Reaching Latinx Communities with Algorithmic Optimization for SARS-CoV-2 Testing Locations.

The COVID-19 pandemic has disproportionately affected communities of color, including Latinx communities. Oregon Saludable: Juntos Podemos (OSJP) is a randomized clinical trial aimed at reducing this disparity by both increasing access to testing for SARS-CoV-2, the virus that causes COVID-19, for Oregon Latinx community members and studying the effectiveness of health and behavioral health interventions on turnout and health outcomes. OSJP established SARS-CoV-2 testing events at sites across Oregon. A critical early question was how to locate these sites to best serve Latinx community members. To propose sites in each participating county, we implemented an algorithmic approach solving a facilities location problem. This algorithm was based on minimizing driving time from Latinx population centers to SARS-CoV-2 testing locations. OSJP staff presented these proposed testing locations to community partners as a starting place for identifying final testing sites. Due to differences in geography, population distributions, and potential site accessibility, the study sites exhibited variation in how well the algorithmic optimization objectives could be satisfied. From this variation, we inferred the effects of the drive time optimization metric on the likelihood of Latinx community members utilizing SARS-CoV-2 testing services. After controlling for potential confounders, we found that minimizing the drive time optimization metric was strongly correlated with increased turnout among Latinx community members. This paper presents the algorithm and data sources used for site proposals and discusses challenges and opportunities for community-based health promotion research when translating algorithm proposals into action across a range of health outcomes.

Comparing the effectiveness of Family Support for Health Action (FAM-ACT) with traditional community health worker-led interventions to improve adult diabetes management and outcomes: study protocol for a randomized controlled trial.

BACKGROUND: Diabetes self-management education and support (DSMES) programs have struggled to deliver sustainable, effective support for adults with diabetes (AWDs) to improve self-management behaviors, achieve glycemic goals, and reduce risk for complications. One largely untapped resource for this support is AWDs' social networks. Fifty to 75% of AWDs have an unpaid family member or friend ("support person") who provides ongoing help with diabetes management. However, DSMES interventions to date lack structured and effective approaches to directly engage support persons in AWDs' diabetes management. METHODS: This parallel arm randomized trial is designed to determine the effectiveness of Family Support for Health Action (FAM-ACT), a novel community health worker (CHW)-delivered program focused on educating and supporting patients with type 2 diabetes (T2D) and their support persons (SPs), relative to an established, CHW-delivered, individual patient-focused DSMES and care management (I-DSMES) intervention. Both interventions were developed using a community-based participatory research (CBPR) approach. The study will be conducted in partnership with an urban Federally Qualified Health Center (FQHC) serving a low-income, Latino/a community, with target enrollment of 268 dyads consisting of an FQHC patient with T2D with high HbA1c and an SP. Patient-SP dyads will be randomized to receive FAM-ACT or I-DSMES over 6 months. The primary outcome is change in patient HbA1c from baseline to 6 months. Secondary patient outcomes include 12-month change in HbA1c, changes in patient blood pressure, diabetes self-management behaviors, diabetes distress, patient activation, diabetes self-efficacy, and perceptions of and satisfaction with SP support for diabetes. Secondary SP outcomes include self-efficacy for helping the patient with diabetes management and SP distress about the patient's diabetes. We also will assess the effect of the COVID-19 pandemic on patient's ability to manage diabetes. DISCUSSION: This study will inform scalable, evidence-based approaches that leverage family support to help AWDs improve and sustain self-management strategies that underpin optimal management of multiple diabetes complication risk factors. The protocol is designed for and evaluated with a low-income and predominantly Latino/a community, which may increase applicability to other similar communities. The COVID-19 pandemic presented several challenges to study protocol and intervention delivery; modifications made to address these challenges are described. TRIAL REGISTRATION: ClinicalTrials.gov NCT03812614. Registered on 18 January 2019.

Riesgo Y Resiliencia: Exploring the Role of Parenting Stress and Self-efficacy on Young Latino Children's Well-being and Home Learning Experiences during COVID-19

The current study explored the associations between parenting stress and p\arental self-efficacy on children's social-emotional functioning and home learning practices among Latino families. Families were recruited as part of a pilot study of a parent-focused school readiness intervention that was conducted via telehealth during the COVID-19 pandemic. The sample was comprised of children (Mage = 3.02 years;64% male) enrolled in Early Head Start, and their parents (97% biological mothers). At baseline, parents reported on family demography, parenting stress, involvement in home learning activities (i.e., literacy and math), their self-efficacy in managing a range of situations related to raising young children, and children's social-emotional functioning. Study findings indicated that parenting stress was negatively associated with parent's home literacy involvement, but not with home math involvement. Results also indicated that parental self-efficacy moderated the relationship between parenting stress and children's social-emotional functioning, specifically externalizing and internalizing problems. Lastly, results indicated a positive association between parenting stress and children's adaptive skills. Findings from the current study help elucidate our understanding of the psychological well-being of young Latino children and families during COVID-19, and will potentially inform future efforts aimed at supporting Latino parents' well-being and children's early learning experiences during a global health crisis. [ FROM AUTHOR] Copyright of Journal of Latinos & Education is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Computers Secured, Connection Still Needed: Understanding How COVID-19-related Remote Schooling Impacted Spanish-speaking Mothers of Emergent Bilinguals with Dis/abilities

When the COVID-19 pandemic triggered shelter-in-place orders and school closures, many turned to remote schooling as a means for delivering vital instruction while observing public health guidelines. However, the swift shift to remote schooling highlighted an area of significant educational inequity across the United States, especially in urban districts and immigrant households: technology access. Centering the experiences of Spanish-speaking immigrant mothers of emergent bilinguals with disabilities in New York City, this paper presents how technology served as both burden and utility for linguistically-, economically-marginalized families and shares how direct multilingual home-school communication was the most supportive yet scarce resource. [ FROM AUTHOR] Copyright of Journal of Latinos & Education is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Double lockdown: The effects of digital exclusion on undocumented immigrants during the COVID-19 pandemic

The COVID-19 pandemic shifted many activities online. However, there is little research on the digital inclusion of undocumented immigrants and their experience of the pandemic in the United States. We conducted 32 interviews with undocumented Latino immigrants in the United States to examine how digital technologies mediated their experiences of the pandemic. We find that undocumented immigrants (1) face barriers to telehealth services, (2) are at high risk of COVID-19 misinformation, (3) experience difficulties in assessing privacy risks, and (4) experienced heterogeneous outcomes of technology use during the pandemic. Our analysis shows that digital technologies both supported and further marginalized undocumented immigrants during the pandemic. Future research on the digital inclusion of vulnerable populations should pay particular attention to the interaction between their underlying vulnerabilities, on one hand, and attitudes, uses, and outcomes associated with technology, on the other. [ FROM AUTHOR] Copyright of New Media & Society is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Another Brick in the Wall: Healthcare Access Difficulties and Their Implications for Undocumented Latino/a Immigrants.

The mounting evidence highlighting the disproportionate impact of the COVID-19 pandemic in ethnic minority communities underscores the need to understand how distress and healthcare access impacts the well-being of undocumented Latino/a immigrants (ULIs), one of the most marginalized and vulnerable ethnic minority communities in the U.S. We used existing data from a cross sectional study (Proyecto Voces) of 252 ULIs to conduct path analyses that explored the relations among distress due to immigration legal status, healthcare access difficulties, and the health of ULIs. Results demonstrated that distress due to immigration legal status is related to the physical and mental health of ULIs, and that difficulties in accessing healthcare explained these relations. These data support the importance of immediate, targeted efforts for increasing access to healthcare among undocumented immigrants and highlight the long-term importance of a much-needed healthcare reform for improving access to marginalized populations.