RESUMEN
Behavioral health disorders such as mental disorders (MD) and substance use disorders (SUD) are epidemics in the US; however, the availability of treatment and prevention services remains low. This study assessed neighborhood-level sociodemographic attributes to characterize the availability of behavioral health treatment facilities in Florida. The American Community Survey and SAMHSA's Behavioral Health Treatment Locator were used to identify behavioral health treatment facilities in Florida and calculate their density by census tract. Spatial lag regression models were used to assess census tract-level correlates of facility density for 390 MD treatment facilities, 518 SUD facilities, and subsets of affordable MD and SUD facilities. Behavioral health treatment facility density was negatively associated with rurality and positively associated with the proportion of non-Latino Black, Latino, insured, and college-educated populations. Stark rural-urban disparities in behavioral health treatment availability present opportunities to prioritize telehealth and mobile interventions and improve treatment utilization.
Asunto(s)
Accesibilidad a los Servicios de Salud , Trastornos Relacionados con Sustancias , Humanos , Estudios Transversales , Florida , Hispánicos o Latinos , Características de la Residencia , Trastornos Relacionados con Sustancias/terapia , Negro o AfroamericanoRESUMEN
Purpose: The study aimed to identify HIV prevention, testing, and care services prioritizing young Latino men who have sex with men (MSM) in an HIV service delivery network in Miami-Dade County, Florida, by visually describing structural features and processes of collaboration within and between health and social venues.Methods: The study used cross-sectional data from 40 social and healthcare venues providing goods and services to young Latino MSM. Each venue provided information surrounding HIV-related services provided and collaborations with other venues. Network visualization analyses were performed using UCINET6 and NetDraw2.160.Results: The most commonly used services offered by health and social venues were free condoms and HIV education materials. Collaborations both within and between health and social venues components of the network existed. Not all health and social venues provided services to young Latino MSM.Conclusion: Health venues can reach and incorporate hard to reach populations, such as non-English speaking and undocumented young Latino MSM, to provide HIV-related services using service delivery venue social networks.
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Atención a la Salud , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Minorías Sexuales y de Género , Análisis de Redes Sociales , Adulto , Estudios Transversales , Florida , Infecciones por VIH/terapia , Servicios de Salud , Hispánicos o Latinos , Humanos , Masculino , Asunción de Riesgos , Red SocialRESUMEN
OBJECTIVE: Identifying and understanding determinants of alcohol use behavior among Hispanic immigrants is an increasingly significant public health concern. Although prior research has examined associations of cultural stressors with alcohol use among Hispanics, few studies have tested these associations among recent adult immigrants. As such, this study aimed to examine (a) the association of immigration stress on alcohol use severity among recently immigrated Hispanic adults (≤ 1 year in the United States) and (b) the moderating effects of gender, immigration status, and social support. METHOD: A hierarchical multiple regression and moderation analyses were conducted on a sample of 527 participants in South Florida. RESULTS: Results indicated that, after controlling for demographic variables, preimmigration drinking behavior, and dimensions of social support, the association of higher immigration stress with higher alcohol use severity was statistically significant. Moderation analyses indicated that immigration stress had a statistically significant association with alcohol use severity among men, but not women. Also, dimensions of social support consistently reduced the deleterious effect of immigration stress on alcohol use severity. CONCLUSION: This study adds to the scarce literature on cultural stressors and alcohol use among recent Hispanic immigrants. Findings suggest that it may be important to design gender-specific interventions and that increasing levels of social support may offset the effects of immigration stress on alcohol use.
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Consumo de Bebidas Alcohólicas/etnología , Trastornos Relacionados con Alcohol/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Apoyo Social , Estrés Psicológico/etnología , Adulto , Emigrantes e Inmigrantes/legislación & jurisprudencia , Femenino , Florida/etnología , Humanos , Masculino , Adulto JovenRESUMEN
This study examines whether orphan and vulnerable children (OVC) primary caregivers are facing absolute household wealth (AWI) disparities, the association between AWI and women's overweight status, and the modifying role of OVC primary caregiving status on this relationship. Demographic Health Surveys data (2006-2007) from 20 to 49 year old women in Namibia (n = 6,305), Swaziland (n = 2,786), and Zambia (n = 4,389) were analyzed using weighted marginal means and logistic regressions. OVC primary caregivers in Namibia and Swaziland had a lower mean AWI than other women in the same country. In Zambia, OVC primary caregivers had a lower mean AWI score than non-primary caregivers living with an OVC but a higher mean AWI score than non-OVC primary caregivers. In Swaziland and Zambia, even small increases in household wealth were associated with higher odds for being overweight regardless of women's caregiving status. Only in Namibia, OVC primary caregiving modified the effect of the previous association. Among Namibian OVC primary caregivers, women who had at least medium household wealth (4 or more AWI items) were more likely to be overweight than their poorest counterparts (0 or 1 AWI items). OVC primary caregivers are facing household wealth disparities as compared to other women from their communities. Future studies/interventions should consider using population-based approaches to reach women from every household wealth level to curb overweight in Swaziland and Zambia and to focus on specific household wealth characteristics that are associated with OVC primary caregivers' overweight status in Namibia.
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Cuidadores/estadística & datos numéricos , Niños Huérfanos , Sobrepeso/epidemiología , Pobreza , Poblaciones Vulnerables/estadística & datos numéricos , Adulto , África del Sur del Sahara , Niño , Estudios Transversales , Esuatini/epidemiología , Composición Familiar , Femenino , Estado de Salud , Encuestas Epidemiológicas , Humanos , Renta , Modelos Logísticos , Persona de Mediana Edad , Namibia/epidemiología , Características de la Residencia , Factores Socioeconómicos , Zambia/epidemiologíaRESUMEN
OBJECTIVE: To examine patient and provider barriers and facilitators of colorectal cancer (CRC) screening among mid-Atlantic Latinos seeking care at urban primary care clinics and describe implications for the design of interventions in primary care. DESIGN AND METHOD: Nine focus groups were conducted with 70 Latino patients and 27 primary care providers. Content analysis of focus group transcripts was performed using established qualitative techniques. RESULTS: Comments on CRC screening fell into 10 content areas: primary care site or provider characteristics (25% patient/21% provider comments); knowledge (18% patient/12% provider comments); cost/insurance coverage (10%/25%); attitudes (14%/7%); ordering of priorities (10%/11%); language (12%/7%); procedural issues regarding screenings (8%/10%); discrimination (2%/1%); and issues related to being a new immigrant (.2%/6%). Patient lack of understanding of the screening test procedures, inadequate knowledge about colorectal cancer, inadequate numbers of Spanish-speaking providers, and the cost of screening were most often cited as barriers by patients. Both providers and patients repeatedly mentioned the lack of funding and referral sources for colonoscopy as a key barrier to performing screening, even with lower-cost fecal occult blood tests, as colonoscopy follow-up would not be available. Patients favored receiving CRC screening recommendations from their usual continuity physician, but were open to receiving information on test procedures and indications from a Spanish-speaking health educator. CONCLUSIONS: Efforts to improve funding and availability of colonoscopy for low-income persons could proceed in tandem with linguistically and culturally appropriate clinic-based efforts to improve CRC screening among Latinos.
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Neoplasias Colorrectales/diagnóstico , Hispánicos o Latinos , Aceptación de la Atención de Salud/etnología , Atención Primaria de Salud/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Grupos Focales , Humanos , Masculino , Mid-Atlantic Region , Persona de Mediana EdadRESUMEN
BACKGROUND: Latinos have low representation in cancer prevention trials and intervention studies. Culturally appropriate recruitment strategies are needed to address this issue. OBJECTIVE: To describe and summarize the effectiveness of recruitment strategies used by the Latin American Cancer Research Coalition (LACRC). DESIGN: Descriptive report of recruitment methods. PARTICIPANTS: Uninsured Latino immigrants (N=1,170; 77% female, 23% male) from Central and South America recruited to 7 cancer control studies. APPROACH: The LACRC recruitment model involved inclusion of Latino researchers and providers, and use of culturally acceptable materials released through culturally appropriate outlets such as Latino radio stations. RESULTS: The overall participation rate was high-96% of patients identified as eligible agreed to participate. Women were excellent referrals for recruiting men to research studies. Additionally, a local Latino radio program was used to efficiently recruit eligible study participants. CONCLUSIONS: Latinos are interested and willing to participate in cancer control studies when culturally relevant approaches are used. Research teams that partner with Latino researchers and with Latino service providers are important in educating Latinos about cancer control and encouraging participation in research.