Aim To describe immigrant Latinas’ perspectives of a lifestyle behavior intervention, focusing on their interactions with and perceptions of the promotoras who delivered the program in the United States. Background Immigrant Latinas in the United States have high obesity rates, which contribute to increased risk for cardiovascular disease and other chronic diseases. Interventions using the promotora model appear to be effective in reducing cardiovascular disease risk by improving dietary habits, physical activity, and selected clinical variables among Latinas. However, there has been very limited inquiry into what it is about these interventions and promotoras that facilitates behavior change, from the perspective of participants. Design Grounded theory methodology guided the data collection and analysis. Methods This qualitative study was completed in 2012 in California, after the end of a lifestyle behavior intervention. Four focus groups and seven one-on-one interviews were conducted with a total of 18 immigrant Latina intervention participants. Results Women described promotoras as helping them change by motivating them through three interconnected elements: tools, support, and knowledge. Latinas viewed their ability to make lifestyle changes as connected with their emotional and psychological health, and saw promotoras as counselors who provided emotional and social support. In this respect, the intervention was emotionally therapeutic for this sample of Latinas, although this was not the original intention of the program. Conclusion Promotoras provided the backbone of the intervention and were crucial in motivating Latinas to implement lifestyle changes. Future lifestyle behavior interventions should include a strong component of mental and emotional well-being.

A community-based participatory research study was conducted using focus groups with 39 women living with AIDS (WLA) in the rural setting of Andhra Pradesh, India. In addition, three nurses, two physicians, and five reproductive health accredited social health activists (ASHAs) took part in focus groups. The WLA offered insight Support for this research was provided by grant MH82662 from the National Institute on Mental Health.Address correspondence to Adeline M. Nyamathi, ANP, PhD, FAAN, UCLA, School of Nursing, Room 2-250, Factor Building, Los Angeles, CA 90095-1702, USA. E-mail: anyamath@ sonnet.ucla.edu Services, 9:385-404, 2010 Copyright # Taylor & Francis Group, LLC ISSN: 1538-1501 print=1538-151X online DOI: 10.1080DOI: 10. /15381501.2010 into the benefits of HIV-trained ASHAs including emotional support, assistance with travel to health care providers and antiretroviral therapy medication adherence. Health care providers also identified benefits of using HIV-trained ASHAs and suggested modalities for how to train these individuals. These findings will contribute to the design of a future program of care involving HIV-trained ASHAs. Journal of HIV/AIDS & SocialKEYWORDS accredited social health activists (ASHAs), HIV= AIDS, rural India, women Approximately 2.3 million adults are living with HIV=AIDS in India, of whom 38% are women (Joint United Nations Programme on HIV=AIDS [UNAIDS], 2008). The state of Andhra Pradesh has the second highest HIV adult prevalence rate in all of India (0.97% total; 0.75% for women and 1.22% for men), according to the National Family Health Survey (NFHS, 2008). Data from antenatal clinics indicate that almost half of 23 districts in Andhra Pradesh have HIV prevalence rates for women above 2% to 2.5% (National AIDS Control Organization [NACO], 2007), indicating a feminization of the epidemic in this area. Indeed, 85% of HIV transmission in India is sexual, and 75% of women living with HIV=AIDS (WLA) become positive within the first few years of marriage (Solomon, Chakraborty, & Yepthomi, 2004).In India there exist gender-specific disparities in HIV prevention and treatment. One of the main factors influencing India's HIV epidemic is a high rate of gender stratification, in which women experience extreme social disadvantage (Bloom & Griffiths, 2007). Indian women suffer disproportionate vulnerability to HIV=AIDS (Kambou, Magur, Hora, & Mukherjee, 2007), often because they often lack HIV awareness, live in conditions of poverty, and experience gender inequity (Van Rompay et al., 2008). WLA have been found to have low levels of psychosocial well-being (Solomon et al., 2008), which is confounded by the fact that many women live in rural areas and are socially and physically distant from help and government resources (NFHS, 2008).The purpose of this study is to assess the benefits and challenges related to engaging HIV-trained accredited social health activists (ASHAs) in the care of WLA in the rural district of Nellore, Andhra Pradesh. Our goal is to determine the utility and acc...

Mexican migrant workers residing in the United States are a vulnerable population at high risk for HIV infection. This article critically appraises the published data surrounding HIV prevalence in this vulnerable group, as seen through the lens of the Vulnerable Populations Conceptual Model. This model demonstrates how exposure to risk and resource availability affect health status. The health status of Mexican migrants in the United States is compromised by a number of factors that increase risk of HIV: limited access to health services, multiple sexual partners, low rates of condom use, men having sex with men, and lay injection practices. Migration from Mexico to the United States has increased the prevalence of HIV in rural Mexico, making this an issue of urgent binational concern. This review highlights the implications for further nursing research, practice, and policy.

This study describes correlates of high levels of depressive symptoms among recently paroled men in Los Angeles who reside in a community substance abuse treatment program and report homelessness. Cross-sectional data were obtained from male residents who were released on parole within the last 30 days (N=157) to assess parental relationship, self-esteem, social support, coping behaviors, drug and alcohol use behaviors, depressive symptoms, and sociodemographic information. Results indicated that 40% of participants were classified as experiencing high levels of depressive symptoms (CES-D ≥ 10). Results of a logistic regression analysis showed that the following were predictors of depressive symptoms (p < .05): physical abuse in childhood, non-residential alcohol treatment, violent behaviors, low self-esteem, and disengagement coping. Being Mexican-American, Mexican, American Indian, or Asian) and not displaying cognitive problems was inversely related to depressive symptoms in the final model (B = −2.39, p < .05). Findings support proper use of both prison and community assessment services to at-risk individuals eligible for parole to increase self-esteem and coping.

Background Alcohol-using clients are considered at great risk for hepatitis and ongoing liver damage. This study explores the correlates of depression among a sample of methadone maintained treatment (MMT) adults in the Los Angeles area, and is part of a larger study on hepatitis health promotion among MMT clients who use alcohol. Objectives We sought to determine correlates of depressive symptoms among moderate and heavy alcohol-using adults enrolled in methadone maintenance. Methods A cross-sectional correlation study was conducted of baseline data from a randomized control trial of adults (N = 189) receiving methadone maintenance treatment (MMT) in Los Angeles. Depressive symptoms were measured with the 10-item short-form CES-D. Results Multiple regression analysis revealed that pain and social support were key correlates of depressive symptoms. More pain was associated with higher levels of depressive symptoms (p=.001), while more social support was related to lower depressive symptom severity (p=.001). Having been in sufficiently poor health that a blood transfusion, clotting factors, or an organ transplant was necessary was associated with greater depressive symptomatology, as was having injected drugs in the past month (p=.024). Conclusions The findings from this investigation can aid clinicians in selecting clients to monitor for early signs of depression and encourage early treatment for opioid users with comorbidities. Scientific Significance The use of an interdisciplinary team to care for MMT clients, routinely screen for depressive symptoms, and emphasize adequate pain control is indicated.