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Mexican-origin youth, as a large and growing population among U.S. youth, have been disproportionately affected by COVID-19. Understanding what, when, and how sociocultural factors may influence their COVID-19 vaccine uptake could inform current and future pandemic-response interventions promoting vaccination behaviors among Mexican-origin youth. The current study takes a developmental approach to reveal the long-term and short-term sociocultural antecedents of 198 Mexican-origin adolescents' COVID-19 vaccination uptake behaviors and explores the underlying mechanism of these associations based on the Knowledge-Attitude-Behavior model. The current study adopted Wave 1 (2012-2015) and Wave 4 (2021-2022) self-reported data from a larger study. Analyses were conducted to examine four mediation models for four sociocultural antecedents-daily discrimination, ethnic discrimination, foreigner stress, and family economic stress-separately. Consistent indirect effects of higher levels of concurrent sociocultural risk factors on a lower probability of COVID-19 vaccine uptake were observed to occur through less knowledge about the COVID-19 vaccines and less positive attitudes toward the COVID-19 vaccines at Wave 4. Significant direct effects, but in opposite directions, were found for the associations between Wave 1 ethnic discrimination/Wave 4 daily discrimination and the probability of COVID-19 vaccine uptake. The findings highlight the importance of considering prior and concurrent sociocultural antecedents and the Knowledge-Attitude-Behavior pathway leading to COVID-19 vaccination uptake among Mexican-origin youth and suggest that the impact of discrimination on COVID-19 vaccination uptake may depend on the type (e.g., daily or ethnic) and the context (e.g., during the COVID-19 pandemic or not) of discrimination experienced.
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OBJECTIVE: The COVID-19 pandemic disproportionately affected ethnic minority populations and exacerbated preexisting health disparities. The current study aims to promote vaccine uptake among Mexican-origin youth from immigrant families by examining their time to COVID-19 vaccine uptake and assessing the influence of demographic, cognitive, and social factors on the incidence of COVID-19 vaccination. METHODS: The study conducted Survival Analysis using a Cox proportional hazards model based on a sample of 202 Mexican-origin youth (61.39% female; Mage = 20.41) with data collected from August 2021 to January 2023 in central Texas. RESULTS: The results show a critical time period for vaccine uptake (i.e., in the first six months after the vaccines were publicly available), evidenced by a surge decrease in COVID-19 unvaccination probability. In addition, more positive attitudes toward the COVID-19 vaccine (Hazard ratio/HR = 1.89, 95% Confidence Interval/CI = [1.64, 2.18]), greater motivation (HR = 2.29, 95% CI = [1.85, 2.85]), higher education levels (HR = 1.52, 95% CI = [1.24, 1.86]), and fewer general barriers to COVID-19 vaccine knowledge (HR = 0.75, 95% CI = [0.60, 0.94]) were associated with greater incidences of receiving COVID-19 vaccines at any given time point during the pandemic. CONCLUSION: The findings suggest that COVID-19 vaccine uptake among Mexican-origin youth occurred primarily within the initial months of vaccines being publicly distributed. To encourage vaccination among Mexican-origin youth, sustained COVID-19 vaccine promotion efforts are needed by targeting their motivation and positive attitudes and reducing barriers to vaccine information, particularly for youth with lower education levels.
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Using baseline data from three partnering federally qualified health centers, we examined factors associated with depressive symptoms among Mexican-origin adults at risk of chronic disease living in three counties in Southern Arizona (i.e., Pima, Yuma, and Santa Cruz). Multivariable linear regression models identified correlates of depressive symptoms for this population controlling for sociodemographic characteristics. Among 206 participants, 85.9% were female and 49% were between 45 and 64 years of age. The proportion of depressive symptoms was 26.8%. Low levels of physical pain and high levels of hope and social support were also reported. Physical pain was positively and significantly related to depressive symptoms (ß = 0.22; 95% CI = 0.13, 0.30). Conversely, hope was negatively and significantly associated with depressive symptoms (ß = -0.53; 95% CI = -0.78, -0.29). A better understanding of factors related to depressive symptoms among Mexican-origin adults is necessary to fulfill their mental health needs, as well as to achieve health equity and to eliminate health disparities in the US-Mexico border region.
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Depressão , Americanos Mexicanos , Dor , Adulto , Feminino , Humanos , Masculino , Arizona/epidemiologia , Depressão/epidemiologia , Depressão/etnologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Dor/epidemiologia , Dor/etnologia , Dor/psicologiaRESUMO
BACKGROUND: Community-clinical linkages (CCLs) connect public health organizations and health care providers to better support patients. Community health workers (CHWs), representatives from priority populations with special connections to their community, can lead CCLs. OBJECTIVES: Our objective was to learn about how to conduct a CHW-led CCL from the perspectives of those implementing the intervention. METHODS: We conducted focus groups with CHWs and their supervisors and regularly consulted community partners while coding and analyzing data. RESULTS: We learned that CHWs thrive when supported by peers, supervisors, institutions, and researchers. Supervisors- who are new to the CHW role-should consider seeking training in CHW professional development and performance evaluation. Focus group participants agreed that by balancing the strengths and weaknesses of their organization, CHW-led CCLs benefit patients because the collaboration helps them to better manage their health. CONCLUSIONS: Future CHW-led CCL practitioners should consider how to best institutionally support CHWs to maximize benefits for patients.
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Agentes Comunitários de Saúde , Pesquisa Participativa Baseada na Comunidade , Agentes Comunitários de Saúde/educação , Grupos Focais , Humanos , México , Saúde PúblicaRESUMO
INTRODUCTION: Compared with their non-Hispanic White counterparts, Latino/a people have limited access to health resources that might improve their emotional well-being. Interventions that prioritize the Latino/a population, address social determinants of health, and decrease health disparities are needed. The objective of this study was to describe a community-clinical linkage intervention led by community health workers (CHWs) in 3 Latino/a populations along the US-Mexico border. METHODS: Researchers at the Arizona Prevention Research Center conducted the Linking Individual Needs to Community and Clinical Services (LINKS) study during 2017-2018. Clinic-based CHWs referred participants to community-based CHWs who met with participants monthly for 6 months to assess participant needs, provide support for emotional well-being, and link them to resources. Two community-based CHWs collaborated to maximize participant care; they also administered an emotional well-being questionnaire at baseline and at 3-month and 6-month follow-up. We estimated changes in emotional well-being outcomes. RESULTS: Scores for social support, perceived hopefulness, and quality-of-life measures among 189 LINKS participants increased significantly during the study period, especially among men and participants with low baseline scores. For each of the 3 outcomes, the standardized change was approximately 0.28 per 3 months of intervention, a decrease of more than half an SD (0.56) during 6 months of follow-up. CONCLUSION: A CHW-led community-clinical linkage intervention can result in positive emotional well-being outcomes. We encourage policy makers, funders, and public health practitioners to further investigate such interventions as a solution to reduce disparities in emotional well-being.
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Agentes Comunitários de Saúde , Hispânico ou Latino , Humanos , Masculino , México , Encaminhamento e Consulta , Apoio SocialRESUMO
BACKGROUND: Social support plays a critical role in physical and emotional health, making it an important component of community health worker (CHW) health promotion interventions. Different types of support operate in different ways, however, and the relationship between the nature of CHW support and the subsequent health benefit for their clients is not well understood. METHODS: This paper describes an integrated mixed methods study of the emotional, informational, appraisal and tangible support CHWs provided to Latinx community members residing in three US-Mexico border communities. Using a cohort (n = 159) from a CHW community-based intervention, we identify and describe four clusters of social support in which participants are characterized by life situations that informed the types of social support provided by the CHW. We examine the association between each cluster and client perceptions of social support over the 6-month intervention. RESULTS: CHWs provided emotional, appraisal, informational and tangible support depending on the needs of participants. Participants who received higher levels of emotional support from the CHW experienced the greatest post intervention increase in perceived social support. CONCLUSIONS: Study findings suggest that CHWs may be adept at providing non-directive social support based on their interaction with a client rather than a health outcome objective. Health promotion interventions should allow CHWs the flexibility to tailor provision of social support based on their assessment of client needs.