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Service use among Latino Health Access's Emotional Wellness participants, showing trends in volume of services and participants during 10 months (March 2019-June 2020). The ratio of services to participants increased from an average of 4.0 in the pre-COVID-19 period to an average of 4.3 in the COVID-19 period (P = .54). Significance was assessed by using an independent t test.

Service use among Latino Health Access's Emotional Wellness participants, showing trends in volume of services and participants during 10 months (March 2019-June 2020). The ratio of services to participants increased from an average of 4.0 in the pre-COVID-19 period to an average of 4.3 in the COVID-19 period (P = .54). Significance was assessed by using an independent t test.

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Introduction: The disproportionate impact of the COVID-19 pandemic on Latino communities has resulted in greater reports of depression, anxiety, and stress. We present a community-led intervention in Latino communities that integrated social services in mental health service delivery for an equity-based response. Methods: We used tracking sheets...

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Context 1
... participants (P < .001) increased significantly ( Figure 2). Although the volume of participants was driven, in part, by the promotores' COVID-19 outreach, the ratio of services to participants increased, though not significantly, from an average of 4.0 in the prepandemic period to 4.3 in the pandemic period (P = .54), ...
Context 2
... participants (P < .001) increased significantly ( Figure 2). Although the volume of participants was driven, in part, by the promotores' COVID-19 outreach, the ratio of services to participants increased, though not significantly, from an average of 4.0 in the prepandemic period to 4.3 in the pandemic period (P = .54), ...
Context 3
... participants (P < .001) increased significantly ( Figure 2). Although the volume of participants was driven, in part, by the promotores' COVID-19 outreach, the ratio of services to participants increased, though not significantly, from an average of 4.0 in the prepandemic period to 4.3 in the pandemic period (P = .54), ...

Citations

... Popular education asserts individuals' capacity to bring about social change by engaging those who have historically lacked power, increasing awareness of their capacity as change agents, and developing critical consciousnessby identifying injustices they have experienced firsthand and reflecting on root causes-to work towards collective, structural change [10,11]. Evaluations of LHA's COVID-19 response efforts that used popular education as a conceptual model, have identified the value and pertinence of CHWs in effective and equitable interventions [12,13]. This informed AQE's campaign model development into one that would be led and driven by CHWs. ...
Article
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Community health workers (CHWs), or promotores de salud, have long played a role in health promotion, but the COVID-19 pandemic has brought renewed attention to the functions, sustainability, and financing of CHW models. ¡Andale! ¿Que Esperas? was a 12-month (June 2021–May 2022) campaign that expanded the CHW workforce to increase COVID-19 vaccination rates in structurally vulnerable, Latinx communities across California. This mixed-methods evaluation aims to elucidate (1) the role of CHWs in COVID-19 response, recovery, and rebuilding and (2) the importance, needs, and perils of CHW models in the COVID-19 era and beyond. CHWs facilitated 159,074 vaccinations and vaccine appointments by countering mis/disinformation, addressing mental health and social needs, building digital competencies, and meeting people where they are, all of which expanded access and instilled confidence in the COVID-19 vaccine. CHWs’ success in engaging the community lies in their shared lived experience as well as their accessibility and recognition in the community, enabling their role in both immediate response and long-term recovery. Funding instability imperils the advances made by CHWs, and efforts are needed to institutionalize the CHW workforce with sustainable funding models. While Medicaid reimbursement models exist in some states, these models are often limited to healthcare services, overlooking a critical function of the CHW model: building community resilience and mobilizing the community for social change.
... Our study contributes to the burgeoning literature on mental health among Latino immigrants by focusing on individuals residing in rural areas, a rarely studied population; contextualizing immigrants' mental health experiences after the onset of the COVID-19 pandemic; and combining in-depth qualitative methods with survey-based psychological symptom screeners to explore differences in subjective narratives according to depression/anxiety "case" status. Our work builds on epidemiologic studies conducted in the first year of the pandemic, which report high rates of depression and anxiety symptoms among Latino farmworkers in California (Mora et al., 2022), Latina immigrant women in Washington state (Ornelas et al., 2021), and nationwide samples of Latino individuals (Thomeer et al., 2022), as well as on qualitative studies that have focused on mental health stressors, coping strategies, and social service access in Latino households (Garcini et al., 2021b;Moon et al., 2021;Pineros-Leano et al., 2022). This study also contributes to the small literature on rural mental health in the context of COVID-19, which has previously found that rural residents fared better psychologically than those in urban areas, potentially due to greater perceived safety and comfort in being outdoors (Grocke-Dewey et al., 2021). ...
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The mental health of the United States' Latino population significantly deteriorated during the SARS-CoV-2 (COVID-19) pandemic, and Latino immigrants living in rural areas faced unique vulnerabilities. However, few studies have specifically examined the mental health burden and experiences of rural Latino immigrants during the COVID pandemic. To understand the mental health experiences of first- and second-generation Latinos in rural areas, we conducted semi-structured interviews with 35 Latino residents of rural California counties during July 2020-February 2021 and screened all respondents for major depression and generalized anxiety symptoms using the Patient Health Questionnaire [PHQ]-2 and Generalized Anxiety Disorder [GAD]-2 screeners. We explored the prevalence of symptoms of depression and anxiety in our sample, iteratively analyzed participants' narratives regarding the mental health impact of the pandemic, and used their mental health screener status to contextualize these narratives. Results indicated that nearly all respondents viewed mental health as a major concern, and 34% (n = 12) of respondents screened positive for major depression or generalized anxiety disorder. Respondents connected their mental health concerns to experiences of financial precarity, fear of contracting COVID-19, social isolation, and the challenges of remote schooling. Additional themes emerged around problems accessing the mental health care system, the utility of pre-pandemic mental health services, and using healthy coping mechanisms to alleviate psychological problems. Respondents’ narratives tended to focus on the mental health challenges facing their family members, particularly their children. Our findings suggest that mental health intervention models that engage with multiple family members, policies that support infrastructure for encouraging exercise and outdoor activity, and ensuring access to culturally and linguistically appropriate mental health care for Latino communities may be important for protecting population mental health.
... The impact on this group was exacerbated by uncertainty, social isolation, loss of employment and income, mortality, and social suffering. 1 Latinx youth make up one of the largest and fastest-growing ethnic minority populations of Latinx in the United-States (US) and suffer from higher rates of mental health issues than their peers. Among Latinx youth, 22% report depressive symptoms, which is higher than all other groups except Native American youth. 2 Despite this, Latinx youth are less likely to receive mental health treatment (8%) compared to their Caucasian peers (14%). ...
... 4 Despite the increased prevalence of mental health disorders among Latinx adolescents and their families, they encounter unmet mental health needs stemming from disparities in the availability, accessibility, and quality of mental health services. 1 Until we acknowledge and address these limitations of our healthcare system and the disparities in the social determinants of health, we continually fail to foster the social and emotional well-being of this vulnerable population. Consistently pursuing opportunities to tackle ingrained health injustices within our nation remains paramount. ...
... The role of peer support in behavioral health has promising outcomes, particularly when members of the community are trained in providing behavioral health services (A. Gonzalez et al., 2021;Moon, 2021;Sternberg et al., 2019). Including families in appointments, with the patient's consent, may increase the comfort level in the provider's office (O'Mahony & Clark, 2018). ...
Article
Introduction: In 2020, 18.4% of Hispanics experienced mental illness, yet only about a third received treatment compared with nearly half of non-Hispanic Whites. In Montana, where only 11% of the mental health needs are currently met, service utilization is low. The purpose of this study was to determine the perceptions of the Hispanic immigrant population in a rural state on mental health and professional service utilization. Methods: Using a descriptive phenomenological approach, we conducted semi-structured telephone interviews in Spanish. Audio recordings were transcribed, translated to English, and analyzed for themes. Results: We recruited a sample of 14 participants from Mexico, Ecuador, Colombia, and Venezuela ranging in age from 33 to 59. We identified five themes: definitions of mental health, maintaining mental health, familismo/socialization, stigma, and acculturation stress. Discussion: Novel findings point to the need for Spanish-language services focused on reducing stigma around mental illness and incorporating the importance of social connections.
... from medical institutions that have not earned the community's trust are common in these communities. [17][18][19][20][21][22][23] These challenges are counterbalanced by important assets observed in Latinx communities in the United States (US), including strong social cohesion [24][25][26][27] and informal, multigenerational networks that share information and resources that have been vetted by trusted gatekeepers. 5,18,24,[28][29][30][31] Community-initiated promotor/a programs capitalize on these assets by identifying and elevating these trusted gatekeepers that are knowledgeable of trustworthy (and untrustworthy) resources that peers in their community can access. ...
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Community-initiated health interventions fill important gaps in access to health services. This study examines the effectiveness of a community-initiated health intervention to improve diabetes management in an underserved community of color using a retrospective observational study, comparing a study intervention, the Latino Health Access Diabetes Self-Management Program (LHA-DSMP), with usual care. The LHA-DSMP is a 12-session community health worker (promotor/a) intervention developed and implemented by a community-based organization in a medically underserved area. Usual care was delivered at a federally qualified health center in the same geographic area. Participants were 688 predominantly Spanish-speaking Latinx adults with type 2 diabetes. The main outcome was change in glycemic control (glycosylated hemoglobin [HbA1c]) from baseline to follow-up. At 14-week follow-up, mean (95% CI) HbA1c decrease was -1.1 (-1.3 to -0.9; P < .001) in the LHA-DSMP cohort compared with -0.3 (-0.4 to -0.2; P < .001) in the comparison cohort. Controlling for baseline differences between cohorts, the adjusted difference-in-differences value in HbA1c was -0.6 (-0.8 to -0.3; P < .001) favoring the LHA-DSMP. A community-initiated promotor/a-led educational program for diabetes self-management is associated with clinically significant improvement in blood sugar control, superior to what was observed with usual medical care.
... It has long been recognized that disparities in health care access and patient outcomes are associated with factors related to race, sex, gender, sexual orientation, primary language, and socioeconomic status (27). Epps and coauthors recognize that African Americans and other underrepresented racial and ethnic groups are often not included in health decision making and policy development (9). As a result, these public health experts describe steps undertaken to improve participation, joint decision making, and capacity building between an integrated academic health system and a community coalition to address complex health challenges with the aim of increasing the capacity of health systems to reduce the burden of COVID-19. ...
Article
In June 2017, Preventing Chronic Disease (PCD) invited a panel of 7 nationally recognized experts in scientific publishing to respond to key questions about the journal’s mission, quality of scientific content, scope of operations, intended audience, and future direction (1). PCD and the panel of experts recognized that chronic disease is a major contributor to poor health outcomes, an increase in health care costs, and a reduction in quality of life. Reducing the burden of chronic disease is a challenge requiring diverse collaborations and dissemination and adoption of effective interventions in multiple settings. The expert panel strongly encouraged the journal to focus more on complementing its rich body of published work on epidemiological studies with content that is attentive to evaluating population-based interventions and policies. © This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.
Article
This review examines the current reporting trends of program design, implementation, and evaluation of training programs for Latinx community health workers. Five scholarly databases were searched using a scoping review methodology to identify articles describing training programs for Latinx community health workers. The timeframe was 2009 to 2021. We identified 273 articles, with 59 meeting inclusion criteria. Researchers thematically coded the articles to identify reporting strategies related to program design, implementation, and evaluation. Findings suggest a lack of consensus in reporting elements critical to program resources, instructor qualifications, frequency and length of training implementation, theoretical background, and pedagogical tools associated with the training program. We offer detailed reporting recommendations of community health worker training programs to support the consistent dissemination of promising practices and facilitate the initiation of new programs for Latinx community health workers.