IntroductionGender-based violence (GBV) is a major public health concern affecting adolescents across Latin America. Yet, little is known about how parents, as key figures in adolescents' social environments, understand these risks. This study explored parental perspectives on adolescent GBV in Colombia.MethodsBetween February to April 2024, we conducted 28 semi-structured interviews with parents of adolescents aged 10-19 in the metropolitan area of Medellín, Colombia. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis.ResultsTwenty-eight parents participated; most were women (79%), and collectively they were caregivers to 35 adolescents with a median age of 14. Parents consistently described GBV as an urgent and pervasive threat to adolescent well-being, particularly in relation to sexual abuse, dating violence, and the normalization of harm. Machismo emerged as a central cultural and structural determinant shaping gender norms and adolescents' vulnerability. Family-level dynamics - including silence, fear, and modeled behaviors - were perceived as contributing to cycles of violence. Parents also emphasized prevention through early child education on abuse, active communication with adolescents, and clear guidance on boundaries and respectful relationship practices.ConclusionParents' perspectives highlight the need for culturally grounded, caregiver-centered public health interventions to address GBV among adolescents in Colombia.
IntroductionMany Spanish-speaking individuals in the United States experience high levels of stress but disproportionately underutilize mental health services due to cultural, socioeconomic, and religious barriers in accessing culturally relevant mental health care.MethodsCross-sectional survey of Spanish-speaking adults to assess demographics, religious beliefs, and stress-coping preferences.ResultsOf 100 participants, 90% of participants identified as religious, with 75% reporting moderate to high religious influence on daily life. Higher religious influence correlated with a broader range of coping strategies, both faith-based (e.g., prayer, church attendance) and secular (e.g., work-related tasks, nature immersion, creative outlets). Non-religious participants primarily relied on exercise, entertainment, and socialization. Acculturation correlated with religious influence (r [1, 99] = 0.348, p < 0.001), while country of origin was not significantly associated with particular coping strategies.ConclusionThese findings suggest that religiosity is associated with an expanded breadth of coping behaviors among Spanish-speaking patients and may serve as an additional protective factor in managing stress. By defining specific mechanisms that are commonly utilized within this population, these findings inform the development of more culturally and spiritually sensitive mental health interventions. Lastly, this study reiterates the importance of tailoring support to individual levels of religiosity and acculturation.
BackgroundCervical cancer is a preventable disease, and reaching populations who are under-screened and/or at highest risk is essential to the goal of disease elimination. Hispanic women in the US have a disproportionately higher incidence rate than non-Hispanic women.ObjectivePost hoc analysis of the SELF-CERV study of the unique experience and preferences among Hispanic compared to non-Hispanic participants with the goal of facilitating and improving screening and follow-up in more vulnerable populations.MethodsWomen 25 to 65 years who were enrolled performed self-collection (SC) of vaginal samples for high-risk human papillomavirus (hrHPV) testing using a unique device in a simulated at-home environment. For method comparison, a clinician-collected (CC) sample was obtained. Participants also completed usability and screening preference surveys.ResultsA total of 609 participants were consented and 603 used the SC device. Of the 603 SC users, 115 (19.1%) identified themselves as Hispanic/Latinx. Compared to non-Hispanic women, Hispanic women, had significantly lower annual income (p < .001), a lower percentage of private insurance with more uninsured (p < .001) and lower levels of education (p < .001). There was no significant difference between Hispanic and non-Hispanic women in understanding the purpose of cervical cancer screening. No difference was noted in delaying screening, although English Not Primary speaking Hispanic women were somewhat more likely to delay (p = 0.22). Financial barriers were observed to be more of an impediment to Hispanic women compared to non-Hispanic women (p = 0.016). Negative experiences with in-clinic speculum exams were similar; however, Hispanic women (78%) expressed a significantly higher endorsement of SC than non-Hispanic women (62%), (p = 0.001). Both populations reported that they would be more likely to stay up to date with cervical cancer screening with the at-home SC device, but non-Hispanic women to a significantly lesser degree (p = 0.002). In terms of assessing utility of telemedicine in screening, both populations reported similar engagement in healthcare activities, willingness to try new technology and current use of smartphones. Hispanic and non-Hispanic women were both nearly equally divided as to their preference for in-clinic visits vs telehealth.ConclusionsFacilitating screening uptake is especially critical for Hispanic women, who bear a disproportionate burden of cervical cancer diagnoses and mortality while facing more obstacles to screening than non-Hispanic women. A clinically validated and accessible at-home SC alternative holds potential for meaningful impact and improved health outcomes within this community.
IntroductionAsthma disproportionately affects children who are racial or ethnic minorities and those from poorer families. This study examined how the language spoken in the home affected asthma care and health outcomes for school-aged Hispanic children diagnosed with asthma.MethodsA randomized controlled trial was conducted over 12 months to test the effectiveness of a parent-child asthma education intervention on asthma outcomes. Baseline analyses were run to identify differences between Spanish-speaking and English-speaking Hispanic families. RM-ANOVA examined changes from baseline to 12-months in health outcomes. Within each group, participants were sorted by language, then ANOVA were run on 12-month data to determine if post-intervention changes were similar within the assigned groups.ResultsThe Spanish-speaking families had significantly lower socio-economic status than their English-speaking Hispanic peers. The intervention significantly improved the treatment group's inhaler skill, asthma severity, and quality of life. There were no differences within either treatment or control group when comparing language spoken; the intervention improved health outcomes for both the Spanish-speaking and English-speaking treatment group participants.ConclusionIntervention delivery by trained bilingual teachers using dual-language education materials was effective in supporting family asthma management and improving children's health.
Introduction Alzheimer's disease and related dementias affect Latino older adults who are living longer with dementia. Puerto Ricans are the second-largest Hispanic group in the United States, and they differ in language, norms, and values from other cultures. As the number of dementia cases increases, the demand for caregivers will rise. Method The integrative review was guided by Whittemore and Knafl's framework and aimed to evaluate and synthesize the existing literature regarding the experience, beliefs, and values of Puerto Rican dementia family caregivers. A comprehensive search of PubMed, CINAHL, Embase, PsycInfo, and LILACS databases was performed to examine the literature from 2013 to 2025. Results Four key themes emerged: (1) spirituality is essential for caregiving, (2) home is a better place to be, (3) toll of caregiving, and (4) long-established gender roles. Conclusion The findings demonstrate the scarcity of Puerto Rican caregiver representation in the literature. Further research is needed to determine Puerto Rican values and beliefs regarding caregiving.
Background Latinas in the U.S. experience higher rates of sleep disturbances and shorter sleep durations compared to non-Hispanic White women. This study employed community-engaged research methods to explore sleep-related knowledge, beliefs, attitudes, and behaviors within the Latina socio-cultural context, utilizing insights from focus groups with Latina community health workers (CHWs). Methods CHWs served on a community advisory board (CAB) to develop focus group questions addressing sleep among diverse women. CHWs from four racial/ethnic groups, including Latinas, conducted three focus groups. CAB members facilitated participant recruitment and focus groups. Thematic analysis guided coding of emergent themes. We conducted sessions in Spanish and were recorded, transcribed, and analyzed collaboratively. Results Thirty-one Latinas participated, revealing four overarching cultural themes influencing sleep behaviors: (1) Familismo , prioritizing family needs over personal well-being; (2) Marianismo, self-sacrifice and duty to maternal and spousal roles, often neglecting sleep; (3) Confianza , the importance of trust, particularly in healthcare relationships; and (4) Self-reliance , addressing sleep concerns through culturally accepted solutions. Conclusion Findings underscore the connection between culture and sleep-health behaviors, highlighting the necessity of culturally sensitive interventions. CHWs demonstrated confidence in advocating for sleep health within their communities. Building trust with CHWs facilitated actionable insights for future development of effective sleep interventions.
IntroductionCertain factors influence sexual risk behaviors among gay and bisexual Hispanic men (GBHM). Childhood sexual abuse, one component of Adverse Childhood Experiences (ACEs), influences sexual risk behaviors among GBHM. Little is known about the association between ACEs, sexual risk behaviors and suicidal behaviors among GBHM; therefore, the purpose of this study was to explore the relationship of these variables.MethodsA cross-sectional design was used. Participants completed standardized measures of ACEs (ACEs Scale), sexual risk behaviors (Behavioral Risk Assessment Test [BRAT]), and a demographic questionnaire that included questions about suicidal behavior. Data were analyzed using descriptive statistics and Chi-square analysis.ResultsTotal ACEs ranged from 0-10 (M = 2.47, SD ± 2.46); 37.6% (n = 21) reported ACEs total scores ≥4, indicating increased physiological/psychological health risks. Several sexual risk behaviors were reported. Total ACEs scores ≥4 were associated with sexual risk behaviors, a lifetime history of suicidal behavior, and a self-reported HIV positive antibody status.ConclusionsThis study provided evidence that ACEs may be associated with sexual risk behaviors and suicidal behaviors among GBHM. More research with a larger sample is needed. Clinicians should consider incorporating ACEs screening during healthcare encounters with GBHM. This information could be used to discuss sexual and suicidal risk reduction and may be integrated into interventions for GBHM.
Suicide is the 11th-leading cause of death in the U.S., contributing significantly to healthcare burdens. Recent data indicate alarming increases in suicidal behaviors among Hispanic individuals, with a 38.6% rise in suicide rates from 2011 to 2021. This study utilizes pooled data from the 2015-2019 National Survey on Drug Use and Health (NSDUH) to examine trends in suicidal ideation, planning, and attempts among Hispanic adults, stratified by sexual orientation identity. Our analysis reveals higher odds of suicidal behaviors among lesbian, gay, and bisexual (LGB) Hispanic individuals, particularly bisexual Hispanic adults, compared to their heterosexual peers. Significant associations were found between alcohol use and increased suicidal behaviors across all groups. These findings underscore the urgent need for culturally competent mental health services and targeted interventions that address the unique stressors faced by those with multiple marginalized identities. Addressing these disparities is crucial for effective suicide prevention strategies within Hispanic and, and particularly among those who are also LGB.
IntroductionThere is evidence of the relationship between psychosocial distress and elevated blood glucose levels. However, data in the Dominican Republic is limited. The study aims to measure the prevalence of four types of psychosocial distress, assess their associations with A1c levels and stratify these associations by gender among rural Dominican adults with diabetes.MethodsBetween June-July 2023, 501 diabetes patients participated in a cross-sectional survey measuring psychosocial distress (e.g., diabetes distress, depressive symptoms, acute stress, anxiety). Descriptive analyses were conducted to determine prevalence of psychosocial distress, linear regression was run on psychosocial distress and A1c levels, and logistic regression was run to examine psychosocial distress levels by gender.ResultsParticipants reported mild-to-moderate levels of psychosocial distress. Almost a fifth of participants reported high levels of depressive symptoms (20.2%) and acute stress (22.0%). Only diabetes distress was significantly associated with A1c levels (b = 0.037, SE = 0.009, p = 0.001). Men were significantly less likely to report moderate-to-severe depressive symptoms (OR:2.35; CI:1.51-3.66), anxiety (OR:3.07; CI:1.52-6.19), and acute stress (OR:2.13; CI:1.51-3.66) than women.ConclusionPrevalence of psychosocial distress varies by type, and severity varies by gender. Diabetes distress is associated with diabetes outcomes. Findings highlight the importance of addressing psychological distress and mental health in the context of diabetes care.
Introduction: Climate change has intensified extreme weather events, creating growing challenges for occupational health. Rising temperatures, air pollution, and climatic instability increase the burden of respiratory, cardiovascular, and mental health conditions among workers, particularly those exposed to adverse environmental conditions. Outdoor workers and individuals with pre-existing chronic diseases are especially vulnerable, while informal workers face compounded health and social risks. Addressing these challenges requires climate-adaptive workplaces, supportive occupational health policies, and coordinated action among governments, employers, and the scientific community to protect workers' health in a changing climate.
IntroductionThis paper explores the life and contributions of Dr. Gonzaléz, a Spanish American male from South Texas, whose career exemplifies resilience and leadership. Born in Roma, Texas, in 1937 and descended from Spanish settlers who arrived in the region in 1747, Dr. Gonzaléz rose from modest beginnings and limited educational opportunities to become a nursing leader, educator, and international advocate. At a time when men and ethnic minorities faced significant barriers to entering the profession, his journey was shaped by personal determination and early support from an employer who encouraged his pursuit of higher education.MethodsEmploying traditional historical research methods, including the examination of published sources and personal archives, this work affirms Dr. Gonzaléz's legacy in nursing history.ResultsHis story contributes to the growing body of literature that recognizes the role of underrepresented leaders in shaping the nursing profession and underscores the continued importance of mentorship and inclusive practices in healthcare education.ConclusionAs one of the founders of the National Association of Hispanic Nurses, Dr. Gonzaléz's journey represents the legacy of an unsung hero.
Introduction: This study addresses the diversity within Hispanic communities by examining mammogram screening adherence among various Hispanic subgroups, focusing on how social drivers of health influence adherence to United States Preventive Services Task Force (USPSTF) mammogram screening guidelines from 2010, 2013, 2015, and 2018. Methods: We analyzed datasets from the 2010, 2013, 2015, and 2018 National Health Interview Survey (NHIS). We included 3,120 Hispanic women aged 50–74 and assessed their demographic and health characteristics, including insurance coverage and healthcare utilization. The primary outcome was adherence to mammogram guidelines. Results: Health insurance significantly increased mammogram screening adherence across all Hispanic subgroups (PR 1.39, p < 0.001). For Mexican Americans, longer U.S. residency was associated with lower screening adherence (PR 0.72, p < 0.001), and among Dominicans, education beyond high school was associated with lower screening adherence (PR 0.68, p = 0.011). Consulting a general doctor in the past (PR 1.17, p < 0.001) and having a usual place to go when sick (PR 1.48, p < 0.001) were associated with mammogram screening adherence across all subgroups. Conclusion: Screening rates varied among subgroups but did not differ significantly, consistent with prior studies. However, inconsistencies in subgroup behaviors highlight the need for targeted healthcare interventions addressing the unique challenges of these diverse communities.
Introduction: Despite ongoing diversity initiatives, Otolaryngology - Head and Neck surgery continues to face a widening representation gap as the Latinx population in the United States grows. To address this disparity, novel strategies for recruiting Latinx medical students into the specialty must be explored. Methods: A descriptive, cross-sectional survey was distributed to Latinx medical students in the United States via social media platforms (Facebook, Twitter, Instagram) and Latino Medical Student Association (LMSA) chapters. Results: Most respondents were unfamiliar with Otolaryngology-specific health disparities affecting Latinx communities and indicated an interest in learning more about these disparities. Most respondents indicated that early exposure to Otolaryngology disparities affecting Latinx communities could increase interest in exploring the specialty. Additionally, most participants deemed a department's commitment to diversity, equity and inclusion and opportunities to serve Latinx patients to be necessary residency program attributes when deciding between programs (69.2% and 66.7%, respectively). Conclusion: Integrating community outreach and education on Otolaryngology-related health disparities into undergraduate medical education may serve as a promising strategy to enhance Latinx recruitment and representation in the specialty.
Introduction: Breast cancer is the leading cause of cancer-related deaths among Hispanic/Latina women in the USA. Mammography utilization in this group falls below Healthy People 2030 targets. Our study examined (a) breast cancer knowledge and mammography behaviors, and (b) the associations between demographics, acculturation, and breast cancer knowledge with the transtheoretical model (TTM) stages of change related to mammography in this population. Methods: This study used a quantitative design with a self-administered questionnaire to collect data from 473 participants recruited via community outreach, social media, and referrals. Results: Participants showed higher acculturation and moderate breast cancer knowledge. Among participants, 66% had regular mammograms, 14.4% never had one, and 19.7% had inconsistent or discontinued screenings. Older participants, non-U.S.-born, primarily Spanish speakers, unmarried, unemployed, less educated, uninsured, without a primary care provider, and with lower acculturation and breast cancer knowledge were more likely to be in the TTM precontemplation/contemplation/preparation stage or exhibit inconsistent screening. Conclusion: Our results identified participants with specific demographics, lower acculturation, and limited breast cancer knowledge as being at higher risk of never receiving or inconsistently obtaining mammograms, highlighting the need for targeted interventions to address socio-demographic barriers and increase knowledge. More TTM studies involving Hispanic/Latina women are needed.
Background: Family caregivers assume their role suddenly and in many cases without the necessary preparation and resources for these responsibilities. Preparedness for Caregiving Scale measures the level of preparedness perceived by the family caregiver to assume the responsibilities of the role. Aim: To assess the validity and reliability of the Preparedness for Caregiving Scale (PCS) in family caregivers of people with chronic illness in Colombia by analyzing its psychometric properties. Methods: Psychometric validation study, conducted in 2022 with 109 family caregivers of people with chronic diseases. Convenience sampling was used. Validity was established by exploratory factor analysis and divergent validity was assessed using ZARIT. Results: Exploratory and confirmatory factor analysis validate the unifactorial structure of PCS. Divergent validity was established with a Pearson correlation of -0.247. PCS has internal consistency, Cronbach's alpha = 0.925. The stability of the scale showed significant correlations between items, with a total correlation of 0.585. Conclusion: The validation of the scale in caregivers of people with chronic diseases in Colombia demonstrates validity and reliability for its use in the Colombian context. More studies are needed to measure caregiving preparedness in different caregivers and to develop interventions focused on caregiver preparedness.
Introduction: Bridges to Health Equity (BHE), a collaborative of community-based organizations (CBOs), insurers, hospitals, and an external evaluator was developed to forge partnerships that improve health in low-income neighborhoods in New York City. BHE developed an asthma program implemented by community health workers (CHWs) at participating CBOs in 2020 and 2021. Initially designed as an in-home intervention, the program shifted to remote delivery at the beginning of the study due to COVID-19. Methods: Researchers conducted a mixed-methods evaluation of BHE to support quality improvement and contribute to the evidence base regarding asthma interventions. The evaluation included participant baseline and follow-up assessments. This paper uses data from these assessments to examine outcomes for children, focusing on changes in asthma control and home-based triggers. Results: Children with baseline and follow-up assessments—90% of whom were Latine—experienced significant improvements in asthma control and reductions in home-based asthma triggers, including home maintenance issues and pest infestations. Conclusion: Findings demonstrate positive outcomes of an asthma program delivered remotely by a CBO. They add to the evidence regarding CBO capacity to deliver health programs effectively and suggest that some in-person CHW interventions may be able to shift to remote delivery, which could facilitate expansion.
Objective: This study aimed to assess the prevalence of respiratory symptoms among informal waste pickers in Colombia and identify the contributing demographic, environmental, and occupational risk factors. Methods: A cross-sectional study was conducted with 179 informal waste pickers from four Colombian cities. Respiratory symptoms and demographic data were collected through questionnaires. Statistical methods including logistic regression, principal component analysis (PCA), Random Forest modelling, and K-means clustering were applied to identify predictors and patterns related to respiratory health. Results: The most frequently reported symptoms were cough (46.8%), phlegm (18.4%), and shortness of breath (19.6%). Logistic regression identified age as a significant predictor of respiratory symptoms, while Random Forest analysis highlighted cough as the strongest predictor, followed by age, race, and education level. K-means clustering revealed three groups, with older workers showing the highest prevalence of symptoms. PCA indicated that respiratory symptoms and demographic factors explained significant variance in health outcomes. Conclusions: Informal waste pickers in Colombia are at elevated risk for respiratory health issues, particularly older workers exposed to prolonged occupational hazards. Targeted interventions, including improved use of protective measures and policies addressing informal work conditions, are needed to mitigate these risks and improve workers' health and safety.
