A Systematic Review of the Relationship between Familism and Mental Health Outcomes in Latino Population

Family-level moderators of daily associations between discrimination and distress among Mexican-origin youth

The current study evaluated cultural values and family processes that may moderate associations between daily racial-ethnic discrimination and distress among Mexican-origin youth. Integrating micro-time (daily diary) and macro-time (longitudinal survey) research design features, we examined familism, family cohesion, and ethnic-racial socialization from youth-, mother-, and father- reports as potential buffers of daily associations between youth racial-ethnic discrimination and youth distress (negative affect and anger). The analytic sample, drawn from the Seguimos Avanzando study, included 317 Mexican-origin adolescents (Mage = 13.5 years) and their parents, recruited from the Midwestern United States. Results indicated that youth-reported familism and family cohesion significantly buffered daily associations between youth racial-ethnic discrimination and youth distress. In contrast, parent-reported familism and family cohesion and some aspects of ethnic-racial socialization exacerbated the discrimination to distress link. The implications of these results are discussed to inform efforts supporting the healthy development of Mexican-origin youth and their families.

Facilitators and Barriers to Shared Decision-Making Communication Between Latina Mothers and Pediatric Mental Healthcare Providers

This study assessed communication factors influencing shared decision-making (SDM) between language-congruent clinicians and Latina mothers of pediatric mental health patients. The sample comprised Latinx youth up to 22 years old who were enrolled in mental healthcare and attended mental health-related sessions with their parent. One hundred transcripts depicting mental health visits were coded using the Conversation Analysis framework. Coding included inductive coding that came from analyzing the structure, or orderliness, of the visits and content discussed that affects SDM. Thematic qualitative analysis revealed that facilitators to SDM included collaborative engagement, parents being active in tailoring session content, and integrating the preferences, roles, and next steps for treatment among all participants. Barriers included unskilled interpersonal interactions undermining rapport, off-topic conversations becoming the session's focus, poor time management, and irregularly integrating parent/patient preferences into the clinician's decisions regarding the child's treatment. Additionally, visit content, structure, tone, and interpersonal engagement were factors that variably facilitated or served as barriers to patient participation in SDM and were integral to collaborative, family-centered care. These findings delineated characteristics of pediatric mental health conversations and identified areas to strengthen communication between parents, patients, and clinicians to shift toward more effective SDM and improve patient outcomes among Latinx families.

A community-engaged qualitative study of factors affecting sleep among Hispanic/Latinos with short sleep duration

BACKGROUND

Despite having high prevalence of short sleep duration, poor sleep quality, and sleep disorders in adult Hispanics living in the US, there is limited understanding of the underlying barriers to sleep and effective interventions in these groups. This study aimed to increase understanding of sleep duration and attitudes toward sleep interventions among Hispanic adults.

METHODS

We conducted 5 online focus group discussions with male and female participants aged 18-65 recruited from the Hispanic community who reported sleeping <7 hours per night. Interviewers utilized a semistructured interview guide to assess attitudes and beliefs about sleep and sleep interventions. Focus groups were conducted in Spanish, recorded, transcribed, and coded to elicit common themes.

RESULTS

Focus groups included 31 participants (19=women) from 12 Hispanic nationalities. Coders identified three main topics: (1) Sleep perceptions, (2) External and internal factors that affect sleep, and (3) Feedback about sleep interventions. Participants discussed the importance of sleep and factors related to stress, family, environment, and acculturation. Sleep interventions were viewed as desirable, and the group discussed a variety of topics of interest. The use of consumer sleep technology was considered a favorable intervention despite few participants having experience with consumer sleep-tracking devices.

CONCLUSION

Results demonstrated that participants were aware of the importance of sleep and sleep duration recommendations. The discussion identified unique issues affecting sleep health in Hispanics as well as enthusiasm for sleep interventions, including interventions using consumer sleep trackers.

Correlates of Positive and Negative Marital Quality Among Older Hispanic Adults in the United States

Marital quality is linked to the well-being of older adults. Social networks tend to shrink in later life, and older adults often rely on their spouses for social support. A better understanding of subpopulations with distinctive sociocultural characteristics, such as older Hispanic adults, is warranted. Hispanic cultural values represented as familismo-the value placed on family relationships-make marital relationships even more critical. The present study investigated the correlates of positive and negative marital quality constructs among older Hispanic adults aged 51 years and older. Regression analysis of the 2016/2018 Health and Retirement Study (HRS) data (n = 1012) showed that women (b = -0.25, p < .05) reported lower positive marital quality than men. Also, depressive symptoms (b = -0.14, p < .05) were associated with greater negative marital quality. The present study evaluated marital quality correlates among unique and understudied older Hispanic populations and explored possible theoretical explanations.

Multidimensional social support and associations between COVID-19 stress and depressive/anxiety outcomes among Hispanic/Latinx and White first-year college students

Objective: The COVID-19 pandemic has led to greater depression and anxiety among college students. Social support may alleviate this risk. We examined how social support from family, friends, and romantic partners may influence internalizing psychopathology outcomes associated with COVID-19-related stressful events. Participants: Participants were first-years (N = 425, 34.8% Hispanic/Latinx, 74.9% female) enrolled in a United States public university. Methods: Participants completed an online survey in Fall of 2020. Linear regression models examined associations between COVID-19 stressors, social support, depressive and anxiety symptoms, and differences between White and Hispanic/Latinx students. Results: Reported COVID-19 stressors were associated with elevated depressive and anxiety symptoms and higher among Hispanic/Latinx students. Family and friend support were negatively associated with both internalizing outcomes. Partner support was negatively associated with depression and more predictive among White students whereas friend support was for Hispanic/Latinx students' anxiety. Conclusions: These findings demonstrate the importance of social connectedness during the COVID-19 pandemic.

A pilot study examining bicultural stress, internalizing problems, alcohol use, and familism's moderating role in Hispanic/Latinx college students

Objective: This study examined how bicultural stress affects depressive, anxiety, and alcohol use disorder (AUD) symptoms in first-year Hispanic/Latinx college students, and whether familism moderates these effects. Method: Using the data from the Pathways to College Health Study, 264 self-identifying Hispanic/Latinx first-year students (74.9% woman) at a large public Hispanic-serving university in the Southwest completed online surveys in 2020 or 2021. Results: Results from hierarchical multiple regression models showed that higher levels of bicultural stress were associated with more depressive and anxiety symptoms but not associated with AUD symptoms. Familism was not associated with depressive, anxiety, or AUD symptoms and did not moderate the associations between bicultural stress and these outcomes. Discussion: These findings highlight the impact of bicultural stress on mental health outcomes and suggest familism may not play a substantial role in Hispanic/Latinx college students internalizing and AUD symptoms.

Cultural values and practices in alcohol and other drug use among immigrant youth: A systematic review

We systematically reviewed the literature to examine the cultural values and practices that can increase risk for or protect against Alcohol and Other Drugs (AOD) use among immigrant youth, and the variation of these risk and protective factors across socio-demographic contexts. We followed the preferred reporting items for systematic review (PRISMA) guidelines. We included quantitative studies that were conducted with immigrant youth between 12 and 35 years and measured cultural values as independent variables and AOD use as dependent variables. All studies were identified via PsycINFO, MEDLINE, CINAHL, EMBASE, and Scopus databases. We used a two-step screening process for all records. Thirty studies met the inclusion criteria; 27 were conducted in the United States (U.S.), 1 each in Spain, Italy, and Israel. The findings regarding family cohesion and collectivistic values were mixed in terms of their role in AOD use. However, religious values and cultural practices relating to parenting were protective against AOD use among immigrant youth from Latin/Hispanic, African, and Asian backgrounds. The findings from this systematic review highlight how cultural values and practices of immigrant youth are important in predicting their health risk behavior such as AOD use. Depending on sociodemographic factors, most of these cultural values and practices serve as protective factors against AOD use, even though some might serve as risk factors for AOD use. However, our understanding of cultural values and practices as a risk or protective factor in AOD use is still limited, especially among immigrant youth outside the U.S.

A scoping review of Spanish language pediatric digital health interventions

OBJECTIVE

Despite the growing number of Hispanic/Latino families in the United States, major concerns are reported when navigating the healthcare system. Monolingual Spanish-speaking families may experience compounded barriers given the inconsistent availability of Spanish resources and services in traditional healthcare settings. Digital health interventions have the potential to alleviate some barriers in healthcare for these individuals. This scoping review summarizes the state of the literature on the development, adaptation, and implementation of pediatric Spanish-language digital health interventions offered to Spanish-speaking families in the United States to better understand current cultural-sensitivity practices and strategies implemented by researchers.

METHODS

A search in major databases was completed in May 2024. Articles that discussed the development, implementation, or outcome of any digital health intervention primarily oriented to a Spanish-speaking pediatric population in the United States were included. Telephone- and telehealth-only interventions were excluded.

RESULTS

A total of 44 articles were reviewed, representing 30 unique digital health interventions. Most covered preventive health topics, utilized SMS texting, and were intended primarily for parents/caregivers. Only 22 articles discussed specific methods to culturally tailor the intervention. The most common methods implemented were advisory boards and collecting qualitative data from parents/caregivers and youth. About 50% of articles reported results related to efficacy, acceptability, and feasibility.

CONCLUSION

While similar methods are implemented to develop and adapt these interventions, there is ample variation throughout the process. Including and learning directly from intended users in the adaptation and development phases of digital health interventions can help create quality and culturally appropriate digital health programs for families.

Navigating Adversity: Ethnoracial Discrimination, Family Support, and Psychotic Symptom Severity in US Latinx People with First Episode Psychosis

INTRODUCTION

Prior research has identified a link between discrimination and psychotic symptoms in community samples, yet less is known about potential protective factors particularly in the context of clinical samples of psychotic illness. The goal of this exploratory study was to examine the relationship between ethnoracial discrimination and symptom severity among U.S. Latinx people experiencing their first episode of psychosis (FEP). We were particularly interested in whether family support quality buffered the negative relationship between discrimination and symptomatology.

METHODS

Data were taken from a longitudinal parent study assessing the effectiveness of a communication campaign on reducing duration of untreated illness among U.S. Latinx communities with FEP. A total of 43 participants with FEP were administered the study measures for the present study at baseline, including self-report survey on perceived discrimination, the Positive and Negative Symptoms Scale clinical interview, and a qualitative interview measuring family support, which was analyzed using deductive methods. Independent samples t-tests and multiple linear regression analyses were conducted.

RESULTS

Endorsement of ethnoracial discrimination was associated with greater positive and general symptoms, but not negative symptoms. Among those endorsing ethnoracial discrimination, family support buffered the association with negative and general symptoms, but not positive symptoms.

CONCLUSION

Family support could be a relevant mechanism to target the negative symptoms of psychosis and general psychopathology among Latinx people with FEP, particularly in the context of racialized stressors.

Suicidal ideation among informal caregivers of older adults: The role of family values, care stigma, and care gains

AIM

This study aims to analyze the association between care-specific psychosocial factors in terms of familism, care stigma, caregiver burden, and gains with suicidal ideation of informal caregivers of older adults in Germany.

METHOD

Data from the Attitudes Towards Informal Caregivers Project (ATTIC) of 433 informal caregivers of adults aged ≥ 60 years was used to analyze the research question. The Internalized Caregiver Stigma Scale was used to measure the internalized attitudes and behavior of informal caregivers regarding care provision for older adults, suicidal ideation was measuring passive suicide thoughts, care gains were measured with positive aspects of care scale and familism was measured with the short attitudinal familism scale. Linear regression analysis with robust standard errors were calculated and adjusted for contextual and personal factors (e.g., co-residence, personality, social support).

RESULTS

Stronger beliefs in negative internalized care stigma were associated with higher frequency of suicide thoughts, while stronger positive internalized care stigma, familism, and care gains were not significantly associated with suicidal ideation. The associations were also found in additional analysis with a log-transformed outcome of suicidal ideation and in analyses excluding mental health as covariate (except for burden, which was significantly associated with suicidal ideation).

CONCLUSION

Care-specific psychosocial factors in terms of negative care stigma are important to the risk for suicidal ideation. Thus, changing negative thoughts, evaluations and expectations about informal care and its performance could be helpful to prevent informal caregivers experiencing (high levels of) suicidal ideation.

Internalization of help-seeking stigma and the moderating role of familism among Latine adults with chronic pain

Latine1 adults with chronic pain face heightened stigmatization of seeking professional psychological help. However, research is needed to test whether stigma is internalized and to identify protective factors. We focus on familism, a value commonly found in collectivist cultures that emphasizes family bonds. We cross-sectionally examined whether self-stigma mediates public stigma and attitudes toward help-seeking while accounting for previous help-seeking experience and whether familism acts as a protective factor. We recruited 259 Latine adults with chronic pain (Mage = 33.05, SD = 11.46) from Prolific. Results revealed that self-stigma mediated the relationship between public stigma and help-seeking attitudes. Additionally, familism moderated the relationship between public stigma and self-stigma. When familism was high, the association between public stigma and self-stigma was weaker, indicating a buffering effect. Findings highlight the need for values-based, culturally tailored interventions to improve help-seeking attitudes and reduce stigma.

Cultural and Social Aspects of Anxiety Disorders

Understanding the cultural and social aspects of anxiety disorders is necessary to ensure the design and implementation of effective, evidence-based methods for diagnosis, prevention, and treatment among diverse populations, particularly those who are minoritized, marginalized, and traditionally underserved. This article describes variations in anxiety disorder prevalence and the association between sociocultural characteristics and stressors known to increase risk for anxiety. The ways sociocultural context impacts anxiety phenomenology and expression is explored. Then, the literature examining differential help-seeking and service utilization among diverse populations is reviewed followed by a summary of culturally responsive, evidence-based practices for anxiety disorders.

Substance use among Latinx youth: The roles of sociocultural influences, family factors, and childhood adversity

Substance use among youth is associated with adverse consequences and may increase vulnerability to addiction and psychiatric disorders later in life. Sociocultural factors such as discrimination have been associated with substance use, while positive cultural resources, such as enculturation and familism, have demonstrated protective outcomes. However, few studies have highlighted how family factors influence substance use among Latinx youth during their transition from adolescence to young adulthood. This study used longitudinal data to explore the associations between sociocultural factors, family factors, childhood adversity, and substance use among Latinx youth. The data were from a longitudinal study of acculturation and substance use among Latinx youth in Southern California (n = 1257, 52.1% female, mixed socioeconomic status). The average age was 14.5 (SD = 0.39). Data collection began in 2005 and ended in 2016. Hierarchical regression models showed that discrimination was associated with higher problematic alcohol susceptibility. Childhood adversity was associated with higher odds of tobacco, alcohol, and marijuana use. Parental communication was associated with lower odds of problematic alcohol and marijuana use. To promote youth well-being, preventive efforts should prioritize reducing childhood adversity and discrimination, while fostering positive family relationships. Overall, our findings suggest the need for interventions targeting various systemic levels to effectively address substance use among Latinx youth.

Cardiovascular reactivity during conversations about discrimination is buffered by social support among U.S. Latines

Racial discrimination is conceptualized as an acute and chronic stressor. Like other acute stressors, lab-based studies demonstrate acute effects of discrimination-related stressors on stress-related cardiovascular outcomes, including total cardiac output, blood pressure, and indices of sympathetic and parasympathetic nervous system activity. Critically, it is important to understand how individual and social factors buffer the experience of race-related acute stress. The current study extends existing work by measuring cardiovascular indices of stress during conversations about racial/ethnic discrimination and examines the moderating role of social support. Latine/Hispanic participants (N = 97) talked about personal discrimination experiences with either a close other or a research assistant they had never previously met. Participants in both conditions exhibited cardiovascular reactivity indicative of stress during the conversation. Additionally, patterns of reactivity reflected a more adaptive stress response and recovery profile when participants talked about discriminatory experiences with a close other relative to a stranger (less parasympathetic withdrawal during the stressor and more parasympathetic rebound during recovery). These patterns are consistent with a stress buffering account of social support, which suggests social bonds and community-level support are critical to consider in interventions to mitigate the harms of experiencing discrimination and prevent chronic health disparities.

Sociocultural, Behavioral, and Physical Correlates of Excessive Social Media Use, Addiction, and Motivation Toward Reduction in a Hispanic College Student Sample

Social media use has been associated with adverse health consequences. However, there is limited research assessing correlates of social media use, addiction, failure to control use, and motivation to reduce use in a Hispanic sample. This study aimed to fill this gap by assessing factors within the National Institute of Minority Health and Health Disparities Research Framework. Participants were Hispanic college students (n = 273) residing either in the United States or Mexico who completed an online survey. Univariate analyses determined independent variables to be assessed in four linear regression models. Results indicated that weekly social media use was negatively associated with sex, attentional impulsivity, and social comparison and positively associated with social media craving (SMC). Social media addiction was positively associated with frequency of posting in Spanish, Fear of Missing Out, SMC, and home restriction of social media use. Social media self-control failure was negatively associated with acculturative language and positively associated with frequency of posting in English, attentional impulsiveness, SMC, and home restriction of social media use. Motivation to reduce social media use was positively associated with residing in the United States. Clinical implications include targeting key factors through tailored interventions aimed at promoting adaptive social media use patterns.

Morality through the lens of Confucian heritage countries: collective self variations and moral worldviews

The issue of Western, Educated, Industrialized, Rich, and Democratic (WEIRD) samples dominating research has been ongoing for decades, and now the emerging trend is to turn to theoretical perspectives from the Majority World. Adopting Western-centric methods based on reductionism can overlook important details and differences between similar cultures, particularly in East Asian cultures, where the Confucian values of relational harmony take many forms. We discuss a novel theoretical perspective on moral constitutions in Confucian heritage cultures. Our central tenet is that divergent moral concepts and ideals are present in Confucian cultures because each culture emphasizes a specific pillar and the self is situated differently in the social relationships that define the scope of interpersonal moral obligations. We consider three Confucian countries: China, Japan, and South Korea as examples. Despite geographical proximity and conventional categorization in cultural psychology, each Confucian country manifests distinct patterns of the self, moral ideals, and behavior in socio-moral contexts. To understand how and why moral worldviews vary within a region, we need to examine how the self in socio-cultural contexts differs and guides interpersonal norms and behaviors across sociocultural contexts. We conclude this paper by offering methodological recommendations for including indigenous moral concepts outside the WEIRD context.

Familism moderates the association between parent-child conflict, interpersonal needs, and suicidal ideation among adolescents

Within the framework of the interpersonal theory of suicide, parent-child conflict in adolescence may be associated with suicidal ideation through increases in thwarted interpersonal needs (i.e., perceived burdensomeness and thwarted belongingness). Familism, a cultural value that emphasizes prioritizing familial interconnectedness and honor, may moderate the association between parent-child conflict and thwarted interpersonal needs. This study examined the relationship between parent-child conflict, familism, and suicidal ideation through the interpersonal theory of suicide. Participants were N = 250 psychiatrically hospitalized adolescents aged 12-17 years (Mage = 14.84, 60.8% female; 41.9% Hispanic, 21.5% African American/Black, 26.0% Caucasian). Participants completed survey and interview measures prior to discharge from psychiatric hospitalization. There was a significant conditional indirect effect of parent-child conflict on suicidal ideation through thwarted interpersonal needs [F (3, 246) = 54.41, p < .01], such that the strength of the indirect effects family conflict on suicidal ideation via thwarted interpersonal needs increased as familism increased. Findings indicate that the relationship between parent-child conflict and thwarted interpersonal needs may be exacerbated when levels of familism are also high. For youth who endorse high levels of familism, parent-child conflict may be particularly pernicious. Interventions targeting the family environment are needed to potentially improve adolescents' interpersonal functioning and protect against suicidal ideation.

Familias con Orgullo: Pilot Study of a Family Intervention for Latinx Sexual Minority Youth to Prevent Drug Use, Sexual Risk Behavior, and Depressive Symptoms

Families are key in the healthy development of Latinx sexual minority youth (Latinx SMY), a group that experiences behavioral, mental, and sexual health disparities. Despite this, there are no family-based interventions for Latinx SMY and their families to prevent drug use, sexual risk behaviors, and depressive symptoms. The purpose of this pilot study was to evaluate the preliminary impact (i.e., estimated effect sizes) of Familias con Orgullo (FcO) and examine its feasibility and acceptability among 30 Latinx SMY and their parents. Parents and adolescents were randomized to FcO or a control condition and assessed pre/post-intervention. Feasibility was measured based on session completion and effect sizes. Focus groups were conducted to evaluate intervention acceptability. Findings showed promising effects favoring FcO on parent-adolescent communication (d = 0.46) and parental involvement (d = 0.34). There were also promising effects favoring FcO on suicidal thoughts (OR = 0.75) and depression symptoms (OR = 0.69). Finally, 100% of the adolescents in FcO either continued to remain drug-free or transitioned from current use to no use (from baseline to post-intervention) compared to 74% in the control. Effect sizes for condomless sex, parental monitoring, and positive parenting were small. Session completion (above 80%) and focus group findings indicated strong feasibility and acceptability. FcO holds promise for reducing drug use and depressive symptoms and improving family functioning among Latinx SMY.

Hispanic/Latino Ethnicity and Loss of Post-Surgery Independent Living: A Retrospective Cohort Study from a Bronx Hospital Network

BACKGROUND

Black race is associated with postoperative adverse discharge to a nursing facility, but the effects of Hispanic/Latino ethnicity are unclear. We explored the Hispanic paradox , described as improved health outcomes among Hispanic/Latino patients on postoperative adverse discharge to nursing facility.

METHODS

A total of 93,356 adults who underwent surgery and were admitted from home to Montefiore Medical Center in the Bronx, New York, between January 2016 and June 2021 were included. The association between self-identified Hispanic/Latino ethnicity and the primary outcome, postoperative adverse discharge to a nursing home or skilled nursing facility, was investigated. Interaction analysis was used to examine the impact of socioeconomic status, determined by estimated median household income and insurance status, on the primary association. Mixed-effects models were used to evaluate the proportion of variance attributed to the patient's residential area defined by zip code and self-identified ethnicity.

RESULTS

Approximately 45.9% (42,832) of patients identified as Hispanic/Latino ethnicity and 9.7% (9074) patients experienced postoperative adverse discharge. Hispanic/Latino ethnicity was associated with lower risk of adverse discharge (relative risk [RR adj ] 0.88; 95% confidence interval [CI], 00.82-0.94; P < .001), indicating a Hispanic Paradox . This effect was modified by the patient's socioeconomic status ( P -for-interaction <.001). Among patients with a high socioeconomic status, the Hispanic paradox was abolished (RR adj 1.10; 95% CI, 11.00-1.20; P = .035). Furthermore, within patients of low socioeconomic status, Hispanic/Latino ethnicity was associated with a higher likelihood of postoperative discharge home with health services compared to non-Hispanic/Latino patients (RR adj 1.06; 95% CI, 11.01-1.12; P = .017).

CONCLUSIONS

Hispanic/Latino ethnicity is a protective factor for postoperative adverse discharge, but this association is modified by socioeconomic status. Future studies should focus on postoperative discharge disposition and socioeconomic barriers in patients with Hispanic/Latino ethnicity.

Determining the role of acculturative stress in predicting mental health service use among Latinx immigrants

OBJECTIVES

Acculturative stress is an important factor that affects health for Latinx immigrants in the US, with multiple studies identifying a link between depression and acculturative stress in this population. However, far fewer studies have examined the specific role and relationship of acculturative stress on mental health service use in this population. Through the lens of Yang's 2016 Model of Immigrant Health Service Use, this study aimed to examine the role of acculturative stress in predicting mental health service use in a sample of Latinx immigrants in the Southeast US.

DESIGN

We conducted a secondary data analysis from a longitudinal study of Latinx immigrant health (n = 391).

RESULTS

Our study found that while total acculturative stress was not significantly associated with mental health service use in this sample, parenting stress was a significant predictor of mental health service use in the past six months when controlling for covariates (OR: 1.043, 95% CI [1.009, 1.078]). Additionally, important Predisposing and Need for Healthcare factors were significantly associated with mental health service use, specifically: males were less likely to utilize mental health services than females (OR: 0.401, 95% CI [0.166-0.968]), English language acculturation was positively associated with mental health service use (OR: 1.953, 95% CI [1.130, 3.377]), and depression was positively associated with mental health service use (OR: 1.107, 95% CI [1.027, 1.194]).

CONCLUSION

These findings support the need for more culturally sensitive mental health services, and the need to develop strategies to engage males and less acculturated individuals in mental health services to promote health equity among Latinx immigrants.

Cross-National Analysis of the Associations Between Familism and Self-Efficacy in Family Caregivers of People With Dementia: Effects on Burden and Depression

Objectives: To examine the cross-national associations between familism and self-efficacy dimensions, and levels of burden and depression. Methods: Sociodemographic, familism, self-efficacy, depressive symptoms, and burden variables were measured in 349 dementia family caregivers from the US and Spain. Results: US sample: greater support from family was positively related to self-efficacy for obtaining respite and self-efficacy for controlling upsetting thoughts and behaviors. Both self-efficacy constructs were negatively related to depression. Similar findings were obtained for burden. Spanish sample: higher scores on family as referents were associated with lower scores on self-efficacy for obtaining respite; lower scores on self-efficacy for obtaining respite were associated with higher depressive symptomatology. Discussion: Study findings suggest that a significant interplay exists between the various facets of familism and self-efficacy, leading to differential caregiving outcomes. Unique cultural contexts and values derived from each country may exert distinct influences on how the caregiving role is perceived and appraised.

Growing up in transit. Personal development and resistance of migrant adolescents travelling through Mexico unaccompanied

Mexico is a major global migration corridor. The last decade has seen an increase in adolescents travelling unaccompanied from Guatemala, Honduras and El Salvador, mainly due to violence and natural disasters. This group of migrants is exposed to migration risks such as trafficking and exploitation, as well as multiple deportations and long waiting times without appropriate access to health and education services. These conditions have significant documented adverse impacts on health and mental health, but the impact on personal development has been less explored. Thus, this article aims to explore the impact of migration transit on identity and resilience of unaccompanied migrant youth, psychosocial mental health constructs that are important for wellbeing and personal development. Through 47 semi-structured interviews conducted with migrant youth and different migration workers in summer 2021 in two migrant shelters in Mexico City and Guadalajara, we found that possibilities for identity building for migrant youth were restricted in a context of curbed freedom. Violence and poverty led to loss of crucial formative years, pushing many to aspire only to work - regardless of the type of work. Resilience overlapped with resistance but was generally maintained with cultural narratives of goal achievement, faith and hope. Strong responsibility towards sending remittances to family made family one of the main goals of the migration journey. Workers highlighted how regional migration management, underlined by discriminatory policies which place profit and national security ideology before a recognition of common humanity, is a considerable barrier to funding services and advancing access to rights for youth. However, youth showed recognition of their own agency and humanity, which represents an important basis on which to build a counter-discriminatory vision and management of this migration. Results are reported according to COREQ guidelines.

Psychosocial Experiences of Spanish-Speaking Parents of Children With Craniofacial Microsomia

Craniofacial microsomia (CFM) and microtia psychosocial research in the US is primarily with English-speaking participants. Given that 19% of the US is Latino, and there is a higher prevalence of CFM in Latino populations, this study aims to describe psychosocial experiences related to CFM among Spanish-speaking Latino caregivers to better inform health care. Narrative interviews (mean 73±17 min) were completed in Spanish with parents of children with CFM aged 3 to 17 (mean age 10.8±4.8 years). Transcripts were analyzed using quantitative linguistic analyses and reflexive thematic analysis. Participants (N=12) were mostly mothers (83%) who had immigrated to the US and had low socioeconomic status. Based upon analysis of grouped word counts, participants spent approximately half of their narratives discussing the first two years of their child's life. Themes selected based on US Latino sociodemographics and cultural values included the Impact of Language, Healthcare Challenges, Supportive Healthcare Experiences, Caregiver Coping with CFM, Family Roles, and Addressing Social Implications of CFM. Results highlighted that the first years of care are of critical importance to parents and suggest this is an optimal time to focus on education and support services for families. Additional treatment suggestions include providing interpretation and informational materials in Spanish, addressing care barriers, supporting familial and child coping, accounting for the role of extended family, and helping address social concerns. Ongoing research with Latino families can further assist in guiding culturally sensitive CFM health care.

The relationships between fear of missing out and psychological and sociocultural factors in Latinx emerging adult college students

OBJECTIVES

The proliferation of social media has resulted in negative consequences such as fear of missing out (FoMO), the anxious feelings one has when others are having rewarding experiences. Few studies have assessed FoMO in Latinx emerging adult college students, none utilizing the socioecological framework. This study assessed the relationships between FoMO and psychological and sociocultural risk and protective factors.

METHOD

Latinx college students (n = 452; Mage = 19.97 years, SD = 1.89; 77.2% female) completed an online survey assessing demographics, FoMO, social media addiction, depression, anxiety, stress, Machiavellianism, narcissism, psychopathy, familism, and acculturation. Two multiple linear regressions assessed the associations between FoMO and psychological and sociocultural factors.

RESULTS

Both regressions were statistically significant. First, FoMO was positively associated with social media addiction, depression, and Machiavellianism. Second, FoMO was positively associated with familial honor and negatively associated with familial interconnectedness and ethnic social relations.

CONCLUSIONS

Associations between FoMO and psychological factors are consistent with past literature, yet they highlight the need for prospective studies to assess temporality. The fact that FoMO was related uniquely to familistic attitudes suggests the importance of family in FoMO perceptions and the need to assess these associations in a more nuanced manner. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sociocultural Risk and Resilience in the Context of Adverse Childhood Experiences

Importance

Knowledge about childhood resilience factors relevant in circumstances of marginalization and high numbers of adverse childhood experiences (ACEs) can improve interventions.

Objective

To identify sociocultural resilience factors in childhood that are associated with better young adult mental health in the context of ACEs.

Design, Setting, and Participants

This cohort study examined 4 waves of data from the Boricua Youth Study, which included Puerto Rican children from the South Bronx, New York, and San Juan, Puerto Rico. Participants were aged 5 to 17 years at waves 1 through 3 (2000-2003) and aged 15 to 29 years at wave 4 (2013-2017). Linear and logistic regression models tested the associations of 7 childhood resilience factors and their interaction with ACEs on young adult mental health outcomes. Data were analyzed from June 2021 to October 2023.

Main Outcomes and Measures

Perceived stress, major depressive disorder and/or generalized anxiety disorder (MDD/GAD), and substance use disorder (SUD) in young adulthood.

Results

Among a total 2004 participants, the mean (SD) age at wave 4 was 22.4 (2.9) years; 1024 participants (51.1%) were female, and 980 (48.9%) were male. Positive parent-child relationships and nonparental adult support during childhood were associated with both lower perceived stress (β = -0.14; SE = 0.02; P < .001; β = -0.08; SE = 0.03; P = .003, respectively) and lower odds of MDD/GAD (adjusted odds ratio [aOR], 0.84; 95% CI, 0.73 to 0.97; aOR = 0.81; 95% CI, 0.69 to 0.95, respectively) in young adulthood. Maternal warmth reported during childhood was also associated with lower young adult perceived stress (β = -0.11; SE = 0.02; P < .001). None of the resilience factors were associated with SUD. The resilience factors familism, friendships, and family religiosity were not associated with any of the mental health outcomes. ACEs were associated with poorer mental health outcomes; however, none of the resilience factors exhibited interactions consistent with being protective for ACEs. Unexpectedly, higher family religiosity was associated with more perceived stress in the presence of higher ACEs.

Conclusions and Relevance

The results of this study suggest that promoting positive relationships with adults during childhood may reduce later young adulthood stress and MDD/GAD. However, there is still a need to identify sociocultural childhood protective factors for ACEs. Caution should be taken in assuming what resilience factors are relevant for a given group, as higher family religiosity (one postulated resilience factor) was unexpectedly associated with a stronger, rather than a weaker, association between ACEs and perceived stress in young adulthood.

Loneliness, Spirituality, and Health-Related Quality of Life in Hispanic English-Speaking Cancer Caregivers: A Qualitative Approach

Hispanic caregivers experiencing higher caregiving burden than their non-Hispanic cohorts, due in part to contextual factors, such as barriers to accessing health care, challenging employment environments, low education and income, immigration issues, and minority stress. Spirituality may serve as a coping strategy for Hispanic caregivers that influences health-related quality of life (HRQoL), possibly by modifying loneliness associated with caregiving. We explored these concepts using semi-structured interviews (N = 10 Hispanic caregivers). Participants shared perceptions of loneliness, spirituality, and how these factors related to HRQoL. Five themes emerged: caregiver experience, coping strategies, loneliness, religion and spirituality to gain strength. Findings suggested that spirituality and religion improved HRQoL partially by reducing loneliness. Future programs to improve HRQoL in Hispanic English-speaking cancer caregivers should address spirituality.

Men With Type II Diabetes in Peru: The Role of Masculine Gender Norms in the Perception of Family Support

Type II diabetes is increasingly becoming a problem in Latin American countries such as Peru. People living with diabetes must incorporate several behavioral changes in their everyday lives, which are done outside the purview of medical professionals. Support from friends and family members is essential to the successful management of any chronic condition. Our study discusses the role of family involvement in supporting the management of diabetes among Peruvian men and examines how masculine norms play a role in the way such support is received and perceived, and their influence in motivation to adhere to treatment recommendations. In-depth interviews with 20 men from a low socioeconomic status, aged 27 to 68 with a diagnosis of Type II diabetes were conducted. Our analysis suggests the importance of the close, complex, and integrated experience that connects family members and patients with a chronic condition. Participant accounts demonstrate they receive multiple forms of support from a diverse range of social relationships. The overwhelming majority of the people giving the support were female and were especially significant in supporting management practices. The participants' accounts were able to demonstrate how living with a chronic condition, such as diabetes, affects the whole family-physically, mentally, and emotionally-and they experience the disease as one unit. Our study demonstrates the need for a family health experience approach that considers masculine gender norms around health and provides relevant insights to inform family-based treatments and therapies to allow for more and better targeted health care for men.

Impact of COVID-19 Pandemic on Health Behaviors and Outcomes by Age Group and Race Ethnicity: Results From Behavioral Risk Factor Surveillance System Data

This study aimed to examine changes in health behaviors and outcomes during early-pandemic (2020) vs pre-pandemic (2019) years by age groups and race/ethnicity. Multivariable logistic regressions were conducted using Behavioral Risk Factor Surveillance System datasets from 2019 (n = 418 268) and 2020 (n = 401 958). All participants reported less likelihood to exercise (aOR, .78; 95% CI: .73-.83) and have poor physical health (aOR, .91; 95% CI: .86-.98) but more likelihood to have excellent general health (aOR, 1.33; 1.17-1.53) during 2020 vs 2019. Compared to 2019, during 2020 (i) Blacks were more likely to exercise (aOR, 1.24; 95% CI: 1.02-1.51) and have excellent general health (aOR, 1.69; 95% CI: 1.13-2.54); (ii) Hispanics were less likely to exercise (aOR, .80; 95% CI: .74-.88), but more likely to have excellent general health (aOR, 2.44; 95% CI: 1.79-3.33) and mental health (aOR, 1.41; 95% CI: 1.15-1.72); and (iii) Whites were less likely to exercise (aOR, .58; 95% CI: .50-.67) and have good physical health (aOR, 0.89; 95% CI: .82-.95). All age groups, except 18-24 years, were less likely to exercise by 18%-39% during 2020 vs 2019. Furthermore, the 55-64 years age-group was 36% more likely to report excellent general health but 14% less likely to have good physical health. Identifying the most vulnerable racial/ethnic and age groups is pivotal to prioritizing public health resources and interventions to mitigate the impact of health crises.

The urgency of restructuring the landscape of behavioral medicine: Commentary from early-career diversity institute scholars

Structural and systemic barriers entrenched in academia have sustained for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for women and underrepresented racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. Increasing opposition to diversity, equity, and inclusion (DEI) efforts in higher education via legislation, policies, and general anti-DEI sentiment contextualizes the importance of prioritizing DEI. The goal of this commentary is to open discussion among academic institutions regarding changes in DEI culture that will facilitate the growth of diverse early-career faculty (ECF). We use an adapted framework which incorporates DEI into a faculty competency model to (i) guide our discussion of the rationale for restructuring academic systems to promote DEI and (ii) recommend strategies for institutional progress for ECF that can translate across academic institutions. Implementing policies and practices that seek to recruit, retain, and support historically underrepresented ECF are needed, and may involve faculty mentorship programs, establishing equitable funding mechanisms, reforming faculty evaluation practices, and examining and correcting inequities in faculty workloads. The onus is on institutions to recognize and replace the exclusionary practices and biases that have existed within their walls, and continuously promote and monitor their DEI efforts and initiatives to ensure their efficacy. Inclusive academic cultures that demonstrate their value of diversity and commitment to equity promotion at all levels of the organization, including among ECF, are necessary for ensuring excellence in scholarship in academia.

Suicide from intimate partner and other relationship conflicts: demographic and clinical correlates'

BACKGROUND

A significant portion of suicides are precipitated by interpersonal relationship problems.

AIMS

To examine demographic and clinical correlates of any intimate partner conflicts (IPC) and other interpersonal conflicts (OPC) as suicide precipitants.

METHODS

We analyzed data on 92,805 (72,628 male; 20,177 female) adult suicide decedents from the 2017 to 2019 U.S. National Violent Death Reporting System, using multinomial and binary logistic regression models. We included case examples from coroners/medical examiner (CME) and law enforcement (LE) agency reports.

RESULTS

Of all decedents, 23.6% had IPC and 8.0% had OPC as a suicide precipitant. Compared to those without any relationship conflict, those who had IPC or OPC were younger and more likely to have had previous suicide attempt(s), alcohol/other substance use problems, and job/finance/housing and legal problems. Compared to those with OPC, those with IPC were more likely to be male and Hispanic and had higher odds of previous suicide attempt, depression diagnosis, alcohol problems, and more acute crises. CME/LE reports showed distress of divorce/break-up, other life stressors, prior suicide attempt(s), alcohol/other substance involvement, and/or loss of family support.

CONCLUSIONS

Access to behavioral health treatment for those at risk of suicide in the face of IPC or OPC is essential for suicide prevention.

Emotional health and its association with neurocognition in Hispanic and non-Hispanic White people with HIV

OBJECTIVE

Emotional functioning is linked to HIV-associated neurocognitive impairment, yet research on this association among diverse people with HIV (PWH) is scant. We examined emotional health and its association with neurocognition in Hispanic and White PWH.

METHODS

Participants included 107 Hispanic (41% primarily Spanish-speakers; 80% Mexican heritage/origin) and 216 White PWH (Overall age: M = 53.62, SD = 12.19; 86% male; 63% AIDS; 92% on antiretroviral therapy). Emotional health was assessed via the National Institute of Health Toolbox (NIHTB)-Emotion Battery, which yields T-scores for three factor-based summary scores (negative affect, social satisfaction, and psychological well-being) and 13 individual component scales. Neurocognition was measured via demographically adjusted fluid cognition T-scores from the NIHTB-cognition battery.

RESULTS

27%-39% of the sample had problematic socioemotional summary scores. Hispanic PWH showed less loneliness, better social satisfaction, higher meaning and purpose, and better psychological well-being than Whites (ps <.05). Within Hispanics, Spanish-speakers showed better meaning and purpose, higher psychological well-being summary score, less anger hostility, but greater fear affect than English speakers. Only in Whites, worse negative affect (fear affect, perceived stress, and sadness) was associated with worse neurocognition (p <.05); and in both groups, worse social satisfaction (emotional support, friendship, and perceived rejection) was linked with worse neurocognition (p <.05).

CONCLUSION

Adverse emotional health is common among PWH, with subgroups of Hispanics showing relative strengths in some domains. Aspects of emotional health differentially relate to neurocogntition among PWH and cross-culturally. Understanding these varying associations is an important step towards the development of culturally relevant interventions that promote neurocognitive health among Hispanic PWH.

Health, Salud, : Individualizing Behavioral Needs in a Multicultural World

Diversity within the United States continues to increase, making it imperative that health care providers understand the impact of cultural background on health behaviors and perceptions. These practices promote trusting patient-provider relationships, improve outcomes, and increase patient satisfaction. In this article, we discuss the 3 largest ethnic or racial minority groups in the United States, Hispanics, African Americans, and Asians, and the intersection of culture and health care through the lens of these distinct communities. We also offer behavioral recommendations to increase awareness and knowledge regarding vast cultural variations within our communities while embracing cultural humility.

Development of mental health first-aid guidelines for suicide risk: a Delphi expert consensus study in Argentina and Chile

BACKGROUND

Suicide continues to pose a significant global public health challenge and ranks as one of the leading causes of death worldwide. Given the prevalence of suicide risk in the community, there is a significant likelihood of encountering individuals who may be experiencing suicidal thoughts or plans, creating an opening for non-health professionals to offer support. This study aims to culturally adapt the original Australian Mental Health First Aid Guidelines for suicide risk to the Chilean and Argentine context.

METHODS

A two-round Delphi expert consensus study was conducted involving two panels, one comprising individuals with personal experience in suicide thoughts/attempts or caregiving for those with such experiences (n = 18), and the other consisting of professionals specialized in suicide assessment and support for individuals at risk (n = 25). They rated a total of 179 items mainly derived from guidelines developed by Australian experts and translated into Spanish (168), and new items included by the research team (11). The panel members were requested to assess each item utilizing a five-point Likert scale. During the second round, items that received moderate approval in the initial round were re-evaluated, and new items suggested by the local experts in the first round were also subjected to evaluation in the next round. Inclusion in the final guidelines required an 80% endorsement as "essential" or "important" from both panels.

RESULTS

Consensus of approval was reached for 189 statements. Among these, 139 statements were derived from the English-language guidelines, while 50 locally generated statements were accepted during the second round. A significant difference from the original guideline was identified concerning the local experts' reluctance to discuss actions collaboratively with adolescents. Furthermore, the local experts proposed the inclusion of an entirely new section addressing suicide risk in older individuals, particularly focusing on suicide methods and warning signs.

CONCLUSIONS

A Delphi expert consensus study was conducted to culturally adapt mental health first aid guidelines for assessing suicide risk in Chile and Argentina. This study involved professionals and individuals with lived experience. While many items were endorsed, some related to inquiring about suicide risk and autonomy, particularly for adolescents, were not. An additional section for older individuals was introduced. Future research should explore the implementation and impact of these adapted guidelines in training courses. This is vital for enhancing mental health support and implementing effective suicide prevention strategies in Chile and Argentina.

Both/And: Mixed methods analysis of network composition, communication patterns, and socio-economic support within social networks of transgender women involved in sex work in Lima, Peru

INTRODUCTION

Social networks contribute to normative reinforcement of HIV prevention strategies, knowledge sharing, and social capital, but little research has characterized the social networks of transgender women (TW) in Latin America. We conducted a mixed methods analysis of three network clusters of TW in Lima, Peru, to evaluate network composition, types of support exchanged, and patterns of communication.

METHODS

We recruited TW residing in or affiliated with three "casas trans" (houses shared among TW) in Lima between April-May 2018. Eligible participants were 18 or older, self-reported HIV-negative, and reported recent intercourse with a cis-male partner. Participants completed demographic questionnaires, social network interviews, and semi-structured interviews to assess egocentric network structures, support exchanged, and communication patterns. Quantitative and qualitative data were analyzed using Stata v14.1 and Atlas.ti, respectively.

RESULTS

Of 20 TW, median age was 26 years and 100% reported involvement in commercial sex work. Respondents identified 161 individuals they interacted with in the past month (alters), of whom 33% were TW and 52% family members. 70% of respondents reported receiving emotional support from family, while 30% received financial support and instrumental support from family. Of the 13 (65%) respondents who nominated someone as a source of HIV prevention support (HPS), the majority (69%) nominated other TW. In a GEE regression analysis adjusted for respondent education and region of birth, being a family member was associated with lower likelihood of providing financial support (aOR 0.21, CI 0.08-0.54), instrumental support (aOR 0.16, CI 0.06-0.39), and HPS (aOR 0.18, CI 0.05-0.64). In qualitative interviews, most respondents identified a cis-female family member as their most trusted and closest network member, but other TW were more often considered sources of day-to-day support, including HPS.

CONCLUSION

TW have diverse social networks where other TW are key sources of knowledge sharing and support, and family members may also represent important and influential components. Within these complex networks, TW may selectively solicit and provide support from different network alters according to specific contexts and needs. HIV prevention messaging could consider incorporating network-based interventions with TW community input and outreach efforts for supportive family members.

Years of life lost to drug overdose in the Latinx community during the most recent wave of overdose deaths

BACKGROUND AND OBJECTIVES

This study estimated years of life lost (YLL) among US Latinx individuals during the most recent wave of drug overdose deaths.

METHODS

A serial cross-sectional study of YLL (life expectancy minus age at death) from death certificate records of Latinx individuals who died from drug overdoses from 2015 to mid-2022.

RESULTS

Over the study period, 58,209 Latinx individuals aged 15-64 years died from drug overdoses resulting in 2,266,784 YLL. Age-group YLL differences remained stable, but gender YLL trajectories diverged.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

This study extends our understanding of the immense loss to Latinx communities from preventable drug deaths.

The application of clique percolation method in health disparities research

AIMS

Clique percolation, one of the joint community detection algorithms in network science, is a novel and efficient approach to detecting overlapping communities in real networks. The current study illustrated how clique percolation can help to identify overlapping communities within the complex networks underlying health disparities, particularly highlighting nodes with strong associations with more than one community.

DESIGN

A cross-sectional study.

METHODS

The study used a dataset on Latinx populations (N = 1654; mean age = 43.3 years; 53.1% women) as an example to demonstrate the role of such overlapping nodes in the network of syndemic conditions and their common risk factors. Syndemic conditions in the network included HIV risk, substance abuse (smoking, heavy alcohol consumption and marijuana use) and poor mental health. Moreover, the risk factors encompassed individual (education and income) and sociostructural (adverse childhood experiences [ACEs] and access to services) factors. The network was estimated using the R-package bootnet. Clique percolation was conducted on the estimated network using the R-package CliquePercolation.

RESULTS

A total of three communities were detected, with HIV risk and poor mental health not being assigned to any community. In general, Community 1 was comprised of ACE categories, Community 2 included education, income and access to services and Community 3 included other syndemic conditions. Of note, two nodes were assigned to two communities: 'household dysfunction' to Communities 1 and 2 and 'smoking' to Communities 2 and 3.

CONCLUSION

Household dysfunction might be the key connector, among other ACEs, to individual and structural barriers. Such barriers further exposed Latinx individuals to risky behaviours, especially smoking, which further linked to marijuana use and heavy alcohol consumption.

IMPACT

Clique percolation facilitated our understanding of the complex systems of factors shaping health disparities. The overlapping nodes are promising intervention targets for reducing health disparities in this historically marginalized population.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Perceived discrimination and Latina college students' depressive symptoms: The roles of dyadic coping with sisters and familism values

Latinx young adults' experiences of discrimination are associated with high levels of depressive symptoms and examining protective factors that buffer the negative consequences of discrimination is important. In a sample of 195 Latina college students, predominately of Mexican origin, we examined associations between perceived discrimination and depressive symptoms, and how sisters' dyadic coping behaviors and familism values moderated this association. We conducted hierarchical regression analyses to test our study hypotheses. We found that Latina college students who were older sisters reported more conflictual and antagonistic sibling relationships, or who perceived higher levels of discrimination also reported the most depressive symptoms, which supports prior research. Importantly, Latina college students who strongly endorsed supportive, obligatory, and referent familism values reported fewer depressive symptoms. Supportive familism values weakened the association between perceived discrimination and Latina college students' depressive symptoms but strengthened associations between sisters' negative dyadic coping behaviors and depressive symptoms. Furthermore, sisters' negative dyadic coping behaviors strengthened the positive association between perceived discrimination and depressive symptoms. Our findings highlight the importance of familism values for Latinx young adults' well-being, as well as the harmful effects of perceived discrimination, particularly in the context of sisters' negative dyadic coping behaviors.

Assessing Brigada Digital de Salud Audience Reach and Engagement: A Digital Community Health Worker Model to Address COVID-19 Misinformation in Spanish on Social Media

U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally tailored, Spanish-language COVID-19 information on social media. From 1 May 2021 to 30 April 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize the topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%) and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By 9 June 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mainly women ages 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos with audio narration, healthcare providers, influencers, or music artists. This community-based model to engage Spanish-speaking audiences on social media with culturally aligned content to counter misinformation shows promise for addressing public health threats.

The role of pharmaceutical side-effects in depression among immigrants

OBJECTIVES

This study explores the role of pharmaceuticals with depression or suicidality as a side-effect in explaining the immigrant depression paradox. Immigrants generally report less depression than their native-born peers, despite the socio environments that are less conducive to well-being. This immigrant advantage in mental health tends to recede with time in the US and more acculturation. To date, an explanation for this pattern has remained elusive, partly because acculturation is also associated with many desirable outcomes, suggesting less depression with more acculturation.

DESIGN

Data came from seven two-year waves (2005-2006 to 2017-2018) of the National Health and Nutrition Examination Survey (NHANES). Depression was measured using the Patient Health Questionnaire (PHQ-9). Linear and logistic regressions were used to estimate the immigrant differences in depression, while controlling for sociodemographic characteristics, healthcare access, health conditions, and the use of medications with depression or suicidality as a side-effect.

RESULTS

30.3% and 22.7% of US-born adults used at least one medication with depression or suicidality as a side-effect, compared to 16.4% and 9.2% of foreign-born adults. Access to healthcare improved with time in the US and with acculturation, and both of these factors were also positively associated with the use of medications with depression or suicidality as a side-effect. The magnitude of the mediation associated with medication side-effects was significant, in many cases sufficient to eliminate the relationship between acculturation - whether expressed in terms of time in the US, English-language use, or nativity - and depression.

CONCLUSION

Exposure to medications with depression or suicidality as a side-effect helped explain part of the relative mental health advantage of foreign-born residents, as well as the diminishing advantage associated with time in the US and with acculturation.

Rationale and design of a pilot randomized controlled trial to increase moderate-to-vigorous physical activity in preadolescent Latina girls and their mothers

Background

Hispanic/Latina girls have a low prevalence of moderate-intensity physical activity (PA) compared to their male counterparts and non-Hispanic White girls. Mothers influence their children's activity levels by creating and supporting PA opportunities, modeling PA, and reinforcing children's efforts to be physically active. The Conmigo trial will evaluate a mother-daughter intervention to promote PA and examine potential mechanisms of change including mothers' PA, parenting regarding PA, and mother-daughter communication.

Method

This randomized controlled trial examines the feasibility, acceptability, and impact of a 12-week intervention promoting PA in preadolescent Latina girls in San Diego County, CA. Participants (n = 90 dyads) are randomized to the Conmigo PA intervention or to a control group that receive an abbreviated version of the intervention. The intervention was informed by Social Cognitive Theory and Family Systems Theory and emphasize family-level factors to promote PA using an actor-partner model. Mothers and daughters attend weekly 90-min sessions in English or in Spanish via Zoom video conferencing, supported by facilitator follow-ups and WhatsApp supportive chat group for mothers. Objective (accelerometer) and self-report measures at baseline, 3 months, and 6 months capture the frequency and intensity of PA and correlates and predictors of PA. We also examine the impact of the intervention on the bidirectional influence of mother-daughter PA.

Implications

The findings from the Conmigo trial will form the basis of a randomized controlled community trial and will move the field forward in identifying targets of change in preventing chronic disease risk in Hispanic/Latino communities.

A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico

This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.

Discrimination and Depressive Symptoms Among Mexican American Women: Exploring Multilevel Sociocultural Moderators

Relative to empirical studies on risk factors, less research has focused on culturally based protective factors that reduce the impact of discrimination on mental health. The current prospective study evaluated two potential moderators of the effect of discrimination on depressive symptoms among Mexican American women: individually held familism values and neighborhood cultural cohesion. Mexican-origin women in the United States (N = 322; mean age = 27.8 years; 86% born in Mexico) reported on frequency of discrimination, depressive symptoms, familism, and neighborhood cultural cohesion. Independent models evaluated familism and neighborhood cultural cohesion as moderators of the effect of discrimination on subsequent depressive symptoms. More frequent discrimination predicted higher subsequent depressive symptoms. High familism buffered the harmful effect of discrimination on depressive symptoms, such that more frequent discrimination was associated with higher subsequent depressive symptoms only for women who reported average and low familism. Neighborhood cultural cohesion did not buffer the effect of discrimination on depressive symptoms.

Sibling Support and Perceived Daily Hassles in Latino and Non-Latino Families of Children with DD

Parents of children with developmental delay (DD) report significantly higher levels of parenting stress compared to parents of children with typical development. There is a heightened need for social support among families of children with DD. Siblings play an important role in these contexts as a supportive resource and primary stress buffer. Little to no research has examined how these stress and supportive processes may differ among Latino and non-Latino parents. The current study examined the relation between sibling support and parents' perceived daily hassles between Latino and non-Latino parents of children with DD (N = 146; 65% Latino; mean parent age = 37.39 years; mean child age = 49.63 months; SD = 7.9). Latinos reported significantly greater use of sibling support and lower perceived daily hassles compared to non-Latino counterparts. In the combined sample, greater sibling support was significantly correlated with lower daily hassles. When examined separately in Latino and non-Latino groups, this correlation only remained significant among Latinos. The interaction between ethnicity and sibling support on perceived daily hassles was approaching significance, such that Latinos who reported high levels of sibling support reported lower perceived daily hassles. Findings emphasize the universal importance of familial support systems for the well-being of parents of children with DD and point to the possible protective role of Latino cultural factors that influence the degree to which these supports are employed. Results may inform culturally sensitive adaptations to parenting interventions for Latino families that harness sibling support to target and buffer parenting stress.

Acceptance of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) Intervention: A Caregiver Case Study

Latinos frequently assume caregiver roles when the need arises in their social nucleus. Because of their active role, caregivers are heavily involved in their family member's cancer trajectory. Therefore, there is a need for culturally adapted interventions that integrate the caregiver and cancer patient. The objective is to present a case study of a former caregiver's experience and acceptance of the cultural adaptation of Caregiver-Patient Support to Latinx Coping with Advanced Cancer (CASA) intervention. We conducted a case study with a male caregiver between the ages of 20 and 30. A male caregiver expressed his experience and acceptance of a psychosocial intervention. He conveyed moderate to high acceptance of intervention components through anecdotes and opinions based on his experiences as a caregiver for multiple family members. Finally, he reported distress, but he presented little to no symptoms of caregiver burden, depression, anxiety, and hopelessness. It is crucial to culturally adapt interventions that integrate caregivers when they play a big part in their loved one's cancer journey. Integrating their perspective when adapting an intervention may assist in providing essential information that will benefit the patient and caregiver.

Maternal and adolescent depressive symptoms and family conflict: An autoregressive cross-lagged examination of competing models in multi-stressed mothers and adolescents

Maternal and adolescent depression are challenges that often co-occur. Many studies have drawn bivariate associations between maternal depressive symptoms, adolescent depressive symptoms, and family conflict, but few have examined reciprocal effects. Even among extant studies, there is a lack of clarity related to directionality of influence. Three competing theoretical models may explain the relationship between maternal depressive symptoms, adolescent depressive symptoms, and family conflict, and these processes may differ by adolescents' sex. Using three time points of data from 187 diverse mother-adolescent dyads, we fit a taxonomy of autoregressive cross-lagged structural equation models to simultaneously evaluate the competing theoretical models and also examine differences by sex using multiple-group analyses. Results indicate a symptom-driven model whereby adolescent depressive symptoms predicted increases in family conflict. Sex differences were also found. For males, but not females, greater adolescent depressive symptoms predicted subsequent increases in maternal depressive symptoms, which then predicted lower family conflict-possibly indicating maternal disengagement/withdrawal. Our findings suggest addressing adolescent depressive symptoms in order to prevent family conflict and that distinctive targets for the prevention/intervention of family conflict should account for differences by adolescents' sex.

Association between Familism and Mental Health in College Adolescents during the COVID-19 Pandemic

Familism, also known in the literature as allocentrism, is the cultural propensity of a society to place the family at the center of its value system. Adherence to this value has been related to less depressive symptomatology in young people; however, these results are not conclusive, since it has also been found that the influence of familism on depressive symptoms is more indirect than direct. This study aimed to explore the direct relationships between familism (allocentrism and idiocentrism) and mental health (depression, anxiety, and stress). Methodologically, the study had a non-experimental, cross-sectional, descriptive, and correlational design. A sample of 451 Chilean university students responded to an instrument composed of the subscales allocentrism, idiocentrism, depression, anxiety, and stress during the COVID-19 pandemic. The results showed that family allocentrism was positively and significantly associated with depression (γ = 0.112, p < 0.05), anxiety (γ = 0.209, p < 0.001), and stress (γ = 0.212, p < 0.001), and family idiocentrism was negatively and significantly linked with depression (γ = -0.392, p < 0.001), anxiety (γ = -0.368, p < 0.001), and stress (γ = -0.408, p < 0.001). These findings contribute to supporting actions to reduce negative symptomatology and promote greater well-being in university students.

Positive Social Interaction and Psychological Kinship Mediate the Effect of Identity Fusion on Psychological Well-Being in South-South Migrants

The present study provides evidence of how positive social interaction and the perception of psychological kinship are mechanisms by which identity fusion with the host country is associated with the psychological well-being of Venezuelan migrants in Chile. The sample consisted of 323 Venezuelan migrants, of whom 147 (45.5%) were men. The participants were residents of the city of Santiago, Chile. The variables assessed were psychological well-being, identity fusion with host country, positive social interaction, and psychological kinship. Structural equation modeling was performed to estimate the proposed mediation model. The estimation method used was robust weighted least squares estimation. The first model showed that people who felt more fused with the host country had higher levels of psychological well-being. On the other hand, the second estimated model indicated that both positive social interaction and psychological kinship fully mediate the relationship between identity fusion with the host country and immigrants’ psychological well-being. It is not the mere sensation of feeling merged with the host country that increases the psychological well-being of migrants, but rather it is the positive social interactions and feeling that members of the host country are like family that are the components that link the fusion with the host country and the psychological well-being of Venezuelan migrants in Chile.

Understanding the psychosocial impact of the COVID-19 pandemic on Latinx emerging adults

There is growing evidence about the potential negative psychosocial impact of the COVID-19 pandemic on ethnoracially minoritized young adults. Emerging adulthood is a developmental stage (ages 18-29 years old) that is characterized by identity exploration, instability, self-focus, feeling "in between" and having a sense of possibilities. Latinx emerging adults have reported significant socio-emotional consequences as a result of the COVID-19 pandemic. The aim of this study was to explore the psychosocial impact of the COVID-19 pandemic on Latinx emerging adults (N = 31; ages 18-29) in California and Florida through online focus group interviews. A qualitative constructivist grounded theory approach was used in an effort to develop empirical knowledge, as research on the psychosocial impact of the COVID-19 pandemic on Latinx young adults is limited. This method served to capture the richness of the experiences of participants by allowing analytic codes and categories to drive theory development. In total, seven focus groups were held and participants attended a virtual focus group with other Latinx emerging adults from their state. The focus groups were transcribed verbatim and coded using constructivist grounded theory. Five themes were identified from the data concerning the impact of the pandemic on Latinx emerging adults, which centered around mental health experiences, navigating family factors, pandemic-related communication, career and academic disruptions, and systemic and environmental factors. A theoretical model was constructed to generate an understanding about factors influencing psychosocial functioning for Latinx emerging adults during the pandemic. The study has implications for advancing science on the consequences of pandemics on mental health and cultural considerations that may influence disaster recovery. Examples of these cultural considerations that emerged from this study include multigenerational values, heightened responsibilities, and mediating pandemic information. Results can inform efforts to increase support and resources for Latinx emerging adults in order to address the psychological difficulties resulting from the COVID-19 pandemic.

Family-based psychosocial interventions for adult Latino patients with cancer and their caregivers: A systematic review

Objective

This review aimed to systematically examine the characteristics and outcomes of family-based psychosocial interventions offered to adult Latino patients with cancer and their caregivers.

Methods

We searched six databases from their inception dates through June 2022. Studies were eligible for inclusion if they (1) targeted both adult Latino patients diagnosed with cancer and their adult caregivers or reported subgroup analyses of Latino patients and caregivers; (2) included family-based psychosocial interventions; (3) used randomized controlled trial (RCT) or quasi-experimental designs; and (4) were published in English, Spanish or Portuguese. Members of our multidisciplinary team assessed the risk of bias in the reviewed studies using the Cochrane Collaboration's Risk of Bias Tool.

Results

Our database searches yielded five studies. The studies were conducted in the U.S. and Brazil. Three studies were RCTs, and two used quasi-experimental designs. The sample sizes ranged from 18 to 230 patient-caregiver dyads. These studies culturally adapted the intervention contents and implementation methods and involved bilingual interventionists. The interventions had beneficial effects on multiple aspects of psychosocial outcomes for both patients and caregivers. We also identified methodological limitations in the reviewed studies.

Conclusions

Findings from this systematic review help deepen our understanding of family-based psychosocial interventions for Latinos affected by cancer. The small number of psychosocial interventions focused on adult Latino cancer patients and their caregivers is concerning, considering that Latino populations are disproportionally burdened by cancer. Future research needs to design and evaluate culturally-appropriate interventions to support Latino patients and families who cope with cancer.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=274993, identifier CRD42021274993.