Search Results (732)

Background: Caregiving grandparents face unique stressors that may affect cognitive health. Discrimination is associated with poorer cognitive performance, whereas stronger perceived control over cognitive aging is associated with better performance. This study examined how everyday discrimination and perceived control over cognitive aging relate to executive function in caregiving grandparents. Methods: Using cross-sectional data from the Midlife in the United States study (MIDUS 3), we analyzed 1326 grandparents (166 caregiving and 1160 non-caregiving) with complete data on all study measures. Everyday discrimination, perceived control over cognitive aging, and executive function were assessed with self-report surveys and telephone-based cognitive assessments. Mediation and moderated mediation models were estimated with covariates. Results: Perceived control over cognitive aging mediated the relation between discrimination and executive function, and this mediation was moderated by caregiving status. Among non-caregivers, stronger perceived control was associated with a weaker negative relation between discrimination and executive function. This protective pattern was not observed among caregiving grandparents. The moderation was attenuated to nonsignificance when an expanded covariate set was added, so it should be considered preliminary. Conclusions: The demands of caregiving may lessen the influence of control beliefs on cognitive performance. Because the design is cross-sectional, these results describe statistical rather than temporal mediation. The findings support targeted interventions for this vulnerable population, although they warrant further investigation. Full article

Background/Objectives: This study was conducted to determine the effect of a Health Belief Model–based education program implemented in Family Health Centers on women’s cervical cancer knowledge and their attitudes and beliefs toward HPV vaccination. Methods: This quasi-experimental pretest–posttest control group study was conducted between March and May 2026 at the Tuşba Training Family Health Center in Van, eastern Türkiye. The study included 150 women aged 18–49 years who had adolescent daughters aged 10–18 years. Data were collected using the Descriptive Information Form, the Cervical Cancer Knowledge Scale, and the Carolina HPV Immunization Attitudes and Beliefs Scale. The intervention group received a structured education program based on the Health Belief Model focusing on cervical cancer, HPV infection, and HPV vaccination. Descriptive statistics, chi-square tests, independent samples t-tests, paired samples t-tests, and mixed-design analysis of variance (ANOVA) were used for data analysis. Results: Following the educational intervention, cervical cancer knowledge scores increased from 2.13 ± 0.79 to 7.24 ± 0.84 in the intervention group, whereas no significant change was observed in the control group (p < 0.001). Total CHIAS scores increased from 24.32 ± 5.30 to 41.23 ± 2.51, accompanied by significant improvements in HPV vaccination attitudes and beliefs (p < 0.001). Significant Group × Time interaction effects were observed for cervical cancer knowledge, total CHIAS scores, and all CHIAS subdimensions (p < 0.001). Conclusions: The findings indicated that the Health Belief Model–based education program was associated with improved knowledge about cervical cancer and HPV and with more favorable attitudes and beliefs toward HPV vaccination. Structured educational programs implemented in primary healthcare settings may support the promotion of preventive health behaviors. Full article

Background: Operating room (OR) nurses are at high risk for work-related musculoskeletal disorders (WMSDs) due to physically demanding tasks and the use of heavy lead aprons. Objectives: This study evaluated the impact of a multidimensional ergonomic intervention on injury prevention awareness, compliance, and health outcomes among OR staff. Methods: A prospective quality improvement pilot study was conducted with 33 OR nurses. The intervention, based on the Health Belief Model and Human Factors Engineering, integrated ergonomic education with environmental modifications. Outcomes were assessed via questionnaires, field audits, and sick leave records at baseline, post-intervention, and 6-month follow-up. Results: Awareness scores improved from 68.7% to 98.8% (p < 0.001). Observational audits demonstrated a reduction in non-ergonomic actions from 2227 to 440 (mean deviations per nurse: 111.4 to 22.0, p < 0.001), with improvements sustained at 6 months. Annual sick leave cases decreased from three to one. Conclusions: A multifaceted real-world pilot intervention combining education with system-level engineering was associated with enhancing ergonomic compliance and reducing unsafe behaviors. This approach fosters the self-efficacy necessary for sustainable WMSD risk mitigation in high-intensity clinical settings. Full article

Background: Breast cancer comprises 31.4% of all female cancers in Saudi Arabia (2020 Cancer Registry). Despite free national screening services existing since 2005, mammography utilization remains critically low. This study assessed breast cancer knowledge, attitudes, and practices (KAP) among females in Saudi Arabia and identified independent predictors of screening behavior. Methods: A cross-sectional study (December 2024–February 2025) enrolled 426 females aged ≥20 years from all 13 Saudi administrative regions using a quota-based design combining facility-based and online recruitment. Attitude and barrier domains were adapted from Champion’s Health Belief Model Scale (CHBMS), validated in Arabic; knowledge items used validated regional instruments. Knowledge-score reliability: KR-20 = 0.45; attitude subscale: α = 0.74. Binary logistic regression identified independent predictors of screening uptake (outcome: any screening in the preceding five years, coded as screened = 1; not screened = 0). Results: Mean composite knowledge score: 4.51 ± 1.52/7 (KR-20 = 0.45); 54.0% achieved high knowledge (≥5). Mammography uptake was 30.5% overall and 52.2% among women aged ≥40 (n = 136; the recommended target group). Predominant barriers: Fear of diagnosis (83.6%), belief in incurability (76.3%), radiation concern (73.2%), and pain anxiety (72.3%). Logistic regression (χ²(8) = 188.96, p < 0.001; McFadden’s pseudo R² = 0.323) identified older age (OR = 1.52; 95% CI: 1.21–1.92), higher income (OR = 1.57; 95% CI: 1.25–1.99), transportation barriers (OR = 3.39; 95% CI: 1.95–5.89), and family discouragement (OR = 3.03; 95% CI: 1.72–5.34) as significant predictors (all p < 0.001). Conclusions: A significant knowledge–practice gap persists across all 13 Saudi regions. These findings suggest several implications for a multi-level public health response to be evaluated through future intervention research; multi-level strategies targeting CHBMS Barriers are needed. Full article

End-stage kidney disease (ESKD) is a growing public health concern in Oman, with an increasing number of adults requiring hemodialysis and facing complex dietary restrictions. Adequate nutrition knowledge and nutrition literacy are essential for effective dietary self-management, yet their relationship with dietary adherence in the Omani hemodialysis population remains underexplored. To determine the level of dialysis-specific nutrition literacy among Omani adults with end-stage kidney disease undergoing hemodialysis and to identify socio-demographic and clinical factors that predict acceptable nutrition literacy in this population. A cross-sectional study was conducted among 140 adults with ESKD receiving hemodialysis in Oman. Data were collected using a structured, self-administered questionnaire comprising socio-demographic and clinical items, the Dialysis-Specific Nutrition Literacy Scale (DSNLS), the Dialysis-Related Diet Knowledge Questionnaire (DDKQ), and adherence/health-belief subscales (perceived benefits, barriers, seriousness, susceptibility, and self-efficacy). Descriptive statistics summarized sample characteristics and scale scores. Correlation analyses assessed relationships between nutrition literacy, diet knowledge, and adherence-related perceptions. Multiple logistic regression identified independent predictors of acceptable nutrition literacy. Participants had a mean age of 48.19 years and a mean dialysis duration of 5.46 years. Overall, 60.7% had acceptable dialysis-specific nutrition literacy and 39.3% had limited literacy. Dialysis-related diet knowledge was low in 10.7%, moderate in 46.4%, and high in 42.9% of participants. Perceived benefits of dietary adherence were high, whereas perceived barriers, seriousness, and susceptibility were moderate and self-efficacy was relatively low. Nutrition literacy was positively correlated with perceived benefits, seriousness, susceptibility, and self-efficacy, while diet knowledge showed weaker associations with these beliefs. In the logistic regression model, living in the city (OR = 0.17, p = 0.01) and having diabetes mellitus as a comorbidity (OR = 0.17, p = 0.01) were associated with lower odds of acceptable nutrition literacy, whereas higher hemoglobin levels (OR = 1.51, p = 0.04) and self-rated “very good” overall health (OR = 5.80, p = 0.03) were associated with higher odds. Most Omani adults on hemodialysis demonstrated acceptable nutrition literacy and at least moderate renal-diet knowledge, but a substantial subgroup had limited literacy and low self-efficacy for dietary adherence. Nutrition literacy was more strongly linked to adherence-related beliefs than factual knowledge alone and was influenced by place of residence, comorbid diabetes, hemoglobin level, and perceived health. These findings highlight the need for culturally tailored, literacy-sensitive nutrition education in Omani dialysis units, with particular attention to urban patients and those with diabetes, to strengthen self-efficacy, address perceived barriers, and ultimately improve dietary adherence and clinical outcomes. Full article

Forecasting fine particulate matter with a diameter of 2.5 μm (PM_2.5) is critically important due to its adverse effects on human health and environmental sustainability. Although ground-based monitoring stations provide accurate measurements, their limited spatial coverage restricts large-scale PM_2.5 assessment, especially in complex urban regions. Consequently, aerosol optical depth (AOD) derived from satellite imagery, combined with advanced deep learning (DL) techniques, has emerged as an effective alternative by offering wide spatial coverage and rich spatio-temporal information. This paper proposed an optimization-driven fuzzy transformer–deep belief network (ODFT-DBN) for accurate PM_2.5 air pollution prediction. The proposed framework integrates a fuzzy inference module to model uncertainty and nonlinear environmental relationships, a transformer encoder to capture long-range spatio-temporal dependencies, and a DBN to extract hierarchical features and improve prediction robustness. In addition, a novel multi-objective gray wolf optimizer (NMOGWO) is employed to jointly optimize the model hyper-parameters and fuzzy membership functions. The proposed approach is implemented for the city of Tehran, Iran, using meteorological variables, topographical features, ground-based PM_2.5 measurements, and satellite-derived AOD data. The ODFT-DBN model is compared with several benchmark methods, including bidirectional encoder representations from transformers (BERT), transformer, long short-term memory (LSTM), gated recurrent unit (GRU), convolutional neural network (CNN), DBN, and extreme gradient boosting (XGBoost). Experimental results demonstrate that the proposed framework achieves superior predictive performance, attaining an R² value of 0.94 and root mean square error (RMSE) of 0.8 μg/m³. Scatter plot analyses indicate a strong agreement between predicted and observed PM_2.5 values, while the proposed model exhibits low variance, stable convergence behavior, and acceptable computational time. Overall, the results confirm the effectiveness, robustness, and practical applicability of the proposed ODFT-DBN framework for spatio-temporal PM_2.5 forecasting. Full article

Background/Objectives: Large language models (LLMs) are increasingly used by the public to seek health information, yet their accuracy in addressing common vaccine myths remains unclear. Sycophantic LLM behavior, where models align with rather than correct user-stated beliefs, poses specific risks in health contexts. Methods: We conducted an exploratory multi-vendor evaluation of three LLMs (GPT-5, Gemini 2.5 Flash, Claude Sonnet 4) using officially curated vaccination myths from Germany’s public health institution and two realistic user framings (curious skeptic, convinced believer). All model responses were independently evaluated by two blinded medical experts for misconception addressal (binary criterion applied to the response text), scientific accuracy, and communication clarity (5-point Likert scales). Additionally, blinded marketing experts ranked models for lay communication clarity. Flesch Reading Ease scores were computed for all outputs. Results: Across all myths, framings, and models (66 response items), both medical raters judged that all responses refuted the targeted misconception; no response affirmed or ignored a myth, including under the adversarial convinced believer framing. Scientific accuracy and clarity ratings were high and tightly clustered (median 4.0–4.5), with no combined score below 3 and substantial inter-rater agreement. Marketing experts independently ranked Gemini 2.5 Flash and GPT-5 highest for lay clarity. Readability analysis revealed generally low accessibility, particularly for the convinced believer framing and for Claude Sonnet 4 outputs. Conclusions: Our findings suggest that general-purpose LLMs can produce scientifically accurate, on-topic rebuttals to widely documented vaccine myths under realistic default conditions, although linguistic complexity and framing-sensitive style may limit accessibility. Whether such outputs change beliefs or behavior in hesitant individuals was not tested. With readability optimization, these outputs could serve as building blocks for myth-debunking tools, given prospective evaluation with behavioral endpoints. Full article

Objectives: Inadequate access to safe water, sanitation, and hygiene (WASH) continues to drive infectious diseases, malnutrition, and educational disparities, particularly among vulnerable populations. This systematic review examined WASH intervention strategies implemented in Malaysia between 2014 and 2025, focusing on shifts in hygiene-related knowledge, attitudes and practices (KAP), health outcomes, infrastructure improvements, and implementation challenges. Methods: A comprehensive search across five databases (Science Direct, PubMed, Scopus, Web of Science, and Google Scholar) identified twelve eligible studies targeting schools, healthcare settings, and rural or Indigenous communities. Results: Education-based interventions predominated (n = 10), often employing participatory and theory-driven approaches grounded in the Health Belief Model or Information–Motivation–Behavioural Skills framework. Evidence revealed significant improvements in KAP, particularly when digital, gamified, or storytelling elements were integrated. Community-led and caregiver-inclusive models demonstrated greater behavioural adoption and retention. Thematic analysis identified several implementation challenges, which include (i) sole reliance on self-reported outcomes with limited use of objective indicators, (ii) short intervention durations (<2 months) that limit long-term impact, and (iii) lack of policy and curriculum integration. Conclusions: Findings underscore the need for culturally tailored, longitudinal, and system-embedded interventions that combine behavioural theory with infrastructure investment. Integrating WASH initiatives into Malaysia’s health and education frameworks could advance Sustainable Development Goal 6, ensuring scalable and equitable improvements in hygiene literacy, community resilience, and public health outcomes. Full article

Public health emergencies create demand environments in which routine demand can be estimated from historical observations, whereas emergency demand is often characterized by limited data and expert assessments. To address this challenge, this study develops an uncertain-random newsvendor model for emergency supply chains based on chance theory. Routine demand is modeled as a random variable, while emergency demand is represented as an uncertain variable, enabling both stochastic and epistemic uncertainties to be incorporated within a unified analytical framework. The model is analyzed under decentralized and centralized decision-making modes, and closed-form optimal ordering policies are derived. The results show that the proposed framework generalizes both stochastic and uncertain newsvendor models as special cases. Residual value, shortage cost, expected emergency demand, and belief degree significantly affect inventory decisions and supply chain performance. Higher residual values and larger emergency demand expectations encourage inventory expansion, while centralized decision-making consistently generates higher order quantities and expected profits than decentralized decision-making. Moreover, the efficiency loss associated with decentralized decision-making increases with the belief degree, indicating that supply chain coordination becomes increasingly important when decision-makers place greater confidence in emergency demand forecasts. The findings highlight the importance of inventory incentives, demand forecasting, and coordinated decision-making in emergency operations. This study provides a theoretical foundation for emergency procurement and inventory planning when historical data are limited and demonstrates the value of integrating chance theory into emergency supply chain management under uncertain-random demand environments. Full article

Background/Objectives: Nutrition during childhood and adolescence is a key determinant of long-term health, influencing metabolic homeostasis, neurocognitive development, and immune system maturation. Globalization and technological advances have reshaped food production and consumption, increasing the availability of ultra-processed foods (UPF) of low nutritional quality. This study aimed to investigate the relationship between parental factors, namely food literacy, perceived barriers and enablers, dietary attitudes, and healthy eating behaviors, and the consumption of discretionary UPF among children and adolescents living in 5 Mediterranean countries. Methods: This cross-sectional study was based on a survey completed by 2011 parents of children and adolescents aged 6–17 years from 5 Mediterranean countries, who reported on their children’s dietary and lifestyle habits. Adherence to the Mediterranean diet was assessed through the KIDMED index. Parental food literacy was measured using the Short Food Literacy Questionnaire (SFLQ). Perceived barriers and enablers were assessed based on the Theory of Planned Behavior, and parents’ attitudes toward their child’s diet were evaluated using the Healthy-Eating Attitudes Questionnaire (HEAQ). Finally, the Theory of Internet Use Related to Health (TIUH) questionnaire was used to assess parents’ tendencies related to health information use online. Results: Higher perceived barriers and enablers were significantly associated with lower discretionary UPF consumption across all models. Parental food literacy (SFLQ) showed a positive association with discretionary UPF consumption, remaining significant in the fully adjusted model, although with reduced magnitude. Healthy-eating attitudes (HEAQ) were initially positively associated with discretionary UPF intake but lost statistical significance after full adjustment. Regarding health-related internet use (TIUH), the Health Information dimension showed a strong positive association with discretionary UPF consumption, while other dimensions (Consciousness and Beliefs) showed inconsistent and non-significant associations in the fully adjusted model. Conclusions: Children’s consumption of discretionary UPF is shaped by several interrelated factors, such as family environment, eating patterns, and parents’ perceptions, rather than solely by knowledge or attitudes. Full article

Background: Cervical cancer remains a significant health issue in Indonesia, where structural barriers, fragmented information, and sociocultural norms continue to hinder timely diagnosis and treatment. Families play a central role throughout the illness journey, yet their perspectives are often overlooked in the development of digital patient navigation systems. This study explored family experiences, caregiving challenges, and expectations for a family-centered digital navigation model, DIVA.ID, by integrating Digital Health frameworks and Family Systems Theory. Methods: A qualitative descriptive approach was employed through semi-structured, in-depth interviews with 18 purposively selected family caregivers of women with cervical cancer at a major referral hospital in West Java. Participants were selected because they were directly involved in daily care, treatment decisions, logistical support, or emotional assistance. Interviews were conducted between August and October 2025 and continued until thematic saturation was reached, as indicated by repetition of categories and the absence of new major codes in the final interviews. Data were analyzed using inductive–deductive content analysis guided by Elo and Kyngäs, with five researchers conducting independent coding, iterative code comparison, consensus meetings, and theoretical mapping. Results: Four main themes emerged: (1) family involvement in decision-making, including collective discussion, shifting authority roles, and patient autonomy; (2) caregiver burden, involving physical exhaustion, psychological distress, social restriction, stigma, financial pressure, and employment disruption; (3) psycho-spiritual coping mechanisms, including emotional sharing, prayer, crying, patience, and surrender to God; and (4) digital healthcare needs, covering BPJS guidance, treatment information, scheduling, communication pathways, shelter support, and mental–spiritual support. Mapping these themes to Digital Health frameworks and Family Systems Theory clarified how DIVA.ID could translate family experiences into practical navigation functions. Conclusions: This study provides empirical foundations for a culturally sensitive, family-centered digital navigation model in Indonesia. Rather than demonstrating effectiveness, the findings identify design requirements for DIVA.ID that should be tested in subsequent feasibility, usability, and intervention studies. Full article

Background: Panvascular disease (PVD) is a systemic atherosclerotic condition that poses a substantial threat to global health. Despite the recognized importance of early proactive screening, proactive screening beliefs among high-risk populations are poorly understood. Objective: To explore the proactive screening beliefs among Chinese high-risk patients for PVD based on the Health Belief Model (HBM), so as to provide evidence for developing targeted nursing intervention strategies and health policies. Methods: A descriptive qualitative study was conducted. Employing a purposive sampling strategy with maximum variation, participants at elevated risk for PVD were recruited from a tertiary hospital in Shanghai between October and December 2025 to conduct semi-structured interviews. Data saturation guided sample size (n = 22; 14 male, 8 female; mean age 62.68 years). Data were analyzed using qualitative content analysis. Results: Five main themes were extracted: multifaceted perceptions of susceptibility, multidimensional fear of severity, positive attitudes toward the benefits of proactive screening, multiple perceived barriers to proactive screening, and significant differences in self-efficacy for proactive screening. Conclusions: The proactive screening beliefs in Chinese high-risk patients of PVD were deeply embedded in local cultural values and healthcare realities. Tailored health education, age-friendly service optimization, and stratified intervention strategies are urgently needed to reduce screening barriers and improve population-wide proactive screening beliefs. Full article

Opioid misuse continues to be a major public health issue in the United States. Older adults (≥65) are at particular risk of harm from opioids due to changes in opioid pharmacokinetics with age; however, healthcare professionals lack training and confidence in addressing opioid harm reduction strategies in this population. Therefore, the purpose of this study was to improve healthcare professional knowledge and beliefs regarding opioid harm reduction strategies amongst older adults. An 8 h interprofessional conference was conducted 1 May 2025 to educate healthcare providers about opioid misuse prevention strategies for older adults. This study utilized a quasi-experimental one-group pretest–posttest design to assess changes in healthcare professional knowledge and beliefs before and after the conference. Healthcare professionals in the U.S. were recruited to participate in the conference via email listservs with national reach, predominantly concentrated in Alabama. Data were collected at pre- and post-conference via an anonymous online survey informed by the Theory of Planned Behavior and Health Belief Model. Primary outcome measures included: (1) knowledge of opioid use and misuse in older adults (5 items); (2) prescribing and dispensing attitudes surrounding opioids and medications for opioid use disorder (MOUD) (5 items); (3) perceived susceptibility to harm from opioids (4 items); and (4) perceived barriers to opioid harm reduction in older adults (17-items). Constructs were measured using multiple-choice questions (knowledge) and Likert-type scales (1 = strongly disagree, 5 = strongly agree). Secondarily, intention to join a Microsoft Teams working group for ongoing collaboration was assessed through a single categorical (Yes/No/Unsure) multiple-choice question at post-conference. Data were analyzed using descriptive statistics, and differences in mean knowledge, attitudes, susceptibility, and barriers scale scores from pre- to post-conference were analyzed using Wilcoxon signed-rank tests (alpha = 0.05). Of N = 75 survey respondents, the majority were White (86.7%), female (74.7%), 50 years of age on average, and employed as pharmacists (68%). Overall, mean (SD) knowledge (83.73% [19.92] versus 90.67% [12.45]; p = 0.011) and perceived susceptibility (3.82 [0.63] versus 4.03 [0.63]; p = 0.002) increased from pre- to post-conference, while perceived barriers decreased (2.71 [0.54] versus 2.54 [0.58]; p = 0.001). Despite an upward trend, there was no statistically significant change in the mean prescribing and dispensing attitudes from baseline to post-conference. Additionally, 34.7% intended to join the Microsoft Teams working group at post-conference. Findings support the utility of interprofessional educational interventions to increase healthcare provider knowledge and beliefs regarding opioid harm reduction strategies amongst older adults. Full article

Background: Cervical cancer is among the most common cancers affecting women worldwide, with high morbidity and mortality in low- and middle-income countries. In Saudi Arabia, most cases are diagnosed at a late stage despite the availability of free HPV vaccination and screening. Objectives: To identify Saudi women’s perceptions of the HPV vaccine using the Health Belief Model, estimate willingness to receive the HPV vaccine and the factors influencing it, assess uptake of Pap smear and HPV vaccine, and define barriers to both practices. Methodology: A cross-sectional study of a convenience sample of 1334 Saudi women aged 16 to 65 years, from all regions of Saudi Arabia, was conducted. Data were collected via an online questionnaire that included sociodemographic characteristics, beliefs about the HPV vaccine based on the Health Belief Model, vaccine hesitancy, and HPV vaccine and Pap smear uptake. Data were analyzed using SPSS version 29. Results: Only 6% completed their vaccination series or received at least one dose; 37.3% planned to get vaccinated; and 56.7% stated they do not intend to get vaccinated. The main reasons for vaccine refusal were lack of trust (41.8%) and fear of side effects (32.3%). Only 21% had undergone Pap smear testing, with barriers including embarrassment and fear. Among the HBM constructs, perceived susceptibility, benefits, and barriers remained statistically significant predictors of HPV vaccination. Increased perceived susceptibility and benefits raise the likelihood of accepting the HPV vaccine, while higher perceived barriers lessen it. Vaccine hesitancy had a significant negative effect on willingness to receive the HPV vaccine (OR = 0.78, 95% CI 0.69–0.90, p < 0.01). Additionally, Pap smear uptake was an independent predictor of the intent to get the HPV vaccine (OR = 1.78, 95% CI 1.25–2.54, p < 0.01). The independent factors influencing HPV vaccine uptake were largely similar to those affecting the willingness to receive the vaccine, except for age, perceived benefits, and Pap smear uptake. Conclusions: There is a gap between Saudi women’s intention to get HPV vaccinated and actual vaccination. Women who saw a high risk of HPV-related cancer, believed in vaccine efficacy, had a Pap smear, and were open to vaccination were more likely to vaccinate. Hesitant women and those perceiving barriers were less likely to vaccinate or consider it. The main gaps for future campaigns are perceptions of HPV severity and cultural factors influencing decision-making. Emphasizing HPV as a cancer-related virus rather than a sexually transmitted infection can reduce barriers and highlight its severity. Full article

Background: Black Sub-Saharan African immigrants are among the fastest-growing immigrant populations in the United States, and their mental health needs, particularly with respect to depression, remain understudied. Cultural beliefs, linguistic frameworks, and coping practices in this population often diverge from Western psychiatric models, suggesting that conventional approaches may fail to capture how distress is experienced and expressed. Objective: This scoping review mapped literature on how Black Sub-Saharan African immigrant adults in the United States perceive, report, and respond to depression. Methods: Following PRISMA-ScR guidelines, six electronic databases were systematically searched for empirical studies published between 2000 and 2026. Two reviewers independently screened and extracted data using a standardized form. Data were analyzed using a narrative synthesis approach combining deductive thematic categorization across three predefined review domains with inductive identification of subthemes through iterative team discussion and consensus, with sociocultural, religious, linguistic, and structural factors examined as cross-cutting themes. Findings were synthesized narratively across three domains: perceptions of depression, reporting and communication, and responses to depression. Results: A total of 19 studies met the inclusion criteria (7 quantitative, 10 qualitative, 2 mixed methods; total N ≈ 1900), generating 24 themes. Perception themes highlighted cultural non-recognition of depression (12 of 19 studies), absence of equivalent terms in African languages (7 studies), spiritual explanatory models, and profound stigma. Reporting patterns showed predominant somatic symptom expression and very low disclosure to providers (2.6–4.2%), with depression prevalence ranging from 8.1% to 100% and no validated screening instrument identified for this population. Response themes emphasized religion and social support as primary coping strategies, with formal mental health utilization virtually absent due to structural, cultural, and intersectional barriers. Conclusions: Depression among Black Sub-Saharan African immigrants is widely experienced yet rendered invisible through interlocking cultural, linguistic, somatic, and institutional mechanisms, which this review terms an architecture of invisibility, leaving it largely unaddressed by formal mental health systems. The identification of only one intervention study underscores a substantial gap between documenting the burden of depression and advancing evidence-informed solutions. Culturally validated measures, faith-based intervention models, longitudinal designs, and attention to structural determinants are urgently needed. Full article