Journal articles: 'Acculturation and Health Care'

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González, Hector M., Wassim Tarraf, and Mary N. Haan. "The Metabolic Syndrome, Biomarkers, and the Acculturation–Health Relationship Among Older Mexican Americans." Journal of Aging and Health 23, no. 7 (September 23, 2011): 1101–15. http://dx.doi.org/10.1177/0898264311421371.

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Objective: To examine the acculturation–health relationship using metabolic syndrome biomarkers. Method: Cross-sectional sample data. Participants: 1,789 Mexican Americans (60 years and older) from northern California. Main Outcome: Biomarkers (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipids) were used to construct the metabolic syndrome indicator using American Heart Association criteria. Main Predictor: Acculturation Rating Scale for Mexican Americans-II scores. Results: Higher acculturation scores were associated with a significantly lower risk for the metabolic syndrome for foreign-born, but not U.S.-born, Mexican Americans. Conclusion: Immigrant health advantages over U.S.-born Mexican Americans are not evident in older adulthood. Higher acculturation was associated with lowered metabolic syndrome risk among older foreign-born Mexican Americans. This suggests that the prevailing acculturative stress hypothesis may not apply to the health of older adults and that any negative relationship between acculturation and health found in younger adults may yield to different developmental health influences in later adulthood.

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Kuo, Shu-Fen, I.-Hui Chen, Tsai-Wei Huang, Nae-Fang Miao, Kath Peters, and Min-Huey Chung. "Self-Efficacy Mediates Acculturation and Respite Care Knowledge of Immigrant Caregivers." International Journal of Environmental Research and Public Health 18, no. 20 (October 10, 2021): 10595. http://dx.doi.org/10.3390/ijerph182010595.

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Past studies have shown that acculturation and self-efficacy can affect respite care knowledge, which are notable issues among immigrant caregivers due to the rapid increasing aging family members. The aim of this study was to investigate relationships among acculturation, self-efficacy, and respite care knowledge in immigrant caregivers, and to determine the mediating effects of self-efficacy on the relationship between acculturation and respite care knowledge. A cross-sectional design was used. We enrolled 134 female immigrant caregivers who had married Taiwanese men and lived with care recipients who used LTC services. Based on Baron and Kenny’ mediating analytic framework, multiple regression and Sobel tests were used to examine whether self-efficacy mediated the relationship between acculturation and respite care knowledge. The findings showed that after controlling for confounding factors, acculturation and self-efficacy separately affected respite care knowledge (B = 0.229, standard error (SE) = 0.084; B = 0.123, SE = 0.049, respectively). Acculturation had a positive impact on respite care knowledge through self-efficacy (B = 0.181, SE = 0.084). Therefore, self-efficacy partially mediated the effect of acculturation on respite care knowledge, and accounted for 20.9% of the total mediating effect in this study. Acculturation predicted immigrant caregiver’ respite care knowledge partially through self-efficacy. The association between acculturation and respite care knowledge was partially mediated by immigrant caregivers’ self-efficacy. As a result, it was proposed that boosting self-efficacy could increase and drive immigrant caregivers’ respite care knowledge. To assist this population in obtaining enough resources, targeted educational programs to promote immigrant caregivers’ self-efficacy should be designed and implemented. Furthermore, health care practitioners should be aware of the relevance of immigrant caregivers’ acculturation.

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Wang, Kaipeng, Anao Zhang, Fei Sun, and Rita X. Hu. "FAMILY COHESION MODERATES THE RELATIONSHIP BETWEEN ACCULTURATION AND HEALTH AMONG OLDER CHINESE AMERICANS." Innovation in Aging 3, Supplement_1 (November 2019): S629—S630. http://dx.doi.org/10.1093/geroni/igz038.2346.

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Abstract Migration and resettlement are major life events that affect immigrants’ functioning and health status. Previous research has well-established the influence of acculturation and family cohesion on Chinese Americans’ mental health and health behavior; however, the moderation effect of family cohesion on the relationship between acculturation and self-rated health – a robust measure of an individual’s general health – has not been examined among this population. The purpose of this study is to examine the association between family cohesion, acculturation, and self-rated health among older Chinese Americans. Data came from a survey of 385 Chinese Americans aged 55 and older living in a large metropolitan area in Southwest America through face-to-face interviews. We used logistic regression to examine the association between acculturation, family cohesion, and self-reported health. In general, acculturation was significantly associated with higher odds of reporting excellent or good health after adjusting for demographic and psychosocial covariates; however, the association between acculturation and self-reported health differed by family cohesion. We found that acculturation was positively associated with self-reported health only among those with medium or high family cohesion, but not among those with low family cohesion. Findings highlighted the significance of involving family members and strengthening family support for providing acculturation services, such as language class and healthy literacy education, to older Americans. Family cohesion needs to be considered by health and mental health care providers for older Chinese Americans to further understand the resources and barriers that influence their health service use and health behaviors.

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Bauldry, Shawn, and Magdalena Szaflarski. "Immigrant-based Disparities in Mental Health Care Utilization." Socius: Sociological Research for a Dynamic World 3 (January 1, 2017): 237802311668571. http://dx.doi.org/10.1177/2378023116685718.

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Studies of immigrant-based disparities in mental health care have been limited by small sample sizes and a lack of measures of different dimensions of acculturation. This study draws on the National Epidemiological Survey on Alcohol and Related Conditions to address these limitations. Results indicate first-generation immigrants have lower rates of utilization for both mood and anxiety disorders. Nativity-based disparities in treatment are particularly notable among people from African and Hispanic origins, while there is little evidence of disparities among people from European origins. Of three dimensions of acculturation, only the identity dimension has a positive association with mental health care utilization.

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Wang, Kaipeng, Fei Sun, Yanqin Liu, and Carson De Fries. "Family Conflict and Older Chinese Americans’ Self-Efficacy in End-of-Life Care Planning: The Role of Acculturation." Innovation in Aging 5, Supplement_1 (December 1, 2021): 569–70. http://dx.doi.org/10.1093/geroni/igab046.2188.

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Abstract Family involvement in end-of-life (EOL) care is critical to ensure older adults’ health and quality of life. Older adults’ self-efficacy in discussing EOL care plans with family members can facilitate family involvement in EOL care planning. Research shows that family relationships are associated with self-efficacy in discussing EOL care with family members among older Chinese Americans. However, the roles of family conflict and acculturation remain unknown. This study examines the association between family conflict and self-efficacy in discussing EOL care with family members and whether such an association differs by acculturation levels among older Chinese Americans. Data were collected from 207 Chinese Americans aged 65-102 in two metropolitan areas in 2017. Ordinary least squares regression was conducted to examine the association between family conflict, acculturation, and self-efficacy in discussing EOL care with family. Family conflict was negatively associated with older adults’ self-efficacy in discussing EOL care with family. More specifically, the negative association between family conflict and self-efficacy in discussing EOL care with family members was more pronounced for those with higher levels of acculturation. Findings highlighted differential effects of family conflict on self-efficacy of EOL care plan discussion for older adults with different acculturation levels. Those with higher acculturation may be more independent in their EOL care planning and aware of the possible negative effects of family conflict in their EOL care planning discussions. Acculturation needs to be considered by geriatric health providers to develop family-centered interventions in improving end-of-life care planning for this population.

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Schutt, Russell K., and Camila Mejía. "Health Care Satisfaction: Effects of Immigration, Acculturation, Language." Journal of Immigrant and Minority Health 19, no. 6 (March 30, 2016): 1372–78. http://dx.doi.org/10.1007/s10903-016-0409-z.

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Van der Stuyft, Patrick, Aimé De Muynck, Leo Schillemans, and Chris Timmerman. "Migration, acculturation and utilization of primary health care." Social Science & Medicine 29, no. 1 (January 1989): 53–60. http://dx.doi.org/10.1016/0277-9536(89)90127-5.

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Yi, Jenny K. "Acculturation and Barriers to Health Care Among Cambodian Women." Journal of Health Care for the Poor and Underserved 14, no. 3 (2003): 341–50. http://dx.doi.org/10.1353/hpu.2010.0587.

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Johns, Jeanine. "Trust: Key to acculturation in corporatized health care environments." Nursing Administration Quarterly 20, no. 2 (1996): 13–24. http://dx.doi.org/10.1097/00006216-199602020-00005.

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Cruz, G. D., R. Shore, R. Z. Le Geros, and M. Tavares. "Effect of Acculturation on Objective Measures of Oral Health in Haitian Immigrants in New York City." Journal of Dental Research 83, no. 2 (February 2004): 180–84. http://dx.doi.org/10.1177/154405910408300219.

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Acculturation is a complex phenomenon that can serve as a proxy for cultural norms and behaviors affecting care-seeking, prevention behaviors, and, ultimately, health outcomes. The purpose of this study was to assess the effect of acculturation on the oral health of Haitian immigrants in New York City. We hypothesized that acculturation would be a predictor of the oral health status of the participating individuals. An acculturation scale was specifically developed and validated for this study. A sample of 425 adult Haitian immigrants living in NYC was obtained through outreach activities. Oral health examinations were conducted, and a questionnaire was administered to the participants. After adjustment for age, sex, education, income, and marital status, acculturation was negatively associated with measures of decayed teeth, periodontal attachment loss of ≥ 4 mm, and the number of missing teeth. Results suggest a positive impact of acculturation on the oral health status of these individuals.

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Farokhi, Moshtagh R., Stephanie M. Cano, Irene G. Bober-Moken, Joseph A. Bartoloni, Sue E. D. Cunningham, and Martha X. Baez. "Maternal Acculturation." Journal of Primary Care & Community Health 2, no. 2 (February 18, 2011): 87–95. http://dx.doi.org/10.1177/2150131910388942.

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Kim, Kyungmin, Yuri Jang, Nan Sook Park, and David Chiriboga. "Acculturation and Healthcare Utilization Among Older Korean Immigrants: A Dyadic Study of Married Couples." Innovation in Aging 4, Supplement_1 (December 1, 2020): 583. http://dx.doi.org/10.1093/geroni/igaa057.1945.

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Abstract Research has focused on the socioeconomic/cultural characteristics of individuals to address health disparities among immigrant populations. Dyadic studies of acculturation and healthcare utilization among older immigrants are rare. Using data from 263 older Korean immigrant couples in the U.S. (Mean_age = 74.75 for husbands; 71.03 for wives), this study examined how each spousal acculturation levels (e.g., English proficiency, familiarity with American culture) are associated with healthcare utilization (e.g., usual source of care, medical checkup) and difficulty in using health services, controlling for sociodemographic characteristics. Overall, husbands showed higher levels of acculturation than their wives, but there was also substantial similarity between spouses (ICC = .58). For healthcare utilization, one’s own acculturation (actor effect) was significant only for wives, but spouse’s acculturation (partner effect) was significant only for husbands. For difficulty in health service use, one’s own acculturation was significant for both spouses, but spouse’s acculturation was significant only for husbands.

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Li, Lydia W., Sara J. McLaughlin, and Jiaan Zhang. "Healthy Aging in Older Chinese Americans: Associations With Immigrant Experiences." Journal of Aging and Health 32, no. 9 (November 26, 2019): 1098–108. http://dx.doi.org/10.1177/0898264319889122.

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Objectives: We examined the associations of aspects of the immigrant experience—acculturation, neighborhood belonging, and perceived discrimination—with healthy aging in older Chinese Americans and explored whether the associations vary by age and gender. Method: The sample included 3,056 older Chinese Americans. Healthy aging was defined as no disability, no cognitive impairment, and high physical functioning, coded dichotomously (1 = meets all criteria, 0 = otherwise). Acculturation, neighborhood belonging, and perceived discrimination were measured using standardized scales. Results: About 31% of the sample experienced healthy aging. Acculturation was positively associated with healthy aging, with stronger associations in older age and women. A greater sense of neighborhood belonging was associated with higher odds of healthy aging; experiences of discrimination were associated with lower odds. Discussion: Interventions to promote healthy aging in Chinese Americans are needed. Programs that support immigrants with low acculturation levels, strengthen immigrants’ connectedness to their neighbors, and promote inclusiveness may improve population health.

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Greaney, Mary L., Furong Xu, Christie L. Ward-Ritacco, Steven A. Cohen, Kerri A. Ellis, and Deborah Riebe. "Does Healthcare Provider Counseling for Weight Management Behaviors among Hispanic Adults Who Are Overweight/Obese Vary by Acculturation Level?" International Journal of Environmental Research and Public Health 20, no. 4 (February 4, 2023): 2778. http://dx.doi.org/10.3390/ijerph20042778.

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This cross-sectional study explored differences in the receipt of health care provider (HCP) counseling to control/lose weight and adopt weight-related lifestyle behavior changes among Hispanic respondents according to acculturation level. Differences in reported action regarding HCP counseling were also examined. Data from four National Health and Nutrition Examination Survey (NHANES) cycles (2011–2018) were analyzed, with the analytic sample limited to Hispanic respondents who were overweight/obese. Respondents’ acculturation levels were derived from their reported country of origin and the primary language spoken at home. Respondents who reported speaking only Spanish or more Spanish than English at home were classified as primarily speaking Spanish at home. In contrast, those who reported speaking Spanish and English equally, more English than Spanish, or only English were categorized as primarily speaking English at home. Weighted multivariate logistic regression models were utilized to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to determine if differences in acculturation levels existed regarding the likelihood of receiving HCP counseling to (1) control/lose weight, (2) increase exercise/PA, and (3) reduce fat/calorie intake. Similar analyses examined differences in reported action regarding HCP counseling according to acculturation level. The analysis found no significant differences in receiving HCP counseling according to acculturation level. However, non-US-born respondents who primarily spoke Spanish at home were less likely than US-born respondents to report acting to control/lose weight (p = 0.009) or increase exercise/PA (p = 0.048), but were more likely to report having taken action to reduce fat/calorie intake (p = 0.016). This study revealed differences between acting on recommendations of health care professionals according to acculturation level, indicating a need for interventions tailored to acculturation levels.

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Cho, Soyeon. "THE MEDIATING ROLE OF ADVANCE CARE PLANNING IN ACCULTURATION AND USE OF NURSING HOME AMONG KOREAN AMERICANS." Innovation in Aging 3, Supplement_1 (November 2019): S518. http://dx.doi.org/10.1093/geroni/igz038.1909.

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Abstract The study examined attitudes towards Advance Care Planning (ACP) as a potential mediator in the association between acculturation and willingness to use nursing home in Korean American older adults (aged 60 and older). Data were driven from a cross-sectional study of 235 community-dwelling Korean American older adults (aged 60 and older) in 2013. Multivariate regression models of willingness to use nursing home were entered in the following order: (1) demographics, (2) health, (3) acculturation, and (4) attitudes towards advance care planning. The mediation effect of attitudes towards ACP in the relationship between acculturation and willingness to use nursing home was separately examined using the bootstrapping method. Higher acculturation was associated with positive attitudes towards ACP and more likelihood of using nursing home. The proposed mediation model was fully supported: positive attitudes towards ACP served as an intervening step between acculturation and willingness to use nursing home. The mediating role of attitudes towards ACP yields implications for developing culturally sensitive advance care planning education program targeting older individuals.

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Tiwari, Tamanna, Anila Poravanthattil, Nayanjot Rai, and Anne Wilson. "Association of Acculturation and Latino Parents’ Oral Health Beliefs and Knowledge." Children 8, no. 3 (March 22, 2021): 243. http://dx.doi.org/10.3390/children8030243.

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The purpose of our study was to explore the association of acculturation and Latino parent behavioral and psychosocial characteristics. A cross-sectional survey was conducted with 197 parent-children triads. Participating parents completed survey questions encompassing oral health knowledge, behaviors and beliefs from a validated oral health instrument. The mean score for acculturation in this sample was 3.8, where acculturation was dichotomized to a categorical variable. The bivariate associations between the independent variables (caregiver psychosocial factors and socio-economic factors (SES) factors) and acculturation (more/less acculturated) were conducted using logistic regression analysis, and for the final model a multivariate logistic regression model was used. In the bivariate analyses, less acculturated parents reported lower oral health knowledge (p = 0.02), higher social support (p = 0.028) and chronic stress (p = 0.015) and lower perceived susceptibility to dental caries in their children (p = 0.039). The bivariate analysis demonstrated that less acculturated parents had less education and employment (p < 0.0001) than more acculturated parents. The multivariate logistic model demonstrated that social support (p = 0.028), chronic stress (p = 0.015) and health beliefs as barriers to access dental care (p = 0.039) were higher in less acculturated parents compared to more acculturated parents. Less acculturated parents demonstrated lower oral health knowledge, higher stress and more barriers to accessing oral health care for their children. Oral health interventions for Latino families should incorporate strategies that include consideration of parental oral health beliefs.

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Samarasinghe, Kerstin Linnéa. "A Conceptual Model Facilitating the Transition of Involuntary Migrant Families." ISRN Nursing 2011 (November 20, 2011): 1–6. http://dx.doi.org/10.5402/2011/824209.

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Refugee families face a complex transition due to the nature of involuntary migration and the process of acculturation. There are several risk factors to the family adaptation process during the transition period, which are sociocontextually environmental dependant. Facilitating a healthy transition for refugee families, therefore, requires the role of nursing to incorporate sociopolitics into the discipline. This paper introduces a sociopolitically oriented and community-driven assessment and intervention model which is based on a family systematic approach. Interventions that aid the families in their acculturation process as well as empowers them to a well-functioning daily life, as per the SARFI model, should be adopted. As such, the future of nursing may provide additional primary health care services for refugee families; this is through a team-led “family nurse” who provides quality care for the family unit in collaboration with other health care professionals and societal authorities.

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Oguz, Tunay. "Is Patient-Provider Racial Concordance Associated with Hispanics’ Satisfaction with Health Care?" International Journal of Environmental Research and Public Health 16, no. 1 (December 24, 2018): 31. http://dx.doi.org/10.3390/ijerph16010031.

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This study adds a gender approach to determine how patient provider racial concordance and acculturation affect Hispanics’ satisfaction with care and inform more nuanced approaches to improving the quality of care for this population. Using the Medical Expenditure Panel Surveys (MEPS) from 2009–2011, four binary satisfaction outcome measures were created from the MEPS: “doctor showed respect”, “spent enough time”, “explained things in a way you could understand”, and “listened carefully”. Next, a Probit model was employed to estimate the impact of racial concordance and acculturation on the probability of being satisfied with provider care for both male and female Hispanics. For Hispanic women, no significant association was found for the relationship between patient-provider concordance and the overall satisfaction with their care. Hispanic men were found to be less likely to be satisfied with some aspects of their medical care when they were racially concordant with their provider. Overcoming assumptions about shared identity is a crucial step in providing culturally competent care for all patients. There is a need for additional considerations in medical training to help physicians connect with patients, regardless of any type of observable concordance.

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Han, Woojae, and Sungkyu Lee. "Racial/ethnic variation in health care satisfaction: The role of acculturation." Social Work in Health Care 55, no. 9 (June 28, 2016): 694–710. http://dx.doi.org/10.1080/00981389.2016.1191580.

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Alcalay, Rina. "Perceptions about Prenatal Care among Health Providers and Mexican-American Community Women: An Exploratory Study." International Quarterly of Community Health Education 13, no. 2 (July 1992): 107–18. http://dx.doi.org/10.2190/xd14-dn54-9etn-rw73.

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Latino women in California have less access to health care, particularly prenatal care, than any other ethnic group. This exploratory study identified perceptions about prenatal care needs, barriers to utilization of health services and common health behaviors during pregnancy among a sample of Mexican American women and a sample of prenatal care providers. The research used a combination of written questionnaires and focus-group discussions to gather data from a sample of sixty Mexican American community women, and a written questionnaire only to get information from a sample of forty providers. Results showed that providers perceived Mexican American women as doing better than non-Latino women regarding a series of health behaviors during pregnancy and as doing worse regarding another set of prenatal care behaviors. Results also showed that Mexican American pregnant teenagers are at particularly high risk regarding prenatal care due to a combination of structural and cultural factors. Acculturation was found to be an important factor affecting prenatal care beliefs and behaviors among this population. This relationship deserves further study. The influence of acculturation also needs to be considered in the design of prenatal care communication strategies with Mexican American women.

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Choi, Eun Young, Yuri Jang, and David A. Chiriboga. "Gender as a Moderator of the Effect of Education and Acculturation on Cognitive Function: A Study of Older Korean Immigrants." Journal of Aging and Health 32, no. 10 (August 12, 2020): 1659–66. http://dx.doi.org/10.1177/0898264320950554.

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Objectives: This study examined gender variations in the effect of education and acculturation on cognitive function in a group of older immigrants. Methods: Data were from the Study of Older Korean Americans, a multistate survey of Korean Americans aged 60 years and older ( N = 2061). Multivariate linear regression models of cognitive function, measured with the Mini-Mental State Examination, were tested to examine the independent and interactive effects of education, acculturation, and gender. We hypothesized that gender would be a moderator in the relationships of education and acculturation with cognitive function. Results: Supporting the hypothesis, the positive effect of both education and acculturation was greater among women than men. Furthermore, the positive association of education with cognitive function was pronounced among women with low acculturation. Discussion: Our findings suggest that gender plays a critical role in determining the cognitive health benefit arising from education and acculturation singularly and in concert.

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Eamranond, Pracha P., Christina C. Wee, Anna T. R. Legedza, Edward R. Marcantonio, and Suzanne G. Leveille. "Acculturation and Cardiovascular Risk Factor Control among Hispanic Adults in the United States." Public Health Reports 124, no. 6 (November 2009): 818–24. http://dx.doi.org/10.1177/003335490912400609.

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Objectives. We sought to determine whether low acculturation, based on language measures, leads to disparities in cardiovascular risk factor control in U.S. Hispanic adults. Methods. We studied 4,729 Hispanic adults aged 18 to 85 years from the National Health and Nutrition Examination Survey, 1999–2004. We examined the association between acculturation and control of low-density lipoprotein (LDL) cholesterol, blood pressure, and hemoglobin A1c based on national guidelines among participants with hypercholesterolemia, hypertension, and diabetes, respectively. We used weighted logistic regression adjusting for age, gender, and education. We then examined health insurance, having a usual source of care, body mass index, fat intake, and leisure-time physical activity as potential mediators. Results. Among participants with hypercholesterolemia, Hispanic adults with low acculturation were significantly more likely to have poorly controlled LDL cholesterol than Hispanic adults with high acculturation after multivariable adjustment (odds ratio [OR] = 3.4, 95% confidence interval [CI] 1.2, 9.5). Insurance status mildly attenuated the difference in LDL cholesterol control. After adjusting for diet and physical activity, the magnitude of the association increased. Other covariates had little influence on the observed relationship. Among those with diabetes and hypertension, we did not observe statistically significant associations between low acculturation and control of hemoglobin A1c (OR=0.5, 95% CI 0.2, 1.2), and blood pressure (OR=1.1, 95% CI 0.6, 1.7), respectively. Conclusions. Low levels of acculturation may be associated with increased risk of inadequate LDL cholesterol control among Hispanic adults with hypercholesterolemia. Further studies should examine the mechanisms by which low acculturation might adversely impact lipid control among Hispanic adults in the U.S.

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Anderson, Cheryl, and Sarah Strickland. "The Influence of Acculturation on Traumatic Stress Following Childbirth Among Hispanic Adolescents." Hispanic Health Care International 15, no. 3 (July 5, 2017): 99–106. http://dx.doi.org/10.1177/1540415317717410.

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Introduction: Many studies have explored the role of acculturation on health outcomes; however, no studies to date have examined relationships between acculturation and the traumatic stress of childbirth among Hispanic adolescents. Method: A convenience sample of 66 Hispanic adolescents 13 to 19 years of age completed the Acculturation Rating Scale for Mexican Americans–II (ARSMA-II), a demographic sheet, birth appraisal scale, and the Impact of Event Scale within 72 hours of birth. Results: Significant associations were found between the ARSMA-II subscales and acculturation proxy variables, excluding language; however, only the Mexican Orientation Subscale and generation proxy variable influenced the birth experience. The study findings showed that Hispanic adolescents reporting a more traumatic childbirth identified closer with the Mexican culture and reported fewer family generations residing in the United States. Conclusion: As an overlooked area of research, our findings support the need for additional research related to the traumatic stress of birth among Hispanic adolescents. Using multiple acculturation measurements, including the ARSMA-II, with larger, more diverse samples of adolescents, equally balanced between all categories of acculturation and placement within the five-tier generation matrix, can provide some insightful information and directed health care.

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Messer, Michael M., and Norman H. Rasmussen. "Southeast Asian Children in America: The Impact of Change." Pediatrics 78, no. 2 (August 1, 1986): 323–29. http://dx.doi.org/10.1542/peds.78.2.323.

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This is a review of the psychiatric literature on acculturation and child development in Southeast Asian refugees. Each age group suffers somewhat differrently from refugee experience, and these differences are described further. In addition, to aid the acculturation and developmental processes, treatment approaches are suggested. This article should be useful to pediatricians who care for refugee children and are unfamiliar with the psychiatric literature about refugees.

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Polonsky, Michael Jay, Ahmed Shahriar Ferdous, Andre M. N. Renzaho, Neil Waters, and Zoe McQuilten. "Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation." Journal of Public Policy & Marketing 37, no. 2 (November 2018): 306–26. http://dx.doi.org/10.1177/0743915618813115.

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Developed countries that accept refugees are obligated, under the UN Convention for Refugees, to integrate refugees into host communities, with inclusion in the health system being pivotal. Integration programs can be difficult though, because many refugees’ home countries have different health systems, lower health literacy, and different expectations of health services. Country health system differences require cultural adaptation of host country services when designing targeted, inclusive health care programs. Using a sample of 317 Australian-based African refugees, the authors examine how refugees’ acculturation, perceptions of discrimination, past behavior, objective knowledge, and medical mistrust affect their health inclusion, depending on their blood donation intentions. The results indicate that perceived discrimination and objective blood donation knowledge directly affect donation intentions. Perceived discrimination mediates the relationships between acculturation and intentions and between medical mistrust and donation intentions, and objective knowledge mediates the relationship between past behavior and donation intentions. The authors offer recommendations to policy makers designing social inclusion programs and health service providers designing and delivering targeted initiatives, to better facilitate refugee participation in host country health systems.

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Zlotnick, Cheryl, and Laura Dryjanska. "Immigrants’ Health, Acculturation, and the Work–Retirement Continuum." Health & Social Work 45, no. 1 (January 7, 2020): 13–22. http://dx.doi.org/10.1093/hsw/hlz039.

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Abstract Although the link between immigrants’ health status and employment is well established, there is little information on the combined impact of three components of acculturation (that is, dual self-identity, language proficiency, and realized expectations) on this link. Immigrants who came to Israel from English-speaking countries (N = 377) were categorized into three groups based on the work–retirement continuum (that is, working, same occupation; working, changed occupation; or retired). Using a cross-sectional design, this study examined whether the link between health and acculturation varied by immigrants’ location on the work–retirement continuum. Bivariate analyses revealed group differences for two acculturation components, language proficiency (p < .0001) and dual self-identity (p < .05). Multivariable analyses indicated an interaction effect between the acculturation component of realized expectations and work–retirement continuum group status on health status. As a result, good health was related to higher levels of realized expectations for the retired group; related to lower levels of realized expectations for the “working, changed occupations” group; and unrelated to realized expectations for the “working, same occupation” group. The acculturation component of realized expectations varies depending on the immigrant’s location on the work–retirement continuum. Health and social welfare professionals can promote health in working or retired immigrants by providing clear and realistic information to better align with immigrants’ expectations.

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Dow, Helena D. "The Acculturation Processes: The Strategies and Factors Affecting the Degree of Acculturation." Home Health Care Management & Practice 23, no. 3 (December 31, 2010): 221–27. http://dx.doi.org/10.1177/1084822310390877.

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R. Terry, Daniel, and Quynh Lê. "Social capital among migrating doctors: the “Bridge” over troubled water." Journal of Health Organization and Management 28, no. 3 (June 10, 2014): 315–26. http://dx.doi.org/10.1108/jhom-09-2012-0178.

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Purpose – The purpose of this paper is to examine the concept of social capital among International Medical Graduates (IMGs). It will specifically examine bridging social capital and greater intercultural communication which provides IMGs access to the wider community and plays a key role in cross-cultural adaptation and acculturation. Design/methodology/approach – A review of the literature. Findings – An Australian wide shortage of doctors has led to an increased reliance on the recruitment of IMGs. As IMGs migrate, they may encounter different meanings of illness, models of care and a number of social challenges. Nevertheless, greater cross-cultural adaptation and acculturation occurs through bridging social capital, where intercultural communication, new social networks and identity aids integration. This process produces more opportunities for economic capital growth and upward mobility than bonding social capital. Practical implications – Concerns regarding immigration, appropriate support and on-going examination processes have been expressed by IMGs in a number of studies and policy papers. However, there is very little insight into what contributes cross-cultural adaptation of IMGs. Originality/value – As IMGs migrate to not only a new country, but also a new health system and workplace they arrive with different cultural meanings of illness and models of care. These differences may be in contrast to the dominant western medical model, but often bring positive contributions to patient care in the new environment. In addition, improving bridging social capital provides IMGs access to the wider community and has been demonstrated to play a key role in cross-cultural adaptation and ultimately acculturation.

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Shipp, M. P.-L., S. A. Francis, K. R. Fluegge, and S. A. Asfaw. "Perceived Health Issues: A perspective from East-African immigrants." Health, Culture and Society 6, no. 1 (May 19, 2014): 13–32. http://dx.doi.org/10.5195/hcs.2014.113.

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This Study explores Somali and Ethiopian community leaders’ perceptions about health issues in their communities and the barriers to access and utilization of primary health care services. Fourteen in-depth interviews were conducted with community leaders and thematic analysis was used to analyze interviews. Participants identified chronic diseases, the unhealthy behaviors associated with them, and mental health as major health issues. Infectious diseases were secondarily mentioned as important health concerns. Lack of insurance and limited understanding of the health system were viewed as barriers to utilizing health care services. Other identified needs were: better education within immigrant communities about major health issues, enhanced cultural awareness of health care providers, improved health care access, and assistance with the acculturation process. Recommendations to improve the communities’ health status included enhancing providers' cultural competence, educating immigrants about major health issues, and increasing mental health care access.

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Basnyat, Supriti, and Kerry Chamberlain. "Dietary Acculturation of Nepalese Women in Aotearoa, New Zealand." Proceedings 37, no. 1 (December 13, 2019): 9. http://dx.doi.org/10.3390/proceedings2019037009.

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The immigrant population in New Zealand is growing dramatically, giving those arriving on work visas, student visas and visitor visas no guaranteed right to remain as well as restrictions to social resources such as health care. [...]

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Roncancio, Angelica M., Kristy K. Ward, and Abbey B. Berenson. "Hispanic Women's Health Care Provider Control Expectations: The Influence of Fatalism and Acculturation." Journal of Health Care for the Poor and Underserved 22, no. 2 (2011): 482–90. http://dx.doi.org/10.1353/hpu.2011.0038.

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Terry, Daniel, Mohammed Ali, and Quynh Lê. "Asian migrants' lived experience and acculturation to Western health care in rural Tasmania." Australian Journal of Rural Health 19, no. 6 (November 21, 2011): 318–23. http://dx.doi.org/10.1111/j.1440-1584.2011.01229.x.

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Bermúdez-Parsai, Mónica, Jennifer L. Mullins Geiger, Flavio F. Marsiglia, and Dean V. Coonrod. "Acculturation and Health Care Utilization among Mexican Heritage Women in the United States." Maternal and Child Health Journal 16, no. 6 (July 2, 2011): 1173–79. http://dx.doi.org/10.1007/s10995-011-0841-6.

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Fang, Mei Lan, Lorraine Halinka Malcoe, Judith Sixsmith, Louise Yuen Ming Wong, and Matthew Callender. "Exploring traditional end-of-life beliefs, values, expectations, and practices among Chinese women living in England: Informing culturally safe care." Palliative and Supportive Care 13, no. 5 (October 27, 2014): 1261–74. http://dx.doi.org/10.1017/s1478951514001126.

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AbstractObjective:This study explores the end-of-life (EoL) beliefs, values, practices, and expectations of a select group of harder-to-reach Chinese women living in England.Method:A cultural safety approach was undertaken to interpret 11 in-depth, semistructured interviews. Interviews were conducted in Mandarin and Cantonese. Transcripts were translated and back-translated by two researchers. Findings were analyzed using the technical analytical principles of grounded theory.Results:The key themes generated from our analysis include: acculturation; differential beliefs and norms in providing care: family versus health services; language and communication; Eastern versus Western spiritual practices and beliefs; and dying, death, and the hereafter.Significance of Results:End-of-life discussions can be part of an arduous, painful, and uncomfortable process, particularly for migrants living on the margins of society in a new cultural setting. For some Chinese people living in the United Kingdom, end-of-life care requires attention to acculturation, particularly Western versus Eastern beliefs on religion, spirituality, burial practices, and provision of care, and the availability of culturally specific care, all of which encompass issues related to gender. Stories of a purposive sample of Chinese women were viewed through a cultural safety lens to gain a deeper understanding of how social and cultural norms and expectations, in addition to the pressures of acculturation, impact gendered roles and responsibilities. The analysis revealed variations between/within Eastern and Western culture that resulted in pronounced, and oftentimes gendered, differences in EoL care expectations.

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Chiriboga, David, Nan Sook Park, Yuri Jang, and Victor Molinari. "Change Over Time in Linguistic Acculturation: A Comparison Between Cuban and Non-Cuban Hispanic Immigrants." Innovation in Aging 4, Supplement_1 (December 1, 2020): 334–35. http://dx.doi.org/10.1093/geroni/igaa057.1073.

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Abstract While acculturation and its implications for mental health have received extensive attention in studies with older immigrant populations, change over time in acculturation less so. This paper examines change over a two-year period in levels of linguistic acculturation among Cuban (n = 186) and non-Cuban Hispanic (n = 116) immigrants living in Florida. Data came from the waves of the Survey of Older Floridian (SOF), conducted using a statewide sampling frame based on population densities, with a computer-assisted telephone interview strategy. Calls were initiated through random digit dialing, and a follow-up interview was added approximately two years later. Measures included six acculturation items, one dealing with the participant’s language preference for the interview itself and five items dealing with language ability and usage. Results indicated that non-Cuban Hispanics were significantly more acculturated than Cuban Hispanics, and that at least 75% of Wave 2 acculturation was accounted for by Wave 1 status. After controlling for initial levels of acculturation, those who at first interview reported more economic problems and those reporting fewer depressive symptoms were more acculturated at follow-up. It was concluded that while linguistic acculturation is relatively stable, interventions to increase acculturation have implications for mental health service utilization.

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Vo, Dzung X., and M. Jane Park. "Racial/Ethnic Disparities and Culturally Competent Health Care Among Youth and Young Men." American Journal of Men's Health 2, no. 2 (May 19, 2008): 192–205. http://dx.doi.org/10.1177/1557988308317758.

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Racial/ethnic disparities in health and health care are receiving increasing national attention from the fields of public health and medicine. Efforts to reduce disparities should adopt a life-span approach and recognize the role of gender. During adolescence, young people make increasingly independent decisions about health-related behavior and health care, while developing gender identity. Little is known about how cultural context shapes gender identity and gender identity's influence on health-related behavior and health care utilization. The authors review disparities in health status and health care among adolescents, especially young men, by reviewing health care access, clinical services, and issues related to culture, identity, and acculturation. Significant differences in health status by gender exist in adolescence, with young men faring worse on many health markers. This article discusses gaps in research and offers recommendations for improving health care quality and strengthening the research base on gender and disparities during adolescence.

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Gast, Julie, and Terry Peak. "Current Perspectives on Latino Men’s Health." American Journal of Lifestyle Medicine 6, no. 3 (November 4, 2011): 268–76. http://dx.doi.org/10.1177/1559827611426530.

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Health concerns for Latinos, the largest ethnic minority in the United States, merit attention by policy makers. Given the importance of the Latino population to the economic well-being of the United States, ensuring good health for this group is crucial. Lack of access to health care is the most obvious barrier to maintaining good health for Latinos, but it is not the only important factor. Sociocultural factors, including acculturation, culturally competent health professionals, immigration status, income, and education are also influential to health concerns. Recommendations to decrease health disparities among Latino men include theoretically based health interventions, better integration of research findings, working with local communities, and incorporating Latino masculine values into both health care and health education. Given the importance of the sociocultural factors, the discussion that follows emphasizes these and the interaction of these factors with Latino cultural values.

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Barron, Florencia, Anita Hunter, Rachel Mayo, and Deborah Willoughby. "Acculturation and Adherence: Issues for Health Care Providers Working with Clients of Mexican Origin." Journal of Transcultural Nursing 15, no. 4 (October 2004): 331–37. http://dx.doi.org/10.1177/1043659604268950.

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Geltman, Paul L., Jo Hunter Adams, Katherine L. Penrose, Jennifer Cochran, Denis Rybin, Gheorghe Doros, Michelle Henshaw, and Michael Paasche-Orlow. "Health Literacy, Acculturation, and the Use of Preventive Oral Health Care by Somali Refugees Living in Massachusetts." Journal of Immigrant and Minority Health 16, no. 4 (June 9, 2013): 622–30. http://dx.doi.org/10.1007/s10903-013-9846-0.

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Gao, Xiang, Fei Sun, Eunjeong Ko, Jung Kwak, and Huei-Wern Shen. "Knowledge of advance directive and perceptions of end-of-life care in Chinese-American elders: The role of acculturation." Palliative and Supportive Care 13, no. 6 (June 11, 2015): 1677–84. http://dx.doi.org/10.1017/s147895151500067x.

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ABSTRACTObjective:This study aimed to describe knowledge of an advance directive (AD) and preferences regarding end-of-life (EoL) care communication, decision making, and designation of surrogates in Chinese-American elders and to examine the role of acculturation variables in AD awareness.Method:Survey data were collected through face-to-face interviews on a sample of 385 Chinese-American elders aged 55 or above living in the Phoenix metropolitan area. The choice of language (Mandarin, Cantonese, or English) and place of interview (senior apartments, Chinese senior centers, or homes) was at the respondent's preference. Hierarchical logistic regression analysis was employed to examine the influence of acculturation variables on AD awareness.Results:Some 21% of participants had heard about ADs, and only 10% had completed one. Elders with higher acculturation levels (OR = 1.04, p < 0.10) and those residing more than 20 years in the United States (OR = 6.87, p < 0.01) were more likely to be aware of ADs after controlling for the effects of demographics, health, and experiences of EoL care. The majority preferred physicians to initiate AD discussions (84.9%) and identified burdens on families as the most important factor in making EoL decisions (89.3%). About 55.1 % considered daughters as the preferred healthcare surrogate.Significance of Results:Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.

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Husa, Robyn, Hisako Matsuo, Jennifer Hale Gallardo, and Lisa Willoughby. "EXAMINATION OF TRUST IN THE HEALTH CARE SYSTEM AMONG OLDER IMMIGRANTS RESIDING IN THE MIDWEST." Innovation in Aging 3, Supplement_1 (November 2019): S516. http://dx.doi.org/10.1093/geroni/igz038.1903.

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Abstract Ethnic minority populations, such as immigrants, have demonstrated lower levels of trust in the health care system and their health care providers compared with non-migrant populations (Navaza et al., 2012; Renzaho, Polonsky, McQuilten, & Waters, 2013). This medical mistrust may adversely influence older adult immigrants’ use of and satisfaction with health services (Hong et al., 2018a; Jang, Kim, & Chiriboga, 2005). Thus, the current project aimed to characterize influences of medical mistrust (healthcare system and healthcare providers) in older adult immigrant populations living in the United States of America (U.S.). We interviewed 142 older adult immigrants and refugees (aged 60+ years) who identified as Bosnian, Chinese, Indian, Korean, Latino, and Vietnamese about their perceptions on living in the U.S., of the healthcare system, and healthcare utilization as a part of the Successful Aging among Immigrants in Midlife (SAIM) project. Linear regression models predicting trust in the healthcare system and trust in healthcare providers were tested with healthcare knowledge (measured with a single item about flu shots) , acculturation, length of time in the U.S. , and age as predictors. We found that older age and healthcare knowledge was predictive of higher levels of trust in healthcare providers for Chinese. Although healthcare knowledge was predictive of trust in the health care system for the Chinese participants, greater length of time and higher acculturation were associated with higher trust in the healthcare system among Indian participants. The implications of the different predictive variables in each of the hypothesized models will be discussed.

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Lee, Jaewon. "Mediating role of resilience between successful aging and acculturation among older Korean immigrants In the United States." Advances in Social Sciences Research Journal 7, no. 5 (May 16, 2020): 117–33. http://dx.doi.org/10.14738/assrj.75.8185.

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Background: This study was to investigate how acculturative stress affects older Korean immigrants' successful aging and whether resilience can play a mediator's role to the sample population's successful aging or not. The research design was a cross-sectional survey using three valid and reliable scales such as Successful Aging Scale, Acculturative Stress Scale, and Resilience Scale. A research shows that there is no or minimum correlation between acculturative stress and successful aging (Choi & Thomas, 2009). However, it was hypothesized that although there was a weak correlation between acculturative stress and successful aging, once the resilience involved as a mediator, the correlation would be stronger. Methods: The study was designed as a self-administered survey research using the scales mentioned above. One hundred and two (N=102) older Koreans who currently enrolled in Adult Health Care Centers in Los Angeles, CA, participated in this study. Multiple Regression, Correlation, ANOVA, and t-test was administered to analyze the collected data. Results: The results indicated that there was a positive but weak correlation between acculturative stress and the sample population's successful aging rate (r = .252, p<.05). Interestingly, when resilience intervened as a mediator, the correlation between acculturation and successful aging was increased to (r = .622, p<.05). Therefore, the study discovered that the resilience was able to play a mediator's role between acculturative stress and successful aging among the older Korean immigrants. Implications: The findings can be directed to social work researchers and practitioners to help educate the ethnic older adults in the community on the social and behavioral importance of the positive aspects of aging such as successful aging and healthy aging to increase the chance of community member's longevity. Future research will include other ethnic and immigrant older populations in the community to show internal and external validity of the study related to successful aging, acculturative stress, and resilience.

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Sullivan, John, and Beth Rosenberg. "The Vietnamese Community Members Who Were Part of GC-HARMS Are More Aware of Their Health, Environmental Impacts on Their Health, and How They Can Have Better Health: An Interview With Dustin Nguyen." NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy 28, no. 4 (November 21, 2018): 637–50. http://dx.doi.org/10.1177/1048291118811356.

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In this interview, Mr. Nguyen, Gulf Coast Health Alliance: Health risks related to the Macondo Spill Vietnamese community project hub manager (D’Iberville, Mississippi), describes his community’s cultural and financial difficulties finding adequate avenues for healthcare and wellness information before the Deepwater Horizon oil spill. He comments extensively on how the project’s clinical component in tandem with the Affordable Care Act promoted transformational changes in access to healthcare for his community and comments on generational shifts within the community in terms of language marginalization, its relationship to the pace of acculturation, and the allure of commercial fishing as a livelihood and a career.

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Wu, Tina. "A Culturally Sensitive Health Care Practice Model — Theory Construction and Its Testing." American Journal of Chinese Medicine 32, no. 03 (January 2004): 467–85. http://dx.doi.org/10.1142/s0192415x04002120.

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The major purpose of this paper was to develop a model for the use of complementary and alternative health care options. Chinese-American families were selected due to their large proportion among all ethnic populations in the United States. Andersen's (1973 and 1995) perception of predisposing and enabling was adopted to test study variables singly and interactively on their health care use. The dependent variable was defined as health behavior preference towards Chinese treatment (also known as complementary and alternative medicine treatment) or Western treatment, and a combination of Chinese and Western treatment (also known as integrative medicine treatment). Data were randomly collected from 240 adult Chinese-American respondents out of 1080 members of the Chinese American Association in the greater Cleveland area. Findings both in the full and partial research models reveal that the factors contributing the most to their medical preferences were their acculturation level and health beliefs. Inter-generational differences in health care use were also discussed.

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El Hajj, Dana G., Paul F. Cook, Kathy Magilvy, Michael E. Galbraith, Lynn Gilbert, and Marla Corwin. "Tobacco Use Among Arab Immigrants Living in Colorado." Journal of Transcultural Nursing 28, no. 2 (July 9, 2016): 179–86. http://dx.doi.org/10.1177/1043659615617512.

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Purpose: The authors determined the prevalence of smoking among Arab immigrants living in Colorado. The authors also evaluated the relationship between acculturation and tobacco use, including both cigarettes and hookah among Arab immigrants. Method: A cross-sectional survey of 100 adult Arab immigrants living in Colorado was carried out. Results: The results revealed that 19% of the study participants were current cigarette smokers and 21% were current hookah smokers. Participants who were more integrated into Arab culture were more likely to use tobacco products ( p = .03) and to have family members ( p = .02) and friends who use tobacco products ( p = .007). Conclusions: Acculturation plays a major role in affecting the health habits of Arab immigrants living in Colorado, especially in the area of hookah smoking. Implications for Practice: Understanding some culturally relevant predictors of tobacco use might assist health care providers in designing successful smoking cessation programs.

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Kataoka-Yahiro, Merle R., James Davis, Lana Sue Ka’opua, and Angela Sy. "Sociodemographic Characteristics and Preferences for Family (Informal) and Formal Caregiver Help With ADLs." Home Health Care Management & Practice 31, no. 2 (October 8, 2018): 120–27. http://dx.doi.org/10.1177/1084822318801811.

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The purpose of this article was to compare sociodemographic characteristics and various care preferences for family and formal caregivers help with activities of daily living (ADLs). The sample was 56,337 noninstutionalized U.S. civilian adults, 40 to 65 years of age. This is a cross-sectional study using secondary data from the National Health Interview Survey (NHIS)—2011 to 2014. Respondents’ sociodemographic characteristics and various care preferences for caregiver help with ADLs were analyzed. Subsequent analysis examined associations using adjusted multivariable logistic regression models. Preference for family caregivers help with ADLs was independently and significantly associated with race/ethnicity, age, gender, education, acculturation, and income. Future studies need to examine sociodemographic characteristics and caregiver preferences to tailor health care services for aging adults in the United States.

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Yoon, Hyunwoo, Hyunwoo Yoon, Yuri Jang, and Kwangyul Choi. "FACTORS ASSOCIATED WITH UNMET HEALTHCARE NEEDS IN OLDER ASIAN AMERICANS." Innovation in Aging 3, Supplement_1 (November 2019): S31. http://dx.doi.org/10.1093/geroni/igz038.120.

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Abstract Older Asian Americans are the fast-growing but understudied population in health disparities research. Using a sample that reflects cultural/linguistic diversity, the present study explored general (health insurance, usual place for care, income) and immigrant-specific (nativity, length of stay in the US, English proficiency, acculturation) risk factors of unmet healthcare needs in older Asian Americans. Data were drawn from the Asian American Quality of Life survey (N = 533). With the inclusion of a considerable number of non-English-speaking individuals, the present sample presented a high rate of unmet healthcare needs. Those with a shorter stay in the US, limited English proficiency, and lower level of acculturation had increased odds of having unmet healthcare needs than their counterparts after controlling for background characteristics. Challenging the myth of model minority, findings highlight the importance of immigrant-specific factors in identifying risk groups of unmet healthcare needs and demonstrate vulnerability in access to healthcare.

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Deyo, R. A., A. K. Diehl, H. Hazuda, and M. P. Stern. "A simple language-based acculturation scale for Mexican Americans: validation and application to health care research." American Journal of Public Health 75, no. 1 (January 1985): 51–55. http://dx.doi.org/10.2105/ajph.75.1.51.

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Steel, Zachary, Robert Mcdonald, Derrick Silove, Adrian Bauman, Phil Sandford, Jennifer Herron, and I. Harry Minas. "Pathways to the First Contact with Specialist Mental Health Care." Australian & New Zealand Journal of Psychiatry 40, no. 4 (April 2006): 347–54. http://dx.doi.org/10.1080/j.1440-1614.2006.01801.x.

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Objective: To examine the pathways to mental health care followed by patients presenting for the first time to community- and hospital-based services and the degree to which individual characteristics, cultural background, illness type, severity and service-related variables influence the time and pathways taken to reach care. Method: One hundred and forty-six consecutive Australian-born, Asian and Arabicspeaking patients making their first lifetime contact with mental health services in two area health regions were included. Symptom severity was assessed using the Health of the Nations Outcome Scales. Illness explanatory models, social support, English-language proficiency and acculturation were also assessed. Results: An average of three professional consultations were made prior to first contact with public mental health services. Family physicians occupied a pivotal role in the helpseeking pathway with 53% of patients consulting a general practitioner. The median time taken to reach specialist mental health services was 6 months, with significantly shorter time for patients with psychotic disorders. Individual variables such as gender, social support, ethnicity and English flency were not associated with delays in receiving public mental health care. Ethnicity was associated with lower utilization of allied health professionals. Conclusions: The data suggest that social and cultural factors influence the range of professionals consulted by those with a mental illness but do not delay their presentation to public mental health services.

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Prentovic, Risto. "Potentials of pre-school institutions in the field of demographic development of Vojvodina." Zbornik Matice srpske za drustvene nauke, no. 121 (2006): 227–40. http://dx.doi.org/10.2298/zmsdn0621227p.

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Preschool institutions, as principal institutions for social child care, with their three main functions - education, preventive health and social care represent a significant support to modern families in the field of improving protection, acculturation, socialisation and providing happy and carefree childhood and development of children at the preschool age. Such institutions also represent an important agent for motivating, that is encouraging and supporting spouses and other partners of different gender in having children which can be a positive factor of significant demographic development and instrument of the pronatalist population policy.

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Journal articles on the topic 'Acculturation and Health Care'

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