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This article reports on formative research to develop the Adelante brand, an innovative program for Latino immigrant adolescents and their families. The brand applies social marketing principles used in previous health brands in areas such as tobacco control, substance use, and HIV prevention. Specific objectives were to apply branding principles as an approach to increasing adolescent engagement with, and participation in, a community-based youth development program called Adelante, which is based on positive youth development theory. We collected data in a primarily low-income Latino immigrant community, Langley Park, MD, located near Washington, DC. A total of 39 adolescents, ages 13–19, participated in six focus groups. We designed and tested a brand positioning statement, associations, a logo and graphics, and youth archetypes. We used thematic content analysis to code focus group data into broad topic areas and then analyzed the data using substantive coding to identify themes. The concepts of strength, resilience, and “turning the corner” by overcoming life obstacles and succeeding were the main themes. Latino youth face a challenging environment in which they grow up, finish school, and succeed. Adelante represents a source of support and help to turn the corner. A graphic depicting a city street corner with a darker side (past) and a brighter side (future) was identified as the Adelante logo. Youth characters named Victor and Erika, and an educational entertainment strategy, were conceived as a way to create a brand persona. Adelante is now actively building its brand to increase youth engagement in the program. [ABSTRACT FROM AUTHOR]

The gelatin test has been utilized for many years as a characteristic to separate the genus Serratia from other members of the tribe Klebsielleae. Gelatin is a large protein matrix that cannot diffuse into bacterial cells. Microbes that attack gelatin do so by producing extracellular proteinases. The measurement of gelatinase has suffered from the lack of a defineable endpoint and the inability to quantitate the enzyme. A method was developed utilizing an azodye-labelled collagen substrate that could measure the extracellular proteinase of Serratia. The test was easy to perform, inexpensive, and potentially quantifiable. The azodye test corresponded completely with the gelatinase tests. [ABSTRACT FROM AUTHOR]

The Community Firearm Violence Prevention Network (CFVP Network), funded by the National Institutes of Health (NIH), supports a network of research projects that develop and test interventions through collaborations with community partners to prevent firearm violence, injury, and mortality. The CFVP Network presents a unique opportunity to accelerate the science of preventing firearm injuries. The data harmonization workgroup of the CFVP Network led the process of aligning studies across the three unique inaugural network projects, with particular attention to how the CFVP Network could address current gaps in the science. The goal of the data harmonization workgroup was to align study measures, assessment timelines, and data management and archival processes across projects to enable robust cross-project analyses that accelerate the science of preventing firearm injuries. To accomplish this goal, the workgroup established the infrastructure to facilitate cross-project data collection, data sharing and archiving, and analyses. Among the three inaugural network projects, the workgroup's process resulted in harmonizing two assessment timepoints (baseline and one year post-implementation) and 60 constructs (with 31 identical standardized constructs). These harmonized products provide opportunities for novel analyses across the network projects. We expect that the harmonized study infrastructure developed through this process will catalyze future research focused on preventing firearm injury, including and extending beyond CFVP Network projects. The CFVP data harmonization workgroup's process can serve as a model for future networks that seek to build the science in a particular area., (© 2024. Society for Prevention Research.)

Language identity, an understudied factor, can influence isolation and discrimination, leading to disparities in well-being and mental health among immigrants. This study aims to investigate the role of language identity on structural racism and discrimination among 1.5 generation Asian/Asian American immigrants in a diverse U.S. state. We developed a three-step sequential approach: Stage 1-qualitative analysis (1A, focus group discussion; 1B, in-depth interviews); Stage 2-quantitative analysis (2A, language identity measurement scale; 2B, cross-sectional online survey; 2C, multivariate multiple linear regression); Stage 3-another round of qualitative analysis (3A, follow-up in-depth chronological interviews). Therefore, this study will contribute to the field by introducing a novel three-step mixed methods approach, marking a notable improvement over conventional explanatory or exploratory sequential designs.

Importance: Heart failure (HF) is a leading cause of death in the US. The current evidence on the burdens of HF in Asian American populations, especially Asian American subgroups, is limited and inconsistent., Objective: To assess and compare the incidence and prevalence of HF in Asian American subgroups., Design, Setting, and Participants: This retrospective cohort study used electronic health record data from patients 40 years or older with health care encounters from January 1, 2015, to December 31, 2019, recorded in the Oracle Electronic Health Record Real-World Data database, which has more than 100 health care systems across the US contributing to the database as of February 2024. For prevalence analysis, the study samples were those who had at least 1 encounter in the study calendar year. For incidence analysis, participants were additionally limited to those without HF before the study year who also had encounter(s) the year before the study year. Data analysis was performed from August 1, 2023, to July 31, 2024., Exposure: Race and ethnicity were determined using patient self-reported data, which were categorized as Black, East Asian, South Asian, Southeast Asian, other Asian (without specified ethnicity), and White., Main Outcomes and Measures: Outcomes were incidence and prevalence of HF, identified using recorded International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes. Age- and sex-standardized incidence and prevalence were used to calculate the risk ratio of each racial and ethnic group compared with White patients., Results: Incidence and prevalence analyses were performed for 6 845 791 patients (mean [SD] age, 62.1 [12.5] years; 59.9% female; 2.8% Asian, 6.7% Black, and 90.5% White) and for 13 440 234 patients (mean [SD] age, 61.7 [12.7] years; 57.0% female; 2.9% Asian, 7.1% Black, and 90.0% White), respectively. Using the 2015 population as the standard, age- and sex-standardized HF incidence was 2.26% (95% CI, 2.07%-2.45%) for Southeast Asian patients, 1.56% (95% CI, 1.31%-1.82%) for South Asian patients, and 1.22% (95% CI, 1.06%-1.38%) for East Asian patients compared with 1.58% (95% CI, 1.57%-1.59%) for White patients and 2.39% (95% CI, 2.36%-2.42%) for Black patients. Similarly, heterogeneous rates in Asian American subgroups were also observed in the prevalence analysis., Conclusions and Relevance: In this study of HF outcomes, the disparities between Southeast and East Asian patients were larger than those between Black and White patients, with the estimates in Southeast Asian patients being similar to those of Black patients. These findings reinforce that individual Asian ethnicities and cardiovascular risk factors should be considered in the assessment of HF risks.

Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation.

Background: The Doctor of Public Health (DrPH) degree is an advanced and terminal professional degree that prepares the future workforce to engage in public health research, teaching, practice, and leadership. The purpose of the present research was to discuss the desirable future direction and optimal education strategies for the DrPH degree in the United States., Methods: A total of 28 Council on Education for Public Health (CEPH)-accredited DrPH programs in the United States was identified through the Association of Schools and Programs of Public Health (ASPPH) Academic Program Finder. Then, a qualitative analysis was conducted to obtain perspectives from a total of 20 DrPH program directors through in-depth interviews., Results: A DrPH program should be recognized as equal but different from an MPH or a PhD program and strengthen the curriculum of methodology and leadership education. It is important that a DrPH program establishes specific partnerships with other entities and provide funding for students. In addition, rather than being standardized nationwide, there is value in each DrPH program maintaining its unique character and enabling students to be open to all career pathways., Conclusions: The future of DrPH programs in the twenty-first century should aim at effective interdisciplinary public health approaches that draw from the best of both academic and applied sectors. A DrPH program is expected to provide academic, applied public health, and leadership training for students to pursue careers in either academia or the public/private sector, because public health is an applied social science that bridges the gap between research and practice.

While some research on health determinants for immigrant/refugee populations has considered migration itself as a health determinant, much of this research employs constructs that focus on factors such as language, acculturation, norms, behaviours, beliefs, and social support, in a manner analogous to health risk factors for domestic U.S. populations. These are, however, often disassociated from the broader context of migration and its transnational continuum. As a contribution towards addressing that gap, this study reports on 75 life history interviews from recent Central American immigrants to assess potential health determinants in three linked domains - home country situation, migration experience, and adjustment to the U.S. These domains were conceptualised as one transnational continuum, with health outcomes potentially resulting from combined effects across domains. Interview data showed, among other results, extensive experience with/victimisation from violence in the home countries and during migration, resulting in multiple health outcomes (including PTSD) in the U.S. It also showed some patterns of resiliency, as well as added stressors from the current political environment. The results and protocol from this pilot study are useful for broader research efforts in multiple global settings, and as narratives, should also help counter negative public representations and support improved treatment.

Interest has been growing in regard to increasing the public health workforce and standardizing training to ensure there are competent professionals to support rebuilding and reinforcing the public health infrastructure of the United States. The need for public health leaders was recognized as early as the hookworm control campaign during 1909-1914 when it became apparent that prevention of disease should be distinct from clinical medicine and should be conducted by professionally trained, dedicated full-time public health practitioners. In recent years, research on the public health workforce and on standardizing health workforce education has significantly expanded. A key element of such a workforce is public health leadership, and DrPH programs are the means to provide effective public health education for these future health professionals. The purpose of this paper is to analyze the general trend of DrPH programs from past to present and analyze the common themes and variations of 28 Council on Education for Public Health (CEPH)-accredited DrPH programs in the United States. This research utilized a mixed-methods approach, investigating DrPH education at each school or program to improve our understanding of the current status of DrPH programs., Competing Interests: The authors have declared that no competing interests exist.

Religious belief and participation may facilitate well-being and the transition to living in the United States for Korean immigrants. However, there is little known about how Korean immigrant young adults obtain social/emotional support from church involvement and benefit from spiritual networks. A qualitative study was conducted through in-depth interviews with 22 members of one Protestant church in the Washington, DC metropolitan area. According to our findings, all respondents were supported in their transition to living in the United States through the social support and well-being effects of religious belief/affiliation. They manifested their belief mainly in two different ways, either engaging in spiritual networks as a church leader or by focusing on their education and livelihoods with their religious belief as a powerful motivator. It is hoped that further study will elucidate more of the mechanisms linking religious belief to the living transition for Korean and other immigrants to the United States.

Structural marginalization exerts its effects through multiple social-ecological levels down to the individual behavior of youth violence and related risks. However, there is very little research or theoretical literature documenting or specifying mechanisms, paths, and linkages across levels. This paper traces one path in which long-term structural constraints intersect with the adolescent development process via a construct called the cultural persona-a form of archetype or model that embodies the value-structure, role, and performance of violence and related risk behavior within the kinds of underground or street economies that develop and persist in high-poverty communities as an outcome of structural marginalization. This mechanism is described, together with its limitations, along with examples and recommendations for interventions and further research., (© 2020 Wiley Periodicals, Inc.)

•An increasing number of health promotion/behavior change programs focus on changing social norms.•However, in current usage, norms are typically not linked to the underlying social and cultural context (decontextualized).•The use of social norms to change health behavior could be improved if norms were understood as culturally embedded . •Social norms may represent underlying cultural meanings and values, power configurations, or shared cultural models.•Social norms may serve as cultural tools for the exercise of individual agency.•There may be multiple and competing normative options in a given situation.•Social norms can be public or private, and norms change over time for many reasons.•There are ways to use social norms in health promotion programs that can help reconnect norms to cultural context.•These are described in the article along with a revised definition of social norms., (© 2020 The Authors.)

The authors designed and evaluated an innovative, branded campaign called 'Adelante' to promote positive youth development (PYD) and reduce risk behaviors among Latino youth near Washington, DC. Repeated cross-sectional surveys were conducted in the intervention and a comparison community to evaluate campaign exposure and changes in PYD outcomes. The sample consisted of 1549 Latino and immigrant adolescents surveyed at three time points in intervention and comparison communities. A social marketing campaign was implemented using outdoor advertising, Web, video and social media channels to promote PYD and health outcomes over a 1-year period from 2015 to 2016. Measures included media use; self-reported exposure to campaign promotions; Adelante message receptivity; validated PYD scales; substance use, sexual risk taking, violence-related knowledge, attitudes, beliefs, intentions and risk behavior. Outcomes were regressed first on campaign exposure to examine dose-response effects of the Adelante campaign over time. Second, we compared outcomes between the Adelante and comparison communities. We observed a positive effect of self-reported exposure on multiple outcomes, including improvements in pro-violence and sexual risk outcomes and lower pro-violence attitudes and lower risky attitudes toward sex. Adelante was effective in improving youth risk outcomes and offers a promising model for future health promotion with Latino and immigrant populations., (� The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

A common reason for nonuse of modern contraceptives is concern about side effects and health complications. This article provides a detailed characterization of the belief that modern contraceptives cause infertility, and an examination of how this belief arises and spreads, and why it is so salient. We conducted focus group discussions and key informant interviews in three rural communities along Kenya's eastern coast, and identified the following themes: (1) the belief that using modern contraception at a young age or before childbirth can make women infertile is widespread; (2) according to this belief, the most commonly used methods in the community were linked to infertility; (3) when women observe other women who cannot get pregnant after using modern contraceptives, they attribute the infertility to the use of contraception; (4) within the communities, the primary goal of marriage is childbirth and thus community approval is rigidly tied to childbearing; and, therefore (5) the social consequences of infertility are devastating. These findings may help inform the design of programs to address this belief and reduce unmet need., (© 2018 The Authors. Studies in Family Planning published by John Wiley & Sons Ltd. on behalf of The Population Council, Inc.)

This paper reports on mediation analysis of effects of the Adelante brand, an innovative program for Latino immigrant adolescents and their families, and positive youth development (PYD) outcomes. Specific objectives were to increase adolescent engagement and participation in a community-based program called Adelante, based on PYD theory, which sought to reduce substance use, sexual risk taking, and interpersonal violence among Latino immigrant youth. A total of 238 parent-child dyads were recruited from a predominantly low-income Latino immigrant community and followed for an average of 22 months. Measures included demographics; acculturation; stress and coping; social support; violence, substance use, and sexual risk attitudes; future expectations; the Adelante brand equity scale; and PYD asset measures. Multiple regression modeling shows that the leadership brand equity construct is associated with decreased proviolence and increased antiviolence attitudes. Additionally, having any program exposure (vs. none) is associated with improved substance abuse attitudes in models adjusting for the loyalty brand equity construct. In mediation analysis, we observed a mediating effect of the leadership brand equity construct on improved antiviolence attitudes among those exposed to the Adelante program. As found in previous research, Adelante brand equity operated as a mediator of program effects on Latino youth PYD outcomes.

Latinos consume more sugary drinks and less water than other demographic groups. Our objective was to understand beverage choice motivations and test promotional concepts that can encourage Central American Latino urban youth to drink more water. Two rounds of focus group discussions were conducted (n = 10 focus groups, 61 participants, 6-18 years old). Data were transcribed verbatim and analyzed using inductive and deductive coding approaches. Youth motivations for drinking water were shaped by level of thirst, weather, energy, and perceptions of health benefits. Youth were discouraged from drinking water due to its taste and perceptions of the safety and cleanliness of tap water. Youth beverage preference depended on what their friends were drinking. Availability of water versus other beverages at home and other settings influenced their choice. Promotional materials that included mixed language, informative messages about the benefits of drinking water, and celebrities or athletes who were active, energized, and drinking water were preferred. A promotional campaign to increase water consumption among these Latino youth should include bicultural messages to underscore the power of water to quench true thirst, highlight the health benefits of drinking water, and address the safety of tap water.

Although Latino and other immigrant populations are the driving force behind population increases in the U.S., there are significant gaps in knowledge and practice on addressing health disparities in these populations. The Avance Center for the Advancement of Immigrant/Refugee Health, a health disparities research center in the Washington, DC area, includes as part of its mission a multi-level, participatory community intervention (called Adelante) to address the co-occurrence of substance abuse, violence and sex risk among Latino immigrant youth and young adults. Research staff and community partners knew that the intervention community had grown beyond its Census-designated place (CDP) boundaries, and that connection and attachment to community were relevant to an intervention. Thus, in order to understand current geographic and social boundaries of the community for sampling, data collection, intervention design and implementation, the research team conducted an ethnographic study to identify self-defined community boundaries, both geographic and social. Beginning with preliminary data from a pilot intervention and the original CDP map, the research included: geo-mapping de-identified addresses of service clients from a major community organization; key informant interviews; and observation and intercept interviews in the community. The results provided an expanded community boundary profile and important information about community identity.

While numerous factors contributing to racial/ethnic health disparities have been identified, the clustering and interaction of these factors as a syndemic or trajectory has not been well-studied (Starfield in Soc Sci Med 64:1355-1362, 2007; Singer in Soc Sci Med 39(7):931-948, 1994). More importantly, for immigrant/refugee populations, the interaction of contributing factors is not documented adequately enough to provide a solid framework for planning, implementation and evaluation of interventions aimed at reducing disparities. In this paper, the authors draw from the literatures on health disparities and immigrant/refugee health, as well as direct program and research experience, to propose an approach for assessment of the diachronic interaction of ecological factors (a trajectory, or "diachronic ecology") contributing to health disparities among immigrant/refugee populations. It is our hope that this approach will contribute to the important effort to collect data supporting the development of interventions and policies that effectively address the dynamic processes through which health disparities are created, maintained, and changed.

Background: This paper describes a multilevel youth violence prevention effort called SAFER Latinos (Seguridad, Apoyo, Familia, Educacion, y Recursos), a collaboration between The George Washington University School of Public Health and Health Services (GWU) and two key Latino community organizations., Objectives: To implement and evaluate an intervention addressing factors within the social ecology of an immigrant Latino community., Methods: The intervention includes (1) Social promotores for family outreach and problem resolution; (2) Youth peer advocates at the high school level; (3) a drop-in center with support services for families and youth; and (4) community events, capacity building, and messages. Evaluation includes a baseline and follow-up surveys (N = 1,400) and focus groups., Lessons Learned: (1) Community circumstances change, requiring regular program adaptation. (2) Community interventions with research face potential contradictions in purpose impacting management of the collaboration and model fidelity. (3) Etiological models tied to interventions may have to be revisited owing to changes in the character and dynamics of the immigrant community.

This paper describes the intervention model, early implementation experience, and challenges for the Seguridad, Apoyo, Familia, Educacion, y Recursos (SAFER) Latinos project. The SAFER Latinos project is an attempt to build the evidence for a multilevel participatory youth violence prevention model tailored to the specific circumstances of Central American immigrants. Specific circumstances targeted in this intervention are decreased family cohesion as a result of sequential immigration (i.e., parents arriving first and bringing their children years later or youth arriving without parents); multiple school barriers; community disorganization and low community efficacy; limited access to services; and a social context (including gang presence) that is linked to youth norms supporting violence. In its implementation, the initial intervention model was adapted to address barriers and challenges. These are described, along with lessons learned and the ongoing evaluation.

This paper discusses a study (funded by the Center for Substance Abuse Prevention) of the health/mental health and work-related well-being of flight attendants in the aftermath of September 11. Flight attendants, as an occupational group, had a distinctive exposure to September 11. In addition to work-related exposure in the immediate aftermath of the attacks, flight attendants have experienced major and ongoing changes in their work environment and job description and many have been exposed to potentially traumatic incidents on the job. Analysis of survey and focus group data from flight attendants in the Association of Flight Attendants showed high reported stress and related mental health and behavioral impacts among flight attendants since September 11. A significant new finding is that the effect of continued trauma in the flight attendants' work environment impacted their ability to recover from the original trauma associated with the events of that day. This study highlights the role of the after-effects of a traumatic event on trauma response and suggests that direct exposure, as traditionally defined, is not necessarily a primary mediating factor in trauma response for this occupational group.

The examination of water and other environmental sources for microbial pollution is a major public health undertaking. Currently, there are two accepted methods in use: the multiple-tube fermentation (MTF) and the membrane filtration (MF) tests. Both methods are designed to enumerate the secondary indicator group, total coliforms. Both tests suffer several inherent limitations, including a time delay of three to seven days to obtain a definitive result, the subjective nature of the test interpretation, and the inability to provide directly useful public health information. A defined substrate technology, originally used to enumerate specific bacterial species from mixtures in clinical urine specimens, was applied to water testing; the technology was constituted to enumerate simultaneously both total coliforms and the primary indicator bacterium E. coli. Examination of environmental isolates of these two classes of target microbes showed sensitivity equal to available methods, with potentially greater specificity. It was not subject to inhibition by bacteria other than the targets, grew injured coliforms, did not require confirmatory tests, and the maximum time to a positive was 24 hours. The defined substrate technology provides both regulatory and directly useful public health information.