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Opioid use disorder is a growing public health concern in South Texas. To assist in mitigating the effects of this epidemic, staff produced a program that focused on replicating, modifying, and evaluating the impact of the "Opioid Addiction Treatment ECHO™ (Extension of Community Health Outcomes) for CHWs (community health workers) program" on 26 CHWs practicing in rural and other medically underserved areas through teleconferencing technology. CHWs trained on the topic of substance use disorder concentrated on behavioral health integration with a focus on opioid prescription misuse. The analysis found that knowledge attainment was increased above the pretest means. The ECHO™ model proved to be effective at linking subject matter experts and specialists at an academic "hub" with CHWs in local communities.

BACKGROUND Latinos living in rural South Texas have a higher prevalence of diabetes, but their access to diabetes self-management education and support (DSMES) is limited. OBJECTIVE We aimed to test the feasibility of a community health worker-led, mobile health (mHealth)-based DSMES intervention to reduce disparities in accessing DSMES in underserved rural Latino residents in South Texas. METHODS This 12-week, single-arm, pre-post trial was delivered by trained community health workers to 15 adults with type 2 diabetes. The intervention consisted of digital diabetes education, self-monitoring, a cloud-based connected platform, and community health worker support. Feasibility was evaluated as retention, actual intervention use, program satisfaction, and barriers to implementation. We also explored the intervention’s effect on weight loss and hemoglobin A1c (HbA1c). RESULTS All 15 participants were Latino (mean age 61.87 years, SD 10.67; 9/15 female, 60%). The retention rate at posttest was 14 of 15 (93%). On average, the participants completed 37 of 42 (88%) digital diabetes education lessons with 8 participants completing all lessons. Participants spent 81/91 days (89%) step tracking, 71/91 days (78%) food logging, 43/91 days (47%) blood glucose self-monitoring, and 74/91 days (81%) weight self-monitoring. The level of program satisfaction was high. On average, participants lost 3.5 (SD 3.2) kg of body weight (P=.001), while HbA1c level remained unchanged from baseline (6.91%, SD 1.28%) to posttest (7.04%, SD 1.66%; P=.668). CONCLUSIONS A community health worker-led mHealth-based intervention was feasible and acceptable to improve access to DSMES services for Latino adults living in rural communities. Future randomized controlled trials are needed to test intervention efficacy on weight loss and glycemic control.

Purpose: Hispanics residing in rural areas are among those who are least likely to be screened for colorectal cancer (CRC) and more likely to present with late stage CRC than other racial or ethnic groups. We conducted a pilot study utilizing a mixed-method approach to explore perceptions of CRC and CRC screening among Hispanic adults residing in South Texas rural communities and to identify health literacy needs associated with CRC screening uptake. Methods: A convenience sample of 58 participants, aged 35–65, were recruited to complete questionnaires and participate in focus groups, ranging in size from 4 to 13 participants. Six focus groups were conducted across 3 adjacent rural counties. A semi-structured moderator’s guide was designed to elicit discussion about participants’ experiences, knowledge, and perceptions of CRC and CRC screening. Findings: Lack of knowledge of CRC and CRC screening as cancer prevention was a common theme across focus groups. A majority, 59%, reported never been screened. Thirty-nine percent reported they had been screened for colon cancer and 5% reported they did not know if they had been screened. Participants with lower educational levels perceived themselves at high risk for developing CRC polyps, would not want to know if they had CRC, and if they did have CRC, would not want to know until the very end. Limited information about CRC and CRC screening, a lack of specialized providers, limited transportation assistance, and compromised personal privacy in small-town medical facilities were perceived to be barriers to CRC screening. Conclusions: Low screening rates persist among rural Hispanics. Improving CRC screening literacy and addressing factors unique to rural Hispanics may be a beneficial strategy for reducing screening disparities in this at-risk population.

This paper introduces the concept of contextual mitigating factors (CMFs) as a theoretical construct to help understand how Latinas who demonstrated success in STEM pipelines navigated the fluidly and dynamically shifting socio-historical-political contexts in which they found themselves. Further, understanding the ways in which CMFs contribute to the development of circumstances within fluid social fields is essential to understand the factors which Latinas both experience and create in their social interactions. We framed the development of CMFs within discussions of social place (Bourdieu and Wacquant in An invitation to reflexive sociology, University of Chicago Press, Chicago, 1992), social field (Swartz in Culture and power: the sociology of Pierre Bourdieu, University of Chicago Press, Chicago, 1997), and dynamic space (Tobin in Keynote address at 8th international congress on science teaching and learning, Barcelona, Spain, 2009). Given that CMFs appear as the result of social interactions within contextualized spaces, acknowledging the importance of place, be it physical or metaphorical, is essential in framing discussions on the sense-making of the participants’ STEM successes. In accounting for our participants’ positionalities and the materiality of their contextual experiences, we use CMFs as a theoretical underpinning to guide our methodological approach which we identify as CMF analysis. In each case, CMF analysis is used to explore how positionalities and experiences reflexively shaped each other, all while contributing to individual and social personhoods. Furthermore, the use of CMFs, by placing importance on both context and history, allowed us to discern not only the similarities of our participants’ sociocultural, -economical, -historical and -political navigations toward success, but also the substantive differences between them. In presenting our discussion of CMFs, we present two of sixty case studies focusing on Latinas’ successes in STEM fields using the intrinsic case study method (Stake, in: Denzin, Lincoln (eds) The SAGE handbook of qualitative research, 3rd edn, pp 443–466, SAGE, Thousand Oaks, 2005). This was the most appropriate method in analyzing our participants’ experiences, because this allowed our participants to tell their stories of becoming and being successful in pursuing STEM pathways. Marrying this framework with intrinsic case study method provided internal consistency to the study. Ultimately, we want other researchers to see the benefits associated with CMF analysis, namely the provision of an additive framework in understanding the lived experiences of minority groups. By accounting for the role macro-, meso-, and microgenic CMFs play in the minority students’ educational experiences, educators at all levels may play a substantively larger role in helping sustain their agency as learners.

This study examines the role of alternative media in the socio-environmental movement for justice for the Lumad, the indigenous peoples of the southern Philippines, and the fight to protect the environment in the Philippines from extractive companies and mono-crop plantations. Using thematic textual analysis and framing analysis, the study analysed selected news articles, press releases and advocacy articles from bulatlat.com and civil society group websites posted online from September to December 2015. Anchored on Downings theory of alternative media as social movement media and Fuchs theory of alternative media as critical media, the study reveals four categories of alternative media: (1) as giver of voice to the oppressed Lumad; (2) as social movement media used for social mobilisation; (3) as an alternative media outfit fulfilling a complementary role with the socio-environmental movement; and (4) as making social movements offline activism visible. It concluded that alternative media play a vital role in socio-environmental movements and the continuing challenge to mitigate the climate crisis.

This study examines the ‘theater of struggle’ in young Filipino women's reception of Korean television dramas in view of the American cultural imperialism that is deeply entrenched in the Philippine society. Mainly anchored on Gramsci's concept of hegemony and Stuart Hall's encoding-decoding theory, the researcher conducted a reception analysis through a textual analysis of selected Korean television comedy-dramas and focus group discussions with young Filipino women in different colleges. The young Filipino women expressed cultural affinity with the culture, storylines, values, and environment in Korean and other Asian television dramas that have invaded the Philippines in the twenty-first century. ‘Negotiation, resistance, and struggle’, in Hall's sense, against both the liberalism in American dramas and the pre-modern themes in local dramas were manifested in the young women's discourses. Consequently, American cultural imperialism in the Philippines was undermined, challenged, and to some extent subve...

To review research examining the influence of "connectedness" on adolescent sexual and reproductive health (ASRH). Connectedness, or bonding, refers to the emotional attachment and commitment a child makes to social relationships in the family, peer group, school, community, or culture. A systematic review of behavioral research (1985-2007) was conducted. Inclusion criteria included examination of the association between a connectedness sub-construct and an ASRH outcome, use of multivariate analyses, sample size of >or=100, and publication in a peer-reviewed journal. Results were coded as protective, risk, or no association, and as longitudinal, or cross sectional. Findings from at least two longitudinal studies for a given outcome with consistent associations were considered sufficient evidence for a protective or risk association. Eight connectedness sub-constructs were reviewed: family connectedness (90 studies), parent-adolescent general communication (16 studies), parent-adolescent sexuality communication (58 studies), parental monitoring (61 studies), peer connectedness (nine studies), partner connectedness (12 studies), school connectedness (18 studies), and community connectedness (four studies). There was sufficient evidence to support a protective association with ASRH outcomes for family connectedness, general and sexuality-specific parent-adolescent communication, parental monitoring, partner connectedness, and school connectedness. Sufficient evidence of a risk association was identified for the parent overcontrol sub-construct of parental monitoring. Connectedness can be a protective factor for ASRH outcomes, and efforts to strengthen young people's pro-social relationships are a promising target for approaches to promote ASRH. Further study regarding specific sub-constructs as well as their combined influence is needed.

Background U.S., Hispanic women have higher cervical cancer incidence rates than non-Hispanic Whites and African Americans and lower rates of cervical cancer screening. Knowledge, attitudes, and cultural beliefs may play a role in higher rates of infection of HPV and decisions about subsequent diagnosis and treatment of cervical cancer. Study aim To explore the level of HPV knowledge, attitudes, and cultural beliefs among Hispanic men and women on the Texas-Mexico border. Methodological Approach Informed by feminist ethnography, the authors used an interpretive approach to understand local respondents' concerns and interests. Focus group sessions were analyzed using thematic content analysis. Recruitment and sample Promotoras (lay health workers) recruited participants using convenience sampling methods. Group sessions were held in public service centers in Brownsville. Participants' ages ranged from 19 to 76 years. Methods analysis Focus group discussions were audio-recorded and transcribed in Spanish. Researchers read and discussed all the transcripts and generated a coding list. Transcripts were coded using ATLAS.ti 5.0. Key findings Participants had little understanding about HPV and its role in the etiology of cervical cancer. Attitudes and concerns differed by gender. Women interpreted a diagnosis of HPV as a diagnosis of cancer and expressed fatalistic beliefs about its treatment. Men initially interpreted a diagnosis of HPV as an indication of their partners' infidelity, but after reflecting upon the ambiguity of HPV transmission, attributed their initial reaction to cultural ideals of machismo. Men ultimately were interested in helping their partners seek care in the event of a positive diagnosis. Implications for practice Results suggest that understanding Hispanics' cultural norms and values concerning disease, sexuality, and gender is essential to the design and implementation of preventive interventions for HPV and cervical cancer.

ENCOREplus , a breast and cervical cancer outreach, education, and screening referral program, was implemented by the YWCA of the United States and funded by Avon’s Breast Cancer Awareness Crusade. ENCOREplus was designed to address the educational and access needs of low socioeconomic status and minority women who experience substantial barriers to breast and cervical cancer screening. This article describes the dissemination of ENCOREplus to 78 YWCAs in 30 states. It illustrates the application of social cognitive theory and diffusion theory to increase program adoption, implementation, and maintenance among community organizations that have not traditionally provided public health related services. The article highlights elements of the program that enhanced its adoption and implementation and describes procedures for accelerating the diffusion of the program across the country.