Training Promotoras to Implement a Mindfulness-Based Healthy Lifestyle Program in Rural Communities.

Partnering with promotoras to implement a healthy lifestyle intervention has proven efficacious in reaching community members whom they serve. However, there are no clearly defined guidelines for implementing promotora training, especially when it involves developing mindfulness skills in promotoras unfamiliar with this concept. This is a report about the facilitators and barriers to training promotoras to implement a mindfulness-enhanced healthy eating and physical activity intervention, ADAPT+, using the Train-the-Trainer model. Following this model, we laid the foundations for sustained implementation of ADAPT+ even after the training process. Future studies may examine how these guidelines help map promotora training in other mindfulness-related interventions.

Social Concern Theory and Family Violence Among Latino Families.

This paper examines whether Agnew's Social Concern Theory can be applied to explain family violence perpetration among Latino families. Social concern theory maintains that people have biological inclinations to care for the welfare of others, desire close ties with certain individuals, follow certain moral intuitions, and conform to the behaviors of others. As such, this study tests whether an individual's social capital (care about the welfare of others), familismo (desire for close ties), code of the streets (moral intuitions), and obligation to obey the police (conformity to social norms) is associated with family violence among a Latino sample. Using data from the El Paso Neighborhood Survey Project, which surveyed a random sample of 1,059 adults living in El Paso County, Texas in 2014, findings indicate that three of out of four theoretical constructs in the final model were found to be significant. Higher levels of social capital and familismo were associated with lower odds of perpetrating family violence, while code of the streets increased family violence. Obligation to obey the police was non-significant. Agnew's theory modestly explained family violence among Latino families.

Validation of a new scoring approach of a child dietary questionnaire for use in early childhood among low-income, Latino populations.

BACKGROUND: Measuring diet quality in early childhood requires time-intensive and costly measurements (e.g., 24-hour diet recall) that are especially burdensome for low-income, minority populations. This study aimed to validate a new method for calculating overall diet quality among low-income, Latino preschoolers. METHODS: This study was an observational study using data from a randomized controlled trial. Participants included parents of Latino preschoolers who reported child diet quality at baseline, 4-month, 7-month, 12-month, and 13-month follow-up. At each timepoint parents responded to a 28-item child dietary questionnaire (CDQ), based on the National Health and Nutrition Examination Survey (NHANES) dietary module, which generated the number of times/day that a child ate each of 28 foods in the past month. These 28 items were then used to create a total standardized child diet quality index (possible range 0-100), using a percent of maximum method. Parents were asked to complete three 24-hour diet recalls at the 13-month follow-up, from which the 2015 Healthy Eating Index (HEI) was derived. Construct validity was evaluated by Spearman's rank correlations between the new child diet quality index and the 2015 HEI at the 13-month follow-up. Test-retest reliability was assessed by intraclass correlation coefficients (ICC) for sequential pairs of time points. RESULTS: Among 71 eligible parent-child pairs, mean child age was 4.2 (SD = 0.8) years, 50.7% of children were female, and mean child body mass index (BMI) was 17.8 (SD = 2.0) kg/m2. Mean Child Diet Quality Index was 45.2 (SD = 3.2) and mean HEI was 68.4 (SD = 10.5). Child Diet Quality Index and HEI total scores were significantly correlated (r = 0.37; p = 0.001). Test-retest ICCs were statistically significant between all sequential pairs of time points. CONCLUSION: The new approach for calculating a measure of overall diet quality from the previously-validated 28-item dietary questionnaire demonstrated modest construct validity. When time and resources are limited, this new measure of overall diet quality may be an appropriate choice among low-income, Latino preschoolers. TRIAL REGISTRATION: This reports presents observational data collected as a part of a clinical trial, which was registered on clinicaltrials.gov prior to participant enrollment (NCT03141151).

Exploring patterns between school perceptions, child behavior, and maternal well-being among Latina mothers of children with autism spectrum disorder (ASD).

Research suggests that child problem behavior and poor family-school partnerships contribute to maternal stress in families of children with autism spectrum disorder (ASD). However, most extant research focuses only on White families even though Latina mothers of children with ASD experience greater systemic barriers impacting parent well-being and access to school services. Using individual interviews, this study investigates the pattern between school perceptions, child behavior, and psychological well-being among 13 Latina mothers of school-aged children with ASD. This sample was selected based on their elevated scores on the Difficult Child subscale of the Parenting Stress Index. Findings indicate that all participants reported feeling fear, frustration, worry and stress due to their child's behavior. Specifically, participants worried about their child's safety and expressed frustration with their child's problem behavior. Notably, participants reported mixed responses regarding the schools' actions to address their children's behavior. Implications for research and practice are discussed with respect to family-school partnerships among Latina mothers.

Latino Parents' Perspectives on the Life Trajectories of Mixed-Status Children.

Many immigrant Latino families have one or more U.S. -born children and at least one foreign-born non-citizen child. Contextual theories of human development would argue that these siblings would have very different life trajectories by virtue of their citizenship status or lack thereof. However, researchers and policy-makers know very little about the home environment of mixed-status siblings. Using data from in-depth personal interviews, this study examined parental perceptions of the life trajectories of mixed-status youth. Participants were 18 parents with at least one adolescent between the ages of 10-18 residing at home. Using grounded theory, two broad themes emerged. First, parental perceptions of children's life trajectories based on citizenship and parental concerns' regarding their children's mixed legal status. Within this first theme, parents discussed youth's educational opportunities, job prospects, health care access, and travel restrictions. The second theme was parental concerns' about their children's citizenship status; ambivalence about migrating to the United States; and coping with fear and anxiety. Results of this study highlight the pervasive influence of immigration policies and practices on family dynamics and child development, the risk they posit to youth development and individual family resilience.

Parent immigration stress predicts youth externalizing behavior trajectories among Latino families in an emerging immigrant context.

According to ecodevelopmental and social learning models, Latino immigrant parents experience considerable stress associated with the immigration process, and such immigration-related stress is theorized to influence behavioral outcomes among their youth. Using a three-year longitudinal design among 217 Latino immigrant families in western Oregon, we assessed whether parents' (94% mothers, Mage  = 36.2 years) experience of immigration-related stress influenced the trajectory of their adolescents' (43% female, Mage = 13.4 years) externalizing behaviors. Controlling for covariates (gender, acculturation, age at migration, and gender), results showed that youth exhibited a normative downward trajectory for externalizing behaviors, and parents' experience of immigration stress significantly and negatively predicted this trajectory. Findings suggest that parents' experience of immigration stress may disrupt a normative trajectory of declining externalizing behaviors among Latino immigrant adolescents.

De acuerdo con los modelos de ecodesarrollo y de aprendizaje social, los padres inmigrantes latinos sufren bastante estrés asociado con el proceso de inmigración, y se cree que este estrés relacionado con la inmigración influye en los resultados conductuales entre sus hijos adolescentes. Utilizando un diseño longitudinal de tres años entre 217 familias de inmigrantes latinos del oeste de Oregon, evaluamos si el estrés sufrido por los padres debido a la inmigración (el 94 % madres, edad promedio = 36.2 años) influyó en la trayectoria de las conductas de exteriorización de sus hijos adolescentes (el 43 % de sexo femenino, edad promedio = 13.4 años). Teniendo en cuenta las covariables (el género, la aculturación, la edad al momento de la migración), los resultados indicaron que los adolescentes demostraron una trayectoria normativa descendente para las conductas de exteriorización, y que el estrés sufrido por los padres debido a la inmigración predijo significativamente y negativamente esta trayectoria. Los resultados indican que el estrés sufrido por los padres debido a la inmigración puede alterar una trayectoria normativa de disminución de las conductas de exteriorización entre los hijos adolescentes de inmigrantes latinos.

Engaging Latino Families About COVID-19 Vaccines: A Qualitative Study Conducted in Oregon, USA.

OBJECTIVES: Latinos are disproportionately vulnerable to severe COVID-19 due to workplace exposure, multigenerational households, and existing health disparities. Rolling out COVID-19 vaccines among vulnerable Latinos is critical to address disparities. This study explores vaccine perceptions of Latino families to inform culturally centered strategies for vaccine dissemination. METHOD: Semistructured telephone interviews with Latino families (22 mothers and 24 youth, 13-18 years old) explored COVID-19 vaccine perceptions including (1) sources of information, (2) trust of vaccine effectiveness and willingness to get vaccinated, and (3) access to the vaccine distribution. We identified thematic patterns using immersion-crystallization. RESULTS: We found that (1) 41% expressed optimism and willingness to receive the vaccine coupled with concerns about side effects; (2) 45% expressed hesitancy or would refuse vaccination based on mistrust, myths, fear of being used as "guinea pigs," and the perceived role of politics in vaccine development; (3) families "digested" information gathered from social media, the news, and radio through intergenerational communication; and (4) participants called for community-led advocacy and "leading by example" to dispel fear and misinformation. Optimistic participants saw the vaccine as a way to protect their families, allowing youth to return to schools and providing safer conditions for frontline essential workers. CONCLUSIONS: Culturally centered vaccine promotion campaigns may consider the Latino family unit as their target audience by providing information that can be discussed among parents and youth, engaging a range of health providers and advocates that includes traditional practitioners and community health workers, and disseminating information at key venues, such as schools, churches, and supermarkets.

A Study of the Families Included in Receiving Better Special Education Services (FIRME) Project for Latinx Families of Children with Autism and Developmental Disabilities.

Family-professional partnership is an essential component of the special education process for children with intellectual and/or developmental disabilities (IDD), including autism spectrum disorder (ASD). Latinx families face systemic barriers when participating in educational decision-making for their children with IDD. Few studies have examined the effectiveness of advocacy trainings among Latinx families of children with IDD, including ASD. The purpose of this pilot study was to examine the effectiveness and feasibility of the Familias Incluidas en Recibiendo Mejor Educación Especial (FIRME), an advocacy program for Latinx families of children with IDD, with respect to increasing special education knowledge, advocacy, empowerment, and receipt of services; and decreasing stress. After completing the FIRME program, participants demonstrated significantly increased: special education knowledge; advocacy; and empowerment.

Developing Adaptando Dieta Y Acción Para Todos (ADAPT): An Intervention to Improve Healthy Lifestyle Behaviors Among Latino Parents and Children Living in Rural Communities.

Latino migrant farmworkers are at great risk of obesity and its concomitant negative health impacts. Obesity interventions for this underserved, minority population are limited. We expanded upon our prior intervention work in childhood obesity to develop a multi-family, behavioral intervention, ADAPT. We conducted three phases in the development of the ADAPT program: Phase 1, a needs assessment, Phase 2, in-depth focus groups with Latino parents, their children, and stakeholders, and Phase 3, a feasibility and acceptability trial to inform program optimization. Acceptability and feasibility of ADAPT promoting healthier eating and physical activity behaviors was found. Each phase of the project led to implementation changes to ADAPT, resulting in greater intervention optimization. Participants reported key facilitators and barriers to our intervention, expressing great interest in participation. They particularly liked our mindfulness session. We are currently examining the feasibility of integrating mindfulness to optimize ADAPT efficacy.

Design and rationale for ADAPT+: Optimizing an intervention to promote healthy behaviors in rural, Latino youth with obesity and their parents, using mindfulness strategies.

Latino youth living in rural areas represent an ethnic and geographical minority population at increased risk for obesity and obesity-related complications. We previously modified our child obesity intervention to be a multi-family behavioral intervention, Adaptando Dieta y Acción Para Todos (ADAPT), to better meet the needs of our target population, rural Latino youth with obesity (8-12 years old) and their parents. Recognizing the role of parent stress on obesity, the main goal of this study is to 1) further refine and optimize the original ADAPT multi-family behavioral obesity intervention protocol to include mindfulness parent stress reduction strategies (now called ADAPT+) and then 2) assess the feasibility of ADAPT+ implementation via a small randomized control trial (RCT) with rural Latino families. Two aims guide the study. For Aim 1 we conduct a series of focus groups with stakeholders and parents, and then conduct a one-arm trial with both parents and their children to obtain feedback for further refining each of our eight integrated ADAPT+ sessions. Aim 2 tests the acceptability and feasibility of our intervention with multi-family groups of Latinos in two rural communities over time (pre-intervention, post-intervention, 3-month follow-up) in a randomized pilot trial (ADAPT+ vs. Enhanced Usual Care [EUC] comparison). This study is intended to set the groundwork for a larger clinical trial to test ADAPT+'s efficacy to improve rural Latino families' eating and physical activity behaviors.