Migration and health is an important topic of inquiry for nursing; it is consistent with nursings' interest in high risk populations as well as individual and group adaptation to environmental contexts in relation to health outcomes. Yet, knowledge about the sources of immigrants' distress and the process of their adaptation is too limited for developing theoretically based interventions to promote positive health outcomes. Knowledge about Soviet immigrants, the largest growing refugee group in the U.S., is even more limited. Current research focuses on southeast Asians who began entering the U.S. after the Vietnam war. Yet stressors faced by Southeast Asians may not be comparable for Soviets. Although Soviet immigrants from the same cohorts as southeast Asians have not experienced the horrors of war, they have spent their entire lives under the tutelage of communism. Political, economic, and socio-cultural differences between communist and capitalist countries may pose unique adaptive challenges for Soviet immigrants resettling in the U.S. Even if the theoretical base were available for developing clinical interventions, the paucity of valid standardized measures for foreign populations limits evaluation of treatment efficacy. The purposes of this proposed research are to develop the theoretical base needed to generate clinical interventions for promoting Soviet immigrants' adaptation and the standardized instruments for testing those interventions. A sequential cross-sectional and longitudinal design and multi-methods (e.g., in-depth interviews, participant observation, clinical ratings, and standardized self-report and observational measures) will be used for inductive theory generation instrument development, and testing deductive hypotheses related to immigrants' psycho-social adaptation. The project will have 2 phases. Phase I will be exploratory and use a cross-section of immigrant cohorts to generate description of the local Soviet community and inductive hypotheses [which will be tested during Phase II] about stress and adaptation. Standardized measures that will be employed during Phase II hypothesis testing will also be pilot tested during Phase I and revised to improve their psychometric characteristics. During Phase II, cross-sectional and panel data from the standardized measures will be combined with longitudinal interview data to test hypotheses about Soviet immigrants' psychological risk and adaptation. Accomplishing these aims will provide the foundation for clinical trials that will be conducted after the completion of this project by generating the theoretical base for designing and timing interventions for promoting adaptation among high risk Soviet immigrants and the process and outcome indicators for testing the efficacy of those interventions.
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