Latino children in the United States, whether immigrants themselves or children in immigrant families, are at high risk for mental health disorders stemming from poverty, exposure to trauma, assimilation stressors, and discrimination. The timely identification and treatment of mental health disorders in Latino children are compromised by limited healthcare access and quality as well as the lack of routine mental health screening in pediatric primary care. Here we review Spanish-language validity and implementation studies of Bright Futures previsit mental health screening tools and models of care. We identify strengths and weaknesses in the literature and suggest tools for use in mental health care assessment, management, and treatment for Latino children in pediatric primary care. Pediatricians can improve care of Latino children through awareness of risk factors for mental health disorders, integration of evidence-based screening tools, and advocacy for culturally tailored mental health resources.
Objective (1) To measure healthcare activation among low-income parents by language (English/Spanish); and (2) to assess the psychometrics of the Parent-Patient Activation Measure (P-PAM) in the study population. Methods We surveyed parents/guardians of publicly-insured children who were established patients at a pediatrics clinic for ≥6 months. Surveys included the Parent-Patient Activation Measure (P-PAM), a 13-item measure adapted from the well-validated Patient Activation Measure (PAM). Results Of 316 surveys, 68% were completed in Spanish. Mean activation score in the English-language survey group was 79.1 (SD 16.2); mean score in the Spanish-language group was 70.7 (SD 17.9) (p < 0.001). Scale reliability was high (English α = 0.90; Spanish α = 0.93). The P-PAM had acceptable test-retest reliability, but no previously reported PAM factor structure fit the study data adequately for either language. Conclusions Healthcare activation among low-income parents was greater for parents surveyed in English compared with those surveyed in Spanish. The P-PAM has acceptable reliability and validity in English and Spanish, but a different factor structure than the PAM. Practice implications Activation as measured by the P-PAM may not have the same associations with or impact on health/healthcare outcomes in pediatrics compared with adults owing to possible measure differences between the P-PAM and PAM.
Latinxs in the United States are disproportionately affected by HIV and present with more advanced disease than their non-Latinx peers, due to numerous barriers to care including HIV stigma. We describe the adaptation, implementation, and reach of Sólo Se Vive Una Vez (You Only Live Once), Baltimore's first social marketing campaign promoting HIV screening among Spanish-speaking Latinxs. The 6-month campaign promoted free HIV testing by addressing HIV stigma. The campaign included a website, a social marketing campaign, community outreach events, and advertisements via radio, billboards, local partners, and buses. During the campaign, there were 9,784 unique website users, and ads were served to over 84,592 people on social media platforms. Among Latinx HIV testers at the Baltimore City Health Department, 31.6% reported having seen or heard of Sólo Se Vive Una Vez and 25.3% of Latinx HIV testers reported that the campaign influenced them to get tested.
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