Community health survey development, administration, social determinants and mental health in African immigrants and refugees in Portland Oregon.

backgroundCommunity-based organizations interested in members' health may lack data to develop culturally-appropriate, evidence-based interventions. Community leaders perceived the need for a health survey, developed and administered in partnership with research scientists, to address mental health concerns of black African immigrants and refugees (principally depression).

objectivesThe goals of the project were: development of a community health survey for African immigrant and refugee populations; translation, piloting and administering the survey, and descriptive analyses and dissemination. Consultation with a community Advisory Board throughout the study was an overarching goal.

methodsA working partnership between members of the African Family Holistic Health Organization, including an Advisory Board, and members of Oregon Research Institute was formed. Recommended protocols to measure demographics, social determinants of health, everyday discrimination, perceived stress, mental health and substance use, including combustible tobacco use, were included after multiple consultations with the Advisory Board. The survey was translated and piloted in multiple African languages. Survey participants were recruited individually and at community-based organization events and completed the survey. Descriptive and bivariate analyses and dissemination to multiple groups was performed.

resultsThe survey (Demographics and Disability, Social Determinants of Health, Substance Use), was administered electronically and completed by N = 385 (73% ≤40 years, 61% female) participants in the 2nd quarter of 2023. Participant symptoms of anxiety and depression were elevated relative to US 2022 National Health Interview Survey data (overall and compared to individuals identifying as non-Hispanic Black), due to increased reporting of mild symptoms, and in participants who were younger, food insecure, English proficient or with greater levels of perceived discrimination or stress. Measures of ever smoking were low (even a puff, 11%), with greater ever smoking observed in participants who were male, with some college, English proficient, or with greater levels of perceived discrimination or stress.

conclusionsSurvey development and administration in multiple languages benefited from validated tools, repeated consultations of the research team with Advisory Board members, and community-based organization staff contributions. Community concerns about mental health appear justified, though increased symptoms were mild and subclinical. While absolute levels of ever smoking are low, tobacco use associations suggest opportunities for prevention.