Patricia Rodriguez Espinosa

All Publications

• The Spanish translation, adaptation, and validation of a Community-Engaged Research survey and a pragmatic short version: Encuesta Comunitaria and FUERTES JOURNAL OF CLINICAL AND TRANSLATIONAL SCIENCE Espinosa, P., Pena, J. M., Devia, C., Boursaw, B., Avila, M., Rudametkin, D., Aguilar-Gaxiola, S., Alegria, M., de Laurido, L., Perez, E., Wallerstein, N. 2024; 8 (1)

  View details for DOI 10.1017/cts.2024.613

  View details for Web of Science ID 001332018800001

• Partnering With Community Health Workers to Address COVID-19 Health Inequities: Experiences of the California Alliance Against COVID-19 American Journal of Public Health Rodriguez Espinosa, P., Vazquez, E., AuYoung, M., Zaldivar, F., Cheney, A. M., Sorkin, D., Zender, R., Corchado, C. G., Burke, N. J. 2024; 114

  View details for DOI 10.2105/AJPH.2023.307471

• What matters for weight loss in behavioral trials in the Latinx community: Learnings from three randomized controlled trials. Obesity research & clinical practice Rodriguez Espinosa, P., Xiao, L., Ma, J., Rosas, L. G. 2023

  Abstract

  Nearly half of Latinx adults in the US are obese, making effective weight loss interventions crucial to prevent associated chronic conditions.To identify factors associated with increased session attendance and clinically significant weight loss among Latinx adults.Latinx participants from the Vivamos Activos (n = 207), Vida Sana (n = 191), and HOMBRE (n = 424 Latinx men) randomized clinical trials.Post-hoc analysis of randomized controlled trial data.Culturally-adapted behavioral weight loss interventions based on the Diabetes Prevention Program among Latinx adults over 12 months.Demographic, clinical, and psychosocial predictors of session attendance and 5% weight loss at 12-months.Bi-variable associations between baseline characteristics and outcomes were tested with chi-square and t-tests. Those with p-value< 0.15 were then included in stepwise logistic regressions.Participants (N = 822) were middle age with diverse socioeconomic backgrounds. Older age in the Vivamos Activos and Vida Sana trials, and lower acculturation in the HOMBRE trial were significant predictors of increased session attendance. Factors associated with 5% weight loss varied by trials. These included younger age (OR 0.96 95% CI 0.92, 0.99) in Vivamos Activos, higher acculturation (OR 1.88 95% CI 1.05, 3.37) in Vida Sana, and higher education (OR 3.20 95% CI 1.3, 7.03) and greater body image dissatisfaction (OR 1.29, 95% CI 1.04, 1.6), and lower acculturation (0.69 95% CI 0.5, 0.96) in HOMBRE.Few and conflicting baseline characteristics were associated with session attendance and clinically significant weight loss, suggesting that alternative approaches to optimizing interventions are needed.

  View details for DOI 10.1016/j.orcp.2023.11.005

  View details for PubMedID 38071165

• Toward decolonized fiscal relationships between universities and community organizations: lessons learned from the California community engagement alliance against COVID-19 CRITICAL PUBLIC HEALTH Burke, N. J., Espinosa, P., Corchado, C. C., Vazquez, E., Rosas, L. G., Wooe, K. J., Lesarre, M., Gallegos-Castillo, A., Cheney, A., Lo, D. D., Hintz, R., Vassar, S. D., Brown, A. F. 2024; 34 (1): 1-13

  View details for DOI 10.1080/09581596.2024.2323715

  View details for Web of Science ID 001187561900001

• Mental health care-seeking and barriers: a cross-sectional study of an urban Latinx community. BMC public health Newberry, J. A., Gimenez, M. A., Gunturkun, F., Villa, E., Maldonado, M., Gonzalez, D., Garcia, G., Espinosa, P. R., Hedlin, H., Kaysen, D. 2024; 24 (1): 3091

  Abstract

  The Latinx community faces an increasing amount of mental health challenges and disparities in care. While the contributing factors are complex, there are likely potential barriers related to connecting with mental health support and accessing care that can be addressed.To investigate barriers in connecting to mental health care, we conducted a cross-sectional survey of mental health service use and barriers in an urban community with a primarily Hispanic/Latinx ethnicity using a modified random walk approach for door-to-door data collection with a two-cluster sampling frame. Survey included questions on socio-demographic, mental health status, desire and attempt to seek care, and the Barriers to Access to Care Evaluation. Shapley additive explanation (SHAP) identified impactful barriers and demographic characteristics. Our primary outcome was the number of respondents who saw a professional in the past 12 months and the key determinants that enabled their successful connection. Secondary outcomes were people with poor mental health who had wanted or tried to seek any source of mental health support.Of the 1004 respondents enrolled, 70.5% were foreign born; 63.4% were women. In the past 12 months, 23.8% of respondents wanted to connect with mental health care; 15.5% tried to connect, and only 11.7% successfully connected to mental health services. The two most cited barriers had the highest SHAP values: concerns about treatments available (65%) and financial costs (62.7%). Additional barriers with high SHAP values: being seen as weak and having no one to help them find care. Of demographic characteristics, age had the highest SHAP values.In a community with a high density of Latinx immigrants, just under half of respondents wanting mental health care successfully connected. Perceived informational, financial, and stigma-related barriers impacted the likelihood to connect with mental health care. These factors should be considered when designing programs and interventions to improve mental health care access and services in the Latinx community.

  View details for DOI 10.1186/s12889-024-20533-6

  View details for PubMedID 39516848

  View details for PubMedCentralID 10413745

• Addressing diabetes by elevating access to nutrition (ADELANTE) - A multi-level approach for improving household food insecurity and glycemic control among Latinos with diabetes: A randomized controlled trial. Contemporary clinical trials Radtke, M. D., Chen, W. T., Xiao, L., Espinosa, P. R., Orizaga, M., Thomas, T., Venditti, E., Yaroch, A. L., Zepada, K., Rosas, L. G., Tester, J. 2024: 107699

  Abstract

  Latinx adults are disproportionately impacted by the interrelated challenges of food insecurity and nutrition sensitive chronic diseases. Food and nutrition insecurity can exacerbate the development and progression of chronic diseases, such as diabetes. Sustainable, effective interventions aimed at improving food insecurity and diabetes management for Latinx populations are needed.This hybrid type 1 trial evaluates the effectiveness of a multi-level intervention that includes a medically supportive food and behavioral lifestyle program on the primary outcome of Hemoglobin A1c (HbA1c) at 6 months. Latinx adults (n = 355) with type 2 diabetes (HbA1c of 6.0-12.0 %), overweight/obesity (BMI > 25 kg/m2), and self-reported risk of food insecurity will be randomized 1:1 to intervention (12 weekly deliveries of vegetables, fruits, and whole-grain foods + culturally-modified behavioral lifestyle program) versus control (food deliveries after a 6-month delay). Outcome asessments will occur at 0, 6 and 12 months, and include HbA1c, dietary intake, psychosocial health outcomes, and diabetes-related stressors. In addition, food insecurity and the impact of the intervention on up to two household members will be measured. Qualitative interviews with patients, healthcare providers, and community partners will be conducted in accordance with Reach, Effectivenes, Adoption, Implementation, and Maintenence (RE-AIM) framework to identify barriers and best practices for future dissemination.The ADELANTE trial will provide novel insight to the effectiveness of a multi-level intervention on diabetes-related outcomes in Latinx adults. The mixed-method approach will also identity the reach of this 'Food is Medicine' intervention on additional household members to inform diabetes prevention efforts.NCT05228860.

  View details for DOI 10.1016/j.cct.2024.107699

  View details for PubMedID 39322114

• The development and current directions of a diversity specialty clinic: Implications for multicultural training in psychology. Training and education in professional psychology Espinosa, P. R., Johnson-Esparza, Y., Lopez, G., Benson, J., Moss, N. C., Avila-Rieger, R., Venner, K., Verney, S. P. 2024; 18 (3): 221-229

  Abstract

  Addressing systemic injustices and racism in training and clinical service provision are key next steps in clinical science. While the APA Multicultural Guidelines and accreditation standards have long emphasized this need, most graduate programs offer a single course on diversity, equity, and inclusion topics, which is inadequate to train and sustain culturally humble providers and redress systemic injustices and racism within psychology. Few "real-world" examples exist to guide the development of training models. We provide background on the development and components of a specialty clinic, the University of New Mexico's Cultural Counseling Center, whose mission is providing culturally informed clinical services to diverse clientele, and to infuse multicultural training throughout the graduate program. Informed by the racial-spatial framework for psychology and critical race theory, we describe our approach intended to: 1) offer applications for the operationalization and delivery of multicultural and antiracist training; 2) enhance supervisory models; and 3) increase awareness of structural competence. Our clinic, developed collaboratively among students and faculty, serves as a safe forum for dialogue around structural injustices and seeks to improve treatment for diverse clients and those underserved in mental health care. We discuss issues of student and faculty engagement and offer the perspectives of faculty and students of color, case examples illustrating our services, and current efforts to expand and formalize community collaborations. We offer a model that integrates coursework, informal activities, and multicultural supervision for comprehensive student training and that promotes a departmental culture of dialogue and support around equity, diversity, and justice.

  View details for DOI 10.1037/tep0000465

  View details for PubMedID 39081902

• Misdiagnosis, missed diagnosis and delayed diagnosis of lupus: A qualitative study of rheumatologists. Arthritis care & research Bane, S., Falasinnu, T., Rodriguez Espinosa, P., Simard, J. F. 2024

  Abstract

  Diagnostic errors in outpatient settings lead to significant consequences, especially in rare diseases such as systemic lupus erythematosus (SLE). A recent vignette-based experimental study revealed that demographic factors influenced rheumatologists' diagnoses of SLE, raising concerns about potential diagnostic biases. We conducted a qualitative study to contextualize these results to generate insights about diagnostic challenges and biases, and root causes.We conducted 41 semi-structured interviews among U.S. rheumatologists. Transcripts were independently coded by at least two coders using a hybrid deductive-inductive approach and thematic analysis. A team of four researchers reviewed and defined themes collectively, and also resolved any discrepancies.Participants were 66% women and 49% had >10 years of post-fellowship experience. Five major themes were generated, including receiving training through the lens of race or gender, the role of the documented epidemiology of SLE, pattern recognition and test-taking strategies, case vignettes as an imperfect proxy for patient interactions, and varied consequences to patients from diagnostic bias. Participants noted that the consequences of diagnostic bias could include progressed disease from delayed diagnosis, unnecessary and inappropriate treatment due to missed diagnosis or misdiagnosis, and increased cost and harm.This study underscores the unique challenges of diagnosing SLE, with complex factors contributing to diagnosis bias and delays. Interventions during medical education could prevent downstream diagnostic biases. Future research should explore interventions to mitigate diagnostic bias and refine vignettes to better mirror real-world clinical scenarios. Understanding diagnostic bias in SLE is crucial for improving patient outcomes and refining medical training practices.

  View details for DOI 10.1002/acr.25405

  View details for PubMedID 39037219

• Vida Sana y Completa: A randomized controlled trial to examine the effectiveness of diabetes prevention with and without medically supportive groceries among Latina women. Contemporary clinical trials Rosas, L. G., Perez, J. A., Chen, W. T., Xiao, L., Espinosa, P. R., Venditti, E. M., Lewis, M. A., Gardner, C. D., Marti, A., Martinez, E., Murthy, M., Hauser, M. 2024: 107582

  Abstract

  Latina women have a high prevalence of obesity and obesity-related chronic diseases, such as diabetes. Approximately half of Latinas with obesity will also experience food insecurity, or a lack of access to enough food for an active and healthy life. Food insecurity is a barrier for effective prevention and management of obesity-related chronic diseases. The goal of this type 1 hybrid comparative effectiveness trial is to compare a culturally-tailored diabetes prevention intervention with and without medically supportive groceries. Adult Latina women (n = 412) with obesity (Body Mass Index (BMI) of >30 kg/m2) and food insecurity will be 1:1 randomized to the Vida Sana intervention (control), or to Vida Sana y Completa (intervention plus integrated treatment for food insecurity). Vida Sana is an evidence-based culturally tailored, 12-month diabetes prevention intervention that targets at least 5% weight loss and at least 150 min/week of moderate-to-vigorous physical activity. Participants enrolled in Vida Sana y Completa will also receive 12 weekly deliveries of medically supportive groceries. Those in Vida Sana alone will receive information on local food resources. Participants will be assessed at baseline and every 6 months for 24 months. The primary outcome is weight loss at 12 months. Secondary outcomes include weight loss maintenance, diet quality, and quality of life. Barriers and facilitators of implementation will be assessed using mixed methods according to the Consolidated Framework for Implementation Research. This study will provide critical evidence for addressing the combination of obesity and food insecurity in primary care for diabetes prevention. Trial Registration: NCT052111.

  View details for DOI 10.1016/j.cct.2024.107582

  View details for PubMedID 38810932

• Community of Practice of Promotoras de Salud to address health inequities during and beyond the COVID-19 pandemic. Frontiers in public health Rodriguez Espinosa, P., Martinez Mulet, Y., Chen, W. T., Kirk, C., Tran, C., Gonzalez, M., Rosas, L. G. 2023; 11: 1260369

  Abstract

  Using principles of Community-Based Participatory Research, we describe a community of practice for community health workers and promotoras (CHW/Ps) to address COVID-19 inequities in the Latinx community. We offer a concrete example of how programs can engage CHW/Ps as full partners in the research process, and how programs can support CHW/Ps' capacity and workforce development during implementation. We conducted four focus groups with CHW/Ps (n = 31) to understand needs and invited 15 participants to the community of practice to work on issues identified by the group. We examined impact according to number of community members reached, types of outreach activities, surveys, and online views of educational materials. Process evaluation involved two focus groups with seven organizations and a Ripple Effects Mapping session with the CHW/Ps. Our community of practice has built CHW/Ps' capacity via 31 workshop and co-created culturally and linguistically relevant COVID-19 materials that have reached over 40,000 community members and over 3 million people online. The community of practice proved effective in supporting CHW/Ps to address COVID-19 inequities in the Latinx community. Our evaluations demonstrated benefits for community-academic partnerships, for CHW/Ps, and for the community. This model represents an innovative workforce training model to address health inequities and can be applied to other health topics.

  View details for DOI 10.3389/fpubh.2023.1260369

  View details for PubMedID 38026325

  View details for PubMedCentralID PMC10679433

• Engaging diverse midlife and older adults in a multilevel participatory physical activity intervention: evaluating impacts using Ripple Effects Mapping. Translational behavioral medicine Rodriguez Espinosa, P., King, A. C., Blanco-Velazquez, I., Banchoff, A. W., Campero, M. I., Chen, W., Rosas, L. G. 2023

  Abstract

  Multilevel interventions are increasingly recommended to increase physical activity (PA) but can present evaluation challenges. Participatory qualitative evaluation methods can complement standard quantitative methods by identifying participant-centered outcomes and potential mechanisms of individual and community-level change. We assessed the feasibility and utility of Ripple Effects Mapping (REM), a novel qualitative method, within the context of a multi-level cluster randomized trial, Steps for Change. Housing sites with ethnically diverse, low-income aging adults were randomized to a PA behavioral intervention alone or in combination with a citizen science-based intervention (Our Voice) for promoting PA-supportive neighborhoods. Four REM sessions were conducted after 12 months of intervention and involved six housing sites (n = 35 participants) stratified by intervention arm. Interviews (n = 5) were also conducted with housing site staff. Sessions leaders engaged participants in visually mapping intended and unintended outcomes of intervention participation and participant-driven solutions to reported challenges. Maps were analyzed using Excel and Xmind 8 Pro and data were classified according to the socio-ecological model. Eight themes were identified for outcomes, challenges, and solutions. Most themes (6/8) were similar across intervention arms, including increasing PA and PA tracking, improving health outcomes, and increasing social connectedness. Groups (n = 2) engaged in Our Voice additionally identified increased community knowledge and activities directly impacting local environmental change (e.g., pedestrian infrastructure changes). Housing staff interviews revealed additional information to enhance future intervention recruitment, sustainability, and implementation. Such qualitative methodologies can aid in evaluating multi-level, multi-component interventions and inform future intervention optimization, implementation, and dissemination.

  View details for DOI 10.1093/tbm/ibad018

  View details for PubMedID 37011041

• Moderators of a diet and physical activity intervention: who responds best to sequential vs. simultaneous approaches International Journal of Behavioral Medicine Patel, M. L., Rodriguez Espinosa, P., King, A. C. 2023

  View details for DOI 10.1007/s12529-023-10223-9

• Citizen science for health promotion research: Emerging best practices, challenges, and opportunities for advancing health equity Global Handbook of Health Promotion Research, Vol. 3 - Doing Health Promotion Research Chrisinger, B. W., Rodriguez Espinosa, P., Fernes, P. K., Rosas, L. G., Banchoff, A. W., King, A. C. Springer Nature. 2023: 275-287
• Community of Practice of Promotoras de Salud to address health inequities during and beyond the COVID-19 pandemic Frontiers in Public Health Rodriguez Espinosa, P., Martinez Mulet, Y., Chen, W., Kirk, C., Tran, C., Gonzalez, M., Rosas, L. G. 2023; 11

  View details for DOI 10.3389/fpubh.2023.1260369

• Power of Community in “Engage for Equity PLUS” for Strengthening Equity-Centered Patient and Community-Engaged Research in Academic Health Centers Metropolitan Universities Wallerstein, N., Sanchez-Youngman, S., Dickson, E., Adsul, P., Muhammad, M., Akintobi, T. H., Holliday, R., Hoffman, L., Grant, H., Kottke, M., Rosas, L. G., Patel, A., Rodriguez Espinosa, P., et al 2023; 34 (5): 124-136

  View details for DOI 10.18060/27595

• Melanoma awareness and prevention among latinx and non-latinx white adults in urban and rural California: A qualitative exploration. Cancer medicine Mesia, R. J., Espinosa, P. R., Hutchison, H., Safaeinili, N., Finster, L. J., Muralidharan, V., Glenn, B. A., Haile, R. W., Rosas, L. G., Swetter, S. M. 2022

  Abstract

  Melanoma mortality rates in the US are highest among older men, individuals of lower socioeconomic status (SES), and people of color. To better understand these inequities, a qualitative exploratory study was conducted in Northern and Southern California to generate knowledge about barriers and facilitators of awareness, prevention, and early detection of melanoma in lower SES Latinx and non-Latinx White (NLW) individuals living in urban and semi-rural areas.Nineteen focus groups were conducted (N = 176 adult participants), stratified by race/ethnicity (Latinx, low-income NLW), geography (semi-rural, urban), and language (English and Spanish). Inductive and deductive thematic analysis was conducted, and the findings were organized using the socioecological model framework: individual, interpersonal, community, and health system/policy levels.Four socioecological themes describe how key factors affect knowledge, perceived risk, preventive behaviors, and melanoma screening. Individual level findings revealed that many participants were not familiar with melanoma, yet were willing to learn through trusted sources. Having brown or darker skin tone was perceived as being associated with lower risk for skin cancer. Interpersonally, social relationships were important influences for skin cancer prevention practice. However, for several Latinx and semi-rural participants, conversations about melanoma prevention did not occur with family and peers. At the community level, semi-rural participants reported distance or lack of transportation to a clinic as challenges for accessing dermatology care. Healthcare systems barriers included burdens of additional healthcare costs for dermatology visits and obtaining referral.Varying factors influence the awareness levels, beliefs, and behaviors associated with knowledge, prevention, and early detection of melanoma among low-income Latinx and NLW individuals and in semi-rural areas. Results have implications for health education interventions. Navigation strategies that target individuals, families, and health care settings can promote improved prevention and early detection of melanoma in these communities.

  View details for DOI 10.1002/cam4.5457

  View details for PubMedID 36433634

• Inclusionary trials: A review of lessons not learned. Epidemiologic reviews Adkins-Jackson, P. B., Burke, N. J., Espinosa, P. R., Ison, J. M., Goold, S. D., Rosas, L. G., Doubeni, C. A., Participation And Vaccine Hesitancy Working Groups, T. S., Brown, A. F. 2022

  Abstract

  The COVID-19 pandemic revealed weaknesses in the public health infrastructure of the United States, including persistent barriers to engaging marginalized communities towards inclusion in clinical research, including trials. Inclusive participation in clinical trials is crucial for promoting vaccine confidence, public trust, and addressing disparate health outcomes. A long-standing literature describes the value of community-based participatory research (CBPR) in increasing marginalized community participation in research. CBPR emphasizes shared leadership with community members in all phases of the research process including in the planning and implementation, interpretation, and dissemination. Shared leadership between academic and industry with marginalized communities can assist with inclusive participation in vaccine trials and increase public trust in the development of the vaccines and other therapies that are used during public emergencies. Nevertheless, epidemiological and clinical research do not yet have a strong culture of community partnership in the scientific process, which takes time to build and therefore may be difficult to develop and rapidly scale to respond to the pandemic. This article outlines practices that contribute to a lack of inclusive participation and offers steps that trialists and other researchers can take to increase marginalized communities' participation in research. Practices include planning for community engagement during the planning and recruitment phases, having regular dialogues with communities about their priorities, supporting them throughout a study, and navigating complex structural determinants of health. Additionally, we discuss how research institutions can support inclusive practices by reexamining their policies to increase participation in clinical trials and instilling institutional trustworthiness.

  View details for DOI 10.1093/epirev/mxac007

  View details for PubMedID 36124656

• Well-being in Thailand: A Culturally Driven Grounded Inquiry Exploration of a Complex Construct APPLIED RESEARCH IN QUALITY OF LIFE Suavansri, P., Pichayayothin, N., Espinosa, P., Areekit, P., Nilchantuk, C., Jones, T. S., French, J. J., Mam, E., Moore, J. B., Heaney, C. A. 2022

  View details for DOI 10.1007/s11482-022-10067-7

  View details for Web of Science ID 000807267600001

• Found in Translation: Reflections and Lessons for Qualitative Research Collaborations Across Language and Culture INTERNATIONAL JOURNAL OF QUALITATIVE METHODS Rodriguez Espinosa, P., Pichayayothin, N. B., Suavansri, P., French, J. J., Areekit, P., Nilchantuk, C., Jones, T. S., Mam, E., Moore, J. B., Heaney, C. A. 2022; 21

  View details for DOI 10.1177/16094069221101280

  View details for Web of Science ID 000800069800001

• Innovative participatory evaluation methodologies to assess and sustain multilevel impacts of two community-based physical activity programs for women in Colombia. BMC public health Rubio, M. A., Guevara-Aladino, P., Urbano, M., Cabas, S., Mejia-Arbelaez, C., Rodriguez Espinosa, P., Rosas, L. G., King, A. C., Chazdon, S., Sarmiento, O. L. 2022; 22 (1): 771

  Abstract

  BACKGROUND: Community-based physical activity (PA) programs are appealing to women in Latin America and show potential for improving women's health. This study aimed to engage healthy middle-aged women, breast cancer survivors and local stakeholders participating in two publicly funded community-based PA programs in Bogota, Colombia (Recreovia and My Body) to assess and visually map the perceived barriers, facilitators, and outcomes to promote programs' improvement, scaling and sustainability.METHODS: We used two participatory action research methods, the 1) Our Voice citizen science method to capture data and drive local change in built and social environmental facilitators and barriers that influence women's engagement in community-based PA; and 2) Ripple Effects Mapping to visually map the intended and unintended outcomes of PA programs. We used thematic analysis to classify the results at the individual, social, and community levels.RESULTS: The stakeholders engaged in the participatory evaluation included cross-sector actors from the programs (N=6) and program users (total N=34) from the two programs (Recreovia N=16; My Body N=18). Program users were women with a mean age of 55.7years (SD=8.03), 65% lived in low-income neighborhoods. They identified infrastructure as the main feature affecting PA, having both positive (e.g., appropriate facilities) and negative (e.g., poorly built areas for PA) effects. Regarding program improvements, stakeholders advocated for parks' cleaning, safety, and appropriate use. The most highlighted outcomes were the expansion and strengthening of social bonds and the engagement in collective wellbeing, which leveraged some participants' leadership skills for PA promotion strategies in their community. The facilitated dialogue among program users and stakeholders fostered the sustainability and expansion of the community-based PA programs, even during the COVID-19 pandemic.CONCLUSIONS: The implementation of both participatory methodologies provided a multidimensional understanding of the programs' impacts and multisectoral dialogues that fostered efforts to sustain the community-based PA programs.

  View details for DOI 10.1186/s12889-022-13180-2

  View details for PubMedID 35428285

• Addressing racial/ethnic inequities in vaccine hesitancy and uptake: lessons learned from the California alliance against COVID-19. Journal of behavioral medicine AuYoung, M., Rodriguez Espinosa, P., Chen, W., Juturu, P., Young, M. D., Casillas, A., Adkins-Jackson, P., Hopfer, S., Kissam, E., Alo, A. K., Vargas, R. A., Brown, A. F., And the STOP COVID-19 C. A. Communications Working Group,, 1800

  Abstract

  Lack of trust in biomedical research, government, and health care systems, especially among racial/ethnic minorities and under-resourced communities, is a longstanding issue rooted in social injustice. The COVID-19 pandemic has further highlighted existing health and socioeconomic inequities and increased the urgency for solutions to provide access to timely, culturally, and linguistically appropriate evidence-based information about COVID-19; and ultimately to promote vaccine uptake. California's statewide alliance STOP COVID-19 CA (comprising eleven sites), leverages long standing community partnerships to better understand concerns, misinformation, and address racial/ethnic inequities in vaccine hesitancy and uptake. Using data from the California CEAL Communication Working Group, we demonstrate the wide range of strategies, communication methods, languages, and trusted messengers that have been effective in reaching diverse communities across the state. We also showcase challenges and lessons learned, such as the importance of including trusted community partners to share information or provide vaccines. These approaches, rooted in community engagement, are crucial for addressing inequities and responding to future public health emergencies.

  View details for DOI 10.1007/s10865-022-00284-8

  View details for PubMedID 35066696

• Understanding Historical Trauma Among Urban Indigenous Adults at Risk for Diabetes American Indian and Alaska Native Mental Health Research Rodriguez Espinosa, P., Garcia, L. C., Vasquez, J. J., Xiao, L., Stafford, R. S., Krenzel, L. D., Ojeda, A., Rosas, L. G. 2022; 29 (3): 43-70

  View details for DOI 10.5820/aian.2903.2022.43

• An in-depth comparison of well-being among Latinx and non-Latinx White adults: A cautionary tale. Preventive medicine reports Rodriguez Espinosa, P., Patel, M. L., King, A. C., Campero, I., Freeman, M. 2., Garcia, D. M., Winter, S. J., Heaney, C. A. 2021; 24: 101513

  Abstract

  Understanding how to optimize the health and well-being of Latinxs is crucial and will aid in informing actions to address inequities. Latinxs' unique cultural backgrounds and lived experiences could have implications for their well-being, which may differ from other racial/ethnic groups. We compared overall and domain-specific well-being and their socio-demographic correlates among two samples of Latinxs and a sample of non-Latinx Whites. Cross-sectional samples were independently drawn from the Stanford WELL Initiative (n=217 Latinxs, n=943 non-Latinx Whites) and the On the Move Trial (n=238 Latinxs), both recruiting in Northern California. Well-being was assessed using the Stanford WELL scale, a novel multifaceted measure. Propensity score matching and mixed effect regressions were employed to compare well-being between samples. Overall well-being levels did not differ between groups. However, when examining constituent domains of well-being, several differences were found. Both Latinx samples reported experiencing more stress, having worse physical health, and being more religious than did the matched non-Latinx White sample. However, on four other well-being domains, only one of the Latinx samples differed from the non-Latinx White sample. Moreover, the two Latinx samples differed from each other in four out of nine domains examined. When evaluating well-being across racial/ethnic groups, we recommend employing multidimensional measures and multiple samples to promote greater confidence in the conclusions. This approach can better inform future research and the tailoring of public health efforts by furthering our understanding of the nature of group well-being differences. Our methods offer a blueprint for similar studies examining well-being in multi-ethnic groups.

  View details for DOI 10.1016/j.pmedr.2021.101513

  View details for PubMedID 34401222

• Intersection of Health Informatics Tools and Community Engagement in Health-Related Research to Reduce Health Inequities: Scoping Review. Journal of participatory medicine Rajamani, G., Rodriguez Espinosa, P., Rosas, L. G. 2021; 13 (3): e30062

  Abstract

  BACKGROUND: The exponential growth of health information technology has the potential to facilitate community engagement in research. However, little is known about the use of health information technology in community-engaged research, such as which types of health information technology are used, which populations are engaged, and what are the research outcomes.OBJECTIVE: The objectives of this scoping review were to examine studies that used health information technology for community engagement and to assess (1) the types of populations, (2) community engagement strategies, (3) types of health information technology tools, and (4) outcomes of interest.METHODS: We searched PubMed and PCORI Literature Explorer using terms related to health information technology, health informatics, community engagement, and stakeholder involvement. This search process yielded 967 papers for screening. After inclusion and exclusion criteria were applied, a total of 37 papers were analyzed for key themes and for approaches relevant to health information technology and community engagement research.RESULTS: This analysis revealed that the communities engaged were generally underrepresented populations in health-related research, including racial or ethnic minority communities such as Black/African American, American Indian/Alaska Native, Latino ethnicity, and communities from low socioeconomic backgrounds. The studies focused on various age groups, ranging from preschoolers to older adults. The studies were also geographically spread across the United States and the world. Community engagement strategies included collaborative development of health information technology tools and partnerships to promote use (encompassing collaborative development, use of community advisory boards, and focus groups for eliciting information needs) and use of health information technology to engage communities in research (eg, through citizen science). The types of technology varied across studies, with mobile or tablet-based apps being the most common platform. Outcomes measured included eliciting user needs and requirements, assessing health information technology tools and prototypes with participants, measuring knowledge, and advocating for community change.CONCLUSIONS: This study illustrates the current landscape at the intersection of health information technology tools and community-engaged research approaches. It highlights studies in which various community-engaged research approaches were used to design culturally centered health information technology tools, to promote health information technology uptake, or for engagement in health research and advocacy. Our findings can serve as a platform for generating future research upon which to expand the scope of health information technology tools and their use for meaningful stakeholder engagement. Studies that incorporate community context and needs have a greater chance of cocreating culturally centered health information technology tools and better knowledge to promote action and improve health outcomes.

  View details for DOI 10.2196/30062

  View details for PubMedID 34797214

• The Role of Citizen Science in Promoting Health Equity. Annual review of public health Rosas, L. G., Espinosa, P. R., Jimenez, F. M., King, A. C. 2021

  Abstract

  While there are many definitions of citizen science, the term usually refers to the participation of the general public in the scientific process in collaboration with professional scientists. Citizen scientists have been engaged to promote health equity, especially in the areas of environmental contaminant exposures, physical activity, and healthy eating. Citizen scientists commonly come from communities experiencing health inequities and have collected data using a range of strategies and technologies, such as air sensors, water quality kits, and mobile applications. On the basis of our review, and to advance the field of citizen science to address health equity, we recommend (a) expanding the focus on topics important for health equity, (b) increasing the diversity of people serving as citizen scientists, (c) increasing the integration of citizen scientists in additional research phases, (d) continuing to leverage emerging technologies that enable citizen scientists to collect data relevant for health equity, and (e) strengthening the rigor of methods to evaluate impacts on health equity. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  View details for DOI 10.1146/annurev-publhealth-090419-102856

  View details for PubMedID 34724389

• Testing the effectiveness of community-engaged citizen science to promote physical activity, foster healthier neighborhood environments, and advance health equity in vulnerable communities: The steps for change randomized controlled trial design and methods. Contemporary clinical trials King, A. C., Campero, M. I., Garcia, D., Blanco-Velazquez, I., Banchoff, A., Fierros, F., Escobar, M., Cortes, A. L., Sheats, J. L., Hua, J., Chazaro, A., Done, M., Espinosa, P. R., Vuong, D., Ahn, D. K. 2021: 106526

  Abstract

  While low-income midlife and older adults are disproportionately affected by non-communicable diseases that can be alleviated by regular physical activity, few physical activity programs have been developed specifically with their needs in mind. Those programs that are available typically do not address the recognized local environmental factors that can impact physical activity. The specific aim of the Steps for Change cluster-randomized controlled trial is to compare systematically the initial (one-year) and sustained (two-year) multi-level impacts of an evidence-based person-level physical activity intervention (Active Living Every Day [ALED] and age-relevant health education information), versus the ALED program in combination with a novel neighborhood-level citizen science intervention called Our Voice. The study sample (N = 300) consists of insufficiently active adults ages 40 years and over living in or around affordable senior public housing settings. Major study assessments occur at baseline, 12, and 24 months. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of physical activity, assessed via validated self-report measures supported by accelerometry, and physical function and well-being variables. Additional intervention impacts are assessed at 24 months. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. TRIAL REGISTRATION: clinicaltrial.gov Identifier = NCT03041415.

  View details for DOI 10.1016/j.cct.2021.106526

  View details for PubMedID 34371162

• Social support protects against symptoms of anxiety and depression: Key variations in Latinx and non-Latinx White college students Journal of Latinx Psychology Johnson-Esparza, Y., Rodriguez Espinosa, P., Verney, S. P., Boursaw, B., Smith, B. W. 2021

  View details for DOI 10.1037/lat0000184

• The Underutilization of Community-based Participatory Research in Psychology: A Systematic Review. American journal of community psychology Rodriguez Espinosa, P., Verney, S. P. 2020

  Abstract

  Traditional non-participatory research methodologies have struggled to address the needs of multicultural populations in the United States (U.S.). Community-based participatory research (CBPR) is a research paradigm offering a unique opportunity for culturally appropriate research and improving health equity. CBPR is an equitable, strength-based approach involving all stakeholders throughout the research process. We investigate the field of psychology's utilization of CBPR as an approach for working with multicultural populations to collaboratively address relevant and impactful research questions. A total of 1912 CBPR-related articles, from 2004 to 2014, were identified using PsycINFO, PubMed, and CINAHL Complete databases. Of these, approximately 16% (n=311) met our criteria for psychology-related CBPR articles accounting for a negligible amount (<1%) of peer-reviewed publications in mainstream psychological journals during the same time period. Among U.S. psychology-related CBPR articles, 86% focused on multicultural and marginalized populations. Prominent topics of investigation included physical health, mental and behavioral health, and theoretical or methodological articles. Features of publications, including authors' training, types of journals, study populations, and topics under investigation, were explored for all 1912 publications. Findings highlight an opportunity for further utilization of CBPR within psychology, with key implications for health equity. Recommendations for increasing CBPR uptake within the discipline are also offered.

  View details for DOI 10.1002/ajcp.12469

  View details for PubMedID 33165973

• Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching. International journal of environmental research and public health Ahuja, N. J., Nguyen, A., Winter, S. J., Freeman, M., Shi, R., Rodriguez Espinosa, P., Heaney, C. A. 2020; 17 (19)

  Abstract

  The morbidity and mortality experiences of people who are unhoused have been well-described, but much less is known about the overall well-being of these individuals. In this mixed methods study, housed and unhoused participants completed a multi-faceted 10 domain measure of well-being (the Stanford WELL Survey), and a subset of unhoused participants shared their experiences during qualitative interviews. Using propensity score matching, unhoused participants (n = 51) were matched at a ratio of 1:5 with housed participants (n = 255). The mean overall well-being score of the unhoused participants was significantly lower than that of the matched housed participants (B = -5.022, p = 0.013). Additionally, the two groups differed on some of the constituent domains of well-being, with unhoused participants reporting statistically significantly lower mean scores on social connectedness (B = -1.086, p = 0.000), lifestyle and daily practices (B = -1.219, p = 0.000), stress and resilience (B = -0.493, p = 0.023), experience of emotions (B = -0.632, p = 0.009), physical health (B = -0.944, p = 0.0001), and finances (B = -3.099, p = 0.000). The unhoused participants had a statistically significantly higher mean score for spirituality and religiosity (B = 2.401, p = 0.000) than their matched housed counterparts. The qualitative interviews further highlighted spirituality and religion as a coping mechanism for the unhoused. The results of this study highlight both unexpected strengths exhibited by the unhoused individuals and areas of challenge.

  View details for DOI 10.3390/ijerph17197228

  View details for PubMedID 33023231

• Testing the effectiveness of physical activity advice delivered via text messaging vs. human phone advisors in a Latino population: The On The Move randomized controlled trial design and methods. Contemporary clinical trials King, A. C., Campero, I., Sheats, J. L., Castro Sweet, C. M., Espinosa, P. R., Garcia, D., Hauser, M., Done, M., Patel, M. L., Parikh, N. M., Corral, C., Ahn, D. K. 2020: 106084

  Abstract

  Physical inactivity is a key risk factor for a range of chronic diseases and conditions, yet, approximately 50% of U.S. adults fall below recommended levels of regular aerobic physical activity (PA). This is particularly true for ethnic minority populations such as Latino adults for whom few culturally adapted programs have been developed and tested. Text messaging (SMS) represents a convenient and accessible communication channel for delivering targeted PA information and support, but has not been rigorously evaluated against standard telehealth advising programs. The objective of the On The Move randomized controlled trial is to test the effectiveness of a linguistically and culturally targeted SMS PA intervention (SMS PA Advisor) versus two comparison conditions: a) a standard, staff-delivered phone PA intervention (Telephone PA Advisor) and b) an attention-control arm consisting of a culturally targeted SMS intervention to promote a healthy diet (SMS Nutrition Advisor). The study sample (N = 350) consists of generally healthy, insufficiently active Latino adults ages 35 years and older living in five northern California counties. Study assessments occur at baseline, 6, and 12 months, with a subset of participants completing 18-month assessments. The primary outcome is 12-month change in walking, and secondary outcomes include other forms of PA, assessed via validated self-report measures and supported by accelerometry, and physical function and well-being variables. Potential mediators and moderators of intervention success will be explored to better determine which subgroups do best with which type of intervention. Here we present the study design and methods, including recruitment strategies and yields. Trial Registration: clinicaltrial.gov Identifier = NCT02385591.

  View details for DOI 10.1016/j.cct.2020.106084

  View details for PubMedID 32659437

• Employing Participatory Citizen Science Methods to Promote Age-Friendly Environments Worldwide. International journal of environmental research and public health King, A. C., King, D. K., Banchoff, A., Solomonov, S., Ben Natan, O., Hua, J., Gardiner, P., Rosas, L. G., Espinosa, P. R., Winter, S. J., Sheats, J., Salvo, D., Aguilar-Farias, N., Stathi, A., Akira Hino, A., Porter, M. M., Our Voice Global Citizen Science Research Network, O. B. 2020; 17 (5)

  Abstract

  The trajectory of aging is profoundly impacted by the physical and social environmental contexts in which we live. While "top-down" policy activities can have potentially wide impacts on such contexts, they often take time, resources, and political will, and therefore can be less accessible to underserved communities. This article describes a "bottom-up", resident-engaged method to advance local environmental and policy change, called Our Voice, that can complement policy-level strategies for improving the health, function, and well-being of older adults. Using the World Health Organization's age-friendly cities global strategy, we describe the Our Voice citizen science program of research that has specifically targeted older adults as environmental change agents to improve their own health and well-being as well as that of their communities. Results from 14 Our Voice studies that have occurred across five continents demonstrate that older adults can learn to use mobile technology to systematically capture and collectively analyze their own data. They can then successfully build consensus around high-priority issues that can be realistically changed and work effectively with local stakeholders to enact meaningful environmental and policy changes that can help to promote healthy aging. The article ends with recommended next steps for growing the resident-engaged citizen science field to advance the health and welfare of all older adults.

  View details for DOI 10.3390/ijerph17051541

  View details for PubMedID 32121001

• Exploring health and well-being in Taiwan: what we can learn from individuals' narratives. BMC public health Rodriguez Espinosa, P. n., Chen, Y. C., Sun, C. A., You, S. L., Lin, J. T., Chen, K. H., Hsing, A. W., Heaney, C. A. 2020; 20 (1): 159

  Abstract

  Our aim was to explore the concepts of health and well-being from the point of view of the people experiencing them. Most of the efforts to understand these concepts have focused on disease prevention and treatment. Less is known about how individuals achieve health and well-being, and their roles in the pursuit of a good life. We hoped to identify important components of these concepts that may provide new targets and messages to strengthen existing public health programs. An improved understanding of health and well-being - or what it means to be well - can guide interventions that help people lead healthier, more fulfilling lives.Using a grounded qualitative approach drawing from narrative inquiry, we interviewed 24 Taiwanese adults. Thematic inductive coding was employed to explore the nature of health and well-being.Eight constituent domains emerged regarding well-being and health. While the same domains were found for both constructs, important frequency differences were found when participants discussed health versus well-being. Physical health and lifestyle behaviors emerged as key domains for health. Disease-related comments were the most frequently mentioned sub-category within the physical health domain, along with health care use and aging-related changes. For well-being, family and finances emerged as key domains. Family appears to be a cornerstone element of well-being in this sample, with participants often describing their personal well-being as closely tied to - and often indistinguishable from - their family. Other domains included work-life, sense of self, resilience, and religion/spirituality.Health and well-being are complex and multifaceted constructs, with participants discussing their constituent domains in a very interconnected manner. Programs and policies intended to promote health and well-being may benefit from considering these domains as culturally-appropriate leverage points to bring about change. Additionally, while the domains identified in this study are person-centered (i.e., reflecting the personal experiences of participants), the stories that participants offered provided insights into how well-being and health are influenced by structural, societal and cultural factors. Our findings also offer an opportunity for future refinement and rethinking of existing measurement tools surrounding these constructs.

  View details for DOI 10.1186/s12889-020-8201-3

  View details for PubMedID 32013898

• Personal Outcomes in Community-based Participatory Research Partnerships: A Cross-site Mixed Methods Study. American journal of community psychology Rodríguez Espinosa, P. n., Sussman, A. n., Pearson, C. R., Oetzel, J. G., Wallerstein, N. n. 2020

  Abstract

  Community-based participatory research (CBPR) has been embraced by diverse populations to address health inequities within their communities. CBPR has been shown to produce favorable health outcomes, but little is known about personal outcomes (e.g., individual growth and capacities) resulting from the direct involvement in a CBPR partnership. We empirically examine which CBPR partnerships' processes and practices are associated with personal outcomes. We hypothesize that higher levels of collaborative approaches and adherence to CBPR principles and practices would be associated with personal outcomes. Based on a national cross-site CBPR study, Research for Improved Health, we utilized mixed-method data from a comprehensive community-engagement survey (N = 450) and seven in-depth case studies to explore the hypothesized relationships. Our multivariate mixed-effects model revealed the importance of various partnering practices. Relationship dynamics emerged as key predictors including the following: respect in the partnership, voice and influence in decision-making among partners, and stewardship. Qualitative findings highlighted individual, partnership, and community-level impacts, within and beyond the partnership. Our findings have implications for CBPR best practices and highlight the potential role of personal outcomes for partnerships' sustainability, long-term outcomes, and health equity research.

  View details for DOI 10.1002/ajcp.12446

  View details for PubMedID 32706125

• Power Dynamics in Community-Based Participatory Research: A Multiple-Case Study Analysis of Partnering Contexts, Histories, and Practices. Health education & behavior : the official publication of the Society for Public Health Education Wallerstein, N. n., Muhammad, M. n., Sanchez-Youngman, S. n., Rodriguez Espinosa, P. n., Avila, M. n., Baker, E. A., Barnett, S. n., Belone, L. n., Golub, M. n., Lucero, J. n., Mahdi, I. n., Noyes, E. n., Nguyen, T. n., Roubideaux, Y. n., Sigo, R. n., Duran, B. n. 2019; 46 (1_suppl): 19S–32S

  Abstract

  Community-based participatory research has a long-term commitment to principles of equity and justice with decades of research showcasing the added value of power-sharing and participatory involvement of community members for achieving health, community capacity, policy, and social justice outcomes. Missing, however, has been a clear articulation of how power operates within partnership practices and the impact of these practices on outcomes. The National Institutes of Health-funded Research for Improved Health study (2009-2013), having surveyed 200 partnerships, then conducted seven in-depth case studies to better understand which partnership practices can best build from community histories of organizing to address inequities. The diverse case studies represented multiple ethnic-racial and other marginalized populations, health issues, and urban and rural areas and regions. Cross-cutting analyses of the qualitative results focus on how oppressive and emancipatory forms of power operate within partnerships in response to oppressive conditions or emancipatory histories of advocacy within communities. The analysis of power was conducted within each of the four domains of the community-based participatory research conceptual model, starting from how contexts shape partnering processes to impact short-term intervention and research outputs, and contribute to outcomes. Similarities and differences in how partnerships leveraged and addressed their unique contexts and histories are presented, with both structural and relational practices that intentionally addressed power relations. These results demonstrate how community members draw from their resilience and strengths to combat histories of injustice and oppression, using partnership principles and practices toward multilevel outcomes that honor community knowledge and leadership, and seek shared power, policy, and community transformation changes, thereby advancing health equity.

  View details for DOI 10.1177/1090198119852998

  View details for PubMedID 31549557

• Community-Based Participatory Research (CBPR): Towards Equitable Involvement of Community in Psychology Research AMERICAN PSYCHOLOGIST Collins, S. E., Clifasefi, S. L., Stanton, J., Straits, K. E., Gil-Kashiwabara, E., Espinosa, P., Nicasio, A. V., Andrasik, M. P., Hawes, S. M., Miller, K. A., Nelson, L. A., Orfaly, V. E., Duran, B. M., Wallerstein, N., LEAP Advisory Board 2018; 73 (7): 884–98

  Abstract

  Community-based participatory research (CBPR) answers the call for more patient-centered, community-driven research approaches to address growing health disparities. CBPR is a collaborative research approach that equitably involves community members, researchers, and other stakeholders in the research process and recognizes the unique strengths that each bring. The aim of CBPR is to combine knowledge and action to create positive and lasting social change. With its origins in psychology, sociology, and critical pedagogy, CBPR has become a common research approach in the fields of public health, medicine, and nursing. Although it is well aligned with psychology's ethical principles and research aims, it has not been widely implemented in psychology research. The present article introduces CBPR to a general psychology audience while considering the unique aims of and challenges in conducting psychology research. In this article, we define CBPR principles, differentiate it from a more traditional psychology research approach, retrace its historical roots, provide concrete steps for its implementation, discuss its potential benefits, and explore practical and ethical challenges for its integration into psychology research. Finally, we provide a case study of CBPR in psychology to illustrate its key constructs and implementation. In sum, CBPR is a relevant, important, and promising research framework that may guide the implementation of more effective, culturally appropriate, socially just, and sustainable community-based psychology research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  View details for DOI 10.1037/amp0000167

  View details for Web of Science ID 000446233100003

  View details for PubMedID 29355352

  View details for PubMedCentralID PMC6054913

• Partnership agreements: A practical guide to developing data sharing, ownership, and publishing agreements Community-based participatory research for health: Advancing social and health equity Rodriguez Espinosa, P., Richmond, A. New Jersey: John Wiley & Sons, Inc. 2017; 3: 385–393
• Does the Race of the Discrimination Agent in Latinos' Discrimination Experiences Influence Latino Group Identity? SOCIOLOGY OF RACE AND ETHNICITY Sanchez, G. R., Rodriguez Espinosa, P. 2016; 2 (4): 531–47

  View details for DOI 10.1177/2332649215624237

  View details for Web of Science ID 000509761600009

• CULTURALLY SENSITIVE ASSESSMENTS AS A STRENGTH-BASED APPROACH TO WELLNESS IN NATIVE COMMUNITIES: A COMMUNITY-BASED PARTICIPATORY RESEARCH PROJECT AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH Verney, S. P., Avila, M., Rodriguez Espinosa, P., Cholka, C., Benson, J. G., Baloo, A., Pozernick, C. 2016; 23 (3): 271–92

  Abstract

  American Indians and Alaska Natives (AI/ANs) have a unique, traumatic, and alienating history of education in the U.S., which may be directly related to overall health and well-being. Community engagement is critical in well-being research with Native communities, especially when investigating culturally sensitive topics, such as early education experiences. This study investigates the value of a community-based participatory research approach in gaining valuable culturally sensitive information from Native people in a respectful manner. Assessment participation and feedback are analyzed and presented as indicators of Native participant engagement success in a potentially sensitive research project exploring early education experiences.

  View details for Web of Science ID 000392723800014

  View details for PubMedID 27383096