Lohr, Abby

Abstract Background Immigrant women experience disproportionate psychosocial stress driven by acculturation, socioeconomic hardship, discrimination, and transnational responsibilities. Despite evidence supporting culturally tailored stress‑management interventions, limited formative research has examined program preferences across diverse immigrant communities. Methods Using a community‑based participatory research (CBPR) approach, we conducted three language‑concordant focus groups (Somali, Spanish, English; n = 18) and a mixed‑methods survey (n = 88) with immigrant women in southeast Minnesota. Qualitative data were analyzed using constant comparative methods; quantitative data were summarized descriptively. Results Participants described intersecting stressors including caregiving burdens, financial insecurity, immigration‑related fears, bicultural identity strain, and transnational obligations (e.g., “Every day you are being told of problems back at home”). Barriers to discussing stress included stigma, limited culturally concordant care, religious norms discouraging emotional disclosure, and structural constraints such as lack of insurance (e.g., “How are you gonna pay for a therapist if you don't have health insurance?”). Coping strategies varied culturally but consistently emphasized social support, spirituality, and practical stress‑reduction techniques. Survey findings indicated strong preference for education on stress, stigma reduction, culturally and linguistically aligned support groups, and flexible delivery formats (in‑person, hybrid). Conclusions Immigrant women experience multifaceted stress shaped by minority stress processes and structural inequities. Findings highlight the need for culturally responsive, community‑informed stress‑management interventions that integrate education, social support, and flexible delivery modalities. These results directly inform adaptation of a stress‑management program for Somali, Spanish‑, and English‑speaking immigrant women.

Abstract Background: Self-efficacy theory proposes that confidence to engage in a health behavior is associated with engaging in that specific behavior. Most research examining self-efficacy has been conducted with white young adult populations. This secondary analysis examined the association of self-efficacy (i.e., confidence) for healthy eating and physical activity in two immigrant communities. Methods: At enrollment into the Healthy Immigrant Community study, a clinical weight management and cardiovascular risk reduction intervention set in southeastern [state], 475 participants completed assessments about their confidence for healthy eating and physical activity. Measurements also included self-reports of dietary quality and intake, physical activity, quality of life, and biometric assessments. Study materials were available in English, Spanish, and Somali. Results In total, 450 adults (Hispanic/Latinx = 267; Somali = 183) completed measures at baseline and were included for analysis. Their average age was 45 years (range 18–87) and 59% were female. Confidence for healthy eating was significantly associated with self-report of eating healthy snacks ( p = < 0.0001) and less consumption of high-calorie drinks ( p = 0.02) and regular soda ( p = < 0.0001). Confidence to be physically active was significantly associated with more self-reported physical activity ( p = < 0.01). Conclusions Confidence to eat healthy and be physically active appears to be associated with having a healthier diet and higher levels of physical activity. Given the large sample size and strength of the associations, it also appears that the theoretical model of self-efficacy can be effectively measured and applied within these immigrant populations. Self-efficacy theory may be useful in understanding potential mediating mechanisms when designing future interventions with immigrant communities. ClinicalTrials.gov registration: NCT05136339; April 23, 2022