ABSTRACTS

Evaluation of the Multi-level Adelante Intervention to Address Risk Behaviors among Latino Immigrant Youth: Challenges and Solutions

Sean Cleary, PhD, MPH , Department of Epidemiology & Biostatistics, The George Washington University School of Public Health & Health Services, Washington, DC
Lauren Simmons, MPH , Department of Epidemiology & Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC
Mark Edberg, PhD, MA , Department of Epidemiology & Biostatistics, George Washington University School of Public Health & Health Services, Washington, DC
Elizabeth Andrade, DrPH, MPH , Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC
Idalina Cubilla, MPH , Avance Center/ Prevention and Community Health Dpt/ Epidemiology Departments, The George Washington University School of Public Health and Health Services, Washington, DC
Rosa Delmy Alvayero, LGSW , Maryland Multicultural Youth Center, Hyattsville, MD
Emily Putzer, MA , Maryland Multicultural Youth Center, Hyattsville, MD
Elizabeth Freedman, MPH , Department of Epidemiology & Biostatistics, George Washington University, Washington, DC

BACKGROUND: A positive youth development (PYD) framework was used to develop the Adelante intervention for a predominately immigrant Latino community to address social and health issues as a socio-ecological model at the individual, family, and community level. Three challenges encountered and solutions are discussed.

METHODS: A CBPR approach was used for survey sampling design, instrument, and intervention development.

RESULTS: To obtain a representative community sample with limited census data due to immigrant status and transience. Service utilization data combined with an ethnographic approach (key informant interviews, resident interviews, observation) were used for a boundary study to delineate the “community,” as a social and geographic entity, from the residents’ perspective. Population data was collected from apartment complexes. Population estimates were used in the two-stage cluster sampling design for community surveys. To conduct surveys in Spanish and English. Instruments were developed and tested in Spanish for youth, young adults, and parents. Surveys measured change in positive youth development variables as well as adverse health behaviors (e.g., alcohol use) across all domains. Surveys were conducted by an experienced team of 26 bilingual Latino interviewers. To document at all levels delivery of the intervention. We developed and utilize a process data collection system that captures each contact with Adelante activities across all levels of the intervention.

CONCLUSION: Using a CBPR approach enabled us to identify challenges and to collaboratively develop solutions to ensure the intervention is being evaluated with fidelity and the community partners and residents continue to be engaged in the process.

Picturing Adelante: Latino Youth participate in CBPR using place-based photovoice

Idalina Cubilla, MPH , Avance Center/ Prevention and Community Health Dpt/ Epidemiology Departments, The George Washington University School of Public Health and Health Services, Washington, DC
Lauren Simmons, MPH , Department of Epidemiology & Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC
Elizabeth Andrade, DrPH, MPH , Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC
Gloriana Sojo , Avance Center/Prevention and Community Health Department, George Washington University School of Public Health and Health Services, Washington DC, DC
Sean Cleary, PhD, MPH , Department of Epidemiology & Biostatistics, The George Washington University School of Public Health & Health Services, Washington, DC
Mark C. Edberg, PhD, MA , Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC
W. Douglas Evans, PhD , Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC
Benjamin Rosado, BS , Maryland Multicultural Youth Center, Hyattsville, MD

BACKGROUND: Community-based participatory research (CBPR) often confronts barriers such as language, literacy, and legal status when studying health and social issues, especially among marginalized immigrant communities. To have true community participation in CBPR interventions, researchers must use innovative communication tools to give a voice to those who are sometimes unheard. This study sought to: 1) expand our understanding of current needs and experiences of Latino youth and their families living in Langley Park, Maryland; 2) involve youth in the process of developing a targeted CBPR intervention; and 3) build skills in photography, critical thinking, and community activism among Latino youth.

METHODS: Using photovoice, we engaged twelve Latino youth, including six recently arrived and six second generation immigrants, in a dialogue about peer, family, community, and health issues affecting Latinos. Through four sessions, participants developed photography skills, used photographs to stimulate critical thinking and discussion, and suggested solutions for emergent issues.

RESULTS: Important themes emerged from the photo-assignments: housing needs, health care access, food deserts, and substance abuse, in particular heavy alcohol use, all of which were cited by participants as having substantial influences on their lives. Participants organized a photography exhibition and community forum to raise awareness about important findings.

CONCLUSIONS: Both recently arrived and second generation Latino youth have important perspectives to share that guide and refine ongoing targeted CBPR interventions. Photovoice is a unique way to engage these youth in CBPR as well as to share their work and findings with the larger community, stakeholders, and academic partners.

Planning and Implementation of the Multi-level Adelante Positive Youth Development Intervention: Lessons Learned

Emily Putzer, MA , Maryland Multicultural Youth Center, Hyattsville, MD
Rosa Delmy Alvayero, LGSW , Maryland Multicultural Youth Center, Hyattsville, MD
Luisa Montero, MS
Mark C. Edberg, PhD, MA , Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC
Elizabeth Andrade, DrPH, MPH , Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, DC
Lauren Simmons, MPH , Department of Epidemiology & Biostatistics, The George Washington University School of Public Health and Health Services, Washington, DC
Idalina Cubilla, MPH , Avance Center/ Prevention and Community Health Dpt/ Epidemiology Departments, The George Washington University School of Public Health and Health Services, Washington, DC
Sean Cleary, PhD, MPH , Department of Epidemiology & Biostatistics, The George Washington University School of Public Health & Health Services, Washington, DC

BACKGROUND: Langley Park, Maryland, a predominantly Central American Latino immigrant community experiences considerable health disparities linked to a history of marginalization. The Adelante intervention aims to reduce substance abuse, sexual risk, and interpersonal violence disparities among Latino residents through a Positive Youth Development (PYD) framework. Adelante is being implemented by Maryland Multicultural Youth Centers (MMYC), a division of the Latin American Youth Center, and in collaboration with the George Washington University’s Avance Center for the Advancement of Immigrant/Refugee Health.

METHODS: Planning and implementing Adelante is a collaborative process involving both community and academic partners. Planning was guided by PYD theory and involved operationalizing PYD constructs (both linguistically and culturally) for this population, and reviewing evidence-based curricula and salient research to develop relevant programming, services, and processes linked to PYD constructs. For this community-academic partnership, MMYC’s role as a PYD-centered community-based organization is instrumental in providing the community’s perspective.

RESULTS: The Adelante intervention currently provides programs and services to Langley Park Latino youth/families. These include skill- and capacity-building activities, as well as those that engage participants in community prevention efforts and promote supportive relationships. Leadership and advocacy opportunities have created channels for participants to tell their stories in new and meaningful ways. Successes and challenges encountered (related to recruitment/retention, engagement, staff training, and communication) will be discussed from the community partner perspective.

CONCLUSIONS: Adelante is an innovative, multi-level intervention that combines both community-wide and targeted program components, strengthened by capacity building and support services to prevent Latino youth risk behavior.