Emerging Latino Community Research Articles

Prevalence of healthy diet and activity behaviours among U.S. Latino preschool children living in an emerging Latino community.

This pilot study provides preliminary insights into whether Latino preschool children living in an emerging Latino community (ELC) are meeting recommendations for healthy diet and activity behaviours and whether those behaviours are associated with sociodemographic or home environment variables. Secondary data analysis was conducted utilising cross-sectional baseline survey data from ANDALE Pittsburgh, a home-based intervention study. Measures included parent-reported information on child dietary intake, screen time and the home environment, and objectively measured physical activity and anthropometry. χ2 and Fischer's exact tests were used to determine associations. The study was conducted in an ELC in western Pennsylvania in the US. Fifty-one Latina mothers (age: 33⋅5 ± 6⋅1 years; 63 % Mexican origin; 86 % low acculturation) and their children (age: 3⋅9 ± 1⋅3 years; 55 % male) 2-5 years of age. On average, children consumed 2⋅25 ± 1⋅44 cups of fruits/vegetables, viewed 98⋅7 ± 74⋅2 min of screen time, accumulated 12⋅9 ± 2⋅9 min/h of total physical activity and consumed 15⋅5 ± 26⋅0 kcals of sugar-sweetened beverages per day. Forty-one percent met the fruit/vegetable recommendation, 54 % met the screen time recommendation, 27 % met the physical activity recommendation and 58 % met the sugary drink recommendation. Country of origin (P = 0⋅032) and acculturation (P = 0⋅048) were significantly associated with children meeting sugary drink recommendations. No other relationships were significant. The proportion of children in this sample meeting diet and activity recommendations was mixed. More research with larger sample sizes is needed in ELCs to identify effective intervention strategies for improving health behaviours.

Using implementation science frameworks to translate and adapt a pregnancy app for an emerging Latino community

BackgroundDigital mobile health (mHealth) applications are a popular form of prenatal education and care delivery in the U.S.; yet there are few Spanish language options for native speakers. Furthermore, existing applications do not consider cultural differences and disparities in healthcare access, including those specific to emerging Latino communities.ObjectiveTo adapt and translate an English-language pregnancy mobile health app to meet the language and cultural needs of Spanish-speaking Latino immigrants living in the United States.MethodsWe use a multi-step process, grounded in implementation science frameworks, to adapt and translate the contents of an existing pregnancy app. Interviews with stakeholders (n = 12) who advocate for the needs of pregnant individuals in an emerging Latino community were used to identify domains of possible disparities in access to prenatal care. We then conducted semi-structured interviews with peripartum Spanish-speaking Latino users (n = 14) to understand their perspectives within those domains. We identified a list of topics to create educational material for the modified app and implemented a systematic translation approach to ensure that the new version was acceptable for immigrants from different countries in Latin America.ResultsThe interviews with stakeholders revealed seven critical domains that need to be addressed in an adapted prenatal app: language and communication, financial concerns, social support, immigration status, cultural differences, healthcare navigation, and connection to population-specific community resources that offer Spanish language services. The interviews with peripartum Spanish-speaking Latino women informed how the existing content in the app could be adjusted or built upon to address these issues, including providing information on accessing care offered in their native language and community support. Finally, we used a systematic approach to translate the existing application and create new content.ConclusionThis work illustrates a process to adapt an mHealth pregnancy app to the needs of an emerging Latino community, by incorporating culturally sensitive Spanish language content while focusing on addressing existing health disparities.

Effectiveness of a Promotores Network to Improve Health in an Emerging Latino Community.

Latinos living in emerging communities (i.e., nontraditional destinations with a small but growing population) face obstacles to their mental and physical health. This study evaluated the effectiveness of a 6-month, promotor-led intervention on access to care, physical activity, dietary practices, and perceived social support among Latino adults living in an emerging community, compared with a nonrandomly assigned control group. Participants (n = 81 intervention; n = 86 control) were drawn from Allegheny county, Pennsylvania. Promotores used an intervention tool offering nondirective social support to assist participants in developing SMART goals to address their life concerns in eight domains (e.g., social, diet, and exercise/recreation); the control group received printed materials. Participants completed a survey in Spanish at baseline and follow-up to assess outcomes and had their height and weight measured. Adjusted linear mixed effects models compared change in outcomes over time. There was a marginally significant improvement in dietary practices in the intervention group at follow-up, and no change in access to care. Both groups experienced an improvement in social support. There was a significant intervention-by-time interaction such that the intervention group increased physical activity by 259 minutes/week compared with the control group. This study demonstrates the potential effectiveness of a promotores network in assisting individuals living in an emerging Latino community to address their life concerns and improve health behaviors. Future studies should include objective and more rigorous measures with a larger sample to replicate these results.

Using Participatory Action Research to Sustain Palliative Care Knowledge and Readiness Among Latino Community Leaders.

We examined the effectiveness of nurse-led training on palliative care knowledge and advance care planning readiness with Latino leaders. As part of a larger participatory action research study, we used a one-group, pretest-posttest design to evaluate Latino leaders' preparation to share information during home visits with Latinos with advanced cancer. Using Spanish and English materials, 2 palliative care nurse specialists provided a 10-hour training plus a 6-month, post-training booster session. The Palliative Care Knowledge Scale (PaCKS) was administered at baseline (T0), post-training (T1), and 10months post-training (T2). The Advance Care Planning and Engagement Survey (ACPES) was administered at T0 and T2. Among the 15 leaders, 93% were women and 73% were of Mexican heritage. There was a significant increase in the PaCKS score between T0 and T1 (MdT0 = 10; MdT1 = 12, z = -2.15, pexact = .031) and T0 and T2 (z = -2.49, pexact = .008) with a medium-to-large effect size (r = .45). There was a significant increase in ACPES scores between T0 and T2. Nurse-led training of Latino community leaders improves palliative care knowledge and may bolster the palliative care infrastructure in emerging Latino communities.

Managing Precarity: Understanding Latinas' Sexual and Reproductive Care-Seeking in a Midwest Emergent Latino Community.

In this qualitative interview study, we took a two-pronged approach to understand the complexities of sexual and reproductive health (SRH) care access for Latinas in an emerging Latino community (ELC). Phase 1 assessed the SRH resources available for uninsured Latinas through provider interviews. In Phase 2, we interviewed 15 Latina-identified women about their considerations for SRH care-seeking. The scant options for SRH care are focused largely on contraception and pregnancy. Providers viewed themselves as prevention-oriented and perceived Latinas did not prioritize preventive care. Women described compounding challenges and precarious conditions. Annual checkups, accessing contraception, and treating vaginal infections were identified as needs. Barriers to SRH care were enhanced in an ELC. Participants described too much paperwork and limited time as organizational barriers which aggravated others, such as language limitations and feeling embarrassed to ask questions. Further research on SRH care using a reproductive justice approach is needed in ELCs.

The role of bilingualism in Latino youth experiences of acculturation stress when living in an emerging Latino community

Latino youth experience unique stressors as they navigate two cultural contexts. While a substantial amount of research has been conducted investigating Latino youths’ experiences of acculturation, most have been conducted in cities with a substantial Latino community, with less research focusing on emerging communities, or areas with small, but growing cultural communities. The aim of this study was to understand Latino youths’ experiences of acculturation stressors when living in an emerging Latino community. To achieve this aim, 30 youth (ages 7–16) living in an emerging Latino community were recruited to participate in a creative-arts based research method in which they were placed in groups based on developmental stage and participated in six dialogue sessions. During sessions, youth were asked to paint a picture based on prompts and then discuss the topics that emerged in their paintings in small groups. Prompts were designed to illicit youths’ experiences with acculturation stress and Latino identity. Thematic analysis of qualitative data indicated that the role of language was featured prominently in youths’ experiences. In this paper, we discuss the role of bilingualism in multiple contexts in Latino youth experience of acculturation when living in an emerging Latino community. The results suggest that bilingualism is central to the identity of Latino youth in this context and may be essential to incorporate into interventions that aim to facilitate positive youth development among Latino youth living in emerging Latino communities.

Outcomes from a Male-to-Male Promotores Intervention in an Emerging Latino Community.

Emerging Latino communities experience social isolation and lack services tailored to their culture. Few male-to-male promotores (community health workers in Spanish) interventions exist. This 6-month participatory study aimed to improve social support, healthcare access, depressive symptoms, and decrease alcohol consumption among Latino immigrant men. Promotores delivered non-directive social support to participants recruited from community venues. We analyzed baseline and 6-month questionnaires data (n = 89) using paired chi square tests. All participants were immigrants; 47% had not finished high school, 29% had depression symptoms, 35% reported past month binge drinking and 93% were uninsured. The intervention significantly improved having a usual source of care (24 to 43%), doctor's visits (41 to 62%) and dentist's visits (27 to 42%) in the past year. Other outcomes did not improve. Male promotores increased healthcare access among vulnerable Latino men. Addressing drinking behavior and depression may require longer interventions or specialized providers.

Latino Parents' Perceptions of Physical Activity and Healthy Eating: At the Intersection of Culture, Family, and Health

ObjectiveTo explore Latino parents' perspectives on healthy living and identify strategies to incorporate in a future child obesity intervention. DesignDescriptive, qualitative study. SettingParticipants were recruited from an emerging Latino community (area with low [ < 5%] yet growing concentrations of Latinos) in Allegheny County, PA. ParticipantsThirty-two parents of preschool children participated in 5 Spanish-language focus groups. Phenomenon of InterestParents' perceptions of a healthy lifestyle (ie, physical activity and nutrition). AnalysisData were analyzed using the constant comparison method to identify salient categories, themes, and patterns. ResultsThree overarching themes were identified: (1) Healthy Living: Beyond One's Control; (2) Estamos Acostumbrados [We Are Used to a Certain Lifestyle]; and (3) Latin American and US Culture Conflict. In general, parents perceived maintaining a healthy lifestyle to require enormous effort and that change was difficult given a lack of knowledge and control. Conclusions and ImplicationsKey intervention approaches with this population may include a focus on the family environment. Increasing knowledge, building self-efficacy, and modeling behavior through family recipe preparation and physical activity breaks may be necessary, as well as an emphasis on and orientation to community resources to support behavior change and physical activity and healthy eating habits.

“You can never understand a culture until you experience it”: How an experiential learning course prepared students for practice with Latino communities through learning for advocacy

ABSTRACTThis study used grounded theory to analyze focus group data of students participating in an experiential learning course developed in partnership with a local Latino-serving community agency. A central phenomenon, Learning for Advocacy, emerged from the data, describing a process through which students’ personal encounters led to the development of awareness and perspective taking, thereby encouraging students to develop an advocacy orientation for practice with Latino clients and communities. Study findings highlight (a) how experiential courses support students’ development of an advocacy orientation and (b) how social work programs in newly emerging Latino communities might approach the development of an experiential learning course to prepare students to serve these communities.

Social Support, Health, and Health Care Access Among Latino Immigrant Men in an Emerging Community.

To determine the association of social support with alcohol abuse, depression, and health care access among Latino immigrant men in an emerging Latino community (an area with a small yet growing Latino population). Cross-sectional baseline data of 140 men prior to a participatory male-to-male community health worker intervention among Latino immigrants were analyzed using logistic regression. Community health workers recruited community participants in Western Pennsylvania between 2011 and 2013. Participants constituted a vulnerable group: 47% had not finished high school, 36% had moderate to severe depression, and 30% reported binge drinking in the past month. Health care access was low (insurance = 6%, usual source = 20%). In multivariable logistic regression high social support was associated with less binge drinking (odds ratio [OR] = 0.44; 95% confidence interval [CI] [0.20, 0.98]) and lower depression (OR = 0.22; 95% CI [0.09-0.54]). Social support was associated with having a dentist visit but not with other health care access measures. Results indicate that the role of social support seems important for drinking and depression but remains controversial for health care access. It raises the hypothesis that low social support may be one of the mechanisms for the increase in drinking that happens after immigration.

Helping undocumented children in an emerging Latino community

PurposeThe purpose of this paper is to describe and discuss the limitations of strategies that mothers of undocumented Latino children use in an emerging community to address the health needs of their children.Design/methodology/approachIn-depth interviews with low-income immigrant mothers of undocumented Latino children (n=10) and social service providers (n=6). Interviews were transcribed, coded using Atlas-ti and analyzed to identify common perspectives on the strategies used to secure healthcare for uninsured undocumented children.FindingsMothers of undocumented Latino children struggle to secure healthcare for their children. Based on the principles of familismo and personalismo, they rely on social support networks such as friends, relatives and fellow churchgoers to secure information about available healthcare options. Despite the willingness of social and health service providers to help them access healthcare, options are limited and depend on the actions of individuals rather than organized solutions. Securing care for undocumented children using families, friends and sympathetic individual providers as the source of information and advice leads to fragile unsustainable solutions.Research limitations/implicationsThis paper adds to the small yet growing literature of Latinos in emerging communities.Practical implicationsEmerging Latino communities are usually unprepared to welcome Latinos and address its various needs. Undocumented children are a particularly vulnerable group and any sustainable strategy to address their needs would require structural changes in existing health services to ensure that undocumented children’s lives are not affected by poor health.Originality/valueHealthcare access problems for immigrant children are presented from the perspective of parents and offers a nuanced description of health systems unpreparedness to provide care for vulnerable groups whose immigrant status is poorly understood.

Study Protocol for a Home-based Obesity Prevention Program in Latino Preschool Children.

This paper describes the study design for ANDALE Pittsburgh, a culturally-appropriate, family-based intervention to promote a healthy weight in Latino preschool children. The study was organized into two major phases: Phase I: Conduct focus groups with 30 Latino parents of preschool children to inform the development of a culturally-appropriate intervention; Phase II: Test the feasibility and effectiveness of the intervention with 50 families. Participants were recruited from an emerging Latino community through community gatherings, flyers, and word of mouth. Six promotoras (females >18 years, active in community) received 25 hours of training using the intervention curriculum finalized after Phase I. Promotoras delivered the home-based intervention to families over 10, 90-minute weekly sessions that included education, practice, and action (i.e., goal setting). Behavior modification constructs and strategies (e.g., goal setting, problem solving, social support), and building of self-efficacy through healthy recipe preparation and physical activity breaks, were also included. Outcomes (e.g., child BMI) were assessed pre- and post-intervention. Process evaluation assessed fidelity, dose, reach, recruitment, and contextual factors using multiple data sources and mixed methods. The ANDALE Pittsburgh study will expand the body of knowledge on interventions to promote a healthy weight in Latino preschool children living in an emerging Latino community. If successful, this approach will be evaluated in a future, larger-scale intervention and provide a potential model to help to address and prevent obesity in this population.

Mental Health Needs of an Emerging Latino Community in a MidAtlantic City: The Case of Baltimore City (2012-2015)

Over the last decade, Baltimore has become a non-traditional Sanctuary City, receiving an unprecedented influx of Latino immigrants. Undocumented immigrants, especially ones coming from Central America’s Northern Triangle, are often exposed to traumatic experiences before, during and after migration, increasing their risk of mental health distress. The purpose of the study was to explore the nature and frequency of healthcare utilization for mental health problems among Latinos who received outpatient care at the Johns Hopkins Hospital between July 2012 and June 2015. We performed a descriptive analysis of Latino participants in The Access Partnership of Johns Hopkins Medicine (TAP) program. The TAP program covers primary and specialty services to uninsured patients living within zip codes in the Johns Hopkins Hospital and Bayview catchment area without regard to documentation status. We assessed the frequency of visits for symptoms and conditions associated with mental health diagnoses. Among all health conditions, mental health disorder was the most common diagnostic category and accounted for 14.88% of all encounters. Within this category, mood disorders (78%) and anxiety disorders (16%) were the most prevalent diagnoses. This descriptive study presents a unique opportunity to explore the burden and nature of mental health disorders among an emerging Latino community for which health care information is rarely attainable. The high use of mental health services in this population highlights the need to develop culturally competent screening mechanisms and interventions to address the stressors faced by emergent Latino communities.

Familism and Latino adolescent depressive symptoms: The role of maternal warmth and support and school support.

This study examined the relationship between familism and depressive symptoms across relational contexts in adolescence, and whether maternal warmth and support, and school support moderated the relationship between familism and depressive symptoms. A total of 180 Latino adolescents (53% female) in 7th through 10th grades (average age = 14 years) participated in this cross-sectional study. The adolescents lived in an emerging Latino community in a rural area in the U.S. South. Most of the adolescents were Mexican-origin (78%) and born in the United States (60%), while the vast majority of their parents were foreign born (95%). Overall, familism was associated with fewer adolescent depressive symptoms. School support moderated the relationship between familism and adolescent depressive symptoms such that familism's protective effect was only evident when adolescents reported low levels of school support. In the context of average to high school support, adolescents reported low depressive symptoms regardless of familism. However, maternal warmth and support failed to moderate the relationship. Familism may be most protective for adolescents not feeling supported at school, suggesting that these values may offset the risk of a risky school environment. (PsycINFO Database Record

Mendota: Life and Times of an Emerging Latino Community, 1891–2012. By Manuel G. Gonzales.

Mendota: Life and Times of an Emerging Latino Community, 1891–2012 . By Manuel G. Gonzales. Foreword by Gerald Haslam. (Walnut Creek, CA: Hardscratch Press, 2015. xvi + 344 pp. Illustrations, maps, notes, bibliography, index. $24.00, paper.) Romanticizing a bygone era of one’s youth is a major theme in local history. This frequently fuels researchers to spend countless hours combing through dusty documents and yellowed newspapers, tracking down tidbits of information, and interviewing elderly residents. One of the hallmarks of local history (and perhaps its greatest limitation) is the tendency to accentuate the positive aspects of a beloved hometown. Critical analysis is often suspended for the greater good of presenting a tribute honoring hometown, family, and friends. Manuel G. Gonzales, who holds a … bandres{at}uncc.edu

Promotores' perspectives on a male-to-male peer network.

Little documentation exists about male community health workers (promotores) networks. The experiences of promotores can provide input on how to attract, train, supervise and maintain male promotores in CHW programs. We present the experience and perspectives of promotores who participated in a male promotores network assisting Latino immigrant men in an emerging Latino community. All promotores in this community-based participatory study received payment for work 10 hours a week. We conducted qualitative interviews with all promotores starting the program, after 5 and 13 months. Three main themes emerged: 1) Men decided to become promotores to help others, yet appreciated being paid. 2) Promotores' learning experience was ongoing and was facilitated by a cooperative dynamic among them. Learning how to listen was crucial for promotores 3) Promotores experienced difficulty separating their personal lives form their role as a promotor We conclude that paying promotores facilitates the fulfillment of their drive to serve the community. Enhancing listening abilities needs to be part of promotores' training curricula. Finally, it is advisable to build a project with many opportunities for promotores and project staff to share professional and non-professional time and discuss their challenges.

A Male Promotores Network for Latinos: Process Evaluation From a Community-Based Participatory Project.

Background Lay health advisor (LHA) interventions with Latino men are rare, especially in emerging Latino communities. We present a process evaluation of a male LHA network aiming at connecting Latino men to various kinds of services and to the Latino community. It assesses the feasibility of (1) maintaining a steering coalition; (2) hiring, training, and retaining male LHA; and (3) recruiting and assisting underserved participants. Methods Project management data and LHA debriefings were analyzed qualitatively and compared to a logic model and evaluation table prepared before the project started. Results The community coalition steered the project during its implementation. Eleven men attended the initial LHA training. Two thirds of them reflected the community in educational level. One third did not and required extra mentoring from the other LHA to recruit participants. LHA requested topics for monthly trainings according to their needs in the field, including housing, sexual health, and immigration. LHA enrolled 182 participants. Participants' needs went beyond health issues. Therefore, LHA needed to forge new collaborations with local social service organizations. Conclusions Recruiting male LHA is feasible. LHA and the community coalition can suggest adaptations to fit the local context.

Development of a theory-based, peer support intervention to promote weight loss among Latina immigrants.

BackgroundObesity rates are disproportionately high among Latinas living in the United States. Few community-based weight management studies have focused on Latina immigrants living in emerging Latino communities. The purpose of this study was to develop and pilot test a theory-based, promotora-delivered, peer support weight loss intervention for Latina immigrants to be administered in a community setting.We employed participatory methods to develop an 8-week program grounded in self-determination theory. Overweight Latina immigrants were recruited to participate in a quasi-experimental pilot study. Data collected pre and post-intervention included height, weight, fasting lipids, glucose, dietary practices, physical activity and depressive symptoms.ResultsTwenty-two women completed the intervention. Mean age was 36, mean time in the U.S. was 12 years; the majority was from Mexico. Mean BMI was 33; 68% had a family history of diabetes. The intervention resulted in statistically significant weight loss (mean 2.1 kg, SD 2.6, p < 0.001); mean change in weight remained significant when compared with that of a historical control group (-2.1 kg vs 1.10 kg, p < 0.01) but was attenuated at 6 months. Levels of moderate physical activity increased significantly (p < 0.05) and dietary practices improved (p < 0.01) and remained significant at 6 months. Notably, depressive symptoms also improved (p = <0.001).ConclusionsThis theory-based, promotora-delivered intervention resulted in significant weight loss among a sample of Latina immigrants at 8 weeks. Future studies are needed to test the impact of an extended peer support intervention on long-term weight management.Trial registrationNational Clinical Trials: NCT02344212. Registered 21 January 2015.

Erratum to: Citizenship status and language education policy in an emerging Latino community in the United States

This article draws on a 23 month ethnographic study of an emerging—newly established and rapidly growing—Latino community in the New Latino Diaspora of the U.S. in order to examine how educators and parents interpret language education policy (LEP). It analyzes how an English as a Second Language director and one undocumented Mexican mother respond to the federal education legislation of 2002, known as the No Child Left Behind (NCLB) Act, which seeks to improve educational achievement by assessing student progress through standardized testing, mandating curricular reforms, and improving teacher quality. The analysis focuses on the portion of NCLB known as Title III, which is the section of the legislation that attempts to enlist parental participation in public schooling by mandating that schools communicate with parents in a language that they can understand. Drawing on participant observations, interviews, and informal conversations, this research demonstrates the ways that participants’ understandings of citizenship influence their interpretation of language education policy reforms resulting from Title III of NCLB. The findings indicate that various conceptualizations of citizenship circulate between home and school settings, and that those conceptualizations shape approaches to enlisting and offering parental participation. The article contributes to our understanding of three aspects of LEP: the way that LEP is interpreted in formal and informal educational settings, the role of parents and educators in shaping policy implementation locally, and the way individual understandings of LEP are linked to beliefs about citizenship and immigration.

Citizenship status and language education policy in an emerging Latino community in the United States

Citizenship status and language education policy in an emerging Latino community in the United States