One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, since linguistically and culturally appropriate information is often not available. In response to these needs, we developed a website for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in three countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.
Objective: Chronic pain is a common health problem in the United States, and it is associated with numerous physical and mental health issues. Disparities in pain treatment are high for particular populations, including Latinos, who comprise a significant percent of the U.S. population. The purpose of this study was to develop and evaluate an online health education intervention for Spanish-speaking Latinas with chronic pain. The intervention was developed based on a biopsychosocial approach to treatment and targeted multiple domains including exercise, psychological wellbeing, regaining function, emotional wellbeing, sleep hygiene, and stress management. Method: Through a mixed-method, single-arm design, this pilot study examined patients’ and providers’ acceptability of and satisfaction with the intervention, as well as the impact of the intervention on patients’ knowledge, chronic pain self-efficacy, pain severity, and pain interference (measured pre and post intervention). Results: Both chronic pain patients (n = 40) and provider participants (n = 10) reported high rates of participation, and high ratings for website features and website content. Patient participants also experienced a significant increase in knowledge regarding pain management and treatment options, and in chronic pain self-efficacy, as well as a significant decrease in pain interference. Although means for pain severity were lower at the posttest session, this change was not significant. Conclusions: Overall, results indicate that an online educational intervention that targets Spanish-speaking Latinas with chronic pain is feasible, potentially impactful, and that there is a need for such interventions. Recommendations include additional content and interactive features that could improve satisfaction, engagement, and impact.
Sex education in the United States is often approached through an individual lens that focuses on personal protection, safety, and rights. This focus on personal responsibility and care-for-self reflects national values and permeates governmental systems and actions, including generalized public health approaches. This issue has been most recently highlighted in the individual and systemic attitudes, beliefs, and responses towards the recent, ongoing crisis following the global surge of COVID-19. In this paper, we provide examples and discuss lessons gleaned from the public health response to this crisis, particularly in the areas and intersections of gender, individualism, and neoliberalism, and the parallels of these issues in sex education. We make an appeal for a collectivist and community-oriented approach to sex education, which would focus not only on prevention and protection, but on inequities, ethics, and care for others.
In the United States, a majority of immigrants living with undocumented status hail from Latin America. Their migration is often propelled by adverse conditions and experiences of violence in their countries, which are inextricably linked to historical and ongoing policies of global political powers. However, their suffering does not end in the United States. Whereas many studies focus on the direct/individual violence experienced, few examine the impact of structural violence. Structural violence refers to the injustices embedded in social and institutional structures including laws and policies within societies that result in harm to an individual's psychological and physical well-being. This qualitative study explored the experiences and consequences of structural violence faced by Latina women with undocumented status living in the United States. Participants (n ϭ 8) were recruited in the community using snowball sampling. We conducted in-depth, semistructured interviews focusing on participants' immigration process, health, work, education, and support systems. Using thematic analysis (Braun & Clarke, 2006) as a method, multiple themes that highlighted participants' experiences of structural violence were identified. These included: (a) violence across several contexts, including places of employment, home, community, and while accessing services; (b) psychological and physical consequences of structural violence for participants; and (c) experiences of support and resilience that helped participants survive structural violence. Participants' intersecting identities (e.g., gender, ethnicity/race, documentation status) increased their vulnerability to violence. We highlight the importance of calling attention to violent structures embedded in sociopolitical histories, the importance of systemic changes, including challenging laws and policies, and building solidarity across struggles. Public Significance StatementThis study identifies the structural violence experienced by undocumented Latinas and calls for systemic changes.
Antiretroviral therapy (ART) is the primary treatment for HIV, and adherence to it is crucial to addressing health disparities. Approximately half of individuals in the United States living with HIV are African Americans, and those over 45 years of age are more likely to die early from HIV/AIDS than their White counterparts. This mixed-method pilot study evaluated the feasibility of a text-based mobile phone intervention designed to improve ART adherence among older African Americans with HIV. Feasibility was assessed via implementation, participant adherence, acceptability, and satisfaction, as well as short-term impact on medication adherence, adherence-related self-efficacy, and positive affect. The intervention utilized pill reminder, motivational, and health educational texts. Participants ( N = 21) ranged in age from 50 to 68 years. Outcomes were evaluated via quantitative results from self-report measures and qualitative data from four focus groups. There was no attrition in participation. After 8 weeks, participants reported statistically significant improvements in medication adherence, but not in self-efficacy or affect scores. Qualitative findings highlight the psychologically supportive potential of the intervention, challenges to adherence, as well as suggestions for improvement. The study demonstrates that a text messaging intervention may be feasible for older African Americans with HIV, and helpful in supporting ART adherence.
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