3 results
2395 Developing a conceptual model of healthcare access for adolescent Latinas in the US South
- Mercedes M. M. Aleman, Gwendolyn Ferreti, Isabel C. Scarinci
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, p. 68
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OBJECTIVES/SPECIFIC AIMS: Alabama (AL) experienced a 145% increase in its Latino population between 2000 and 2010; making it the state with the second fastest growing Latino population in the United States (US) during that time. Adolescent Latinas in the United States and in AL are disproportionately affected by sexual health disparities as evidenced by the disproportionate burden of HIV, STIs and early pregnancy compared with their non-Hispanic, White counterparts. In 2011, Alabama passed 1 of the harshest anti-immigration laws in the nation. Following the passing of this law, county health department visits among Latino adults decreased by 25% for STIs and 13% for family planning. Empirical data with adult Latinas in the Southeast suggest significant barriers to sexual healthcare access. However, to our knowledge, no other researchers have examined barriers and facilitators to sexual healthcare access for this subpopulation. Therefore, the goal of this 3-phase study is to: (a) better understand the factors underlying sexual health disparities and gaps in healthcare access among adolescent Latinas; (b) develop a conceptual model based on these data and the extant literature summarizing the theorized pathways through which factors at differing levels of the socioecological model of health (SEMH) impact sexual healthcare access for this group; and (c) develop community-driven, theory-based, culturally-relevant, multilevel intervention strategies to reduce sexual health disparities and increase sexual healthcare access for adolescent Latinas through a community-engaged, intervention mapping process. Community based participatory research (CBPR), which ensures equitable participation of stakeholder groups through partnerships, and the SEMH, which conceptualizes the individual as nested within a set of social structures, provide the philosophical and theoretical frameworks for the work. METHODS/STUDY POPULATION: From January of 2017 to December of 2017 we completed phase 1 of the study: conducting and analyzing 20 semi-structured qualitative interviews with adolescents who: self-identified as Latina, were between 15 and 20 years of age, had been in the United States for over 5 years, and lived in one of the counties of West AL and 15 semi-structured qualitative interviews with key stakeholders (healthcare providers, parents, policy makers, etc.) who regularly work with Latina adolescents. Interview participants were recruited through purposeful-convenience sampling. Two bilingual (in English and Spanish) coders used an iterative process (between independent coding and consensus building) to analyze the data using NVivo 11. Phase 2 of the study is currently underway: constructing a conceptual model on sexual healthcare access for young Latinas in Alabama. We have utilized an iterative process between qualitative interview data collected in phase 1 and review of the extant literature to draft a conceptual model of healthcare access among adolescent Latinas in the US South. This model will serve as the foundation of future studies including the development of intervention strategies through a CBPR process (phase 3), to commence in January 2018. RESULTS/ANTICIPATED RESULTS: PHASE 1: Several barriers and facilitators to sexual healthcare access emerged from the semi-structured qualitative research interviews with young women. These included: (1) parental approval/disapproval and embarrassment (“pena”); (2) structural barriers/facilitators to care (e.g., lack of transportation, flexible clinic hours); and (3) negative/positive experiences with providers (e.g., perceived discrimination based on immigrant status). Key stakeholders identified the following barriers and facilitators to sexual healthcare access for adolescent Latinas in their interviews: (1) language barriers/need for interpreters and outreach workers to work with young Latina women; (2) need for better sexual health education across the state; (3) lack of knowledge among young women and their parents about institutions in general and sexual healthcare, in specific; and (4) perceived lack of “deservingness” and discrimination from providers/“not my patients” phenomenon. PHASE 2: This presentation will summarize the development of our conceptual model (see drafts attached). For ease of interpretation, we have created 2 sub-models (centering gender and immigration, respectively) which summarize theorized pathways through which policy, community, organizational, and family-level factors influence young Latina women’s access to sexual healthcare services. DISCUSSION/SIGNIFICANCE OF IMPACT: The proposed research is significant because: (1) the state of AL experienced a dramatic increase in its Latino/a population over the last 15 years and adolescent Latinas in AL are disproportionately affected by sexual health disparities; (2) to our knowledge, this is the only study to examine the multilevel factors associated with sexual healthcare access for adolescent Latinas in the South and inform intervention strategies to promote sexual healthcare access in this population; (3) the work is being conducted under the philosophical lens of CBPR such that community members are involved in every step of the research process, resulting in culturally relevant and youth-specific intervention strategies.
2333: Examination of barriers and facilitators to sexual healthcare access among adolescent Latinas in Alabama
- Mercedes Margarita Morales Aleman, Isabel C. Scarinci, Gwendolyn Ferreti
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- Journal:
- Journal of Clinical and Translational Science / Volume 1 / Issue S1 / September 2017
- Published online by Cambridge University Press:
- 10 May 2018, p. 74
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OBJECTIVES/SPECIFIC AIMS: Alabama (AL) experienced a 145% increase in its Latino population between 2000 and 2010; making it the state with the second fastest growing Latino population in the United States (US) during that time. Adolescent Latinas in the US and in AL are disproportionately affected by sexual health disparities as evidenced by the disproportionate burden of HIV, STIs and early pregnancy compared with their non-Hispanic, White counterparts. Empirical data with adult Latinas in the southeast suggest significant barriers to sexual healthcare access. However, to our knowledge, no other researchers have examined barriers and facilitators to sexual healthcare access for this subpopulation. Therefore, the purpose of this study is to examine adolescent Latinas’ sexual healthcare needs through in-depth qualitative interviews. These qualitative interviews (phase 1 of a 3-phase study) will inform the development of community-driven, theory-based, culturally-relevant, multi-level intervention strategies to reduce sexual health disparities and increase sexual healthcare access for this group. Community-based participatory research (CBPR), which ensures equitable participation of stakeholder groups through partnerships, and the socioecological model of health, which conceptualizes the individual as nested within a set of social structures, provide the philosophical and theoretical frameworks for the work. METHODS/STUDY POPULATION: Between January and March of 2017, we will conduct 30 qualitative interviews with eligible adolescents who: self-identify as Latina, are between 15 and 19 years old, have been in the US for over 5 years, and live west AL. We will use venue-based, purposeful convenience sampling to recruit participants. We will manage and analyze the data with the qualitative software NVivo 10. We will use a multi-step, consensus-based process to code and analyze the interviews in the language in which they were conducted (ie, Spanish or English). We will maintain detailed audit trails during the analysis process and seek an inter-rater reliability of 0.85. RESULTS/ANTICIPATED RESULTS: We expect to identify barriers and facilitators to sexual healthcare services at distinct levels of the socioecological model of health. Study results and implications for practice in clinical settings will be discussed in detail. DISCUSSION/SIGNIFICANCE OF IMPACT: The proposed research is significant because (1) the state of AL experienced a dramatic increase in its Latino/a population over the last 15 years and adolescent Latinas in AL are disproportionately affected by sexual health disparities; (2) to our knowledge, this will be the first study to examine the multi-level factors associated with sexual healthcare access for adolescent Latinas in the South and inform intervention strategies to promote sexual healthcare access in this population; (3) the work will be conducted under the philosophical lens of CBPR such that community members will be involved in every step of the research process, resulting in culturally relevant intervention strategies.
Strategies for enhancing research in aging health disparities by mentoring diverse investigators
- Nina T. Harawa, Spero M. Manson, Carol M. Mangione, Louis A. Penner, Keith C. Norris, Charles DeCarli, Isabel C. Scarinci, Julie Zissimopoulos, Dedra S. Buchwald, Ladson Hinton, Eliseo J. Pérez-Stable
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- Journal:
- Journal of Clinical and Translational Science / Volume 1 / Issue 3 / June 2017
- Published online by Cambridge University Press:
- 23 February 2017, pp. 167-175
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Introduction
The Resource Centers for Minority Aging Research (RCMAR) program was launched in 1997. Its goal is to build infrastructure to improve the well-being of older racial/ethnic minorities by identifying mechanisms to reduce health disparities.
MethodsIts primary objectives are to mentor faculty in research addressing the health of minority elders and to enhance the diversity of the workforce that conducts elder health research by prioritizing the mentorship of underrepresented diverse scholars.
ResultsThrough 2015, 12 centers received RCMAR awards and provided pilot research funding and mentorship to 361 scholars, 70% of whom were from underrepresented racial/ethnic groups. A large majority (85%) of RCMAR scholars from longstanding centers continue in academic research. Another 5% address aging and other health disparities through nonacademic research and leadership roles in public health agencies.
ConclusionsLongitudinal, team-based mentoring, cross-center scholar engagement, and community involvement in scholar development are important contributors to RCMAR’s success.