Barriers and facilitators to mental health promotion for Mexican immigrants in the U.S. through the Ventanillas de Salud program

IntroductionMental health promotion and screenings are recommended as part of standard preventive care. Mexican immigrants in the U.S. are at high risk for mental health illness especially after the COVID-19 pandemic, however access to mental health prevention for this population has been limited, which results in important implementation and equity gaps. The Ventanilla de Salud (VDS) program provides preventive services through Mexican consulates in the U.S.ObjectiveThe objective of this study was to assess capability, opportunity, and motivation for promotores to implement mental health programming through the VDS, leveraging early experiences of ongoing mental health prevention efforts.MethodsThis was a qualitative study using the Capability, Opportunity, and Motivation for Behavior Change model (COM-B). We conducted 9 focus groups with 40 VDS promotores and 6 semi-structured interviews with program stakeholders. Data were analyzed using inductive and deductive coding.ResultsWe found high levels of interest from the leadership, partners, and promotores to provide mental health services through the VDS. Early implementation of a mental health strategy that included training sessions for promotores and mental health promotion, screenings and referrals for VDS users was ongoing. We identified facilitators and barriers that could affect capability, opportunity, and motivation to provide mental health services. Facilitators included promotores’ extensive knowledge about the importance of mental health, promotores service mindset and commitment to provide services to VDS users, and general support from the VDS network and partners. Barriers included promotores’ turnover, need for additional economic compensation, burnout, competing priorities, and lack of mental health professionals to provide clinical services or supervision. Additional investments are recommended to support promotores’ well-being.ConclusionThe main lesson learned from this study was that investing in VDS promotores’ training, resources, and well-being is key to their capability, opportunity and motivation to provide mental health services for Mexican immigrants in the US. Results from this study can be applied to improve the ongoing VDS mental health strategy and increase its impact on the mental health of Mexican immigrants

Maternal health among working women: A case study in the Mexican-U.S. border

This work is a description  of the differences in maternal  health among  women of the  wage-earning  class  along the Mexican/United States  border  in Tijuana,  Baja California. The study analyzes the specific case of women using the services of the Mexican  Institute of Social  Security  (IMSS), breaking  up the sample  according  to their employment  and level of physical labor on the job in industrial, business, and service sectors. The  study  is based  on information  from  a survey  titled, "Social  Conditions of Women and Reproductive Health in Tijuana".This was a post-partum  survey administered to a total of 2,596 obstetrical  patients seen at the Gynecology-. Obstetrics hospital of the Tijuana IMSSoffice during the spring of 1993.The results indicate differing maternal health oonditions among workers, in relation to some of  the factors considered  risks for infant and maternal health.Este trabajo es una descripción de las diferencias en salud materna entre las mujeres de la cLase trabajadora a lo largo de la frontera México-Estados Unidos, en especial la ciudad de Tijuana, Baja California. El estudio analiza el caso de mujeres que usan los servicios del Instituto Mexicano del Seguro Social (IMSS), terminando el ejemplo de acuerdo con su empleo y el nivel de trabajo físico en los sectores industrial, empresarial y de servicios. El estudio está basado en información de una encuesta intitulada "Condiciones sociales de las mujeres y salud reproductiva en Tijuana". Ésta fue una encuesta aplicada a un total de 2 596 pacientes posparto, en el hospital de gíneco-obstetricia del IMSS en Tijuana, durante la primavera de 1993. Los resultados indican diferentes condiciones de salud materna entre las trabajadoras, en relación con algunos de los factores considerados de riesgo tanto para la salud del infante como de la madre

Respuesta frente al Covid-19 para la atención de la población migrante mexicana en el sur de Estados Unidos

One of the current questions is about the impact of the pandemic caused by Covid-19, SARS-CoV-2 on the most vulnerable groups of people. In general, it has been documented that the pandemic is affecting different populations unequally. Therefore, this exploratory work investigates the impact that Covid-19 is having on the population of Mexican immigrants residing in United States. To do this, a sample of Mexican migrants who have been treated through the Program of Mobile Health and Welfare Units of the United States-Mexico Border Health Commission in the cities of Phoenix and Tucson, Arizona, is considered. The work also explores and analyzes the first actions carried out in the border region by government actors from both countries. Among the results, it stands out that more than half of the population reported having diabitis mellitus, a moderate or high fat and sugar diet and little physical activity; Thus, it was also observed that they are a population with an average stay in the United States of around 12 years, with a level lower than high school and a low level of English, and work in low-wage occupations.Una de las interrogantes actuales es sobre el impacto de la pandemia causada por la Covid-19, SARS-CoV-2 sobre los grupos de personas de mayor vulnerabilidad. En general se ha documentado que la pandemia está afectando de manera desigual a diferentes poblaciones. Por ello, este trabajo exploratorio indaga sobre el impacto que está teniendo el Covid-19 sobre la población de inmigrantes mexicanos que residen en Estados Unidos. Para ello, se considera una muestra de migrantes mexicanos que han sido atendidos a través del Programa de Unidades Móviles de Salud y Bienestar de la Comisión de Salud Fronteriza México-Estados Unidos en las ciudades de Phoenix y Tucson, Arizona. El trabajo también explora y analiza las primeras acciones realizadas en la región fronteriza por los actores gubernamentales de ambos países. Entre los resultados se destaca que más de la mitad de la población reportó tener diabetes mellitus, una alimentación moderada o alta en grasas y azúcares y poca actividad física; así también se observó que son una población con una estancia promedio en Estados Unidos de alrededor de 12 años, con un nivel menor a la preparatoria y bajo nivel de inglés, y labora en ocupaciones de baja remuneración salarial

Mortalidad por VIH/SIDA en la frontera norte de México: niveles y tendencias recientes

En México, el VIH/SIDA se ha posicionado como una de las principales causas de muerte en ciertos grupos poblacionales y regiones del país, en particular la frontera norte. El objetivo de este artículo es revisar de manera general los niveles y tendencias recientes de la mortalidad por VIH/SIDA en los estados fronterizos del norte mexicano. Para medir la mortalidad se utilizaron los registros de defunciones ocurridas en México en el periodo 2000-2010. En ese periodo, las entidades de la frontera norte del país concentraron alrededor de una quinta parte de las defunciones relacionadas con VIH/SIDA, con una tendencia ascendente y con un comportamiento diferencial al del resto del país en cuanto a la estructura por edad y sexo, similar a la situación registrada en el caso de las infecciones

Factores condicionantes del acceso a los servicios de salud de las personas migrantes en tránsito : el caso de Tijuana

Nacionalidad de la autora: mexicana.El acceso a los servicios de salud de las y los migrantes mexicanos que transitan por la frontera norte de México es un problema social modelado, esencialmente, por el incremento de la vulnerabilidad que genera las circunstancias del cruce fronterizo indocumentado o la condición de expulsados de Estados Unidos de América (EUA). Este estudio investiga el tema en el caso de la ciudad de Tijuana, uno de los principales lugares de cruce y puntos de repatriación de migrantes indocumentados, a partir de entrevistas a actores claves, a migrantes recién repatriados o deportados; y, de la observación etnográfica de los espacios e instituciones de tránsito migratorio

Relationship between adherence to medical appointments HIV+ patients and geographical accessibility to health services among patients living with HIV Tijuana´s CAPASITS

Objetivo: Estudiar la relación entre adherencia a citas médicas de personas que viven con VIH+ que acuden al CAPASITS de Tijuana y la accesibilidad geográfica a servicios de salud. Material y métodos: Se realizó un estudio transversal con 267 expedientes clínicos de personas que viven con VIH en tratamiento antirretroviral. Se elaboró el perfil demográfico y epidemiológico, un modelo de regresión logística multivariada con variable dependiente “asistencia a cita médica en el CAPASITS durante últimos seis meses” y variable independiente de interés “índice de accesibilidad geográfica”. Resultados: La asistencia a citas médicas en últimos seis meses de personas VIH+ está afectada significativamente por variables como: características de la población (edad), disponibilidad de recursos y avance de la infección. Discusión: Para Tijuana, el acceso no fue impedimento para asistencia a citas médicas programadas en los últimos seis meses. No obstante, los factores individuales marcan la diferencia entre quienes asisten o no a dichas citas.Objective: To study the relationship between adherence to medical appointments HIV+ patients attending the CAPASITS Tijuana and geographical accessibility to health services. Material and Methods: Across-sectional study with 267 medical records of people living with HIV on antiretroviral therapy was performed. Demographic and epidemiological profile was developed, a model of multivariate logistic regression with dependent variable "Assistance CAPASITS appointment during the last six months" and the independent variable of interest "Geographic availability index". Results: Attendance at medical appointments in last six months of HIV+ people, is significantly affected by variables such as population characteristics (age), availability of resources and advancing infection. Discussion: To Tijuana, access did not stop to medical appointments scheduled in the last six months. However, individual factors make the difference between those who attend to any such appointments

Relación entre adherencia a citas médicas de pacientes VIH+ y la accesibilidad geográfica a servicios de salud entre quienes acuden al CAPASITS de Tijuana

Objective: To study the relationship between adherence to medical appointments HIV+ patients attending the CAPASITS Tijuana and geographical accessibility to health services. Material and Methods: Across-sectional study with 267 medical records of people living with HIV on antiretroviral therapy was performed. Demographic and epidemiological profile was developed, a model of multivariate logistic regression with dependent variable "Assistance CAPASITS appointment during the last six months" and the independent variable of interest "Geographic availability index". Results: Attendance at medical appointments in last six months of HIV+ people, is significantly affected by variables such as population characteristics (age), availability of resources and advancing infection. Discussion: To Tijuana, access did not stop to medical appointments scheduled in the last six months. However, individual factors make the difference between those who attend to any such appointments.Objetivo: Estudiar la relación entre adherencia a citas médicas de personas que viven con VIH+ que acuden al CAPASITS de Tijuana y la accesibilidad geográfica a servicios de salud. Material y métodos: Se realizó un estudio transversal con 267 expedientes clínicos de personas que viven con VIH en tratamiento antirretroviral. Se elaboró el perfil demográfico y epidemiológico, un modelo de regresión logística multivariada con variable dependiente “asistencia a cita médica en el CAPASITS durante últimos seis meses” y variable independiente de interés “índice de accesibilidad geográfica”. Resultados: La asistencia a citas médicas en últimos seis meses de personas VIH+ está afectada significativamente por variables como: características de la población (edad), disponibilidad de recursos y avance de la infección. Discusión: Para Tijuana, el acceso no fue impedimento para asistencia a citas médicas programadas en los últimos seis meses. No obstante, los factores individuales marcan la diferencia entre quienes asisten o no a dichas citas

Together for Health: An Initiative to Access Health Services for the Hispanic/Mexican Population Living in the United States

A disproportionately small percentage of the Hispanic/Mexican population in the United States has adequate access to health services, which decreases quality of life at both the individual and community levels. In addition, it increases risk for preventable diseases through insufficient screening and management. The Mexican Section of the U.S./Mexico Border Health Commission, in efforts to address barriers to accessing preventive health care services for vulnerable populations, launched the initiative Juntos por la Salud (JPLS) that offers health promotion and disease prevention services to Hispanics living in and around 11 U.S. metropolitan cities via mobile health units. This paper presents a descriptive analysis of the JPLS initiative and potential positive impact it has had in reducing barriers faced by the Hispanic population. JPLS screens and provides referrals to primary care services to establish a medical home and has the potential to reduce health care costs in a high-risk population through education and timely health screenings.Mexican GovernmentOpen access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Economic vulnerability, violence, and sexual risk factors for HIV among female sex workers in Tijuana, Mexico.

Economic vulnerability is often reported to underlie involvement in sex work among female sex workers (FSW), but may also create urgency in women's work, limiting women's negotiating power with clients and in turn, increasing their vulnerability for violence and HIV. This study assessed economic vulnerability in relation to violence and sexual risk behaviors for HIV among a sample of FSW in Tijuana, Mexico. FSW at least 18 years of age were recruited through venue-based sampling for a survey (n = 228) and in-depth interviews (n = 50) to investigate HIV risk factors in this region. Using crude and adjusted logistic regression models, we assessed lack of financial support from others as well as reports of financial hardship separately in relation to experiencing sexual violence (e.g. by clients, police, relationship partners, in the past 6 months), physical violence (past 6 months), STI diagnosis, and inconsistent condom use (past 30 days). Qualitative interviews (n = 50), conducted with a subsample of the survey participants, were also examined for related themes. FSW who reported no financial support were more likely to report sexual violence (OR = 2.1; 95% CI:1.1-4.2). FSW who reported financial hardship were more likely to experience sexual violence (OR = 1.9; 95% CI:1.1-3.6) and physical violence (OR = 1.9; 95% CI:1.1-3.6), as well as to report past 30-day inconsistent condom use (OR = 2.4; 95%CI: 1.3-4.6) and to test positive for an STI (OR = 1.9; 95% CI:1.1-3.4). Qualitative data substantiated these findings. Findings suggest that interventions to improve economic well-being may be useful to prevent the intersecting concerns of violence and HIV among FSW