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APHA 2016


Water Up! A community-academic coalition to improve water drinking behaviors among Latino immigrants

Uriyoan Colon-Ramos, Mark Edberg, Sean Cleary, W. Douglas Evans, Elizabeth Andrade

Introduction: The Avance Center for the Advancement of Immigrant/Refugee Health at the George Washington University is a community-academic partnership to address health disparities in the Latino immigrant community of Langley Park, MD. In prior Avance Center activities, youth expressed concern about the lack of healthful foods in their neighborhood, and we established a coalition to understand and address risk factors for poor nutrition. Methods: From 2014-2015, we held monthly coalition meetings to define a mission statement and nutrition casual framework, and to conduct formative research, including: food environment observations, 10 focus group discussions, 15 interviews with mothers using a photovoice approach, and 15 key informant interviews. Results: The coalition decided to focus on reducing sugary drink consumption by improving water drinking behaviors. Results from formative research reveal that restaurants and stores promote sugary drinks from the US and Latin American countries. Despite knowledge of the health benefits of drinking water, there are concerns about the safety of tap water in schools and at home. Mothers purchased bottled water for home consumption. Among community stakeholders, there is limited readiness to improve access to palatable and free drinking water. We expanded the existing coalition to include organizations that focus on tap water and water safety, and to design interventions (Water Up!) to improve water drinking behaviors. Discussion: The Water Up! coalition responds to the growing concern of sugary beverage consumption, and highlights the need for community-academic partnerships to increase drinking water consumption in schools, businesses, homes, and in communities.

Session: Community-Based Participatory Research for Safe Drinking Water
Program: Community-Based Public Health Caucus
Day: Tuesday, November 01, 2016

Post, Like, Share: Smoking Prevention for Latino Youth using the Power of Digital Media

Ricardo Villalba, Elizabeth Andrade, W. Douglas Evans, Angela Gonzalez, Rosa Delmy Alvayero

Background: The Avance Center is an academic-community partnership to address health disparities among Latinos in Langley Park, MD. We are implementing a multi-level Positive Youth Development (PYD) intervention, Adelante, which aims to reduce substance abuse, sexual health risk, and violence among Latino youth. As part of a larger Adelante branding strategy, we created and disseminated anti-smoking messages using web-based, youth-generated videos, social media engagement, and posters placed throughout the community. Methods: Using an active audience engagement methodology, Adelante program participants, ages 12-17 (n=10), created anti-smoking campaign messages. During 8 weeks, youth convened weekly, 2-hour sessions to conceptualize messages, develop posters and storyboards, act/model, film, and disseminate videos and posters. Youth provided input on message framing, content, and execution elements that would resonate with peers, including language, style, and culture-specific features. Results: We developed two PSA videos and four posters for dissemination through youth digital networks and in community venues, including local businesses, community clinics, schools, and youth organizations. Youth participants wanted to provide specific reasons to not smoke: 1) Cigarettes make people smell bad; 2) Cigarettes affect your sports game; and 3) Smoking interrupts important life moments when you need to go outside to smoke. Conclusions: Youth-generated Adelante messages represent a novel approach to behavior change using branding and social media strategies. The anti-smoking campaign successfully engaged Latino youth in addressing smoking disparities within their community. Results from the process of campaign message development inform practice for reaching vulnerable, Latino immigrant youth with prevention information in an engaging, youth-appropriate way.

Session: The Good, the Bad, and the Ugly: Media’s Focus on Tobacco (organized by HCWG)
Program: Public Health Education and Health Promotion
Day: Wednesday, November 02, 2016

Adelante media campaign development: Innovative strategies to equitably engage Latino youth in the prevention of co-occurring substance use, sexual risk and violence

Elizabeth Andrade, W. Douglas Evans, Nicole Barrett, Ricardo Villalba, Sean Cleary, Mark Edberg, Elexis Kierstead

Adelante is a community-based intervention that uses a Positive Youth Development (PYD) framework to build Latino immigrant assets and reduce co-occurring substance use, sexual risk, and violence. Formative research results are presented for a media campaign implemented as part of an overall Adelante engagement strategy. methods: We conducted five focus groups (FG): one with Adelante implementers (n=8) and four with Latino youth ages 14-17 (n=35). FGs lasted 90 minutes, used semi-structured protocol, were audio recorded, and documented by two note-takers. Adelante implementers provided guidance on target youth risk factors, dissemination channels, and program messages to amplify. Two youth FGs identified campaign themes and messages across PYD constructs, and two youth FGs reviewed campaign concepts. Notes were manually coded, reviewed against recordings, and summarized by pre-determined inquiry areas or emergent concepts. results: Participants identified four campaign themes: 1) Adelante Is (what Adelante means to you) ; 2) Making Good Choices; 3) Live Your Dream; and 4) Be Part of Something Bigger. Participants suggested portraying resilient, proud youth who achieved goals despite adversity. Youth guided selection of campaign features, including message/visual content, stylistic elements, and indicated preference for bilingual ads that showed youth in groups, familiar community scenes, and piqued curiosity through creating mystery. The 12-month campaign was delivered via: 1) Print and social media ads (n=28); 2) Social media contests (n=8); and 3) youth-generated videos (n=4). conclusions: This project informs practice for addressing health disparities through improving engagement in prevention for hard-to-reach youth. Next steps include evaluation of the engagement strategy, campaign, and Adelante program.

Session: Communicating about Race, Culture, and Community in Advancing Health for All (organized by HCWG)
Program: Public Health Education and Health Promotion
Day: Monday, October 31, 2016

Right to Score: Adelante Youth Soccer Program Supports Immigrant Latinos’ Right to Optimal Physical and Emotional Health

Angela Gonzalez, Rosa Delmy Alvayero, Ronald Vega, Mark Edberg, Elizabeth Andrade, Sean Cleary

Langley Park, Maryland is home to a large Latino immigrant population experiencing health disparities. Recently immigrated youth often struggle to assimilate, live in low-income households, report being victims of bullying and crime, and have limited access to recreation and supportive services. Adelante, an intervention with a Positive Youth Development (PYD) framework, offers a culturally-tailored soccer program to build PYD assets and to support immigrant youths’ right to optimal physical and emotional health. Methods: We implemented a 30-week co-ed soccer program with weekly, 2-hour sessions from April-August, 2015. Youth ages 13-19 (n=58) were recruited through the Adelante program. Community partners provided equipment donations and field access. Two Adelante staff provided coaching and facilitated nurturing, supportive group dynamics. Pre-post tests measured changes in PYD assets. Results: Adelante’s soccer program demonstrates promise in building specific PYD assets and in engaging Latino youth in additional Adelante services. Overall 35% of youth showed improvements in Confidence, 54% in Athletic Competence, and 15% in Connection to Peers. Youth also showed dedication by attendance (95% attended more than 1 session, 50% attended 7 or more sessions). The team qualified for a soccer tournament and was awarded ‘Most Disciplined Team’. The program also built family and community connections, with parental involvement and engagement in community-level activities. Conclusion: Adelante’s soccer program improved youth’s developmental assets and access to recreation, while also improving family and community connections and preserving cultural identity for a population who are vulnerable to experiencing isolation and challenges in adapting to life in the U.S.

Session: Gaming, Counseling and Sports: Oh My!
Program: Physical Activity
Day: Wednesday, November 02, 2016

Breaking bread while strengthening families: Multi-family dinners as a holistic approach to healthy family reunification for Latino immigrants

Marilyn Calderon, Ronald Vega, Rosa Delmy Alvayero, Mark Edberg, Elizabeth Andrade, Sean Cleary

Langley Park, Maryland, a predominantly Latino immigrant community, experience health disparities linked to marginalization. Many youth experienced emotional trauma from sequential migration and extended periods of family separation. Reunification then becomes the source of family conflict, affecting family dynamics and youth well-being, thus further exacerbating existing health disparities. The Adelante intervention aims to reduce substance abuse, sexual risk, and violence among Latino youth using a Positive Youth Development (PYD) framework. The Adelante Multi-Family Dinners (MFD) program addressed challenges with family reunification. Methods: This 8-week program was implemented with 10 families in two rounds, in March and October of 2015 (n=10 youth, n=13 parents, and n=10 additional family members). Weekly, 2-hour dinners, families were guided through discussions and activities. We developed a curriculum based on the PYD framework to improve family connection and cohesion by solidifying family traditions, memories, and establishing healthy communication practices. Pre-post tests were conducted to detect changes in family-level PYD assets. Results: The MFD program showed considerable promise for improving Latino family dynamics after reunification. Results indicated improvement in the following PYD constructs: Connection to family (53% of parents; 35% of youth); Competence for healthy family relationships (53% of parents; 46% of youth); and Confidence (21% of parents; 20% of youth). There was a 70% retention rate of recruited families. Conclusions: The MFD program addresses a critical need faced by Latino immigrant families of resolving challenges and overcoming obstacles related to separation and sequential migration. This program shows promise for replication in communities facing similar struggles.

Session: Innovative strategies and policies to promote health in refugees and immigrant communities
Program: Caucus on Refugee and Immigrant Health
Day: Tuesday, November 01, 2016

Differences in Predictors of Violence among Latino Immigrant Youth and Young Adult

Ryan Snead, Mark Edberg, Sean Cleary

The process of immigrating to a new country can be emotionally and mentally stressful, increasing the likelihood of engaging in risky behavior including violence. While immigration occurs at different stages of life, few research articles have examined differences in psychosocial or positive youth development (PYD) constructs among youth and young adults that predict violent behavior. Data were analyzed from repeated cross-sectional samples of non US-born Latino youth (12-17) and young adults (18-24) from 2012 and 2014 (n=1506) in the DC metro area. Validated psychosocial measures included acculturative stress, depression, religiosity, perceived support from community or family, future expectations, and stressful life events. After controlling for survey year and gender, higher levels of acculturative stress, depression, and stressful life events were directly related to more violent behavior (p < .05) for both age groups. Significant inverse associations were observed for religiosity and contributing to the community among youth only, and perceived parental support across age groups. Youth and young adults with stronger connections to school, family, and culture, and those that felt competent academically or in the workforce, had lower levels of violent behavior (p<.05). A significant interaction was observed (p < .05) indicating a greater reduction in youth violent behavior that reported greater connection to education and higher future expectations. Young adults that lacked confidence or connectedness to romantic partners engaged in more violent behavior. Findings indicate that parental support and positive engagement in education and the community may reduce levels of violent behavior among Latino immigrants.

Session: Conflicts, Violence and the health of refugee and immigrant populations
Program: Caucus on Refugee and Immigrant Health
Day: Monday, October 31, 2016