Hypertension disproportionately affects Hispanic/Latino communities in the United States, yet culturally tailored interventions that support sustained lifestyle modification and self-management remain limited. This study evaluated the feasibility and preliminary effectiveness of Building Healthy Temples with Less Pressure (BHT-LP), a faith-based, lay leader–delivered hypertension self-management intervention implemented in Hispanic church communities. Guided by social cognitive theory, BHT-LP included a Medical Moment and a 12-session hypertension self-management program delivered by trained Church Lay Health Leaders. Forty adults with hypertension or elevated blood pressure were recruited from two Hispanic churches in San Antonio, Texas, during 2021 to 2022. Participants completed baseline and post-intervention assessments, and focus groups were conducted at program completion. Twenty-nine participants completed both assessments. Mean systolic and diastolic blood pressure decreased modestly, although the changes were not statistically significant. Hypertension self-care behaviors, dietary quality, and physical activity improved, with aerobic activity increasing by 72 min/week ( p < .01). Participants with excess weight experienced significant reductions in body weight and waist circumference. Qualitative findings indicated program acceptability, high trust in lay leaders, and increased motivation to monitor blood pressure and adopt healthier behaviors. These findings support the feasibility and promise of a spiritually integrated, lay leader–facilitated intervention for hypertension control and related health behaviors in Hispanic faith communities. The program’s culturally grounded approach, group support, and integration of self-monitoring tools may offer a practical strategy for advancing community-based hypertension prevention and management.
Obesity prevalence in the United States has risen significantly, with uneven distributions across populations. Communication can play an important role in affecting health behaviors, and persuasion literature is clear on several evidence- and theory-based strategies, including efficacy, threat, emotional tone, use of graphics when presenting statistics, and narratives. Yet, little is known about the extent to which these strategies appear in obesity prevention efforts. This study examined the prevalence of key persuasive strategies in health communication: emotional appeals, narrative strategies, statistical and graphic evidence, and efficacy cues in U.S. obesity campaign messages. We analyzed 182 print materials from 25 campaigns in 2013 and 106 print materials from 20 campaigns in 2022. Findings reveal gaps in persuasive strategy use, suggesting many campaigns fail to maximize their potential impact. While efficacy messaging was more prevalent, narrative strategy, along with emotional appeals, was barely used across observed time points. This paper calls for more theoretically grounded persuasive campaign messages to address obesity in the U.S.
Organized out-of-school time activities (e.g., afterschool programs, extracurriculars) may mitigate adverse childhood experiences’ (ACEs) negative effects. Little is known about caregivers’ views on activity providers and the value, accessibility, and quality of activities for families with ACEs. To describe caregivers’ perspectives on activities and their interest in activity providers linking families to health and social-need resources, we cross-sectionally surveyed 310 caregivers of children aged 6–17 with varying caregiver and child ACE exposure in Los Angeles, CA, from December 2023 to August 2024. We described caregiver-reported activity goals, perceived family impacts, barriers, recommendations, and interest in resource connections via activity providers. Responses were compared across ACE groups (no ACEs, low ACE burden, high ACE burden), and covariate-adjusted logistic analysis examined the association between ACE burden and caregiver requests for resource assistance. Most caregivers reported health-promoting goals and perceived activity benefits, like preventing substance use and strengthening family relationships. Cost was a key barrier; expanding activity options was the top recommendation. Compared to families with zero ACEs, families with any ACEs were more likely to desire help with housing, mental health, education, employment, and finances. Families with high ACE burdens were more likely to desire assistance with mental health, parenting, housing, basic needs, trauma recovery, legal, and disability services, compared to families with zero or low ACE burdens. Families with ACEs value activities and are receptive to receiving resource support through activity providers. Lower costs, broader activity options, and stronger referral pathways may improve engagement and support families with ACE exposure.
HIV continues to disproportionately affect men who have sex with men (MSM), particularly Black and Latino populations. With pre-exposure prophylaxis (PrEP) now central to HIV prevention efforts, understanding perceptions of safer sex practices among racial and ethnic minority MSM is essential. This qualitative study conducted three focus groups with 22 Asian, Black, and Latino MSM aged 18 to 29 in Los Angeles County between January and April 2022 to explore how safer sex has evolved since PrEP’s Food and Drug Administration approval in 2012. Four themes emerged: (a) shifting definitions of safer sex, (b) sexual autonomy and empowerment, (c) peer perceptions and stigma surrounding PrEP use, and (d) provider judgment and limited knowledge. Participants described PrEP as a source of sexual agency but also highlighted ongoing stigma and discomfort when disclosing PrEP use or engaging with health care providers. Although all participants were active PrEP users, broader access disparities remain, particularly for MSM of color. The recent Food and Drug Administration approval of a biannual injectable PrEP offers a promising opportunity to expand uptake by reducing stigma, enhancing convenience, and improving adherence. These findings underscore the need for culturally responsive messaging, supportive clinical environments, and policy efforts to ensure equitable PrEP access for marginalized MSM. Public health practitioners and providers can use this insight to improve HIV prevention strategies and tailor interventions to the lived experiences of MSM of color.
Examining the relationship between determinants and implementation outcomes is key to advancing implementation science. However, the vast number of approaches, determinants, and outcomes make it difficult to synthesize findings. The aim of this exploratory paper was to assess the association between key determinants and outcomes across diverse health interventions. To that end, the Implementation Determinants and Outcomes Questionnaire (IDOQ) was developed, refined with face validity, and administered to implementation researchers ( N = 208). The IDOQ asks participants to rate the success of a recent implementation project for five outcomes (Feasibility, Adoption, Fidelity, Penetration, and Sustainability) and the impact of five determinants (Available Resources, Compatibility, Leadership Engagement, Formal Internal Implementation Leaders, and External Implementation Change Agents) on those outcomes. We examined the relationship between determinants and outcomes using multiple regression analyses. While exploratory, all five determinants were found to be significant predictors of at least one outcome—in 10 instances as barriers and in nine instances as facilitators (out of 50 possible pairings). Available Resources, functioning as a barrier, was found to be a significant predictor for every outcome. Overall, Available Resources and Compatibility were the most common significant predictors of implementation outcomes. In conclusion, by examining the relationship between key determinants and outcomes across program type and setting, we can more systematically understand these complex relationships. This may lead to causal frameworks and models, further advancing the power of implementation science. In addition, the nuance of whether determinants functioned as a barrier or a facilitator may support more adaptive approaches to implementation and sustainment across diverse health interventions.
