ABSTRACT
BACKGROUND: In the past two decades, melanoma incidence among Hispanic people has risen greatly. This qualitative study explored Hispanic people's perceived barriers and facilitators to skin cancer-related preventive behaviors. METHODS: Five focus groups among Hispanic people (2 in Spanish and 3 in English; n = 34; 11 Spanish-preferring and 23 English-preferring) were conducted, where participants discussed their perceptions and behaviors relating to skin cancer, sun protection, and skin self-examination. Additionally, healthcare providers (n = 9) and Hispanic community leaders (n = 6) were recruited for individual interviews to complement the results of focus groups. A thematic analysis was conducted on all transcripts. RESULTS: Perceived barriers to sun protection included: 1) Low levels of knowledge and awareness/misperception; 2) low perceived importance or not a priority, 3) economic issues or limited access, 4) downsides/concerns about engaging in sun protection behaviors, and 5) Hispanic cultural norms (e.g., machismo). Facilitators to sun protection included: 1) relevance/care for family, 2) negative consequences of sun exposure, and 3) Hispanic cultural norms (e.g., familismo). Barriers to skin examination included: 1) low levels of knowledge and awareness, 2) lack of insurance coverage or access, and 3) difficulty or discomfort associated with practicing skin self-examination. Facilitators to skin examination included: 1) relevance/previous experience and 2) having insurance coverage or access. CONCLUSIONS: Future interventions should focus on individual, community, and system-level strategies to address misperceptions in the Hispanic community, increase knowledge and awareness, address perceptions of cultures regarding skin cancer preventive activities, and emphasize the importance or priority of health issues related to skin cancer.
Subject(s)
Focus Groups , Health Knowledge, Attitudes, Practice , Hispanic or Latino , Qualitative Research , Skin Neoplasms , Humans , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Female , Skin Neoplasms/prevention & control , Skin Neoplasms/ethnology , Male , Adult , Middle Aged , Sunscreening Agents/administration & dosage , Sunscreening Agents/therapeutic use , Self-Examination , Aged , Health Services Accessibility , Young AdultABSTRACT
OBJECTIVES: Hispanic/Latinx youth vary in their immigration heritage (e.g., country of origin, familial migration history, etc.) and the structure of their communities. This study is a qualitative exploration of Hispanic/Latinx youth experiences of cultural stress in Miami and Los Angeles in 2021. METHOD: A total of 23 Hispanic/Latinx adolescents in Los Angeles (n = 12) and Miami (n = 11) provided in-depth interviews to assess: (a) appraisals of family immigration history and (b) experiences across three cultural stressors: sociopolitical, language brokering, and intragroup marginalization. Interviews were analyzed using a general inductive analytic approach and case comparison methodology to assess differences across sites. RESULTS: For appraisals of family immigration history, gratitude and hope emerged as positive emotions experienced when youth reflected on their immigrant origins. Miami participants reported perceived worsening of sociopolitical stress as a result of changes in political administration whereas participants in Los Angeles felt a sense of relief. Participants in Miami and Los Angeles reported similar strengths and challenges in language brokering with COVID-19 variedly impacting youth's perceived language brokering stress. Last, to youth intragroup marginalization experienced from family members was experienced as more detrimental than from peers, and they reported the use of cognitive reframes to cope. CONCLUSION: Cultural stressors are dynamic and diverse. This study further informs cultural stress theory by cataloging how families' immigration history and national current events inform experiences of stress among youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
Hispanic or Latino , Qualitative Research , Stress, Psychological , Humans , Hispanic or Latino/psychology , Female , Adolescent , Los Angeles , Male , Stress, Psychological/ethnology , Stress, Psychological/psychology , Florida , COVID-19/psychology , COVID-19/ethnology , Emigrants and Immigrants/psychology , SARS-CoV-2ABSTRACT
The recent COVID-19 global emergency may have ripple effects on mental health of many people worldwide. This is especially true for populations like birthing and postpartum women where many changes to daily routines, access to medical care, work-related routines and socialization were experienced. This brief report presents data from an ongoing cohort study aiming to describe maternal mental health during the pandemic T12 (March 2020 to April 2021) with post-pandemic T2 (May 2022 to May 2023) of mothers followed in Puerto Rico. 47 out of 100 mothers have been recalled and assessed with psychosocial interviews (COPE-IUS) and assessments of anxiety (GAD-7) and depression (PHQ-9). Paired t-test revealed mean scores of depressions (PHQ-9) were significantly higher for T2 with a mean of 6.35 and a range of 4.4+/- than for T1 where mean was 5.15 (+/- 2.9), t=-1.954, df=45, p < .05. Similarly, anxiety scores (GAD-7) were significantly higher in T2 6.67 (4.2) than for T1 5.35 (3.7), t=-1.8, df=45, p < .05. Also, COPE-IUS Post-pandemic psychosocial interview results evidence that 80% of mothers do not feel the COVID-19 pandemic is a significant stressor at T2 and are able to maintain routine activities with no social distancing measures. However, reports of loneliness, sadness, worry, and fear continue to be present. Our findings point to the need to further identify other contributing factors to the deterioration of maternal mental health during the perinatal/peripartum period (pregnancy, birth, and postpartum) in Puerto Rico. Possibly the effects of repeated adversity that has been present in the island (multiple environmental stressors, history of traumatic experiences, and constant hardships) may all have cumulative impact over maternal mental health during the perinatal/peripartum period.
Subject(s)
Anxiety , COVID-19 , Hispanic or Latino , Mental Health , Humans , Female , COVID-19/psychology , COVID-19/epidemiology , Puerto Rico , Hispanic or Latino/psychology , Adult , Cohort Studies , Anxiety/epidemiology , Mothers/psychology , Young Adult , Depression/epidemiology , Pregnancy , Maternal Health , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Postpartum Period/psychologyABSTRACT
Differences in acoustic environments have previously been linked to socioeconomic status (SES). However, it is crucial to acknowledge that cultural values can also play a significant role in shaping acoustic environments. The goal of this study was to investigate if social behaviors related to cultural heritage and SES could help us understand how Latinx and European college students in the U.S. have different acoustic environments. College students were given digital recorders to record their daily acoustic environments for two days. These recordings were used to (1) evaluate nearfield noise levels in their natural surroundings and (2) quantify the percentage of time participants spent on behavioral collectivistic activities such as socializing and interacting with others. Behavioral collectivism was examined as a mediator between cultural heritage, SES, and nearfield noise levels. Findings revealed that both SES and cultural heritage were associated with nearfield noise levels. However, behavioral collectivism mediated the relationship between culture and nearfield noise levels. These findings show that collectivist cultural norms significantly relate to Latinx' daily noise levels. The implications of these findings for public health and health inequities included promoting equitable auditory well-being and better knowledge of socio-cultural settings.
Subject(s)
Acoustics , Hispanic or Latino , Noise , Humans , Female , Male , Young Adult , Noise/adverse effects , Hispanic or Latino/psychology , Adult , White People/psychology , Students/psychology , Social Behavior , Adolescent , Social Class , CultureABSTRACT
BACKGROUND: This cross-sectional study explored how masculinity beliefs may influence colorectal cancer (CRC) screening participation among ethnic subgroups of screening-age-eligible (45-75 years) Hispanic/Latino men. METHODS: Using a consumer panel, we recruited self-identified Hispanic/Latino men fluent in English or Spanish, and residing in Florida, New York, or Texas. The Masculinity Barriers to Medical Care (MBMC) scale and its six subscales were used to assess masculinity beliefs. Multivariable logistic regression was used to estimate the association between MBMC and CRC screening participation, adjusting for Hispanic/Latino subgroup, marital status, survey language, age group, and health insurance status. Results were then stratified by Hispanic/Latino subgroup. RESULTS: Of the participants (n=611), approximately 31% identified as Puerto Rican, 30% as other Hispanic/Latino, 26% as Mexican, and 14% as Cuban; 63% had ever been screened for CRC. We found no differences in the prevalence of screening participation by Hispanic/Latino subgroup. The majority of participants had completed both a stool-based test and an exam-based screening test (29.3%). After adjusting for confounding, MBMC reduced the odds of screening participation. Slight MBMC-subscale differences were observed by Hispanic/Latino subgroup. For example, higher scores on the Restrictive Emotionality subscale were associated with a lower likelihood of screening participation among Puerto Rican men, but higher odds of screening for Cuban men. CONCLUSIONS: Masculinity barriers to CRC screening may exist. Tailored interventions to address masculinity barriers among specific Latino subgroups may improve CRC screening uptake in this population.
Subject(s)
Colorectal Neoplasms , Early Detection of Cancer , Hispanic or Latino , Masculinity , Humans , Male , Middle Aged , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/psychology , Colorectal Neoplasms/ethnology , Aged , Early Detection of Cancer/psychology , Early Detection of Cancer/statistics & numerical data , Florida , Cross-Sectional Studies , Texas/epidemiology , New York , Patient Acceptance of Health Care/psychology , Patient Acceptance of Health Care/ethnologyABSTRACT
Importance: Determining the influence of race and ethnicity on change in cognitive test performance has significant implications for clinical practice and research in populations at risk for Alzheimer disease. Objective: To evaluate the significance of race and ethnicity in predicting longitudinal cognitive test performance and to develop models to support evidence-based practice. Design, Setting, and Participants: This prognostic study included baseline and 24-month follow-up data that were obtained from the Health and Aging Brain Study-Health Disparities (HABS-HD) study, an ongoing longitudinal observational study of aging and dementia in a multiracial, multiethnic cohort. Participants included community-dwelling adults and elders living in the Dallas and Fort Worth metropolitan area who were Hispanic and non-Hispanic adults older than the age of 50 years and were cognitively unimpaired. Exposure: The primary exposure of interest was time, measured in months. Main Outcomes and Measures: Demographic variables included age, sex, education, and race and ethnicity. Cognitive domains included attention and working memory, processing speed, language, memory, and executive functioning. Linear regression models predicted follow-up performance from baseline performance and demographic variables for 13 commonly used neuropsychological tests. Follow-up testing was the primary outcome for all domains. Raw scores from 13 standardized tests were used for analyses. Results: This study included 799 adults who were cognitively unimpaired (352 Hispanic individuals [44.1%]; 447 non-Hispanic individuals [55.9%]; 524 female [65.6%]; mean [SD] age, 65.4 [8.1] years). In the regression models, all 13 follow-up scores were significantly predicted from their respective baseline scores and demographic variables. Baseline performance and education were the most consistent predictors of follow-up scores, contributing to all 13 models. Age was significantly associated with follow-up in 11 models, and sex was significant in 5 models. Race and ethnicity contributed to 10 of 13 models, with Hispanic participants predicted to have poorer follow-up scores than their non-Hispanic White counterparts on each test. Conclusions and Relevance: In this longitudinal study of cognitive change in Hispanic and non-Hispanic older adults who were cognitively unimpaired, standardized regression-based models were influenced by multiple demographic variables, including race and ethnicity. These findings highlight the importance of including race and ethnicity in such cognitive change models. This ability to accurately predict cognitive change is expected to become increasingly important as clinical practice and clinical trials need to become more diverse and culturally appropriate in this burgeoning global medical and societal crisis.
Subject(s)
Cognition , Hispanic or Latino , Neuropsychological Tests , Humans , Female , Male , Hispanic or Latino/statistics & numerical data , Hispanic or Latino/psychology , Aged , Middle Aged , Longitudinal Studies , Neuropsychological Tests/statistics & numerical data , Cognitive Dysfunction/ethnology , Aged, 80 and over , Aging/psychology , Aging/ethnologyABSTRACT
BACKGROUND: In the past 2 decades, melanoma incidence among Hispanic individuals has risen by 20%. The mortality rate of Hispanic individuals is higher than that for non-Hispanic White individuals. Skin cancer can largely be prevented with regular sun protection, and skin cancer outcomes can be improved through early detection, for example, by skin self-examination. Alarmingly, Hispanic individuals are less aware of the symptoms and harms of skin cancers, tend to have misperceptions regarding the risks and benefits of skin cancer prevention behaviors, and engage in less sun protection behaviors than non-Hispanic White individuals. OBJECTIVE: This study aimed to use a community-engaged approach and conduct both group and individual interviews among Hispanic individuals and relevant key stakeholders to explore the potential design of a mobile-based skin cancer prevention intervention for Hispanic individuals. METHODS: This study used a qualitative design (focus groups and individual interviews). Participants were recruited from local community organizations' social media, local events, and contact lists (eg, email). Zoom interviews were conducted to examine whether Hispanic individuals would be interested in a mobile-based skin cancer intervention and to explore their preferences and suggestions to inform skin cancer prevention intervention design. RESULTS: Five focus groups (2 in Spanish and 3 in English) among self-identified Hispanic individuals (n=34) and 15 semistructured, in-depth individual interviews among key stakeholders (health care providers and community leaders; eg, dermatologist, nurse practitioner, licensed social worker, and church leader) were conducted. The main themes and subthemes emerging from the group discussions and individual interviews were organized into the following categories: intervention platform, delivery frequency and format, message design, engagement plan, and activities. WhatsApp and Facebook were identified as suitable platforms for the intervention. Messages including short videos, visuals (eg, images and photographs), and simple texts messages were preferred. Recommendations for message design included personalized messages, personal stories and narratives, culturally relevant design (eg, incorporating family values), and community-trusted sources. Potential engagement and retention recommendations were also discussed. Additional details and exemplar quotes of each theme and subtheme are described. CONCLUSIONS: This study provides important insights and directions for the design of a mobile, digital skin cancer intervention to modify Hispanic individuals' sun protection and skin self-examination behaviors to help improve skin cancer outcomes. Insights gathered from community leaders and health care providers provided valuable additions to the community-derived data. Leveraging popular digital platforms among Hispanic individuals such as WhatsApp or Facebook could be a promising approach to skin cancer prevention. Recommendations from the community included the use of concise videos, illustrative images, clear text messages, tailored communications, narratives featuring personal experiences, designs that reflect cultural significance, and information from sources that are trusted by the community, which provided useful strategies for future intervention design among Hispanic individuals.
Subject(s)
Focus Groups , Hispanic or Latino , Qualitative Research , Skin Neoplasms , Humans , Hispanic or Latino/psychology , Female , Skin Neoplasms/prevention & control , Skin Neoplasms/ethnology , Male , Adult , Middle Aged , AgedABSTRACT
BACKGROUND: Studies evaluating the effects of natural disasters on cancer outcomes are scarce, especially among USA ethnic minority groups, and none have focused on the effects of concurrent natural disasters and the COVID-19 pandemic. The goal of this secondary data analysis is to explore the impact of concurrent exposure to COVID-19 and earthquakes on psychological distress and symptom burden among Puerto Rican cancer survivors. METHODS: This secondary data analysis (n = 101) was part of a longitudinal case-control cohort study (n = 402) aimed at describing unmet psychological needs among Puerto Rican cancer patients and non-cancer subjects previously exposed to Hurricane María in 2017. The research team pooled data from participants (cancer survivors and non-cancer group) from their baseline assessments and from follow-up assessments conducted during January-July 2020 (earthquake and the lockdown period). A descriptive, paired t-test, non-parametric mean rank test, and two-sided Pearson correlation analyses were performed. RESULTS: Psychological distress and cancer symptom burden diminished over time. Resilience was significantly correlated with all the psychological and symptom burden variables during both pre- and post-earthquake and COVID-19 assessment periods. CONCLUSIONS: The results support the role of resilience, social support, and post-traumatic growth as potential protective factors preventing psychological distress and diminishing cancer symptom burden among cancer survivors exposed to natural disasters and the COVID-19 pandemic.
Subject(s)
Anxiety , COVID-19 , Cancer Survivors , Depression , Hispanic or Latino , Natural Disasters , Stress Disorders, Post-Traumatic , Humans , Cancer Survivors/psychology , Male , Female , Middle Aged , COVID-19/psychology , COVID-19/epidemiology , Hispanic or Latino/psychology , Anxiety/epidemiology , Anxiety/psychology , Depression/epidemiology , Depression/psychology , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Adult , Aged , Case-Control Studies , Longitudinal Studies , Puerto Rico/epidemiology , Stress, Psychological/psychology , Psychological Distress , SARS-CoV-2 , Cyclonic Storms , Earthquakes , Symptom BurdenABSTRACT
BACKGROUND: Latino caregivers caring for children under 5 years old who are under resourced, and underserved may be most vulnerable for experiencing mental health problems. Furthermore, Latino families with young children-during the COVID-19 pandemic-were at particular risk for multiple and concurrent stressors and acute adversities. OBJECTIVES: The Family Wellbeing Program (FWP) was designed to strengthen Latino caregivers' mental health and mental well-being, and facilitate their access to mental health supports and service providers. METHODS: Using the principles of community-based participatory research, a university research team and staff from a federally qualified health care center co-developed and implemented the FWP. Pre- and post-implementation focus groups with six staff were conducted and data analysis was guided by the RE-AIM framework. RESULTS: Staff identified implementation challenges related to the pandemic and socioenvironmental factors affecting the reach and participation of Latino families. Staff perceived the program improved caregivers' help-seeking behaviors, yet suggestions for improving the FWP for Latino caregivers were noted. Staff also discussed implementation strategies to sustain future programming. CONCLUSIONS: Implementation strategies along the RE-AIM dimensions were identified to improve the participation of Latino caregivers in future adaptations of the FWP. The implications of this work could show promise for sustaining programs designed to address disparities in mental health among Latino caregivers.
Subject(s)
Caregivers , Community-Based Participatory Research , Health Status Disparities , Hispanic or Latino , Mental Health , Adult , Child, Preschool , Female , Humans , Male , Caregivers/psychology , Focus Groups , Hispanic or Latino/psychology , Program DevelopmentABSTRACT
BACKGROUND: Colorectal cancer (CRC) screening decision aids can inform patients about CRC screening benefits, costs, and procedures. Patients who receive the decision aid report wanting to share the information with their families and friends. We evaluated a CRC screening decision aid on Hispanic patients' communication to their alters and whether patient-alter communication leads to alters' CRC screening intention. METHODS: We conducted a one-arm pre/post study of Hispanic patients and their alters; patients (n = 42) and their alters (n = 19) were recruited from a clinic site in Yakima County, Washington State. Patients viewed a CRC screening decision aid at the clinic site. Survey data from patients and alters were collected via telephone including patients' communication with their alters about CRC screening after viewing the decision aid and alters' intention to be screened for CRC after talking to the patient. RESULTS: Most participants reported sharing CRC information with their alters after viewing the decision aid, and most alters confirmed they had received CRC information from participants (68%). The decision aid was associated with participants' own intention to undergo CRC screening and with alters' intention to be screened for CRC using a fecal occult blood test (p = 0.014) and sigmoidoscopy (p = 0.011). CONCLUSIONS: Patient decision aids have the potential to increase CRC screening behavior beyond the decision aid recipients to their social network. TRIAL REGISTRATION: Trials Registration Number: NCT04444232 "Retrospectively registered."
Subject(s)
Colorectal Neoplasms , Early Detection of Cancer , Hispanic or Latino , Information Dissemination , Humans , Colorectal Neoplasms/ethnology , Colorectal Neoplasms/diagnosis , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Female , Male , Middle Aged , Early Detection of Cancer/psychology , Early Detection of Cancer/statistics & numerical data , Aged , Washington , Decision Support Techniques , Social Support , AdultABSTRACT
Pre-exposure prophylaxis (PrEP) is a highly effective tool to prevent HIV, yet it is underutilized among women. The current study aims to evaluate the awareness, attitudes, and perceptions of PrEP among a large survey sample of Black and Latina women in New York City (NYC). Interviewer-administered surveys were conducted in high HIV incidence neighborhoods in NYC among Black, Latina, and Afro-Latina women who reported recent sex with a man in 2017 (n = 398) and 2018 (n = 405). About 40% of participants were aware of PrEP, whereas 30.4% indicated interest in using it. The top reason for not utilizing it was low HIV risk perception. However, most participants supported the idea that using PrEP meant asserting control over their health (94.1%). Primary care providers and obstetricians/gynecologists were participants' preferred sources for PrEP (91.6%). Across survey cycles, compared to non-Black Latina participants, Black participants had significantly higher PrEP awareness (44.4% vs. 29.1%). PrEP awareness was also significantly higher among survey participants in 2018 (45.2%) than in 2017 (34.3%). Less than half of the participants were aware of PrEP, but those who were aware expressed largely positive attitudes toward the medication. Our findings may inform future PrEP implementation strategies to optimize awareness and access to PrEP among women disproportionately affected by HIV, like focusing on personal empowerment instead of risk-based messaging and training women's sexual health care providers in PrEP provision.
Subject(s)
Black or African American , HIV Infections , Health Knowledge, Attitudes, Practice , Hispanic or Latino , Pre-Exposure Prophylaxis , Adolescent , Adult , Female , Humans , Middle Aged , Young Adult , Anti-HIV Agents/therapeutic use , Anti-HIV Agents/administration & dosage , Black or African American/psychology , Black or African American/statistics & numerical data , Health Surveys , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , HIV Infections/prevention & control , HIV Infections/ethnology , HIV Infections/psychology , New York City/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology , Pre-Exposure Prophylaxis/statistics & numerical data , Sexual Behavior/statistics & numerical data , Sexual Health/ethnologyABSTRACT
Social Identity Theory proposes that a positive in-group social identification fosters students' academic motivation and psychological well-being. The present study, grounded in Social Identity Theory, investigated the roles of racial/ethnicity identity (REI) in the development of school adjustment among Black and Latinx youth as well as the psychological mechanisms underlying these longitudinal associations. We hypothesized that REI would positively predict the development of academic achievement and emotional symptoms. In addition, we hypothesized that the development of school belonging would mediate the predictive effects of REI on the growth of academic achievement and emotional symptoms. Participants were 475 (n = 182 Black, 48.9% female; 293 Latinx, 47.8% female) students in Grades 7-9. Students self-reported their REI, school belonging, and emotional symptoms. Academic achievement was assessed using standardized achievement test scores. The longitudinal mediation models indicated that REI indirectly predicted the development of academic achievement and emotional symptoms through students' sense of school belonging. Specifically, higher REI embedded achievement and lower REI awareness of racism predicted higher school belonging in Grade 7. Higher Grade 7 school belonging in turn predicted faster academic growth in Grade 7 to Grade 9 as well as lower emotional symptoms in Grade 7. In addition, the three dimensions of REI also directly predicted the growth of academic achievement and emotional symptoms in Grades 7-9. The mediated effects were smaller in size than the direct effects. These findings highlight the importance of fostering positive REI and a strong sense of school belonging in promoting school adjustment among racial/ethnic minoritized, academically at-risk youth.
Subject(s)
Academic Success , Black or African American , Hispanic or Latino , Schools , Social Identification , Students , Humans , Female , Male , Adolescent , Hispanic or Latino/psychology , Students/psychology , Longitudinal Studies , Black or African American/psychology , Racism/psychologyABSTRACT
BACKGROUND: Immigrant Latinas (who are foreign-born but now reside in the USA) are at greater risk for developing postpartum depression than the general perinatal population, but many face barriers to treatment. To address these barriers, we adapted the Mothers and Babies Course-an evidence-based intervention for postpartum depression prevention-to a virtual group format. Additional adaptations are inclusion of tailored supplemental child health content and nutrition benefit assistance. We are partnering with Early Learning Centers (ELC) across the state of Maryland to deliver and test the adapted intervention. METHODS: The design is a Hybrid Type I Effectiveness-Implementation Trial. A total of 300 participants will be individually randomized to immediate (N = 150) versus delayed (N = 150) receipt of the intervention, Mothers and Babies Virtual Group (MB-VG). The intervention will be delivered by trained Early Learning Center staff. The primary outcomes are depressive symptoms (measured via the Center for Epidemiologic Studies-Depression Scale), parenting self-efficacy (measured via the Parental Cognition and Conduct Towards the Infant Scale (PACOTIS) Parenting Self-Efficacy subscale), and parenting responsiveness (measured via the Maternal Infant Responsiveness Instrument) at 1-week, 3-month, and 6-month post-intervention. Depressive episodes (Structured Clinical Interview for DSM-V- Disorders Research Version) at 3-month and 6-month post-intervention will also be assessed. Secondary outcomes include social support, mood management, anxiety symptoms, perceived stress, food insecurity, and mental health stigma at 1-week, 3-month, and 6-month post-intervention. Exploratory child outcomes are dysregulation and school readiness at 6-month post-intervention. Intervention fidelity, feasibility, acceptability, and appropriateness will also be assessed guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. DISCUSSION: This study will be one of the first to test the efficacy of a group-based virtual perinatal depression intervention with Latina immigrants, for whom stark disparities exist in access to health services. The hybrid effectiveness-implementation design will allow rigorous examination of barriers and facilitators to delivery of the intervention package (including supplemental components) which will provide important information on factors influencing intervention effectiveness and the scalability of intervention components in Early Learning Centers and other child-serving settings. REGISTRATION: ClinicalTrials.gov NCT05873569.
Subject(s)
Depression, Postpartum , Hispanic or Latino , Female , Humans , Infant , Infant, Newborn , Pregnancy , Depression, Postpartum/ethnology , Depression, Postpartum/therapy , Depression, Postpartum/psychology , Depression, Postpartum/prevention & control , Depression, Postpartum/diagnosis , Emigrants and Immigrants/psychology , Hispanic or Latino/psychology , Maryland , Mother-Child Relations , Mothers/psychology , Parenting/psychology , Parenting/ethnology , Randomized Controlled Trials as Topic , Self Efficacy , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: Cancer predisposition syndromes (CPS) impact about 10% of patients with pediatric cancer. Genetic testing (CPS-GT) has multiple benefits, but few studies have described parent and child knowledge and attitudes regarding CPS-GT decision-making. This study examined parent and patient CPS-GT decision-making knowledge and attitudes. PROCEDURE: English- or Spanish-speaking parents of children with pediatric cancer and patients with pediatric cancer ages 15-18 within 12 months of diagnosis or relapse were eligible to participate. Seventy-five parents and 19 parent-patient dyads (N = 94 parents, 77.7% female, 43.6% Latino/a/Hispanic; 19 patients, 31.6% female) completed surveys measuring CPS-GT-related beliefs. Independent samples t-tests compared parent responses across sociodemographic characteristics and parent-patient responses within dyads. RESULTS: Spanish-speaking parents were significantly more likely than English-speaking parents to believe that CPS-GT not being helpful (p < .001) and possibly causing personal distress (p = .002) were important considerations for deciding whether to obtain CPS-GT. Parents with less than four-year university education, income less than $75,000, or Medicaid (vs. private insurance) were significantly more likely to endorse that CPS-GT not being helpful was an important consideration for deciding whether to obtain CPS-GT (p < .001). Parents felt more strongly than patients that they understood what CPS-GT was (p = .01) and that parents should decide whether patients under 18 should receive CPS-GT (p = .002). CONCLUSIONS: Spanish-speaking parents and parents with lower socioeconomic statuses were more strongly influenced by the potential disadvantages of CPS-GT in CPS-GT decision-making. Parents felt more strongly than patients that parents should make CPS-GT decisions. Future studies should investigate mechanisms behind these differences and how to best support CPS-GT knowledge and decision-making.
Subject(s)
Genetic Predisposition to Disease , Genetic Testing , Health Knowledge, Attitudes, Practice , Parents , Humans , Female , Male , Adolescent , Parents/psychology , Adult , Child , Neoplasms/genetics , Neoplasms/psychology , Neoplasms/diagnosis , Decision Making , Surveys and Questionnaires , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Hispanic or Latino/genetics , Middle Aged , Sociodemographic Factors , Socioeconomic FactorsABSTRACT
Introduction: The purpose of this study is to culturally adapt the Awareness and Beliefs about Cancer (ABC) measure for use in the Hispanic/Latino population living in the United States (US). Methods: In accordance with Patient Reported Outcomes (PRO) Consortium guidelines for cross-cultural adaptation of measures for content and linguistic validity, we conducted: two forward-translations, reconciliation, two back-translations, revision and harmonization, six cognitive interviews, revision, external expert review, and finalization of the version. We used a mixed methods approach, conducting cognitive interviews with Hispanic/Latino community members while also convening an expert panel of six clinicians, health professionals, and community representatives and including the in the entire process. After cross-culturally adapting the ABC measure, we assessed the psychometric properties of the instrument using item response theory analysis. Item parameters, discrimination and category thresholds, and standard errors were calculated. For each of the adapted subdomains, we used item information curves to report the graphical profile of item effectiveness. Results: Twenty-two Hispanic/Latino community members were enrolled in cognitive interviews, and Hispanics/Latinos fluent in Spanish completed the measure to assess its psychometric properties. Cognitive interviews revealed opportunities to improve items. Key changes from the original measure include the inclusion of gender inclusive language and an inquiry into e-cigarette use on items related to smoking habits. Psychometric property analyses revealed that the anticipated delay in seeking medical help, general cancer beliefs, and cancer screening beliefs and behaviors subdomains had some slope parameters that were < 1; this implies that those items were not able to adequately discriminate the latent trait and had poor performance. Discussion: The adapted ABC measure for US Hispanics/Latinos meets content and linguistic validity standards, with construct validity confirmed for cancer symptom recognition and barriers to symptomatic presentation subdomains, but revisions are necessary for others, highlighting the need for ongoing refinement to ensure the cultural appropriateness of instruments.
Subject(s)
Health Knowledge, Attitudes, Practice , Hispanic or Latino , Neoplasms , Psychometrics , Humans , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Female , Male , United States , Middle Aged , Adult , Surveys and Questionnaires , Cross-Cultural Comparison , AgedABSTRACT
BACKGROUND: Exercise interventions often improve moderate to vigorous physical activity, but simultaneously increase sedentary time due to a compensatory resting response. A higher level of sedentary time is associated with a lower level of executive function, while increased moderate to vigorous physical activity is associated with improved global cognition and working memory among Latino adults. Latino adults are the fastest-growing minority group in the United States and are at high risk for cognitive decline, spend more time sedentary compared to non-Hispanic populations, and engage in low levels of physical activity. Interventions that are culturally appropriate for Latino adults to replace sedentary time with physical activity are critically needed. OBJECTIVE: This study aims to develop and test the feasibility and acceptability of an ecological momentary intervention (EMI; delivered in real time) that is individually designed to replace sedentary time with physical activity in Latino adults. METHODS: This pilot study randomized 39 (n=26, 67% female; mean age 61, SD 5.8 years) community-dwelling, Spanish-speaking Latino adults (1:1 allocation) to either a 6-week EMI program designed to replace sitting time with physical activity (20/39, 51%) or physical activity guidelines education (19/39, 49%). The program was conducted on the web and in Spanish. The intervention was individualized based on individual interview responses. The intervention included the use of a Fitbit activity monitor, weekly didactic phone meetings, interactive tools (SMS text messages), and coach-delivered feedback. Feasibility and acceptability were assessed via study satisfaction (Likert scales), motivation (ecological momentary assessment), retention, and compliance. Sedentary time and physical activity were assessed via 7-day actigraphy. Cognitive performance was assessed via the trail making test part A and B (part B=executive function) and via the National Institutes of Health Toolbox remote cognitive assessment. Statistical analysis included a linear model on change score from baseline, adjusting for age, sex, and education, emphasizing effect size. RESULTS: Participant satisfaction with EMI was high (9.4/10), with a high degree of motivation to replace sitting time with physical activity (9.8/10). The intervention compliance rate was 79% with low difficulty using the Fitbit (1.7/10). Weekly step count increased in the intervention group by 5543 steps (group difference: d=0.54; P=.05) and sedentary time decreased by a mean 348 (SD 485) minutes (group difference: d=0.47; P=.24) compared to controls, with moderately strong effect sizes. The trail making test part B improved in the intervention group (mean -35.26, SD 60.35 seconds), compared to the control group (mean 7.19, SD 46 seconds; group difference: d=0.74; P=.01). No group differences were observed in other cognitive measures. CONCLUSIONS: An individualized EMI designed for midlife and older Latino adults has the potential to replace sitting time with physical activity and improve executive functioning. The intervention was feasible and well received with a high degree of satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov NCT04507464; https://tinyurl.com/44c4thk5.
Subject(s)
Executive Function , Exercise , Hispanic or Latino , Sedentary Behavior , Humans , Pilot Projects , Female , Male , Middle Aged , Hispanic or Latino/psychology , AgedABSTRACT
BACKGROUND: Pre-exposure prophylaxis (PrEP) is a highly effective pharmaceutical intervention that prevents HIV infection, but PrEP uptake across the US has been slow among men who have sex with men (MSM), especially among Black/African American (B/AA) and Hispanic /Latino (H/L) MSM. This study investigates the acceptability and essential components of a peer-driven intervention (PDI) for promoting PrEP uptake among MSM, with a specific focus on B/AA and H/L communities. METHODS: We conducted 28 semi-structured, qualitative interviews with MSM in southern New England to explore the components of a PDI, including attitudes, content, and effective communication methods. A purposive sampling strategy was used to recruit diverse participants who reflect the communities with the highest burden of HIV infection. RESULTS: Of 28 study participants, the median age was 28 years (interquartile range [IQR]: 25, 35). The sample comprised B/AA (39%, n = 11) and H/L (50%, n = 14) individuals. Notably, nearly half of the participants (46%) were current PrEP users. We found that many participants were in favor of using a PDI approach for promoting PrEP. Additionally, several participants showed interest in becoming peer educators themselves. They emphasized the need for strong communication skills to effectively teach others about PrEP. Moreover, participants noted that peer education should cover key topics like how PrEP works, how effective it is, and any possible side effects. CONCLUSIONS: Our study shows that effective PDIs, facilitated by well-trained peers knowledgeable about PrEP, could enhance PrEP uptake among MSM, addressing health disparities and potentially reducing HIV transmission in B/AA and H/L communities.
Subject(s)
HIV Infections , Homosexuality, Male , Peer Group , Pre-Exposure Prophylaxis , Qualitative Research , Humans , Male , Pre-Exposure Prophylaxis/statistics & numerical data , Pre-Exposure Prophylaxis/methods , Homosexuality, Male/psychology , Homosexuality, Male/statistics & numerical data , Adult , HIV Infections/prevention & control , New England , Interviews as Topic , Black or African American/statistics & numerical data , Black or African American/psychology , Patient Acceptance of Health Care/statistics & numerical data , Patient Acceptance of Health Care/psychology , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Anti-HIV Agents/therapeutic use , Anti-HIV Agents/administration & dosageABSTRACT
OBJECTIVES: This article explores the stages where trauma is experienced (123s) and its physiopsychological impact (affect, behavior, and cognitions [ABCs]) in unaccompanied Latinx Minors through the analysis of a composite case study. Unaccompanied Latinx Minors represent a unique and growing population in the United States that warrants careful consideration from a trauma-informed and resilience-based framework. METHOD: A detailed case study was implemented, triangulating caregiver and client therapy records to illustrate the framework of stages of trauma exposure (123s) and physiopsychological impact (ABCs). RESULTS: Latinx children often encounter various potentially traumatic experiences and adverse childhood experiences at the following stages (123s): (1) Preimmigration; (2) During immigration; and (3) Postimmigration. The extended traumas experienced by immigrant youth may easily constitute toxic stress. Moreover, once in the destination country, youth may lack coping resources or encounter stressful circumstances that prolong or exacerbate the impact of previous traumas. This continuous physiological hyperarousal can also result in changes in brain neurobiology, which further compounds the experience of other symptoms (Krupnik, 2021). These potentially complex trauma responses may manifest for these children through ABCs. The cumulative impact of these incidents may have significant effects on minors' A. Affective, B. Behavioral, and C. Cognitive functioning. CONCLUSIONS: Relevant clinical implications and policy recommendations for addressing the multifaceted needs of unaccompanied Latinx minors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Subject(s)
Hispanic or Latino , Minors , Humans , Hispanic or Latino/psychology , Adolescent , Female , Male , Minors/psychology , United States , Child , Adaptation, Psychological , Cognition , Emigrants and Immigrants/psychology , Adverse Childhood Experiences , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/ethnologyABSTRACT
BACKGROUND: Latino/a youth are at increased risk of electronic (e)-cigarette or electronic nicotine delivery systems (ENDS) use; thus, identifying factors impacting initiation is critical. Parenting practices reflecting warmth (e.g., relationship quality) and control (e.g., parental monitoring) and substance use-specific parenting (e.g., reactions to use, parenting self-efficacy) may influence youth substance use. For Latino/a youth, tensions from intergenerational acculturative differences are linked to substance use. We investigated ENDS use-specific parenting as a mediator between general parenting and youth ENDS use, examining whether acculturative gap conflict moderated the association between general and ENDS use-specific parenting. We expected mediation among families experiencing low acculturative gap conflicts. METHOD: Data were analyzed over two waves from a predominantly White and Latino/a sample of caregiver-child dyads (N = 143) who identified with a culture in addition to or distinct from American. Youth (Mage = 14.9 years, SD = 0.67; 62.9% female) reported relationship quality, parental monitoring, caregiver ENDS attitudes and reactions, acculturative gap conflicts, and ENDS use. Caregivers reported on ENDS use-specific parenting self-efficacy. Two moderated multiple mediator regression models (i.e., relationship quality, parental monitoring) were estimated. RESULTS: Among youth reporting low and mean levels of acculturative gap conflict, ENDS use-specific parenting self-efficacy mediated the association between relationship quality and reduced ENDS use. There was no evidence for an interaction in the parental monitoring model. CONCLUSIONS: In families experiencing low levels of acculturative gap conflict, relationship quality may impact ENDS use through caregivers' confidence in their ability to prevent child ENDS use.
Subject(s)
Acculturation , Parenting , Humans , Parenting/psychology , Female , Male , Adolescent , Hispanic or Latino/psychology , Electronic Nicotine Delivery Systems , Vaping/psychology , Parent-Child Relations , Self Efficacy , AdultABSTRACT
OBJECTIVE: This study derived parent-child acculturative stress (AS) profiles to evaluate how dyadic AS relates to parental expressed emotion (EE) and academic achievement. METHOD: A sample of 284 Latinx youth (Mage = 11.5 years; 55.6% female) and their parents completed The Acculturative Stress Measure, and AS profiles were obtained using latent profile analyses (LPA). Profiles were compared across two outcomes: child and parent reports of parental EE using the Brief Dyadic Scale of Expressed Emotion, which measures parental warmth, criticism, and emotional overinvolvement (EOI), and child standardized test scores. RESULTS: Four AS profiles emerged using LPA fit indices: high child-low parent (HCLP; 7.7%), low child-high parent (LCHP; 13.4%), moderate child-low parent (MCLP; 14.4%), and low child-low parent (LCLP; 64.4%). Youth and parents in profiles reporting higher AS reported higher EE, particularly EOI. Youth in profiles characterized by greater AS obtained lower test scores. CONCLUSION: Parent and child dyads can experience different levels of AS. Higher dyadic AS was associated with worse perceived parental attitudes, as measured by EE, and lower academic achievement. Parental EE subscale differences varied based on the informant and their AS level. Findings underscore the importance of considering cultural factors and incorporating multiple family member experiences to meet the needs of Latinx families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).