Spanish-speaking Latinx Research Articles

Trajectories of Change in Parent–Child Interaction Therapy Outcomes in Latinx Families: Implications for Cultural Adaptation

ABSTRACT Objective Parent–Child Interaction Therapy (PCIT) is a parenting program in which caregivers must achieve “skill criteria” in using Do Skills and avoiding Don’t Skills to complete treatment. Despite PCIT’s emphasis on these skills, little is known about how Latinx caregivers acquire these Western-based parenting practices and whether cultural mismatches lead to inequities in outcomes. This study compared the trajectories of change in PCIT skills and treatment outcomes of Latinx and non-Latinx White families. Method We analyzed weekly treatment data from 64 families (20.3% Spanish-speaking Latinx, 51.6% English-speaking Latinx, 28.1% non-Latinx White) served in community clinics. Caregivers were mostly females (95.3%), on average 35.13 years old, and lived in poverty (77.6%). PCIT skills were coded using the Dyadic Parent–Child Interaction Coding System, and child behavior problems were reported using the Eyberg Child Behavior Inventory. Results Latinx and non-Latinx White caregivers acquired Do Skills similarly during treatment. In contrast, some Latinx caregivers began treatment using significantly more Don’t Skills and needed more sessions to achieve some aspects of PCIT skill criteria compared with non-Latinx White caregivers. Latinx families also experienced similar or even more pronounced reductions in child behavior problems than non-Latinx White families. There were no significant differences in the percentage of caregivers who achieved PCIT skill criteria or left treatment prematurely. Conclusions This study provides evidence that strictly defined PCIT skill criteria may lead to inequities in treatment length for some Latinx families. Informed by these findings, we propose data-driven adaptations to improve the cultural fit of PCIT for Latinx groups.

A - 79 Comparison of Neuropsychological Test Performance between Monolingual Older Adults with Varying Cognitive Profiles

Abstract Objective With the rapid aging and cultural differences of the Latinx population, psychologists have expressed concerns regarding neuropsychological evaluations used for Alzheimer’s disease (ad), including the appropriateness of normative data and misinterpretation of test scores. This study explores various facets of neuropsychological performance between Spanish and English-speaking older adults with ad or normal cognition (NC). Method Participants (N = 17,716) from a de-identified database from the National Alzheimer’s’ Coordinating Center were administered Boston Naming Test-30 items (BNT-30), Animal & Vegetable Verbal Fluency, Digit Symbol, Mini-Mental Status Examination (MMSE), Logical Memory I & II (LM-I & II), and Trail Making Test A & B (TMT-A & B). Correlations, multiple linear hierarchical regressions, and two-factor Analyses of Variance (ANOVAs) were used. Results Significant associations between interest areas (e.g., sex, ethnicity, race, age, education level, and/or age of cognitive onset) and test performances were found in each diagnosis group. Primary language, education level, and diagnosis were found to be significant predictors of LM-I (f2 = 0.19), LM-II (f2 = 0.22), and TMT-B (f2 = 0.15) performance. Significant interactions of primary language and diagnosis group were found among test performances for the MMSE, LM-II, Animals Verbal Fluency, TMT-A, and TMT-B (p < 0.05). Conclusions Further research is warranted to understand the complexity of using neuropsychological assessments to detect ad-related deficits among Spanish-speaking Latinx individuals. Evidence-based neuropsychological practice guidelines must acknowledge the importance of education level and primary language on test performance.

Nadie Me Ve Como Latinx

Abstract Studies on how observers’ perceptions affect youth Ethnic-Racial Identity (ERI) formation focus on adolescents, and typically fail to consider non-English language use as a salient ERI marker. The current research examines two novel dimensions by examining employing Spanish-language mixed methods to study Midwestern heritage Spanish-speaking Latinx children, ages 7–13. Study outcomes correlate skin tone to ERI such that children identified by observers as ‘phenotypically’ Latinx reported higher levels of ethnic exploration compared to peers identified as ‘phenotypically’ non-Latinx. Children’s phenotypic self-identification and ERI exploration correlated highly with level of understanding of their ethnic group, and in turn with reported higher linguistic discrimination. Qualitative results further highlight that “white-presenting” Latinx children more strongly affirm their Latinx identity through high Spanish language competence. Findings suggest that healthy ERI development in Latinx children may be uniquely aided by bilingualism and biliteracy.

Characterizing the Communication Networks of Spanish- and English-Speaking Latinx Sexual Minority Men and Their Roles in Pre-Exposure Prophylaxis Uptake

While pre-exposure prophylaxis (PrEP) has demonstrated efficacy in preventing HIV transmission, disparities in access persist in the United States, especially among Hispanic/Latinx sexual minority men (SMM). Language barriers and differences in how Latinx SMM obtain information may impact access to PrEP and HIV prevention. This study used data from the 2021 American Men’s Internet Survey (AMIS) to examine differences in communication networks and PrEP use among Latinx SMM by primary language (Spanish vs. English). We examined the associations between Latinx SMM’s individual- and meso-level communication networks and PrEP-related outcomes using modified Poisson regression with robust variances. Spanish-speaking Latinx SMM in the study were less likely to test for HIV, be aware of PrEP, and use daily PrEP, compared to English-speaking participants. Sexuality disclosure to a healthcare provider was positively associated with PrEP uptake among all participants and predicted STI testing over the past 12 months among English-speaking Latinx SMM. Findings highlight disparities in PrEP awareness and uptake among Latinx SMM, especially among those whose primary language is Spanish. Addressing these disparities through targeted interventions, including improved communication with healthcare providers, may help facilitate PrEP access and use in this population.

A Randomized Controlled Trial of a Culturally Adapted, Community-Based, Remotely Delivered Mindfulness Program for Latinx Patients With Breast Cancer is Acceptable and Feasible While Reducing Anxiety.

Few Spanish mindfulness interventions have been evaluated in Latinx patients with cancer. We culturally adapted a mindfulness intervention for Spanish speaking Latinx patients. The objective was to measure feasibility and acceptability as primary outcomes, with changes in anxiety, depression, and sleep as secondary outcomes. Spanish-speaking Latinx patients with breast cancer (n = 31) were randomized, between April 2021 and May 2022 to either intervention or wait-list control groups. The mindfulness intervention consisted of 6-weekly 1.5-hour sessions remotely delivered by a novice facilitator. Cultural adaptations included language, metaphor, goal, concept, trauma informed, and acknowledgement of spirituality. Feasibility was benchmarked as 75% of participants attending their first session, 75% of participants completing 4 of 6 sessions, and scoring ≥ 4 on a 5-point Likert feasability scale measuring ability to implement changes after 6-weeks. Acceptability was measured as scoring ≥ 4 on a 5-point Likert scale measuring usefulness and relevance of the mindfulness intervention for each session. An intention-to-treat, linear mixed model with repeated measures analysis examined changes in anxiety, depression, and sleep at week 6 and 18 (3months post intervention). All three feasibility benchmarks were met with 75% of first session attendance, 96% of participants completing 4 of 6 sessions, and 94% scoring ≥ 4, on the feasibility scale (Mean (SD) = 4.3 (0.6)). Acceptability scores for both usefulness and relevance questions were ≥ 4 across all 6 sessions. Anxiety was significantly reduced at 3 months (-3.6 (CI -6.9, -0.2), P = .04), but is of unclear clinical significance given the small change. Depression scores declined, but not significantly, and there were no changes in sleep. This culturally adapted, remotely delivered mindfulness intervention using a novice facilitator was acceptable and feasible and demonstrated associated reductions in anxiety amongst Spanish speaking Latinx patients with breast cancer. ClinicalTrials.gov ID# NCT04834154.

Preliminary Outcomes and Adaptation of an NDBI for Spanish-Speaking Families

Naturalistic, Developmental, and Behavioral Interventions (NDBIs) are an empirically supported intervention approach for young autistic children and their families. Spanish-speaking (SS) Latinx families have been underrepresented in autism intervention research, limiting our understanding of whether NDBIs are aligned with Latinx family values and belief systems. This study piloted a parent-mediated NDBI, Project ImPACT, within outpatient services for SS Latinx families. We aimed to examine the preliminary impact of Project ImPACT on family and child outcomes while using the Ecological Validity Model to evaluate program adaptations made by bilingual clinicians. Results from 15 families indicated good treatment completion and high satisfaction, alongside significant increases in child social communication skills and parent self-efficacy in supporting their child’s development. Mixed-methods data examining program adaptations indicated the need to provide additional information related to autism, bilingual language development, and service navigation, as well as adaptations to language and metaphors used in the program.

Beyond translation: Transcreation of a clinicians’ guide to structure discussions about health-related values with Latinx patients throughout cancer

ObjectiveThis study aimed to ensure accurate translation and cultural appropriateness of a guide designed to help oncology clinicians provide person-centered care to Spanish-speaking Latinx patients with cancer. MethodsInitial translation of a clinician-patient values discussion guide in open-ended question format (“Guide”) was pretested in interviews with 27 Spanish-speaking individuals, followed by national expert panel review. At three sites, semi-structured, in-depth, audio-recorded interviews in the participant’s preferred language (Spanish/English) were then conducted with Latinx patients receiving systemic treatment for a solid tumor malignancy and family joining them at clinic. ResultsInterviews of 43 patient/family participants representing diverse Latinx communities addressed the Guide’s understandability, acceptability, relevance and responsiveness. Rapid analysis of interviews contributed to cultural adaptation/transcreation of the Guide for a pilot interventional trial. ConclusionMoving beyond translation to transcreation can help promote inclusion, equity, and cultural sensitivity in oncologic care/communication. Practice implicationsClinicians now have a linguistically- and culturally-adapted guide including questions and prompts to help structure discussions in Spanish or English of health-related values with Latinx patients receiving oncologic care.

Enrollment of Spanish-speaking Latinx adults in clinical trials: Five lessons learned from a randomized study in substance use treatment

Latinx individuals are the largest ethnic minoritized group in the United States (US) at 19% of the population. However, they remain underrepresented in clinical research, accounting for less than 8% of clinical trial participants. Consideration of cultural values could help overcome barriers to inclusion in clinical trials and result in better recruitment and retention of Latinx individuals. In this commentary, we describe general guidance on culturally responsive modifications to facilitate the successful recruitment and retention of Spanish-speaking Latinx participants in Randomized Clinical Trials (RCTs) for substance use. We identify five culturally responsive strategies to help enroll participants in RCTs: 1. Create an ethnically diverse research team, 2. Assess available community partners, 3. Familiarize oneself with the target community, 4. Establish confianza (trust) with participants, and 5. Remain visible to participants and staff from recruitment sites. Representation of Latinx individuals in clinical trials is essential to ensure treatments are responsive to their needs and equitydriven. Some of these strategies can further research in helping to promote the participation of Latinx individuals experiencing substance use concerns, including outreach to those not seeking treatment.

Pandemic retelling: What GoFundMe posts reveal about the socioeconomic context of COVID-19 death and bereavement among Latinx and Spanish-speaking communities in the United States

COVID-19 has had an outsized impact on Latinx communities in the United States, turning thousands of individuals into newly bereaved survivors. Despite an eagerness among scholars to document social inequities in COVID-19, data limitations prevent a deeper understanding of the socioeconomic context of COVID-19 death. This study explores the social relationships, economic factors, and emotional experiences that surround COVID-19 deaths among the members of Spanish-speaking Latinx communities in the United States, as retold in user-written posts on the GoFundMe crowdfunding platform. GoFundMe posts for funeral and related expenses in the aftermath of a COVID-19 death are an unexplored source of information about the impacts of COVID-19 mortality inequities on the health and well-being of bereaved individuals. First, we used computational query methods to systematically identify a sample of Spanish-language/bilingual GoFundMe posts from U.S. locations referencing the death of someone due to COVID-19. After excluding posts that did not meet search criteria, we used deductive and inductive coding to analyze a corpus of selected posts (n = 68). We found that a more complete story about the social context of COVID-19 deaths in Latinx and Spanish-speaking communities includes a focus on family roles and responsibilities, compounded financial hardship, risk of complicated grief, religiosity, and unexpected death. Our exploratory study highlights the need for further research into the contextualized health and well-being impacts of COVID-19 bereavement for structurally marginalized communities.

18.2 Implementing Cultural Considerations for Spanish-Speaking Latinx Families: A Closer Look at Intergenerational Trauma Impacting Access to Care

18.2 Implementing Cultural Considerations for Spanish-Speaking Latinx Families: A Closer Look at Intergenerational Trauma Impacting Access to Care

Expansion of the Community Engagement Studio Method: Deepening Community Participation in Health Care Innovation

Abstract: Background: The Community Engagement Studio (CE Studio) method has emerged as a valuable model for community participation in health innovation research, and we advance the model by expanding the timing and number of CE Studio sessions, as well as facilitation. Objectives: The authors expanded the CE Studio method first to include five sessions corresponding to five phases of innovation: a) health experiences, b) community readiness, c) design features, d) adoption, and e) sustainability. Community experts were engaged throughout the duration of the research. Second, the authors positioned the CE Studio Team to be deeply embedded within the research team and the community of interest through community health workers. Methods: The expanded CE Studio method was incorporated into a federally funded research project focused on a health technology platform. The CE Studio Team held five sessions with each of four community expert panels (total of 20 sessions) based on race/ethnicity and language: African American, Asian American, English-speaking Latinx, and Spanishspeaking Latinx. Conclusions: CE Studio sessions revealed community experts' shared and unique evolving and deepening perspectives that show promise for expanding the model.

Optimizing usability of a mobile health intervention for Spanish-speaking Latinx people with HIV through user-centered design: a post-implementation study.

Latinx people comprise 30% of all new human immunodeficiency virus (HIV) infections in the United States and face many challenges to accessing and engaging with HIV care. To bridge these gaps in care, a Spanish-language mobile health (mHealth) intervention known as ConexionesPositivas (CP) was adapted from an established English-language platform called PositiveLinks (PL) to help improve engagement in care and reduce viral nonsuppression among its users. We aimed to determine how CP can address the challenges that Latinx people with HIV (PWH) in the United States face. We conducted a post-implementation study of the CP mHealth platform, guided by principles of user-centered design. We enrolled 20 Spanish-speaking CP users in the study, who completed the previously validated System Usability Scale (SUS) and semistructured interviews. Interviews were transcribed and translated for analysis. We performed thematic coding of interview transcripts in Dedoose. The SUS composite score was 75, which is within the range of good usability. Four categories of themes were identified in the interviews: client context, strengths of CP, barriers to use and dislikes, and suggestions to improve CP. Positive impacts included encouraging self-monitoring of medication adherence, mood and stress, connection to professional care, and development of a support system for PWH. While CP is an effective and easy-to-use application, participants expressed a desire for improved personalization and interactivity, which will guide further iteration. This study highlights the importance of tailoring mHealth interventions to improve equity of access, especially for populations with limited English proficiency.

Generous, egalitarian, and competitive social values: An intercultural, intracommunity analysis of preschoolers

Social values orientation (SVO) refers to stable individual differences in the allocation of resources between self and others. In the present study, an intracommunity sample of preschool-age children was administered two economic dictator games, one pitting cooperation against selfishness and the other generosity against egalitarianism. A third game assessed competitiveness against cooperation. Results revealed that Spanish-speaking Latinx children (collectivistic family background) were more likely to make both cooperative choices and generous choices than a combined subsample of English-speaking Latinx, African American and Caucasian children (non-collectivistic background). These findings suggest that generosity rather than egalitarianism underlies the cooperative tendency of children from collectivist backgrounds. As expected, English-speaking Latinx children (mixed background) were highest on competitiveness. Contrary to predictions, neither cultural background, social values, nor their interaction were associated with teacher-rated child behavioral adjustment. Findings support SVO validity for the intracommunity sample but not its usefulness for predicting behavioral adjustment of preschool students.

A qualitative assessment of factors contributing to Spanish-speaking federally qualified health center patients' chronic pain experiences.

People of Hispanic or Latino ethnicity (Latinx people) experience pain diagnosis, treatment, and care disparities relative to non-Latinx Whites. Those whose preferred language is Spanish may experience additional disparities when receiving care in a language-discordant environment. In order to better understand medically underserved Spanish-speaking Latinx patients' pain care experience in primary care, we conducted semi-structured qualitative interviews with federally qualified health center staff members (n = 9) and Spanish-speaking adult Latinx patients with chronic pain (n = 12) to capture data on their perspectives. Interview data were mapped to the individual (microsystem), interpersonal (mesosystem), organizational (exosystem), and environmental (macrosystem) levels of Bronfenbrenner's Ecological Systems Theory and analyzed using thematic content analysis informed by the Framework Method. Findings suggest that Spanish-speaking patients and English-speaking care team members may interpret information about pain state and severity differently, may have misaligned expectations about care, treatment methodologies, and treatment goals, and may experience difficulty forming a mutual understanding during health care encounters due to cross-linguistic and cross-cultural miscommunication. Patients preferred to describe their pain in words rather than with numbers or standardized scales, and both patients and frontline care team members expressed frustration with medical interpretation services, which added time and complexity to visits. Patients and health center staff emphasized the diversity of experiences among Spanish-speaking Latinx people, and the need to account for both linguistic and cultural differences during care encounters. Both groups supported hiring more Spanish-speaking, Latinx healthcare personnel who better resemble the patient population, which has the potential to improve linguistic and cultural concordance and competence, with the aim of improving care outcomes and patient satisfaction. Further study is warranted to examine how linguistic and cultural communication barriers impact pain assessment and treatment in primary care, the extent to which patients feel understood by their care teams, and their confidence in their ability to understand and interpret treatment recommendations.

Reactions to Testing HIV Negative: An Assessment of Measurement Invariance and Associations with Condomless Anal Sex among English and Spanish-speaking Latinx Sexual Minority Men in the United States.

Among the many effective prevention strategies, frequent HIV testing continues to be promoted to reduce the risk of HIV transmission among sexual minority men (SMM). Testing negative for HIV can result in varied reactions that influence subsequent HIV transmission behaviors, yet the extant research has primarily been conducted in English. The current study examined measurement invariance of a Spanish-translated Inventory of Reactions to Testing HIV Negative (IRTHN). The study also examined whether the IRTHN was associated with subsequent condomless anal sex. Data were drawn from 2,170 Latinx SMM subsample of the UNITE Cohort Study. We conducted a multigroup confirmatory factor analysis to test for measurement invariance between participants who opted to take the survey in English (n = 2,024) and those who opted to take it in Spanish (n = 128). We also examined if the IRTHN is associated with subsequent CAS. The results were suggestive of partial invariance. The subscales of Luck and Invulernability were associated with CAS at the 12-month follow-up. Practice and research-based implications are discussed.

Creating an Alianza: Group Perinatal Education for Newly Immigrated Latinx Pregnant People.

Pregnant people who are recent immigrants often face barriers navigating the health care system and establishing a support network to sustain them through pregnancy and new parenthood. The Cultivando una Nueva Alianza (CUNA) program from the Children's Home Society of New Jersey was created to address these obstacles. For over 20 years, CUNA has collaborated with local midwives to develop a program for newly immigrated, Spanish-speaking Latinx pregnant people. The curriculum, facilitated by trained members of the community, provides education around pregnancy, birth, and early parenting and connects participants with prenatal care and community resources while cultivating a social support network. The program's success is seen in improved clinical outcomes, ongoing involvement by graduates, and strong continued support from community stakeholders. The CUNA program has been replicated in nearby communities and offers a blueprint for a low-tech intervention to improve the health and wellness of this population.

Review: Feminista Frequencies: Community Building through Radio in the Yakima Valley, by Monica De La Torre

Review: <i>Feminista Frequencies: Community Building through Radio in the Yakima Valley</i>, by Monica De La Torre

Feasibility, acceptability and preliminary outcomes of implementing a family-based intervention Your Family, Your Neighborhood with Latinx immigrant families

School-based parent involvement is associated with child academic outcomes, positive behaviors, and social skills. However, schools often struggle to engage low-income, Latinx immigrant, Spanish-speaking parents and are tasked with finding new and creative ways to involve these parents. Despite the need to engage this diverse group of parents, culturally and linguistically responsive programs to engage parents are limited. This study sought to evaluate the feasibility, acceptability and preliminary outcomes of a family-based intervention—Your Family, Your Neighborhood (YFYN)—with Latinx immigrant Spanish-speaking families. YFYN is an empirically supported, dual-generation, in-person, manualized curriculum that supports and strengthens bonds between parents and their children while fostering neighborhood social cohesion among families living in low-income communities and project-based subsidized housing. Parent-child dyads (N = 15) residing in a mid-sized city within a southwestern state participated in the YFYN intervention. Participating families attended 10 two-hour skills-based curriculum sessions during which they gathered for a community dinner and participated in parent- and child-specific skills-based groups (e.g., learning skills such as parent–child communication, school engagement strategies, positive youth development and leadership, and community strengths and challenges through photovoice). Intervention feasibility and acceptability were evaluated based on parent attendance (parents attended a mean of 8.39 out of 10 sessions), attrition rates and qualitative post-participation focus groups. Parents demonstrated a statistically significant change in parent–child relationships from pre-assessment to post-assessment and positive trends for participation in school activities, positive child behavior and community connections. Findings from this study reveal that the YFYN intervention is feasible and highly acceptable with Spanish-speaking Latinx immigrant families, demonstrated by high session attendance and low attrition. Focus groups with parent participants indicated improvements in their parent–child relationships, changes in participants’ perspectives of their impact on their child’s education and the development of new connections with other YFYN parent participants. This study offers preliminary findings regarding the effects of the YFYN intervention among Latinx families living in low-income neighborhoods. Future directions for engaging Spanish-speaking Latinx immigrant families in schools are discussed.

A factorial experiment grounded in the multiphase optimization strategy to promote viral suppression among people who inject drugs on the Texas-Mexico border: a study protocol

BackgroundPeople who inject drugs living with HIV (PWIDLH) suffer the lowest rates of HIV viral suppression due to episodic injection drug use and poor mental health coupled with poor retention in HIV care. Approximately 44% of PWIDLH along the US-Mexico border are retained in care and only 24% are virally suppressed. This underserved region faces a potential explosion of transmission of HIV due to highly prevalent injection drug use. This protocol describes an optimization trial to promote sustained viral suppression among Spanish-speaking Latinx PWIDLH.MethodsThe multiphase optimization strategy (MOST) is an engineering-inspired framework for designing and building optimized interventions and guides this intervention. The primary aim is to conduct a 24 factorial experiment in which participants are randomized to one of 16 intervention conditions, with each condition comprising a different combination of four behavioral intervention components. The components are peer support for methadone uptake and persistence; behavioral activation therapy for depression; Life-Steps medication adherence counseling; and patient navigation for HIV care. Participants will complete a baseline survey, undergo intervention, and then return for 3-,6-,9-, and 12-month follow-up assessments. The primary outcome is sustained viral suppression, defined as viral loads of < 40 copies per mL at 6-,9-, and 12-month follow-up assessments. Results will yield effect sizes for each component and each additive and interactive combination of components. The research team and partners will make decisions about what constitutes the optimized multi-component intervention by judging the observed effect sizes, interactions, and statistical significance against real-world implementation constraints. The secondary aims are to test mediators and moderators of the component-to-outcome relationship at the 6-month follow-up assessment.DiscussionWe are testing well-studied and available intervention components to support PWIDLH to reduce drug use and improve their mental health and engagement in HIV care. The intervention design will allow for a better understanding of how these components work in combination and can be optimized for the setting.Trial registrationThis project was registered at clinicaltrials.gov (NCT05377463) on May 17th, 2022.

Improving Self-management of Type 2 Diabetes in Latinx Patients: Protocol for a Sequential Multiple Assignment Randomized Trial Involving Community Health Workers, Registered Nurses, and Family Members

The rate of Type 2 diabetes mellitus (T2DM) among Mexican American individuals is 16.3%, about twice that of non-Hispanic White individuals. While a number of education approaches have been developed and shown to improve diabetes self-management behaviors and glycemic control for Spanish-speaking Latinx patients with T2DM, there is little research to guide health practitioners regarding which interventions to apply and when so that resources are used efficiently, and treatment outcomes are maximized. This study aimed to describe an adaptive intervention that integrates community mental health workers, diabetes nurse educators, family members, and patients as partners in care while promoting diabetes self-management for Mexican American individuals with T2DM. The project incorporates four evidence-based, culturally tailored treatments to determine what sequence of intervention strategies work most efficiently and for whom. Given the increasing prevalence of T2DM, achieving better control of diabetes and lowering the associated medical complications experienced disproportionally by Mexican American individuals is a public health priority. Funded by the National Institute of Nursing Research (National Institutes of Health grant R01 NR015809), this project used a sequential multiple assignment randomized trial and included 330 Spanish-speaking Latinx patients with T2DM. In the first phase of the study, subjects were randomly assigned to an evidence-based diabetes self-management educational program called Tomando Control delivered in a group format for 6, biweekly 1.5-hour sessions, led either by a community health worker or a diabetes nurse educator. In the second phase of the study, those subjects who did not improve their diabetes self-management behaviors were rerandomized to receive either an augmented version of Tomando Control or a multifamily group treatment focused on problem-solving. The primary outcome measure was the "Summary of Diabetes Self-Care Activities." Evaluations were made at baseline and at 3, 6, and 12 months. This study was funded in June 2016 for a period of 5 years. Institutional review board approval was obtained in November 2016. Between March 2017 and September 2020, a total of 330 patients were recruited from the outpatient primary care clinics of Olive View-UCLA Medical Center, with a brief hiatus between May 2020 and July 2020 due to COVID-19 restrictions. The study interventions were completed in December 2020. Data collection began in March 2017 and was completed in December 2021. Data analysis is expected to be completed in Spring 2023, and results will be published in Fall 2023. The results of this trial should help practitioners in selecting the optimal approach for improving diabetes self-management in Spanish-speaking, Latinx patients with T2DM. ClinicalTrials.gov NCT03092063; https://clinicaltrials.gov/ct2/show/NCT03092063. DERR1-10.2196/44793.