Responding to health and social needs of aging Latinos in new-growth communities: a qualitative study

Background The development of new-growth communities of Latino immigrants in southern states has challenged the traditional health and social service infrastructure. An interprofessional team of service providers, Latino leaders, and university faculty partnered to establish linkages with the Latino community and providers serving aging adults and to explore the health and social needs of aging Latinos residing in a rural region. Methods A qualitative descriptive study was conducted through a community-university partnership, the Aging Latino Research Team (ALRT). Data were generated from nine focus groups and 15 key informant interviews with Latino and non-Latino community members and service providers in rural, eastern North Carolina (ENC). Results Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Themes common to Latino participants were: “We are put off to one side�; “If I can't work, I can't survive�; and “Without documents, you are no one.� Themes common to non-Latino participants were: “Older Latinos are not well served�; “Older Latinos are invisible�; “Older Latinos are undocumented and afraid�; and “Older Latinos are wandering the highway�. Conclusion A major finding of this research was the extent to which discrepancies in perceptions between Latino participants and non-Latino participants exist. These discrepancies revealed ethnic stereotyping and cultural insensitivity as major barriers in access to care.Open Access Fun

The Feasibility of Using Social Networks to Understand the Causal Pathways of Cancer Disparities

Background: While it is recognized that multiple factors interact at different socioecological levels to influence cancer disparities, many of the proposed solutions to eliminating disparities have been narrowly focused on individual level factors. Social networks have been shown to influence health outcomes through various pathways, including shared social capital, social and cultural norms, risky behaviors, and the transmission of infectious diseases. Current research has shown how social networks influence health behavior; however there are still some critical gaps in this understanding. There is lack of data about social networks and the context in which individuals make decisions about their medical care and health behavior. The purpose of this study is to explore how certain sociocultural conditions influence the composition and nature of social networks structure; and how in turn these networks serve as mediating structures for certain psychosocial mechanisms that influence decisions about screening health behaviors. Methods: Social network analysis of egocentric networks was conducted to visualize the social networks of 65 African American, Latino, and Caucasian men and women. Descriptive statistics (e.g. frequencies, proportions, and means) will be produced to describe sample characteristics in terms of screening behaviors performed/not performed, network sizes, and flow of information. Bivariate statistics (e.g., Chi-square, Mc Nemar, t-tests, ANOVAs) will be computed to make comparisons on these variables by racial/ethnic group membership. Multivariate statistics will be computed to evaluate the impact of social network characteristics on screening practices, health decisions, and access to health care. Results: Our analysis allows us to describe the structural and compositional network characteristics that are related to prostate, breast, and colorectal cancer screening, and explore whether there is variation in the ways that social network characteristics influence cancer screening behaviors. Our analysis explores the structural and compositional measures of the network (e.g., size, density, strength of ties) and associations among sociocultural conditions, the composition and nature of social networks structure and how in turn these networks serve as mediating structures for certain psychosocial mechanisms that may influence decisions about cancer screening health behaviors. Conclusion: Social network analysis has the potential to provide measureable data to help characterize how individuals interact with and access cancer screening services and other key variables that impact health risk behaviors. Before evidenced-based, multi-level interventions can be developed to improve prostate, breast, and colorectal cancer screening, more scientific knowledge is needed about how interpersonal factors shape these screening behaviors

Assessing the attitudes, beliefs, perceptions, and practices surrounding tobacco use and exposure among pregnant women in the Dominican Republic

Thesis (Ph. D.)--University of Rochester. Margaret Warner Graduate School of Education and Human Development, 2011.Purpose: The purpose of this study is to assess the attitudes, beliefs, perceptions, and practices regarding tobacco use and exposure among pregnant women in the Dominican Republic and determine if these are emerging public health issues. Methods: This study used a mixed methods research design to assess the attitudes, beliefs, perceptions, and practices surrounding tobacco use and exposure using a systematic qualitative Rapid Assessment Procedure (semi-structured interviews, direct observations, and collection of documents and public health literature) and a secondary analysis of an existing quantitative database from a survey examining pregnant women’s tobacco use, second-hand smoke exposure, knowledge about risks of smoking and benefits of quitting, and attitudes toward women’s tobacco use in the Dominican Republic. All data were collected in the same public health hospitals in Santiago, Dominican Republic between April and August 2009. Results: Findings from the qualitative data (n=28) suggests that respondents perceived an overall high prevalence of smoking in their respective communities, and a perceived increase in the prevalence of smoking among women. Although reference to the mandated general health warning (“Fumar es Prejuidicial para la Salud” – Smoking is harmful to your health) was common, knowledge of specific health risks related to smoking for both women and their unborn children was limited. Secondhand smoke exposure was frequent among respondents who reported being exposed to secondhand smoke by family members, spouses, friends, and/or neighbors. Respondents perceived only minimal advice from health care provider regarding tobacco use and exposure during pregnancy. The quantitative data indicated that 5% (n=192) of pregnant women were ever regular smokers and among these ever regular smokers. Among this 5%, half reported being current smokers (n=5) and half reported being ex-smokers (n=5). Among all women, 14% reported experimenting with smoking and 6% reported they would likely resume or begin smoking within the next year. Rates of self-reported secondhand smoke exposure among pregnant women were 31% and over half reported their young children being exposed to secondhand smoke, 57%. Most of the pregnant women in this study allowed smoking in their home, 76%. Conclusions: This study provides a preliminary understanding of tobacco use and exposure among pregnant women, and its potential impact on the Dominican Republic’s public health efforts that include improving maternal and child health. Data from this study suggests that tobacco use and exposure among pregnant women in the Dominican Republic are emerging public health problems and further research is needed

Covariates of Identified Stress and Depression among Seasonal Farmworkers

Many noted difficulties of farmworker life result in increased risk for stress and depression. To date, limited research has focused primarily on seasonal farmworkers; much of the prior research examines migrant farmworkers or both groups collectively. This study aims to: (1) describe levels of stress and depression among a sample of seasonal farmworkers; and (2) identify if covariates (age, gender, marital status, education level, years of residency, problems obtaining healthcare due to documentation, language barriers, transportation, costs, medical insurance, and stress level) are significant predictors of depressive symptoms. Survey data were collected from 150 Latino seasonal farmworkers. A hierarchical binary logistic regression was conducted to identify significant covariates. The results indicated that the only statistically significant covariates were health insurance coverage (p = 0.025) and stress (p = 0.008). Those farmworkers without health insurance were 1.8 times more likely than those with health insurance to possess depressive symptoms, while those demonstrating higher stress levels were over 7 times more likely to demonstrate symptoms of depression. The implications of the results are discussed in the manuscript

Covariates of Identified Stress and Depression among Seasonal Farmworkers

Covariates of Identified Stress and Depression among Seasonal Farmworkers. Int. J. Environ. Res. Public Health 2017 , 14 , 711.

Responding to health and social needs of aging Latinos in new-growth communities: a qualitative study

Background: The development of new-growth communities of Latino immigrants in southern states has challenged the traditional health and social service infrastructure. An interprofessional team of service providers, Latino leaders, and university faculty partnered to establish linkages with the Latino community and providers serving aging adults and to explore the health and social needs of aging Latinos residing in a rural region.Methods: A qualitative descriptive study was conducted through a community-university partnership, the Aging Latino Research Team (ALRT). Data were generated from nine focus groups and 15 key informant interviews with Latino and non-Latino community members and service providers in rural, eastern North Carolina (ENC).Results: Thematic analysis was used to identify common patterns and form recommendations for future research and programs. Themes common to Latino participants were: "We are put off to one side"; "If I can't work, I can't survive"; and "Without documents, you are no one." Themes common to non-Latino participants were: "Older Latinos are not well served"; "Older Latinos are invisible"; "Older Latinos are undocumented and afraid"; and "Older Latinos are wandering the highway".Conclusion: A major finding of this research was the extent to which discrepancies in perceptions between Latino participants and non-Latino participants exist. These discrepancies revealed ethnic stereotyping and cultural insensitivity as major barriers in access to care