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Article: The Impact of Binational Barriers to Medical Care on the Care-Seeking Practices of Mexican Immigrants.

Crocker, Rebecca M

2021 Volume 31, Issue 6, Page(s) 1043–1055

Abstract: Barriers to health care access faced by Mexican immigrants in the United States have been well-documented, including lack of insurance, fear of deportation, and language barriers. However, little is known about this population's care-seeking experiences ... ...

Abstract	Barriers to health care access faced by Mexican immigrants in the United States have been well-documented, including lack of insurance, fear of deportation, and language barriers. However, little is known about this population's care-seeking experiences before migration. In this article, I use a life-course approach to explore binational isolation from health care and the ways in which early-life experiences pattern Mexicans' care-seeking practices in the United States. This ethnographic research project took place in Tucson, Arizona, between 2013 and 2014 and used semistructured interviews with service providers and first-generation Mexican immigrants. The majority of participants faced significant barriers to medical care in Mexico, which resulted in low rates of care utilization and heavy reliance on lay modalities. Immigrants faced an even broader array of barriers to care in the United States, and their lack of prior health care access further discouraged care utilization and compromised their medical care experiences after migration.
MeSH term(s)	Arizona ; Emigrants and Immigrants ; Health Services Accessibility ; Humans ; Mexico ; Patient Acceptance of Health Care ; United States
Language	English
Publishing date	2021-02-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1275716-0
ISSN	1552-7557 ; 1049-7323
ISSN (online)	1552-7557
ISSN	1049-7323
DOI	10.1177/1049732321992041
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Article ; Online: Santos Remedios: How Mexican Immigrants Use Authoritative Healing Knowledge to Survive Migration.

Crocker, Rebecca M / Gonzales, Patrisia

Culture, medicine and psychiatry

2021 Volume 46, Issue 2, Page(s) 509–530

Abstract: Mexicans living in the United States frequently rely upon popular healing to address a broad spectrum of physical, psychological, and spiritual ailments. They practice Mesoamerican healing ways including using herbal remedies, employing nutritional ... ...

Abstract	Mexicans living in the United States frequently rely upon popular healing to address a broad spectrum of physical, psychological, and spiritual ailments. They practice Mesoamerican healing ways including using herbal remedies, employing nutritional health promotion and illness remediation, over the counter pharmaceuticals, prayer and religion, and visiting expert healers. In this article, we utilize Brigitte Jordan's theory of "authoritative knowledge," to show how Mexican immigrants' ancestral and ecological-based healing knowledge travels with them through migration. Based on original ethnographic research in the Southwest borderlands, we expand an understanding of the factors that support the continuity of authoritative knowledge spatially and temporally. Mexicans' healing knowledge persisted north of the border because it (1) incorporated a wide array of healing techniques and materials that remained accessible post-migration, (2) enabled immigrants to heal according to Mesoamerican worldviews that privileged natural modalities and a holistic approach to body, mind, and spirit, and (3) remained relevant by allowing immigrants to remedy daily health stressors inherent to Mexican migration, including the border crossing, detention and deportation, and daily fear provoked by undocumented status. While lay practices have often been interpreted as problematic by medical professionals, we conclude that Mexicans' authoritative healing knowledge serves as a survival mechanism during the challenging circumstances of binational migration.
MeSH term(s)	Emigrants and Immigrants ; Humans ; Mexico ; United States
Language	English
Publishing date	2021-07-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	752957-0
ISSN	1573-076X ; 0165-005X
ISSN (online)	1573-076X
ISSN	0165-005X
DOI	10.1007/s11013-021-09734-5
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Article ; Online: "My own corner of loneliness:" Social isolation and place among Mexican immigrants in Arizona and Turkana pastoralists of Kenya.

Pike, Ivy L / Crocker, Rebecca M

Transcultural psychiatry

2020 Volume 57, Issue 5, Page(s) 661–672

Abstract: This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural ... ...

Abstract	This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural shaping of expectations for social lives and the ways in which structural vulnerability and violence can undermine these expectations. We draw on ethnographic research with two groups of migrants: Mexican immigrants living in southern Arizona and Turkana pastoralists of Kenya who experience displacement and unpredictable mobility as a result of low intensity violence. For Mexican immigrants, feelings of loneliness intertwine with the emotions of fear, trauma, and sadness, all closely associated with social isolation. The Turkana describe loneliness associated with the loss of their animals, or the shifting social landscapes they must traverse to keep their families safe. The culturally salient experiences described by these two communities highlight the complexity of defining loneliness. Given the pace of global migration and the number of refugees and displaced persons, closer scrutiny of how cultural expectations and structural violence interact to produce feelings of loneliness seems overdue.
MeSH term(s)	Arizona ; Culture ; Emigrants and Immigrants/psychology ; Humans ; Kenya ; Loneliness ; Mexico/ethnology ; Social Determinants of Health ; Social Isolation
Language	English
Publishing date	2020-08-17
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1378978-8
ISSN	1461-7471 ; 1363-4615
ISSN (online)	1461-7471
ISSN	1363-4615
DOI	10.1177/1363461520938286
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Article ; Online: How Mexicans' Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care.

Crocker, Rebecca M / Morrill, Kristin E / Villavicencio, Edgar A / Garcia, David O

Journal of transcultural nursing : official journal of the Transcultural Nursing Society

2022 Volume 33, Issue 5, Page(s) 615–623

Abstract: Introduction: This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people.: Methodology: This article ... ...

Abstract	Introduction: This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people. Methodology: This article presents findings from qualitative interviews ( Results: We documented common experiences of surprise, fear, and hope during study participation, all of which motivated research participants to reduce their NAFLD risk by seeking additional information, sharing it with others, and making lifestyle changes. Discussion: Understanding how these emotional experiences are tied to cultural and historical factors-including Mexico's high rates of liver disease, participant's limited access to health care, and the ability to address the NAFLD risk with lifestyle changes-may promote the development of more effective and culturally congruent care in this population.
MeSH term(s)	Culturally Competent Care ; Emigrants and Immigrants ; Emotions ; Humans ; Mexico ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/epidemiology
Language	English
Publishing date	2022-06-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1291524-5
ISSN	1552-7832 ; 1043-6596
ISSN (online)	1552-7832
ISSN	1043-6596
DOI	10.1177/10436596221101923
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Article ; Online: A Qualitative Analysis of Mexican-Origin Men's Knowledge and Cultural Attitudes Toward Non-Alcoholic Fatty Liver Disease and Interest in Risk Reduction.

Villavicencio, Edgar A / Crocker, Rebecca M / Garcia, David O

American journal of men's health

2021 Volume 15, Issue 6, Page(s) 15579883211063335

Abstract: Mexican-origin men are at increased risk of developing non-alcoholic fatty liver disease (NAFLD). The purpose of this qualitative research was to assess Mexican-origin men's knowledge and cultural attitudes toward NAFLD and their interest in risk ... ...

Abstract	Mexican-origin men are at increased risk of developing non-alcoholic fatty liver disease (NAFLD). The purpose of this qualitative research was to assess Mexican-origin men's knowledge and cultural attitudes toward NAFLD and their interest in risk reduction. Semi-structured interviews were conducted with 11 Spanish-speaking Mexican-origin men who were considered high-risk of having NAFLD according to transient elastography (FibroScan®) continuous attenuation parameter (CAP) scores (≥280). Audio recordings of these interviews were transcribed and interpreted in their respective language to facilitate data analysis using NVivo 12. A thematic codebook was developed, from which the research team identified emerging themes. Findings demonstrated limited knowledge about NAFLD and in general chronic liver disease among Mexican-origin men. Cultural attitudes appeared to both enhance and mitigate their perceived risk for NAFLD. Interviews also revealed high interest levels for reducing NAFLD risk, with family and loved ones acting as the main motivators for engagement in healthier behaviors. Inclination toward family-based interventions was reported as a subject of interest for this high-risk population. This qualitative study suggests that the development of a NAFLD-specific intervention approach for Mexican-origin men may be feasible and should consider a familial and cultural context centered in improving lifestyle health behaviors.
MeSH term(s)	Attitude ; Humans ; Language ; Male ; Men ; Non-alcoholic Fatty Liver Disease/prevention & control ; Risk Reduction Behavior
Language	English
Publishing date	2021-11-30
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2275106-3
ISSN	1557-9891 ; 1557-9883
ISSN (online)	1557-9891
ISSN	1557-9883
DOI	10.1177/15579883211063335
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Article ; Online: A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample.

Palmer, Kelly N B / Crocker, Rebecca M / Marrero, David G / Tan, Tze-Woei

Frontiers in clinical diabetes and healthcare

2023 Volume 4, Page(s) 1027578

Abstract: Aim: To describe patients' reported employment challenges associated with diabetic foot ulcers (DFUs).: Methods: Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a ... ...

Abstract	Aim: To describe patients' reported employment challenges associated with diabetic foot ulcers (DFUs). Methods: Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a tertiary referral center from June 2020 to February 2021. Participants consented to an audio-recorded semi-structured phone interview. Interviews were transcribed and thematically analyzed using the Dedoose data analysis platform. Results: Participants shared a common theme around the cyclic challenges of DFU prevention/management and employment. Those employed in manual labor-intensive jobs or jobs requiring them to be on their feet for long durations of time believed working conditions contributed to the development of their DFUs. Patients reported work incapacity due to declines in mobility and the need to offload for DFU management. Many expressed frustration and emotional distress related to these challenges noting that DFUs resulted in lower remuneration as medical expenses increased. Consequently, loss of income and/or medical insurance often hindered participants' ability to manage DFUs and subsequent complications. Conclusion: These data illuminate the vicious cycle of DFU and employment challenges that must be addressed through patient-centered prevention strategies. Healthcare providers should consider a person's contextual factors such as employment type to tailor treatment approaches. Employers should establish inclusive policies that support patients with DFUs returning to work through flexible working hours and adapted work tasks as needed. Policymakers can also mitigate employment challenges by implementing social programs that provide resources for employees who are unable to return to work in their former capacity.
Language	English
Publishing date	2023-04-14
Publishing country	Switzerland
Document type	Journal Article
ISSN	2673-6616
ISSN (online)	2673-6616
DOI	10.3389/fcdhc.2023.1027578
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Article ; Online: Communicating

Villavicencio, Edgar A / Maldonado, Adriana / Crocker, Rebecca M / Guan, Yue / Stallman, Chris / Garcia, David O

Frontiers in public health

2023 Volume 10, Page(s) 1090101

Abstract: Introduction: The burden of non-alcoholic fatty liver disease (NAFLD) continues to disproportionately impact under-resourced communities in the U.S., particularly Mexican-origin populations. Genetic polymorphisms such as the rs738409 C/G variant in ... ...

Abstract	Introduction: The burden of non-alcoholic fatty liver disease (NAFLD) continues to disproportionately impact under-resourced communities in the U.S., particularly Mexican-origin populations. Genetic polymorphisms such as the rs738409 C/G variant in patatin-like phospholipase domain-containing 3 ( Methods: Semi-structured interviews were conducted with 17 Mexican-origin men whose NAFLD status and genetic predisposition were determined as part of a previous cross-sectional study. The interview guide included questions exploring participants' insights on how genetic risk status was delivered, how the information influenced their motivation for lifestyle modification to reduce NAFLD risk, and any knowledge sharing that occurred with family members after learning of their Results: Results highlighted men's preference for receiving this type of genetic risk information through a letter sent to their homes. General comprehension of Discussion: Findings from this qualitative study suggest the feasibility of communicating genetic risk for NAFLD among Mexican-origin men. Future strategies for the dissemination of genetic risk results among Mexican-origin individuals should consider familial and cultural appropriate strategies.
MeSH term(s)	Humans ; Male ; Genetic Predisposition to Disease ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/genetics ; Polymorphism, Single Nucleotide ; Risk Factors ; Acyltransferases/genetics ; Phospholipases A2, Calcium-Independent/genetics
Chemical Substances	PNPLA3 protein, human (EC 3.1.1.3) ; Acyltransferases (EC 2.3.-) ; Phospholipases A2, Calcium-Independent (EC 3.1.1.4)
Language	English
Publishing date	2023-01-04
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2022.1090101
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Article ; Online: Ambiguous Loss and Embodied Grief Related to Mexican Migrant Disappearances.

Crocker, Rebecca M / Reineke, Robin C / Ramos Tovar, María Elena

Medical anthropology

2021 Volume 40, Issue 7, Page(s) 598–611

Abstract: Since the 1990s, thousands of Latin Americans have died or disappeared along the US-Mexico border, following the funneling of migration through remote desert regions. The families of missing migrants face long-term "ambiguous loss," a lived experience in ...

Abstract	Since the 1990s, thousands of Latin Americans have died or disappeared along the US-Mexico border, following the funneling of migration through remote desert regions. The families of missing migrants face long-term "ambiguous loss," a lived experience in which a loved one is physically absent but psychologically present. Mexican relatives of the missing in Arizona and Sonora report that these losses produce deep emotional suffering along a timeline - worrying about the crossing, learning of the disappearance, beginning to search, and finally, coping with the long-term impacts of unknowing. Close relatives experience embodied health effects including headaches, insomnia, anxiety, depression, and chronic disease.
MeSH term(s)	Anthropology, Medical ; Grief ; Hispanic Americans ; Humans ; Mexico ; Transients and Migrants
Language	English
Publishing date	2021-02-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603228-x
ISSN	1545-5882 ; 0145-9740
ISSN (online)	1545-5882
ISSN	0145-9740
DOI	10.1080/01459740.2020.1860962
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Article ; Online: The patient's perspective of diabetic foot ulceration: A phenomenological exploration of causes, detection and care seeking.

Crocker, Rebecca M / Tan, Tze-Woei / Palmer, Kelly N B / Marrero, David G

Journal of advanced nursing

2022 Volume 78, Issue 8, Page(s) 2482–2494

Abstract: Aims: Diabetic foot ulceration can contribute to lowered life expectancy and quality of life for people with diabetes, and yet, scant attention has been given to improving preventive and educational measures. This article uses a phenomenological ... ...

Abstract	Aims: Diabetic foot ulceration can contribute to lowered life expectancy and quality of life for people with diabetes, and yet, scant attention has been given to improving preventive and educational measures. This article uses a phenomenological approach to explore individuals' lived experiences of diabetic foot ulcerations to explore factors that can be harnessed to achieve improved outcomes. Design: This was a qualitative study using semi-structured interviews grounded in a phenomenological framework to explore how patients perceive and understand their foot problems. Methods: Study participants were recruited from February 2020 to February 2021 from a tertiary referral centre that treats foot problems in persons with diabetes. A total of 15 Hispanic, Native American and White patients participated in the study. We conducted in-depth semi-structured interviews which were audio recorded with the participant's consent. Interview data were transcribed and analysed with Dedoose data management software. Results: Analysis revealed findings in two primary domains: (1) how patients perceive foot ulceration, with themes around limited understandings of foot ulceration, close sensory observation of foot problems and barriers to ulcer perception and (2) how patients experience the timing of foot ulceration, with themes on how time perceptions shifted as foot problems became more serious, which correlated closely to how patients responded to their foot problems. Conclusion: Despite the close sensory observation of their feet, people with diabetes face an array of barriers to recognizing and understanding the implications of diabetic foot ulceration, which can lead to delayed care seeking. Nurses can play a critical role in promoting patient education and improving patient self-management of foot ulcers. Impact: This phenomenological study offers important lessons to guide nurses and other providers in enhancing patient self-management of DFUs and improving care outcomes by expanding an understanding of DFU early warning signs, the imperative to seek medical care quickly, and addressing possible barriers.
MeSH term(s)	Diabetes Mellitus ; Diabetic Foot/therapy ; Humans ; Patient Acceptance of Health Care ; Qualitative Research ; Quality of Life ; Ulcer
Language	English
Publishing date	2022-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	197634-5
ISSN	1365-2648 ; 0309-2402
ISSN (online)	1365-2648
ISSN	0309-2402
DOI	10.1111/jan.15192
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Article ; Online: Awareness, Knowledge, and Misperceptions Related to Nonalcoholic Fatty Liver Disease in a Community Sample of Mexican-Origin Women: A Mixed Methods Study.

Morrill, Kristin E / Crocker, Rebecca M / Hingle, Melanie D / Thomson, Cynthia A / Garcia, David O

Frontiers in public health

2021 Volume 9, Page(s) 626428

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Adult ; Diabetes Mellitus, Type 2 ; Female ; Health Education ; Humans ; Non-alcoholic Fatty Liver Disease/epidemiology ; Risk Factors ; Surveys and Questionnaires
Language	English
Publishing date	2021-08-13
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2021.626428
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