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Using Gloria Anzaldúa's theories of conocimiento as a critical lens, the authors examine several literary works including Side by Side / Lado a lado; They Call Me Güero; Land of the Cranes; Efrén Divided; and Gabi, a Girl in Pieces.

Deportation has become more commonplace in the United States since the mid-2000s. Latin American noncitizens—encompassing undocumented and documented immigrants—are targeted for deportation. Deportation’s threat also reaches naturalized and US-born citizens of Latino descent who are largely immune to deportation but whose loved ones or communities are deportable. Drawing on 6 y of data from the National Survey of Latinos, this article examines whether and how Latinos’ deportation fears vary by citizenship and legal status and over time. Compared with Latino noncitizens, Latino US citizens report lower average deportation fears. However, a more complex story emerges when examining this divide over time: Deportation fears are high but stable among Latino noncitizens, whereas deportation fears have increased substantially among Latino US citizens. These trends reflect a growing national awareness of—rather than observable changes to—deportation policy and practice since the 2016 US presidential election. The article highlights how deportation or its consequences affects a racial group that the US immigration regime targets disproportionately.

Non-prescription weight loss substances, such as supplements and herbal remedies, can be harmful. Hispanic immigrant students may be highly susceptible to these substances, especially those advertised on social media. This study was a feasibility/acceptability pilot trial of an intervention to reduce this susceptibility. Latino or Hispanic immigrant students aged 18–35 were randomized to receive either a single-session, culturally tailored online intervention ( Redes Sociales Para la Salud ), or a dose-matched intervention focused on general support for immigrant students ( Immigrant Support ). Following the intervention, participants answered quantitative and open-ended questions about intervention satisfaction, and completed measures of susceptibility to non-prescription weight loss substances. Participants additionally completed measures of social media use and social norm perceptions. Fifty-five participants enrolled in the study, and 32 had primary outcome data. Participants were majority female (62.5%) and graduate students (81.3%) with a mean BMI of 24.6 ± 3.5 kg/m 2 . Ratings of intervention satisfaction were moderate (3.5–3.7 out of 5). In open-ended questions, participants identified areas of high satisfaction (cultural appropriateness, learning new information) and suggested improvements (increase interactivity, improve presentation appearance). Considering signal of an effect, participant ratings indicated that susceptibility to non-prescription weight loss substances was lower after Redes Sociales Para la Salud compared to the control intervention. In exploratory analyses, susceptibility to non-prescription weight loss substances was positively associated with extent of social media use ( r  = 0.41–0.46) and social norms about use of these substances ( r  = 0.38). With additional refinement, the Redes Sociales Para la Salud has promise for addressing susceptibility to non-prescription weight loss substances.

Several factors exacerbate the risk of HIV infection among Latino men, including low HIV/AIDS knowledge, low perception of HIV risk, and higher related stigma, as well as limited access to health care prevention services. HoMBRES de Familia was a randomized controlled trial to adapt and test the efficacy of an intervention that was implemented with Latino men in semi-rural and urban areas of Miami-Dade County. The HoMBRES de Familia intervention, conducted during the COVID-19 pandemic, aimed to reduce the risk of substance abuse, intimate partner violence, and HIV/AIDS (i.e., SAVA syndemic) among Latino men. Participants ( n  = 122) were randomly assigned to either the intervention or the control group with a 1:1 ratio. Participants were interviewed by phone in the language of their preference at baseline and at 6-month follow-up after the intervention. Control group received one diabetes prevention session while the HoMBRES de Familia intervention consisted of four video sessions on HIV, substance use, and intimate partner violence prevention. Results suggest that this intervention was effective in increasing HIV knowledge and HIV self-efficacy, as well as reducing risky sexual behaviors among the intervention group participants. We discuss possible effects of the pandemic on participants’ levels of stress and alcohol use quantity and potential impacts on problematic drinking for Latino men.

Background Although some studies have shown that greater acculturation is associated with an increased risk of cardiovascular disease (CVD) among Latino/a adults, the relationship between acculturation and modifiable health behaviors in older Latino/a adults living in the United States (US) remains underexplored. This secondary analysis of the COMPASS physical activity trial explored the relationship between acculturation and adherence to combined movement behavior guidelines for moderate to vigorous physical activity (MVPA) and sedentary behavior guidelines at 12 months among 245 midlife and older Latino/a adults from the San Francisco Bay Area. Methods Baseline acculturation was measured using the Short Acculturation Scale for Hispanics, yielding a total score and three subscales on a 5-point Likert scale, higher scores represented higher acculturation. MVPA was evaluated via the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire, while sedentary behavior was measured using a validated 1-week recall survey. We employed logistic regression to analyze linear and non-linear associations between acculturation and adherence to the combined MVPA (≥ 150 min/wk) and sedentary behavior (< 8 h/day) movement behavior guidelines, adjusting for baseline MVPA and sedentary behavior, intervention arm, gender, income, body mass index, education, and years in the US. Results At baseline, 6.4% adhered to combined MVPA and sedentary behavior guidelines, with the prevalence of adherence rising to 30.2% at 12 months. Each one-point increase in language use acculturation subscale score was linked to 1.7 times greater adherence ( p  = 0.01) at 12 months. A similar pattern was observed when acculturation was operationalized as a binary variable ( p  = 0.03). For the summary acculturation score, participants with higher acculturation had 2.6 times higher odds of adhering to guidelines at 12 months compared to those with lower acculturation ( p  = 0.04). Conclusions Higher acculturation was associated with a higher odds of 12 month adherence to MVPA and sedentary behavior guidelines among a sample of older Latino/a adults. Results underscore the importance of incorporating acculturation into behavioral trialsand the need to tailor physical activity interventions for Latino/a older adults with lower acculturation. Trial registration Clinicaltrials.gov NCT02111213 Registered April 2, 2014 https//clinicaltrials.gov/study/NCT02111213.

Background Despite the availability of highly effective HPV vaccines that can reduce HPV-associated cancer mortality, HPV vaccination rates in Texas rank 48th nationwide. Although evidence shows Latino parents are more accepting of HPV vaccination than non-Hispanic parents, this disparity in vaccination rates underscores the importance of understanding Latino parental HPV vaccine hesitancy. Latinos/as typically receive healthcare at Federally Qualified Health Centers (FQHCs), which often need support implementing and improving access to evidence based preventive services. However, the current literature around implementation comes from large integrated healthcare systems and there is limited research around what works in the FQHC settings with Latino/a patients. Preliminary data from our previous work suggest practice facilitation is a feasible approach for building the capacity in FQHCs to select and implement provider- and practice-level strategies for increasing vaccination rates. Methods This proposal considers the HPV vaccine as the evidence-based intervention and describes the rational and study design for “ TRU sted h E alth SY stem implementatio N strat EGI es to increase vaccination (TRUE SYNERGI)”, a hybrid type 2 study that uses previously-piloted implementation strategies (i.e., practice facilitation, provider education, among others) to influence provider recommendations (implementation outcome) and practice-level vaccination rates (effectiveness outcome). To test whether these facilitator-driven implementation strategies influence our implementation and effectiveness outcomes, we will use a stepped-wedge cluster randomized trial and randomize three FQHCs ( n  = 9 practices, 3 per FQHC) to three clusters. We will conduct baseline assessments at each practice, which will provide data to assist the practice facilitator in engaging with the providers and leadership to develop a tailored implementation plan for each practice. In addition, we will employ theory-guided, qualitative methods, to assess the complexity associated with context and the recipients involved in the implementation of strategies in practices, along with sustainability. Discussion The study will advance our understanding of what it means to conduct implementation research in resource limited practices that work with populations experiencing substantial disparities. Findings from the current study will inform national implementation efforts and contribute towards future research targeting dissemination and scale-up, key foci for health equity focused implementation research. Trial registration Registered in ClinicalTrials.gov (NCT06598475) on September 9, 2024.

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.

We used results from an optimization randomized controlled trial which tested five behavioral intervention components to support HIV antiretroviral adherence/HIV viral suppression, grounded in the multiphase optimization strategy and using a fractional factorial design to identify intervention components with cost-effectiveness sufficiently favorable for scalability. Results were incorporated into a validated HIV computer simulation to simulate longer-term effects of combinations of components on health and costs. We simulated the 32 corresponding long-term trajectories for viral load suppression, health related quality of life (HRQoL), and costs. The components were designed to be culturally and structurally salient. They were: motivational interviewing counseling sessions (MI), pre-adherence skill building (SB), peer mentorship (PM), focused support groups (SG), and patient navigation (short version [NS], long version [NL]. All participants also received health education on HIV treatment. We examined four scenarios: one-time intervention with and without discounting and continuous interventions with and without discounting. In all four scenarios, interventions that comprise or include SB and NL (and including health education) were cost effective (< $100,000/quality-adjusted life year). Further, with consideration of HRQoL impact, maximal intervention became cost-effective enough to be scalable. Thus, a fractional factorial experiment coupled with cost-effectiveness analysis is a promising approach to optimize multi-component interventions for scalability. The present study can guide service planning efforts for HIV care settings and health departments.

Exercise interventions often improve moderate to vigorous physical activity, but simultaneously increase sedentary time due to a compensatory resting response. A higher level of sedentary time is associated with a lower level of executive function, while increased moderate to vigorous physical activity is associated with improved global cognition and working memory among Latino adults. Latino adults are the fastest-growing minority group in the United States and are at high risk for cognitive decline, spend more time sedentary compared to non-Hispanic populations, and engage in low levels of physical activity. Interventions that are culturally appropriate for Latino adults to replace sedentary time with physical activity are critically needed. This study aims to develop and test the feasibility and acceptability of an ecological momentary intervention (EMI; delivered in real time) that is individually designed to replace sedentary time with physical activity in Latino adults. This pilot study randomized 39 (n=26, 67% female; mean age 61, SD 5.8 years) community-dwelling, Spanish-speaking Latino adults (1:1 allocation) to either a 6-week EMI program designed to replace sitting time with physical activity (20/39, 51%) or physical activity guidelines education (19/39, 49%). The program was conducted on the web and in Spanish. The intervention was individualized based on individual interview responses. The intervention included the use of a Fitbit activity monitor, weekly didactic phone meetings, interactive tools (SMS text messages), and coach-delivered feedback. Feasibility and acceptability were assessed via study satisfaction (Likert scales), motivation (ecological momentary assessment), retention, and compliance. Sedentary time and physical activity were assessed via 7-day actigraphy. Cognitive performance was assessed via the trail making test part A and B (part B=executive function) and via the National Institutes of Health Toolbox remote cognitive assessment. Statistical analysis included a linear model on change score from baseline, adjusting for age, sex, and education, emphasizing effect size. Participant satisfaction with EMI was high (9.4/10), with a high degree of motivation to replace sitting time with physical activity (9.8/10). The intervention compliance rate was 79% with low difficulty using the Fitbit (1.7/10). Weekly step count increased in the intervention group by 5543 steps (group difference: d=0.54; P=.05) and sedentary time decreased by a mean 348 (SD 485) minutes (group difference: d=0.47; P=.24) compared to controls, with moderately strong effect sizes. The trail making test part B improved in the intervention group (mean -35.26, SD 60.35 seconds), compared to the control group (mean 7.19, SD 46 seconds; group difference: d=0.74; P=.01). No group differences were observed in other cognitive measures. An individualized EMI designed for midlife and older Latino adults has the potential to replace sitting time with physical activity and improve executive functioning. The intervention was feasible and well received with a high degree of satisfaction. ClinicalTrials.gov NCT04507464; https://tinyurl.com/44c4thk5.

Purpose Depression is among the most common comorbid psychiatric disorders of patients with breast cancer. Depression decreases patient quality of life and, if untreated, can adversely affect cancer treatment. We sought to identify treatment barriers for women with breast cancer receiving psychotherapy for depression. Findings may help policy makers and researchers determine funding and design of future studies involving this population, especially in communities with high rates of health disparities. Methods We used data from a randomized trial for women with breast cancer and current DSM-IV non-psychotic unipolar major depressive disorder (MDD). Patients were randomly assigned to 12 weeks of one of three psychotherapies and attrition was assessed by whether subjects completed 12 weekly treatment sessions. We used descriptive analyses and logistic regression to identify treatment barriers. R shiny was used to determine study patient residences. Results Of 134 randomized patients, 84 (62.7%) were Hispanic. Fifty-nine patients (44%) either did not start or dropped out of treatment, 49 (83.1%) of them being Hispanic. Being a Hispanic woman, less educated, and geographically distant from treatment significantly predicted attrition. Single Hispanic mothers had significantly higher attrition risk than married and/or childless women. Conclusion Identifying barriers to treatment is important to improve treatment adherence for patients with concurrent diagnoses of breast cancer and MDD, especially for traditionally underserved minorities. Additional support such as affordable tele-medicine, multi-language assistance, financial aid for transportation and child-care, and allocation of more funds to address some identified barriers deserve consideration to improve treatment adherence and outcomes.