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<journal-id journal-id-type="publisher">ujph</journal-id>
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<journal-title>Undergraduate Journal of Public Health</journal-title>
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<article-id pub-id-type="publisher-id">6061</article-id>
<article-id pub-id-type="manuscript">from-the-middle-east-to-america_-examining-acculturative-factors-of-adolescent-immigration_april-3.docx</article-id>
<article-id pub-id-type="doi">10.3998/ujph.6061</article-id>
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<article-title>From the Middle East to America: Examining Acculturative Factors of Adolescent Immigration</article-title>
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<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Kharal</surname>
<given-names>Maariyah</given-names>
</name>
<xref rid="aff1" ref-type="aff">&#x002A;</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Abdellatif</surname>
<given-names>Jennah</given-names>
</name>
<xref rid="aff1" ref-type="aff">&#x2020;</xref>
</contrib>
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<aff id="aff1"><label>&#x002A;</label><institution>New York University</institution>, <institution content-type="dept">Department of Applied Psychology</institution>, <email>mk7424@nyu.edu</email></aff>
<aff id="aff2"><label>&#x2020;</label><institution>New York University</institution>, <institution content-type="dept">Department of Applied Psychology</institution>, <email>jha7515@nyu.edu</email></aff>
<pub-date><day>15</day><month>7</month><year>2024</year></pub-date>
<volume>8</volume><issue></issue>
<issue-title></issue-title>
<history>
<date date-type="received"><day></day><month></month><year></year></date>
<date date-type="rev-recd"><day></day><month></month><year></year></date>
<date date-type="accepted"><day></day><month></month><year></year></date>
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<license><license-p>CC-BY-NC-ND 4.0</license-p></license>
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<abstract id="ABS1">
<p id="P1">Global immigration necessitates acculturation which is the process of adapting to cultural norms while maintaining aspects of origin-country culture. Acculturation is the process through which individuals adapt to the culture, norms, and belief systems of their host country (<xref ref-type="bibr" rid="R90">Sayegh &amp; Lasry, 1993</xref>; <xref ref-type="bibr" rid="R115">Yeh et al., 2008</xref>). Acculturation is difficult for adolescents because they are undergoing identity formation throughout immigration. For Middle Eastern individuals in particular, cultural differences, threat of harmful stereotyping, and socioeconomic difficulties further complicate this process. This study examined factors that relate to acculturation for Middle Eastern immigrants who immigrated during adolescence. Eight participants were interviewed for this study and interview transcriptions were analyzed using thematic analysis. Results found three overarching themes related to community, personal identity, and American infrastructure. Further research should be conducted to explore each of these constructs in detail to ensure Middle Eastern adolescent immigrants can receive acculturative support and to reduce the stigma held by the American public around Middle Eastern individuals.</p>
</abstract>
<kwd-group>
<kwd>mental health</kwd>
<kwd>immigration</kwd>
<kwd>Middle East</kwd>
<kwd>adolescent immigration</kwd>
<kwd>acculturation</kwd>
</kwd-group>
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<p>Research on the immigration experience has revealed the importance of acculturation for the physical, emotional, and social well-being of immigrants (<xref ref-type="bibr" rid="R24">Clarke &amp; Isphording, 2016</xref>; <xref ref-type="bibr" rid="R75">Park, 2011</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>). Acculturation involves balancing cultural identities with an emphasis on adopting the host-country culture to a greater extent (<xref ref-type="bibr" rid="R90">Sayegh &amp; Lasry, 1993</xref>; <xref ref-type="bibr" rid="R115">Yeh et al., 2008</xref>). Two key demographic features, age at the time of immigration and country of origin shape the context of the transition and relate to the extent to which the immigrant may adapt to American culture (<xref ref-type="bibr" rid="R20">Cheung et al., 2010</xref>; <xref ref-type="bibr" rid="R52">Kimbro, 2009</xref>; <xref ref-type="bibr" rid="R60">Marvasti, 2005</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>). Thus, this review will address acculturation in the context of adolescent immigration and in the context of Middle Eastern immigration to the United States (US). Adolescence is a particularly vulnerable time for immigration as the process of identity formation may be challenged by the need to balance two sets of cultural values and expectations (<xref ref-type="bibr" rid="R40">Goodenow &amp; Espin, 1993</xref>; <xref ref-type="bibr" rid="R58">Mann, 2004</xref>; <xref ref-type="bibr" rid="R79">Phinney, 1989</xref>). Immigrants of Middle Eastern origin are important to examine as descent from the region rapidly increases due to political and economic struggles. Between 2000 and 2019, MENA immigrant population doubled from 596,000 to 1.2 million (<xref ref-type="bibr" rid="R42">Harjanto &amp; Batalova, 2022</xref>). Their experiences provide insight on how cultural differences and American stigmatization, relate to acculturative outcomes (<xref ref-type="bibr" rid="R12">Buda &amp; Elsayed-Elkhouly, 1998</xref>; <xref ref-type="bibr" rid="R35">Fuligni &amp; Tsai, 2015</xref>; <xref ref-type="bibr" rid="R62">Minardi, 2021</xref>). Thus, this literature review will analyze the circumstances of adolescent immigration and the circumstances of immigration from the Middle East to better understand the unique processes of acculturation for these populations.</p>
<sec id="S1">
<title>Challenges with Immigration &amp; Acculturation</title>
<p>Being an immigrant poses many challenges that serve as barriers to acculturation (<xref ref-type="bibr" rid="R28">Dustmann &amp; Fabbri, 2003</xref>; <xref ref-type="bibr" rid="R72">Noels et al., 1996</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>; <xref ref-type="bibr" rid="R110">Valent&#x00ED;n-Cort&#x00E9;s et al., 2020</xref>). A significant barrier includes lack of proficiency in the language of their new country, which can prevent immigrants from finding jobs, leaving them and their dependents in unfavorable socioeconomic conditions (<xref ref-type="bibr" rid="R36">Galarneau &amp; Morissette, 2004</xref>; <xref ref-type="bibr" rid="R72">Noels et al., 1996</xref>; <xref ref-type="bibr" rid="R100">St&#x00F6;ren, 2004</xref>). Their lack of language proficiency and unfavorable socioeconomic status can prevent immigrants from interacting with natives and therefore lead to social isolation (<xref ref-type="bibr" rid="R24">Clarke &amp; Isphording, 2016</xref>; <xref ref-type="bibr" rid="R28">Dustmann &amp; Fabbri, 2003</xref>; <xref ref-type="bibr" rid="R112">Watkins et al., 2012</xref>). Having social connections, whether it be with individuals from the same country of origin or from the new country, is associated with greater financial, social, and psychological success of immigrants (<xref ref-type="bibr" rid="R1">Ahmad, 2011</xref>; <xref ref-type="bibr" rid="R67">Nakhaie &amp; Kazemipur, 2012</xref>). These social connections in the new country may help immigrants cope with the locals&#x2019; stereotypes about and discrimination towards them (<xref ref-type="bibr" rid="R1">Ahmad, 2011</xref>; <xref ref-type="bibr" rid="R102">Subervi-Velez, 1986</xref>).</p>
<p>Depending on their country of origin, immigrants may experience poor treatment from natives (<xref ref-type="bibr" rid="R18">Casanova, 2012</xref>; <xref ref-type="bibr" rid="R60">Marvasti, 2005</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>). For example, if an individual from Latin America or Africa migrates to a southern state in the US, they may face discrimination and difficulty finding a job to a greater extent than a European immigrant, due to larger discrepancies in their physical appearance and cultural norms (<xref ref-type="bibr" rid="R67">Nakhaie &amp; Kazemipur, 2012</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>). Living in a nation that is culturally sensitive and has low levels of discrimination against immigrants is associated with better acculturative outcomes (<xref ref-type="bibr" rid="R2">Alegr&#x00ED;a et al., 2017</xref>). Better acculturative outcomes also occur when immigrants have informed expectations about society in the new country and the natives&#x2019; perception of immigrants prior to immigrating (<xref ref-type="bibr" rid="R47">Idema &amp; Phalet, 2007</xref>; <xref ref-type="bibr" rid="R51">Kim et al., 1996</xref>; <xref ref-type="bibr" rid="R69">Nghe et al., 2003</xref>).</p>
<p>Immigrants who have false expectations about the societal norms such as gender roles in the new country may have greater difficulty acculturating (<xref ref-type="bibr" rid="R47">Idema &amp; Phalet, 2007</xref>; <xref ref-type="bibr" rid="R51">Kim et al., 1996</xref>; <xref ref-type="bibr" rid="R69">Nghe et al., 2003</xref>). Exposure to media depicting host country norms prior to immigration may aid in acculturation by providing immigrants with realistic expectations about life in the new country (<xref ref-type="bibr" rid="R102">Subervi-Velez, 1986</xref>; <xref ref-type="bibr" rid="R116">Zhou &amp; Cai, 2002</xref>). Furthermore, exposure to origin country media post-immigration allows immigrants to maintain some connections to their heritage, which is an important facet of acculturation (<xref ref-type="bibr" rid="R102">Subervi-Velez, 1986</xref>; <xref ref-type="bibr" rid="R116">Zhou &amp; Cai, 2002</xref>). Challenges associated with immigration including language barriers, social isolation, discrimination, and false expectations can be considered barriers to acculturation because they make it more difficult for individuals to adapt to the social norms, belief systems, and practices of the new country (<xref ref-type="bibr" rid="R23">Chung et al., 2000</xref>; <xref ref-type="bibr" rid="R69">Nghe et al., 2003</xref>; <xref ref-type="bibr" rid="R72">Noels et al., 1996</xref>). It is important to consider that the aforementioned challenges and overall process of acculturation may differ depending on age at the time of immigration (<xref ref-type="bibr" rid="R84">Renzaho et al., 2017</xref>; <xref ref-type="bibr" rid="R99">Stevens et al., 2004</xref>).</p>
</sec>
<sec id="S2">
<title>Acculturation &amp; Immigration During Adolescence</title>
<p>Age at the time of immigration can have a major impact on acculturative outcomes (<xref ref-type="bibr" rid="R84">Renzaho et al., 2017</xref>; <xref ref-type="bibr" rid="R99">Stevens et al., 2004</xref>). Immigration specifically during adolescence poses a unique set of challenges (<xref ref-type="bibr" rid="R27">Dorner et al., 2008</xref>; <xref ref-type="bibr" rid="R39">G&#x00F6;n&#x00FC;lta&#x015F; &amp; Mulvey, 2020</xref>; <xref ref-type="bibr" rid="R54">Kirchengast &amp; Schober, 2005</xref>; <xref ref-type="bibr" rid="R78">Perez, 2016</xref>). Adolescents have lower neuroplasticity than children, thus acculturation may be slower in adolescents than in children because it may take longer for them to adopt the societal norms of the new country (<xref ref-type="bibr" rid="R38">Gershoff et al., 2014</xref>). Thus, adolescents with adaptable dispositions and emotion- regulation skills often have more favorable acculturative outcomes than their peers (<xref ref-type="bibr" rid="R41">Gopnik et al., 2017</xref>; <xref ref-type="bibr" rid="R45">Hermansen, 2017</xref>; <xref ref-type="bibr" rid="R117">Zhou, 2013</xref>). Mood disorders may be partially attributable to assuming significant responsibilities at a young age, such as serving as translators for their families (<xref ref-type="bibr" rid="R27">Dorner et al., 2008</xref>; <xref ref-type="bibr" rid="R74">Orellana, 2003</xref>; <xref ref-type="bibr" rid="R109">Uma&#x00F1;a-Taylor, 2003</xref>). These health issues that arise due to immigration reduce acculturation and hinder adolescent development (<xref ref-type="bibr" rid="R38">Gershoff et al., 2014</xref>; <xref ref-type="bibr" rid="R40">Goodenow &amp; Espin, 1993</xref>).</p>
<p>Adolescent development is characterized by the process of identity formation, which according to Erikson&#x2019;s theory of psychosocial development, is the main task associated with adolescence (<xref ref-type="bibr" rid="R30">Erikson, 1968</xref>; <xref ref-type="bibr" rid="R50">Kidwell et al., 1995</xref>; <xref ref-type="bibr" rid="R64">Mitchell et al., 2021</xref>). Erikson proposed that in this stage of identity versus role confusion, the main concern of adolescents is cultivating a sense of identity and solidifying this identity through meaningful social connections (<xref ref-type="bibr" rid="R30">Erikson, 1968</xref>; <xref ref-type="bibr" rid="R50">Kidwell et al., 1995</xref>; <xref ref-type="bibr" rid="R64">Mitchell et al., 2021</xref>). If immigrant adolescents can develop social connections, their acculturation levels and identity formation are both bolstered (<xref ref-type="bibr" rid="R96">Sirin, Gupta, et al., 2013</xref>; <xref ref-type="bibr" rid="R105">Thomas &amp; Jong Young Choi, 2006</xref>). Unfortunately, experiencing meaningful connections and developing friendships is especially difficult for adolescent immigrants who feel alienated due to cultural and linguistic differences (<xref ref-type="bibr" rid="R3">Alivernini et al., 2019</xref>; <xref ref-type="bibr" rid="R16">Caravita et al., 2019</xref>; <xref ref-type="bibr" rid="R22">Chow, 2007</xref>). Additionally, school bullying of immigrant adolescents is more common than bullying of non-immigrants, and the resulting social isolation leads to lower levels of acculturation and hinders identity formation (<xref ref-type="bibr" rid="R16">Caravita et al., 2019</xref>; Caravita, <xref ref-type="bibr" rid="R17">Strohmeier, et al., 2019</xref>; <xref ref-type="bibr" rid="R39">G&#x00F6;n&#x00FC;lta&#x015F; &amp; Mulvey, 2020</xref>). Social barriers to acculturation and identity formation are not limited to the school environment, because societal perception of immigrants may also impact ego identity formation and acculturation among adolescents (<xref ref-type="bibr" rid="R10">Bhugra, 2013</xref>; <xref ref-type="bibr" rid="R44">Hashemi et al., 2019</xref>; <xref ref-type="bibr" rid="R79">Phinney, 1989</xref>).</p>
<p>Ego identity development among immigrant adolescents varies depending on country of origin and the extent to which they feel accepted by the host-country natives (<xref ref-type="bibr" rid="R10">Bhugra, 2013</xref>; <xref ref-type="bibr" rid="R79">Phinney, 1989</xref>). For those unable to pass as natives, race and religion-based stereotypes can impact immigrant adolescents&#x2019; identity, acculturation, self-esteem, and overall development (<xref ref-type="bibr" rid="R10">Bhugra, 2013</xref>). Maintaining home-country customs, such as religious practices and cultural traditions, may help immigrant adolescents cope with the challenges of moving, however it may also cause stress and hinder acculturation if these customs are rare and highly stigmatized in the new country (<xref ref-type="bibr" rid="R44">Hashemi et al., 2019</xref>; <xref ref-type="bibr" rid="R62">Minardi, 2021</xref>; <xref ref-type="bibr" rid="R101">Stuart &amp; Ward, 2018</xref>).</p>
</sec>
<sec id="S3">
<title>Acculturation &amp; Middle Eastern Immigrants</title>
<p>Children, adolescents, and adults from the Middle East all face a particularly unique transition when migrating to the United States due to differences in cultural and religious values, as well as the threat of harmful stereotypes (<xref ref-type="bibr" rid="R44">Hashemi et al., 2019</xref>; <xref ref-type="bibr" rid="R62">Minardi, 2021</xref>; <xref ref-type="bibr" rid="R101">Stuart &amp; Ward, 2018</xref>). Understanding the context of Middle Eastern immigration is relevant when analyzing acculturative factors of the transition (Aly &amp; Rajan, 2009; <xref ref-type="bibr" rid="R31">Falah, 1996</xref>; <xref ref-type="bibr" rid="R32">Foad, 2013</xref>; <xref ref-type="bibr" rid="R114">Witty, 2011</xref>).</p>
<p>Middle Eastern immigration to the United States has been prominent since the 1800s, with political climates varying the circumstances of the Middle Eastern immigration experience (Aly &amp; Rajan, 2009; <xref ref-type="bibr" rid="R32">Foad, 2013</xref>). Between the 1940s and 1960s, political instability in the Middle East was the primary motive for immigration, however strict regulations only allowed those who were highly educated and prepared for skilled labor (Coleman, n.d.; <xref ref-type="bibr" rid="R31">Falah, 1996</xref>; <xref ref-type="bibr" rid="R32">Foad, 2013</xref>; &#x201C;Immigration Act of 1924,&#x201D; 2019; <xref ref-type="bibr" rid="R97">Shakry, 2015</xref>; <xref ref-type="bibr" rid="R114">Witty, 2011</xref>). Acculturation during this period was aided by laws which ensured that immigrants had their paperwork and economic plans sorted before arriving to America, thus mitigating some of the bureaucratic difficulties associated with transition (<xref ref-type="bibr" rid="R31">Falah, 1996</xref>; <xref ref-type="bibr" rid="R114">Witty, 2011</xref>). In 1965, laws that limited non-European immigration were revoked and Middle Eastern immigration to the US soared (&#x201C;Immigration Act of 1924,&#x201D; 2019; <xref ref-type="bibr" rid="R97">Shakry, 2015</xref>). By allowing immigrants from different statuses and contexts to enter the US, the process of acculturation broadened, and the American ethnic landscape changed from one of white dominance to cultural diversity (Coleman, n.d.; <xref ref-type="bibr" rid="R31">Falah, 1996</xref>; Foad; 2013; &#x201C;Immigration Act of 1924,&#x201D; 2019).</p>
<p>With cultural diversity came the increased prominence of stereotyping, especially for immigrants from the Middle East, who were engaged in several political tensions with the US during the late 20th and early 21st centuries (<xref ref-type="bibr" rid="R86">Reyna et al. 2013</xref>; <xref ref-type="bibr" rid="R104">Timberlake &amp; Williams, 2012</xref>). Stereotyping hinders acculturation because it alienates immigrants thus increasing feelings of isolation(Seeman, 2014; <xref ref-type="bibr" rid="R104">Timberlake &amp; Williams, 2012</xref>). Stereotyping of Middle Eastern individuals was perpetuated through American media (<xref ref-type="bibr" rid="R15">Campbell, 1997</xref>; <xref ref-type="bibr" rid="R85">Rettberg &amp; Gajjala, 2015</xref>; <xref ref-type="bibr" rid="R94">Semaan, 2014</xref>). For instance, during the Israel-Palestine conflicts of the 1948, American newspapers cemented their solidarity with Israel by portraying Palestinians as a detestable people to gain support from the American public (<xref ref-type="bibr" rid="R6">Baker &amp; Sawafta, 2015</xref>; <xref ref-type="bibr" rid="R94">Semaan, 2014</xref>). Furthermore, American depictions of conflicts with Iran and Libya in the 1970s and 80s shaped the perception of the Middle Eastern man as a dangerous terrorist (<xref ref-type="bibr" rid="R15">Campbell, 1997</xref>; <xref ref-type="bibr" rid="R85">Rettberg &amp; Gajjala, 2015</xref>, <xref ref-type="bibr" rid="R94">Semaan, 2014</xref>). These instances embedded harmful tropes about Middle Easterners into the American subconscious because the &#x201C;average American is uneducated about the Middle East [and] they tend to conflate all countries and cultures in that part of the world&#x201D; (Campbell, 2017, p. 178). The negative image of Middle Eastern individuals in American media only worsened after the 9/11 attacks in New York City because Arab-hate and Islamophobia became a means of nationalism in the so-called &#x2018;War on Terror&#x2019; (<xref ref-type="bibr" rid="R85">Rettberg &amp; Gajjala, 2015</xref>; <xref ref-type="bibr" rid="R87">Salaita, 2006</xref>). Because of these damaging stereotypes, Middle Eastern immigrants are predisposed to challenges with feeling accepted, and thus becoming acculturated in America (<xref ref-type="bibr" rid="R86">Reyna et al., 2013</xref>; <xref ref-type="bibr" rid="R93">Seiter, 1986</xref>).</p>
<p>In addition to stereotypes hindering the acculturation of Middle Eastern immigrants, differences in religious beliefs can also pose a challenge to acculturation (<xref ref-type="bibr" rid="R19">Cesari, 2009</xref>; <xref ref-type="bibr" rid="R44">Hashemi et al., 2019</xref>; <xref ref-type="bibr" rid="R108">Tubergen, 2007</xref>). Immigration to America is unique for Middle Eastern individuals who come from Islamic countries and must adjust to a secular culture (<xref ref-type="bibr" rid="R19">Cesari, 2009</xref>; <xref ref-type="bibr" rid="R108">Tubergen, 2007</xref>). Islam is the most common religion of the Middle East, and with it comes ingrained expectations that define norms around gender roles, modesty, and overall code of conduct (<xref ref-type="bibr" rid="R44">Hashemi et al., 2019</xref>; <xref ref-type="bibr" rid="R103">Terman, 2017</xref>). In the Middle East, it is common for Muslim women to conserve their modesty by wearing hijab, however in the West, the veil is seen as a mechanism of oppression that puts women in a subordinate position (<xref ref-type="bibr" rid="R57">Manley, 2017</xref>; <xref ref-type="bibr" rid="R103">Terman, 2017</xref>). Thus, not conforming to American ideology about modesty may hinder the acculturation of Middle Eastern women (<xref ref-type="bibr" rid="R57">Manley, 2017</xref>; <xref ref-type="bibr" rid="R103">Terman, 2017</xref>). Moreover, in the Middle East, it is common for women to hold domesticated roles, whereas in the West, women are, often expected, to join the workforce (Foroutan, 2018). Immigrants often have financial struggles and maintaining the Middle Eastern norms of women as homemakers upon immigration may impact their financial stability and therefore their acculturation (Foroutan, 2018). These religion-based cultural differences make the immigration and acculturation experience uniquely challenging for Middle Eastern immigrants as they attempt to adjust themselves to new expectations while also maintaining the values of their home-countries (<xref ref-type="bibr" rid="R44">Hashemi et al., 2019</xref>; <xref ref-type="bibr" rid="R66">Montgomery &amp; Foldspang, 2007</xref>; <xref ref-type="bibr" rid="R101">Ward et al., 2018</xref>).</p>
</sec>
<sec id="S4">
<title>Our Focus</title>
<p>General trends in the literature indicate that immigration is accompanied by a variety of stressors that may hinder acculturation (<xref ref-type="bibr" rid="R28">Dustmann &amp; Fabbri, 2003</xref>; <xref ref-type="bibr" rid="R72">Noels et al., 1996</xref>; <xref ref-type="bibr" rid="R110">Valent&#x00ED;n-Cort&#x00E9;s et al., 2020</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>). Acculturation is often impaired by financial struggles, lack of language proficiency, social isolation, discrimination, and culture shock (<xref ref-type="bibr" rid="R28">Dustmann &amp; Fabbri, 2003</xref>; <xref ref-type="bibr" rid="R72">Noels et al., 1996</xref>; <xref ref-type="bibr" rid="R82">Reimers, 1983</xref>; <xref ref-type="bibr" rid="R110">Valent&#x00ED;n-Cort&#x00E9;s et al., 2020</xref>). Challenges with identity formation and social contexts cause adolescents specifically to experience unique acculturative processes (<xref ref-type="bibr" rid="R8">Beck et al., 2012</xref>; <xref ref-type="bibr" rid="R45">Hermansen, 2017</xref>; <xref ref-type="bibr" rid="R91">Schaafsma &amp; Sweetman, 2001</xref>). Focusing on adolescents will provide insight into the process of acculturation for individuals navigating a critical developmental period (<xref ref-type="bibr" rid="R20">Cheung et al., 2010</xref>; <xref ref-type="bibr" rid="R21">Chiswick &amp; Miller, 1999</xref>; <xref ref-type="bibr" rid="R63">Minoura, 1992</xref>). Due to the vast diversity among immigrant experiences, this paper will focus on adolescent immigrants specifically of Middle Eastern origin and Muslim faith. It will explore how stereotyping, religious differences, and cultural differences impact acculturation among Middle Eastern immigrants. Additional acculturative factors that will be explored include socioeconomic status (SES), education, social support, and pre-existing familiarity with the United States. Therefore, this paper will address the following question: What factors relate to the acculturative outcomes of Middle Eastern individuals who immigrated to the US during adolescence?</p>
</sec>
<sec id="S5">
<title>Method</title>
<sec id="S6">
<title>Participants</title>
<p>In June of 2023, the researchers recruited eight participants for this qualitative study through personal connections. These participants are all of Middle Eastern descent, coming from Turkey, Algeria, Palestine, Egypt, Kuwait, and two participants from Lebanon. Three males (pseudonyms NA, SA, IE) and five females (pseudonyms NS, GM, AK, NH, TS) participated in this study. All participants immigrated to the United States during adolescence between 13 and 18 years of age (<italic>M</italic>=15.5; <italic>MD</italic>=15) between the years of 1983 and 2007 to the states of California (NA, GM, TS, SA, NS), Georgia (AK), New York (IE), and Missouri (NH). They all currently reside in California. Researchers collected the following demographic data from each participant: age at the time of immigration, country of origin, year of immigration, and whether the participant immigrated alone or with others (see <xref ref-type="app" rid="app2">Appendix B</xref>).</p>
</sec>
<sec id="S7">
<title>Procedure</title>
<p>Participants were asked to partake in semi-structured interviews in June of 2023. Participant verbal consent was obtained to record responses and use their data. Interviews occurred over Zoom and lasted an average of thirty minutes. Each interview consisted of ten open-ended questions about the participant&#x2019;s immigration experience, focusing on factors related to their acculturation, English-language proficiency, the presence of assistive school programs, the impact of religion during their transition, and other facets of socio-cultural adaptation (see <xref ref-type="app" rid="app1">Appendix A</xref>). Researchers asked follow-up, open-ended questions to ensure the responses could be extensively analyzed. All interviews were recorded, transcribed, and then analyzed using qualitative coding techniques.</p>
</sec>
<sec id="S8">
<title>Transcription &amp; Coding</title>
<p>After acquiring data through recorded interviews, the interviews were transcribed using Zoom so they could be coded. Each transcript was cleaned and verified by both researchers. Based on the participants&#x2019; responses, the researchers generated a codebook using thematic analysis and identified nine main factors relating to acculturation among those who immigrated from the Middle East to America during adolescence which were organized into three overarching themes. These factors were defined and verified through four rounds of reading, coding, and discussion. To qualify as a factor of acculturation, at least four of the eight participants needed to mention it during their interview. This was done to ensure that the factors were representative of the sample. In addition, if every factor mentioned by every participant was included, succinctness would be compromised and the factors would not be generalizable. The number of times each factor was mentioned throughout the interviews was recorded such that the frequency of the factors relative to each other would be evident.</p>
</sec>
</sec>
<sec id="S9">
<title>Results</title>
<p>Nine factors relating to acculturation emerged from the interviews and were grouped into three overarching themes: community, identity, and American infrastructure.</p>
<sec id="S10">
<title>Community</title>
<p>Participants&#x2019; acculturation was enhanced by support from family who immigrated with them, from family and friends who had immigrated before them, and from those they met in the US. Community support was operationalized to include a socioemotional dimension and a physical dimension. The socioemotional dimension entailed forming bonds, collaborating on adapting to American customs, and comforting one another when coping with changes. The physical dimension involved factors such as financial assistance, housing security, and guidance for admittance into school/work environments.</p>
<sec id="S11">
<title>Family Support</title>
<p>Family support entails emotional, intellectual, and financial assistance from members related to the participant. In the interviews, family support was discussed twenty-four times throughout the transcriptions by seven out of eight of the participants. Participants explained that immigrating with family members helped them adjust to American society and customs. Having family members &#x201C;compare notes&#x201D; on the Americans that they worked with allowed participants to &#x201C;understand and imitate American mannerisms.&#x201D; Participants noted that although immigrating with family members furthered their acculturation, at times it forced them to take on additional responsibilities such as language brokering for parents and caring for siblings while parents worked. Particpants who had family members that had already been living in the US utilized these connections to understand the American education system, culture, housing market, and social etiquette. Participants who immigrated to the US alone noted that perceived isolation and sadness due to separation from family inhibited their acculturation because the participants were &#x201C;constantly thinking about family back home.&#x201D;</p>
</sec>
<sec id="S12">
<title>Social Support</title>
<p>Another aspect that was valued by participants in the acculturation process was social support, which was mentioned twenty-two times by seven participants. During the initial transition, some participants relied on preexisting social connections for shelter and guidance on navigating the American job market. For participants who immigrated without social connections in America, there was a trend of seeking other immigrants and/or Americans from the same ethnic origin. Because our participants all identify as Muslim, the mosque was essential in helping participants develop social circles and &#x201C;feel at home&#x201D; in the US. Social connections helped immigrants feel less culturally isolated and allowed them to learn about how other Middle Eastern individuals found success in integrating into American society. These connections also enabled some participants to find jobs and obtain financial assistance. Some participants connected with non-Middle Eastern immigrants at school with whom they could &#x201C;relate to&#x201D; and discuss &#x201C;how weird American food was and how hard American school was.&#x201D; The participants who struggled to make friends reported that lack of social bonds prevented them from &#x201C;connecting to American society.&#x201D;</p>
</sec>
</sec>
<sec id="S13">
<title>Identity</title>
<p>Participants revealed that immigration impacted their identity formation which had consequences for their acculturation. Immigration contributed to participants&#x2019; mental health struggles, difficulty adapting to cultural differences, and discrimination, all of which challenged their formation of a Middle Eastern-American identity. Researchers operationalized identity as mental-health, personality, and value-based characteristics of participants. Identity was shaped by the mental processes, values, religion, and social adversity that accompanied acculturation.</p>
<sec id="S14">
<title>Mental Health</title>
<p>Mental health was a significant factor related to identity and acculturation, mentioned by seven participants a total of eleven times. For some participants, positive mental health characteristics such as resilience and determination were related to successful acculturation. For these participants, the mindset of &#x201C;adapt or go home&#x201D; propelled them to overcome their challenges and to continue pursuing their goals in America. In addition to resilience and determination, the development and expression of independence also related positively to acculturation, allowing participants to feel strong, responsible, and capable in their ability to succeed. Other participants were challenged with negative mental health outcomes during their immigration. These participants felt culturally isolated by language barriers and physically isolated due to ostracization and lack of work opportunities. Notably, depressive symptoms occurred as a result of isolation, thus inhibiting identity formation and reducing motivation to acculturate.</p>
</sec>
<sec id="S15">
<title>Cultural Differences</title>
<p>The impact of cultural differences between their country of origin and the US on identity formation and acculturation was discussed frequently, totaling eighteen mentions across all eight participants. Cultural differences include any mention of differences in norms between the origin country and America. Interviews indicated that cultural differences impacted participants&#x2019; willingness to adopt an American identity. For instance, many participants were fascinated by multiculturalism in America and felt excited to immerse themselves in the culture and learn about the world through these interactions. For other participants, certain aesthetic features of American culture, such as long nails, dyed hair, and &#x201C;weird music,&#x201D; made participants feel uncomfortable and reduced their motivation to acculturate and &#x201C;fit in.&#x201D; Discomfort with aspects of American culture led some participants to have difficulty &#x201C;viewing [themselves] as having an American identity.&#x201D; Adjusting to cultural norms around work was found to make acculturation difficult. In the Middle East, it is common for men to hold financial responsibility for the family, however the financial structure of the US often requires two sources of income for survival. This caused conflict in some families and added stress to the participants&#x2019; transition. It is also common for students to have jobs in America, unlike in the Middle East. For one participant, not working caused her to be othered by her peers, who assumed this choice came from a place of entitlement. For those who balanced both school and work, valuable lessons about adulthood were learned, however the need to &#x201C;grow up and be responsible very quickly&#x201D; came at the cost of enjoying &#x201C;teen life and doing things without thinking of consequences.&#x201D;</p>
</sec>
<sec id="S16">
<title>Religion</title>
<p>Seven participants mentioned the role of religion in their acculturative process and identity formation, for a total of twelve times. All participants were Muslim. For many, Islam &#x201C;reminded [them] of home and brought comfort&#x201D; during the transition which allowed them to better acculturate. In the Middle East, Islam is ingrained in the culture, so continuing to pray, celebrate religious holidays, and connect with God post-immigration allowed the participants to retain their cultural identity. Islam also instilled a value system into participants that &#x201C;set guidelines on how to behave&#x201D; as they navigated a change in the societal moral structure. Some participants noted that their religious identity shaped their social identity. For example, participants were less likely to succumb to peer pressure around sex, substance use, and delinquent behaviors, such as disrespecting authority figures, when it went against their religious values. For some participants, being outwardly Muslim caused them to feel outcasted which hindered their acculturation. Despite this, these participants continued to practice religion and form identities centered around religion.</p>
</sec>
<sec id="S17">
<title>Discrimination</title>
<p>Five participants experienced discrimination against their Middle Eastern heritage and Islamic identity. Discrimination negatively impacted identity formation and acculturation and was mentioned sixteen times throughout the interviews. Negative attitudes against Arabs caused participants to be alienated by schoolmates and society as a whole. Physical appearance played a significant role in this process. Participants who experienced higher levels of discrimination were more visibly Middle Eastern, most often through the presence of a beard or hijab. Those who did not mention instances of discrimination were less distinctly Middle Eastern, being either white passing or ethnically ambiguous. Participants who immigrated after 9/11 experienced more discrimination because there was a common belief &#x201C;that every Muslim and every person from the Middle East was a terrorist.&#x201D; Discrimination caused social rejection, harassment, career disadvantages, and mental health struggles, thus hindering identity formation and acculturation.</p>
</sec>
</sec>
<sec id="S18">
<title>American Infrastructure</title>
<p>Participants noted that acculturation was greatly impacted by certain factors that were specific to American infrastructure. Infrastructure was operationalized as the language, school system, and economy of the United States.</p>
<sec id="S19">
<title>English Language</title>
<p>All eight participants noted that English-language proficiency was essential for acculturation. English was mentioned in the context of acculturation twenty-six times across all interviews. Participants who had learned some level of English prior to immigrating felt as though knowing English &#x201C;made the transition easier,&#x201D; by allowing them to &#x201C;become part of society,&#x201D; &#x201C;watch American television,&#x201D; and &#x201C;fit in with Americans.&#x201D; Four participants emphasized how using television and music to learn English also taught them about American culture and behaviors which aided in their acculturation. Participants noted that English was essential for success in school and job attainment. Those who were not fluent in English prior to immigration had greater difficulty in school, social settings, and in the workplace. Although all participants noted the importance of English proficiency for acculturation, one particular participant explained that they still struggled with English because of the &#x201C;American accent&#x201D; and the rapid speech rate.</p>
</sec>
<sec id="S20">
<title>School Assistance</title>
<p>School assistance was found to be entirely useless in immigrant acculturation. All of the participants stated that their school did nothing to aid their transition to the US. One participant mentioned that their school offered English-Second-Language classes but the &#x201C;teachers were not too nice and did not do anything to help.&#x201D; Three participants described how the education system was much more rigorous than it had been in their origin countries and no programs existed to support their academic transition. One participant noted that their school had cultural clubs, &#x201C;but there was no Arab or Algerian cultural club.&#x201D; One participant expressed that perhaps their schools did offer support for international students, however they were not made aware of these programs. Another participant proposed that because American schools are very large, they likely do not have the resources to offer &#x201C;special attention&#x201D; to immigrant students.</p>
</sec>
<sec id="S21">
<title>Finances</title>
<p>Money was mentioned seventeen times across all participants as helpful for acculturation. Seven of the eight participants experienced significant financial struggles upon moving to the US due to their parents working low-wage jobs. Poor finances limited acculturation by preventing participants from accessing education and tutoring. Acculturation was further hindered because inability to afford trendy clothes and new technology prevented participants from forming social connections with Americans. One participant who came from a wealthy family noted that money aided her acculturation because she could afford tutoring services like English lessons and entertainment like dance classes and movie tickets that allowed her to socialize with Americans.</p>
<table-wrap id="T1" position="float" orientation="landscape">
<label>Table 1.</label><caption><p><italic>Factors Relating to Acculturation of Middle Eastern Immigrants</italic></p></caption>
<table frame="hsides" rules="groups">
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<thead>
<tr>
<th colspan="10" align="left" valign="top"><p>Factors Relating to Acculturation of Middle Eastern Immigrants</p></th>
</tr>
<tr>
<th align="left" valign="top"><p></p></th>
<th colspan="2" align="left" valign="top"><p>Community</p></th>
<th colspan="3" align="left" valign="top"><p>Identity</p></th>
<th colspan="3" align="left" valign="top"><p>American Infrastructure</p></th>
</tr>
<tr>
<th align="left" valign="top"><p></p></th>
<th align="left" valign="top"><p>Family Support</p></th>
<th align="left" valign="top"><p>Social Support</p></th>
<th align="left" valign="top"><p>Mental Health</p></th>
<th align="left" valign="top"><p>Cultural Differences</p></th>
<th align="left" valign="top"><p>Religion</p></th>
<th align="left" valign="top"><p>Discrimination</p></th>
<th align="left" valign="top"><p>English Language</p></th>
<th align="left" valign="top"><p>School Assistance</p></th>
<th align="left" valign="top"><p>Finances</p></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top"><p># of times mentioned</p></td>
<td align="left" valign="top"><p>24</p></td>
<td align="left" valign="top"><p>22</p></td>
<td align="left" valign="top"><p>11</p></td>
<td align="left" valign="top"><p>IS</p></td>
<td align="left" valign="top"><p>12</p></td>
<td align="left" valign="top"><p>16</p></td>
<td align="left" valign="top"><p>26</p></td>
<td align="left" valign="top"><p>S</p></td>
<td align="left" valign="top"><p>17</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>Contexts that the Factor was Mentioned In</p></td>
<td align="left" valign="top"><p>Easing the transition</p></td>
<td align="left" valign="top"><p>Easing the transition</p></td>
<td align="left" valign="top"><p>Independence or Isolation</p></td>
<td align="left" valign="top"><p>Fashion, Music, Gender Norms</p></td>
<td align="left" valign="top"><p>Coping Mechanism or Source of Discrimination</p></td>
<td align="left" valign="top"><p>Social</p>
<p>Rejection,</p>
<p>Career</p>
<p>Disadvantages</p></td>
<td align="left" valign="top"><p>Integrating into Communities</p></td>
<td align="left" valign="top"><p>Rigorous</p>
<p>Education</p>
<p>System</p></td>
<td align="left" valign="top"><p>Poor finances</p>
<p>increased</p>
<p>struggle</p></td>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
</sec>
</sec>
<sec id="S22">
<title>Discussion</title>
<p>This qualitative study was designed to examine factors that relate to the acculturative outcomes of Muslim, Middle Eastern individuals who immigrated to the US during adolescence. The results indicate that factors related to acculturative outcomes of Middle Eastern adolescent immigrants include community-based, identity-based, and American infrastructure-based factors. Immigrating with family members and forming social connections with others from the same ethnic origin enhanced acculturation for participants by providing socioemotional, financial, and cultural support. These findings align with existing literature which has found that family and social support are associated with higher levels of acculturation (<xref ref-type="bibr" rid="R23">Chung et al., 2000</xref>; <xref ref-type="bibr" rid="R29">Edwards &amp; Lopez, 2006</xref>; <xref ref-type="bibr" rid="R89">Sanchez et al., 2019</xref>). Past research has also demonstrated the role of the mosque in building collective self-esteem and providing emotional support (<xref ref-type="bibr" rid="R70">Nguyen et al., 2013</xref>; <xref ref-type="bibr" rid="R71">Nguyen, 2017</xref>). This study reveals the importance of the mosque in the establishment of social support for Middle Eastern immigrants. One participant noted &#x201C;The community at the mosque helped my mom get involved in event planning so she would not be bored at home and they helped my dad find a job with better pay.&#x201D;</p>
<p>Not only did community impact the extent to which these participants could acculturate, but the importance of identity-based factors on acculturation was revealed. Previous research has found that adolescence is the period in which identity formation occurs, and that culture shock, bullying, and socioeconomic challenges associated with immigration often negatively impact identity formation (<xref ref-type="bibr" rid="R10">Bhugra, 2013</xref>; <xref ref-type="bibr" rid="R16">Caravita et al., 2019</xref>; <xref ref-type="bibr" rid="R30">Erikson, 1968</xref>). This study agreed with the literature because participants noted that depressive symptoms, social isolation, and cultural differences led to identity confusion which made it more difficult to adjust to life in the US. Previous research also aligns with our findings that immigrants who feel accepted by natives and are native passing have better acculturative outcomes (<xref ref-type="bibr" rid="R10">Bhugra, 2013</xref>; <xref ref-type="bibr" rid="R79">Phinney, 1989</xref>). One participant explained, &#x201C;I think that when I could blend in with White people, no one really stared at me or talked to me with hesitation or weird looks but when I was wearing [hijab] some people were more hesitant to speak with me and I definitely noticed people staring and being less likely to smile at me or reply when I said hello.&#x201D; This study expanded upon the literature because participants noted that being resilient, strong in their morals, and independent allowed them to better acculturate.</p>
<p>Because adolescent Muslim, Middle Eastern immigrants are a very specific population, literature on their acculturation in the United States is very limited (<xref ref-type="bibr" rid="R86">Reyna et al., 2013</xref>; <xref ref-type="bibr" rid="R93">Seiter, 1986</xref>). Research has found that discrimination against those from the Middle East is common in the US (<xref ref-type="bibr" rid="R86">Reyna et al., 2013</xref>; <xref ref-type="bibr" rid="R93">Seiter, 1986</xref>). Previous research has also shown that proficiency in the language of the new country aids in acculturation (<xref ref-type="bibr" rid="R75">Park, 2011</xref>; <xref ref-type="bibr" rid="R100">St&#x00F6;ren, 2004</xref>). This study concurred with previous findings (<xref ref-type="bibr" rid="R75">Park, 2011</xref>; <xref ref-type="bibr" rid="R86">Reyna et al., 2013</xref>; <xref ref-type="bibr" rid="R100">St&#x00F6;ren, 2004</xref>). Participants who had better English skills were able to communicate with natives, succeed in school, and find jobs which supported their acculturation. This study also identified that insufficient finances and the difficulty of US schools serve as acculturative obstacles for participants. One participant rooted much of her familial conflict to money struggles. Her mother was forced to work to make ends meet in America, which she had never had to endure in the Middle East which led to familial tensions. The American economy is significantly stronger than the economies of Middle Eastern countries (&#x201C;GDP per Capita,&#x201D; n.d.). Lack of sufficient finances can hinder acculturation due to inability to afford trendy clothes, tutoring, and entertainment can further alienate Middle Eastern immigrants from the American population, which can prevent them from feeling integrated into society.</p>
<sec id="S23">
<title>Conclusion</title>
<p>Through this research, the main factors related to acculturation for Middle Eastern, adolescent immigrants in the US were revealed. Factors that assist and hinder acculturation were discussed. In the future, this study should be replicated with a larger sample size. Given that many of the participants in this study immigrated to California, future research should also examine participants from other states to understand how the state of relocation relates to acculturative outcomes. Results of this study suggest that further research should be conducted on the role of religious institutions in enhancing immigrant acculturation. The three overarching themes that emerged around acculturation imply that future research should examine how community, identity, and infrastructure independently relate to acculturation in more depth.</p>
<p>Findings from this study imply that the American public should be better educated about religious and cultural diversity such that a climate of tolerance and acceptance can be fostered. Elimination of discrimination through destigmatizing media campaigns may benefit the identity formation and acculturation of Middle Eastern adolescent immigrants. It is also hoped that this study prompts discourse on school programs to enhance acculturation. School programs could be developed that prepare immigrant students for the rigor of the American curriculum and teach them about obtaining higher education and jobs. School programs could also connect immigrant students with each other and with natives who are willing to provide social support for immigrants and teach them about American culture and behaviors. It is hoped that implementation of such programs and continued research on Middle Eastern adolescent immigrants will spark policy change that can ease the acculturation processes for this population.</p>
<p>While we were able to grasp a comprehensive understanding of the factors of acculturation for our participants&#x2019;, our study contained limitations regarding sample size, demographics, and time. We used a narrow sample size of eight participants which limits the extent to which we can generalize these findings. Moreover, our participants all currently reside in California. As a diverse state, this may influence their view of American society differently than someone who resides in a less diverse state, regardless of the fact that they all originally immigrated to various states. Lastly, our participants immigrated to America between the years of 1983 and 2007, a 24 year range. Given that political circumstances, media representation, and general knowledge impact how certain groups are treated in a society, the year in which the participant immigrated may have impacted their acculturation in ways we did not consider.</p>
</sec>
</sec>
</body>
<back>
<fn-group>
<fn fn-type="conflict" id="fn1"><p>Conflicts of interest: The author has no conflicts of interest to disclose.</p></fn>
</fn-group>
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<app-group>
<app id="app1">
<label>Appendix A</label>
<list list-type="order">
<title>Interview Questions</title>
<list-item><label>1.</label><p>What were some factors that eased the transition for you and made you feel more acculturated?</p></list-item>
<list-item><label>2.</label><p>What were some factors that made the transition more difficult?</p></list-item>
<list-item><label>3.</label><p>How did you adjust to America socially?
<list list-type="alpha-lower">
<list-item><label>a.</label><p>How did you meet your social group?</p></list-item>
<list-item><label>b.</label><p>How did ethnicity/race influence your connections?</p></list-item>
</list></p></list-item>
<list-item><label>4.</label><p>Did you immigrate alone or with others?
<list list-type="alpha-lower">
<list-item><label>a.</label><p><italic>(Alone)</italic> Given that you immigrated alone, how did this affect your acculturation?</p></list-item>
<list-item><label>b.</label><p>(<italic>With others)</italic> Given that you immigrated with others, how did this affect your acculturation? What were the experiences of those you immigrated with?</p></list-item>
</list></p></list-item>
<list-item><label>5.</label><p>How did your school assist your transition both academically and socially?
<list list-type="order">
<list-item><label>a.</label><p>What services were provided to assist you in acclimation to new academic and cultural expectations?</p></list-item>
</list></p></list-item>
<list-item><label>6.</label><p>Can you describe your comfort level with English at the time you immigrated to the US? Did that play a role in your immigration experience or acculturation process?</p></list-item>
<list-item><label>7.</label><p>Can you describe the predominant attitude about your middle eastern heritage in the place you moved to?
<list list-type="alpha-lower">
<list-item><label>a.</label><p>How did your ethnic origin influence your acculturation?</p></list-item>
</list></p></list-item>
<list-item><label>8.</label><p>Given that you came from a predominantly Muslim country, how did Islam influence your acculturation process?</p></list-item>
<list-item><label>9.</label><p>(Prime with specific information about interviewee; i.e. white passing, wears hijab) How did your physical appearance influence your ability to acculturate?</p></list-item>
<list-item><label>10.</label><p>A psychologist named Erikson described adolescence as the time in which we undergo identity formation. Can you describe the relationship between your immigration experience and your adolescent identity formation?</p></list-item>
</list>
</app>
<app id="app2">
<label>Appendix B</label>
<table-wrap id="TB1" position="float" orientation="portrait">
<label>Table B1.</label><caption><p><italic>Participant Demographics</italic></p></caption>
<table frame="hsides" rules="groups">
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<col align="left" valign="middle" />
<thead>
<tr>
<th align="left" valign="top"><p>Pseudonym</p></th>
<th align="left" valign="top"><p>Country of Origin</p></th>
<th align="left" valign="top"><p>State of Relocation</p></th>
<th align="left" valign="top"><p>Age at Immigration</p></th>
<th align="left" valign="top"><p>Year of Immigration</p></th>
<th align="left" valign="top"><p>Immigration Alone or With Others</p></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top"><p>NA</p></td>
<td align="left" valign="top"><p>Lebanon</p></td>
<td align="left" valign="top"><p>California</p></td>
<td align="left" valign="top"><p>18</p></td>
<td align="left" valign="top"><p>1983</p></td>
<td align="left" valign="top"><p>Alone</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>GM</p></td>
<td align="left" valign="top"><p>Lebanon</p></td>
<td align="left" valign="top"><p>California</p></td>
<td align="left" valign="top"><p>14</p></td>
<td align="left" valign="top"><p>1997</p></td>
<td align="left" valign="top"><p>Mom, Dad, Brother</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>AK</p></td>
<td align="left" valign="top"><p>Turkiye</p></td>
<td align="left" valign="top"><p>Georgia</p></td>
<td align="left" valign="top"><p>13</p></td>
<td align="left" valign="top"><p>1992</p></td>
<td align="left" valign="top"><p>Mom, Dad</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>TS</p></td>
<td align="left" valign="top"><p>Algeria</p></td>
<td align="left" valign="top"><p>California</p></td>
<td align="left" valign="top"><p>16</p></td>
<td align="left" valign="top"><p>2007</p></td>
<td align="left" valign="top"><p>Mom, Dad, Sister, Sister</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>SA</p></td>
<td align="left" valign="top"><p>Palestine</p></td>
<td align="left" valign="top"><p>California</p></td>
<td align="left" valign="top"><p>18</p></td>
<td align="left" valign="top"><p>1988</p></td>
<td align="left" valign="top"><p>Alone</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>NS</p></td>
<td align="left" valign="top"><p>Egypt</p></td>
<td align="left" valign="top"><p>California</p></td>
<td align="left" valign="top"><p>14</p></td>
<td align="left" valign="top"><p>1989</p></td>
<td align="left" valign="top"><p>Alone</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>IE</p></td>
<td align="left" valign="top"><p>Kuwait</p></td>
<td align="left" valign="top"><p>New York</p></td>
<td align="left" valign="top"><p>18</p></td>
<td align="left" valign="top"><p>1986</p></td>
<td align="left" valign="top"><p>Mom, Dad, Brother</p></td>
</tr>
<tr>
<td align="left" valign="top"><p>NH</p></td>
<td align="left" valign="top"><p>Iran</p></td>
<td align="left" valign="top"><p>Missouri</p></td>
<td align="left" valign="top"><p>13</p></td>
<td align="left" valign="top"><p>2002</p></td>
<td align="left" valign="top"><p>Dad</p></td>
</tr>
</tbody>
</table>
</table-wrap>
</app>
</app-group>
</back>
</article>
