Living in Limbo: Latinas' Assessment of Lower Rio Grande Valley Colonias Communities.

Community asset mapping (CAM) is the collective process of identifying local assets and strategizing processes to address public health issues and concerns and improve quality of life. Prior to implementing a community-based physical activity intervention with Latinas in the Texas Lower Rio Grande Valley, promotoras [community health workers] conducted 16 interactive sessions in 8 colonias. The analysis of the transcribed CAM recordings and on-site observational data resulted in the construction of Living in Limbo as the thematic representation of these Latinas' social isolation and marginalization associated with pervasive poverty, undocumented immigration status or lack of citizenship, their fears emanating from threats to physical and emotional safety, and the barriers created by lack of availability and access to resources.

Does injury prevention education initiate household changes in a Spanish-speaking minority population?

Young children from low income families are among the most affected population of unintentional injury. This non-randomized longitudinal study examined knowledge for home and child safety with an injury prevention training offered to parents of children who reside in the Rio Grande Valley of Texas. Eighty eight parents received the training and pre-and post-test surveys were used to measure knowledge outcomes. A follow-up survey was conducted 2 months after the educational intervention to identify how many parents reported household and safety behavior changes as a result of the training. The most significant change in behavior, as it pertains to the household, was related to locking and storage of dangerous cleaning chemicals. Other significant changes in behavior were in areas that directly related to the child such as learning how to swim, use of sun block and fire safety in the home. This study suggests that tailored trainings can improve parent knowledge and change in behaviors for the promotion of safety activities to avoid risks for unintentional injuries. Further, the study identified certain at-risk areas that need to be addressed from an educational perspective. These areas include bicycle and water safety; specifically, the use of protective gear when bicycling; understanding and adhering to traffic rules when bicycling; and, the dangers of drowning in small quantities of water.

Mexican-American children's perspectives: neighborhood characteristics and physical activity in Texas-Mexico border colonias.

The qualitative study described in this article investigated perceptions about environmental factors influencing physical activity (PA) among children from underserved neighborhoods known as colonias in the U.S.-Mexico border. Ten focus groups were conducted with 67 Mexican-American colonia children ages 8 to 13 living in one of the poorest border counties in the U.S. Analyses indicated that PA among children was influenced by neighborhood characteristics, including litter, speeding cars, unleashed dogs, and dark streets. The children also underlined intrapersonal and social environmental factors. Findings may inform policy makers and public health professionals about ways to promote PA among underserved children through urban planning and programs focusing on PA-supportive infrastructure, neighborhood safety, and family- and home-based physical activities.

Bridging research and policy to address childhood obesity among border Hispanics: a pilot study.

BACKGROUND: Mexican-American children are disproportionately affected by obesity compared to other population groups. Although national guidelines recommend using environmental and policy approaches to address this public health issue, the majority of Mexican-American children do not meet physical activity recommendations. PURPOSE: To describe a knowledge transfer process involving local decision makers to address childhood obesity and physical activity needs among low-income, Mexican-American children and to examine environmental policy recommendations generated in this process. METHODS: This pilot study employed a qualitative research design that included the dissemination of primary research data to local decision makers in the Texas-Mexico border region. Stakeholders attending public meetings were briefed about a research project reporting on the physical activity needs of Mexican-American children from impoverished neighborhoods known as colonias. Seventy-four stakeholders responded to an unstructured questionnaire and proposed policy recommendations. Data were collected January-April 2011 and analyzed July-September 2011. Data were analyzed using a content analysis technique. RESULTS: Four policy themes emerged from the data: (1) establishing sustainable community-based health programs; (2) improving neighborhood infrastructure and safety; (3) increasing access to parks; and (4) supporting community organizations to disseminate health education to parents and children. CONCLUSIONS: Knowledge transfer processes planned and facilitated by researchers at public meetings with local decision makers are effective methods to influence policy development related to childhood obesity.

Promotoras de Salud: roles, responsibilities, and contributions in a multisite community-based randomized controlled trial.

There is widespread recognition of the cultural and linguistic appropriateness of (a Spanish term for community health workers [CHW]) in health education and outreach among Hispanic communities. Yet, there are significant gaps in the literature regarding the preparation, implementation, and evaluation of ' engagement in research. To address this gap, we examine ' research-related training, roles, responsibilities, and contributions in a community-based participatory research project involving a multisite randomized controlled trial (RCT) of a physical activity intervention for Mexican-origin women in Texas and South Carolina. We identify both benefits and challenges associated with ' engagement as community researchers; examine variations and differences in roles and responsibilities related to the research contexts, sites, settings, and individual characteristics; and discuss implications for research and practice.

Factors influencing health care utilization in older Hispanics with diabetes along the Texas-Mexico border.

Little is known about predictors of health care utilization for older Hispanics with chronic conditions. This study aimed to determine: (1) the level of health care access for older Hispanics with type 2 diabetes living in a US-Mexico border area; and (2) personal and health correlates to health care utilization (ie, physician visits, eye care, emergency room [ER] use). This was a cross-sectional study based on a community assessment conducted at a clinic, senior centers, and colonias. Colonias are impoverished neighborhoods with substandard living conditions along the US-Mexico border. Hispanics living in colonias are one of the most disadvantaged minority groups in the United States. The study sample consisted of 249 Hispanics age 60 years and older who have type 2 diabetes. Descriptive analyses, multiple linear regression, and generalized linear models were conducted. Older age (P = 0.02) and affordability of physician fees (P = 0.02) were significant correlates to more frequent physician visits. Factors significantly associated with eye care were being insured (P = 0.001) and reporting high cholesterol (P = 0.005). ER use was significantly associated with younger age (60-64 years old; P = 0.03) and suffering from hypertension (P = 0.02). Those who received diabetes education (P = 0.04) were less likely to use the ER. Identifying patterns of health care utilization services in aging underserved minorities who are disproportionately affected by diabetes may lead to culturally appropriate preventive practices and timely access to health care. Adequate health care access can decrease or delay the onset of diabetes complications in older Hispanics with type 2 diabetes who live along the US-Mexico border.

Incorporating what promotoras learn: becoming role models to effect positive change.

Promotoras (community health workers) play an important health promotion role and must be continuously trained, but little is known about how much of their learning they actually put into practice. This non-randomized, longitudinal study examined knowledge and home environmental outcomes of an asthma and healthy homes training offered to promotoras using a train-the-trainer model. Eighty-five promotoras received the training and pre- and post-test surveys were used to measure training outcomes. Results showed a statistically significant increase in asthma and healthy home-related knowledge (P < .001). At 12-months post-intervention, a majority of the promotoras (69%) reported they made household changes to improve their indoor environment as a result of the training. This study suggests that effective trainings can improve promotoras knowledge and behaviors for the promotion of healthy homes in the community. Further evaluation is needed to investigate whether these trainings allow promotoras to serve as role models within their communities "by educating through example" and thereby enhance their credibility as health educators.

[Masculinity and sexual and reproductive health: a case study among adolescents of Mexico City]. / Masculinidad y salud sexual y reproductiva: un estudio de caso con adolescentes de la ciudad de México.

OBJECTIVE: To understand how the social construction and expression of masculinity among male adolescents and young adults are related to sexual health and reproductive risks. MATERIAL AND METHODS: The study was carried out in an underserved and a popular area of Mexico City. Eighteen focal groups and 18 individual interviews were applied to a sample of males from three age groups: 10 to 14, 15 to 19, and 20 to 24 years. Data analysis was performed inductively through open codification of the verbal transcriptions. These were used to create more abstract concepts and search for relationships among them. RESULTS: This paper centers on interpretations of masculinity as expressed by the youngsters themselves. Our research sheds light on what youngsters do and say to "be men". Their ideas and practices produce different forms of masculinity through which risk behavior is manifested, as well as specific speech and dressing styles, and ways of courting and "going steady". These behaviors and their meanings are associated with sexual and reproductive health risk taking. CONCLUSIONS: The traditional model of masculinity characteristic of both social settings involves poor communication about sexuality in couple relationships, which results in infrequent protection and exposure to Sexually Transmitted Infections and unwanted pregnancies. On the other hand, their economic living conditions prevent them from fully practicing central elements of their own concept of masculinity, such as being a hard worker, a provider, and a responsible person. These unmet needs may cause frustration, aggression, and domestic violence.

Masculinidad y salud sexual y reproductiva: un estudio de caso con adolescentes de la Ciudad de México / Masculinity and sexual and reproductive health: a case study among adolescents of Mexico City

OBJETIVO: Comprender cómo la construcción social y la expresión de la masculinidad entre los adolescentes y varones jóvenes se articulan con los riesgos para la salud sexual y reproductiva. MATERIAL Y MÉTODOS: El estudio se realizó en una zona "marginal" y otra "popular" de la Ciudad de México. Se llevaron a cabo 18 grupos focales y 18 entrevistas individuales a una muestra propositiva de varones de tres grupos de edad: 10 a 14, 15 a 19 y 20 a 24. El análisis de la información se hizo de forma inductiva, mediante una codificación abierta de las transcripciones verbales, a partir de la cual se generaron conceptos más abstractos y se buscaron las relaciones entre ellos. RESULTADOS: Este trabajo se enfoca en las maneras de entender la masculinidad, tal y como fueron expresadas por los jóvenes. Nuestra investigación arroja alguna luz sobre lo que los adolescentes dicen y hacen para "ser hombres". Sus ideas y prácticas llevan a varias formas de masculinidad mediante las cuales se reconstruyen comportamientos arriesgados, estilos de hablar y de vestir, formas de cortejo y de noviazgo específicas. Estos y sus significados son articulados con los riesgos en el campo de la salud sexual y reproductiva de los jóvenes y de sus parejas. CONCLUSIONES: El modelo tradicional de masculinidad que predomina en ambos sectores sociales tiene como resultado, por una parte, que haya poca comunicación sobre la sexualidad en las relaciones de pareja y que, consecuentemente, la utilización de medidas de protección se dé en muy raras ocasiones, exponiendo a los jóvenes a ITS y al riesgo de transformarse en padres sin ser aún adultos. Por otra parte, las condiciones económicas en que viven dificultan que lleven a la práctica elementos centrales de su propio concepto de masculinidad, como el ser trabajador, proveedor, responsable, lo que pudiera traducirse en frustración, agresividad y en violencia intrafamiliar