Transformative impacts of a civic leadership program created by and for refugees and immigrants.

Immigrants and refugees are severely underrepresented at all levels of political decision-making in the United States. These groups face significant barriers to civic and political participation and leadership, despite a frequent commitment to community care and engagement. There is an urgent need to address immigrant integration and underrepresentation through transformative means that go beyond voting to create a more inclusive and socially just society. We investigated outcomes associated with participation in an immigrant integration program designed to increase immigrants' access to civic engagement through a community-based participatory research and action process that centered the voices, experiences, and wisdom of refugees and immigrants. Thirty immigrants and refugees representing at least eight different communities participated in semi-structured interviews. Results illustrate how the program assisted in transforming participants' consciousness, skills, and relationships related to meaningful civic engagement and realizing their voice, power, and rights. These results emphasize the impact and potential of community based participatory research to transform individual and collective efficacy, consciousness, and capabilities-a vital first step in transformative justice.

A social interaction learning model approach to understand adverse childhood experiences and drug use among Latinx youth.

Latinx youth, members of an ethnic minority group growing faster than the national growth rate, are at increased risk of experiencing adverse childhood experiences (ACEs) but it remains unclear how ACEs relate to externalizing behaviors, such as substance use and behaviors leading to injury and violence, in this population. In a sample of 100 Latinx youth, the current study examined how ACEs related to drug use and behaviors leading to injury and violence. Exposure to ACEs was associated with increased drug use, and that association was significantly moderated by behaviors leading to injury and violence for Latina adolescents. Given these findings, more attention needs to be diverted to screening for ACEs and externalizing behaviors in Latina girls.

Creating collective solidarity: Insights from the development and process evaluation of civic action for refugee empowerment in Cincinnati.

OBJECTIVE: Our goal was to describe the development, progress, and functioning of Civic Action for Refugee Empowerment in Cincinnati (CARE: Cincinnati) as a model for community-based participatory research (CBPR) with refugees. We conducted a participatory evaluation to assess our collective ability to employ shared power and equitable decision-making, and to facilitate structures that build member ownership and solidarity. We identify principles and processes that can be used by researchers, practitioners, and activists interested in working toward the creation of more equitable community spaces for refugees. METHOD: Twelve refugee research team members representing seven different countries and ranging in age from 16 to 75 engaged in the participatory evaluation and are coauthors of this manuscript. All participants were interviewed by an external researcher, who transcribed and anonymized responses. Academic researchers first developed preliminary themes and then the entire research team verified, prioritized, and expanded themes. RESULTS: The experiences of refugee team members illustrate an iterative process of reflection and action that are both personally satisfying and encourage work for deeper change. The themes further illustrate that the CBPR process aided in developing a sense of solidarity among diverse team members and that the dynamic and participatory organization of the group fostered equitable and creative decision-making. CONCLUSIONS: Our participatory evaluation suggests that future research partnering with refugees that brings together diverse teams to share power will not only improve research quality and dissemination, but will also serve as a tangible benefit for refugee team members. The shared reflection, analysis, and action process inherent in the research process are individually motivating to refugee team members and foster possibility for transformative change. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A scoping review of youth advisory structures in the United States: Applications, outcomes, and best practices.

Although youth advisory structures (YASs) have proliferated internationally to facilitate the voice of young people, little is known about the practices of such groups, especially in the United States. To address this gap of knowledge, this study describes the findings of a scoping review of scholarly research on YAS in the United States. The review found that although the use of YAS is increasing, current scholarship offers little information about YAS processes or how youth are engaged. Most YAS in the review partnered with marginalized young people to inform research and programming around sensitive health topics, such as human immunodeficiency virus prevention. Youth who participated in YAS experienced positive outcomes such as leadership and skill development, healthier decision-making, and confidence. Although most studies involved youth in minimal ways, there is a growing body of literature where youth are engaged in long-term partnerships that support positive youth development. This review details other key characteristics of YAS and provides recommendations for best practices, such as building consensus around terms used to refer to YAS and promoting the dissemination of process details around YAS facilitation.

Group Level Assessment (GLA) as a methodological tool to facilitate science education.

Group Level Assessment (GLA) is a qualitative, participatory research methodology that can be used within science education, specifically to meet the Science and Engineering Practices dimension of the K-12 Next Generation Science Standards. In contrast to traditional qualitative research methods, GLA is a concrete methodological tool intended for large groups. GLA follows a 7-step process in which diverse stakeholders work together to generate, analyze and prioritize ideas that lead to action planning. Emphasizing personal relevance, shared decision making, systematic inquiry, and collaboration in the design and process, GLA is best positioned conceptually and theoretically within community-based participatory research and inquiry-based learning approaches. The purpose of this manuscript is to describe how GLA can be utilized as an innovative methodology to incorporate students' lived experiences in science education. We describe how to conduct GLA and provide a case example of GLA in action conducted as part of a larger science education program with students and teachers in STEM.

Boricua de pura cepa: Ethnic identity, cultural stress and self-concept in Puerto Rican youth.

OBJECTIVES: The available literature on ethnic identity among Puerto Ricans has focused on those living in the United States, with little to no attention placed on examining ethnic identity and psychological constructs among youth living in Puerto Rico. Using a colonial mentality framework, the current study examined the associations between ethnic identity, cultural stress, and self-concept among adolescent boys and girls living in Puerto Rico. METHOD: The current cross-sectional study surveyed participants (N = 187) recruited from several junior high schools in the metropolitan area in Puerto Rico. RESULTS: Relations between ethnic identity, cultural stress, and self-concept differed by gender. First, cultural stress was associated with self-concept for boys, such that higher cultural stress predicted lower self-concept. Second, among girls, cultural stress moderated the relation between ethnic identity and self-concept. Specifically, for girls experiencing high cultural stress, exploration and resolution of their ethnic identity was associated with higher ratings of self-concept. CONCLUSIONS: Although cultural stress has been widely understood as a phenomena associated with immigrants, our study indicated that cultural stress is important in understanding self-concept of youth living in Puerto Rico. For boys, cultural stress, but not ethnic identity, is particularly important to their self-concept. Among girls experiencing high cultural stress, exploration and resolution of ethnic identity was associated with higher self-concept. Results suggested that the cultural stress associated with the colonial context of Puerto Rico is salient in ethnic identity and self-concept development, even though Puerto Rican youth are the ethnic majority in the island. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Measuring lifetime stress exposure and protective factors in life course research on racial inequality and birth outcomes.

There has been a long-standing interest in better understanding how social factors contribute to racial disparities in health, including birth outcomes. A recent emphasis in this context has been on identifying the effects of stress exposure and protective factors experienced over the entire lifetime. Yet despite repeated calls for a life course approach to research on this topic, very few studies have actually assessed how stressors and protective factors occurring over women's lives relate to birth outcomes. We discuss this issue here by describing how challenges in the measurement of lifetime stress exposure and protective factors have prevented researchers from developing an empirically-based life course perspective on health. First, we summarize prevailing views on racial inequality and birth outcomes; second, we discuss measurement challenges that exist in this context; and finally, we describe both new tools and needed tools for assessing lifetime stress exposure and suggest opportunities for integrating information on stress exposure and psychosocial protective factors. We conclude that more studies are needed that integrate information about lifetime stress exposures and the protective factors that promote resilience against such exposures to inform policy and practice recommendations to reduce racial disparities in birth outcomes.

Demographic Characteristics Associated With Barriers to Health Care Among Mexican and Guatemalan Immigrants in a Nontraditional Destination Area.

The purpose of this study was to examine demographic factors associated with health care barriers among Mexican (n = 258) and Guatemalan (n = 143) immigrants in Cincinnati, a nontraditional destination (new migration area). Three primary results emerged: length of US residence was not associated with fewer health care barriers, Mexican women and younger Guatemalans endorsed fewer skills-related barriers, and childless Guatemalans reported more barriers to care the longer they reside in the United States, when compared with Guatemalans with children. Our study highlights the importance of disaggregating data to create more tailored interventions to eliminate health disparities for Latinos.

Partnering with youth to map their neighborhood environments: a multilayered GIS approach.

Mapping approaches offer great potential for community-based participatory researchers interested in displaying youth perceptions and advocating for change. We describe a multilayered approach for gaining local knowledge of neighborhood environments that engages youths as coresearchers and active knowledge producers. By integrating geographic information systems with environmental audits, an interactive focus group, and sketch mapping, the approach provides a place-based understanding of physical activity resources from the situated experience of youths. Youths report safety and a lack of recreational resources as inhibiting physical activity. Maps reflecting youth perceptions aid policy makers in making place-based improvements for youth neighborhood environments.

Attributions of Mental Illness: An Ethnically Diverse Community Perspective.

Although the prevalence of mental illness is similar across ethnic groups, a large disparity exists in the utilization of services. Mental health attributions, causal beliefs regarding the etiology of mental illness, may contribute to this disparity. To understand mental health attributions across diverse ethnic backgrounds, we conducted focus groups with African American (n = 8; 24 %), Asian American (n = 6; 18 %), Latino/Hispanic (n = 9; 26 %), and White (n = 11; 32 %) participants. We solicited attributions about 19 mental health disorders, each representing major sub-categories of the DSM-IV. Using a grounded theory approach, participant responses were categorized into 12 themes: Biological, Normalization, Personal Characteristic, Personal Choice, Just World, Spiritual, Family, Social Other, Environment, Trauma, Stress, and Diagnosis. Results indicate that ethnic minorities are more likely than Whites to mention spirituality and normalization causes. Understanding ethnic minority mental health attributions is critical to promote treatment-seeking behaviors and inform culturally responsive community-based mental health services.

Immigrant Perspectives of Social Connection in a Nontraditional Migration Area.

Social connection is a core dimension of health and wellness among all populations, yet the experience of moving to and living in a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Using hybrid (inductive/deductive) qualitative analysis, we identified seven domains of social connection from the perspective of the interviewed participants: (1) lens of the individual; (2) immigrant experience; (3) interpersonal support; (4) community belonging; (5) community capital; (6) community navigation; and (7) social acceptance. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of social connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. Additionally, these results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess the social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.

Youth as partners, participants or passive recipients: a review of children and adolescents in community-based participatory research (CBPR).

Community-based participatory research (CBPR) is an orientation to research that places value on equitable collaborations between community members and academic partners, reflecting shared decision making throughout the research process. Although CBPR has become increasingly popular for research with adults, youth are less likely to be included as partners. In our review of the literature, we identified 399 articles described by author or MeSH keyword as CBPR related to youth. We analyzed each study to determine youth engagement. Not including misclassified articles, 27 % of percent of studies were community-placed but lacked a community partnership and/or participatory component. Only 56 (15 %) partnered with youth in some phase of the research process. Although youth were most commonly involved in identifying research questions/priorities and in designing/conducting research, most youth-partnered projects included children or adolescents in several phases of the research process. We outline content, methodology, phases of youth partnership, and age of participating youth in each CBPR with youth project, provide exemplars of CBPR with youth, and discuss the state of the youth-partnered research literature.

The use of concept mapping to identify community-driven intervention strategies for physical and mental health.

Research that partners with youth and community stakeholders increases contextual relevance and community buy-in and therefore maximizes the chance for intervention success. Concept mapping is a mixed-method participatory research process that accesses the input of the community in a collaborative manner. After a school-wide health needs assessment at a low-income, minority/immigrant K-8 school identified bullying and obesity as the most important health issues, concept mapping was used to identify and prioritize specific strategies to address these two areas. Stakeholders including 160 K-8 students, 33 college students working in the school, 35 parents, 20 academic partners, and 22 teachers/staff brainstormed strategies to reduce and prevent obesity and bullying. A smaller group of stakeholders worked individually to complete an unstructured sorting of these strategies into groups of similar ideas, once for obesity and again for bullying. Multidimensional scaling and cluster analysis was applied to the sorting data to produce a series of maps that illustrated the stakeholders' conceptual thinking about obesity and bullying prevention strategies. The maps for both obesity and bullying organized specific strategies into themes that included education, parental role, teacher/school supervision, youth role, expert/professional role, and school structure/support.

Sexual Health Interventions for Racial/Ethnic Minorities Using Community-Based Participatory Research: A Systematic Review.

BACKGROUND: Racial/ethnic minorities (REMs) continue to carry the burden of sexual health disparities in the United States, including increased health risks and lower proportions of preventative care. Community-based participatory research (CBPR) has been useful in developing interventions aimed at reducing these disparities. Specifically, partnership with the target group members has resulted in more culturally relevant intervention strategies. AIM: The purpose of this systematic review was to analyze the existing research on sexual health interventions targeting U.S. REMs that were developed using CBPR, to highlight the role target group members played in the development of these interventions, and to explore the benefits and outcomes of these partnerships. METHOD: Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guided the search of 46 thesauri terms for CBPR, sexual health, and REMs across six databases. RESULTS: The initial search yielded 805 identified studies. After applying limiters, reviewing abstracts, and doing a full-text review, 24 appropriate studies were retained. The key findings indicated significant intervention outcomes such as increased health knowledge, attitude change, and behavioral intention that could reduce sexual risk-taking behaviors. Twelve studies detailed the methods for partnering with target group members to formulate interventions, highlighting the benefits related to recruitment, retention, and cultural relevance. DISCUSSION: CBPR is well-positioned to address sexual health disparities among REMs. While community partnership strategies vary, the findings yield evidence that CBPR addressing sexual health disparities is achievable, can influence the effectiveness of interventions, and should be considered as an orientation in future sexual health research.

Dual Pandemics: Race-Related COVID Stress and Mental Health Outcomes in Black Individuals.

Black individuals have been disproportionately affected by the COVID-19 pandemic, likely due in part to historically rooted stressors that lie at the intersection of the COVID-19 pandemic and racism. We used secondary data from The Association of Black Psychologists' multi-state needs assessment of 2480 Black adults to examine the link between race-related COVID stress (RRCS) and mental health outcomes. We also examined the moderating roles of everyday discrimination, cultural mistrust, Black activism, Black identity, and spirituality/religiosity in these associations. T-tests revealed that several demographic and cultural factors are associated with RRCS endorsement. A series of regression analyses showed that endorsement of RRCS is associated with higher psychological distress and lower well-being, above and beyond several sociodemographic characteristics. While traditional cultural protective factors did not buffer against the effects of RRCS on mental health, cultural mistrust strengthened the positive association between RRCS and psychological distress; nonetheless, the association of cultural mistrusts with psychological distress was only seen in those who endorsed RRCS. We provide recommendations for policymakers, clinicians, and researchers to consider the impact of RRCS when addressing Black mental health and well-being in the age of COVID-19.

Adverse Childhood Experiences and alcohol use among U.S.-born and immigrant Latinx youth: the roles of social support and stress hormones.

The biobehavioral correlates of Adverse Childhood Experiences (ACEs) among Latinx youth have been strikingly understudied. The purpose of this study was to 1) examine the effects of T-ACEs (e.g., maltreatment, family dysfunction) and E-ACEs (e.g., family deportation, community violence) in alcohol use, 2) test whether social support moderated these associations and 3) explore whether ACEs and alcohol use were related via adrenocortical hormones (i.e., cortisol, dehydroepiandrosterone [DHEA]). A total of 100 Latinx youth, between the ages of 13 and 19, participated in this study (53% female). Community samples of United States (U.S.)-born (N = 54) and immigrant Latinx (N = 46) youth provided morning saliva samples and completed self-report questionnaires. Results highlighted that for immigrant youth, social support buffered the effects of E-ACEs on alcohol use, F(9,89)= 3.34, p = .01, R2 = .25. Although our mediation hypothesis was not supported, the direct effects of T-ACEs (ß = .25, t (94) = 2.21, p = .03) and E-ACES (ß = -.24, t (94) = -2.23, p = .03) on DHEA were significant for the entire sample. Preventing maltreatment and reducing community-level adversities seem critical for optimal child development, as exposure to these may increase alcohol use risk and affect HPA Axis functioning. Increasing extrafamilial support may be particularly salient for immigrant Latinx youth, as many experience extended immigration-related periods of separation from family members.

A systematic review examining caregivers' of color experiences with the diagnostic process of autism spectrum disorder.

LAY ABSTRACT: Children of color are diagnosed with autism later than White children. Caregivers of color are also more likely than White caregivers to report that their child's healthcare providers do not treat them as a partner, spend enough time with them, or respect their culture and values. We wanted to better understand the experiences of caregivers of color with the diagnostic process of autism spectrum disorder, from the time they discuss developmental concerns with their child's primary care provider to when the diagnosis is shared with them. We systematically reviewed the literature and found 15 articles that explored the experiences of caregivers of color. Caregivers of color described that they faced large-scale barriers, such as the cost of appointments, transportation, and long wait lists. They also reported negative experiences with providers, including providers not taking their concerns seriously, making assumptions about caregivers, and delaying referrals for an evaluation. Caregivers stated that their own lack of knowledge of autism spectrum disorder, stigma, their family's thoughts and opinions, and cultural differences between providers and caregivers served as barriers during the diagnostic process. Communication challenges were discussed and included use of medical and technical jargon, a lack of follow-up, language barriers, and difficulty obtaining high-quality interpreters. Some families described providers, other individuals, community networks, and self-advocacy as helpful during the diagnostic process. Large-scale changes are needed, such as increases in the number of providers who are trained in diagnosing Autism. Provider-level changes (e.g. implicit bias training) are also important for improving caregivers' experiences.

Understanding Barriers and Facilitators of Attention-Deficit/Hyperactivity Disorder Treatment Initiation and Adherence in Black and Latinx Children.

OBJECTIVE: Despite evidence that consistent treatment is important for Attention-Deficit/Hyperactivity Disorder (ADHD) management, ADHD treatment initiation and adherence remains suboptimal in minoritized children. The goal of this study was to explore barriers and facilitators to ADHD treatment initiation/adherence for minoritized children to further inform development of our family navigation intervention. METHODS: Using a virtual platform, we completed 7 focus group sessions (total n.ß=.ß26) and 6 individual interviews with representatives from 4 stakeholder groups: experienced caregivers of children with ADHD, caregivers of children newly diagnosed with ADHD, family navigators, and clinicians who care for children with ADHD. All caregivers identified as Black and/or Latinx. Separate sessions were conducted for each stakeholder group and caregivers had the option to attend an English or Spanish session. Using a thematic analysis strategy, barriers and facilitators to ADHD treatment initiation and/or adherence were coded in focus group/interview data and themes were identified across groups. RESULTS: The primary barriers to ADHD treatment initiation and/or adherence identified for minoritized children were lack of support from school/healthcare/family members, cultural barriers, limited resources, limited access, and treatmentconcerns, with variability in endorsement across participants. Reported facilitators included caretakers having experience with ADHD, strong support, access to resources, andwitnessing their child...s functional improvement with treatment. CONCLUSIONS: Caregiver experience with and knowledge about ADHD, support, and access to resources facilitate ADHD treatment in minoritized children. The results from this study have the potential to improve ADHD treatment initiation/adherence and outcomes for minoritized children through the development of culturally tailored, multipronged interventions.

Psychometric Properties of Scales Measuring Resilience in U.S. Latinx Populations: A Systematic Review.

Objectives: Instruments used to measure resilience have typically been developed in European or Anglosphere countries and emphasize personal factors of resilience. In addition to being a quickly growing ethnic minority group in the United States, Latinx individuals face unique stressors and protective factors that may contribute to resilience. This review sought to determine the extent to which instruments measuring resilience have been validated in U.S. Latinx populations and what domains of resilience those scales capture. Methods: A systematic literature review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and included studies describing psychometric properties of resilience scales for Latinx individuals living in the United States. Articles were assessed for quality of psychometric validation; scales used in the final studies were assessed for representation of domains of the social ecological resilience model. Results: Nine studies were included in the final review examining eight separate resilience measures. The populations of these studies were heterogeneous geographically and demographically; more than half the studies only included Latinx populations as a subgroup. The breadth and quality of psychometric validation were variable across studies. The domains represented by the scales in the review most heavily assessed individual domains of resilience. Conclusion: The literature to date on psychometric validation of resilience measures in Latinx populations in the United States is limited and does not robustly capture aspects of resilience that may be particularly meaningful for Latinx populations, such as community or cultural factors. Instruments that are developed with and for Latinx populations are necessary to better understand and measure resilience in this population.

Barriers and Facilitators to Prevention and Care of COVID-19 Infection in Cincinnati Latinx Families: a Community-Based Convergent Mixed Methods Study.

BACKGROUND: Latinx populations have experienced disproportionately high case rates of COVID-19 across the USA. Latinx communities in non-traditional migration areas may experience greater baseline day-to-day challenges such as a lack of resources for immigrants and insufficient language services. These challenges may be exacerbated by the COVID-19 pandemic. OBJECTIVE: This article describes the results of an initial community health needs assessment to better understand the prevention and care of COVID-19 infection in the Cincinnati Latinx community. METHODS: We used convergent mixed methods to examine barriers and facilitators to COVID-19 prevention and care for those with infection. RESULTS: Latinx adults ≥ 18 years old completed 255 quantitative surveys and 17 qualitative interviews. Overarching mixed methods domains included knowledge, prevention, work, challenges, and treatment. Quantitative results largely reinforced qualitative results (confirmation). Certain quantitative and qualitative results, however, diverged and expanded insights related to caring for COVID-19 infection among Latinx adults (expansion). There were infrequent contradictions between quantitative and qualitative findings (discordance). Primary barriers for the Latinx community during the COVID-19 pandemic included insecurities in food, jobs, housing, and immigration. Key facilitators included having trusted messengers of health-related information. CONCLUSION: Public health interventions should be centered on community partnerships and the use of trusted messengers. Wraparound services (including resources for immigrants) are essential public health services. Close partnership with employers is essential as lack of sick leave and mask supplies were more frequent barriers than knowledge. These findings emerged from experiences during the COVID-19 pandemic but likely generalize to future public health crises.