EBP FINAL

Running head: RESEARCH PROJECT 1

RESEARCH PROJECT 2

Research Project

Student Name

School

Dated

NOTE: the paper failed to meet the criteria listed on the instruction page attached with the assignment.

READ: The article dated 2017, should not be used as suggested by instructor, needs to make the introduction page at least 2 pages, needs to include project aim, purpose, outcome measures both primary and secondary should be included on the last paragraph I attached the instruction and the criteria below. (Introduction needs to be 2-3 pages, its less than 2 pages written)

Also include Key concepts, themes, similarities, differences, strengths, and weaknesses should be part of the literature review Explain the EBP framework or model selected to guide this project and why this was selected (second to last paragraph of this section) Summarize and synthesize the review of literature (last paragraph) o highlight what is known about the problem, identify any gaps in the literature, and reiterate the EBP framework to be used to guide the project: what you explained was from the last project which I scored zero because the teacher did not accept that. so it needs to be changed, the last sentence in this paper needs more detailed explanation and work

See below for aims, purpose and more.

CSP Project Topic

Breaking cultural stigma associated with mental health among immigrant population living in urban Midwestern community. I EDITED THE ONE YOU WROTE TO MATCH THIS UPDATED TOPIC

Problem or Issue 
Cultural stigma and discrimination are major issues for mental health patients and families.

Purpose of the Project 
To evaluate the impact of cultural stigma associated with depression and mental health among African immigrant population and ascertain the existing strategies to address the stigma to improve mental health awareness and care among African immigrant population living in St Louis.

Overall AIM

To Implement training program and education for African immigrant population, age 20 -65 years, by 60 % over 6 months

Outcome Measures

primary outcome measure: The number of immigrants identified with depression.

Secondary outcomes: Number of immigrants with depression who attend the educational program and number who were treated or referred for services

Study Question(s) 
· PICO(T) format

Within African immigrants aged 20-65 years living in an urban, midwestern community, what is the impact of standardized screening and education for depression on their ability to obtain treatment or resources to minimize the depression?

The article dated 2017, should not be used as suggested by instructor, needs to make the introduction page at least 2 pages, needs to include project aim, purpose, and more I attached the instruction and the criteria below. Thanks 

Breaking cultural stigma associated with mental health among immigrant population living in urban Midwestern community. (Introducetion needs to be 2-3 pages, its less than 2 pages written) article should be within 5 years, 2017 should be removed,

Mental health as a problem affects millions globally. Approximately 280 million in the world. (WHO, 2021). The data from 2017 showed an 18 percent prevalence among US immigrants, which is higher than among US-borns (WHO, 2021). The immigrants lack care access because of unemployment and financial instability. The immigrants must face the emotional stress of leaving the homeland and the occupation and adjusting to the new place. Immigrants and minority individuals experience significant stigmatization perpetuated by underlying drivers, such as institutions, citizenship status and ethnicity, which are critical factors in mental health (Douglass et al., 2022). The support from the family, proper access to care, and governmental facilities can reduce mental health issues among immigrants (Blankson, 2017).

Black immigrants are a significant growth segment of the U.S. population. (Bamgbose et al., 2022) acknowledges that the intersection of factors, such as race, gender, and migration, plays a significant role in women immigrants experiencing disparities in mental health and associated disorders. Immigrants in the U.S. increase the risk of serious psychological distress (SPD), significantly impacting their health and wellbeing and increasing the risk of depression, anxiety and other mental health related problems. (Ikonte et al., 2020). Understanding the different perspectives of the African immigrant population on mental health concerns and associated stigma is integral to implementing evidence-based approaches to promote positive mental health outcomes.

To evaluate the impact of the cultural stigma associated with mental health among the African immigrant population and ascertain the existing strategies to address the stigma to improve mental health awareness and care among the African immigrant population in St Louis. The question to be studied is, "Within African immigrants aged 20-65 years living in an urban, midwestern community, what is the impact of standardized screening and education for mental health-related problems on their ability to obtain treatment or resources to minimize the problem?”

John Hopkins model framework will direct how the evidence is interpreted and integrated into this project. The framework will assist in identifying questions that can be answered pre-and post-survey. It will also help in conducting a pilot study to implement practice change, assess results, and disseminate findings. The evidence findings will be integrated into practice to resolve the issue (CenterforEvidence-BasedPractice, 2021).

It is the background of the problem on which the research project is based. It is assumed that mental health-related problems are one of the worse issues in the community, and there is a need to discourage them. The United States of America must entertain a massive number of immigrants. Still, it is essential for the states that have an excess number of immigrants are required to maintain the rules and regulations to help the immigrants to get their identity.

Below is the section of the literature review where the studies of mental health and immigrants are included.

Literature Review

(Gopalkrishnan, 2018) took a closer look at some of the most critical aspects of cultural diversity and mental health. People in the mental health field all over the world must deal with patients from various cultural backgrounds. The way people view health and illness, the way they seek treatment, the nature of the therapeutic relationship, and even issues of racism and discrimination are all impacted by cultural differences. Many aspects of mental health are influenced by cultural differences around the world, including how health and illness are perceived, how people seek treatment and the attitudes of both consumers and practitioners. According to a large body of research, health and disease are viewed differently in different cultures.

(Tanaka, 2018) said that the people with mental health problems (PMHP), stigma can have a devastating effect on their quality of life. Results show how stigma is experienced in culturally and socioeconomically distinct contexts and how it is affected by various factors. People with mental health problems (PMHP) face stigma because of cultural traits like the belief that mental illness is a family disease and the tendency to overestimate how severe their condition is and how much it will affect their lives.

(Stangl, 2019) proposed a well-documented link between stigma and health-seeking behavior, participation in health care, and compliance with treatment for a wide range of health conditions worldwide. Stigmatization frameworks tend to focus on one health condition at a time and tend to focus on the psychological pathways that connect individuals. Silos have grown up around research on health stigmas, making it challenging to compare disparate conditions and find new ways to reduce health stigma and improve health outcomes for everyone. Stigmatization is an essential contributor to poor health outcomes worldwide. Research and interventions based on a common framework can help us better understand how stigma affects people across various diseases.

(Ikonte, 2020) collected data from the National Health Interview Survey was examined. Differences in the prevalence of SPD and depression between US-born and immigrant populations were measured using chi-square tests. The relationship between mental health outcomes (depression, SPD) and their predictors was studied using logistic regression models (nativity, length of residence). Depression and SPD trends were analysed using general linear models. The study included a total of 101,142 American adults. There was an 11% (OR 0.89, 95% CI [0.85,0.95]) lower risk of depression among immigrants compared to those born in the United States. Immigrants (p=0.011) and US-born individuals (p=0.0001) had lower depression prevalence over time than did those who were born in the United States (p=0.0001). An additional 17% (OR 1.17, 95% CI [1.00,1.36]) of SPD was found in immigrants living in the United States for more than 15 years. Among immigrants, SPD (p=0.002) and depression (p0.0001) were more common as time in the country increased (p0.0001).

(Nmezi, 2022) said that cardiovascular disease (CVD) is the leading cause of death (U.S.). For example, non-Hispanic Black adults have a higher cardiovascular disease morbidity and mortality rate than non-Hispanic white adults. An increasing number of non-Hispanic black adults in the United States are African immigrants, but little is known about how specific psychological and social factors (such as depression and cultural acculturation) influence their CVH. We wanted to see if acculturation influenced the link between depression severity and cardiovascular disease (CVD) in African immigrants, and if so, how. Participants were drawn from the Baltimore-Washington D.C. area's African Immigrant Health Study. The Patient Health Questionnaire-8 was used to measure the severity of depression symptoms (PHQ-8). The seven metrics of the American Heart Association's Life's Simple rated cardiovascular health from poor to ideal. It was found that the length of time spent in the country and the strategy used to integrate into the culture were both essential moderators of acculturation. The moderating effect of acculturation on depression and CVH was examined using multivariable logistic regression after adjusting for known confounders. Three hundred and seventeen African immigrants took part in the research. As a result, most (60 per cent) of the study participants were female. A total of 8.8% of those who participated in the research reported moderate-to-severe signs of depression.

(Foo, 2018) reported that the world's migrant population grows, it's essential to look at how depression affects this often-vulnerable demographic. International migrants are at an increased risk of developing depression, and this review and meta-analysis aim to examine the prevalence of depression among these individuals. There were 25 studies in the review. Using a random-effects model meta-analysis, 15.6 percent of migrants were found to have the condition. More must be done to ensure the psychological well-being and mental health outcomes of newly arrived migrants by incorporating additional preventive measures and increasing the level of assistance they receive. Psychiatric disorders should be studied more thoroughly among members of this subpopulation.

(Oppedal, 2020) said that in recent decades, many high-income countries have seen a shift in population demographics toward greater cultural diversity as a result of high rates of immigration. Immigrant-background youth are more likely to suffer mental health issues due to socioeconomic deprivation and pre-migration trauma.

The resettlement countries' multi-cultural contexts also present several acculturations demands that may affect their mental health in either beneficial or detrimental ways. Developing the cultural competence required to thrive and participate socially in the heritage and the majority culture is one of these acculturation tasks.

Acculturation-related risk and protective factors should be well-understood from the standpoint of public mental health. Acculturation measures that target the cultural competencies of youth from immigrant backgrounds and are theoretically linked to mental health have been lacking, which has jeopardised this responsibility.

(Abdulhamed, 2022) interested in the relationship between depression and generalised anxiety among first- and second-generation immigrant-background adolescents (aged 14–15) in Finland who have experienced discrimination. The Finnish Institute for Health and Welfare (2017) conducted the National School Health Promotion Study (N = 73,690). The PHQ-2 (for depression) and GAD-7 (for generalised anxiety disorder) scales were used to gauge participants' mental well-being.

There was a significant difference between first-generation and second-generation immigrant children regarding mental health symptoms, and they also had lower scores on all tests. The fact that 42% of first-generation immigrants said they couldn't talk to anyone about their problems was concerning, as was the fact that more than a fifth of this generation's youth rarely discussed personal issues with their parents.

(Slobodin, 2018) published the pilot study of a culturally appropriate psychosocial intervention that examined the mental health needs and expectations of asylum seekers in the United States. Participants were asylum-seekers in the Netherlands, most of whom fled violence in their home countries in the Middle East. Therapy expectations questionnaires were used with 11 participants and two focus groups to identify needs and expectations (17 participants).

According to the participants, post-migration stressors were more frequently linked to mental health problems than were past traumatic events. Often, health issues were suppressed because of shame, guilt, anxiety, and the fear of negative stigma. The stigma and burden of multiple stressors made it difficult for individuals and communities to provide support for those who were suffering from psychosocial distress. Our paper emphasises the importance of considering local mental health knowledge and the need to go beyond the trauma-focused approach to strengthen community capacity.

(Gkiouleka, 2018) assumed that the current socioeconomic instability does not appear to correlate with increased rates of depressive symptoms across countries, nor does it affect migrants and non-migrants alike. Migrants and non-migrants alike are more likely to suffer from depression if they have experienced financial hardship, domestic conflict as a child, female gender, and experiences of perceived discrimination. Living with children, on the other hand, has a protective effect. These associations between migrants and non-migrants, as well as within and between countries, vary widely. Depressive symptoms may be influenced by other factors, including mental health and context.

(Mucci, 2019) said that number of socio-environmental factors, such as a decline in social standing, discrimination, and being cut off from one's family, contribute to the higher incidence of severe mental illnesses among migrant workers, including psychosis, anxiety, and post-traumatic stress disorder (PTSD). The goal is to comprehensively analyze and identify the most prevalent mental health issues among these workers and the most at-risk demographic groups. According to PubMed, Cochrane Library, and Scopus, we looked at articles from 2009 to 2019 that used a variety of keywords.

There were 1.228 results from the online search. One hundred twenty-seven articles, including 12 reviews and 115 original articles, were analyzed using inclusion and exclusion criteria. Anxiety, depression, alcoholism, and substance abuse are among the most common new disorders identified through this study's findings, as are poor sleep quality and depressive symptoms (such as difficulty concentrating at work or feeling depressed or angry).

Migrant workers are often subjected to physical or verbal abuse and forced to work in hazardous or unhealthy environments, all of which contribute to their precarious living conditions. This is why occupational medicine must play a more significant role in promoting the health and well-being of this vulnerable job category.

References

Abdulhamed, R., Lonka, K., Hietajärvi, L., Ikonen, R., & Klemetti, R. (2022). Anxiety and depression symptoms and their association with discrimination and a lack of social support among first-and second-generation immigrant adolescents. International Journal of Intercultural Relations, 87, 193-205. https://doi.org/10.1016/j.ijintrel.2022.03.001

Bamgbose Pederson, A., Waldron, E. M., & Fokuo, J. K. (2022). Perspectives of Black Immigrant Women on Mental Health: The Role of Stigma. Women's health reports (New Rochelle, N.Y.), 3(1), 307–317. https://doi.org/10.1089/whr.2021.0071

Blankson, F. H. (2017). The use of health services in Ghana: experiences and perspectives of Ghanaian women. Dissertation.

CenterforEvidence-BasedPractice. (2021). Johns Hopkins Nursing Evidence-Based Practice. Retrieved from https://guides.upstate.edu/c.php?g=1023176&p=7411252

Chun Tie, Y., Birks, M., & Francis, K. (2019). Grounded theory research: A design framework for novice researchers. SAGE available medicine, 7, 2050312118822927. https://doi.org/10.1177/2050312118822927

Douglass, C. H., Lim, M., Block, K., Onsando, G., Hellard, M., Higgs, P., Livingstone, C., & Horyniak, D. (2022). Exploring stigma associated with mental health conditions and alcohol and other drug use among people from migrant and ethnic minority backgrounds: a protocol for a systematic review of qualitative studies. Systematic reviews, 11(1), 12. https://doi.org/10.1186/s13643-021-01875-

Foo, S. Q., Tam, W. W., Ho, C. S., Tran, B. X., Nguyen, L. H., McIntyre, R. S., & Ho, R. C. (2018). Prevalence of depression among migrants: a systematic review and meta-analysis. International journal of environmental research and public health, 15(9), 1986. DOI:  10.3390/ijerph15091986

Gkiouleka, A., Avrami, L., Kostaki, A., Huijts, T., Eikemo, T. A., & Stathopoulou, T. (2018). Depressive symptoms among migrants and non-migrants in Europe: documenting and explaining inequalities in times of socio-economic instability. European Journal of Public Health, 28(suppl_5), 54-60. https://doi.org/10.1093/eurpub/cky202

Gopalkrishnan, N. (2018). Cultural diversity and mental health: Considerations for policy and practice. Frontiers in public health, 6, 179. https://doi.org/10.3389/fpubh.2018.00179

Ikonte, C. O., Prigmore, H. L., Dawson, A. Z., & Egede, L. E. (2020). Trends in prevalence of depression and serious psychological distress in United States immigrant and non-immigrant populations, 2010–2016. Journal of affective disorders, 274, 719-725. DOI:  10.1016/j.jad.2020.05.010

Ikonte, C. O., Prigmore, H. L., Dawson, A. Z., & Egede, L. E. (2020). Trends in depression and severe psychological distress prevalence in the United States immigrant and non-immigrant populations, 2010 - 2016. Journal of affective disorders, 274, 719–725. https://doi.org/10.1016/j.jad.2020.05.010

Mucci, N., Traversini, V., Giorgi, G., Tommasi, E., De Sio, S., & Arcangeli, G. (2019). Migrant workers and psychological health: A systematic review. Sustainability, 12(1), 120. https://doi.org/10.3390/su12010120

Nmezi, N. A., Turkson-Ocran, R. A., Tucker, C. M., & Commodore-Mensah, Y. (2022). The Associations between Depression, Acculturation, and Cardiovascular Health among African Immigrants in the United States. International Journal of Environmental Research and Public Health, 19(11), 6658. HTTPS:// doi.org/10.3390/ijerph19116658

Oppedal, B., Keles, S., Cheah, C., & Røysamb, E. (2020). Culture competence and mental health across different immigrant and refugee groups. BMC Public Health, 20(1), 1-13. https://doi.org/10.1186/s12889-020-8398-1

Slobodin, O., Ghane, S., & De Jong, J. T. (2018). Developing a culturally sensitive mental health intervention for asylum seekers in the Netherlands: A pilot study. Intervention, 16(2), 86. DOI: 10.4103/INTV.INTV_2_18

Stangl, A. L., Earnshaw, V. A., Logie, C. H., van Brakel, W., C Simbayi, L., Barré, I., & Dovidio, J. F. (2019). The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC medicine, 17(1), 1-13. https://doi.org/10.1186/s12916-019-1271-3

Tanaka, C., Tuliao, M. T. R., Tanaka, E., Yamashita, T., & Matsuo, H. (2018). A qualitative study on the stigma experienced by people with mental health problems and epilepsy in the Philippines. BMC psychiatry, 18(1), 1-13. https://doi.org/10.1186/s12888-018-1902-9

WHO. (2021). Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depressio