Hispanic immigrants are increasingly residing in rural communities, including in the midwestern United States. Limitations in the ability of rural Hispanics to access and utilize health care contribute to patterns of poor health and health disparity. A conceptual model of "vulnerability" guides this community-based participatory assessment project designed to explore rural Hispanics' perceived barriers to accessing and utilizing health care. Findings from a series of 19 focus groups with 181 participants from three communities in the upper Midwest identified perceived barriers at the individual and health care system levels. The most commonly perceived barriers were the lack of and limitations in health insurance coverage, high costs of health care services, communication issues involving patients and providers, legal status/discrimination, and transportation concerns. Findings imply that these barriers could be addressed using multiple educational and health service delivery policy-related strategies that consider the vulnerable nature of this growing population.

This study used the Developmental Niche (DN) framework to examine perceived intergenerational changes in the transmission of Traditional Ecological Knowledge (TEK). Under a cross-sectional and exploratory design, in-depth semi-structured interviews were conducted with a purposeful sample, stratified by gender and generation, of 30 Uitoto (Amazon, Colombia) and 26 Itza' Maya (Peten, Guatemala) adults about their perceptions of intergenerational variations in TEK transmission/acquisition practices. Interview data were analyzed using a grounded approach and resulting coding categories were assigned to text units. Grounded themes were then examined in light of the DN components. Both Uitoto and Itza' Maya participants perceived generational changes in the settings (from natural to school settings) and in the strategies (from experiential to conceptual learning) used for TEK transmission. These changes were attributed to various environmental (biodiversity loss, urbanization), socio-cultural (acculturation, changes in social norms) and individual factors (lack of motivation to teach and learn).

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We investigated whether length of residence and other socio-demographic factors affect how rural Hispanic/Latino immigrants in the U.S. prefer to receive general health information. As part of a federally-funded participatory research project, we surveyed 894 adult Hispanics who were recruited through schools, community-based organizations (CBO) and faith-based organizations (FBO) in six rural communities of Illinois. Data suggest that workshops in Spanish at community settings are the most preferred health information strategy and home visits the least. Preference for these two strategies decreased significantly in the second generation, while preference for mailed printed materials increased. We further explored the role of length of residence in the U.S. on 'in-person' and 'impersonal' health information preferences controlling for other relevant socio-demographic factors finding that first generation and less educated Hispanic immigrants' prefer 'in-person' strategies. These findings suggest that rural health organizations and practitioners should implement not only culturally-appropriate but also acculturation-sensitive approaches to address Hispanic/Latino immigrants' specific health information needs.