Francisco Alejandro Montiel Ishino

• PhD, MPH, BS, CPH
• Investigator at National Institutes of Health

Knowledge of Mexican immigrant sleep health is limited. We investigated the association between acculturation, depression, and having trouble sleeping among a nationally representative sample of Mexican immigrant adults. We used a logistic regression model on cross-sectional data from the 2005–2018 National Health and Nutrition Examination Survey o...

Background South Asians (SA) represent the fastest growing US immigrant group, and previous studies have indicated that they face disproportionately high burden of cardiometabolic disease. Cardiometabolic disease manifests as a syndemic or synergistic epidemic encompassing multiple disease clusters influenced by biological, social, and psychologica...

Background Discrimination and xenophobia toward Hispanic and Latino communities increased during the COVID-19 pandemic, likely inflicting significant harm on the mental health of Hispanic and Latino individuals. Pandemic-related financial and social instability has disproportionately affected Hispanic and Latino communities, potentially compounding...

Hispanic/Latino populations experienced disproportionate exposure to depression risk factors during the COVID-19 pandemic. While aggregated data confirm the risks of depressive symptoms among Hispanic/Latino individuals, little research uses disaggregated data to investigate these risks based on ethnic subgroups. Using the “Understanding the Impact...

Background: United States (US) South Asians are a fast-growing immigrant group that on average, while having a higher socioeconomic status, present with an increased prevalence and faster development of cardiometabolic health (CMH) conditions. Acculturation—the process of adapting norms of a host culture—can give rise to a unique set of stressful c...

Introduction: The prevalence of insomnia symptoms is higher among refugees globally compared to the general population, and poor sleep is a risk factor for poor cardiometabolic health. The resettled Bhutanese refugee community is the third-largest refugee group in the United States (US) and appears to be-based on a few existing studies-particularly...

The novel coronavirus 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has faded from the headlines as infection and mortality rates decline, yet remains a challenge to rural and indigenous communities in locations like Oaxaca, Mexico [1]. Rurality and indigeneity create further obstacles to commu...

Military-connected adolescents are at increased risk of adverse behavioral and mental health outcomes compared to civilian peers, a finding which may be explained by exposure to unique military-specific stressors. Existing measures of adolescent stress fail to account for these stressors, potentially underestimating stress experienced by these yout...

BACKGROUND Discrimination and xenophobia toward Hispanic and Latino communities increased during the COVID-19 pandemic, likely inflicting significant harm on the mental health of Hispanic and Latino individuals. Pandemic-related financial and social instability has disproportionately affected Hispanic and Latino communities, potentially compounding...

Background: Extended literature has demonstrated that COVID-19 vaccination is crucial for the health of all individuals regardless of age. Research on vaccination status in a US sample by nativity is limited. Objective: The objective of our study was to expand on the limited literature regarding COVID-19 vaccination during the pandemic and US na...

Introduction Military-connected students in public schools face a unique set of stressors that may impact their wellbeing and academic functioning. Methods Twenty-four youth in the 7th to 12th grades who had an active-duty parent (mother or father) serving in the U.S. Armed Forces were interviewed. Participants completed a qualitative interview wh...

The digital divide proved a critical barrier to accessing information and healthcare during the Covid-19 pandemic and negatively impacted the Bhutanese refugee community. Moving beyond a technological model of the digital divide that highlights a lack of access to computers and 16 the internet, we engaged the community to co-produce a dynamic appro...

BACKGROUND Extended literature has demonstrated that COVID-19 vaccination is crucial for the health of all individuals, regardless of age. Research on vaccination status in the United States (US) among US-born and non–US-born residents is limited. OBJECTIVE The objective of our study was to examine COVID-19 vaccination during the pandemic among US...

Telomere length is affected by lifestyle and environmental factors and varies between racial and ethnic groups; however, studies are limited, with mixed findings. This study examined the effects of tobacco use and smoke exposure on mean telomere length to identify critical age periods by race/ethnicity. We used time-varying effect modeling on the N...

Background: While malaria and neglected tropical disease (NTD) morbidity and mortality rates among children <5 years old have decreased through public health efforts in the United Republic of Tanzania, associations between household environments and disease outcomes are relatively unknown. Methods: We conducted latent class analysis (LCA) on 201...

Intimate partner violence has adverse effects on mother’s overall health and prevention of mother to child HIV transmission. To identify and examine subgroups of mothers experiencing intimate partner violence and the likelihood of HIV testing during antenatal care, we conducted a latent class analysis using data from the Tanzania Demographic and He...

The objective of this study was to identify profiles of acculturation and weight-by-weight perception status among United States (US) foreign-born Hispanic/Latino adults using a person-centered approach. We conducted a latent class analysis (LCA) on 1999–2004 National Health and Nutrition Examination Survey (NHANES) data from US foreign-born Hispan...

Previous research has shown a reliable association between social media (SM) use and drinking among college students. However, most studies have investigated SM behaviors (e.g., time spent on a platform, posting frequency) in isolation and on a single site. While some have studied multiple SM behaviors across platforms using person-centered approac...

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Acculturation and depression are linked to poor sleep quality and sleep problems that may explain ongoing health disparities for Hispanics/Latinos. We examined the associations of acculturation, depression, and sleep duration among the Mexican American population. We used a multinomial logistic regression model on cross-sectional data from the 2005...

Purpose Sexual minority (SM) identity as well as sociodemographic and socioeconomic factors are associated with asthma prevalence. A syndemics framework analyzes disease conditions in a population and the social, economic, and environmental contexts in which they are found. We used a syndemic model of individual-level socioecological factors to ide...

Background Hypertension and diabetes disproportionately affect older non‐Hispanic Black and Hispanic adults in the United States. Chronic stress may partially explain these disparities. This study identified underlying stress profiles of older US adults, analyzed stress profiles in relation to hypertension and diabetes, examined the distribution of...

Background Limited studies have examined the relationship of neighborhood cohesion and sleep duration between U.S. foreign-born Hispanics/Latinos and non-Hispanics/Latinos. Methods We conducted a multinomial logistic regression using the 2013-2018 National Health Interview Survey on U.S. foreign-born adults ≥18 (N = 27,253). The outcome variable,...

Sleep duration affects physiological functioning and mental health outcomes among Hispanics/Latinos. The limited research reports that Hispanic/Latino subpopulations like Puerto Ricans carry a disproportionate burden. To understand this burden, we identified profiles of sleep duration by psychological distress among Puerto Rican adults (N = 4443) u...

Background: Tennessean women experience the 12th highest breast cancer (BC) mortality in the United States. Yet, few studies have examined BC outcomes among Tennessean women in and outside of Appalachia. We examined whether sociodemographic factors and health insurance status were associated with invasive BC in Tennessee by Appalachian and non-Appa...

Background: The Covid-19 pandemic had many unprecedented secondary outcomes resulting in various mental health issues leading to substance use coping behaviors. The extent of substance use changes in a US sample by nativity have not been previously described. Objective: Our aim was to design an online survey to assess the social distancing and i...

BACKGROUND The COVID-19 pandemic had many unprecedented secondary outcomes resulting in various mental health issues leading to substance use as a coping behavior. The extent of changes in substance use in a US sample by nativity has not been previously described. OBJECTIVE This study aimed to design a web-based survey to assess the social distanc...

The digital divide refers to the physical gap that separates populations from access to digital services including the internet. This draft of our investigation with the Bhutanese Community of Central Ohio, captures how complex and dynamic the digital divide is and how it impacts are not simply technological, but social and related to health and id...

Background: Hispanic/Latina women are less likely to be diagnosed with local stage breast cancer than White women. Additionally, foreign-born women have lower mammography rates than US-born women. We evaluated the combined effect of birthplace and race/ethnicity on screening habits of women at higher-than-average risk of breast cancer. Methods:...

Social media (SM) users are a combination of several behaviors across platforms. Patterns of SM use across platforms may be a better indicator of risky drinking than individual behaviors or sets of behaviors examined previously. This longitudinal study addressed this gap in the literature using latent profile analysis (LPA) to identify subpopulatio...

Background: Acculturation profiles and their impact on telomere length among foreign-born Hispanics/Latinos living in the United States (US) are relatively unknown. The limited research available has linked acculturation with shortened telomere length. Objectives: To identify acculturation profiles among a US representative sample of Hispanics/Lati...

Objective Educational environments that are structured by race perpetuate poor mental health for Black adolescents. This empirical relationship is pronounced when it is examined through Racial Battle Fatigue theory, which provides a framework that links educational environments and poor psychological health of Black students. School police have maj...

The relationship of social determinants of health, Appalachian residence, and prostate cancer treatment delay among Tennessee adults is relatively unknown. We used multivariate logistic regression on 2005–2015 Tennessee Cancer Registry data of adults aged ≥18 diagnosed with prostate cancer. The outcome of treatment delay was more than 90 days witho...

Using the 2013/14 New York City Health and Nutrition Examination Survey population sample, this study compared Afro Caribbean immigrants and US-born African American New Yorkers to determine a) whether prevalence and odds of type 2 diabetes (T2DM) differed between ethnic groups; and b) whether cardiometabolic health profiles differed among those wi...

Background: South Asians (SA) are the second largest US immigrant group and have excess cardiometabolic (CM) disease. While acculturation is associated with increased CM risk among immigrants and refugees, the role of acculturation on SA CM risk is relatively unknown. CM disease presents as a syndemic or synergistic epidemic involving multiple dise...

BACKGROUND During the Coronavirus Disease 2019 (COVID-19) pandemic, social media traffic volume increased exponentially. Previously, Twitter was used as an informational surveillance tool to detect influenza outbreaks and proved to be an efficient and reliable tool. OBJECTIVE The objective of this paper is to spatially examine the association of C...

Background: The Coronavirus Disease 2019 (COVID-19) pandemic exacerbated existing racial/ethnic health disparities in the United States (U.S.). Monitoring nationwide Twitter conversations about COVID-19 and race/ethnicity could shed light on the impact of the pandemic on the racial/ethnic minorities and help address health disparities. Objective:...

Context: Colorectal cancer (CRC) surgical treatment delay (TD) has been associated with mortality and morbidity; however, disparities by TD profiles are unknown. Objectives: This study aimed to identify CRC patient profiles of surgical TD while accounting for differences in sociodemographic, health insurance, and geographic characteristics. Des...

Introduction: Long–standing disparities in colorectal cancer (CRC) outcomes and survival between Whites and Blacks have been observed. A person–centered approach using latent class analysis (LCA) is a novel methodology to assess and address CRC health disparities. LCA can overcome statistical challenges from subgroup analyses that would normally im...

Background Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods Latent class analysis (LCA) was used to identify patterns of adolescent polytoba...

Surgical prostate cancer (PCa) treatment delay may increase the likelihood of recurrence of disease, and influence quality of life as well as survival disparities between Black and White men. We used latent class analysis to identify risk profiles in localized, malignant PCa surgical treatment delays while assessing co-occurring social determinants...

Background Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. Methods A multivariate logistic regression was used on...

While Twitter has been touted as a preeminent source of up-to-date information on hazard events, the reliability of tweets is still a concern. Our previous publication extracted relevant tweets containing information about the 2013 Colorado flood event and its impacts. Using the relevant tweets, this research further examined the reliability (accur...

While Twitter has been touted to provide up-to-date information about hazard events, the reliability of tweets is still a concern. Our previous publication extracted relevant tweets containing information about the 2013 Colorado flood event and its impacts. Using the relevant tweets, this research further examined the reliability (accuracy and true...

Our purpose was to examine the constellation of health determinants in prostate cancer (PCa) surgical treatment delay using a person-centered approach. PCa is the most common and the second leading cause of death among men in the US. Black men are more likely to have advanced disease, and more than twice as likely to die of PCa than white men. Caus...

Introduction. Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods. Latent class analysis (LCA) was used to identify patterns of adolescent polyt...

Introduction. Studies of the patterns of polytobacco use have increased. However, understanding the patterns of using multiple tobacco products among Black adolescents is minimal. This study identified the patterns of polytobacco use among U.S. Black adolescents. Methods. Latent class analysis (LCA) was used to identify patterns of adolescent polyt...

Opioid misuse can lead to use disorder and other adverse outcomes. Identifying sociodemographic risk profiles and understanding misuse patterns in combination with health indicators can inform prevention science and clinical practice. A latent class analysis of opioid misuse was conducted on noninstitutionalized United States civilians aged 18 and...

Background Few studies have comprehensively and contextually examined the relationship of variables associated with opioid misuse. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse in the United States by identifying the most salient predictors. Methods A multivariate logistic regression was used on the 2017 and 2...

Background: Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. Methods: A multivariate logistic regression was used o...

Background: Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. Methods: A multivariate logistic regression was used o...

Background: Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. Methods: A multivariate logistic regression was used o...

Background: Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. Methods: A multivariate logistic regression was used o...

Background: Few studies have comprehensively and contextually examined the relationship of variables associated with opioid use. Our purpose was to fill a critical gap in comprehensive risk models of opioid misuse and use disorder in the United States by identifying the most salient predictors. Methods: A multivariate logistic regression was used o...

Background: Due to media reports of several deaths, consumption of unrecorded alcohol (i.e., alcohol brewed at home) has emerged as a public health threat in developing countries like Kenya. Empirical data on this issue, however, is scarce. This investigation compared demographic characteristics of Kenyans who drank recorded (regulated) and unreco...

Background: Farmworkers’ exposures to pesticides are reduced when they wear personal protective equipment (PPE), and mobile health (mHealth) platforms can potentially deliver information to farmworkers to help promote PPE use. However, little is known about the feasibility of using mHealth platforms to promote farmworkers’ use of PPE. Objective: T...

Objective: Personal protective equipment (PPE) reduces pesticide exposures, but many farmworkers complain that it is difficult to obtain. We examined if PPE provision increased usage. We also delivered motivational messaging aimed to promote PPE use. Methods: First, we delivered a daily survey through a mobile phone app to assess PPE use. Farmwo...

OBJECTIVE: We evaluated an mHealth pilot intervention aimed to increase pesticide safety behaviors among Mexican farmworkers. METHODS: Farmworkers were given dynamically tailored, culturally-appropriate motivational messages in their preferred language (Spanish or English) via mobile smart phones aimed to increase PPE use. Additionally, we provided...

Background: Agricultural harvest workers are a vulnerable, primarily Mexican-origin population who experience substantial pesticide exposure. Evidence strongly indicates that when harvest workers wear personal protective equipment (PPE), exposures to pesticides are substantially reduced. However, the U.S. Environmental Protection Agency’s Worker Pr...

Background: Recruitment and participation among minorities, more specifically, African American/Black and Hispanic/Latino (AA-HL) populations in clinical trials have been challenging for clinical researchers and institutions. Multiple studies have documented financial, structural, and personal barriers; however, few studies have reported on minorit...

Few studies have reported on African American and Hispanic (AA and H) populations' informational needs when seeking cancer care at an institution that offers clinical trials. Moffitt Cancer Center (MCC) sought to identify and examine the decision making process, the perceptions, and the preferred channels of communication about cancer care services...

Bone Marrow Transplantation is a high quality, peer-reviewed journal covering all aspects of clinical and basic haemopoietic stem cell transplantation.

Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a Universit...

Background: Although a great deal of research has focused on patient quality of life (QOL) after hematopoietic cell transplant (HCT), studies of caregivers are relatively scarce. The goal of the current study was to conduct a qualitative analysis of caregiver QOL after HCT. Methods: As part of a larger qualitative study examining patient education...

As globalization blurs borders and boundaries, how has cultural identity been altered and crafted? In the case of indigenous identity, or indigeneity, socioeconomics and sociocultural factors force the assimilation of Westernized values and ideals forsaking indigeneity. Indigenous culture then becomes increasingly hybridized and lost creating gaps...

By 2030, older adults will comprise more than 20% of the US population. This unprecedented rise in the aging population will be met with a dramatic increase in health care expenditures. To reduce this burden and advance public health's mission to achieve longer, healthier and more productive lives across the lifespan, models of healthy aging must b...

Introduction: Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and e...

Oaxacan artisans are celebrated for the quality of their work, their business success, and the ability of their goods to transcend space and time. Weavers of cotton and woolen textiles, potters, and most recently wood carvers who make alebrijes (painted wooden animals) produce goods that are bought and sold on the international market and appear in...

Oaxacan artisans are celebrated for the quality of their work, their business success, and the ability of their goods to transcend space and time. Weavers of cotton and woolen textiles, potters, and most recently wood carvers who make alebrijes (painted wooden animals) produce goods that are bought and sold on the international market and appear in...

In March of 2010, President Obama signed into law the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act (known together as the Affordable Care Act or ACA). The largest legislative overhaul of the US health care system since the expansion of the Social Security Act in the 1960s, it invoked a fierce natio...

Introduction: Biospecimen donation and banking from diverse populations are critical for translational cancer research. Yet, little is known about community members’ perceptions about biospecimen donation and banking. The objectives of this study are to develop instruments to examine perceptions of biospecimen donation and banking and evaluate the...

Preparing healthy community members with timely communications prior to engaging them in a request to donate biospecimens promises to improve the experience of biobanking participation. To this end, a qualitative study was conducted to assess community member knowledge, attitudes, beliefs, and informational needs about cancer-related biospecimen co...

Historically, underserved populations have been disenfranchised from health education and promotion services. In an effort to reduce educational barriers that continue to promote health disparities amongst at-risk populations, health literacy efforts have shifted towards low literacy and culturally competent health educational materials. The Center...

Many legislative, socioeconomic and sociocultural barriers exist in providing proper cancer education and screening to underrepresented and socially marginalized ethnic/racial groups, such as Mexican migrant men. Undocumented Mexican migrants pose a more difficult situation as they are not allowed full access to medical services and adequate health...

Grasshoppers (chapulines) are an important part of rural Oaxacan (Mexico) cuisine and they play a key role in the local diet and market. In this paper, and using data collected over several years of interviewing and ethnographic research in the state, we describe how rural Oaxacan women manage the harvest and prepare chapulines. Second, we examine...