27 research outputs found
El Pueblo, Inc.: Strengthening El Pueblo's Sexual and Reproductive Health Program for Latino/a Youth in North Carolina
Background: Latinos/as in the United States face significant sexual and reproductive health (SRH) disparities; the rapidly growing Latino/a population in Wake County, North Carolina is no exception. El Pueblo, Inc. is a nonprofit agency that aims to bridge the gap between the needs of the Latino/a community and available resources in Wake County. One way in which El Pueblo achieves this is through a youth SRH education program called Nuestros Derechos sin Fronteras (DsF), or Our Rights Have No Borders. During the 2011-2012 academic year, a Capstone team from the Health Behavior Department at the UNC-Chapel Hill Gillings School of Global Public Health partnered with El Pueblo to complete a project aimed at strengthening the DsF program. Methods: The Capstone team conducted informal community engagement and formal assessment activities, including 15 in-depth interviews with El Pueblo staff and four focus groups with youth who have participated in DsF, and their parents. The Capstone team conducted a qualitative analysis of interview and focus group summary reports, the results of which were used to develop four major deliverables aimed at strengthening the DsF program. The Capstone team additionally conducted a literature review and resource scan to supplement engagement and assessment findings. Results: The results from community engagement emphasized the key factors of upmost importance to the Latino/a community and El Pueblo; these included cultural values, structural discrimination against immigrants, and bi-cultural and generational challenges for Latino/a youth. The results from assessment activities provided direct feedback regarding the DsF program; findings included an emphasis on funding and evaluation challenges, the importance of holistic SRH education for Latino/a youth, an increased need for synergy across El Pueblo programs, and an emphasis on male involvement. Sustainability findings place an emphasis on institutionalization of DsF within El Pueblo and capacity building for program continuation. These findings were all addressed through the four deliverables produced by the Capstone team. Discussion: The Capstone project's findings and subsequent deliverables add value to El Pueblo's SRH programming and provide significant benefits to Latino/a youth in North Carolina. These deliverables will lead to improved knowledge and skills among youth participants, and enhanced program sustainability, which will ultimately lead to improved SRH outcomes for Latino/a youth in North Carolina. Specific limitations and challenges are acknowledged, and are accompanied by recommendations regarding the use of project deliverables and next steps in order to ensure that maximum benefits are achieved.Master of Public Healt
Migration and HIV risk: life histories of Mexican-born men living with HIV in North Carolina
Latino men in the Southeastern USA are disproportionately affected by HIV, but little is known about how the migration process influences HIV-related risk. In North Carolina (NC), a relatively new immigrant destination, Latino men are predominantly young and from Mexico. We conducted 31 iterative life history interviews with 15 Mexican-born men living with HIV. We used holistic content narrative analysis methods to examine HIV vulnerability in the context of migration and to identify important turning points. Major themes included the prominence of traumatic early life experiences, migration as an ongoing process rather than a finite event, and HIV diagnosis as a final turning point in migration trajectories. Findings provide a nuanced understanding of HIV vulnerability throughout the migration process and have implications including the need for bi-national HIV prevention approaches, improved outreach around early testing and linkage to care, and attention to mental health
Health Vulnerability Model for Latinx Sexual and Gender Minorities: Typologies with Socioeconomic Stability, Health Care Access, and Social Characteristics Indicators
Vulnerability can undermine positive health outcomes and challenge healthcare services access. However, to date, vulnerable populations research has been limited by overly broad definitions, lack of clear indicators, and failure to explore subtypes of vulnerability. Informed by literature and theory, this analysis used a specific operationalization of health vulnerability to identify typologies among a sample of Latinx sexual and gender minorities. We analyzed baseline data from Latinx sexual and gender minorities (N = 186) recruited for a community-based HIV intervention. We performed latent class analysis to operationalize vulnerability using eight socioeconomic stability, health care access, and social characteristics indicators. We identified three typologies of vulnerability from our sample: Low Education and High Social Support (63.4% of sample), High Education and Year-round Employment (18.8%), and High Education and High Discrimination (17.7%). Using specific indicators produced more nuanced vulnerability typologies which, after further testing, can assist in informing tailored health promotion interventions
Promoting Community and Population Health in Public Health and Medicine: A Stepwise Guide to Initiating and Conducting Community-engaged Research
Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed to guide the community-engaged research process. The process includes steps such as: networking and partnership establishment and expansion; building and maintaining trust; identifying health priorities; conducting background research, prioritizing “what to take on”; building consensus, identifying research goals, and developing research questions; developing a conceptual model; formulating a study design; developing an analysis plan; implementing the study; collecting and analyzing data; reviewing and interpreting results; and disseminating and translating findings broadly through multiple channels. Here, we outline and describe each of these steps
Barriers to HIV Testing Within a Sample of Spanish-speaking Latinx Gay, Bisexual, and Other Men Who Have Sex with Men: Implications for HIV Prevention and Care
Gay, bisexual, and other men who have sex with men (GBMSM) have higher rates of HIV infection compared to the general population in the United States, and the infection rate is growing among Latinx GBMSM, compared to a decline in most other demographic subgroups. Uptake of pre-exposure prophylaxis (PrEP), a biomedical strategy designed to reduce HIV transmission, is very low among Latinx GBMSM. HIV testing is a critical first step in the HIV prevention and care continua. We analyzed data from a community-based sample of Latinx GBMSM in the southeastern United States to identify the most common HIV testing barriers and the factors associated with barriers. The five most commonly reported HIV testing barriers included not knowing where to get tested, not having health insurance, fear of being HIV positive, practicing safer sex and perceiving not needing to be tested, and not being recommended to get tested. Using multivariable logistic regression modeling, speaking only Spanish, being unemployed, and adhering to traditional notions of masculinity were associated with increased barriers to HIV testing. We recommend that interventions to increase HIV testing among Latinx GBMSM be provided in Spanish and use culturally congruent messaging, be accessible to those who are unemployed, and incorporate positive risk-reducing aspects of masculinity
Predictors of Heavy Episodic Drinking and Weekly Drunkenness Among Immigrant Latinos in North Carolina
Few studies have examined correlates of heavy drinking among rural immigrant Latino men. This analysis identified correlates of typical week drunkenness and past 30-day heavy episodic drinking, within a sample of immigrant Latino men in rural North Carolina (n = 258). In the bivariate analyses, Mexican birth, entering the United States as an adult, and year-round employment were associated with increased odds of typical week drunkenness, and higher acculturation and affiliation with a religion with strict prohibitions against drinking alcohol were associated with lower odds of typical week drunkenness. Being older, Mexican birth, and entering the United States as an adult were associated with increased odds of heavy episodic drinking, and affiliation with a religion with strict prohibitions against drinking alcohol was associated with decreased odds of heavy episodic drinking. In multivariable modeling, only religious affiliation was associated with typical week drunkenness. Mexican birth, entering the United States as an adult and were associated with increased odds of heavy episodic drinking, and affiliation with a religion with strict prohibitions against drinking alcohol and completing high school was associated with lower odds of heavy episodic drinking. The health of minority men in the United States has been neglected, and immigrant Latino men comprise a particularly vulnerable population. This analysis provides initial data on some factors associated with heavy drinking within a population about whom little is known. Future studies should examine moderating or mediating factors between age, acculturation, religiosity, and heavy drinking that might be targets for behavioral interventions
Community-Guided Focus Group Analysis to Examine Cancer Disparities
Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) is a systems-change intervention addressing disparities in treatment initiation and completion and outcomes for early stage Black and White breast and lung cancer patients. Using a community-based participatory research approach, ACCURE is guided by a diverse partnership involving academic researchers, a non-profit community-based organization, its affiliated broader-based community coalition, and providers and staff from two cancer centers
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Laws and Policies Related to the Health of US Immigrants: A Policy Scan.
OBJECTIVES: We conducted a policy scan of state and local laws and policies across the United States related to social determinants of health among immigrants. METHODS: We collected all state and municipal laws and policies in 10 domains that had potential to affect immigrant health from all 50 U.S. states and the 30 most populous U.S. metropolitan statistical areas. We coded these laws and policies and created an index of restrictiveness and supportiveness of immigrants. RESULTS: We identified 539 state and 322 municipal laws and policies. The most common restrictive state laws and policies were in the domains of identification requirements and drivers license access. The most common supportive state laws and policies were in the domains of health services and higher education access. The most common restrictive municipal laws and policies were in the domains of identification requirements and immigration policy enforcement. The most common supportive municipal laws and policies were in the domains of immigration policy enforcement and health services access. CONCLUSIONS: Most states had index scores reflecting policy environments that were primarily restrictive of immigrants, indicating potential negative impacts on social determinants of health. Further research examining the impact of these on health behaviors is warranted
HIV-prevention Opportunities With GPS-based Social and Sexual Networking Applications for Men Who Have Sex With Men
The goal of this study was to gain insight on the sexual health needs of men who have sex with men (MSM) who use GPS-based social and sexual networking mobile applications (apps) and the future utility of app-based interventions. A health educator promoted HIV-testing resources in four popular apps used by MSM. Content analysis was used to identify salient themes that emerged from the conversations. Four major themes were identified: (1) soliciting sexual encounters, (2) relationship building, (3) HIV and STI-testing inquiries, and (4) seeking other sexual health information. The results suggest the intervention\u27s social media-based strategy, respect for community culture, and unobtrusive approach was advantageous in establishing credibility and rapport with app users. These results highlight a need for convenient and discreet methods to access accurate sexual health information and suggest that apps provide an alternative, non-traditional venue for sexual health education in addition to HIV testing promotion