Search Results (201)

Background/Objectives: Latinos, particularly those of Mexican ancestry, experience high rates of type 2 diabetes and sleep disturbances, exacerbating adverse health outcomes. This study aimed to examine the prevalence of excessive daytime sleepiness and its associations with diet, cardiometabolic risk factors, and glycemic control in this population. Methods: This cross-sectional study utilized data from the El Banco por Salud biobank, including 1685 participants (aged 52.6 ± 14.5 years, BMI: 32.4 ± 7.0 kg/m²) recruited from Federally Qualified Community Health Centers. Excessive daytime sleepiness was assessed using the Epworth Sleepiness Scale, while dietary information was obtained via the Brief Dietary Assessment Tool for Hispanics. Primary outcomes included cardiometabolic risk factors and glycated hemoglobin (HbA1c) levels. Results: Excessive daytime sleepiness (Epworth Sleepiness Scale > 10) was present in 22.0% of participants and was associated with higher BMI (p < 0.001), larger waist circumference (p = 0.002), poorer diet quality, increased dyslipidemia (p = 0.036), and elevated HbA1c (p = 0.007). Linear regression analyses confirmed that excessive daytime sleepiness was significantly associated with higher HbA1c levels, both in unadjusted (R² = 0.011; p < 0.001) and adjusted for demographic, anthropometric, and socioeconomic factors (R² = 0.107; p = 0.004) models. Conclusions: Excessive daytime sleepiness among Latinos of Mexican ancestry is associated with unhealthy dietary patterns and poor glycemic control, highlighting the need for targeted interventions addressing sleep and dietary habits in this vulnerable population. Full article

Background: Suicidal ideation among adolescents remains a major public health challenge. Exposure to neighborhood violence is associated with increased risk of mental health distress and school-related vulnerabilities. This study investigates the predictors of suicidal ideation among U.S. adolescents who have witnessed neighborhood violence. Methods: Data were drawn from the 2023 Youth Risk Behavior Survey (YRBS), a nationally representative survey of high school students in the United States. A subsample of 3495 adolescents who reported witnessing neighborhood violence was analyzed. Key variables included sociodemographic characteristics, mental health symptoms, perceived school safety, and experiences of victimization. Multivariable logistic regression was used to identify factors associated with suicidal ideation, defined as seriously considering suicide in the past year. Analyses were conducted using Jamovi (version 2.6), with statistical significance set at p < 0.05. Results: The prevalence of suicidal ideation in the sample was 34.2%. Bisexual adolescents had significantly higher odds of suicidal ideation compared to heterosexual peers (OR = 2.34, p < 0.001). Depressive symptoms were the strongest predictor (OR = 7.51, p < 0.001). Both perceived lack of safety at school and differences in ethnic and population backgrounds were significant. Black and Hispanic/Latino adolescents had lower odds compared to White peers. Conclusions: Findings highlight sexual identity, depressive symptoms, school safety concerns, and ethnic and population background differences as key correlates of suicidal ideation. Culturally responsive, trauma-informed interventions are urgently needed for youth exposed to community violence. Full article

Background/Objectives: Effective diabetes self-management is critical for glycemic management and well-being, yet Latino youth face unique cultural and socioeconomic barriers that are insufficiently explored in the literature. This review mapped existing evidence on diabetes self-management for Latino youth. Methods: Searches were conducted in PubMed, CINAHL, SCOPUS, Web of Science, LILACS, ERIC, and The Cochrane Library, using the gray literature and reference lists, in September 2024, following JBI guidelines. The included studies were qualitative, quantitative, and mixed-methods studies and reviews on diabetes self-management for Latinos aged 0–30 with type 1 or 2 diabetes. Studies including participants over 30 or with gestational diabetes were excluded. Two reviewers independently extracted data using a standardized table and analyzed findings using the Association of Diabetes Care & Education Specialists framework (ADCES7) for self-care behaviors: healthy eating, being active, monitoring, taking medication, problem-solving, reducing risks, and healthy coping. Results: Forty-five studies (forty from the United States) were included from 860 citations. The findings highlighted challenges in adopting diabetes-friendly diets, including cultural preferences, food insecurity, and limited resources. Physical activity improved glycemic control but was hindered by family and school obligations. Continuous glucose monitoring (CGM) enhanced outcomes, though economic barriers limited access. Family-centered education improved medication adherence, while family support strengthened problem-solving. CGMs and insulin pumps reduced complications, and culturally adapted psychological support enhanced emotional well-being and glycemic management. Conclusions: This review underscores persistent disparities in diabetes self-management among Latino youth. While the study designs and settings were heterogeneous, the findings highlight the need for culturally tailored, family-centered interventions that address structural barriers and psychosocial needs to improve care. Full article

The COVID-19 pandemic caused immense physical disruptions, affecting young adults in the U.S. The Health Belief Model is a social psychological framework that predicts the likelihood of adopting health behavior. The purpose of this research is to investigate COVID-19-related health beliefs and dietary behaviors among undergraduate students during the pandemic. Using convenience sampling, a cross-sectional survey was completed by 304 individuals at a New Jersey state university. Survey data included the frequency of COVID-19 prevention behaviors (e.g., wearing an indoor mask, handwashing), and consumption of fruit and vegetables. The Health Belief Model constructs measured perceived susceptibility to COVID-19, severity, benefits, barriers, and self-efficacy. Frequency distributions, t-tests, and Kruskal–Wallis tests were investigated for racial subgroups (Whites, Blacks, Latinos, and Asians). The mean age of the sample was 21.7, with 27% males, and 46% self-identified as White. Whites adopted fewer COVID-19 prevention behaviors (p < 0.001) than non-Whites. Black students perceived less COVID-19 severity (p < 0.01) and stronger perceived benefits (p < 0.05) than the other subgroups. Latino students perceived greater susceptibility (p < 0.01) and greater barriers than non-Latinos. Asians practiced higher mask wearing frequency (p < 0.05) but less daily fruit intake than their counterparts (p < 0.01). This research highlights the importance of handwashing, wearing indoor masks, and consuming produce among university students. Addressing barriers to health action while promoting the benefits of enacting behaviors to mitigate the risk of COVID-19 is warranted. Full article

Introduction: Racial and ethnic disparities in end-of-life (EOL) cancer care persist, leading to lower rates of advance care planning (ACP), reduced access to palliative care, and poorer patient outcomes for minority populations. While previous research has documented these inequities, less is known about the specific interventions developed to address them, necessitating a comprehensive review of existing strategies aimed at improving EOL care for racial and ethnic populations. The objective of this scoping review is to examine the extent and characteristics of interventions and their outcomes designed to address racial and ethnic disparities in EOL cancer care in the United States. Methods: A comprehensive search of EOL cancer care interventions for minority populations was conducted in Ovid MEDLINE, CINAHL with Full Text (EBSCOhost), and Scopus (Elsevier) in September 2024. Two independent reviewers screened titles, abstracts, and full texts following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with inclusion limited to studies conducted in the US and published in English. Results: Of 3104 screened studies, 10 met the inclusion criteria. Participants enrolled were only from Latino (n = 6 studies) or Black (n = 4 studies) populations. We identified four types of interventions, including communication skills for patients, caregivers, researchers, and clinicians (n = 2), education programs for patients (n = 1), navigation and support programs for patients and caregivers (n = 3), and training programs for health workers and community leaders (n = 4). The most effective interventions were those that addressed linguistic barriers, integrated cultural values, and involved trusted community figures. Faith-based models were particularly successful among African American patients, while bilingual navigation and family-centered ACP interventions had the greatest impact in Latino populations. Conclusions: This review highlights (1) the importance of culturally tailored interventions for specific minority populations and (2) the limited number of such interventions, which primarily target only the largest minority groups. Full article

Background/Objectives: In 2022, 2.2 million adolescents were diagnosed with substance use disorders, including 265,000 with opioid use disorder. The National Survey on Drug Use and Health revealed that 130,000 adolescents misused prescription pain medications, often obtaining them from friends or relatives. This age group perceives weekly heroin use as less risky than those younger or older. Methods: A questionnaire was developed for 7th to 12th graders in a rural Texas school district as part of a fentanyl awareness curriculum. The questionnaire included Likert scale, multiple choice, and yes/no questions. The participants were categorized into younger (grades 7th and 8th) and older students (grades 9th through 12th), and associations were explored between demographic characteristics, responses, and grade groups using chi-square tests. To assess confidence, behavior, and the impact of education, we used chi-square and Fisher’s exact tests. Results: The participants (n = 94; 85.11%) identified as Hispanic or Latino, with a smaller percentage identifying as White or more than one race. An association was found between feeling more in control of actions related to substances and fentanyl (p-value = 0.04) after receiving education. No association was found between education and confidence in identifying fentanyl. Conclusions: This study aligns with a surge in fentanyl-related overdose deaths in a high-intensity drug trafficking region. Recent fentanyl overdoses among school-age children prompted legislative changes in 2023, making this study valuable for understanding the epidemic within the geographical context. These results suggest that school-based education may play a role in strengthening adolescents’ behavioral intentions to fentanyl exposure, though additional efforts are needed to improve risk identification. Full article

Background/Objective: Patients have historically trusted healthcare providers to be a reliable source of health information. However, with the recent pandemic and subsequent recovery, understanding and developing patients’ trust has become even more important, especially regarding vaccine acceptance. The objective of this work is to explore the current level of trust that rural patients have in their healthcare providers concerning influenza vaccination and related recommendations and its impact on vaccine uptake in a rural county in Washington State. Methods: An anonymous survey was conducted by a survey research center using a random sampling of 3000 addresses for people living in Yakima County in Washington State. Yakima County has a high percentage of people who identify as Hispanic or Latino/a and is a medically underserved area. The survey was designed to evaluate factors influencing the decision to be vaccinated against influenza and the level of trust in information from healthcare providers. Results: Results showed that participants who had been vaccinated against influenza in the previous five years were more likely to trust the advice of their primary care provider (p < 0.001), specialty care provider (p < 0.001), pharmacist (p = 0.02), and nurse (p = 0.002). People who were not vaccinated against influenza in the last five years were statistically more likely to report that a recommendation from a healthcare provider would not make a difference in their decision (p < 0.001). People who were vaccinated were more likely to utilize healthcare providers as a source of information about the influenza vaccine (p < 0.001) and people who were unvaccinated were more likely to use their own personal research as a trusted information source (p = 0.04). Conclusions: Healthcare providers continue to be well regarded and trusted by their patients, especially in rurally located counties, though work still needs to be carried out around influenza vaccination importance messaging. This work identified that all healthcare providers need to work collaboratively to reinforce vaccination guideline recommendations and to both provide education and continue successful access-to-vaccination strategies to promote influenza prevention. Full article

In 2020, California banned the sale and agricultural use of chlorpyrifos, an organophosphate pesticide (OP) associated with neurotoxicity and other adverse health outcomes. We primarily assessed changes in chlorpyrifos associated with this policy and secondarily explored how other OP exposures changed. The participants were from California’s Central Valley, 18 years or older, and English- or Spanish-speaking. The surveys and urine samples were collected pre-ban (December 2020) and post-ban (February–April 2022). The urine samples were analyzed for a chlorpyrifos-specific metabolite (TCPy), six dialkyl phosphates (DEP, DMTP, DETP, DMDTP, DMP, DEDTP), and total DE and DM. The pre- and post-ban metabolite concentrations were compared via Wilcoxon signed-rank tests and natural log-transformed paired differences in linear mixed effects regression, adjusted for covariates. Forty-nine participants had repeated biomarker data. The mean age of the study population was 46.8 years (SD: 16), 61% female, 67% Spanish-speaking, 100% Hispanic/Latino(a), and 47% had less than a high school education. Six urinary metabolites (TCPy, DEP, DMP, DMTP, total DE and total DM) had sufficient variation for further analysis, while DMDTP, DEDTP, and DETP were undetected. The paired differences in adjusted models showed statistically significant increases in TCPy and DMP associated with the policy change (e.g., TCPy estimated ratio of geometric means: 4.53 (95% CI 2.66, 7.69)) Reductions in metabolites of chlorpyrifos exposure were not observed following California’s chlorpyrifos ban, suggesting ongoing exposure to chlorpyrifos from other sources. Full article

Background/Objectives: The incidence of early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, has been rising at an alarming rate, with Hispanic/Latino (H/L) individuals experiencing the most significant increases in both incidence and mortality. Despite this growing public health concern, the molecular mechanisms driving EOCRC disparities remain poorly understood. Oncogenic pathways such as WNT, TGF-beta, and RTK/RAS are critical in colorectal cancer (CRC) progression, yet their specific roles in EOCRC across diverse populations have not been extensively studied. This research seeks to identify molecular alterations within these pathways by comparing EOCRC cases in H/L and non-Hispanic White (NHW) individuals. Furthermore, we explore the clinical significance of these findings to inform precision medicine strategies tailored to high-risk populations. Methods: To investigate mutation frequencies in genes associated with the WNT, TGF-beta, and RTK/RAS pathways, we conducted a bioinformatics analysis using publicly available CRC datasets. The study cohort consisted of 3412 patients, including 302 H/L and 3110 NHW individuals. The patients were categorized based on age (EOCRC: <50 years; late-onset CRC [LOCRC]: ≥50 years) and population group (H/L vs. NHW) to assess variations in mutation prevalence. Statistical comparisons of mutation rates between the groups were conducted using chi-squared tests, while Kaplan–Meier survival analysis was employed to evaluate overall survival differences associated with pathway alterations. Results: Notable molecular distinctions in the RTK/RAS pathway were identified between EOCRC and LOCRC among the H/L patients, with EOCRC exhibiting a lower frequency of RTK/RAS alterations compared to LOCRC (66.7% vs. 79.3%, p = 0.01). Within this pathway, mutations in CBL (p < 0.05) and NF1 (p < 0.05) were significantly more prevalent in the EOCRC cases (5.8% vs. 1.2% and 11.6% vs. 3.7%, respectively), whereas BRAF mutations were notably less frequent in EOCRC than in LOCRC (5.1% vs. 18.3%, p < 0.05). Comparisons between the EOCRC patients from the H/L and NHW populations revealed distinct pathway-specific alterations that were more common in the H/L individuals. These included RNF43 mutations (12.3% vs. 6.7%, p < 0.05) in the WNT pathway, BMPR1A mutations (5.1% vs. 1.8%, p < 0.05) in the TGF-beta pathway, and multiple RTK/RAS pathway alterations, such as MAPK3 (3.6% vs. 0.7%, p < 0.05), CBL (5.8% vs. 1.4%, p < 0.05), and NF1 (11.6% vs. 6.1%, p < 0.05). Survival analysis in the H/L EOCRC patients did not reveal statistically significant differences based on pathway alterations. However, in the NHW EOCRC patients, the presence of WNT pathway alterations was associated with significantly improved survival outcomes, suggesting potential ethnicity-specific prognostic implications. Conclusions: This study highlights the substantial molecular heterogeneity present in EOCRC, particularly among high-risk populations. The H/L EOCRC patients exhibited distinct genetic alterations, with a higher prevalence of CBL, NF1, RNF43, BMPR1A, and MAPK3 mutations compared to their NHW counterparts. Additionally, RTK/RAS pathway alterations were less frequent in EOCRC than in LOCRC. Despite these molecular differences, pathway alterations did not significantly impact survival outcomes in the H/L EOCRC patients. However, in the NHW EOCRC patients, the presence of WNT pathway alterations was associated with improved survival. These findings emphasize the necessity for further research to clarify the molecular mechanisms driving EOCRC disparities in high-risk populations and to inform precision medicine strategies for underrepresented groups. Full article

Research on sleep disorders among migrant populations is limited, particularly in the context of south–south Latinos migrating to other Latin American countries. Objective: This study aims to analyze the effect that the acculturation process may play on the presence of the subjective assessment of insomnia symptoms in South American migrants in Chile. Methods: Under a cross-sectional design, 1844 South American migrants from Colombia, Venezuela and Peru, currently residing in Chile, were evaluated. Of these, 50% were women with an average age of 35 years. Data were collected using the Insomnia Severity Index (ISI), the EBEA scale for acculturation stress, a scale based on Berry’s acculturation strategies, and the anxiety subscale of the DASS-21. Mediation models were employed to assess anxiety as a mediating variable between both acculturation stress and acculturation orientations as well as insomnia symptoms. Results: A home-country-focused orientation was inversely related to insomnia symptoms, whereas a host-country-focused orientation showed a direct association. Anxiety did not mediate either of these relationships. However, acculturation stress was directly associated with the emergence of insomnia symptoms; in this relationship, anxiety partially mediated the negative effect of stress on sleep. Conclusions: There is a complex and dynamic interplay between the acculturation process, insomnia, and anxiety within south-to-south migration in Latin countries. Understanding these relationships could promote culturally sensitive interventions to mitigate the adverse effects of migration-related stressors on sleep health and the overall well-being of Latino migrants. Full article

Previous studies have examined the association between family dysfunction and pubertal timing in adolescent girls. However, the evidence is lacking on the role of family dysfunction during sensitive developmental periods in both boys and girls from racial and ethnic minority groups. This study aimed to determine the effect of family dysfunction on the timing of pubertal maturation among US Hispanic/Latino children and adolescents. Participants were 1466 youths (50% female; ages 8–16 years) from the Hispanic Community Children’s Health Study/Study of Latino Youth (SOL Youth). Pubertal maturation was measured using self-administered Pubertal Development Scale (PDS) items for boys and girls. Family dysfunction included measures of single-parent family structure, unhealthy family functioning, low parental closeness, and neglectful parenting style. We used multivariable ordinal logistic and linear regression analyses to examine the associations between family dysfunction and pubertal maturation (individual and cumulative measures), with adjustment for childhood BMI and socioeconomic factors, design effects (strata and clustering), and sample weights. Multivariable models of individual PDS items showed that family dysfunction was negatively associated with growth in height (OR = 0.66, 95% CI: 0.44, 0.99) in girls; no associations were found in boys. In the assessment of cumulative PDS scores, family dysfunction was associated with a lower average pubertal maturation score (b = −0.63, 95% CI: −1.21, −0.05) in boys, while no associations were found in girls. Pubertal timing lies at the intersection of associations between childhood adversity and adult health and warrants further investigation to understand the factors affecting timing and differences across sex and sociocultural background. Full article

Latinos/as are the largest ethnic group in the U.S. and are a continuous source of population growth. Therefore, their health and quality of life are important public health concerns. Acculturation is an important determinant of health for Latinos/as. However, few studies examine models identifying determinants of acculturation along with its relationship to other social and health behaviors. The current study uses social network data from a sample of crowdsourced recruited Latinos/as (N = 300) to examine a structural model between network acculturation, psychological acculturation, social capital, help-seeking, and quality of life (QoL). The model posits several paths through which social networks (i.e., network acculturation) relate to acculturation and other model variables. Directly, network acculturation was found to be significantly related to Latino/a enculturation (−0.83, p = 0.002) and White American Acculturation (0.47, p = 0.003). Latino/a enculturation was related to help-seeking (0.21, p = 0.029) and social capital (0.36, p < 0.001), while White American acculturation was only related to social capital (0.35, p = 0.003). Social capital demonstrated a robust relationship with help-seeking (0.48, p = 0.004) and QoL (0.96, p = 0.003). The findings suggest that determinants of acculturation (i.e., network acculturation) are meaningful contributors to psychological acculturation and other variables relating to Latino/as’ QoL. Full article

Growing evidence suggests that abnormal diurnal blood pressure rhythms may be associated with many adverse health outcomes, including increased risk of cognitive impairment and dementia. This study evaluates methodological aspects of research on bidirectional associations between ambulatory blood pressure monitoring (ABPM) patterns and cognitive function. By examining the 28 recent studies included in a recent systematic review on the association between ABPM patterns with cognitive function and risk of dementia, our review revealed several significant limitations in study design, sample characteristics, ABPM protocol, cognitive assessment, and data analysis. The major concerns include a lack of diversity in study populations with underrepresentation of Blacks and Latinos, a predominant focus on Alzheimer’s disease or all-cause dementia without distinguishing other dementia subtypes, different and not standardized measures of cognition or dementia, prevalent use of 24 h monitoring without considering the adaption effect, inconsistent definitions of dipping status, and ignorance of individual differences in timings of daily activities such as bed and awakening times. In addition, confounding variables such as class, dose, and timing of antihypertensive medication are inadequately controlled or considered. Further, longitudinal studies were scarce examining the bidirectional relationship between ABPM patterns and cognitive decline over time. Collectively, these deficiencies undermine the reliability and generalizability of current findings. Addressing these methodological challenges is crucial for a more comprehensive understanding of diurnal blood pressure rhythms in diverse populations and for developing an evidence-based guideline for ambulatory monitoring and control of blood pressure across the sleep-wake cycle to prevent cognitive decline and dementia. Full article

Background: The few epidemiologic studies of infection exposure in early life and acute leukemia (AL) risk in Latino children have yielded inconsistent results, suggesting a possible effect of ethnicity. Here, we examined the correlation between infection exposure and acute leukemia risk in children from Mexico City—One of the biggest Latino cities worldwide. Methods: This study included 1455 Mexican children diagnosed with de novo AL (2002–2016), and 1455 control individuals frequency-matched by age and health institution. The AL population included acute lymphoblastic leukemia (ALL), Pre-B ALL, and acute myeloblastic leukemia (AML). Logistic regression analyses were performed to investigate direct and indirect proxies of infection in children or their mothers. Results: Upper respiratory tract infections during the child’s first year of life were a risk factor for AL (OR, 2.76; 95% CI, 1.48–5.15), including ALL (OR, 3.14; 95% CI, 1.67–5.89) and Pre-B (OR, 3.11; 95% CI, 1.63–5.96). Mother’s infections before and during pregnancy were protective factors against AL (OR, 0.55; 95% CI, 0.47–0.64; and OR, 0.61; 95% CI, 0.52–0.72, respectively). These associations included ALL and Pre-B. In contrast, only mothers’ infections before pregnancy and respiratory tract infections were protective factors against AML (OR, 0.45; 95% CI, 0.33–0.62; and OR, 0.50; 95% CI, 0.37–0.68, respectively). Conclusions: Infections during the first year of life were associated with AL development in children of Mexico City. Additionally, mothers’ exposure to respiratory tract infections before and during pregnancy reduced the AL risk in this Latino population. Full article

Background: Marginalized low-income racial and ethnic minority residents of public housing represent an intersectional population with multiple health needs and low healthcare utilization. Telehealth has been proposed as a solution to address healthcare access disparities, yet the role of telehealth attitudes, including perceived benefits and self-efficacy, in influencing telehealth use of this population remains unknown. Objective: This study investigates whether two domains of telehealth attitudes, namely self-efficacy and perceived benefits (expectancy), mediate the relationship between demographic, health, and social determinants of telehealth use among low-income racial and ethnic minority residents of public housing in Los Angeles. Methods: This cross-sectional study analyzed data collected from low-income racial and ethnic minority residents of public housing in Los Angeles. Measures included demographic factors (age and gender), social determinants of health (e.g., education, language, and primacy care provider), health (chronic illnesses and physical mobility), telehealth attitudes (perceived benefits and self-efficacy), and telehealth use frequency. Mediation analysis was conducted to test whether telehealth attitudes explained the association between demographic, social, and health determinants of telehealth use. Results: The findings revealed that neither of the two domains of telehealth attitudes, including perceived benefits and self-efficacy, were significantly associated with telehealth use. As such, these attitude domains did not operate as mediators of the relationship between demographic, health, and social determinants of telehealth use. Conclusion: The study results suggest that structural barriers, rather than individual attitudes, primarily drive telehealth use disparities among this intersectional population. Interventions aimed at increasing telehealth adoption should prioritize addressing systemic inequities rather than focusing solely on changing individual attitudes. These findings underscore the importance of structural solutions to promote equitable telehealth access in marginalized communities. Full article