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1.
MMWR Morb Mortal Wkly Rep ; 70(40): 1395-1400, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34618795

RESUMO

Hispanic or Latino* (Hispanic) persons are disproportionately affected by HIV in the United States. In 2019, Hispanic persons accounted for 18% of the U.S. population, but for 29% of new diagnoses of HIV infection (1). The Ending the HIV Epidemic in the U.S. (EHE) initiative aims to reduce new HIV infections by 90% by 2030 (2). Preexposure prophylaxis (PrEP), medication taken to prevent acquisition of HIV, is an effective strategy for preventing HIV infection.† To examine PrEP awareness and referral to providers among Hispanic persons, CDC analyzed 2019 National HIV Prevention Program Monitoring and Evaluation HIV testing data. Approximately one quarter (27%) of Hispanic persons tested for HIV at CDC-funded sites (n = 310,954) were aware of PrEP, and 22% of those who received a negative HIV test result and were eligible for referral (111,644) were referred to PrEP providers. PrEP awareness and referrals among Hispanic persons were lower compared with those among non-Hispanic White persons. Among Hispanic persons, significant differences were found in PrEP awareness and referrals by age, gender, race, population group, geographic region, and test setting. HIV testing programs can expand PrEP services for Hispanic persons by implementing culturally and linguistically appropriate strategies that routinize PrEP education and referral, collaborating with health care and other providers, and addressing social and structural barriers.


Assuntos
Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Profilaxia Pré-Exposição , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Adulto , Feminino , Infecções por HIV/etnologia , Teste de HIV , Disparidades nos Níveis de Saúde , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
2.
PLoS One ; 16(10): e0257940, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618834

RESUMO

The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Fatores de Risco de Doenças Cardíacas , Hipertensão/epidemiologia , Aculturação , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/psicologia , Criança , Colesterol/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Diabetes Mellitus/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Hipertensão/sangue , Hipertensão/patologia , Hipertensão/psicologia , Masculino , Americanos Mexicanos/psicologia , Características de Residência , Fumar , Estresse Psicológico/fisiopatologia
3.
J Abnorm Psychol ; 130(7): 748-760, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34516171

RESUMO

Experiencing eating disorder symptoms is associated with maladaptive outcomes and impairment in functioning. A paucity of research exists examining eating disorder symptoms among ethnic/racial minority women. Using a network analysis, we evaluated core symptoms of eating disorder psychopathology and the degree of association between eating disorder symptoms in a sample of ethnic/racial minority women. Participants were 296 Black, 261 Hispanic, and 261 Asian American women recruited across the United States to complete an online survey. Inclusionary criteria yielded a sample with high eating disorder psychopathology. The Network Comparison Test was used to identify differences in networks between groups and yielded no significant differences between the three ethnic/racial groups. Thus, one network analysis on the entire sample was conducted in the main analyses. However, separate group analyses are presented in the online supplemental materials. Consistent with the transdiagnostic theory of eating disorders, weight concerns (i.e., strong desire to lose weight and fear of weight gain) emerged as central symptoms. Discrepant from findings with predominantly White samples, purging emerged as a central symptom as well, while shape concerns did not. Interestingly, having to weigh oneself weekly, having a flat stomach, fasting, and compulsive exercising were on the periphery of the network. Findings are discussed in terms of clinical implications and comparative similarities and differences when addressing the existing literature. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Afro-Americanos , Americanos Asiáticos , Transtornos da Alimentação e da Ingestão de Alimentos , Hispano-Americanos , Grupos Minoritários , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Americanos Asiáticos/psicologia , Americanos Asiáticos/estatística & dados numéricos , Transtornos da Alimentação e da Ingestão de Alimentos/etnologia , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Psicopatologia , Inquéritos e Questionários , Estados Unidos
4.
Law Hum Behav ; 45(3): 179-196, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34351202

RESUMO

OBJECTIVES: There are currently 1,308,327 immigrants in removal proceedings, over 80% of whom are Latinx (TRAC, 2021b). This study examined the relation among putative protective markers (i.e. social support, religious support, and legal support) and the emotional and physical well-being of Latinx individuals facing removal proceedings. HYPOTHESES: We hypothesized that increased social support, religious support, and legal support would buffer the negative relations between hopelessness, poor self-efficacy, and well-being measures (depression, anxiety, stress, mental well-being, somatic symptoms, and physical well-being). METHOD: Participants (N = 157; 31.2% men, M age = 33.4 years) had an active immigration court case in Texas and completed a demographic questionnaire, the Beck Hopelessness Scale, General Self-Efficacy Scale, Multidimensional Scale of Perceived Social Support, Multi-Faith Religious Support Scale, Depression, Anxiety, Stress Scale-21, Patient Health Questionnaire-15, and Short Form Health Survey-12. RESULTS: Higher levels of hopelessness and poor self-efficacy were associated with more negative well-being outcomes, while social support was associated with more positive well-being outcomes. Contrary to hypotheses, religious support and legal support served as risk markers independently, while legal support interacted with hopelessness, such that decreased legal support was associated with higher mental well-being at lower levels of hopelessness and interacted with poor self-efficacy, such that increased legal support was associated with poorer mental well-being at lower levels of self-efficacy. All effect sizes were small (rsp2 = .04 to .16). CONCLUSIONS: Targeting hopelessness and poor self-efficacy while promoting social support may help mental health professionals improve the well-being of immigrants in removal proceedings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Deportação , Hispano-Americanos/legislação & jurisprudência , Hispano-Americanos/psicologia , Saúde Mental , Imigrantes Indocumentados/legislação & jurisprudência , Imigrantes Indocumentados/psicologia , Adulto , Idoso , Feminino , Esperança , Humanos , Serviços Jurídicos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Psicometria/instrumentação , Fatores de Risco , Autoeficácia , Apoio Social , Inquéritos e Questionários , Texas/etnologia
5.
Law Hum Behav ; 45(3): 243-255, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34351206

RESUMO

OBJECTIVE: Although researchers, policymakers, and practitioners recognize the importance of the public's perceptions of police, few studies have examined developmental trends in adolescents and young adults' views of police. HYPOTHESES: Hypothesis 1: Perceptions of police legitimacy would exhibit a U-shaped curve, declining in adolescence before improving in young adulthood. Hypothesis 2: At all ages, Black youth would report more negative perceptions of police legitimacy than Latino youth, who would report more negative perceptions than White youth. Hypothesis 3: Perceptions of police bias would be consistently associated with worse perceptions of police legitimacy. METHOD: Utilizing longitudinal data from the Crossroads Study, this study examined within-person trends in males' perceptions of police legitimacy from ages 13 to 22, as well as whether perceptions of police bias were associated with perceptions of police legitimacy. RESULTS: Perceptions of police legitimacy followed a U-shaped curve that declined during adolescence, reached its lowest point around age 18, and improved during the transition to young adulthood. Compared with White youth, Latino and Black youth had shallower curves in perceptions of police legitimacy that exhibited less improvement during the transition to adulthood. Further, perceptions of police bias were consistently associated with more negative perceptions of police legitimacy across races and ages. CONCLUSIONS: While perceptions of police legitimacy may decline during adolescence before improving during the transition to adulthood, perceptions of police bias are consistently negatively related to youth and young adults' perceptions of police legitimacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Atitude/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Hispano-Americanos/psicologia , Percepção , Polícia , Racismo/etnologia , Adolescente , Fatores Etários , Humanos , Aplicação da Lei , Estudos Longitudinais , Masculino , Estados Unidos/etnologia , Adulto Jovem
6.
Nutrients ; 13(8)2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34444850

RESUMO

This scoping review examined intervention and sample characteristics of family-based obesity prevention interventions among Hispanic youth. This review also examined the degree to which existing interventions were culturally-adapted, acknowledged social determinants of health (SDoH), and collaborated with community stakeholders. A comprehensive search across Medline Ovid, Embase, Scopus, PsycInfo, and Pubmed was used to identify 13 studies primarily based in the U.S. (92.3%). Data was extracted by two independent reviewers. Most used a randomized control trial design (69.2%), a behavior change theory (84.6%), and reported moderate to high (≥70%) retention (69.2%). Studies targeted improvements in physical activity (69.2%) and fruit and vegetable intake (92.3%) through nutrition education, cooking demonstrations, and tastings. Younger children from low socioeconomic backgrounds (61.5%) were well represented. Most interventions were culturally-adapted (69.2%), all studies reported collaboration with stakeholders, yet only half used strategies that acknowledged SDoH (46.2%). To increase our understanding of the underlying mechanisms by which family-based approaches can reach and engage Hispanic youth and families, future studies should rigorously evaluate theoretical constructs, family processes, and SDoH that influence program participation and health behaviors. This information will guide the design and development of future interventions aimed at reducing obesity disparities among Hispanic youth.


Assuntos
Terapia Comportamental/métodos , Informação de Saúde ao Consumidor/métodos , Terapia Familiar/métodos , Hispano-Americanos/psicologia , Obesidade/prevenção & controle , Adolescente , Criança , Assistência à Saúde Culturalmente Competente/etnologia , Assistência à Saúde Culturalmente Competente/métodos , Comportamento Alimentar/etnologia , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade/etnologia , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Determinantes Sociais da Saúde/etnologia
7.
Sch Psychol ; 36(5): 335-347, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34383528

RESUMO

Early research on the COVID-19 pandemic has demonstrated differential impact on the Latinx community. There has been limited research exploring the mental health outcomes of the pandemic on Latinx youth. This study explores the severity of pandemic-related stress on Latinx youth considering their resilience factors and previous adverse childhood events (ACEs). Adolescents (n = 142) ages 13-18 completed measures related to exposure to the pandemic, pandemic stress, number of ACEs, resilience factors, and general demographic information. Results of multiple regression analysis found that exposure to the pandemic, ACEs, gender, and resilience factors predicted the levels of stress that youth experienced. No differences in pandemic-related stress were found between Latinx youth and their non-Latinx counterparts. Implications are discussed related to how school psychologists can support all students with culturally sensitive practices as we continue through the pandemic and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Experiências Adversas da Infância/psicologia , COVID-19 , Hispano-Americanos/psicologia , Resiliência Psicológica , Estresse Psicológico/etnologia , Estresse Psicológico/etiologia , Adolescente , Feminino , Humanos , Masculino , Instituições Acadêmicas
8.
Proc Natl Acad Sci U S A ; 118(36)2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34462353

RESUMO

Mounting reports in the media suggest that the COVID-19 pandemic has intensified prejudice and discrimination against racial/ethnic minorities, especially Asians. Existing research has focused on discrimination against Asians and is primarily based on self-reported incidents or nonrepresentative samples. We investigate the extent to which COVID-19 has fueled prejudice and discrimination against multiple racial/ethnic minority groups in the United States by examining nationally representative survey data with an embedded vignette experiment about roommate selection (collected in August 2020; n = 5,000). We find that priming COVID-19 salience has an immediate, statistically significant impact: compared to the control group, respondents in the treatment group exhibited increased prejudice and discriminatory intent against East Asian, South Asian, and Hispanic hypothetical room-seekers. The treatment effect is more pronounced in increasing extreme negative attitudes toward the three minority groups than decreasing extreme positive attitudes toward them. This is partly due to the treatment increasing the proportion of respondents who perceive these minority groups as extremely culturally incompatible (Asians and Hispanics) and extremely irresponsible (Asians). Sociopolitical factors did not moderate the treatment effects on attitudes toward Asians, but prior social contact with Hispanics mitigated prejudices against them. These findings suggest that COVID-19-fueled prejudice and discrimination have not been limited to East Asians but are part of a broader phenomenon that has affected Asians generally and Hispanics as well.


Assuntos
Americanos Asiáticos/psicologia , COVID-19/psicologia , Hispano-Americanos/psicologia , Preconceito , Atitude , COVID-19/etnologia , Humanos , Intenção , Grupos Minoritários/psicologia , Pandemias , Preconceito/etnologia , Racismo/etnologia , Racismo/psicologia , Estados Unidos
9.
PLoS One ; 16(7): e0254127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34242275

RESUMO

Pundits and academics across disciplines note that the human toll brought forth by the novel coronavirus (COVID-19) pandemic in the United States (U.S.) is fundamentally unequal for communities of color. Standing literature on public health posits that one of the chief predictors of racial disparity in health outcomes is a lack of institutional trust among minority communities. Furthermore, in our own county-level analysis from the U.S., we find that counties with higher percentages of Black and Hispanic residents have had vastly higher cumulative deaths from COVID-19. In light of this standing literature and our own analysis, it is critical to better understand how to mitigate or prevent these unequal outcomes for any future pandemic or public health emergency. Therefore, we assess the claim that raising institutional trust, primarily scientific trust, is key to mitigating these racial inequities. Leveraging a new, pre-pandemic measure of scientific trust, we find that trust in science, unlike trust in politicians or the media, significantly raises support for COVID-19 social distancing policies across racial lines. Our findings suggest that increasing scientific trust is essential to garnering support for public health policies that lessen the severity of the current, and potentially a future, pandemic.


Assuntos
Afro-Americanos/psicologia , COVID-19 , Disparidades nos Níveis de Saúde , Hispano-Americanos/psicologia , Pandemias , Distanciamento Físico , SARS-CoV-2 , Confiança , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
10.
J Cross Cult Gerontol ; 36(3): 265-284, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34196838

RESUMO

Clustering Latinos under a single group in Alzheimer Disease (AD) research, neglects, among other things cultural and environmental differences. To address this, we examine knowledge and attitudes about AD among two Latino groups. We held 5 focus groups and 2 interviews all in Spanish with Mexicans and Puerto Ricans between 40 and 60 years old living in the Grand Rapids area in Michigan. Using content analysis of the discussions, we identified themes related to knowledge, attitudes and concerns about AD and caregiving. A total of 20 Mexicans and 9 Puerto Ricans participated. Improving knowledge and awareness, barriers and home-based family care were important themes in both Latino groups. Puerto Rican groups raised more concerns about the disease, whereas lack of knowledge was a key theme among Mexican participants. The exploratory study is a first step in promoting research that is attentive to the commonalities and differences of Latino groups and in continuing efforts to enhance health literacy among these groups.


Assuntos
Doença de Alzheimer , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , México/etnologia , Michigan/epidemiologia , Pessoa de Meia-Idade , Porto Rico/etnologia , Pesquisa Qualitativa
12.
Clin Transl Sci ; 14(6): 2200-2207, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34213073

RESUMO

Understanding and minimizing coronavirus disease 2019 (COVID-19) vaccine hesitancy is critical to population health and minimizing health inequities, which continue to be brought into stark relief by the pandemic. We investigate questions regarding vaccine hesitancy in a sample (n = 1205) of Arkansas adults surveyed online in July/August of 2020. We examine relationships among sociodemographics, COVID-19 health literacy, fear of COVID-19 infection, general trust in vaccines, and COVID-19 vaccine hesitancy using bivariate analysis and a full information maximum likelihood (FIML) logistic regression model. One in five people (21,21.86%) reported hesitancy to take a COVID-19 vaccine. Prevalence of COVID-19 vaccine hesitancy was highest among Black/African Americans (50.00%), respondents with household income less than $25K (30.68%), some college (32.17%), little to no fear of infection from COVID-19 (62.50%), and low trust in vaccines in general (55.84%). Odds of COVID-19 vaccine hesitancy were 2.42 greater for Black/African American respondents compared to White respondents (p < 0.001), 1.67 greater for respondents with some college/technical degree compared to respondents with a 4-year degree (p < 0.05), 5.48 greater for respondents with no fear of COVID-19 infection compared to those who fear infection to a great extent (p < 0.001), and 11.32 greater for respondents with low trust in vaccines (p < 0.001). Sociodemographic differences in COVID-19 vaccine hesitancy raise concerns about the potential of vaccine implementation to widen existing health disparities in COVID-19 related infections, particularly among Black/African Americans. Fear of infection and general mistrust in vaccines are significantly associated with vaccine hesitancy.


Assuntos
Vacinas contra COVID-19/administração & dosagem , COVID-19/prevenção & controle , Vacinação em Massa/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Medo , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Confiança , Adulto Jovem
13.
West J Emerg Med ; 22(3): 660-666, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34125043

RESUMO

INTRODUCTION: Anti-immigrant rhetoric and increased enforcement of immigration laws have induced worry and safety concerns among undocumented Latino immigrants (UDLI) and legal Latino residents/citizens (LLRC), with some delaying the time to care. In this study, we conducted a qualitative analysis of statements made by emergency department (ED) patients - a majority of whom were UDLI and LLRC - participating in a study to better understand their experiences and fears with regard to anti-immigrant rhetoric, immigration enforcement, and ED utilization. METHODS: We conducted a multi-site study, surveying patients in three California safety-net EDs serving large immigrant populations from June 2017-December 2018. Of 1684 patients approached, 1337 (79.4%) agreed to participate; when given the option to provide open-ended comments, 260 participants provided perspectives about their experiences during the years immediately following the 2016 United States presidential election. We analyzed these qualitative data using constructivist grounded theory. RESULTS: We analyzed comments from 260 individuals. Among ED patients who provided qualitative data, 59% were women and their median age was 45 years (Interquartile range 33-57 years). Undocumented Latino immigrants comprised 49%, 31% were LLRC, and 20% were non-Latino legal residents. As their primary language, 68% spoke Spanish. We identified six themes: fear as a barrier to care (especially for UDLI); the negative impact of fear on health and wellness (physical and mental health, delays in care); factors influencing fear (eg, media coverage); and future solutions, including the need for increased communication about rights. CONCLUSION: Anti-immigrant rhetoric during the 2016 US presidential campaign contributed to fear and safety concerns among UDLI and LLRC accessing healthcare. This is one of the few studies that captured firsthand experiences of UDLI in the ED. Our findings revealed fear-based barriers to accessing emergency care, protective and contributing factors to fear, and the negative impact of fear. There is a need for increased culturally informed patient communication about rights and resources, strategic media campaigns, and improved access to healthcare for undocumented individuals.


Assuntos
Racismo , Imigrantes Indocumentados/psicologia , Adulto , California , Serviço Hospitalar de Emergência/organização & administração , Emigração e Imigração/legislação & jurisprudência , Medo/psicologia , Feminino , Acesso aos Serviços de Saúde , Hispano-Americanos/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Política , Pesquisa Qualitativa , Provedores de Redes de Segurança , Imigrantes Indocumentados/estatística & dados numéricos
14.
J Alzheimers Dis ; 82(3): 1203-1218, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34151803

RESUMO

BACKGROUND: The relationships between obesity and cognitive decline in aging are mixed and understudied among Hispanics/Latinos. OBJECTIVE: To understand associations between central obesity, cognitive aging, and the role of concomitant cardiometabolic abnormalities among Hispanics/Latinos. METHODS: Participants included 6,377 diverse Hispanics/Latinos enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation for Neurocognitive Aging (SOL-INCA). Participants were 45 years and older at the first cognitive testing session (Visit 1). Cognitive outcomes (z-score units) included global composite and domain specific (learning, memory, executive functioning, processing speed) measures at a second visit (SOL-INCA, on average, 7 years later), and 7-year change. We used survey linear regression to examine associations between central obesity (waist circumference≥88 cm and≥102 cm for women and men, respectively) and cognition. We also tested whether the relationships between obesity and cognition differed by cardiometabolic status (indication of/treatment for 2 + of the following: high triglycerides, hypertension, hyperglycemia, low high-density lipoprotein cholesterol). RESULTS: Central obesity was largely unassociated with cognitive outcomes, adjusting for covariates. However, among individuals with central obesity, cardiometabolic abnormality was linked to poorer cognitive function at SOL-INCA (ΔGlobalCognition =-0.165, p < 0.001) and to more pronounced cognitive declines over the average 7 years (ΔGlobalCognition = -0.109, p < 0.05); this was consistent across cognitive domains. CONCLUSION: Central obesity alone was not associated with cognitive function. However, presence of both central obesity and cardiometabolic abnormalities was robustly predictive of cognition and 7-year cognitive declines, suggesting that in combination these factors may alter the cognitive trajectories of middle-aged and older Hispanics/Latinos.


Assuntos
Fatores de Risco Cardiometabólico , Envelhecimento Cognitivo/fisiologia , Disfunção Cognitiva/metabolismo , Hispano-Americanos , Testes Neuropsicológicos , Obesidade Abdominal/metabolismo , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Envelhecimento/psicologia , Envelhecimento Cognitivo/psicologia , Disfunção Cognitiva/etnologia , Disfunção Cognitiva/psicologia , Estudos de Coortes , Feminino , Hispano-Americanos/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/etnologia , Obesidade Abdominal/psicologia , Estudos Prospectivos
15.
J Alzheimers Dis ; 82(2): 771-779, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34092634

RESUMO

BACKGROUND: Latinx elders are underrepresented in dementia research. In a previous study we assessed research attitudes in urban minority elders and found a significant minority expressed neutral to negative attitudes relating to trust, safety, and personal responsibility to help research. OBJECTIVE: To assess the impact of a composite intervention on attitudes toward research and research participation among elderly Latinx. The intervention was a collaboratively produced research participation video shown during presentations with our elderly community advisory board (CAB) as co-presenters. METHODS: The video was created by the ADRC and CAB. All senior center attendees were eligible to participate. Afterwards, the Research Attitudes Questionnaire (RAQ) and a brief questionnaire on the impact of the video were administered. Using Wilcoxon Rank Sum Tests, Chi Square, and OLS regressions, RAQ responses were compared to those from a historical cohort from similar centers. RESULTS: 74 in the "Historical Cohort 1" and 104 in "Intervention Cohort 2" were included. RAQ total score was higher in Cohort 2 than Cohort 1 (28.5 versus 26.1, p < 0.05) after controlling for age, education, and country of origin. In response to the question "Has the video influenced your willingness and interest to participate in research", 88.7%of the participants in Cohort 2 reported being "more" or "much more" interested in research. CONCLUSION: Tailoring community research recruitment programs to include relatable peers using novel recruitment techniques may have positive implications for improving enrollment of diverse elderly individuals in research.


Assuntos
Pesquisa Biomédica , Demência , Hispano-Americanos/psicologia , Participação do Paciente , Seleção de Pacientes , Intervenção Psicossocial/métodos , Idoso , Atitude Frente a Saúde , Recursos Audiovisuais , Pesquisa Biomédica/ética , Pesquisa Biomédica/métodos , Diversidade Cultural , Demência/etnologia , Demência/psicologia , Feminino , Humanos , Masculino , Participação do Paciente/métodos , Participação do Paciente/psicologia , Centros Comunitários para Idosos , Estados Unidos , População Urbana/estatística & dados numéricos
16.
Health Secur ; 19(S1): S5-S13, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34014118

RESUMO

Communities of color in the United States have been disproportionately impacted by the COVID-19 pandemic. Studies exploring the mental health implications of these disparities have only just begun to emerge. The purpose of this study is to better understand mental health concerns and test whether social determinants of health and COVID-19-related experiences influence these concerns. In April 2020, we launched a community-based survey for adults across the United States. A total of 341 respondents completed the survey, which included questions about demographics, depression, social isolation, work environment, and preexisting mental health conditions. We generated matched controls by adding county data from the Robert Wood Johnson Foundation to our survey. Chi square, Pearson product-moment correlation, point biserial correlation, and logistic regression were estimated. Our analysis revealed that respondents who identified as Latinx, Latin@, or Hispanic were 10 times more likely to meet the threshold score for depression. Similarly, individuals with prior mental health conditions and those who expressed feelings of social isolation due to COVID-19 were 3 times more likely to meet the threshold score for depression. These results confirm our hypothesis that communities of color will likely experience disproportionate mental health impacts of COVID-19-specifically, the mental health sequela that emerge from exposure, cumulative burden, and social isolation. We discuss the implications for expanding access and quality of health and mental health services to address current inequities.


Assuntos
COVID-19/etnologia , COVID-19/psicologia , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Saúde Mental/estatística & dados numéricos , Determinantes Sociais da Saúde/etnologia , Adaptação Psicológica , Adulto , Hispano-Americanos/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
17.
Prev Chronic Dis ; 18: E53, 2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-34043502

RESUMO

INTRODUCTION: The disproportionate impact of the COVID-19 pandemic on Latino communities has resulted in greater reports of depression, anxiety, and stress. We present a community-led intervention in Latino communities that integrated social services in mental health service delivery for an equity-based response. METHODS: We used tracking sheets to identify 1,436 unique participants (aged 5-86) enrolled in Latino Health Access's Emotional Wellness program, of whom 346 enrolled in the pre-COVID-19 period (March 2019-February 2020) and 1,090 in the COVID-19 period (March-June 2020). Demographic characteristics and types of services were aggregated to assess monthly trends using Pearson χ2 tests. Regression models were developed to compare factors associated with referrals in the pre-COVID-19 and COVID-19 periods. RESULTS: During the pandemic, service volume (P < .001) and participant volume (P < .001) increased significantly compared with the prepandemic period. Participant characteristics were similar during both periods, the only differences being age distribution, expanded geographic range, and increased male participation during the pandemic. Nonreferred services, such as peer support, increased during the pandemic period. Type of referrals significantly changed from primarily mental health services and disease management in the prepandemic period to affordable housing support, food assistance, and supplemental income. CONCLUSION: An effective mental health program in response to the pandemic must incorporate direct mental health services and address social needs that exacerbate mental health risk for Latino communities. This study presents a model of how to integrate both factors by leveraging promotor-led programs.


Assuntos
Ansiedade , COVID-19 , Serviços Comunitários de Saúde Mental/organização & administração , Depressão , Hispano-Americanos , Estresse Psicológico , Adulto , Ansiedade/etiologia , Ansiedade/prevenção & controle , COVID-19/epidemiologia , COVID-19/psicologia , Depressão/etiologia , Depressão/prevenção & controle , Ajustamento Emocional , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Saúde Mental/etnologia , Sistemas de Apoio Psicossocial , SARS-CoV-2 , Serviço Social/métodos , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Estados Unidos/epidemiologia
18.
Neuropsychology ; 35(4): 411-422, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34043391

RESUMO

OBJECTIVE: Prospective memory (PM), a salient component of neurocognitive functioning for people living with HIV (PLH), is necessary for planning and coordinating health-related behaviors and instrumental tasks of daily living. However, little is known regarding the impact of sociocultural factors on PM in diverse populations, particularly Latinx PLH. The aim of this study was to examine ethnic group differences and sociocultural factors related to PM. METHOD: The sample of 127 PLH (91 Latinx and 36 non-Latinx white) completed measures of quality of education, socioeconomic status (SES), and a validated PM measure, the Memory for Intentions Screening Test (MIST). The Latinx group also completed a bicultural acculturation measure. RESULTS: Results revealed the Latinx and the non-Latinx white groups did not significantly differ in overall MIST performance (all p > .05). In the entire sample, better quality of education was associated with better MIST performance (all p < .05). Within the Latinx group, higher Latinx acculturation was associated with worse MIST performance (p = .02), whereas higher U.S. acculturation was associated with better MIST performance at a trend level (p = .07). Multivariate regressions revealed quality of education and Latinx acculturation significantly predicted MIST performance and PM errors (all p < .05). SES was not related to the MIST (all p > .10). CONCLUSIONS: In sum, clinicians must take sociocultural factors into consideration when working with Latinx PLH, as these factors influence cognitive functions (i.e., PM) vital to health-related behaviors. Integrating culturally-informed psychoeducation into care plans is an imperative first step. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Cultura , Soropositividade para HIV/psicologia , Hispano-Americanos/psicologia , Memória , Desempenho Psicomotor , Meio Social , Aculturação , Atividades Cotidianas , Adulto , Idoso , Cognição , Escolaridade , Grupos Étnicos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Cidade de Nova Iorque , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto Jovem
19.
BMC Pregnancy Childbirth ; 21(1): 349, 2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-33934698

RESUMO

BACKGROUND: Although there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives. METHODS: Qualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers. RESULTS: Four themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices. CONCLUSION: Youth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care experiences and outcomes of Latina adolescents. Healthcare systems and providers need to reconfigure their approaches to focus on the needs and priorities of adolescents.


Assuntos
Tomada de Decisões , Pessoal de Saúde/psicologia , Serviços de Saúde Materna , Mães/psicologia , Adolescente , Atitude do Pessoal de Saúde , California , Comunicação , Feminino , Grupos Focais , Hispano-Americanos/psicologia , Humanos , Entrevistas como Assunto , México , Gravidez , Relações Profissional-Paciente , Pesquisa Qualitativa , Respeito
20.
JAMA Netw Open ; 4(5): e2111629, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-34042990

RESUMO

Importance: The impact of COVID-19 in the US has been far-reaching and devastating, especially in Black populations. Vaccination is a critical part of controlling community spread, but vaccine acceptance has varied, with some research reporting that Black individuals in the US are less willing to be vaccinated than other racial/ethnic groups. Medical mistrust informed by experiences of racism may be associated with this lower willingness. Objective: To examine the association between race/ethnicity and rejection of COVID-19 vaccine trial participation and vaccine uptake and to investigate whether racial/ethnic group-based medical mistrust is a potential mediator of this association. Design, Setting, and Participants: This cross-sectional survey study was conducted from June to December 2020 using a convenience sample of 1835 adults aged 18 years or older residing in Michigan. Participants were recruited through community-based organizations and hospital-academic networks. Main Outcomes and Measures: Separate items assessed whether respondents, if asked, would agree to participate in a research study to test a COVID-19 vaccine or to receive a COVID-19 vaccine. Participants also completed the suspicion subscale of the Group-Based Medical Mistrust Scale. Results: Of the 1835 participants, 1455 (79%) were women, 361 (20%) men, and 19 (1%) other gender. The mean (SD) age was 49.4 (17.9) years, and 394 participants (21%) identified as Black individuals. Overall, 1376 participants (75%) reported low willingness to participate in vaccine trials, and 945 (52%) reported low willingness to be vaccinated. Black participants reported the highest medical mistrust scores (mean [SD], 2.35 [0.96]) compared with other racial/ethnic groups (mean [SD] for the total sample, 1.83 [0.91]). Analysis of path models revealed significantly greater vaccine trial and vaccine uptake rejection among Black participants (vaccine trial: B [SE], 0.51 [0.08]; vaccine uptake: B [SE], 0.51 [0.08]; both P < .001) compared with the overall mean rejection. The association was partially mediated by medical mistrust among Black participants (vaccine trial: B [SE], 0.04 [0.01]; P = .003; vaccine uptake: B [SE], 0.07 [0.02]; P < .001) and White participants (vaccine trial: B [SE], -0.06 [0.02]; P = .001; vaccine uptake: B [SE], -0.10 [0.02]; P < .001). Conclusions and Relevance: In this survey study of US adults, racial/ethnic group-based medical mistrust partially mediated the association between individuals identifying as Black and low rates of acceptance of COVID-19 vaccine trial participation and actual vaccination. The findings suggest that partnerships between health care and other sectors to build trust and promote vaccination may benefit from socially and culturally responsive strategies that acknowledge and address racial/ethnic health care disparities and historical and contemporary experiences of racism.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/etnologia , Ensaios Clínicos como Assunto/psicologia , Grupos de Populações Continentais/psicologia , Confiança , Recusa de Vacinação/etnologia , Adolescente , Adulto , Afro-Americanos/psicologia , Afro-Americanos/estatística & dados numéricos , Idoso , Americanos Asiáticos/psicologia , Americanos Asiáticos/estatística & dados numéricos , Atitude Frente a Saúde/etnologia , COVID-19/prevenção & controle , Grupos de Populações Continentais/estatística & dados numéricos , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/psicologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/psicologia , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Confiança/psicologia , Recusa de Vacinação/psicologia , Recusa de Vacinação/estatística & dados numéricos , Adulto Jovem
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