Sociopolitically and Trauma-Informed Public Health Practice With Latinx Families: Conceptual Framework and Best Practices.

Public health practitioners working with Latinx families in the United States must consider the historical contexts of colonization and slavery that have created conditions of violence, displacement, and social and economic marginalization throughout Latin America. Although shared experiences of colonization, dispossession, and migration affect all Latinxs, diverse national histories and sociopolitical contexts, migration patterns, and intersecting identities (e.g., gender, social class, race) complicate efforts to develop a uniform approach to this heterogeneous population. We provide a critical analysis of (1) how past experiences contribute to collective trauma and motivate migration, and (2) how these experiences are replicated in the United States through immigration-related adversities that deprive and threaten children and families through marginalization, fear of detention and deportation, and family separation brought on by a parent's deportation. This knowledge is imperative to advance research, practice, and policymaking with US Latinx populations. We provide best practice recommendations for a sociopolitically and trauma- informed public health workforce interfacing with Latinxs in the United States. (Am J Public Health. 2024;114(S6):S485-S494. https://doi.org/10.2105/AJPH.2024.307589) [Formula: see text].

Immigration Status, Legal Vulnerability, and Suicidal/Self-harm Ideation Disparities Among Immigrant-Origin Latinx Young Adults in the U.S.

Theories of suicidality typically center intrapersonal processes, with limited attention to social determinants of mental health disparities. Using a legal vulnerability framework, we examined the association between self/parental immigration status and suicidal and self-harm ideation (SI) disparities in three groups of immigrant-origin Latinx young adults attending college in the USA: undocumented students (n = 564), US citizens with undocumented parents (n = 605), and US citizens with lawfully present parents (n = 596). We also evaluated whether self/parental immigration status differences in SI could be accounted for by six dimensions of legal vulnerability and, based on prominent theories of suicidality, explored the role of campus belongingness as a protective factor. Participants completed self-report measures, and SI was assessed using one item from the Patient Health Questionnaire-9, a screening tool that assesses the severity of depression symptomatology. Rates of SI were significantly higher among undocumented students (23.1%) and US citizens with undocumented parents (24.3%) compared to US citizens with lawfully present parents (17.8%). Immigration policy-related social exclusion and discrimination-mediated self/parental immigration status differences in SI. Although food insecurity did not differ by self/parental immigration status, greater food insecurity was associated with higher likelihood of SI. Greater campus belongingness was associated with a lower likelihood of endorsing SI for all students regardless of immigration status or legal vulnerability factors. Findings underscore the importance of examining self and parental immigration status as a social determinant of SI and the value of investigating aspects of legal vulnerability as explanatory factors.

Immigration-Related Discrimination and Mental Health among Latino Undocumented Students and U.S. Citizen Students with Undocumented Parents: A Mixed-Methods Investigation.

Research has consistently linked discrimination and poorer health; however, fewer studies have focused on immigration-related discrimination and mental health outcomes. Drawing on quantitative surveys (N = 1,131) and qualitative interviews (N = 63) with Latino undergraduate students who are undocumented or U.S. citizens with undocumented parents, we examine the association between perceived immigration-related discrimination and mental health outcomes and the process through which they are linked. Regression analyses identify an association between immigration-related discrimination and increased levels of depression and anxiety; this relationship did not vary by self and parental immigration status. Interview data shed light on this result as immigration-related discrimination manifested as individual discrimination as well as vicarious discrimination through family and community members. We contend that immigration-related discrimination is not limited to individual experiences but rather is shared within the family and community, with negative implications for the mental health of undocumented immigrants and mixed-status family members.

Sanctuary city policies and Latinx immigrant mental health in California.

This quasi-experimental study examined whether "sanctuary city" policies are an effective mechanism for reducing mental health inequalities by immigrant origin status in Latinx populations in California. Ample evidence indicates that people experience mental health problems when restrictive immigration policies are imposed. It remains unclear whether sanctuary city policies can improve population mental health in the groups targeted by restrictive immigration policies: undocumented immigrant Latinxs, documented immigrant Latinxs, and native-born Latinxs. We combined data on California's 482 cities concerning whether and when they implemented a sanctuary policy with health data on approximately 142,000 adults, 6400 adolescents and 13,000 children from the multi-year California Health Interview Survey. After using propensity score matching to identify non-sanctuary cities comparable to sanctuary cities, we estimated respondent-level difference-in-differences models to determine whether sanctuary city policies had beneficial mental health effects on three age groups: adults, adolescents, and children during the period 2007-2018. There was a trend toward improved mental health in sanctuary cities after policy enactment, but the patterns of mental health in the three Latinx immigration sub-groups of each age group did not conform to our hypotheses. Buffering the adverse effects of harsh federal immigration policies may need to involve other approaches, such as expanded local mental health care access. We discuss these results in terms of alternative treatment interference, residents' policy awareness, the policy's capacity to address past health impacts, methodological issues, and potential policy momentum.

Mental health help-seeking among Latina/o/x undocumented college students.

OBJECTIVES: Informed by a social-ecological framework, this study nested undocumented students' individual mental health needs within micro-level campus factors and the macro-level immigration policy context to examine how these are associated with undocumented Latina/o/x college students' use of on-campus mental health services. METHOD: A large-scale survey was administered to 1,277 undocumented college students attending 4-year public universities in California. Only Latina/o/x respondents were included in this study (N = 1,181). Fifty percent of students attended a UC system (n = 589). On average, students were 21.84 years old (SE = .15), and most were women (75.3%, n = 890). RESULTS: Greater level of mental health symptoms and perceived mental health need, and greater use of campus-wide resources and undocumented student services predicted greater likelihood of using on-campus mental health services. Greater perceptions of social exclusion due to the immigration policy context predicted lower use of mental health services. CONCLUSIONS: Results indicate that a greater use of resources and an inclusive campus environment, as well as efforts to minimize policy-related feelings of social exclusion, may facilitate undocumented students' professional mental health help-seeking. These findings emphasize the need to take multiple and multi-level ecological factors into account when considering mental health service use, particularly in the case of undocumented immigrants and likely other structurally marginalized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Research Infrastructure Core Facilities at Research Centers in Minority Institutions: Part I-Research Resources Management, Operation, and Best Practices.

Funded by the National Institutes of Health (NIH), the Research Centers in Minority Institutions (RCMI) Program fosters the development and implementation of innovative research aimed at improving minority health and reducing or eliminating health disparities. Currently, there are 21 RCMI Specialized (U54) Centers that share the same framework, comprising four required core components, namely the Administrative, Research Infrastructure, Investigator Development, and Community Engagement Cores. The Research Infrastructure Core (RIC) is fundamentally important for biomedical and health disparities research as a critical function domain. This paper aims to assess the research resources and services provided and evaluate the best practices in research resources management and networking across the RCMI Consortium. We conducted a REDCap-based survey and collected responses from 57 RIC Directors and Co-Directors from 98 core leaders. Our findings indicated that the RIC facilities across the 21 RCMI Centers provide access to major research equipment and are managed by experienced faculty and staff who provide expert consultative and technical services. However, several impediments to RIC facilities operation and management have been identified, and these are currently being addressed through implementation of cost-effective strategies and best practices of laboratory management and operation.

Perceived ethnic discrimination, ethnic-racial socialization, and substance use among ethnic minority adolescents.

Perceived discrimination is a significant problem among ethnic minority adolescents and has been consistently linked to negative outcomes, including substance use, although few studies examine this relation with more than one time point. The present study adds to the literature by examining whether ethnic-racial socialization moderates the effects of perceived discrimination at time 1 on recent substance use six months later in a sample of ethnic minority, public high school students in Southern California. The results from analyses of survey data showed that perceived discrimination did not predict the likelihood of the outcomes, and they suggest that discrimination based on attributes other than ethnicity, such as immigration or documentation status, may be operating in the sample. Future research should simultaneously analyze effects of discrimination by type of attribute as well as level (e.g., intragroup, intergroup, and structural). With regard to ethnic-racial socialization in the multivariate models, cultural socialization was negatively related to the likelihood of the outcomes. Preparation for bias was positively related to the likelihood of the outcomes. Promotion of mistrust was not statistically significantly related to the likelihood of the outcomes. Although the socialization variables did not moderate the effect of perceived discrimination, they were clearly related to substance use in multiple ways, suggesting that future research continue to distinguish the effects of socialization by type to better understand how they can be addressed to optimize youth outcomes.

An ecological expansion of the adverse childhood experiences (ACEs) framework to include threat and deprivation associated with U.S. immigration policies and enforcement practices: An examination of the Latinx immigrant experience.

The Adverse Childhood Experiences (ACEs) framework has contributed to advances in developmental science by examining the interdependent and cumulative nature of adverse childhood environmental exposures on life trajectories. Missing from the ACEs framework, however, is the role of pervasive and systematic oppression that afflicts certain racialized groups and that leads to persistent threat and deprivation. In the case of children from immigrant parents, the consequence of a limited ACEs framework is that clinicians and researchers fail to address the psychological violence inflicted on children from increasingly restrictive immigration policies, ramped up immigration enforcement, and national anti-immigration rhetoric. Drawing on the literature with Latinx children, the objective of this conceptual article is to integrate the ecological model with the dimensional model of childhood adversity and psychopathology to highlight how direct experience of detention and deportation, threat of detention and deportation, and exposure to systemic marginalization and deprivation are adverse experiences for many Latinx children in immigrant families. This article highlights that to reduce bias and improve developmental science and practice with immigrants and with U.S.-born children of immigrants, there must be an inclusion of immigration-related threat and deprivation into the ACEs framework. We conclude with a practical and ethical discussion of screening and assessing ACEs in clinical and research settings, using an expanded ecological framework that includes immigration-related threat and deprivation.

Latinx Undocumented Older Adults, Health Needs and Access to Healthcare.

An estimated 10.5 million undocumented immigrants reside in the U.S.; 10% are 55 and older. Undocumented older adults do not qualify for Medicaid or Social Security benefits even though many pay taxes. The study examines undocumented older adults' perceptions on their health status and their experiences in accessing health care. In-depth semi-structured interviews were used to facilitate dialogue with undocumented older adults (N = 30) ages 55-63 (M = 61.67, SD = 5.50). Most of the participants were Mexican (n = 26, 87%) and had lived in the U.S. on average 21 years (SD = 8.78). A constant comparative approach was used while completing initial, focused, and axial coding. Participants were classified into a five-group typology that captures the intersection of perceived health status/need and access to health care; (1) High need, with access to care; (2) High need, with ambiguous access; (3) Undiagnosed need, with no access; (4) Perceived healthy status, with no access; (5) Healthy status, with access to care. Participants who reported high health needs experienced a range of chronic and degenerative health conditions. Participants accessed care by paying-out-of-pocket (between $100 and 300/visit for consultation, lab work, and medications). High need participants with ambiguous access have been able to access care through permanently residing under color of law status or Medically Indigent Services Programs; access is uncertain given their undocumented status and changes in policies. Participants faced multiple barriers to accessing health care-mainly high cost and documentation status. Limited access to care leads to several detrimental consequences such as debilitated health, emotional burden, and economic insecurity. Older undocumented adults are a vulnerable population that experience great health needs. The high cost for health care and limited access to care takes a toll on undocumented older adults. The findings highlight many opportunities for policy advocacy and practice with older undocumented adults.

Latino Immigrant Family Socialization Scale: Development and Validation of a Multidimensional Ethnic-Racial Socialization Measurement.

The study describes multiple steps taken to develop and test the Latino Immigrant Family Socialization (LIFS) scale. Scale items were developed based on qualitative interviews, and feedback on the items was solicited from content experts including an academic, practitioner, and a group of promotoras (or lay health workers). The scale was completed by 300 Latino immigrant parents in the state of Arizona. Exploratory and confirmatory factor analysis confirmed a six-factor model. The six factors were cultural socialization, adapt, advocate, value diversity, promote mistrust, and educate about nativity and documentation. Follow-up studies are needed to continue the measurement validation process and assess how strategies are used in conjunction with each other, the application of the six strategies across different policy contexts, and how the ethnic-racial socialization process supports children's health and well-being.

The Oppression of Latina Mothers: Experiences of Exploitation, Violence, Marginalization, Cultural Imperialism, and Powerlessness in Their Everyday Lives.

Despite Latinos being the largest growing population in the United States, research has not examined the impact of social structures on the well-being of Latina immigrants; negative social discourse and restrictive laws exacerbate inequality and discrimination in this population. Through combined inductive/deductive analysis of in-depth semistructured interviews, we examined immigrant Mexican mothers' ( N = 32) descriptions of oppression in the United States. All five forms of oppression, described in Young's oppression framework are evident: exploitation, violence, marginalization, cultural imperialism, and powerlessness. Discrimination places a high burden on Latinas due to the intersection of forms of oppression and nondominant identities.

Sensitivity and Specificity in Three Measures of Depression Among Mexican American Women.

This paper examined the prevalence of depressive symptomotology among women of Mexican ancestry (N = 205), over the age of 18, of diverse incomes and nativity. We examined differences in rates of diagnosis by Spanish/English preference and the sensitivity and specificity of three common measures: the Patient Health Questionnaire (PHQ9), the Kessler Psychological Distress Scale (K-10), and depression questions from the Composite International Diagnostic Interview, Short Form (MDD CIDI-SF); PHQ9 was used as the "gold standard" measure. Results indicated 18-32 % of participants met criteria for depression with higher rates found among Spanish preference participants. The K-10 had significantly higher sensitivity (0.81) but lower specificity (0.79) than the MDD CIDI-SF items (0.57 and 0.89, respectively). This study suggests that the K-10 and MDD CIDI-SF measures are complementary to each other for screening of depressive symptomatology. Implications for cultural and linguistic assessment of depression are further discussed.

Agarra el momento/seize the moment: Developing communication activities for a drug prevention intervention with and for Latino families in the US Southwest.

This article presents the development of parent-child communication activities by applying Community-Based Participatory Research and focus group methodology. Three parent-child communication activities were developed to enhance an already efficacious parenting intervention: (1) agarra el momento or seize the moment uses everyday situations to initiate conversations about substance use, (2) hay que adelantarnos or better sooner than later stresses being proactive about addressing critical issues with youth, and (3) setting rules and expectations engages parents in establishing rules and expectations for healthy and effective conversations with youth. Focus group data are presented to illustrate how thematic content from the focus groups was used to inform the development of the activities and, furthermore, how such methods supported the development of a culturally grounded intervention.

A Latent Profile Analysis of Latino Parenting: The Infusion of Cultural Values on Family Conflict.

The purpose of the present study was to (a) examine how acculturation and social support inform Latinos' parenting behaviors, controlling for gender and education; (b) describe parenting styles among Latino immigrants while accounting for cultural elements; and (c) test how these parenting styles are associated with family conflict. A 3 step latent profile analysis with the sample (N = 489) revealed best fit with a 4 profile model (n = 410) of parenting: family parenting (n = 268, 65%), child-centered parenting (n = 68, 17%), moderate parenting (n = 60, 15%), and disciplinarian parenting (n = 14, 3%). Parents' gender, acculturation, and social support significantly predicted profile membership. Disciplinarian and moderate parenting were associated with more family conflict. Recommendations include integrating culturally based parenting practices as a critical element to family interventions to minimize conflict and promote positive youth development.

Service needs among Latino immigrant families: implications for social work practice.

This study sought to learn from Latino immigrant families what services they need to promote their families' well-being within a context of stringent anti-immigrant legislation. Fifty-two Latino immigrant parents participated in focus groups. Focus groups took place following the passage of Senate Bill 1070. Findings reveal five major categories of need: mental health, physical health care, education, information and support services, and community efforts. Participants' experiences as immigrants played a significant role in their narratives. The narratives reveal that families need assistance navigating systems of care, coping with discrimination and oppressive environments, strengthening ties among community members, and advocating for policy change. Social workers are called to address the needs of this community and advocate for human rights and social justice.

LATINO FAMILY MENTAL HEALTH: EXPLORING THE ROLE OF DISCRIMINATION AND FAMILISMO.

The purpose of this study was to examine the role of discrimination and familismo on internalizing mental health symptoms among two generations of Latinos, youth and their parents, residing in the Southwest region of the United States. Data from the Latino Acculturation and Health Project was used to determine the direct and moderation effects of discrimination and familismo on internalizing mental health symptoms. The sample included 150 Latino youth-parent dyads who were immigrants or U.S. born. Descriptive results indicate that youth had significantly higher scores on the familismo scale whereas parents reported higher levels of perceived discrimination. Regression analyses results revealed direct effects of familismo and perceived discrimination on internalizing mental health symptoms. Implications for practice are discussed.

The role of young adolescents' perception in understanding the severity of exposure to community violence and PTSD.

This study seeks to (a) identify and measure the lifetime exposure to community violence of 137 African American and Latino middle school students from a low income neighborhood and apply numerical weights to each violent event; (b) examine the relationship between the objective severity of child self reported violence exposure and the child's subjective perception of the most bothersome event; and (c) examine the relationship between child's exposure and posttraumatic stress disorder (PTSD). Results highlight that students' designation of their most bothersome exposure to community violence did not correspond to the most severe violent event they experienced. Regression analyses reveal the weight of the most severe event explains a larger percentage of the variance in PTSD compared with the relationship to victim, level of exposure, weight of the most bothersome exposure, and cumulative weight of all exposure. This study underscores the importance of assessing a child's perception of violent events.