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恐惧的氛围:医疗服务提供者对拉丁裔移民服务利用的看法。

Climate of Fear: Provider Perceptions of Latinx Immigrant Service Utilization.

机构信息

College of Social Work, University of Tennessee, Knoxville, TN, USA.

Texas Institute for Child & Family Wellbeing, The University of Texas at Austin Steve Hicks School of Social Work, Austin, TX, USA.

出版信息

J Racial Ethn Health Disparities. 2020 Oct;7(5):901-912. doi: 10.1007/s40615-020-00714-w. Epub 2020 Feb 21.

Abstract

Latinx immigrants endure stressors throughout the immigration process that detrimentally impact their health and wellbeing. Yet, they also face substantial barriers to accessing and utilizing services. These barriers might be heightened under the Trump administration, which has implemented policies facilitating increased immigration enforcement and punitive immigration practices. This study utilizes data collected from providers who serve Latinx immigrants in the border state of Texas to better understand current immigrant service utilization behaviors. Individual interviews and focus groups were conducted shortly after the last presidential election to inquire about recruitment, retention, program completion, and resources to address key client risk factors. Applying grounded theory analysis strategies, interviews, and focus group recordings were coded for key themes. Data demonstrated central concerns held by providers serving immigrants, and especially those who are undocumented or in mixed-status families. Concerns were related to the following three themes: (1) undocumented immigrant stressors, (2) limited resources for undocumented immigrants, and (3) service utilization barriers. Lack of services for undocumented immigrants and fear related to service utilization were prominent subthemes. These findings extend our knowledge of stressors and barriers of access and utilization for immigrants during this time period of increased immigration enforcement which have valuable implications for practice and future research. Providers can take concrete actions to educate immigrants, regardless of documentation status, on how their clients' identities will be protected. In addition, intentional trust-building strategies are essential to help overcome fear of utilizing services. Future research should ascertain perspectives of immigrant families, as this study drew perspectives only from providers.

摘要

拉丁裔移民在移民过程中承受着各种压力,这些压力对他们的健康和幸福造成了不利影响。然而,他们在获得和使用服务方面也面临着巨大的障碍。在特朗普政府执政期间,这些障碍可能会加剧,因为特朗普政府实施了一些政策,以促进加强移民执法和惩罚性移民做法。本研究利用在边境州德克萨斯州为拉丁裔移民服务的提供者收集的数据,更好地了解当前移民服务使用行为。在上一次总统选举后不久,进行了个人访谈和焦点小组,以了解招募、保留、项目完成情况以及解决关键客户风险因素的资源情况。应用扎根理论分析策略,对访谈和焦点小组录音进行了编码,以确定主要主题。数据显示了服务移民的提供者,特别是那些无证或处于混合身份家庭的提供者所关注的核心问题。这些问题与以下三个主题有关:(1)无证移民的压力源,(2)无证移民的资源有限,以及(3)服务利用障碍。缺乏无证移民服务以及与服务利用相关的恐惧是突出的子主题。这些发现扩展了我们在移民执法力度加大的这段时间内对移民获取和利用方面的压力源和障碍的认识,这对实践和未来研究具有重要意义。提供者可以采取具体行动,教育无论其身份是否合法的移民,了解其客户的身份将如何得到保护。此外,建立信任的策略是必不可少的,以帮助克服对使用服务的恐惧。未来的研究应该确定移民家庭的观点,因为本研究仅从提供者那里获取了观点。

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