Prevention of alcohol consumption and transmission of human immunodeficiency virus: randomized clinical trial.

OBJECTIVE: to know the effects of a nursing intervention to reduce alcohol use and risk factors for transmission of human immunodeficiency virus (HIV). METHOD: randomized single-blinded clinical trial performed by nurses with young women. The study included 66 participants in the intervention group and 66 participants in the control group. The instruments were the Alcohol Use Disorders Identification Test, the HIV Risk Behavior Knowledge and the Condom Use Self-efficacy Scale. Analysis of variance was used. RESULTS: alcohol involvement decreased in the intervention group (F (1.119) = 50.28; p < 0.001; η2p = 0.297), while HIV knowledge (F (1.130) = 34.34; p < 0.001; η2p = 0.209) and condom use self-efficacy increased (F (1.129) = 27.20; p < 0.001; η2p = 0.174). In addition, less participants consumed alcohol in the past week compared to the control group (χ2 = 15.95; p < 0.001). CONCLUSION: the nursing intervention had positive effects, which could help young women stay away from alcohol use and the risk of sexually transmitted infections. NCT: 02405481.

Access to assistive technology (AT) information in Spanish on state and territory program websites: United States, 2018.

BACKGROUND: Compared to non-Hispanic white individuals, assistive technology (AT) utilization is lower among Hispanic individuals.1-7 In the US, Spanish is the 2nd most frequently spoken language. Greater than one-fifth of Spanish-speaking households are limited English proficiencty (LEP) households (i.e., all individuals over age 14 in the household speak English less than "very well").8 Availability of AT materials in Spanish is one factor influencing knowledge about and utilization of AT among Spanish-speakers. OBJECTIVE: To examine the availability of Spanish-language AT information on state AT program websites and to assess the relationship between availability and state demographic and linguistic characteristics. METHODS: In 2018, we evaluated 56 state and territory AT program websites for the availability of AT information in Spanish. We calculated 4 measures (US Hispanic population in the state/territory; Hispanic individuals as a proportion of state population; overall Spanish-speaking households, and Spanish-speaking, limited English proficient households) from the 2016 American Community Survey and created ranked lists for each measure. Point biserial (rpb) correlations were calculated to test associations between each measure and availability of AT information in Spanish on each program's website. RESULTS: Sixteen program websites (15 states, 1 territory) provided access to Spanish-language AT information. None of the 4 measures were strongly associated with this outcome (rpb ranged from 0.30 to 0.42). For any of the 4 measures, no more than half of states in the top 10 ranks offered online access to AT information in Spanish. CONCLUSIONS: Improving the online availability of AT information in Spanish is necessary to increase equity in AT utilization among Spanish-speaking people with disabilities.

Prevention of alcohol consumption and transmission of human immunodeficiency virus: randomized clinical trial / Prevenção do consumo de álcool e transmissão do vírus da imunodeficiência humana: ensaio clínico randomizado / Prevención del consumo de alcohol y transmisión de virus de inmunodeficiencia humana: ensayo clínico aleatorizado

Abstract Objective: to know the effects of a nursing intervention to reduce alcohol use and risk factors for transmission of human immunodeficiency virus (HIV). Method: randomized single-blinded clinical trial performed by nurses with young women. The study included 66 participants in the intervention group and 66 participants in the control group. The instruments were the Alcohol Use Disorders Identification Test, the HIV Risk Behavior Knowledge and the Condom Use Self-efficacy Scale. Analysis of variance was used. Results: alcohol involvement decreased in the intervention group (F (1.119) = 50.28; p < 0.001; η2p = 0.297), while HIV knowledge (F (1.130) = 34.34; p < 0.001; η2p = 0.209) and condom use self-efficacy increased (F (1.129) = 27.20; p < 0.001; η2p = 0.174). In addition, less participants consumed alcohol in the past week compared to the control group (χ2 = 15.95; p < 0.001). Conclusion: the nursing intervention had positive effects, which could help young women stay away from alcohol use and the risk of sexually transmitted infections. NCT: 02405481.

Resumo Objetivo: conhecer os efeitos de uma intervenção de enfermagem para reduzir o uso de álcool e diminuir os fatores de risco para a transmissão do vírus da imunodeficiência humana (HIV, sigla em inglês). Método: ensaio clínico randomizado, simples-cego, realizado por enfermeiras com mulheres jovens. O estudo incluiu 66 participantes no grupo de intervenção e 66 participantes no grupo controle. Os instrumentos foram o Questionário de Identificação de Distúrbios de Uso de Álcool, a HIVRisk Behavior Knowledge e a Escala de Autoeficácia no Uso de Preservativos. Foi utilizada a análise de variância. Resultados: o consumo de álcool diminuiu no grupo de intervenção (F (1,119) = 50,28; p < 0,001; η2p = 0,297), enquanto o conhecimento sobre o HIV (F (1,130) = 34,34; p < 0,001; η2p = 0,209) e a autoeficácia no uso de preservativos aumentaram (F (1,129) = 27,20; p < 0,001; η2p = 0,174). Além disso, menos participantes consumiram álcool na última semana em comparação com o grupo controle (χ2 = 15,95; p < 0,001). Conclusão: a intervenção de enfermagem teve efeitos positivos, que poderiam ajudar as mulheres jovens a ficarem longe do uso de álcool e do risco de infecção por doenças sexualmente transmissíveis. NCT: 02405481.

Resumo Objetivo: conocer los efectos de una intervención de enfermería para reducir el uso de alcohol y disminuir factores de riesgo para transmisión del virus de inmunodeficiencia humana (HIV, siglas en inglés). Método: ensayo clínico aleatorizado, simple ciego, administrado por enfermeras a mujeres jóvenes. Participaron 66 personas en el grupo de intervención y 66 en el de control. Los instrumentos fueron el Cuestionario de Identificación de Trastornos debidos al Consumo de Alcohol, el HIV Risk Behavior Knowledge y la escala de Autoeficacia del Uso de Condón. Se utilizó análisis de la varianza. Resultados: en el grupo de intervención disminuyó el involucramiento con el alcohol (F (1,119) = 50,28; p < 0,001; η2p = 0,297), aumentaron los conocimientos sobre el HIV (F (1,130) = 34,34; p < 0,001; η2p = 0,209) y la autoeficacia para uso de condón (F (1,129) = 27,20; p < 0,001; η2p = 0,174). También menos participantes bebieron alcohol en la última semana en comparación con el grupo de control (χ2 = 15,95; p < 0,001). Conclusión: la intervención de enfermería tuvo efectos positivos que podrían ayudar a las mujeres jóvenes a mantenerse alejadas del uso de alcohol y de contagio de enfermedades de transmisión sexual. NCT: 02405481.

Effects of the home-based educational intervention on health outcomes among primarily Hispanic children with asthma: a quasi-experimental study.

BACKGROUND: Childhood asthma is a significant health issue with 8.3% prevalence in the U.S. Its prevalence is particularly higher among low-income communities in the Texas-Mexico border region, as they often lack access to clinical care and health insurance. This study examines the impact of a home-based education led by Community Health Workers (CHWs) on health outcomes for asthmatic, predominantly Hispanic children in these communities. METHODS: The study was a quasi-experimental design to learn the effectiveness of the asthma home-based education by comparing changes of health outcomes between baseline and follow-up of intervention and control groups. This study enrolled 290 participants, consisting of 130 in the intervention group and 160 in the control group. The educational intervention led by the CHWs referenced the Asthma and Healthy Homes curriculum and contents of the Seven Principles of Healthy Homes. The multiple linear regression analysis was conducted to estimate the associations between the intervention and each health outcome. RESULTS: When comparing the intervention group with the control group, the intervention group showed a significantly greater decrease in asthma attacks than the control group (p = 0.049). Although all of the five Children's Health Survey for Asthma (CHSA) scores showed significant improvements between baseline and follow-up in both groups, we found that increases of CHSA scores in the intervention group were higher than the control group except for emotional health of children (EC) score. The multiple linear regression models demonstrated that the mean changes in asthma attacks (p = 0.036) and emotional health of families (EF) score (p = 0.038) were significantly better in the intervention group than the control group, adjusting for children's age of diagnosis, household income, use of steroids, family history of allergy, and type of insurance. CONCLUSIONS: This study concluded that the home-based education by CHWs effectively improve health outcomes among children in communities lacking access to medical resources. The findings suggest the importance of the home-based education program in promoting emotional and medical care for children and their families in low-income communities like those in the Texas-Mexico border region.

Effect of an Educational Video to Increase Calls and Screening into an Anal Cancer Clinical Trial Among HIV+ Hispanics in PR: Results from a Randomized Controlled Behavioral Trial.

Anal cancer incidence is higher in persons living with HIV/AIDS (PLWHA) than in the general population. Participation of PLWHA in anal cancer clinical trials (CTs) is essential; Hispanic PLWHA are underrepresented in CTs. We conducted a behavioral CT among 305 PLWHA in Puerto Rico to measure the efficacy of an educational video in increasing calls and screening into an anal cancer CT. Participants received printed educational materials on anal cancer and CTs; the intervention group also received an educational video. Outcome assessment based on follow-up interviews showed that printed materials increased awareness about CTs and high-resolution anoscopy (HRA), and willingness to participate in an anal cancer CT in both groups. However, the addition of the video increased the likelihood of participants to call the CT for orientation (RRadjusted = 1.66, 95% CI 1.00-2.76; p = 0.05) and pre-screening evaluation (RRadjusted = 1.70, 95% CI 0.95-3.03; p = 0.07). This intervention could help increase participation of Hispanics into anal cancer-related CTs.

Mapping the Social World of Classrooms: A Multi-Level, Multi-Reporter Approach to Social Processes and Behavioral Engagement.

Understanding the social context of classrooms has been a central goal of research focused on the promotion of academic development. Building on the current literature on classroom social settings and guided by a risk and protection framework, this study examines the unique and combined contribution of individual relationships and quality of classroom interactions on behavioral engagement among low-income Latino students in kindergarten to fifth grade (N = 111). Findings indicate that individual relationships with teachers and peers and classroom quality, each independently predicted behavioral engagement. Moreover, high-quality classrooms buffered the negative influence of students' difficulties in individual relationships on behavioral engagement. Findings illuminate the need to consider multiple layers of social classroom relationships and interactions and suggest the potential benefit of targeting classroom quality as a mechanism for improving behavioral engagement in urban elementary schools.

Results of a Health Education Message Intervention on HPV Knowledge and Receipt of Follow-up Care among Latinas Infected with High-risk Human Papillomavirus.

A clinic-based intervention study was conducted among high-risk human papillomavirus (HPV)-infected Latinas aged 18-64 years between April 2006 and May 2008 on the Texas-Mexico border. Women were randomly assigned to receive a printed material intervention (n=186) or usual care (n=187) and were followed at three months, six months, and 12 months through telephone surveys and review of medical records. The HPV knowledge of nearly all women had increased greatly, but only two-thirds of women reported they had received follow-up care within one year of diagnosis regardless of additional health education messaging. Our findings suggest that, regardless of type of health education messaging, Latinas living on the Texas-Mexico border are aware that follow-up care is recommended, but they may not receive this care. Individual, familial and medical care barriers to receipt of follow-up care may partially account for the higher rates of cervical cancer mortality in this region.

Impacts of parent-implemented early-literacy intervention for Spanish-speaking children with language impairment.

BACKGROUND: Children with language impairment (LI) often have lags in development of print knowledge, an important early-literacy skill. This study explores impacts of a print-focused intervention for Spanish-speaking children with LI in Southeastern Mexico. AIMS: Aims were twofold. First, we sought to describe the print knowledge (print-concept knowledge, alphabet knowledge) of Spanish-speaking children with LI. Second, we determined the extent to which print-referencing intervention delivered by children's parents could improve print knowledge. METHODS & PROCEDURES: Using a pre-test-post-test delayed treatment research design, 13 parent-child dyads were assigned to an intervention (n = 8) versus control (n = 5) condition. Children were drawn from a speech-language clinic and all were receiving services for LI. Caregivers in the intervention group implemented an 8-week home-reading programme following a systematic scope and sequence for improving children's print knowledge. OUTCOMES & RESULTS: Children showed individual differences in their print knowledge based on three baseline measures examining print-concept knowledge, alphabet knowledge and letter-sound knowledge. Those whose caregivers implemented the 8-week programme showed statistically and practically significant gains on two of the three measures over the intervention period. CONCLUSIONS & IMPLICATIONS: The results presented here may stimulate future research on the print knowledge of Spanish-speaking children with LI. Sources of individual differences are important to determine. Caregivers may use the intervention presented here as a potential avenue for improving children's print knowledge.

Engaging Community With Promotores de Salud to Support Infant Nutrition and Breastfeeding Among Latinas Residing in Los Angeles County: Salud con Hyland's.

The Salud con Hyland's Project: Comienzo Saludable, Familia Sana [Health With Hyland's Project: Healthy Start, Healthy Family],was developed to provide education and support to Latina mothers regarding healthy infant feeding practices and maternal health. The promotora-delivered intervention was comprised of two charlas (educational sessions) and a supplemental, culturally and linguistically relevant infant feeding and care rolling calendar. Results indicate that the intervention increased intention to breastfeed exclusively, as well as to delay infant initiation of solids by 5 to 6 months. Qualitative feedback identified barriers to maternal and child health education as well as highlighted several benefits of the intervention.

Testing the feasibility of ¡Cuídate! With Mexican and Central American youth in a rural region of a southern state.

Regions of the US with growing Latino populations are in need of culturally sensitive sexual risk reduction programs. A Latino community, a public school district, and a university in eastern North Carolina collaborated to test the feasibility of ¡Cuídate!, a culturally tailored, evidence-based sexual risk reduction program, with Mexican and Central American youth. Ten male and 10 female adolescents, ages 13-17 years, participated in the ¡Cuídate! program and post-program focus groups. Early adolescent boys and girls (ages 13-15) gained the most from this program. A safe environment facilitated healthy sexual communication, and condom skills-building provided a context for shared partner responsibility. Grade-level and gender differences were significant. Analysis of the focus group data identified three important messages: Everybody needs sex education, We like this program better because it is hands-on, and I'm going to make better decisions about sex. The findings of this study support the need for community-based interventions that ensure cultural respect, trust, and a safe environment in which to discuss sexual issues.

Measuring success: results from a national survey of recruitment and retention initiatives in the nursing workforce.

OBJECTIVES: The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. DESIGN: Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). PARTICIPANTS: Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. METHODS: Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities' graduation and enrollment between nursing schools with and without diversity pipeline programs RESULTS: Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%-10.4%, p = .001), but they decreased among Black (6.8%-5.0%, p = .004) and Native American/Pacific Islander students (2.1 %-0.3%, p ≥ .001). CONCLUSIONS: Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students.

Perceptual and production training of intervocalic /d, r, r/ in American English learners of Spanish.

This study investigates the effectiveness of three high variability training paradigms in training 42 speakers of American English to correctly perceive and produce Spanish intervocalic /d, r, r/. Since Spanish spirantization and English flapping both affect /d/ intervocalically, the acquisition of the /d/-/r/ contrast proves difficult for English learners of Spanish. The acquisition of the trill /r/ is also problematic because it is a new phoneme for English learners and is articulatorily difficult to produce. Past research reported that high-variability perceptual training improves both perception and production [Bradlow et al., J. Acoust. Soc. Am. 101, 2299-2310 (1997); Wang et al., J. Acoust. Soc. Am. 113, 1033-1043 (2003)] and that production training improves both as well [Hirata, Comp. Assisted Lang. Learning 17, 357-376 (2004)]. However, trainees were able to listen to stimuli during production training, making it unclear whether production training alone transfers to perception. This study systematically controls both training modalities so they can be directly compared and introduces a third training methodology that includes both perception and production. All three training paradigms proved effective. While perception and production trainees primarily made gains in perception, combination trainees made gains in production. The effectiveness of each training modality depended on the nature of the contrast being trained and the modality of the test.

Improving awareness of cancer clinical trials among Hispanic patients and families: audience segmentation decisions for a media intervention.

Clinical trials hold great promise for cancer treatment; yet, Hispanic cancer patients have low rates of clinical trial participation. Lack of awareness and knowledge of clinical trials and language barriers may account for low participation rates. Patient education through audiovisual materials can improve knowledge of and attitudes toward clinical trials among Hispanic populations. In this study, 36 Hispanic cancer patients/survivors and caregivers in Florida and Puerto Rico participated in focus groups to aid in developing a Spanish-language DVD and booklet intervention designed to increase knowledge about clinical trials. Focus group results showed (a) low levels of knowledge about clinical trials, (b) uncertainty about why a physician would expect a patient to make a choice about treatment, and (c) desire for family participation in decision making. Respondents expressed various preferences for aspects of the DVD such as showing extended family in the DVD and physician explanations about key terms. On the basis of these preferences, the authors developed a creative brief for a DVD. The content of the DVD was reviewed by Hispanic community leaders and key stakeholders. A final DVD was created, in Spanish, using Hispanic patients and physicians, which contained the information deemed important from the focus groups and stakeholder interviews. The DVD is complete with companion booklet and currently undergoing a randomized control trial.

Between black and brown: blaxican (black-Mexican) multiracial identity in California.

This article explores the racial/ethnic identities of multiracial Black-Mexicans or "Blaxicans." In-depth interviews with 12 Blaxican individuals in California reveal how they negotiate distinct cultural systems to accomplish multiracial identities. I argue that choosing, accomplishing, and asserting a Blaxican identity challenges the dominant monoracial discourse in the United States, in particular among African American and Chicana/o communities. That is, Blaxican respondents are held accountable by African Americans and Chicanas/os/Mexicans to monoracial notions of "authenticity." The process whereby Blaxicans move between these monoracial spaces to create multiracial identities illustrates crucial aspects of the social construction of race/ethnicity in the United States and the influence of social interactions in shaping how Blaxicans develop their multiracial identities.

Preparing underemployed Latino U.S. nurses through the Mexico NCLEX-RN Success Program.

The critical nursing shortage in U.S. communities along the United States-Mexico border is compounded by the need for nurses who are linguistically and culturally concordant with the growing number of Latinos in these communities. The innovative 16-week Mexico NCLEX-RN Success Program responds to this need by helping underemployed Latino nurses, who were educated in Mexico and live in the United States, adapt linguistically and culturally to multiple-choice testing. Ten of the program students have taken the NCLEX-RN with a 50% pass rate, which is twice as high as the internationally educated candidate passing average. This demonstrates potential for the program to build the human capacity of U.S. communities along the United States-Mexico border by infusing linguistically and culturally concordant nurses into the workforce and materializing the dream of underemployed Latino nurses to implement their hard-earned and urgently needed nursing skills. Lessons learned from the program are discussed.

Psychosocial correlates of HIV sexual protective behavior among Puerto Rican women residing in the Bronx, New York.

In this study, correlates of HIV sexual protective behavior, in the form of condom use, were examined within a population of urban women identified as at increased heterosexual risk for HIV infection. Hierarchical regression analyses were used to analyze data collected via structured interviews for 187 Puerto Rican women recruited from the waiting areas of a comprehensive health clinic in the Bronx, New York. Increased condom use with primary partners was associated with higher levels of mastery, more non-Hispanic acculturation, and greater adherence to traditional female gender roles. Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self-efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.

Familias Apoyadas: Latino families supporting each other for diabetes care.

This study was undertaken to improve the cultural and linguistic sensitivity of an established parent-mentor training curriculum for Latino parents of young children newly diagnosed with type 1 diabetes. The cultural sensitivity of curriculum components was determined by interviewing four Latino mothers raising five children (aged 7 to 12 years) with type 1 diabetes. The mothers recommended offering resources in English and Spanish, including access to bilingual taxi service, providing access to family diabetes education on child development and preparation of healthy traditional cultural foods, and training for babysitting children with diabetes. They also suggested offering after-school and weekend diabetes clinics to decrease interference with work and school activities.

Spanish-English bilingual psychotherapists: personal and professional language development and use.

The rapid rise of the Spanish-speaking population in the United States has resulted in an increased demand for Spanish language mental health services. Yet little is known about the training needs of practitioners who provide those services. This qualitative study used in-depth telephone interviews to examine the experiences of 13 Spanish-English bilingual therapists, both native Spanish speakers and heritage speakers of Spanish, in their personal and professional language development and use. The phenomenological analysis highlighted the complexities of living in 2 worlds and providing psychological services in 2 languages. Participants reported that they often felt isolated and disconnected as they struggled to learn and use the 2 languages in their personal and professional lives. While the participants took pride in having the skills of speaking 2 languages and serving a community that is in need, all were aware of their limitations when working bilingually, as they had not received training to do so. Translating their own thoughts during the session, using technical vocabulary, and understanding the variations of Spanish were particularly challenging for the participants who were heritage speakers.

Results of an osteoporosis educational intervention randomized trial in a sample of Puerto-Rican women.

The purpose of this study was to determine the effects of an osteoporosis educational intervention on knowledge, health beliefs, and self-efficacy in college-age Puerto Rican women. The Health Belief Model and Purnell Model formed the theoretical framework for the study. Three hypotheses were tested with a convenience, randomized sample of 51 experimental and 54 control subjects, ages 18-25. The findings support the hypotheses that educational intervention improved osteoporosis knowledge, health beliefs, but had no effect on self-efficacy. Results and directions for future research are discussed.

Health-related characteristics and preferred methods of receiving health education according to dominant language among Latinos aged 25 to 64 in a large Northern California health plan.

BACKGROUND: Latinos are a fast growing segment of the U.S. health care population. Acculturation factors, including English fluency, result in an ethnic group heterogeneous with regard to SES, health practices, and health education needs. This study examined how demographic and health-related characteristics of Spanish-dominant (SD), Bilingual (BIL), and English-dominant (ED) Latino men and women aged 25-64 differed among members of a large Northern California health plan. METHODS: This observational study was based on data from cohorts of 171 SD (requiring an interpreter), 181 BIL, and 734 ED Latinos aged 25-64 who responded to random sample health plan member surveys conducted 2005-2006. Language groups were compared separately by gender on education, income, behavioral health risks (smoking, obesity, exercise frequency, dietary practices, health beliefs), health status (overall health and emotional health, diabetes, hypertension, high cholesterol, heartburn/acid reflux, back pain, depression), computer and Internet access, and health education modality preferences. RESULTS: Compared with ED Latinos, higher percentages of the SD and BIL groups had very low educational attainment and low income. While groups were similar in prevalence of diabetes, hypertension, and high cholesterol, SD were less likely than ED Latinos to rate overall health and emotional well-being as good, very good, or excellent and more likely to report heartburn and back pain (women only). The groups were similar with regard to smoking and obesity, but among women, SD were more likely to be physically inactive than ED, and BIL were less likely than SD and ED groups to eat <3 servings of fruit/vegetables per day. SD and BIL of both genders were significantly less likely than ED Latinos to believe that health practices had a large impact on health. Compared to ED men and women, SD and BIL Latinos had significantly lower Internet and computer access. As a result, SD Latinos had a greater preference for lower technology health education modalities such as videos and taped phone messages. CONCLUSION: There are important differences among Latinos of different English language proficiency with regard to education, income, health status, health behaviors, IT access, and health education modality preferences that ought to be considered when planning and implementing health programs for this growing segment of the U.S. population.