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APHA 2015

Psychosocial disparities experienced by recently arrived Latino immigrant youth

Cleary SD, Snead R, Karver T, O’Brien EK, Andrade E, Edberg MC

Upon arriving in the US, immigrant youth experience significant stress adjusting to a new culture and lifestyle, which in turn affects health status. Previous research has documented the burden that the immigration process can have on families, yet few have focused on recently arrived youth. Understanding psychosocial differences in youth that recently immigrated, compared with those living in the US for five or more years, informs policy change that can address potentially detrimental health consequences. Analyses were based on data from a cross-sectional community survey of Latino youth aged 12-17 years (n=360) in 2012, born outside of the US. Validated measures included English preference, psychological distress, acculturative stress, and stressful life events. After adjusting for age, youth who immigrated to the US more recently had significantly higher acculturative stress (p < .05). Specifically, they felt more discriminated against, that their behavior was interpreted based on Latino stereotypes, and misunderstood in daily situations because of their English skills. Recently arrived youth also reported significantly (p < .05) more stressful life events within the past year, including moving residence, having a family member deported, and divorce. No differences were observed for measures of depression or future expectations. The development of culturally and linguistically appropriate prevention and intervention programs that address these psychosocial factors identified by this study as putting recently arrived immigrants at substantial risk are warranted. Further, interventions should promote social integration, family reunification, and job readiness, which will benefit immigrant youth, their families, and the community as a whole.

Sexual Health Advocates, Promoters and Educators (SHAPE): Development of a comprehensive sexual health curriculum and peer education program for U.S.-based Latino adolescents using a community-based participatory research approach

Benjamin Rosado, BS, Tahilin Karver, MPH and Sean Cleary, PhD, MPH

As the Latino population grows in the United States, there is a pressing need to develop effective, culturally competent sexual health curricula to prevent and reduce rates of sexually transmitted disease, adolescent pregnancy, and gender-based violence and to create supportive spaces for gender identity exploration. This presentation outlines the developmental stages of a sexual health curriculum for peer promotion called SHAPE (Sexual Health Advocates, Promoters and Educators) that emerged from a community-based participatory research (CBPR) project, Adelante, in Langley Park, MD. SHAPE engaged eight Latino adolescents over the course of five months with the purpose of teaching accurate knowledge related to sexual health and gender equality and, to support the development of leadership skills that would allow youth to promote sexual health education in their community. Following a CBPR approach, stages of development included: consulting with community public health researchers, visiting a local teen health center, reviewing current youth sexual health curricula, engaging with a youth-focused theatre program, promoting sexual health information at a community health fair, and engaging youth participants in the content development for peer workshops. Based on our experiences, we identified recommended practices to follow when using a CBPR approach for the development of a curriculum for sexual health peer promotion among Latino youth. One principal practice emphasizes the constant feedback from community youth and local youth advocates. This presentation also discusses how contextualizing sexual health issues through a social justice framework and collaborating with local health organizations can provide opportunities for youth leadership and personal development.

The Role of a Community Advisory Board in Strengthening the Person-Context Relationship for a Positive Youth Development (PYD) Intervention with Latino Immigrant Youth

Edberg M, Cleary SD, Andrade EL, Soles C.

The Adelante project is a collaborative multi-level intervention addressing substance abuse, violence and sex risk among youth in a Latino immigrant community. Adelante is a key activity within a health disparities exploratory research center funded by the National Institute on Minority Health and Health Disparities (NIMHD). There are multiple collaborative relationships involved in this intervention: The university-community partnership, the relationship between this partnership and members of a local county initiative (Transforming Neighborhoods Initiative), and the relationship between the Adelante intervention and a Community Advisory Board (CAB). The latter is the focus of this paper. Adelante is based on a modified positive youth development (PYD) approach; thus it centers on the promotion of multiple developmental assets as a prevention strategy. Moreover, asset promotion should occur as part of an integrated, ecological strategy that builds the person-context relationship, involving the “marshalling of developmental assets” within the community. In order to operationalize this aspect of PYD, we recruited a CAB from multiple constituencies to represent these developmental assets. Then, we instituted a systematic process for linking youth and adults who complete any Adelante skill and knowledge-building activity to CAB members who can incorporate these individuals in order to: 1) build community capacity (e.g., individuals serving as peer educators, trainers, leaders); or 2) provide direct benefit to the youth or adult via an internship, paid position, recommendation, or referral to a paid position. Data are collected on the number and types of community linkages created, with analysis conducted correlating linkages to outcomes.

Victor and Erika Webnovela: Innovative Latino Youth Edutainment for Prevention

Villalba RO, Andrade EL, Evans WD, Cleary SD, Edberg MA, Wolberg M, Batista I, Schrack C

Background: The Avance Center is an academic-community partnership to reduce health disparities among Latinos in Langley Park, MD. We are implementing a multi-level, community-based Positive Youth Development (PYD) intervention called Adelante, which aims to affect PYD assets that will ultimately reduce substance abuse, sexual risk, and interpersonal violence among Latino youth. A key prevention messaging activity, which is part of a larger Adelante branding strategy, is the creation and dissemination of the web-based drama series, Victor and Erika (V&E).

Methods: We developed six V&E webnovela episodes s of the V&E webnovela working collaboratively with Adelante youth ages 12-17. Youth were involved in character development, creation of storyline creations, script writing, acting, filming, and dissemination of the series through their networks. Formative research was conducted for character development (n=20) and creative episode development (n=14). The series is available on Youtube and through the Adelante website.

Results: The V&E webnovela is a dramatic portrayal of the lives of immigrant Latino teenagers that also disseminates risk prevention messages. The storyline represents the “turning the corner” (to a better life) theme that underlies the Adelante brand. Y. As a result of the formative work in developing the series, Results showed that youth recommended inclusion of topics in V&E episodes relevant to theirr own experiences: sex, unintended pregnancy, fidelity, trust, family dynamics, immigration status, violence, school drop-out, respect, and poverty. V&E Because the format and messages are relevant, the series has begun to attracted an online youth following. Participants also gained important leadership, communication and creative writing skills.

Conclusions: Adelante uses innovative branding and social media strategies to engage at-risk Latino youth in their own prevention. The V&E series is an engagement tool, offering an accessible, innovative, and youth-focused strategy for disseminating prevention messages.

Etiology of Gender-based Violence Among Latino Immigrants: Negotiating Changes in Context and Culture

Andrade EL, McDonnell KA, Edberg MC, Cleary SD, Rivera I, Karver TS

Background: Residents of Langley Park, MD, a Latino immigrant enclave near Washington, DC, experience significant gender-based violence (GBV) disparities. Studies exploring GBV etiology among Latino immigrants using a trajectory approach, which examines experiences in the origin country and in the U.S., are limited. Fewer studies have identified GBV social determinants, considering contributors from all social-ecological model (SEM) levels.

Methods: We conducted a study (2008-2011) that explored GBV among Latinos in Langley Park. Fifty-six semi-structure interviews were conducted with men/women, ages 15-60. Respondents were asked about GBV in the origin country, during migration, and while in the U.S. We explored factors in the following domains: individual; family/partner/household; community/neighborhood; and social-cultural. Interviews were audio recorded, transcribed and analyzed using QSR NVivo. Key findings from the interviews are presented.

Results: Participants identified contributors at multiple SEM levels. Individual factors (depression, alcohol consumption, legal status) and relationship circumstances (temporary relationships, sequential migration, employment, infidelity) were mentioned. Participants identified community-level factors (limited services, undocumented population) and adjustment to a new social-cultural context (gender role norms, rights of women, more strictly enforced laws protecting women) as factors contributing to GBV.

Conclusions: Study findings enhance the knowledge base of GBV etiology among Latino immigrants in the U.S. Findings have implications for service providers and policy regarding the health of new immigrants. It is imperative to increase access to services that are responsive to contributing factors identified in this study. Immigrant GBV disparities must be understood and addressed using a trajectory approach, recognizing home country and U.S. experiences.