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The COVID-19 pandemic has affected independently-owned restaurants with implications for food access and health equity. Changes in healthy food availability (HFA) were examined in a randomly selected sample of Hispanic Caribbean restaurants in New York City, before and after the COVID-19 onset (n=76), using an adapted Nutrition Environment Measurement Survey for Restaurants. An overall decrease in HFA scores was found and changes HFA components (fried foods and vegetarian options increased, 100% fruit juice decreased, p<0.10). Changes were examined against restaurant characteristics. This work augments our understanding of ethnic restaurants and the nutrition implications of business adaptations when responding to emergencies.
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OBJECTIVES: Evaluated how COVID-19 impacted Latino health across social, economic, and emotional dimensions and differentiated whether adverse COVID-19-related effects persisted across respondents. METHODS: In both English and Spanish, a cross-sectional survey was conducted in the USA from June 2021 to April 2022. Chi-square tests, Z-tests, and T-tests were used to test for significant differences between Spanish- and English-speaking respondents. Multiple linear regressions were carried out to understand whether previously established determinants of health for Latinos accounted for greater COVID-19-related adversity across social, economic, and mental health dimensions. English as a primary language was significantly related to greater adverse emotional/mental health COVID-19 experiences after controlling for other social determinants of health factors (ß = - 0.355, p < 0.001). Individuals who reported worrying about housing loss were significantly more likely to experience more adverse economic adversity due to COVID-19 (ß = - 0.234, p < 0.001). Household income < $35,000 (ß = 0.083, p < 0.05), having more than 5 people living in the same home (ß = -0.102, p < 0.05), and work-related transportation barriers (ß = - 0.114, p < 0.05) all increased the likelihood of household-related stressors occurring because of the pandemic. CONCLUSIONS: The study highlights the heterogeneity in the Latino community and the key social, economic, and community-level factors most strongly correlated with adverse COVID-19-related outcomes.
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This pilot study provides preliminary insights into whether Latino preschool children living in an emerging Latino community (ELC) are meeting recommendations for healthy diet and activity behaviours and whether those behaviours are associated with sociodemographic or home environment variables. Secondary data analysis was conducted utilising cross-sectional baseline survey data from ANDALE Pittsburgh, a home-based intervention study. Measures included parent-reported information on child dietary intake, screen time and the home environment, and objectively measured physical activity and anthropometry. χ2 and Fischer's exact tests were used to determine associations. The study was conducted in an ELC in western Pennsylvania in the US. Fifty-one Latina mothers (age: 33â 5 ± 6â 1 years; 63 % Mexican origin; 86 % low acculturation) and their children (age: 3â 9 ± 1â 3 years; 55 % male) 2-5 years of age. On average, children consumed 2â 25 ± 1â 44 cups of fruits/vegetables, viewed 98â 7 ± 74â 2 min of screen time, accumulated 12â 9 ± 2â 9 min/h of total physical activity and consumed 15â 5 ± 26â 0 kcals of sugar-sweetened beverages per day. Forty-one percent met the fruit/vegetable recommendation, 54 % met the screen time recommendation, 27 % met the physical activity recommendation and 58 % met the sugary drink recommendation. Country of origin (P = 0â 032) and acculturation (P = 0â 048) were significantly associated with children meeting sugary drink recommendations. No other relationships were significant. The proportion of children in this sample meeting diet and activity recommendations was mixed. More research with larger sample sizes is needed in ELCs to identify effective intervention strategies for improving health behaviours.
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Dieta Saludable , Hispánicos o Latinos , Preescolar , Femenino , Humanos , Masculino , Estudios Transversales , Dieta Saludable/etnología , Dieta Saludable/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Proyectos Piloto , Prevalencia , Verduras , Ejercicio Físico/estadística & datos numéricos , Adulto , Pennsylvania/epidemiologíaRESUMEN
OBJECTIVE: Latino adults in Los Angeles have experienced disproportionate cases, deaths, and socioeconomic impacts from the COVID-19 pandemic. This qualitative study aimed to explore community perspectives on readiness for COVID-19 vaccination and to identify culturally tailored vaccine outreach strategies. METHODS: We conducted virtual focus groups with Los Angeles County Latino/a residents via Zoom between December 2020 to January 2021, as the first COVID-19 vaccines were receiving Emergency Use Authorization (EUA). Focus groups were facilitated in Spanish and English by bilingual members of the research team. Discussions were analyzed via Atlas.ti software using reflexive thematic analysis. RESULTS: Three focus groups (n = 15; four to six people each; two Spanish focus groups; one English) were conducted. Thematic findings centered on Latino COVID-19 vaccine equity: (1) Disproportionate infection risk due to essential worker status and socioeconomic burdens, misinformation, and familial or cultural tensions (2) Concerns for inequitable vaccine access due to immigration fears and limited healthcare access, and (3) A need for community-centered COVID-19 vaccine outreach and access. CONCLUSIONS: Our study on early Latino adult reactions to vaccine roll-out suggests the need for outreach strategies centering on validating community hardships, combating dis-/misinformation through trusted sources, and addressing socio-economic needs impacted by the pandemic.
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Vacunas contra la COVID-19 , COVID-19 , COVID-19/epidemiología , COVID-19/prevención & control , Hispánicos o Latinos , Humanos , Los Angeles , Pandemias/prevención & controlRESUMEN
This study evaluated the dissemination and implementation of a culturally tailored community-wide campaign (CWC), Tu Salud ¡Si Cuenta! (TSSC), to augment fruit and vegetable (FV) consumption and physical activity (PA) engagement among low-income Latinos of Mexican descent living along the U.S.-Mexico Border in Texas. TSSC used longitudinal community health worker (CHW) home visits as a core vehicle to enact positive change across all socioecological levels to induce behavioral change. TSSC's reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) was examined. A dietary questionnaire and the Godin-Shepherd Exercise Questionnaire measured program effectiveness on mean daily FV consumption and weekly PA engagement, respectively. Participants were classified based on CHW home visits into "low exposure" (2-3 visits) and "high exposure" (4-5 visits) groups. The TSSC program reached low-income Latinos (n = 5686) across twelve locations. TSSC demonstrated effectiveness as, compared to the low exposure group, the high exposure group had a greater FV intake (mean difference = +0.65 FV servings daily, 95% CI: 0.53-0.77) and an increased PA (mean difference = +185.6 MET-minutes weekly, 95% CI: 105.9-265.4) from baseline to the last follow-up on a multivariable linear regression analysis. Multivariable logistic regression revealed that the high exposure group had higher odds of meeting both FV guidelines (adjusted odds ratio (AOR) = 2.03, 95% CI: 1.65-2.47) and PA guidelines (AOR = 1.36, 95% CI: 1.10-1.68) at the last follow-up. The program had a 92.3% adoption rate, with 58.3% of adopting communities meeting implementation fidelity, and 91.7% of communities maintaining TSSC. TSSC improved FV consumption and PA engagement behaviors among low-income Latinos region wide. CHW delivery and implementation funding positively influenced reach, effectiveness, adoption, and maintenance, while lack of qualified CHWs negatively impacted fidelity.
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Frutas , Verduras , Agentes Comunitarios de Salud , Ejercicio Físico , Hispánicos o Latinos , Humanos , MéxicoRESUMEN
Coronavirus disease 2019 (COVID-19) exacerbated pre-existing health disparities and disproportionately affected the Latino community. Clinicians identified communication barriers as a major challenge in care for COVID-19 Latino patients with limited English proficiency (LEP). To address these challenges, Juntos (Together) consult service was established to promote language-congruent care with cultural sensitivity, identify barriers to safe discharge, and facilitate referral to appropriate resources. Spanish speaking volunteer health care providers worked synergistically with medical teams caring for LEP Latino patients. Volunteers were trained on consultant responsibilities and discharge planning resources. The program was evaluated by a satisfaction survey distributed to providers who requested a Juntos consult and Juntos volunteers. Between May 5 and July 30, 2020, 19 individuals volunteered time to the Juntos consult service, 12 (63%) Latinos, 14 (74%) physicians, and 5 (26%) staff. The service supported 127 patients, 76 (60%) males, mean age 42 (±16), 83 (65%) uninsured, and 91 (72%) without primary care. The most common referral sources were medical units (52, 41%) and intensive care units (47, 37%). The most common services offered were family engagement (55, 43%), goals of care (35, 28%), and mental status assessment (26, 20%). The majority of providers who consulted Juntos were very satisfied (48/59, 81%) with the care delivered. The Juntos service offered critical support tailored to the patients' and primary teams' needs. The experience reinforced the need for cultural-based communication to provide optimal care to LEP patients. The Juntos consult service could be a model for providing language-congruent care even beyond COVID-19, but to do so will require institutional investment and rigorous outcomes evaluation.
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The COVID-19 pandemic has exacerbated the effects of existing health disparities throughout the United States. While Hispanic/Latino individuals account for only 16% of the Rhode Island (RI) population, Rhode Island Department of Health (RIDOH) data show that 45% of COVID-19 cases and 36% of individuals who have been hospitalized identify as Hispanic/Latino. Clínica Esperanza/Hope Clinic (CEHC) mobilized a comprehensive effort to offer telehealth visits, health education and accessible, walk-up COVID-19 testing for low-income, uninsured and Spanish-speaking individuals living in Rhode Island. With support from CEHC volunteers, the City of Providence, the State of Rhode Island, and local foundations, CEHC has administered 1,649 individual COVID-19 tests as of October 2020. The overall COVID-19 test positivity rate at CEHC was 23%, peaking in April at 48%. Additionally, CEHC has distributed more than 1,600 meal boxes to patients experiencing food insecurity, provided emergency financial resources, while rapidly scaling up healthcare services for the increasing numbers of uninsured individuals in RI.
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Instituciones de Atención Ambulatoria , Infecciones por Coronavirus/diagnóstico , Apoyo Financiero , Abastecimiento de Alimentos , Educación en Salud , Hispánicos o Latinos , Pacientes no Asegurados , Neumonía Viral/diagnóstico , Telemedicina , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Rhode Island , SARS-CoV-2 , Poblaciones Vulnerables , Adulto JovenRESUMEN
Variation in levels of the human metabolome reflect changes in homeostasis, providing a window into health and disease. The genetic impact on circulating metabolites in Hispanics, a population with high cardiometabolic disease burden, is largely unknown. We conducted genome-wide association analyses on 640 circulating metabolites in 3,926 Hispanic Community Health Study/Study of Latinos participants. The estimated heritability for 640 metabolites ranged between 0%-54% with a median at 2.5%. We discovered 46 variant-metabolite pairs (p value < 1.2 × 10-10, minor allele frequency ≥ 1%, proportion of variance explained [PEV] mean = 3.4%, PEVrange = 1%-22%) with generalized effects in two population-based studies and confirmed 301 known locus-metabolite associations. Half of the identified variants with generalized effect were located in genes, including five nonsynonymous variants. We identified co-localization with the expression quantitative trait loci at 105 discovered and 151 known loci-metabolites sets. rs5855544, upstream of SLC51A, was associated with higher levels of three steroid sulfates and co-localized with expression levels of SLC51A in several tissues. Mendelian randomization (MR) analysis identified several metabolites associated with coronary heart disease (CHD) and type 2 diabetes. For example, two variants located in or near CYP4F2 (rs2108622 and rs79400241, respectively), involved in vitamin E metabolism, were associated with the levels of octadecanedioate and vitamin E metabolites (gamma-CEHC and gamma-CEHC glucuronide); MR analysis showed that genetically high levels of these metabolites were associated with lower odds of CHD. Our findings document the genetic architecture of circulating metabolites in an underrepresented Hispanic/Latino community, shedding light on disease etiology.
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Enfermedad Coronaria/genética , Diabetes Mellitus Tipo 2/genética , Predisposición Genética a la Enfermedad , Genoma Humano , Metaboloma/genética , Sitios de Carácter Cuantitativo , Adulto , Cromanos/metabolismo , Estudios de Cohortes , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/etnología , Enfermedad Coronaria/metabolismo , Familia 4 del Citocromo P450/genética , Familia 4 del Citocromo P450/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/etnología , Diabetes Mellitus Tipo 2/metabolismo , Femenino , Expresión Génica , Estudio de Asociación del Genoma Completo , Hispánicos o Latinos , Humanos , Masculino , Proteínas de Transporte de Membrana/genética , Proteínas de Transporte de Membrana/metabolismo , Persona de Mediana Edad , Fenotipo , Polimorfismo de Nucleótido Simple , Propionatos/metabolismo , Salud Pública , Carácter Cuantitativo Heredable , Vitamina E/metabolismoRESUMEN
AIM: To develop a process for returning medically actionable genomic variants to Latino patients receiving care in a Federally Qualified Health Center. METHODS: Prior to recruitment, researchers met with primary care providers to (1) orient clinicians to the project, (2) establish a process for returning actionable and nonactionable results to participants and providers through the electronic health record, and (3) develop a process for offering clinical decision support for follow-up education and care. A Community Advisory Board was engaged to provide input on recruitment strategies and materials for conveying results to participants. Participants in the Sangre Por Salud (Blood for Health) Biobank with hyperlipidemia or colon polyps represented the pool of potentially eligible participants. RESULTS: A total of 1,621 individuals were invited to participate and 710 agreed to an in- person consenting visit (194 no-showed and 16 declined). Over 12-months, 500 participants were enrolled. Participants were primarily Spanish-speaking (81.6%), female (74.2%), and enrolled because of hyperlipidemia (95.4%). All but 2 participants opted to receive primary (i.e., related to enrollment phenotypes) as well as secondary actionable results. CONCLUSION: Efforts to bring precision medicine to community-based health centers serving minority patients may require multilevel engagement activities to include individuals, providers, health systems, and the community.
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Bancos de Muestras Biológicas/organización & administración , Centros Comunitarios de Salud/organización & administración , Genómica/organización & administración , Hispánicos o Latinos/genética , Adulto , Anciano , Arizona , Atención a la Salud/organización & administración , Femenino , Investigación Genética , Disparidades en Atención de Salud , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios , Selección de Paciente , Medicina de Precisión/métodosRESUMEN
The co-occurrence of depression and chronic diseases is often under-recognized, under-treated, and under-studied. Among Latinos, complex structural and cultural barriers exist which complicate the translation of chronic disease self-management programs (CDSMP) for this population. To better understand those barriers and deliver a CDSMP designed to best meet local needs, a community-based, mixed methods study was designed. Formative research was conducted through focus groups with Latinos with chronic illness and minor depression (ICD) and family members to obtain insight into perceived needs and interviews with stakeholders to assess barriers and facilitators to the adoption of CDSMPs. Analytic Hierarchy Process was employed to determine core elements of a CDSMP for ICDs, family members, and the promotores who deliver these programs. Findings guided the transcreation of a CDSMP. This study offers a promising model for enhancing the effects of evidence-based interventions and emphasizes the importance of meeting differing needs within the local population.