. 2016

Diabetes Research and Clinical Practice

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Aims To test the efficacy of a community health worker (CHW) delivered stress management (SM) intervention on psychosocial, glycemic, and cortisol outcomes among U.S. Latinos with type 2 diabetes. Methods A randomized, controlled trial compared CHW-delivered diabetes education (DE; one group session) to DE plus CHW-delivered SM (DE+SM; 8 group sessions). Psychosocial variables and urinary cortisol were measured at baseline and posttreatment. HbA1c was measured at baseline, posttreatment, and 3-month follow-up. Results In intent to treat analysis, compared to DE (n=46), DE+SM (n=61) showed significantly improved symptoms of depression, anxiety, and self-reported health status. There were no significant group effects for HbA1c, diabetes distress, or urinary cortisol. However, there was a dose response effect for HbA1c and diabetes distress; increasing attendance at SM sessions was associated with greater improvements in HbA1c and diabetes distress. Conclusions This is the first randomized, controlled trial demonstrating that CHWs can improve psychological symptoms and self-reported health among Latinos with type 2 diabetes. Efforts to increase intervention attendance may improve HbA1c and diabetes distress.

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Section: 1 Community Health Workers and Diabetes Carementioning

confidence: 99%

A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol

Wagner

Bermúdez‐Millán

Damio

et al. 2016

Diabetes Research and Clinical Practice

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“…How these factors are directly related to health have been examined in the literature [ 19 – 21 ]. The result of this is increased risk of general ill health and chronic illness [ 10 , 20 ]. In addition to this, substance abuse, including alcohol is a notable problem in ASRs as it is thought to be related to posttraumatic stress, prolonged instability and hardship due to displacement.…”

Section: Discussionmentioning

confidence: 99%

A lost tribe in the city: health status and needs of African asylum seekers and refugees in Hong Kong

Wong

Cheng

Holroyd

et al. 2016

Int J Equity Health

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BackgroundHong Kong’s resistance to be a signatory of the 1951 Geneva Convention and lack of domestic policies in this area has resulted in restrictions on access to healthcare amongst asylum seekers and refugees (ASRs). Using social determinants of health framework this study sought to identify health practices, problems and needs of African ASRs in Hong Kong.MethodsA cross-sectional survey comprising of six domains including health status, health-seeking behaviour and social experience targeted at adult African ASRs in Hong Kong was conducted through three local non-governmental organisations between February and April 2013. Outpatient care and inpatient care in the past 12 months were used as proxy measures of general and severe ill health respectively. Associations between the determinants of health factors with general or severe health was explored through logistic regressions.ResultsMajority of 374 participants were young, single, educated males having been in Hong Kong for over 5 years. A third of ARS (36.1 %) screened positive for depression. Most reported problems related to basic necessities (64.7–78.6 %) and access to health services (72.2 %). ASRs with relatively less education, health awareness or higher risk behaviours were less likely to have obtained outpatient or inpatient services. African ASRs reporting problems with case officers (aOR = 2.80; 95 % CI = 1.35-5.79) or illness in the past 30 days (aOR = 6.00; 95 % CI = 2.94-12.25) were more likely to report general ill health. Similarly, problems with the case officers (aOR = 3.76; 95 % CI = 1.97-7.18) and self-reported illness in the past 30 days (aOR = 3.32; 95 % CI= 1.68-6.57) were also significantly associated with severe ill health. At the health system level, those who reported experiencing difficulties accessing the medical services in Hong Kong are 3.29 (95 % CI = 1.48-7.31) and 4.12 (95 % CI = 1.73-9.79) times as likely to report general and severe ill health respectively.ConclusionThe host government should have moral and ethical obligations to attend to the health needs of ASRs. Evidently a number of structural and health system factors have significantly impacted the health of African ASRs in Hong Kong. Changes to current policies regarding how African ASRs are handled whilst in Hong Kong but, more immediately, improvements in healthcare access are needed.

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“…the later development of serious medical problems, such as cardiovascular disease, hypertension, diabetes, and possibly dementia. [24][25][26][27] Rates of hypertension, hyperlipidemia and diabetes in a household probability sample of Cambodian refugees in the US who survived torture and genocide were significantly higher than in an age and gender adjusted American population sample. 28 Also of concern are the findings related to traumatic brain injuries as possible repercussions of torture.…”

Section: S C I E N T I F I C a R T I C L Ementioning

confidence: 99%

Descriptive, inferential, functional outcome data on 9,025 torture survivors over six years in the United States

Ncttp¹

2018

torture

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Background: The National Consortium of Torture Treatment Programs conducted a large voluntary research project among torture rehabilitation centers in the United States (US). Its goal is to fill the void in the literature on demographic and diagnostic data of torture survivors across a large country. Methods: Twenty-three centers across the US collaborated over six years, utilizing training and making decisions via conference calls and webinars. A data use agreement signed by all the participating centers governed plans and the use of the data. Findings: This study reports on torture survivors from 125 countries, 109 of which signed the United Nations Convention against Torture (UNCAT). Of the 9,025 torture survivors represented, most came from Africa and Asia and reported an average of 3.5 types of torture. Asylum seekers have different immigration experiences and show significantly higher rates of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) than refugees. Torture survivors at high risk of PTSD and MDD in this sample reported three or more types of torture, reported rape and had the immigration status of asylum seeker. At one and two years after beginning treatment, both asylum seekers and refugees reported increased rates of employment and improvements in their immigration status. Interpretation: This longitudinal project provides basic data on a large number of torture survivors who accessed services in the US, and provides a foundation for long-term follow up on immigration status, employment status, diagnostic status, medical diagnoses, and eventually, the effectiveness of treatment for torture survivors in the US. This article shares demographic and diagnostic findings useful for informing programmatic and policy decisions. However, these findings on refugees and asylum seekers in the US may not reflect the experience in other receiving countries. Collaboration with other researchers across continents is required to provide a much needed, more complete picture of torture survivors seeking rehabilitation across the world.

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Diabetes Among Refugee Populations: What Newly Arriving Refugees Can Learn From Resettled Cambodians

Cited by 25 publications

References 107 publications

A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol

A randomized, controlled trial of a stress management intervention for Latinos with type 2 diabetes delivered by community health workers: Outcomes for psychological wellbeing, glycemic control, and cortisol

A lost tribe in the city: health status and needs of African asylum seekers and refugees in Hong Kong

Descriptive, inferential, functional outcome data on 9,025 torture survivors over six years in the United States

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