through the Ventanillas de Salud program

Introduction

Mental health promotion and screenings are recommended as part of standard preventive care. Mexican immigrants in the U.S. are at high risk for mental health illness especially after the COVID-19 pandemic, however access to mental health prevention for this population has been limited, which results in important implementation and equity gaps. The Ventanilla de Salud (VDS) program provides preventive services through Mexican consulates in the U.S.

Objective

The objective of this study was to assess capability, opportunity, and motivation for promotores to implement mental health programming through the VDS, leveraging early experiences of ongoing mental health prevention efforts.

Methods

This was a qualitative study using the Capability, Opportunity, and Motivation for Behavior Change model (COM-B). We conducted 9 focus groups with 40 VDS promotores and 6 semi-structured interviews with program stakeholders. Data were analyzed using inductive and deductive coding.

Results

We found high levels of interest from the leadership, partners, and promotores to provide mental health services through the VDS. Early implementation of a mental health strategy that included training sessions for promotores and mental health promotion, screenings and referrals for VDS users was ongoing. We identified facilitators and barriers that could affect capability, opportunity, and motivation to provide mental health services. Facilitators included promotores' extensive knowledge about the importance of mental health, promotores service mindset and commitment to provide services to VDS users, and general support from the VDS network and partners. Barriers included promotores' turnover, need for additional economic compensation, burnout, competing priorities, and lack of mental health professionals to provide clinical services or supervision. Additional investments are recommended to support promotores' well-being.

Conclusion

The main lesson learned from this study was that investing in VDS promotores' training, resources, and well-being is key to their capability, opportunity and motivation to provide mental health services for Mexican immigrants in the US. Results from this study can be applied to improve the ongoing VDS mental health strategy and increase its impact on the mental health of Mexican immigrants.

"Why we stay": immigrants' motivations for remaining in communities impacted by anti-immigration policy

Although restrictive immigration policy is intended to reduce incentives for unauthorized immigrants to remain in the United States, many immigrants remain in their U.S. community despite the anti-immigration climate surrounding them. This study explores motivations shaping immigrants' intentions to stay in Arizona after passage of Senate Bill 1070 in 2010, one of the most restrictive immigration policies in recent decades. We conducted three focus groups in a large metropolitan city in Arizona with Mexican immigrant parents (N = 25). Themes emerging from the focus groups described multiple and interlocking personal, family and community, and contemporary sociopolitical motivations to stay in their community, and suggest that some important motivating factors have evolved as a result of immigrants' changing environment. Implications for research and social policy reform are discussed.

Interpersonal abuse and depression among mexican immigrant women with type 2 diabetes

Evidence for a bi-directional relationship of depression and type 2 diabetes suggests that social distress plays a role in depression among people with diabetes. In this study, we examine the relationship between subjective distress and depression in 121 first- and second-generation Mexican immigrant women seeking diabetes care at a safety-net hospital in Chicago. We used a mixed-methods approach including narrative interview, survey, and finger-stick blood HbA1c data. Using grounded theory analysis, we identified seven life stressors from narrative interviews: interpersonal abuse, stress related to health, family, neighborhood violence, immigration status, and work, and feeling socially detached. Women reported unusually high rates of interpersonal abuse (65%) and disaggregated physical abuse (54%) and sexual abuse (23%). We evaluated depression using CES-D cut-off points of 16 and 24 and assessed rates to be 49 and 34%, respectively. We found that interpersonal abuse was a significant predictor of depression (CESD ≥ 24) in bivariate (OR 3.97; 95% CI 1.58-10.0) and multivariate (OR 5.51; 95% CI 1.85, 16.4) logistic regression analyses. These findings suggest that interpersonal abuse functions as an important contributor to depression among low-income Mexican immigrant women and should be recognized and addressed in diabetes care.

Maternal perception of child weight among Mexicans in California and Mexico

The prevalence of childhood overweight is high in Mexican immigrant communities in the United States. Understanding mother's perceptions of child weight in immigrants' country of origin may help to understand this high prevalence. The goal of this study was to examine and compare mothers' perception of weight in Mexico (MX) and in an immigrant community in California (CA). We assessed perceptions of child weight using a pictorial scale with 314 mothers of 5-year-old children in MX and 60 mothers of 5 year-old-children in CA. We compared maternal reports with children's objectively measured weight. Using chi-square and Analysis of Variance, we investigated associations of maternal perception of and satisfaction with weight according to socio-demographic characteristics. Mothers were more likely to underestimate their children's weight in CA than in MX. On average, CA mothers wanted their children to be smaller than they currently were and mothers in MX wanted their children to be bigger than they currently were. This differed by weight status in CA with mothers of normal weight and at-risk-for-overweight children wanting them to be bigger and mothers of overweight children wanting them to be smaller. In order for programs to be effective, mothers must be able to recognize their children as overweight and want to address it. Because underestimation of weight and a desire for a larger size is common in this population, programs to address overweight may be more effective if they focus on alternative benefits of weight control strategies, such as healthy child development.

Maternal and infant health of Mexican immigrants in the USA: the effects of acculturation, duration, and selective return migration

BACKGROUND

A significant body of research on minority health shows that while Hispanic immigrants experience unexpectedly favorable outcomes in maternal and infant health, their advantage deteriorates with increased time of residence in the USA. This is referred to as the 'acculturation paradox.'

OBJECTIVE

We assess the 'acculturation paradox' hypothesis that attributes this deterioration in birth and child health outcomes to negative effects of acculturation and behavioral adjustments made by immigrants while living in the USA, and investigate the potential for the existence of a selective return migration.

DESIGN

We use a sample of Mexican immigrant women living in two Midwestern communities in the USA to analyze the effects of immigrant duration and acculturation on birth outcomes once controlling for social, behavioral, and environmental determinants of health status. These results are verified by conducting a similar analysis with a nationally representative sample of Mexican immigrants.

RESULTS

We find duration of residence to have a significant and nonlinear relationship with birth outcomes and acculturation to not be statistically significant. The effect of mediators is minimal.

CONCLUSION

The analyses of birth outcomes of Mexican immigrant women shows little evidence of an acculturation effect and indirectly suggest the existence of a selective return migration mechanism.