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Researchers have established the long-term negative impact of adverse childhood experiences (ACEs) on mental health. Evidence also shows that different types of ACEs often co-occur and that ACEs profiles have differential impact on mental health. However, this prior research has often omitted first-generation Latino immigrants—a growing segment of the population, with potentially higher risk for ACEs, decreased access to mental health services, and increased risk for remaining in poor mental health. In this study, we conducted a cluster analysis using a sample of 336 Latina immigrant to examine: (1) patterns of ACEs, and (2) the mediating role of social problem-solving in the association between ACEs and mental health (depression, anxiety, and post-traumatic stress disorder symptoms [PTSD]) and life satisfaction. We identified 5 clusters: (a) Global ACEs (n = 52, 15.5%), (b) Community Violence and Physical Abuse (n = 80, 23.8%), (c) Physical and Emotional Abuse (n = 72, 21.4%), (d) Household Dysfunction with Physical and Emotional Abuse (n = 56, 16.7%), and (e) Low ACEs (n = 76, 22.6%). The clusters differed by social problem-solving, chronic life burden, mental health, and life satisfaction. Compared to the Low Abuse cluster, the Community Violence and Physical Abuse, and Global ACEs clusters were significantly more likely to have higher depression, anxiety, and PTSD symptoms. Social problem-solving was independently associated with all mental health variables and life satisfaction, and mediated the association between ACEs and depression and anxiety for those in the Community Violence and Physical Abuse cluster. Our study sheds light on how ACEs are experienced by Latina immigrants. Social problem-solving also emerged as a significant determinant of mental health and life satisfaction, and may be a point of intervention for improving mental health in this population. [ABSTRACT FROM AUTHOR]

While an increasing body of literature has assessed police response to intimate partner violence (IPV), a dearth of this research has examined police decision-making with formal reports of IPV among Latina immigrants. Using a LatCrit theoretical framework, the current study addressed this substantive gap through the systematic methods of the grounded theory approach to assess a sample of 36 police case files drawn from an agency located in one of the fifth most populous and diverse US cities. Results from the current study identified five themes related to shortcomings in police response to Latina immigrant IPV victims. The themes included cultural coercive control, language barriers, victim participation, case clearance efforts, and service provision. Policy implications and avenues for future research are discussed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the efficacy of mobile health (mHealth) intervention strategies that delivered either personalized, culturally, and linguistically tailored cell phone voice messages or text messages related to breast cancer and prevention, compared to the control group, to determine which strategy is more likely to increase breast cancer knowledge and screening mammography among low-income Latina immigrants. Methods: This randomized controlled trial assigned 256 Latina immigrants 40 years of age or older to one of three groups: an automated cell phone voice message group, an automated text message group, or the control group (mail). The mHealth intervention employed a comprehensive approach that included breast cancer and prevention education and free mammography screening. Outcome measures included knowledge of breast cancer and breast cancer prevention, and adherence to screening mammography. Results: There was a general increase in breast cancer knowledge after the educational intervention for all the groups [p?=?0.01, t(199)?=?3.996]. Knowledge increase and mammography adherence did not differ based on group. Conclusion: More important than the actual method of communication is how breast cancer and prevention messages are constructed, who the messenger is, and the enabling factors that facilitate screening adherence. A breast cancer preventive intervention program that is personalized, culturally and linguistically tailored, and offers a free or low-cost mammogram holds promise to be an effective method in reaching an underserved Latina population with a high breast cancer burden.

The present study examined the links between discrimination-based acculturative stress (DAS), depressive symptoms, and alcohol use among recently immigrated Latina young adults and explored potential within-group Latina ethnic differences. Structural equation modeling was used to assess these relations among 530 Latina young adults (age 18–23) who had immigrated to the USA within approximately 12 months prior to assessment. Women reporting more DAS indicated more depressive symptoms and alcohol use than counterparts reporting less DAS. Women reporting more time in the USA experienced higher levels of DAS. Undocumented participants, and those who had lived in the USA for less time, reported more depressive symptoms than their peers. Findings highlight the need for mental health clinicians to attend to their local sociopolitical climate context for discriminatory practices and integrate cultural factors in mental health and alcohol use interventions targeting Latina young adults who recently immigrated to the USA. [ABSTRACT FROM AUTHOR]

Breast cancer is the most commonly diagnosed cancer among Latinas. Dominican women in particular have a higher lifetime risk of breast cancer than do other Latinas in the U.S. This study examines how gender, ethnic, and language concordance between providers and patients are associated with recent mammography screening for Latina immigrant women from the Dominican Republic. We conducted structured interviews, in Spanish, with 419 Dominican women aged 40 years or older living in New York City. Using bivariate analysis and logistic regressions, we tested whether patient-provider gender, ethnic, and language concordance was associated with recent mammography when controlling for demographic covariates, breast cancer screening knowledge, and self-rated health. Gender concordance predicted recent mammography after controlling for covariates (β = 0.13). Neither ethnic nor language concordance significantly predicted recent mammography. Our findings suggest that promotion of patient-provider gender concordance may help reduce health disparities among Latinos/as and other minority groups across the United States. [ABSTRACT FROM AUTHOR]

As has been documented in public health data, infections and deaths from COVID-19 have been inequitably distributed in the United States, producing adverse health outcomes among vulnerable populations including Latina immigrants. Using a critical feminist theoretical perspective, this discussion examines the mechanisms informing these outcomes including lack of access to health insurance and health care and work in low-waged jobs with high potential exposure to the virus. In addition, we examine related risks to this population, including domestic violence during stay-at-home orders. We argue that social workers can join forces with immigrant-led organizations to support advocacy to reverse government policies that limit immigrants' access to health care as well as ensuring that Latina women workers earn adequate wages for essential jobs. [ABSTRACT FROM AUTHOR]

The 2017 revitalization of the controversial Security Communities program, which requires local law enforcement to cooperate with federal immigration officials in the United States, has made it urgent to better understand such enforcement programs' effects on the well-being of Latinas/os, especially the foreign-born. Social isolation from increased immigration enforcement can have significant impacts on economic, social, and health outcomes among Latina/o immigrants and non-immigrants. This article analyzes the gendered impacts of different levels of increased local involvement in immigration enforcement on social isolation, using a survey of over 2000 Latinas/os in four large US cities, all considered to be traditional destinations. Unsurprisingly, respondents reported increased social isolation resulting from local law enforcement's involvement in immigration enforcement. In contrast to results from previous research, our analysis found that women and men were equally likely to feel socially isolated and that having children led to more social isolation for both women and men. Personal and vicarious experiences with immigration enforcement, as well as living in Phoenix and Houston — two urban areas with the strictest enforcement regimes — were strongly related to social isolation. Our results indicate that local authorities' increased involvement in immigration enforcement can lead to more social isolation for Latina immigrants, particularly those who have children, aligning their experiences with men's and, thus, undermining Latinas' previously recognized role as bridges between their families and social institutions and as community builders. [ABSTRACT FROM AUTHOR]

Acculturative stress is commonly experienced among Latinx immigrants in the United States who may feel pressured to maintain their heritage cultural norms and beliefs and/or adopt norms and beliefs of the dominant culture. The present study examined longitudinal relations between acculturative stress and endorsement of traditional Latina gender role beliefs (i.e., marianismo). We determined strength of the relations and temporal precedence of acculturative stress and endorsement of marianismo across 3 time points during participants' initial 3 years in the United States using a random intercept cross-lagged panel model. Participants were 530 Latina young adult women (ages 18–23) recruited from Miami-Dade County, Florida. Results suggested that acculturative stress levels at Time 1 positively predicted endorsement of the Family Pillar belief at Time 2, but acculturative stress levels at Time 2 negatively predicted the Virtuous and Chaste and Subordinate to Others beliefs at Time 3. In terms of marianismo beliefs predicting acculturative stress levels over time, the Virtuous and Chaste belief at Time 1 positively predicted acculturative stress at Time 2, and the Silencing Self to Maintain Harmony belief at Time 2 positively predicted acculturative stress at Time 3. Findings suggest that the Family Pillar belief, or feeling responsibility for the family's unity, may be protective against acculturative stress over time. Endorsing certain gender role beliefs (i.e., Virtuous and Chaste, Subordinate to Others) may lead to greater acculturative stress, and Latina young adult women experiencing acculturative stress may alter their endorsement of marianismo beliefs in an attempt to resolve culturally conflicting stress experienced after immigration. This study suggests that Latina young adult immigrants' endorsement of certain traditional gender role beliefs may lead to experiences of acculturative stress, and recent immigrants may reduce or increase their endorsement of these beliefs in response to experiencing acculturative stress. Counseling interventions that focus on reducing acculturative stress may consider how the role of the family may be protective against stress. Attending to gender role beliefs in counseling may help facilitate a healthy transition to the United States for recent immigrants who may experience a peak in acculturative stress after immigration or may alter their endorsement of traditional gender role beliefs over time in the United States. [ABSTRACT FROM AUTHOR]

This study explored how low-income documented and undocumented Latina immigrant mothers negotiate motherhood and adapt to life in new cultural and structural contexts. Grounded in ecocultural theory, we analyzed data from 21 in-depth interviews with Latina immigrant mothers to surface how their experiences of motherhood in the United States were shaped by their country of origin experiences and their situatedness in the United States. We documented emergent tensions related to their immigration context, often driven by changes in their legal status as they crossed borders, changes in family and community supports, and differing cultural expectations of their gendered roles as caregivers and family members. These tensions forced mothers to renegotiate and adjust their perceptions, identities, and roles as women, mothers, partners, and members of larger, often transnational kin and community networks. Implications of these tensions and identity and role shifts in the context of immigrant family life in the United States are discussed. [ABSTRACT FROM AUTHOR]

Medical mistrust measures have not been validated in Latino immigrants. This study examined the psychometric properties of the Medical Mistrust Index and its association with health care satisfaction in a sample of Latina immigrants. Participants were 168 self-identified Latinas ≥40 years old. Women were recruited from three Latino-serving health clinics and through a Latino radio program. A bilingual interviewer administered the Medical Mistrust Index in Spanish along with items pertaining to sociodemographic and health care factors. Principal component extraction method was used to evaluate internal consistency reliability to examine Medical Mistrust Index underlying factors. Construct validity was assessed by analyzing the relationship between the Medical Mistrust Index with three related measures (racism, discrimination, trust in doctors). To assess the criterion validity of the Medical Mistrust Index, a logistic regression model examined whether medical mistrust was associated with Latina women's satisfaction with health care controlling for sociodemographic and health care factors. Participants were 51 years old on average, around half had completed High school or less and were uninsured. Most were monolingual Spanish speakers. Two factors: competence and suspicion explained 40% of the total Medical Mistrust Index variance. Internal consistency was favorable and construct validity was supported. Results support the reliability and validity of the Medical Mistrust Index and its association with Latina's satisfaction with health care. [ABSTRACT FROM AUTHOR]

Associations between theorized sociocultural factors and acculturative stress were examined among Latina immigrants (aged 18-23 years) during their initial months in the US. Participants’ quantity of alcohol use was hypothesized to be linked with more acculturative stress. Using respondent-driven sampling, 530 Latinas who recently immigrated to Miami-Dade County, Florida, were recruited from community activities, Latino health fairs, advertisements at community agencies, and online postings. A path analysis revealed associations between acculturative stress and more time in the US and greater commitment to ethnic identity. Marianismo gender role beliefs differentially related with acculturative stress. Quantity of alcohol use moderated the positive association between time in US and acculturative stress, such that women in the US for less time who drank more alcohol experienced higher levels of acculturative stress than their peers. Findings suggest quantity of alcohol use may exacerbate acculturative stress during some Latina young adult immigrants’ initial months in the US. [ABSTRACT FROM AUTHOR]

Latina immigrant women are vulnerable and may experience higher levels of interpersonal or intimate partner violence (IPV) due to their immigrant status and cultural emphasis on familism. The concept of empowerment within the cultural context of Latina immigrant women experiencing IPV was analyzed using a modified version of Walker and Avant’s concept analysis technique. The technique considers usage and definitions in the literature, antecedents, attributes, empirical referents, and the inclusion of a model and contrary case. This analysis encompasses a comparative approach and includes a discussion of how the definition of empowerment compares across the nursing literature. Defining attributes include reciprocal relationships, autonomy, and accountability. Antecedents comprise willingness to learn and motivation to create change. Consequences encompass self-esteem, self-efficacy, and competence for making life decisions. Empowerment has the potential to improve total well-being, having a positive and profound impact on the lives of women experiencing IPV. [ABSTRACT FROM AUTHOR]

Latinas in the U.S. are disproportionately affected by breast and cervical cancer. This project sought to develop and evaluate a culturally relevant training for Community Health Advisors (CHA) to promote breast and cervical cancer screening among Latina immigrants in Alabama. The Empowerment Model guided training development and implementation supported by a formative evaluation and a Community Advisory Committee. The 16-hour CHA training included two intertwined components: knowledge and skills. Fifty-six (56) Latinas participated in the CHA training in six Alabama counties. The training increased the CHAs' (1) knowledge of cancer screening and other health topics and (2) their perceived confidence to communicate with women in their communities about cancer screening and to motivate them to attain cancer screenings. This work demonstrates the application of a transformative philosophical framework to promote capacity-building among CHAs toward the development and implementation of strategies to promote breast and cervical cancer screening among Latina immigrants. [ABSTRACT FROM AUTHOR]

This study focused on how acculturative stress and psychological distress affect Puerto Rican--born women residing in the United States. Mediation path analysis was used to estimate relationships between contextual factors, acculturative stress, and psychological distress. The fit of the data to the final model was adequate as estimated using chi-square analysis, comparative fit index, Tucker-Lewis Index, and root-mean-square error of approximation. Racial discrimination (b = 0.38, p = .01), difficulties visiting family abroad (b = 0.26, p = .03), and age at immigration (b = 0.19, p = .03) were positively associated with acculturative stress. The factor English skills (b = -0.31, p = .02) was negatively associated with acculturative stress. Racial discrimination had the strongest effect on acculturative stress, followed by English skills, difficulties visiting family abroad, and age at immigration. Racial discrimination (b = 0.39, p = .01) and financial constraints (b = 0.30, p = .01) were positively associated with psychological distress. Racial discrimination affected the women's psychological distress the most, followed by economic contexts (financial constraints). This study informs practitioners in considering the significant contextual factors relevant to the psychological distress of Puerto Rican-born women. [ABSTRACT FROM AUTHOR]

Based on Family Stress Management theory, we explored the contextual influence on acculturative stress and psychological distress. We included 639 Latinas from the National Latino Asian American Survey. We hypothesized that (a) impact of acculturative stress on psychological distress depends on specific contexts; (b) U.S. climate (i.e., perceived discrimination, happiness with U.S. move, years in the U.S.) impacts acculturative stress and psychological distress the most, and (c) contextual factors interact in impacting acculturative stress. Acculturative stress did not always lead to psychological distress. Perceived discrimination and difficulty visiting family abroad were positively associated with acculturative stress. Years in the U.S. and happiness with the U.S. move were negatively associated with acculturative stress. Years in the U.S. and perceived discrimination interacted in predicting acculturative stress. These results can aid formulation of effective interventions that target contexts likely to impact acculturative stress and psychological distress among Latinas. [ABSTRACT FROM AUTHOR]

Research has identified numerous mechanisms through which perceived social isolation and lack of social support negatively impact health. Little research attention has been dedicated to factors that influence the development of social networks, which have the potential to decrease perceptions of social isolation and provide social support. There is mixed evidence concerning the availability of supportive social networks for Latinos in the US. This study explores trauma-exposed Latina immigrants' experiences of social isolation in the US and its perceived causes. Twenty-eight Latina immigrant women participated in an interview about traumatic experiences. Informal help seeking and the availability of friendships in the US were also queried. Frequent comparisons between experiences in their home countries and in the US shaped the emerging themes of social isolation and lack of social support. Women reported feeling lonely, isolated, closed-in, and less free in the US due to family separation and various obstacles to developing and maintaining relationships. Socioeconomic, environmental, and psychosocial barriers were offered as explanations for their limited social networks in the US. Understanding experiences of social isolation as well as barriers to forging social networks can help inform the development of social support interventions that can contribute to improved health among Latinos. [ABSTRACT FROM AUTHOR]

This paper addresses the availability and use of mental health resources by Latina immigrants in rural western Pennsylvania. Findings suggest that few formal (i.e. counselors) or informal (i.e. religious figures) culturally sensitive resources for coping with depression are available to Latina immigrants in this area. When resources were available, informants often expressed a preference for seeking help from informal sources and many experienced obstacles when seeking help from formal sources. Drawing on findings, recommendations for making mental health resources more accessible to Latina immigrants in rural communities are discussed. [ABSTRACT FROM PUBLISHER]

Objectives: Breast and cervical cancer are common among Latinas, but screening rates among foreign-born Latinas are relatively low. In this article we describe the design and implementation of a theory-based (PEN-3) outreach program to promote breast and cervical cancer screening to Latina immigrants, and evaluate the program's effectiveness. Methods: We used data from self-administered questionnaires completed at six annual outreach events to examine the sociodemographic characteristics of attendees and evaluate whether the program reached the priority population - foreign-born Latina immigrants with limited access to health care and screening services. To evaluate the program's effectiveness in connecting women to screening, we examined the proportion and characteristics of women who scheduled and attended Pap smear and mammography appointments. Results: Among the 782 Latinas who attended the outreach program, 60% and 83% had not had a Pap smear or mammogram, respectively, in at least a year. Overall, 80% scheduled a Pap smear and 78% scheduled a mammogram. Women without insurance, who did not know where to get screening and had not been screened in the last year were more likely to schedule appointments (P<.05). Among women who scheduled appointments, 65% attended their Pap smear and 79% attended the mammogram. We did not identify significant differences in sociodemographic characteristics associated with appointment attendance. Conclusions: Using a theoretical approach to outreach design and implementation, it is possible to reach a substantial number of Latina immigrants and connect them to cancer screening services. [ABSTRACT FROM AUTHOR]

Poor women are often compelled to accept jobs that jeopardise their health and their social reputations. Cantineras are recently immigrated Latinas employed in working-class Latino bars (cantinas) where they are hired as waitresses to earn sales commissions from beer purchased for them by male clients seeking female companionship. Narratives solicited from 31 cantineras revealed the work subculture of local cantinas, where drinking is a primary work obligation and where men expect sexual favours as a quid pro quo for beers they buy. This paper describes strategies that cantineras adopt to downplay their drinking and to disguise sex-trading practices. This distortion or ‘misrecognition’ of work-related practices functions to manage cantineras' fear of being stigmatised as workers and devalued as individuals. We argue that misrecognition in this context represents more than simple attempts at denial or to uphold a public image. Rather, it is a strategy employed by cantineras in order to function adaptively under oppressive work circumstances. Confronting stigma leads cantineras to adopt social and cognitive strategies that, while minimising social damage in the near term, can lead to devastating health and social consequences over time. [ABSTRACT FROM AUTHOR]

The development of efficacious theory-based, culturally relevant interventions to promote cervical cancer prevention among underserved populations is crucial to the elimination of cancer disparities. The purpose of this article is to describe the development of a theory-based, culturally relevant intervention focusing on primary (sexual risk reduction) and secondary (Pap smear) prevention of cervical cancer among Latina immigrants using intervention mapping (IM). The PEN-3 and Health Belief Model provided theoretical guidance for the intervention development and implementation. IM provides a logical five-step framework in intervention development: delineating proximal program objectives, selecting theory-based intervention methods and strategies, developing a program plan, planning for adoption in implementation, and creating evaluation plans and instruments. We first conducted an extensive literature review and qualitatively examined the sociocultural factors associated with primary and secondary prevention of cervical cancer. We then proceeded to quantitatively validate the qualitative findings, which led to development matrices linking the theoretical constructs with intervention objectives and strategies as well as evaluation. IM was a helpful tool in the development of a theory-based, culturally relevant intervention addressing primary and secondary prevention among Latina immigrants. [ABSTRACT FROM PUBLISHER]

Abstract: Although maternal attachment is an important predictor of infant attachment security and other developmental outcomes, little is known about the formation of maternal attachment in the first few months of the infant''s life, particularly among ethnic minority mothers. The current study examined the predictors of postpartum maternal attachment in a sample of 217 Latina women enrolled in a perinatal depression prevention trial. Mothers’ attachment to their infants was measured at 6–8 weeks postpartum using the Maternal Postnatal Attachment Scale. A variety of predictors of early attachment were explored including: depressive symptoms during pregnancy, pregnancy intention, feelings about the pregnancy, and the quality of the partner relationship. The strongest predictor of lower maternal attachment was depressive symptoms late in pregnancy; pregnancy intention was marginally predictive of attachment, with lower scores being associated with unwanted pregnancies. The study fills a critical gap in our understanding of the role of depressive symptoms during pregnancy in shaping mothers’ early attachment to their infants. [Copyright &y& Elsevier]

This study analyzes the goals and realities of four educated, working, adult Latina, English as a Second language (ESL) students living in North Carolina, a region seeing particularly intense migration of Latino immigrants. The study conceptually frames adjustment issues confronted by these Latina immigrants in terms of gender, language, geography, their educational and professional backgrounds, and current experiences and expectations. It concludes by offering social justice-oriented approaches to teaching English to Latina adults. [ABSTRACT FROM AUTHOR]