Ethnicity & Health最新文献

{"title":"Managing diabetes across borders and screens: mHealth use among older late-life South Asian migrants in the United States.","authors":"Shwadhin Sharma, Anita Khadka","doi":"10.1080/13557858.2026.2655621","DOIUrl":"10.1080/13557858.2026.2655621","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores how older South Asian migrants in the United States navigate mobile health (mHealth) tools for type 2 diabetes self-management. The goal is to identify multilevel facilitators and barriers to digital engagement within culturally and structurally embedded contexts.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive study using semi-structured interviews with 21 South Asian adults aged 55 and older who had migrated to the U.S. later in life and had recent experience using a diabetes management app. Thematic analysis was guided by the Social-Ecological Model (SEM) and the Consolidated Criteria for Reporting Qualitative Research (COREQ).</p><p><strong>Results: </strong>Participants' engagement with mHealth tools was shaped by personal confidence, emotional response, and adaptive strategies at the individual level; family and peer dynamics at the interpersonal level; lack of provider support and culturally misaligned features at the organizational level; culturally rooted norms and informal peer networks at the community level; and broader systemic exclusions related to language access, insurance coverage, and technology infrastructure at the policy level. While participants demonstrated motivation and resilience, emotional fatigue, app complexity, and cultural mismatches often limited sustained use.</p><p><strong>Conclusions: </strong>Older South Asian migrants are not disinterested in digital health; rather, they are systemically excluded. For mHealth to meaningfully support diabetes self-management, tools and systems must be designed with linguistic access, cultural alignment, and policy-level support in mind. Findings underscore the need for culturally tailored, relationally supported, and digitally inclusive interventions that affirm the everyday realities of aging immigrant populations.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"558-582"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At the crossroads of race and migration: understanding violence risk and mental health inequities for African and Caribbean black youth in the U.S.","authors":"Bertranna A Muruthi, Jose Zarate, Amanda Stafford McRell, Heather McClure, Adaobi Anakwe, Dollar Ganu, Francisca Lawson Tettevie","doi":"10.1080/13557858.2026.2688763","DOIUrl":"https://doi.org/10.1080/13557858.2026.2688763","url":null,"abstract":"<p><p>African and Caribbean Black (ACB) immigrant adolescents experience unique constellations of risk factors that increase their vulnerability of both experiencing and initiating violence. Traditional disciplinary and punitive approaches are ineffective at addressing these root causes. Mental health interventions have the potential to reduce and prevent ACB adolescent violence; however, clinicians need culturally-responsive and community-informed strategies for violence prevention and advocacy. To meet this need, this paper employs Critical Race Theory and Intersectional frameworks to examine disparities in youth violence, emphasizing the roles of acculturative stress, social support deficits, and neighborhood disadvantage. This examination reveals equity-driven, culturally grounded strategies for violence prevention including increasing family support and parental monitoring of youth. Clinicians have an ethical responsibility to advocate for ACB families through authentic, trust-based engagement. Strategies for partnering with grassroots organizations and supporting efforts led by Black immigrant communities offer a pathway by which clinicians can promote meaningful and lasting change.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"1-11"},"PeriodicalIF":2.1,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is degree attainment associated with serious psychological distress among Black men aged 24 and older?","authors":"Terrell T Richardson, Leah Cheatham, Daphne S Cain, Vanessa Robinson Dooley","doi":"10.1080/13557858.2026.2635129","DOIUrl":"10.1080/13557858.2026.2635129","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the relationship between degree attainment and serious psychological distress (SPD) among Black men in the United States. Using the Social Determinants of Mental Health (SDoMH) framework, we investigated whether degree attainment serves as a protective factor against SPD and explored how individual factors (age, sexual orientation, state of health), socioeconomic factors (income and marital status), and substance use factors (marijuana use and alcohol use) modify this relationship.</p><p><strong>Design: </strong>We analyzed data from the 2022 National Survey of Drug Use and Health (<i>n</i> = 1,390 Black men aged 24 and older). SPD was measured using the Kessler Psychological Distress Scale-6 (K6) with scores ≥13 indicating SPD. Educational attainment was dichotomized as college graduate versus non-college graduate. Binary logistic regression was conducted to model SPD as a function of all predictor variables aligned with the SDoMH framework.</p><p><strong>Results: </strong>Approximately 11.8% (<i>n</i> = 130) of Black men experienced SPD in the past year. In bivariate analysis, degree attainment showed a trend toward association with SPD (<i>p</i> < 0.1), with college graduates showing lower prevalence (8.9%, <i>n</i> = 31) compared to non-college graduates (12.6%, <i>n</i> = 154). However, when adjusting for covariates, no significant relationship was detected between degree attainment and SPD. Younger Black men (ages 24-25) were over two times more likely to experience SPD than those 35 and older (OR = 2.37, <i>p</i> < .001). Gay and bisexual Black men reported higher levels of SPD than their heterosexual peers (OR = 0.48, <i>p</i> < .05). Black men who reported recent marijuana use were significantly more likely to experience SPD (OR = 2.53, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>The findings challenge traditional assumptions about education as a protective factor, supporting the 'minorities' diminished returns' hypothesis. Systemic racism and structural inequities may diminish the mental health benefits typically associated with higher education among Black men, highlighting the importance of developing culturally responsive mental health interventions.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"417-441"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does time heal all wounds? Examining the lasting impact of historic redlining on contemporary racial disparities in allostatic load in Baltimore, Maryland.","authors":"Marcus R Andrews, Linda M Chatters, Roshanak Mehdipanah, Andrew Grogan-Kaylor, Michele K Evans, Alan B Zonderman, Tiffany M Powell-Wiley, Amy J Schulz","doi":"10.1080/13557858.2026.2635109","DOIUrl":"10.1080/13557858.2026.2635109","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations between historical residential redlining, a form of institutional racism, and contemporary allostatic load (AL), an indicator of physiologic stress, examine differences by race, and whether associations are mediated by neighborhood deprivation.</p><p><strong>Methods: </strong>We used data from Wave 4 (2013-2017) of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study in Baltimore, MD, Home Owners Loan Corporation (HOLC) scores, and data from the American Community Survey (ACS). We conducted a multilevel analysis, controlling for individual demographic and behavioral characteristics.</p><p><strong>Results: </strong>Compared to blue- and greenlined neighborhoods, living in a yellowlined neighborhood was positively associated with allostatic load (<i>p</i> < 0.05). We report a significant negative interaction between living in a yellowlined area and race (<i>β</i> = -0.62, <i>p</i> = 0.00), with African American residents showing greater reductions in allostatic load compared with whites. We also found evidence of a moderated mediation, with the indirect effect of living in a yellowlined area on AL through NDI varying by race.</p><p><strong>Conclusions: </strong>Contemporary residents of historically yellowlined, but not redlined, neighborhoods experienced heightened physiological deterioration. The strength of this association differed by race, and was substantially explained by the contemporary neighborhood deprivation index only for African Americans in yellowlined areas. Addressing health disparities requires attention to the long-lasting impacts of historical practices of institutional racism on contemporary health outcomes.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"349-365"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The dynamic complexity of cardiovascular severe maternal morbidity among Black women in North Texas: insights from a system dynamics group model building study.","authors":"Michael K Lemke, Kyrah K Brown, Saeideh Fallah-Fini, Rhoda Ojo, David W Lounsbury, Mercy Obasanya, Tiffany Kindratt, Thanayi Lambert, Deneen Robinson","doi":"10.1080/13557858.2026.2635588","DOIUrl":"10.1080/13557858.2026.2635588","url":null,"abstract":"<p><strong>Objectives: </strong>Black women in North Texas experience persistently elevated rates of cardiovascular severe maternal morbidity (CSMM). To generate novel insights into the dynamic complexity of CSMM, the study was grounded in four primary research questions: (1) What are the most important causes and consequences of CSMM?; (2) How, and why, have those causes and consequences changed over time?; (3) What is the structure of the systems that drive these outcomes?; and (4) What actionable solutions may mitigate CSMM?</p><p><strong>Design: </strong>Participatory system dynamics group model building (SD GMB) was conducted with 15 community-based stakeholders in North Texas. Two SD GMB sessions were conducted during March 2024, which cumulatively spanned two and a half days and generated four key outputs: (1) key variables ('5 R's') that were prioritized ('model boundary chart'); (2) graphs of key variables over time ('behavior-over-time graphs' [BOTGs]); (3) qualitative maps of system structure ('causal loop diagrams' [CLDs]); and (4) potential leverage points for interventions ('targets for action').</p><p><strong>Results: </strong>Stakeholders identified a total of 252 variables across the 5 R's: 47 results, 109 roles, 46 relationships, 27 rules, and 23 resources. Cumulatively, 64 themes emerged across these five categories. The 11 BOTGs exhibited a high degree of diversity across the five attributes analyzed. Two CLDs were developed that included numerous feedback loops and captured multiple causal mechanisms. Finally, 27 targets for action were elicited and rated, based on cost-effectiveness.</p><p><strong>Conclusion: </strong>The application of SD GMB provided novel complex systems-grounded insights into the causes and consequences of CSMM among Black women in North Texas, and these insights were leveraged by stakeholders to identify potential preventive solutions to curb these outcomes. These insights led to initial answers to the four primary research questions, illustrating the dynamic complexity of the drivers of CSMM and identifying coherent preventive strategies.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"442-462"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural threads of memory: barriers and motivations for brain health, physical activity and nutrition among middle-aged and older Latinos.","authors":"Jacqueline Guzman, Yuliana Soto, Susan Aguiñaga, Karen Aguirre, Isabela Marques, Priscilla M Vasquez, Sara Wilcox, David X Marquez","doi":"10.1080/13557858.2026.2635589","DOIUrl":"10.1080/13557858.2026.2635589","url":null,"abstract":"<p><strong>Objectives: </strong>Alzheimer's disease and related dementias (AD/ADRD) are projected to increase in the Latino population. Physical activity (PA) and adhering to the Mediterranean-DASH diet for Neurodegenerative Delay (MIND) have been shown to reduce the risk of AD/ADRD. However, limited research has explored Spanish-speaking Latinos' perceptions of PA and nutritional changes for brain health. Thus, the purpose of this study was to (1) explore Latinos' perceptions of brain health and health behavior modifications related to PA and nutrition to promote brain health and (2) amplify the voices of low-income, Spanish-speaking, middle-aged and older Latinos to inform culturally tailored interventions.</p><p><strong>Design: </strong>The present study used a qualitative inquiry approach. Focus groups were conducted and analyzed by bilingual and bicultural researchers. Transcripts were open and axially coded through an inductive and deductive approach to identify major themes.</p><p><strong>Results: </strong>Four focus groups were conducted with 26 middle-aged and older Spanish-speaking Latinos. Most participants were women (76.9%; n = 20), with an average age of 64.3 years. Four major themes were extracted: (1) knowledge and concerns about memory loss and Alzheimer's disease (AD); (2) strategies to prevent memory loss; (3) motivators for health behavior change; and (4) barriers to health behavior change.</p><p><strong>Conclusion: </strong>Spanish-speaking middle-aged and older Latinos had limited knowledge about AD/ADRD and expressed concerns about its impact on the Latino community. Findings highlight the need to create culturally tailored Spanish-language educational materials that emphasize the role of PA and nutrition in reducing AD/ADRD risk. Furthermore, future studies should address cultural and structural barriers to behavior change, including familism, low socioeconomic status, and limited awareness to reduce brain health disparities in this population.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"463-478"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/ethnic differences in the association between suicidal ideation and mental health service utilization: a national study of U.S college students.","authors":"Joaquin Guzman, Fares Qeadan","doi":"10.1080/13557858.2026.2635125","DOIUrl":"10.1080/13557858.2026.2635125","url":null,"abstract":"<p><strong>Objectives: </strong>Suicidal ideation (SI) is common among U.S. college students, yet mental health service utilization (MHSU) remains incomplete and may differ across race and ethnicity groups. We examined whether the SI-MHSU association varies by race and ethnicity among U.S. college students.</p><p><strong>Design: </strong>We analyzed pooled repeated cross-sectional data from the American College Health Association-National College Health Assessment III (ACHA-NCHA III), Fall 2019-Fall 2022. We fit multivariable logistic regression models including a SI × race and ethnicity interaction and covariates guided by Andersen's Behavioral Model of Health Services Use. We report race and ethnicity-specific adjusted odds ratios (aORs) for SI (Yes vs No) and ratios of odds ratios (RORs) comparing each group's SI-MHSU association to non-Hispanic (NH) White students.</p><p><strong>Results: </strong>Among 330,436 students, 31.4% reported SI in the past 12 months; among those with SI, 47.4% reported MHSU. Effect modification by race and ethnicity was observed (global SI × race and ethnicity Wald <i>χ</i>² = 48.81, df = 6, <i>p</i> < 0.0001). SI was associated with higher odds of MHSU within each race and ethnicity group (aORs ranged from 1.59-2.02). Relative to NH White students, the SI-MHSU association was weaker among Hispanic or Latino/a/x students (ROR = 0.86; 95% CI: 0.81, 0.91) and NH Biracial or Multiracial students (ROR = 0.89; 95% CI: 0.82, 0.97), and stronger among NH Asian or Asian American students (ROR = 1.09; 95% CI: 1.02, 1.16). Differences relative to NH White were not statistically significant for AI/AN, NH Black or African American, or NH Other students.</p><p><strong>Conclusion: </strong>The association between SI and MHSU varies by race and ethnicity among U.S. college students. Campus mental health strategies may benefit from tailored approaches to equitably reduce barriers to care in groups where the SI-MHSU association appears weaker relative to NH White students. Future research should identify mechanisms underlying these differences in utilization.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"384-396"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ecological and environmental factors shaping refugee resilience: a longitudinal analysis.","authors":"Liza Hinchey, Rasheed Alahmad, Kathleen Gorski, Raya Nashef, Ayat Abed-Ali, Arash Javanbakht","doi":"10.1080/13557858.2026.2635127","DOIUrl":"10.1080/13557858.2026.2635127","url":null,"abstract":"<p><strong>Objectives: </strong>Forced migration and resettlement often expose refugees to severe and ongoing stress, leading to an elevated prevalence of psychiatric symptoms in these populations. Ecological models demonstrate that both intrapersonal and environmental factors contribute to psychological risk and resilience - and that these dynamics may evolve over time. To identify potentially modifiable contextual predictors of refugee mental health, this longitudinal study investigated environmental factors associated with symptom change over time in refugees during resettlement.</p><p><strong>Design: </strong>Syrian and Iraqi adults (<i>n</i> = 344) reported postmigration living difficulties (PMLDs), environmental quality, socioeconomic factors, and symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression at three time points over 7 years following arrival in the United States. Linear mixed effects-modeling (LMM) was used to identify associations between environmental variables and symptom trajectories.</p><p><strong>Results: </strong>LMM identified lower subjective social status and higher PMLDs as predictors of more severe PTSD symptom trajectories. Greater anxiety symptoms over time were associated with lower environmental quality and higher PMLDs, while more severe depression symptom trajectories were linked to unemployment, lower subjective social status, lower environmental quality.</p><p><strong>Conclusion: </strong>The salience of socioeconomic status, environmental quality, and daily living stressors in shaping refugee mental health is consistent with an ecological approach to supporting resilience following adversity. These insights may be leveraged to design individual-, community-, and society-level interventions in partnership with refugee stakeholders.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"397-416"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internalized racism and mental health among Asian American women: the roles of perceived stress and resilience.","authors":"Jiepin Cao, Sahnah Lim","doi":"10.1080/13557858.2026.2635113","DOIUrl":"10.1080/13557858.2026.2635113","url":null,"abstract":"<p><strong>Objectives: </strong>The adverse mental health effects of racism are well documented among Asian American communities, yet little is known about how internalized racism (IR) affects mental health among Asian American women, an underserved group. This study examines perceived stress and resilience as potential mechanism and moderator, respectively, in the relationship between IR and mental health outcomes (depression and anxiety).</p><p><strong>Design: </strong>Using a cross-sectional design, we included a sample of 349 Asian American adult women. Mediation analyses tested whether perceived stress mediated the association between IR and mental health. Moderated mediation analyses examined whether resilience moderated the indirect effects of IR on mental health via stress.</p><p><strong>Results: </strong>Perceived stress significantly mediated the relationship between IR and both depression and anxiety. The indirect effect was significant for depression (b = 1.25, Boot Standard Error (SE) = 0.44, 95% Confidence Interval [CI]: 0.44, 2.13) and anxiety (b = 1.15, Boot SE = 0.40, 95% CI: 0.40, 1.95), while direct effects were not significant. Resilience moderated the indirect effect of IR on depression (index = -0.30, 95% CI: -0.59, -0.09) and anxiety (index = -0.17, 95% CI: -0.33, -0.03), with weaker indirect effects observed at higher levels of resilience.</p><p><strong>Conclusion: </strong>Perceived stress is a key mechanism linking IR to depression and anxiety among Asian American women. Resilience attenuates the impact of IR on both mental health outcomes. These findings highlight the importance of culturally tailored interventions that target stress reduction to reduce mental health disparities in this underserved population.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"366-383"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13081064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study of ecological factors impacting American Indian adolescents living on the Fort Peck Reservation during the COVID-19 pandemic.","authors":"Elizabeth Rink, Olivia Johnson, Malory Peterson, Ana Maria Rodriguez, Paula Firemoon, Mike Anastario","doi":"10.1080/13557858.2026.2655617","DOIUrl":"10.1080/13557858.2026.2655617","url":null,"abstract":"<p><strong>Introduction: </strong>American Indian communities were disproportionately impacted by the COVID-19 pandemic, with the highest COVID-19 mortality rate of all racial and ethnic groups in the United States. In particular, American Indian adolescents faced unique challenges due to the COVID-19 pandemic.</p><p><strong>Objectives: </strong>This manuscript presents the self-reported experiences, interpersonal relationship perspectives, and behaviors of American Indian adolescents aged 14 to 18 living on the Fort Peck Reservation in Northeastern Montana during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Semi-structured interviews (<i>n</i> = 31) investigated the ecological factors influencing the American Indian adolescents during the COVID-19 pandemic, including: (1) tribal governance, economics, environment; (2) protection from COVID-19; (3) social impact of COVID-19; (4) relationships; and (5) access to services. Inductive analyses were conducted within each of these aforementioned categories.</p><p><strong>Results: </strong>Our findings suggest that participants' perspectives varied widely on how well the Fort Peck Tribes handled transmission mitigation strategies. Participants also described how the COVID-19 pandemic had a predominantly negative impact on relationships with peers and their academic performance, and a mixed impact on their ability to access services. Our most striking finding was the positive impact of the COVID-19 pandemic on family connectedness, communication within the family, and the use of traditional medicines and ceremonies among American Indian adolescents.</p><p><strong>Conclusion: </strong>These findings support the importance of promoting family connectedness, parent/caregiver-adolescent communication, and the use of traditional American Indian healing practices to mitigate risk and promote health and wellness during future pandemics.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"479-498"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}