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Objective Patients’ cultural health beliefs and behaviors may conflict with biomedical healthcare values and practices potentially leading to non-adherence with asthma treatment regimens. To optimize shared decision-making, healthcare providers should understand and be sensitive to these cultural beliefs and behaviors and negotiate an asthma management plan acceptable to parents. The purpose of this study was to obtain the perspective of Mexican mothers regarding (1) their experiences of living with a child with asthma, (2) their understanding of the nature of asthma, and (3) how their cultural beliefs influence asthma management. Methods A qualitative, phenomenological study design was employed to assess mothers’ lived experiences with and perceptions of their child’s asthma. Individual in-depth interviews were conducted with a purposeful sample of 20 Mexican mothers of children ages 5-17 years with asthma. An inductive, theory-driven, phenomenological analysis approach was used to elicit thematic findings. Results Mothers expressed a symptomatic perception of asthma and limited understanding of the disease. Most believe the disease is present only when their child is symptomatic. Many are surprised and puzzled by the unpredictability of their child’s asthma attacks, which they report as sometimes “silent”. The inconsistency of triggers also leads to frustration and worry, which may reflect their concerns around daily controller medication use and preference for alternative illness management strategies. Conclusions Our clinical encounters should be refocused to better understand the context of these families’ lives and the cultural lens through which they view their child’s asthma.

Objective: This study examined the short- and long-term effects of a community-based lifestyle intervention among Latino youth with obesity. Methods: Latino adolescents (14–16 years old) were randomized to a 3-month lifestyle intervention ( N =67) or comparison control ( N =69) and followed for 12-months. The intervention included weekly nutrition and health classes delivered to groups of families and exercise sessions (3 days/week) delivered to groups of adolescents. Comparison youth received laboratory results and general health information. Primary outcomes included insulin sensitivity and weight-specific quality of life (QoL) with secondary outcomes of BMI%, waist circumference and percent body fat. Results: At 3-months, youth in the intervention group exhibited significant increases in insulin sensitivity (p<0.05) and weight-specific QoL (p<0.001) as well as reductions in BMI%, waist circumference and percent body fat compared to controls. Increases in weight-specific QoL and reductions in BMI% and percent body fat remained significant at 12-months (p<0.001) while changes in insulin sensitivity did not. In a subsample of youth with prediabetes at baseline, insulin sensitivity (p=0.01), weight-specific QoL (p<0.001), and BMI% (p<0.001) significantly improved at 3-months. Conclusions: Lifestyle intervention can improve cardiometabolic and psychosocial health in a vulnerable population of Latino adolescents at high risk for developing type 2 diabetes.

Purpose To assess the preliminary effects of a new course entitled Freshman 5 to Thrive/COPE Healthy Lifestyles on the cognitive beliefs, knowledge, mental health outcomes, healthy lifestyle choices, physical activity, and retention of college freshmen. Data sources Measures included demographics, nutrition knowledge, healthy lifestyle beliefs, healthy lifestyle perceived difficulty, healthy lifestyle choices, Beck Youth Inventories‐II (anxiety, depression, anxiety, and destructive behavior), step count via pedometer, and college retention. Conclusions The experimental COPE (Creating Opportunities for Personal Empowerment) group had greater intentions to live a healthy lifestyle (p = .02) versus the comparison group. COPE students also significantly increased their physical activity (p = .003) from baseline to postintervention and had a higher college retention rate than students who did not take the course. In addition, there was a significant decrease in depressive and anxiety symptoms in COPE students whose baseline scores were elevated. Implications for practice The Freshman 5 to Thrive Course is a promising intervention that can be used to enhance healthy lifestyle behaviors and improve mental health outcomes in college freshmen.

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This is the first definition of asthma self-management incorporating teen, parent, clinician, and researcher perspectives, which suggests that self-management processes and behaviors are influenced by individually variable personal and interpersonal factors, and are driven by personally important outcomes. Clinicians and researchers should investigate teens' symptom perceptions, medication beliefs, current approaches to symptom management, relevant outcomes, and personal priorities.

Background Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. Objectives To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14–16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. Conclusions The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations.