Promotores, also known as community health workers, deliver culturally- and linguistically-informed public health interventions and can be part of the response to the US’ addiction crisis. However, no promotor programs have addressed addiction in the Latine community, and no Spanish-language curriculum exists. Addiction medicine physicians partnered with community-based organizations to co-design and implement the Program for Education in Drugs and Alcohol for Latine (PEDAL) in Spanish. PEDAL trained promotores to recognize and communicate about substance use, connect individuals to services, and educate the community about addiction. We performed a mixed-methods evaluation to understand PEDAL’s impact on curriculum objectives, substance use-related attitudes and stigma, and promotores’ overall experience via focus groups. We found increased promotor confidence in curricular objectives, but no change in attitudes and stigma immediately following completion. Focus groups showed improved attitudes and reduced stigma three months later. PEDAL may build community capacity to address the addiction crisis, especially among Latine and other communities that may not be reached by current interventions.
Immigrant and refugee youth are at higher risk of developing a psychotic disorder compared to non-newcomers and often have less access to medical care. A potential barrier may be the differing explanatory models of psychosis and attitudes towards mental health care between newcomers and healthcare providers, which can lead to missed early intervention. Furthermore, the explanatory models of psychosis may also differ between youth and their families as a result of acculturation differences, which may lead to intergenerational conflicts and disagreements about care decisions. The aim of the study is to characterize the explanatory models regarding early psychosis and attitudes toward treatment among migrant youth and their caregivers. The Arksey and O’Malley framework for scoping reviews was followed. A search strategy was developed with concepts of “migrants”, “youth”, “explanatory model”, and “psychosis”. Medline, Embase, PsycINFO, EBSCO Child Development Adolescent Studies, Cochrane, and Google Scholar were searched for relevant articles. Of the 1115 studies identified, 10 studies met criteria. The results suggest that people with migration history often held differing explanatory models of psychosis as compared to non-migrants, and that these models were influenced by specific cultural factors. Most studies focused on caregiver perspectives while youth perspectives were underexplored. Rather than a simple relationship in which greater divergence from the biomedical model led to increased disengagement, studies found that explanatory models could evolve over time and that youth and families could hold multiple, sometimes conflicting, illness explanations simultaneously. The integration of multiple explanatory models was crucial in treatment engagement and functional outcomes for many patients. Treating migrant youth with early psychosis remains a significant clinical challenge, yet significant gaps remain in understanding how youth and families understand psychosis. This paper shares findings that add new nuance to the existing literature as the impact of multiple explanatory models and the interaction of familial attitudes have not been reviewed in the treatment of psychosis. Further research should aim to incorporate youth perspectives and how these differ from and/or interact with the perspectives of caregivers. Such work can support more culturally-sensitive care and inform targeted interventions for this marginalized population.
Social determinants of health (SDOH) are increasingly recognized as major contributors to health outcomes. Beyond general social challenges, immigrants face additional barriers related to language, immigration status, legal concerns, discrimination, and exclusionary policies. Despite growing interest in SDOH screening, little is known about how existing screening instruments address immigrant-specific factors. Searches of Web of Science, PubMed, CINAHL, and PsychINFO identified peer-reviewed articles published between 2015 and 2025. Eligible studies included original research articles focused on immigrant populations and the use of an SDOH screening tool. Two reviewers independently screened titles, abstracts, and full texts. Data were extracted on screening tool characteristics, SDOH domains assessed, immigrant-specific indicators, language availability, study setting, and tool validation status. The final search yielded 1,155 articles. Eight studies met full inclusion criteria, describing nine screening tools or variants, including adaptations of the Health Leads Social Needs Screening Toolkit, the Centers for Medicare and Medicaid Services Accountable Health Communities screening tool, and the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences. Most studies occurred in urban primary care settings and primarily served Hispanic/Latinx immigrant populations. Core SDOH domains were well-represented across all tools. While all studies included at least one immigrant-specific measure, these were generally limited to language preference, nativity, legal concerns, and migrant worker status. No adapted or newly developed tool demonstrated formal psychometric validation. Current SDOH screening tools may fail to capture the broader structural factors that shape immigrant health, including immigration-related policies, legal precarity, discrimination, and fear. Significant gaps remain in culturally responsive, psychometrically validated instruments developed with and for immigrant communities.
The mental health of immigrants from Southwest Asia and North Africa, including Arabic-speaking communities, is shaped by a combination of pre-migration trauma, post-migration adjustment challenges, and cultural understandings of psychological well-being. Although this population continues to grow in Canada, there remains a significant gap in research that meaningfully captures their experiences, particularly their mental health and well-being, within the Canadian context. This narrative review synthesizes sixteen Canadian-based studies published between 2017 and 2024 to explore the mental health outcomes, access to care, and coping strategies among SWANA migrants, with particular attention to Arabic-speaking communities represented in the literature. Using a social determinants of health lens and reflexive thematic analysis, this review identified four major themes: Contextual factors for poor mental health, Western vs. SWANA understandings of mental health, barriers to accessing mental health services, and strategies for coping. Findings reveal that mental health stigma within SWANA communities, unfamiliarity with the Canadian health system, and a shortage of culturally responsive providers are major barriers to care. Despite these challenges, participants consistently demonstrated resilience through faith, social networks, and a strong sense of cultural identity. These results highlight the need for mental health interventions that are not only culturally sensitive but also informed by the lived experiences of these populations. Research that is more inclusive is necessary to explore the varied identities within the SWANA region, particularly concerning second-generation migrants and SWANA Christians and other religious minorities.
The North American Free Trade Agreement, now the US-Mexico-Canada Agreement, has increased semi-truck and vehicular traffic at international ports-of-entry, raising air pollution concerns in the US-Mexico border region. Studying the border county of El Paso, Texas, a central hub for Mexican imports, we extend the literature by examining the prevalence of chronic obstructive pulmonary disease (COPD) across census tracts with varying proximities to the port-of-entry, PM2.5 exposure, and percent immigrant. We accomplish this objective by merging NASA PM2.5 measurements with health data from the US Centers for Disease Control and social vulnerability indicators from the US Census’ American Community Survey. We also use ArcGIS Pro to determine each census tract’s proximity to a port-of-entry. Using Generalized Linear Models, we found that PM2.5 and the percent foreign-born noncitizens are positively associated with COPD prevalence. Census tracts close to a port-of-entry, compared with those more than three miles away, have higher COPD prevalence. Moreover, COPD prevalence in immigrant communities and the effects of PM2.5 are stratified across census tracts by proximity to ports-of-entry.
