Low-income Latino Communities Research Articles

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Undue Burden the Medical School Application Process Places on Low-Income Latinos

Latina First-Generation College Students’ Motivation to Persist: An Attribution Theory and Self-determination Theory Perspective

ABSTRACT Fifty-two strongly committed, first-generation Latina women attending a predominantly white institution (PWI) were asked how their first-generation status has had an impact on their college experience and where they see themselves in five years. Written responses to these questions were analyzed from the lens of attribution theory and self-determination theory. Findings show that first-generation Latina college students remain optimistic that they can achieve their goals, which enhances their self-determination to work hard to overcome obstacles. They take proactive steps to find student resources when needed and take pride in their ability to wade through the challenges of the help-seeking process. Through their association with peers from similar backgrounds, students draw strength from the knowledge that they are not alone. Fostered by their strong ethnic identity, many students envision themselves in careers that will help improve the lives of members in low-income Latino communities, a goal aligned with their values and sense of self.

Impact of a school-level intervention on leisure-time physical activity levels on school grounds in under-resourced school districts.

Even the best school physical education programs fall short of providing enough physical activity (PA) to meet students’ PA guidelines thus increasing PA at other times throughout the school day could help students meet recommended PA levels. Unstructured leisure-time periods during the school day represent an opportunity to promote PA, particularly among students in underserved school districts. Between 2014 and 2018, we partnered with 14 elementary and 5 secondary schools in low-income Latino communities to increase students’ leisure time moderate to vigorous physical activity (MVPA). Schools received consultation and technical assistance on their wellness policy, and some created wellness committees. Schools selected 1–2 PA/nutrition promotion activities for the academic year. Following the System for Observing Play and Leisure Activity in Youth protocol, we conducted a pre- vs. post- analysis of observations of school time student PA (levels of MVPA, energy expenditure, proportion of areas in which games and sports were prominent) in 4936 pre-intervention play areas and 4404 post-intervention areas before school, during lunch recess, and after school. We utilized linear and logistic regression analyses to test pre/post changes in these dependent variables using school area characteristics, period of observation, and temperature as covariates. Following our intervention, MVPA levels before school, during lunch recess, and after school increased significantly from 19.8% at baseline to 25.6% among elementary girls and from 25.4% to 33.2% among elementary boys. Decomposition of these effects suggested that the benefits were partially mediated by increased adult playground supervision. We did not observe any significant changes in PA levels among secondary school girls or boys. Our school-level intervention aimed at promoting PA was associated with modest but meaningful increases in leisure-time PA among elementary, but not secondary, school students. The effects were attributable in part to increased adult supervision on the playground.

Factors Associated With Leisure Time Physical Activity Among Schoolchildren in a Predominantly Latino Community.

School initiatives aimed at increasing physical activity (PA) may improve the health of children in low-income communities. Assessors completed 5909 observations of students' PA during leisure periods using a validated instrument in 19 schools in low-income Latino communities. We examined relationships between school environment factors (eg, presence of playground equipment) and levels of moderate-to-vigorous physical activity (MVPA). Overall, 16.4% of students were engaged in vigorous activity, lower than reported in prior analyses. Consistent with earlier reports, boys were more engaged in vigorous PA than girls (18.6% vs 13.2%). Playground equipment, such as balls and jump ropes, were present in 27.5% of activity areas. Supervision was present in 83.1% of observations; however, staff members were only observed leading organized activity in 1.7%. Playground equipment was associated with higher rates of MVPA, particularly among elementary boys (p < .0001). Staff supervision was not associated with MVPA, possibly because staff members rarely led organized activity. We found low rates of leisure time PA among students in this low-income Latino community. The presence of playground equipment was favorably associated with activity levels. Increasing the availability of playground equipment might promote activity among children in similar populations.

Phoenix Rising: The Evolution of Holyoke's Collaborative Organizing for Healthy Food Resilience.

In the Holyoke Food & Fitness Policy Council (HFFPC) case study, the challenges of providing equitable multistakeholder organizing are examined. The importance of housing the work in the community, power sharing, and having community representation in the leadership is made clear. The HFFPC partnership began with vigor, encountered challenges of trust, transparency, aligned goals and values; it dissolved, and reformed. Because it began with shared values of strong communities and healthy people, the partnership continues to evolve, build local leadership, change narratives, and articulate the need for racial equity in their food system, while shifting local systems and policies that frame who has access to healthy food and safe spaces to exercise in a low-income Latino community.

Traffic-light labels and financial incentives to reduce sugar-sweetened beverage purchases by low-income Latino families: a randomized controlled trial.

The objective of the present study was to test the effectiveness of financial incentives and traffic-light labels to reduce purchases of sugar-sweetened beverages in a community supermarket. In this randomized controlled trial, after a 2-month baseline period (February-March 2014), in-store traffic-light labels were posted to indicate healthy (green), less healthy (yellow) or unhealthy (red) beverages. During the subsequent five months (April-August 2014), participants in the intervention arm were eligible to earn a $US 25 in-store gift card each month they refrained from purchasing red-labelled beverages. Urban supermarket in Chelsea, MA, USA, a low-income Latino community. Participants were customers of this supermarket who had at least one child living at home. A total of 148 customers (n 77 in the intervention group and n 71 in the control group) were included in the final analyses. Outcomes were monthly in-store purchases tracked using a store loyalty card and self-reported consumption of red-labelled beverages. Compared with control participants, the proportion of intervention participants who purchased any red-labelled beverages decreased by 9 % more per month (P=0·002). More intervention than control participants reduced their consumption of red-labelled beverages (-23 % v. -2 % for consuming ≥1 red beverage/week, P=0·01). Overall, financial incentives paired with in-store traffic-light labels modestly reduced purchase and consumption of sugar-sweetened beverages by customers of a community supermarket.

Using Electronic Health Record Alerts to Increase Safety Planning with Youth At-Risk for Suicide: A Non-randomized Trial

No study to date has examined the effectiveness of integrating clinical decision support tools, like electronic health record (EHR) alerts, into the clinical care of youth at-risk for suicide. This study aimed to examine the feasibility and acceptability of using an EHR alert to increase clinicians’ use of safety planning with youth at-risk for suicide in an outpatient pediatric psychiatry clinic serving an urban low-income Latino community. An alert intervention was developed to remind clinicians to complete a safety plan whenever they documented that their patient endorsed suicidal ideation, plan, or attempt during a visit in EHR notes. The alert appeared as a separate window containing a reminder message to complete a safety plan once a clinician finished visit documentation. There were 69 at-risk patients between the ages of 13–21 in the intervention period (M = 15.71; SD = 1.86; 66.7% female) and 64 (M = 15.38; SD = 1.93; 68.6% female) in the control period. Logistic regression analyses indicated that patients in the intervention period were significantly more likely than patients in the control period to receive a safety plan (p < .01). The pattern of results remained the same after adjusting for demographic variables (p = .01). Forty clinicians also completed a questionnaire assessing their satisfaction with the EHR alert, indicating moderate satisfaction (M = 3.01; SD = 0.63; range = 1.11–4.11). EHR alerts are associated with changes in clinicians’ behavior and improved compliance with best clinical practices for at-risk youth.

Effectiveness of a Brief Home Parenting Intervention for Reducing Early Sexual Risks Among Latino Adolescents: Salud y Éxito.

Teen pregnancy rates and related risks remain elevated among Latino teens. We tested the impact on youth sexual behaviors of a brief, culturally targeted, bilingual media intervention designed for parents of young adolescents. Salud y éxito (Health & Success) uses dramatic audio stories to model positive parenting practices. After completing classroom surveys, 27 urban schools in the Northeast and Southwest serving low-income Latino communities were randomized so that all families of seventh grade students were sent either: (1) booklets on healthy eating and exercise; (2) Salud-50, where families either received booklets or the intervention, or (3) Salud-100, where all families received the intervention. Postintervention follow-up surveys were conducted at 3- and 12-months. Multilevel analyses tested intervention effects, controlling for sociodemographics. Compared with controls, at 12-months postintervention (8th grade spring), youth in Salud-100 report lower sexual risks (touching, AOR 1.46, CI 1.19-0.84, p < .001; lifetime sex (AOR 0.74, CI 0.61-0.90, p < .01); and sex intentions (AOR 0.78, CI 0.63-0.96, p < .05). Consistent with a dose-response, Salud-50 results are between those from Salud-100 and control schools. Salud y éxito is an effective parenting intervention that can augment school-based health and sexuality education and help Latino parents support their children during early adolescence.

A Culturally Sensitive Approach to Large-Scale Prevention Studies: A Case Study of a Randomized Controlled Trial With Low-Income Latino Communities.

In response to U.S. federal mandates to increase the presence of underrepresented populations in prevention research, investigators have increasingly focused on using culturally sensitive research practices. However, scholars have rarely discussed these practices in terms of a larger culturally sensitive framework. Further, while the literature has explored how culturally sensitive approaches can be employed in a variety of methods, there has been little examination of how to incorporate such approaches into experimental designs. In this paper, we explain how we incorporated a culturally sensitive framework in a cluster randomized field trial with over 3000 predominantly low-income Latino families, utilizing an intervention designed to improve social relations and enhance family functioning. We offer conceptual and practical examples to guide other researchers who want to adopt a similar approach in their research designs. In addition, we discuss the benefits of forging local partnerships throughout the research process to ensure respect for racial and ethnic minorities participating in social and behavioral experimental studies. We conclude with practical considerations for utilizing a culturally sensitive framework to advance prevention programs, policies, and practices among underrepresented groups in order to achieve the ultimate goal of addressing the traditional underrepresentation of racial and ethnic minorities in research.

Lessons learned: Engaging culturally diverse families in neurodevelopmental disorders intervention research.

Low-income and ethnic minority families continue to face critical disparities in access to diagnostic and treatment services for neurodevelopmental conditions, such as autism spectrum disorder and attention deficit hyperactivity disorder. Despite the growing cultural diversity of the United States, ethnic minority children and families continue to be substantially underrepresented across research on neurodevelopmental disorders, and there is a particularly concerning lack of research on the treatment of these conditions in low-income and ethnic minority communities. Of note, there are currently no published studies on adapting autism spectrum disorder treatment for low-income Latino communities and relatively few studies documenting adapted treatments for children with attention deficit hyperactivity disorder in these communities. This article describes methodological considerations and adaptations made to research procedures using a Diffusion of Innovation framework in order to effectively recruit and engage low-income, ethnic minority, particularly Latino, families of children with neurodevelopmental disorders, in a comparative effectiveness trial of two school-based interventions for executive dysfunction.

The association between self-rated eating habits and dietary behavior in two Latino neighborhoods: Findings from Proyecto MercadoFRESCO.

ObjectiveLatinos are the largest racial and ethnic minority group in the United States and bear a disproportionate burden of obesity related chronic disease. Despite national efforts to improve dietary habits and prevent obesity among Latinos, obesity rates remain high. The objective of this study is to explore the relationship between self-rated dietary quality and dietary behavior among Latinos and how this may vary by socio-demographics to help inform future public health efforts aiming to improve eating habits and obesity rates.DesignCross-sectional study using a series of chi-square tests, the non-parametric Wilcoxon–Mann–Whitney test and logistic regression to explore self-rated eating habits.SettingTwo urban, low-income, predominantly Latino neighborhoods in Los Angeles County.Subjects1000 adults who self-identified as their household's primary food purchaser and preparer were interviewed from 2012 to 2013. Households were randomly selected based on their proximity to corner stores participating in a project to improve the food environment.ResultsMost respondents (59%) report “good” eating habits. Significant associations between “good” eating habits and overall health, fruit and vegetable consumption were observed (p < 0.001). Despite these promising findings, we also find high levels of regular soda and energy-dense food consumption.ConclusionThis study revealed a general understanding that healthy dietary habits are associated with fruit and vegetable consumption among Latinos in two urban neighborhoods. However, there is a need for more targeted health promotion and nutrition education efforts on the risks associated with soda and energy-dense food consumption to help improve dietary habits and obesity levels in low-income Latino communities.

Strengthening Parental Engagement in Low-Income Latino Communities

Strengthening Parental Engagement in Low-Income Latino Communities

Education ‘reform’ in Latino Detroit: achievement gap or colonial legacy?

Using critical theory and an analysis of missionary reports and documentation describing education in colonial Puerto Rico and Mexico, the authors cross borders and time periods to socially and historically situate Spanish colonial educational methodologies and their contemporary use in one low-income Latino community in urban Detroit, Michigan. By invoking associations from the colonial past to shed light on contemporary struggles, this study problematizes US educational reform initiatives such as high stakes testing and school turnaround policies. The authors found that when the playing field is not equal, such reform efforts are but another in a long line of colonial and neo-colonial methodologies that further disenfranchise Latino youth and push them out of school.

Indoor air quality in Latino homes in Boulder, Colorado

Indoor concentrations of airborne pollutants can be several times higher than those found outdoors, often due to poor ventilation, overcrowding, and the contribution of indoor sources within a home. Americans spend most of their time indoors where exposure to poor indoor air quality (IAQ) can result in diminished respiratory and cardiovascular health. This study measured the indoor air quality in 30 homes of a low-income Latino community in Boulder, Colorado during the summer of 2012. Participants were administered a survey, which included questions on their health conditions and indoor air pollution sources like cigarette smoke, heating fuel, and building materials. Twenty-four hour samples of fine particulate matter (PM2.5) from the indoor air were collected in each home; ambient PM2.5 samples were collected each day as well. Concurrent air samples were collected onto 47 mm Teflo and Tissuquartz filter at each location. Teflo filters were analyzed gravimetrically to measure PM2.5 and their extracts were used to determine levels of proteins and endotoxins in the fine fraction. The Tissuquartz filters were analyzed for elemental and organic carbon content (EC/OC). Results indicated that the indoor air contained higher concentrations of PM2.5 than the ambient air, and that the levels of OC were much higher than EC in both indoor and outdoor samples. This community showed no smoking in their homes and kept furry pets indoors at very low rates; therefore, cooking is likely the primary source of indoor PM. For responders with significant exposure to PM, it appeared to be primarily from occupational environments or childhood exposure abroad. Our findings indicate that for immigrant communities such as this, it is important to consider not only their housing conditions but also the relevant prior exposures when conducting health assessments.

Neoliberal-Parasitic Economies and Space Building: Chicago's Southwest Side

Neoliberal-parasitic economies currently blanket many low-income Latino communities across urban America. We deepen and nuance the thesis that space building is now a privileged instrument of these neoliberal economies. We unearth the everyday operations of this economy and how its manufactured spaces of human management and control are mediated and responded to by local workers to reshape this economy and local worker lives. Our focus, Chicago's poor Latino Southwest Side, advances understanding of the mechanics and impacts of this complex space building on this transnational population. Ethnographic research reveals complex contingencies where a neoliberal colonizing and producing of space tussle with worker perceptions of affliction and hope. We identify the production of a Latino oppression space that is simultaneously a site for human degradation, human struggle to survive, personal and ethnic hope and possibility, and ethnic enrichment. In this context, we reveal that human resistance and hope etched into this space forms from a persistent imagining: the Latino Village. To date, this ethnoscape's usage for organizing such oppositional spaces has eluded studies of contemporary Latino counterpolitics. We conclude that this economy's operation and people living through its spatial productions need to be seen as an inseparable dialectic. Urban spaces are both economically and institutionally conditioned and poignantly lived through in a continuous flow that determines their multifaceted character and effects.

Child passenger safety for inner-city Latinos: new approaches from the community

Objective: Motor vehicle crashes injuries, the leading cause of death for Latino children in the United States, can be reduced by the correct use of child safety seats. This study...

Reducing Home Triggers for Asthma: The Latino Community Health Worker Approach

This study assessed the ability of a community health worker asthma intervention to change home asthma triggers. A total of 56 children and 47 adults with asthma were enrolled. Home trigger scores for the children averaged 2.8 at the initial home visit and then 2.3, 2.1, and 2.0 at 3, 6, and 12 months. Home trigger scores for the adults showed a similar trend. Every home visit was associated with a 0.32 reduction in home trigger score (p < 0.01) for children and a 0.41 reduction (p < 0.01) for adults. This intervention shows promise as a way to reduce asthma triggers in urban low-income Latino communities.

Using Computer Technology to Bridge School and Community

When a new technology coordinator came to a Chicago elementary school in a low-income Latino community, he made a surprising decision. Instead of teaching the children computer skills, he'd teach their parents. As Ms. Chen and Mr. Dym report, no one could have predicted the far-reaching impact the program would have -- not just on the parents but on the students, the school, and the wider community. EVERY YEAR at Trujillo Bilingual Elementary School in Chicago,1 parent volunteers are recognized for their work. But the ceremony last year included something different: certificates were handed out to 32 parents who had completed an 18-hour computer course. In a congratulatory speech, principal Maria Rodriguez called computer technology the universal language of the future and said it was as important for adults and children to learn as English. Jose Sanchez, the technology coordinator at Trujillo, handed out the certificates to parents. Then he himself was awarded a trophy for his efforts to turn technology into a bridge between the school and the community. Trujillo School serves children from prekindergarten through eighth grade. Eighty-five percent of the children are Latino, and the rest are African American. Almost all the children (92%) are from low-income families and receive free or reduced-price lunches, and 45% have limited proficiency in English. Before Jose Sanchez arrived at the school, Trujillo was like other schools in low-income Latino communities. It had fewer computers than other schools, particularly at the elementary level, and the students had little access to computers at home.2 Sanchez came to Trujillo after 10 years as a social worker at a local mental health center. One of the first things he did as technology coordinator was to conduct a survey of teachers and parents. The results for the two groups were quite different. At the time, Trujillo was on academic probation for low test scores, so the teachers felt that their top priority was to raise students' scores. They didn't believe that they could turn their attention to computer technology until the school was off probation. Parents, on the other hand, expressed a strong interest in learning about computers. If they knew how to use a computer, they said, they could help their children with homework, learn and even get better jobs. After consulting with Trujillo's principal, Sanchez decided he would focus initially on developing technology programs that would benefit the school's families. With his background in social work and his knowledge of the community, he was well equipped and eager to take on the challenge, and plans for a computer course for parents and a neighborhood computer club quickly took shape. A Computer Course for Parents Sanchez designed the course to address two critical needs among parents in the community: to learn English and to develop word-processing skills, both of which are important for getting good jobs. He recounted the story of one parent who worked at a plastics factory. She was being considered for a promotion from the assembly line to an office job, in which she would enter production data into a computer and make labels for boxes. The job would have offered higher wages, better working conditions, and opportunities for advancement. Unfortunately, it was given to someone with computer experience and better English skills. Another parent had a similar story. She was asked to undertake computerized inventory work at the bakery where she was employed, but the offer was quickly rescinded when it became clear she did not know how to use a computer. Sanchez believed it was important to include lessons in English in the computer course -- not just to enhance the parents' employability, but also to help them decipher software programs designed for English speakers. As he put it, Technology is written in English, so computer proficiency is not possible without English proficiency. …