A factorial experiment grounded in the multiphase optimization strategy to promote viral suppression among people who inject drugs on the Texas-Mexico border: a study protocol.

BACKGROUND: People who inject drugs living with HIV (PWIDLH) suffer the lowest rates of HIV viral suppression due to episodic injection drug use and poor mental health coupled with poor retention in HIV care. Approximately 44% of PWIDLH along the US-Mexico border are retained in care and only 24% are virally suppressed. This underserved region faces a potential explosion of transmission of HIV due to highly prevalent injection drug use. This protocol describes an optimization trial to promote sustained viral suppression among Spanish-speaking Latinx PWIDLH. METHODS: The multiphase optimization strategy (MOST) is an engineering-inspired framework for designing and building optimized interventions and guides this intervention. The primary aim is to conduct a 24 factorial experiment in which participants are randomized to one of 16 intervention conditions, with each condition comprising a different combination of four behavioral intervention components. The components are peer support for methadone uptake and persistence; behavioral activation therapy for depression; Life-Steps medication adherence counseling; and patient navigation for HIV care. Participants will complete a baseline survey, undergo intervention, and then return for 3-,6-,9-, and 12-month follow-up assessments. The primary outcome is sustained viral suppression, defined as viral loads of < 40 copies per mL at 6-,9-, and 12-month follow-up assessments. Results will yield effect sizes for each component and each additive and interactive combination of components. The research team and partners will make decisions about what constitutes the optimized multi-component intervention by judging the observed effect sizes, interactions, and statistical significance against real-world implementation constraints. The secondary aims are to test mediators and moderators of the component-to-outcome relationship at the 6-month follow-up assessment. DISCUSSION: We are testing well-studied and available intervention components to support PWIDLH to reduce drug use and improve their mental health and engagement in HIV care. The intervention design will allow for a better understanding of how these components work in combination and can be optimized for the setting. TRIAL REGISTRATION: This project was registered at clinicaltrials.gov (NCT05377463) on May 17th, 2022.

US public charge policy and Latinx immigrants' thoughts about health and healthcare utilization.

OBJECTIVES: We examined Latinx immigrants' perceptions of US policy related to restrictions on immigrants' use of public resources and their thoughts about the influence of these on immigrants' healthcare utilization. DESIGN: A series of 16 focus group discussions with Latinx immigrant men and women (documented and undocumented) (N = 130) were conducted between May and July 2017 across four US cities. RESULTS: Four central themes emerged: participants attributed the limited resources available for affordable healthcare for many uninsured US immigrants (both documented and undocumented) to the US government's view of immigrants as burdens on public resources and its subsequent unwillingness to dedicate funds for their care; participants expressed concerns, some unfounded, about negative immigration ramifications arising from diagnosis with health conditions perceived to be serious and/or expensive to treat; participants noted that some immigrants avoided using health programs and services to which they were entitled because of immigration concerns; finally, participants described how access to information on immigration laws and healthcare resources, and conversely, misinformation about these, influenced healthcare utilization. CONCLUSIONS: Participants were acutely aware of the image of immigrants as public charges or potential burdens on government resources that underlies US immigration policy. In some cases, participants came to inaccurate and potentially harmful conclusions about the substance of laws and regulations based on their beliefs about the government's rejection of immigrants who may burden public resources. This underscores the importance of ensuring that immigrants have access to information on immigration-related laws and regulations and on healthcare resources available to them. Participants noted that access to information also fostered resilience to widespread misinformation. Importantly, however, participants' beliefs had some basis in US immigration policy discourse. Law and policy makers should reconsider legislation and political commentary that frame self-reliance, the guiding principle of US immigration policy, in terms of immigrants' use of publicly funded healthcare resources.

Social and environmental determinants influencing injection drug use and HIV risk among two sister cities on the US-Mexico border: a comparative cross-sectional study, 2016-2018.

The economic, social, cultural and political milieus that influence injection drug-related HIV risk behaviors along the US-Mexico border in the previous decade have been studied comparing cities on an East-West axis. In an effort to inform interventions targeting factors beyond the individual level, we used a cross-sectional study design comparing people who inject drugs during 2016-2018, living on a North-South axis, in two cities-Ciudad Juárez, Chihuahua, Mexico and El Paso, Texas, USA-situated at the midpoint of the 2000 US-Mexico borderland stretch. We conceptualize injection drug use and its antecedents and consequences as influenced by factors operating at various levels of influence. Results of analysis comparing samples recruited from each border city indicated significant differences in demographic, socioeconomic, micro- and macro-level factors that affect risk. Similarities emerged in individual-level risk behaviors and some dynamics of risk at the drug use site most frequented to use drugs. In addition, analyses testing associations across samples indicated that different contextual factors such as characteristics of the drug use sites influenced syringe sharing. In this article, we reflect on the potential tailored interventions needed to target the context of HIV transmission risk among people who use drugs and reside in binational environment.

Validation of Brief Condom Use Attitudes Scales for Spanish-Speaking People Who Use Crack Cocaine in El Salvador.

People who use crack cocaine (PWUCC) are a population severely impacted by a concentrated epidemic of HIV. Behavioral interventions to prevent and treat HIV among PWUCC have been implemented around the world including in low- and middle-income countries which have been disproportionately affected by HIV. However, few studies have validated and assessed psychometric properties of measures on PWUCC, especially in transnational populations. Our sample was comprised of 1324 PWUCC, Spanish mono-lingual speakers, residing in the metropolitan area of San Salvador, El Salvador. Exploratory factor analysis and subsequent confirmatory factor analysis using statistical softwares SPSS and Amos were conducted on three abbreviated and translated condom use attitude measures (i.e., Condom Use Attitudes Scale-Spanish Short Form, Condom Use Social Norm-Spanish Short Form [CUSN-SSF], Condom Use Self-Efficacy-Spanish Short Form). Convergent validity was examined by computing bivariate correlations between the scales and condom use and sexually transmitted disease diagnosis. Results indicated that a two-factor, 8-item correlated model for the CUAS-SSF scale had an excellent fit and adequate reliability (α = .76). The confirmatory factor analysis for the 5-item CUSN-SSF scale indicated a satisfactory fit with 3 of 6 fit indices indicating adequate fit. Analysis of the two-factor 5-item CUSE-SSF scale indicated satisfactory fit and adequate reliability (α = .84). There were significant correlations between all measures and with self-reported condom use. Results indicate that these brief measures are reliable and valid and can be utilized to assess the effectiveness of HIV risk reduction interventions among Spanish-speaking PWUCC.

Intervention Reach and Sexual Risk Reduction of a Multi-level, Community-Based HIV Prevention Intervention for Crack Users in San Salvador, El Salvador.

This article examines the effects of a multi-level, community-based HIV prevention intervention for crack users residing in low-income neighborhoods in San Salvador, El Salvador conducted between August 2011 and June 2016. The intervention consisted of three components introduced sequentially: (1) rapid HIV testing in community settings; (2) a social network HIV testing intervention; and (3) small group interventions with crack users who were members of the same social network. The intervention was evaluated with an interrupted time series design in which we used respondent-driven sampling to conduct 7 cross-sectional surveys with crack users along a 3-4 month period for each assessment (total n = 1597). Results revealed a significant increase in exposure to the intervention over time with 50% of the participants reporting exposure to one or more of the three components. Getting an HIV test at the community site was associated with reductions in total times each individual had sex without a condom (p < 0.05) compared to those who had been exposed to no intervention components. Being referred by another crack user through the Social Network HIV intervention was also associated with reductions in total numbers of condomless sex (p < 0.05) The cumulative effect of being exposed to more than one intervention component was associated with reductions in total number of times individuals had condomless sex (p < 0.05). In spite of the high level of intervention reach and that self-reported exposure to intervention components was associated with lower sexual risk, reductions in sexual risk over time were not observed in the full sample, indicating that the penetration of HIV prevention components was not sufficient to produce population level change.

HPV vaccine acceptance among African-American mothers and their daughters: an inquiry grounded in culture.

BACKGROUND: Much of the research on African-Americans' HPV vaccine acceptance has largely focused on racial/ethnic differences related to cognitive, socio-economical, and structural factors that contribute to differences in HPV vaccine acceptance and completion. A growing body of literature suggest that cultural factors, such as mistrust of healthcare providers (HCPs) and the healthcare system, religion, and social norms related to appropriate sexual behaviors, also plays a prominent role in their HPV vaccine acceptance. However, these studies were limited in their use of theoretical approaches necessary to conceptualize and operationalize culture. OBJECTIVE: To explore the influence of culture on African-American mothers' and daughters' HPV vaccine acceptance using the PEN-3, a culturally-centered conceptual framework. METHODS: Grounded theory techniques were used to explore cultural factors that influenced the acceptance of the HPV vaccine among African-American mothers (n = 28) and their daughters (n = 34). RESULTS: Positive attitudes towards vaccination stemmed from beliefs that the HPV vaccine has cancer prevention benefits and that vaccinations in general protected against infectious diseases. Negative attitudes stemmed from beliefs that the HPV vaccine was too new, not effective, daughters were too young, and that vaccines were not a one-size-fits-all intervention. Majority of mothers and daughters indicated that their religious doctrine did not impede their HPV vaccination decisions. For a few mothers, religious beliefs could not be separated from their HPV vaccination decisions and ultimately deterred HPV vaccine acceptance. HCP recommendations were valued however mothers were often dissatisfied with the detail of information communicated. Support networks provided both positive and negative types of social support to mothers and daughters. The media highlighted the cancer prevention benefits of the HPV vaccine and unintentionally communicated negative information of the HPV vaccine, which deterred HPV vaccine acceptance. CONCLUSION: Study findings can inform the development of culturally appropriate interventions that advances the evidence on cervical cancer prevention.

African-American parents' and daughters' beliefs about HPV infection and the HPV vaccine.

OBJECTIVE: To increase our understanding about the health beliefs of African-American parents and their daughters toward HPV infection and HPV vaccine acceptance. METHODS: The Health Belief Model was used as a guiding framework. Principles of grounded theory, theoretical sampling, and constant comparison analysis were used to qualitatively analyze data generated from personal interviews of African-American parents (n = 30) and their 12- to 17-year-old daughters (n = 34). RESULTS: Mothers and daughters perceived low susceptibility to HPV infection and perceived the HPV vaccine as beneficial in protecting against genital warts and cervical cancer. Compared to daughters, parents placed particular emphasis on the vaccine's protection against genital warts. A major HPV vaccine acceptance barrier among parents and daughters was the politicization of the HPV vaccine by government figures. In addition, concerns about unknown side effects, safety, and effectiveness of HPV vaccination emerged. Cues to action varied among parents and daughters, and self-efficacy was higher among parents than daughters. CONCLUSION: Understanding the health beliefs that promote HPV vaccine acceptance, while identifying and addressing beliefs that are barriers among parents and daughters, will assist in the development of appropriate HPV vaccine promotion initiatives for African-American parents and daughters.

Using Peer-Referral Chains with Incentives to Promote HIV Testing and Identify Undiagnosed HIV Infections Among Crack Users in San Salvador.

In El Salvador, crack users are at high risk for HIV but they are not targeted by efforts to promote early HIV diagnosis. We evaluated the promise of peer-referral chains with incentives to increase HIV testing and identify undiagnosed HIV infections among networks of crack users in San Salvador. For 14 months, we offered HIV testing in communities with a high prevalence of crack use. For the following 14 months, we promoted chains in which crack users from these communities referred their peers to HIV testing and received a small monetary incentive. We recorded the monthly numbers of HIV testers, and their crack use, sexual risk behaviors and test results. After launching the referral chains, the monthly numbers of HIV testers increased significantly (Z = 6.90, p < .001) and decayed more slowly (Z = 5.93, p < .001), and the total number of crack-using testers increased nearly fourfold. Testers in the peer-referral period reported fewer HIV risk behaviors, but a similar percentage (~5 %) tested HIV positive in both periods. More women than men received an HIV-positive diagnosis throughout the study (χ(2)(1, N = 799) = 4.23, p = .040). Peer-referral chains with incentives can potentially increase HIV testing among networks of crack users while retaining a focus on high-risk individuals.

A critical review: early life nutrition and prenatal programming for adult disease.

AIM AND OBJECTIVE: To present the evidence in relation to early life nutrition and foetal programming for adult disease. BACKGROUND: Epigenetics is a new and growing area of study investigating the impact of the intrauterine environment on the lifelong health of individuals. DESIGN: Discursive paper. METHOD: Searches were conducted in a range of electronic health databases. Hand searches located additional articles for review. Maternal search terms included: pregnancy; nutrition; diet; obesity; over nutrition; under nutrition. Offspring related search terms included: macrosomia; intrauterine growth restriction; epigenetics; foetal programming; childhood obesity; adolescent obesity; adolescent type 2 diabetes. DISCUSSION: Results indicate that foetal programming for adult disease occurs in response to particular insults during vulnerable developmental periods. Four main areas of foetal exposure were identified in this review: (1) under nutrition; (2) over nutrition; (3) gestational diabetes mellitus; and (4) infant catch-up growth. Numerous studies also described the trans-generational nature of foetal programming. CONCLUSIONS: Overall, foetal exposure to excess or insufficient nutrition during vulnerable developmental periods appears to result in a lifelong predisposition to obesity and adult disease, such as type 2 diabetes and cardiac disease. For the infant who has been undernourished during early life, a predisposition to renal disease also occurs. RELEVANCE TO CLINICAL PRACTICE: Pregnancy is a time when women are engaged in health systems and are receptive to health messages. These factors suggest that pregnancy may be an optimal time for dietary education and intervention. There is a particular need for education on healthy diet and for interventions which aim to limit over consumption of calories.

Latino community health workers and the promotion of sexual and reproductive health.

Community health worker (CHW) programs have existed for over 50 years across the world. However, only recently has research evidence documented their effectiveness. Research is still needed to identify issues related to implementation and sustainability of CHW programs. This article explores the role and challenges of U.S. Latino CHWs trained to deliver a comprehensive sexual and reproductive health educational intervention to Latino families. We conducted a semistructured interview with a purposive convenience sample of 19 CHWs. Findings suggest that CHWs occupy roles that go beyond those they were trained for. CHWs serve not only as educators but also as providers of social support, facilitators of access to resources, patient navigators, and civil rights advocates. Lack of clarity of the role of a CHW influenced perceptions of adequacy of compensation, training, and integration into the agency that trained them. Policy facilitating the standardization of the CHW occupational category and role expectations is imperative to ensure successful implementation and sustainability of U.S. CHW programs.

Marketing the HIV test to MSM: ethnic differences in preferred venues and sources.

Lack of awareness of HIV status is associated with an increased likelihood of HIV transmission. We surveyed 633 men who have sex with men (MSM) from diverse ethnic groups recruited from a variety of community venues in a U.S. Midwestern city with rising HIV infection rates. Our first aim was to describe patterns of sexual risk, annual HIV testing frequency, and venues where information about HIV and HIV testing could be disseminated to inner-city MSM. Our second aim was to identify preferred sources to receive information about HIV testing and determine whether these preferences differed by ethnic background. Results indicated that despite similar proportions of high-sexual risk behaviors, compared with African American and Latino MSM, smaller proportions of non-Hispanic White MSM had received an HIV test in the last 12 months. Despite ethnic differences in health care access, a physician's office was the most common HIV testing site. Overall, a majority conveyed a preference to see advertisements in mainstream media outlets. However, when preferences were stratified by ethnicity, African American MSM were the least likely to prefer receiving information from mainstream media and conveyed a stronger preference to receive information from authority figures than non-Hispanic White and Hispanic MSM.

Institutional violence from police militarization and drug cartel wars as a 'Big Event' and its influence on drug use harms and HIV risk in people who inject drugs on the U.S.-Mexico border.

BACKGROUND: Globally, the US-Mexico Border is one of the largest drug trafficking regions, with Ciudad Juarez (CJ) and El Paso (EP) making up the second-largest border crossing in the world. Border communities are places where the risk of drug use harm and infectious diseases such as HIV are augmented due to the confluence of factors operating across the physical, social, economic and policy environment. Although the two cities are economically, culturally, and socially intertwined, each has distinct criminal justice systems and policy practices aimed at curtailing substance use. Between 2008 and 2011, the CJ/EP region experienced an unprecedented level of violence that stemmed from the intersection of police militarization and drug cartel wars, which profoundly shaped every aspect of life. Little research has documented the impact of drug cartel wars on the drug use and health harms of people who inject drugs (PWID) living in CJ and EP. The purpose of the study is to understand the effect that the drug cartel war had on the drug use harms and HIV risk of PWID. METHODS: We conducted 40 in-depth interviews with people who inject drugs who resided in CJ or EP and had used heroin or crack cocaine in the last 30 days, and asked how police militarization and drug cartel war affected their daily lives. The risk environment framework informed the analysis and interpretation of findings. RESULTS: Findings indicated that the risk environment was profoundly altered as PWID residing in CJ experienced profound changes in their daily lives that promoted engagement in behaviors that increased drug use and health harms including HIV risk, exacerbated trauma, and prevented use of substance use treatment and harm reduction services. The risk environment was also altered in EP, where PWID experienced drug supply shortages, violent policing practices, and reduced availability of harm reduction services. Findings underscore the permeability of risk environments across geographical borders. CONCLUSION: The intersection of law enforcement militarization and drug cartel wars can be conceptualized as a 'big event' because it disrupts the drug market economy, leads to drug shortages, promotes entrance into the drug market economy by people who use drugs, reshapes drug use sites, and constrains the provision of harm reduction services. The stability of the harm reduction system in CJ was negatively impacted and limited the ability of individuals to reduce harm. Our findings show that drug cartel wars render the CJ/EP region extremely susceptible to drug use and health harms, while also creating vulnerability by severely restricting its ability to respond. Traditional recommendations to intervene to limit the impact of risk environments on the drug use harms of PWID need to be reconsidered in the context of drug cartel wars.

Testing comprehensive models of disclosure of sexual orientation in HIV-positive Latino men who have sex with men (MSM).

Individuals who disclose their sexual orientation are more likely to also disclose their HIV status. Disclosure of HIV-serostatus is associated with better health outcomes. The goal of this study was to build and test comprehensive models of sexual orientation that included eight theory-informed predictors of disclosure to mothers, fathers, and closest friends in a sample of HIV-positive Latino gay and bisexual men. US acculturation, gender nonconformity to hegemonic masculinity in self-presentation, comfort with sexual orientation, gay community involvement, satisfaction with social support, sexual orientation and gender of the closest friend emerged as significant predictors of disclosure of sexual orientation.

Perceived need of a parental decision aid for the HPV vaccine: content and format preferences.

The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process.

The Influence of Perceived Immigration Context and Healthcare Utilization Immigration Law Concerns Latinx Immigrants' HIV Testing.

Although new HIV infections have remained stable or decreased for most U.S. groups at risk for HIV, incidence among Latinx increased by 6% and among Latinx individuals, immigrants are disproportionately infected. One driver of these infections is low rates of HIV testing. While research shows the chilling effect that restrictive immigration laws can have on immigrants' health care utilization, few studies have examined the influence of perceived immigration context and healthcare utilization immigration law concerns on following a public health recommendation such as HIV testing. The purpose of the study is to test an exploratory model of immigration-related variables and their impact on U.S. Latinx immigrants' yearly HIV testing. U.S.-Latinx immigrants (N=169) completed a cross-sectional survey assessing perceived enforcement of immigration laws, perceptions of law enforcement attitudes towards Latinx and immigrants, fear of deportation, concerns with the consequences of immigration laws for health care utilization, and yearly HIV testing. Path analysis findings indicated that perceived enforcement of immigration laws was related to perceived negative attitudes from law enforcement towards Latinx and immigrants which was associated with fear of deportation. Fear of deportation was associated with concerns with the implications of immigration laws for accessing publicly funded healthcare services and these concerns were negatively related to yearly HIV testing and mediated the association between fear of deportation and yearly HIV testing. Findings point to the need of developing and implementing individual- and policy-level interventions to increase HIV testing among Latinx immigrants in a restrictive immigration law environment. Resumen: Aunque nuevas infecciones de VIH se han mantenido estable o han disminuido para la mayoría de los grupos en los Estados Unidos (E.U.) en alto riesgo de contraer VIH, la incidencia de VIH entre Latinx ha aumentado 6% y entre individuos Latinx, los inmigrantes están desproporcionalmente afectados por la epidemia. Uno de los factores que contribuye a la alta tasa de VIH es la baja tasa de pruebas de VIH entre inmigrantes. Aunque la investigación confirma los efectos escalofriantes que las leyes restrictivas de inmigración pueden tener en la utilización de servicios de salud entre los inmigrantes, pocos estudios han examinado la influencia de la percepción del contexto de inmigración y las preocupaciones sobre las implicaciones de las leyes de inmigración si se utilizan servicios de salud públicos en seguir la recomendación de salud pública de hacerse la prueba de VIH regularmente. El propósito del estudio es someter a la prueba un modelo exploratorio de la influencia de variables relacionadas a la inmigración y su impacto en las pruebas anuales de HIV en los inmigrantes Latinx que viven en los E.U. (N=169). Los participantes contestaron un cuestionario transversal que midió la percepción del enforzamiento de las leyes de inmigración, la percepción de las actitudes de los agentes que enforzan las leyes de inmigración hacia Latinx y inmigrantes, el miedo a la deportación, las preocupaciones especificas sobre las consecuencias de las leyes de inmigración para la utilización de servicios de salud, la percepción de la sociedad sobre el estigma de VIH, y si los inmigrantes se hacen la prueba de VIH anualmente. Los resultados de los análisis de trayectoria indicaron que el enforzamiento de las leyes de inmigración esta relacionada con la percepción de que los agentes policiacos que enforzan las leyes tienen actitudes negativas hacia Latinx y inmigrantes lo cual esta asociado con el miedo a la deportación. El miedo a la deportación esta asociado a las preocupaciones sobre las implicaciones de las leyes de inmigración para la utilización de los servicios de salud patrocinados por el gobierno federal y estas preocupaciones fueron negativamente relacionadas con las pruebas anuales de VIH y mediaron la asociación entre el miedo a la deportación y las pruebas anuales de VIH. Los resultados señalan la importancia de desarrollar e implementar intervenciones al nivel individual y al nivel de política para aumentar las pruebas de VIH entre los inmigrantes Latinx en un ambiente de leyes restrictivas de inmigración.

Latinx Immigrants' Legal Concerns About SARS-CoV-2 Testing and COVID-19 Diagnosis and Treatment.

Immigration concerns can deter immigrants from utilizing healthcare services. We examined Latinx immigrants' immigration concerns related to COVID-19 testing and treatment. A multi-state sample of 336 US Latinx immigrants (documented and undocumented) completed a cross-sectional online survey in Spanish. Factor analysis informed the construction of a COVID-19 Immigration Concerns Scale. Multiple logistic regression was used to examine associations between the scale and indices of perceived immigration risk and healthcare access and utilization. Concerns clustered around two factors: (1) providers' release of information to immigration authorities and drawing government attention; and (2) eligibility for COVID-19 services and the immigration ramifications of using these. The regression equation highlighted strong associations between these and perceived instability of immigration laws and enforcement concerns after controlling for healthcare access and utilization. COVID-19-related immigration concerns were substantial and multifaceted. Perceived instability of laws was strongly related to concerns but remains understudied.

Impact of framing on intentions to vaccinate daughters against HPV: a cross-cultural perspective.

BACKGROUND: Effective promotion of the human papilloma virus (HPV) vaccine across ethnic/racial groups may help curtail disparities in cervical cancer rates. PURPOSE: This study aims to investigate mothers' intentions to vaccinate daughters against HPV as a function of message framing (gain versus loss) across three cultural groups: Hispanic, non-Hispanic white, and non-Hispanic African-American. METHODS: One hundred fifty mothers were recruited from city department of health clinics and asked to respond to information about the HPV vaccine for their daughters. In a repeated-measures experiment, two different frames (gain and loss) were used to present the information. RESULTS: The results indicated that both frames are equally effective in promoting vaccination intentions in non-Hispanic white mothers. Conversely, a loss frame message was more effective in non-Hispanic African-American and Hispanic mothers. CONCLUSIONS: Information sharing campaigns, aimed at promoting the HPV vaccine among ethnic minority groups should be modified to not focus exclusively on the benefits of vaccination.

Holistic reasoning on the other side of the world: validation of the analysis-holism scale in Mexicans.

The universality of cognitive processes has been called into question. Research suggests that individuals from Eastern cultures (e.g., China, Korea) when compared to individuals from Western cultures (e.g., the United States) prefer to reason holistically. This line of research has not been extended to cultural groups far removed from cultures traditionally surveyed in cross-cultural research such as Hispanics. We conducted two studies to understand: 1) the generalizability of the construct of holistic reasoning in Mexicans, and 2) the preferred reasoning style of Mexicans when compared to U.S. Americans. Results support the generalization of the factor structure of holistic reasoning as originally hypothesized by Choi, Koo, and Choi (2007). The results of Study 2 suggest that Mexicans scored higher than U.S. Americans on certain aspects of holistic reasoning.

Culture and Probability Judgment Accuracy: The Influence of Holistic Reasoning.

A well-established phenomenon in the judgment and decision-making tradition is the overconfidence one places in the amount of knowledge that one possesses. Overconfidence or probability judgment accuracy varies not only individually but also across cultures. However, research efforts to explain cross-cultural variations in the overconfidence phenomenon have seldom been made. In Study 1, the authors compared the probability judgment accuracy of U.S. Americans (N = 108) and Mexican participants (N = 100). In Study 2, they experimentally primed culture by randomly assigning English/Spanish bilingual Mexican Americans (N = 195) to response language. Results of both studies replicated the cross-cultural variation of probability judgment accuracy previously observed in other cultural groups. U.S. Americans displayed less overconfidence when compared to Mexicans. These results were then replicated in bilingual participants, when culture was experimentally manipulated with language priming. Holistic reasoning did not account for the cross-cultural variation of overconfidence. Suggestions for future studies are discussed.

Assimilation and Individual Differences in Emotion: The Dynamics of Anger and Approach Motivation.

Individuals who cross cultural boundaries face many challenges when trying to adapt to a receiving culture. Adaptation challenges such as learning to maneuver across societal domains may become increasingly complex if structural level factors such as discrimination are present. Researchers have conceptualized acculturation as a relatively autonomous decision indicating that four acculturation strategies exist: assimilation, separation, integration, and marginalization. Moreover, researchers have also long debated the link between acculturation strategy, adaptation hassles and negative health outcomes. However, models seeking to explain how individual difference and structural level variables may influence each other and subsequently influence acculturation and adaptation are needed. The purpose of this study is to lay the foundation for the conceptualization of such a model. We propose that temperamental predispositions to negative emotionality, anger, and impulsivity may highlight discrimination which in turn may lead to increases in acculturative stress and negative markers of psychosocial well-being. We used SEM to test our hypothesized model. Results supported a modified model. Implications for the measurement of adaptation and interventions are discussed.