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Awareness and uptake of the meningitis vaccine remains low among marginalized groups, such as Latino men who have sex with men (LMSM), potentially due to structural and psychosocial barriers in accessing preventative healthcare. The current study explored awareness and uptake of meningitis vaccines among a group of LMSM (N = 99) living in South Florida. A three-pronged variable selection approach was utilized prior to conducting regression models (linear and logistic). Overall, 48.5% of the participants reported little to no knowledge about meningitis vaccines, and 20.2% reported being vaccinated. Living with HIV (OR = 10.48) and time since outbreak (OR = 1.03) were significant predictors of meningitis vaccine uptake. No significant correlates of meningitis vaccine awareness were identified. More research is needed to identify other important factors associated with meningitis vaccine awareness and uptake among LMSM, a multiple marginalized group.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Meningite , Vacinas Meningocócicas , Humanos , Masculino , Surtos de Doenças , Florida , Hispânico ou Latino/psicologia , Homossexualidade Masculina , Meningite/prevenção & controle , Vacinação , Vacinas Meningocócicas/administração & dosagemRESUMO
Biomedical tools for HIV prevention such as post-exposure prophylaxis (PEP) continue to be underutilized by subgroups experiencing significant HIV inequities. Specifically, factors associated with both PEP awareness and uptake both cross-sectionally and longitudinally are under-researched, despite PEP being a part of the United States' Plan for Ending the HIV Epidemic. The current study examined longitudinal predictors of PEP awareness among Latino sexual minority men (LSMM) living in South Florida. This current study (N = 290) employed hierarchal linear modeling across three timepoints (baseline, 4-months, 8-months) to assess within-person and between-person effects over time for several psychosocial and structural factors. Most participants (67.5%) reported little to no awareness of PEP at baseline with general PEP awareness growing slightly across the study (60.5% reporting little to no awareness of PEP at 8 months). Results of the final conditional model suggest significant within-person effects of PrEP knowledge (p = 0.02) and PrEP self-efficacy (p < 0.001), as well as a significant positive between-person effect of PrEP knowledge (p < 0.01) on PEP awareness. Between-person HIV knowledge was also a significant predictor in this model (p = 0.01). This longitudinal analysis of LSMM's PEP awareness indicates that more must be done to increase PEP awareness among this subgroup. Future studies should explore how to build on existing interventions focused on HIV and PrEP knowledge and PrEP self-efficacy to incorporate information about PEP to increase the reach of this effective biomedical HIV prevention tool.
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Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , Homossexualidade Masculina , Infecções por HIV/psicologia , Profilaxia Pós-Exposição , FloridaRESUMO
BACKGROUND: Hispanic/Latinx people have the second highest cervical cancer incidence rates in the U.S. However, there is a lack of disaggregated data on clinical outcomes for this diverse and populous group, which is critical to direct resources and funding where they are most needed. This study assessed differences in stage at diagnosis of cervical cancer among Hispanic/Latinx subpopulations and associated factors. METHODS: We analyzed patients with primary cervical cancer from 2004 to 2019 in the National Cancer Database. Hispanic/Latinx patients were further categorized into Mexican, Puerto Rican (PR), Cuban, Dominican, and Central/South American, as per standard NCDB categories, and evaluated based on stage at diagnosis and sociodemographic characteristics. Multinomial logistic regression quantified the odds of advanced stage at presentation. Regression models were adjusted for age, education, neighborhood income, insurance status, and additional factors. RESULTS: Hispanic/Latinx cervical cancer patients were more likely to be uninsured (18.9% vs. 6.0%, p < 0.001) and more likely to live in low-income neighborhoods (28.6% vs. 16.9%, p < 0.001) when compared to non-Hispanic White populations. Uninsured Hispanic/Latinx patients had 37.0% higher odds of presenting with regional versus localized disease (OR 1.37; 95% CI, 1.19-1.58) and 47.0% higher odds of presenting with distant versus. Localized disease than insured patients (OR 1.47; 95% CI, 1.33-1.62). When adjusting for age, education, neighborhood income, and insurance status, PR patients were 48% more likely than Mexican patients to present with stage IV versus stage I disease (OR 1.48; 95% CI, 1.34-1.64). CONCLUSION: Disaggregating health data revealed differences in stage at cervical cancer presentation among Hispanic/Latinx subpopulations, with insurance status as a major predictor. Further work targeting structural factors, such as insurance status, within specific Hispanic/Latinx subpopulations is needed.
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Neoplasias do Colo do Útero , Feminino , Humanos , Escolaridade , Hispânico ou Latino , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero/epidemiologiaRESUMO
Despite their efficacy, biomedical HIV prevention tools such as post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) have been insufficiently scaled up and disseminated, especially among marginalized subgroups that face substantial HIV disparities. Given the minimal literature available on PEP among Latino sexual minority men (LSMM), this cross-sectional secondary analysis explored factors associated with PEP awareness among a group of LSMM living in South Florida, a US HIV epicenter. The parent study examined patterns of engagement in PrEP and behavioral health treatment services among LSMM (N = 290). The current secondary analysis (N = 243) identified factors associated with PEP awareness using three methods: stochastic search variable selection, participatory data science, and literature review-before being modeled using linear regression. Most participants (67.5%) reported having little to no awareness about PEP before initiating our study. Simple linear regression models suggested that higher PrEP knowledge (B = 0.17, SE = 0.02, p < 0.001), HIV knowledge (B = 0.15, SE = 0.04, p < 0.001), PrEP self-efficacy (B = 0.37, SE = 0.13, p < 0.05), and high perceived community norms for HIV testing (B = 0.29, SE = 0.14, p < 0.05) were each associated with LSMM's greater PEP awareness, while identity affirmation was associated with less PEP awareness (B = -0.13, SE = 0.05, p < 0.01). Results suggest the utility of our three-pronged variable selection approach and address gaps in PEP awareness and use among LSMM living in a US HIV epicenter to support Ending the HIV Epidemic goals.
Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Masculino , Humanos , Profilaxia Pós-Exposição , Estudos Transversais , Florida/epidemiologia , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Hispânico ou Latino , Homossexualidade MasculinaRESUMO
Youth-onset type 2 diabetes (T2D) is on the rise and may be associated with more adverse health outcomes than adult onset. Latinx adolescents are disproportionately at risk for T2D yet are underrepresented in prevention efforts. Extant interventions to prevent T2D in Latinx adolescents show limited effectiveness. Comprehensive understanding of Latinx adolescent/family needs is lacking, but necessary for cultural tailoring of T2D prevention. Researchers conducted focus groups with 32 Latinx adolescents (age 10-18 years) from Northern Colorado and 31 Spanish-speaking parents/caregivers, with 2.5-hr semistructured youth-specific and parent-specific discussions, respectively. No participants included in this study had T2D. Qualitative data were analyzed for emergent themes about barriers/facilitators of healthy living and T2D prevention preferences. Thematic content analysis yielded eight themes within three categories: barriers to healthy living, facilitators of healthy living, and program preferences. Barriers to healthy living included individual motivational factors/food preferences; financial cost and time demands of healthy eating/exercise; negative emotions; and external/relational factors such as parent feeding pressure and peer pressure/bullying. Facilitators of healthy living included individual motivational factors/enjoyment of healthy living and supportive family structure. Program preferences were for family-based programming with adolescent breakout sessions and for facilitation by culturally competent facilitators. T2D is recognized as a serious health concern among Latinx families. There is a need for culturally tailored prevention programming that, in order to be acceptable, should address cultural and socioeconomic considerations, provide coping skills for adolescent-specific psychosocial stressors, and utilize a family-based programming framework with adolescent breakout sessions and culturally competent facilitators.
La diabetes tipo 2 (DT2) que comienza en la juventud está en aumento y esta asociada con peores resultados en comparación con los de la edad adulta. Los adolescentes Latinx tienen un riesgo desproporcionado de DT2 sin embargo, no están representados en los esfuerzos de prevención. Las intervenciones existentes muestran una eficacia limitada. La comprensión sobre las necesidades de los adolescentes y las familias Latinx son escasas, pero son necesarias para prevenir DT2. Se realizaron grupos de enfoque con 32 adolescentes Latinx (de 10 a 18 añ3os) del Norte de Colorado y 31 padres de habla hispana, con sesiones de 2.5 horas para jóvenes y para padres. Ningún participante en este estudio tenía DT2. Se analizaron datos cualitativos que identificaron barreras/facilitadores para una vida sana y preferencias de programas para prevenir DT2. Las barreras incluyeron factores individuales; el costo y el tiempo para tener alimentación/ejercicio sano; emociones negativas; y factores externos como la presión de los padres/compañeros. Los facilitadores incluyeron factores individuales/disfrute de la salud y el apoyo familiar. Las preferencias fueron basada en la familia, con grupos de adolescentes y con facilitadores culturalmente competentes. La DT2 es un grave problema entre las familias Latinx. Se necesitan programas de prevención que consideren la cultura y factores socioeconómicos. También se deben proporcionar habilidades de afrontamiento de los estresores psicosociales para adolescentes, a través de facilitadores culturalmente competentes y utilizar programación basada en la familia, con actividades culturales para adolescentes.
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Few studies examine how neighborhood structural factors (e.g., socioeconomic status [SES] and diversity) and perceived disorder may influence the messages parents communicate to their youth about race/ethnicity. Guided by the integrative model and social disorganization theory, this study examines how parents' ethnic-racial socialization messages (ERS) are shaped by the broader environment. Data come from the MacArthur Studies of Diversity in Midlife. Latinx and African American parents N = 508 (Mage = 39) with a child between 6- and 17-years old living in two urban US cities were included. Cultural perceptions were assessed at both the individual level (e.g., perceived discrimination and ethnic affirmation) and neighborhood level along with demographic and structural neighborhood characteristics at the individual and neighborhood level, respectively. Multilevel analyses revealed that at both the individual level and neighborhood levels, perceived neighborhood problems were associated with more frequent messages about ethnicity and race (e.g., cultural socialization and preparation for bias). In addition, neighborhood-level affirmation promoted cultural messages; in contrast, neighborhood-level discrimination experiences positively impacted preparation for unfair treatment. Results reveal how parents' ERS is informed by their own characteristics as well as neighborhood factors. Further, cross-level interactions were found. Findings are discussed in terms of contextual and cultural-developmental theorizing about parenting.
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Negro ou Afro-Americano , Socialização , Adolescente , Adulto , Criança , Etnicidade , Humanos , Poder Familiar , Pais , Identificação SocialRESUMO
INTRODUCTION: This paper examined individual, family, and peer roles in promoting Latinx youths' math and science performance. The role of maternal/paternal modeling in education was examined as shaping academic self-efficacy and, in turn, math/science grades among a population considered at risk of low academic achievement. Moreover, the study tested the moderating roles of class ethnic fit (i.e., feelings of fit based on having same-ethnic peers in class) and gender. METHOD: Cross-sectional data came from a southwestern U.S. sample of Latinx adolescents (N = 329; 54% female, Mage = 13.69 years, SD = 0.56) who reported on maternal/paternal educational modeling, academic self-efficacy, math/science grades, class ethnic fit, and gender. RESULTS: Adolescents' perceptions of maternal modeling, but not paternal, related to higher levels of academic self-efficacy which, in turn, related to higher math/science performance. Moderation results revealed: (a) for adolescents who perceived low science class ethnic fit, high levels of parental modeling related to higher levels of academic self-efficacy which, in turn, were related to higher science grades, and (b) maternal modeling positively related to girls', but not boys', academic self-efficacy and paternal modeling positively related to girls', but not boys', math/science performance. CONCLUSIONS: These results suggest maternal modeling is a promotive factor, supporting Latinx youths' academic self-efficacy which, in turn, related to math/science grades. Additionally, a negative direct relation between maternal modeling and science grades suggests maternal modeling generally support academic self-efficacy, but not necessarily science attainment. These associations are nuanced as they are informed by context and parent-child gender.
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Logro , Autoeficácia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Matemática , EstudantesRESUMO
The COVID-19 pandemic has greatly impacted families from low-income backgrounds. The shift to remote learning has required parents with preschool-age children to adapt to new ways of collaborating with teachers. Given the longstanding inequities in the education of children from economically disadvantaged backgrounds, exacerbated by the pandemic, it is critical to learn about the challenges that parents encountered and how they supported their children's learning. This knowledge will help to identify ways to better serve these communities during times of crisis and beyond. This study examined how Latinx parents from low-income backgrounds engaged in their children's early education during the COVID-19 crisis. The term Latinx is used in an effort to be gender inclusive when referring to people of Latin American descent. We explored: 1) How do Latinx parents perceive and apply teachers' suggested activities to support children's learning during the early childhood education program closure? 2) What parent and child-initiated learning opportunities do parents report? 3) What challenges with remote learning do parents encounter? Twenty parents of preschoolers in a mountain state metropolitan area participated in a 30-45 min. phone interview. All parents spoke Spanish at home to a different degree. Findings revealed the emergence of more authentic parent-teacher partnerships and parents' extensive engagement in teacher-suggested activities. Importantly, families created a variety of practices to support children's learning and well-being. Yet, a vast majority of parents expressed feeling stressed with the demands of remote education, particularly keeping their child interested in remote learning. Implications for home-school partnerships are discussed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10643-021-01210-4.
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Group parenting programs based on cognitive-behavioral and social learning principles are effective in improving child behavior problems and positive parenting. However, most programs target non-Hispanic, White, English-speaking families and are largely inaccessible to a growing Hispanic and non-White population in the United States. We sought to examine the extent to which researchers have culturally adapted group parenting programs by conducting a systematic review of the literature. We identified 41 articles on 23 distinct culturally adapted programs. Most cultural adaptations focused on language translation and staffing, with less focus on modification of concepts and methods, and on optimizing the fit between the target cultural group and the program goals. Only one of the adapted programs engaged a framework to systematically record and publish the adaptation process. Fewer than half of the culturally adapted programs were rigorously evaluated. Additional investment in cultural adaptation and subsequent evaluation of parenting programs is critical to meet the needs of all US families.
Los programas grupales de crianza basados en principios cognitivo-conductuales y de aprendizaje social son eficaces a la hora de mejorar los problemas de conducta de los niños y la crianza positiva. Sin embargo, la mayoría de los programas están orientados a familias no hispanas, blancas y angloparlantes, y son, en su gran mayoría, inaccesibles para una población hispana y no blanca cada vez mayor de los Estados Unidos. Nos propusimos analizar el grado en el cual los investigadores han adaptado culturalmente los programas grupales de crianza realizando un análisis sistemático de las publicaciones. Identificamos 41 artículos sobre 23 programas diferentes adaptados culturalmente. La mayoría de las adaptaciones culturales se centraron en la traducción a idiomas y la contratación de personal, haciendo menos hincapié en la modificación de conceptos y métodos, y en la optimización de la compatibilidad entre el grupo cultural meta y los objetivos del programa. Solo uno de los programas adaptados incorporó un marco para registrar sistemáticamente y publicar el proceso de adaptación. Menos de la mitad de los programas culturalmente adaptados se evaluaron rigurosamente. Es fundamental que se invierta más en adaptación cultural y en evaluaciones posteriores de los programas de crianza para satisfacer las necesidades de todas las familias de los Estados Unidos.