This article outlines the theory and resulting approach employed in a multilevel, integrated, collaborative community intervention called Adelante, implemented by a university-community partnership in a Latino immigrant community to address co-occurring health disparities of substance abuse, sex risk, and interpersonal violence among youth. The basis for the intervention is a social-ecological interpretation of positive youth development theory, which focuses on changes in the person environment context and community assets as a preventive mechanism. This approach is viewed as appropriate for a community facing multiple barriers to health equity. The article describes the translation of this positive youth development model to practice, including the design of the intervention, intervention components, and the protocol for evaluation. The Adelante intervention is intended to reduce health disparities and, in addition, to add a broader community model to the evidence base.
Latent tuberculosis infection (LTBI) remains the main source of new active tuberculosis (TB) cases worldwide. Household close contacts (HCCs) are at high risk of acquiring LTBI and subsequent development of TB. In this study, we aim to identify risk factors associated with LTBI in HCCs of TB patients living in a low TB-incidence setting. Our results revealed that HCCs who are aged more than 50 years (OR = 4.05) and overweight (OR = 15.3) are at higher risk of acquiring LTBI. None of these LTBI household contacts progressed to active TB. These findings suggest that HCCs who are young adults and children with normal and low body mass index are less likely to acquire LTBI after exposure to TB patients, even in low TB-incidence settings.
We applied Photovoice, an innovative methodology, in order to enhance participation by Latino youth living in Langley Park, MD in community-based participatory research (CBPR) and in the ongoing Adelante Positive Youth Development intervention. This study sought to: 1) expand our understanding of current needs and experiences of Latino youth and update our information on the evolving Marketplace; 2) involve youth in the process of developing CBPR intervention and social marketing components; and 3) build skills in photography, critical thinking, and community activism among Latino youth. Using Photovoice, we engaged twelve Latino youth, including six recently arrived to the U.S. and six second generation immigrants, in a dialogue about peer, family, community, and health issues affecting Latinos. Through six sessions, participants developed photography skills, used photographs to stimulate critical thinking and discussion, and suggested solutions for emergent issues. Sixty pictures selected for group discussion all corresponded to one of the three main domains of inquiry: 1) Strengths and needs of Langley Park, 2) Latino youth experiences, and 3) Community health assets and risks. Participants organized a photography exhibition and community forum to raise awareness about important findings. Both recently arrived and second generation Latino youth have important perspectives to share that guide and refine ongoing targeted CBPR interventions. Findings from this study shed light on the most relevant topics for community-based interventions, advocacy, and social marketing campaigns needed in this community. Photovoice is a useful tool for social marketing formative research targeting immigrant youth sub-groups.
This article reports on formative research to develop the Adelante brand, an innovative program for Latino immigrant adolescents and their families. The brand applies social marketing principles used in previous health brands in areas such as tobacco control, substance use, and HIV prevention. Specific objectives were to apply branding principles as an approach to increasing adolescent engagement with, and participation in, a community-based youth development program called Adelante, which is based on positive youth development theory. We collected data in a primarily low-income Latino immigrant community, Langley Park, MD, located near Washington, DC. A total of 39 adolescents, ages 13–19, participated in six focus groups. We designed and tested a brand positioning statement, associations, a logo and graphics, and youth archetypes. We used thematic content analysis to code focus group data into broad topic areas and then analyzed the data using substantive coding to identify themes. The concepts of strength, resilience, and “turning the corner” by overcoming life obstacles and succeeding were the main themes. Latino youth face a challenging environment in which they grow up, finish school, and succeed. Adelante represents a source of support and help to turn the corner. A graphic depicting a city street corner with a darker side (past) and a brighter side (future) was identified as the Adelante logo. Youth characters named Victor and Erika, and an educational entertainment strategy, were conceived as a way to create a brand persona. Adelante is now actively building its brand to increase youth engagement in the program.
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