Wei-ting Chen, PhD

All Publications

• Impact of a multicomponent food-as-medicine intervention on behavioral and mental health outcomes for patients with and without food insecurity. Nutrition (Burbank, Los Angeles County, Calif.) Radtke, M. D., Tester, J. M., Xiao, L., Chen, W., Emmert-Aronson, B. O., Markle, E. A., Chen, S., Rosas, L. G. 2025; 134: 112734

  Abstract

  BACKGROUND: Increasingly, food-as-medicine (FAM) programs are being implemented as a strategy for improving the health of patients. However, current policies limit nutrition resources to patients with specific chronic condition diagnoses and do not include food insecurity as a qualifying condition.OBJECTIVE: Explore the impact of Recipe4Health (R4H), a multicomponent FAM intervention, on behavioral and mental health outcomes in patients with and without food insecurity.METHODS: Patients (n = 336) with diet-related chronic conditions and/or food insecurity were referred to R4H, which included 16-weekly produce deliveries and behavioral intervention sessions. Food security status was assessed using the U.S. Department of Agriculture 6-item survey. Outcomes included vegetable/fruit intake, physical activity (PA) and mental health. Within- and between-group pre-post changes were assessed using repeated-measures linear mixed-effects models, adjusting for baseline.RESULTS: The majority of patients had one or more chronic conditions (96%) and identified as food insecure (62%). Patients with food insecurity experienced significant increases in daily servings of vegetables/fruit (+0.38 ± 0.15; P = 0.01) and minutes of moderate-to-vigorous PA per week (+28.94 ± 9.84; P < 0.01). Patients with food security did not experience significant increases in vegetables/fruit (P = 0.09) or PA (P = 0.06). Food-insecure and food-secure patients both experienced significant improvements in loneliness, anxiety, and depressive symptoms from baseline (P < 0.01 for all). Between-group differences were observed only for anxiety, where patients with food security experienced significant improvements in anxious symptoms compared to food-insecure patients (-1.24 [-2.33, -0.14]; P = 0.03).CONCLUSION: Policymakers may consider expanding eligibility criteria to include food insecurity as an independent qualifying condition for FAM.

  View details for DOI 10.1016/j.nut.2025.112734

  View details for PubMedID 40132449

• Implementing Food as Medicine During COVID-19: Produce Prescriptions and Integrative Group Medical Visits in Federally Qualified Health Centers. Global advances in integrative medicine and health Thompson-Lastad, A., Ruvalcaba, D., Chen, W. T., Espinosa, P. R., Chiu, D. T., Xiao, L., Rosas, L. G., Chen, S. 2025; 14: 27536130251316535

  Abstract

  Food as Medicine is a rapidly developing area of health care in the United States, aimed at concurrently addressing nutrition-sensitive chronic conditions and food and nutrition insecurity. Recipe4Health (R4H) is a Food as Medicine program with an integrative health equity focus. It provides prescriptions for locally grown produce ('Food Farmacy') with or without integrative group medical visits, alongside training for clinic staff.To describe the initial implementation of R4H in four Federally Qualified Health Centers in Northern California, using a convergent mixed-methods approach.We used the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) implementation science framework to assess the first two years of R4H (2020-2022). We draw from 40 interviews (26 partner organization staff, 14 patients) and program data on reach and adoption. Qualitative data were analyzed using codebook thematic analysis.Reach: From January 2020 to August 2022, 3255 patients were referred to the program; 1997 of those referred (61%) enrolled in the Food Farmacy only (N = 1681) or Food Farmacy + integrative group medical visits (N = 316). Participating patients included a wide range of ages (mean age 41.4, [SD 20]; 18% < 18 years old) and racial and ethnic backgrounds (3% American Indian or Alaska Native, 6% Asian or Pacific Islander, 19% Black, 57% Hispanic/Latine, 7% white). 69% were female; 43% primarily spoke Spanish. Adoption: 84% of trained clinic staff referred two or more patients to R4H. Implementation: Elements of successful implementation included: (1) support from county government leadership, (2) centralized coordination of the multi-sector partnership, and (3) a flexible approach responsive to organizational and COVID-related shifts. R4H implementation informed statewide Medicaid policy changes. Maintenance: To date, all four clinics continue to participate in R4H.Centralized implementation, training, and administration of Food as Medicine programs can strengthen community health centers' capacities to concurrently address chronic conditions and food insecurity. Multi-sector partnerships can support Food as Medicine program sustainability.

  View details for DOI 10.1177/27536130251316535

  View details for PubMedID 39877693

  View details for PubMedCentralID PMC11773540

• Unpacking scalability in produce prescription: A qualitative implementation science investigation using the Consolidated Framework for Implementation Research. Translational behavioral medicine Parks, C. A., Rodriguez Espinosa, P., Yaroch, A. L., Chen, W. T., Reynolds, M., Rosas, L. G. 2025; 15 (1)

  Abstract

  The purpose of this study was to Produce prescription (PPR) programs aim to improve fruit and vegetable (FV) access and health outcomes by providing FVs and nutrition education to participants with low income. While PPRs show promise in increasing FV intake and reducing food insecurity, more research is needed to understand effective implementation. To determine how PPRs work in different settings, and to describe implementation characteristics. In-depth interviews were conducted with PPR project implementers using a semi-structured guide based on the Consolidated Framework for Implementation Research (CFIR). PPR sites were selected through maximum variation and interviewees at each site were selected using snowball sampling. Interviews were recorded, transcribed, and coded using NVivo software using a deductive codebook, with two researchers coding each interview. Interviewees included 33 individuals across 13 PPR projects. The analysis identified themes across CFIR constructs: (i) project characteristics (e.g. eligibility, nutrition education, adaptations to local context, relative advantage, cost), (ii) characteristics of individuals (e.g. participants, food retailers, healthcare staff, role delineation, networks), (iii) evidence (e.g. economic impact, FV Intake, household food security and health-related outcomes, scope and impact), (iv) implementation climate (e.g. project genesis, alignment with organization values, leadership engagement, geography, technology), and (v) challenges (e.g. COVID-19 impacts, capacity limitations). Interviewees also provided recommendations for resources that would be helpful in their PPR implementation, such as "plug and play" materials to reduce setup burden. This study highlights PPR implementation characteristics, which can elucidate which features may be most effective in particular contexts. There was also an identified need for further investigation into fostering healthcare organization buy-in and engagement.

  View details for DOI 10.1093/tbm/ibaf012

  View details for PubMedID 40372784

• Food as medicine, community as medicine: Mental health effects of a social care intervention. Health services research Thompson-Lastad, A., Chiu, D. T., Ruvalcaba, D., Chen, W. T., Tester, J., Xiao, L., Emmert-Aronson, B. O., Chen, S., Rosas, L. G. 2025: e14431

  Abstract

  To assess mental health related outcomes of Recipe4Health, a multisectoral social care partnership implementing produce prescriptions with or without group medical visits (GMVs).Recipe4Health was implemented at five community health centers from 2020 to 2023. Primary care teams referred patients with food insecurity and/or nutrition-sensitive chronic conditions (e.g., diabetes, depression) to 16 weeks of Food Farmacy (produce prescriptions) with the option of GMV participation. We used a convergent mixed-methods design including survey and interview data.We conducted (1) participant surveys pre- and post-intervention and (2) semi-structured interviews with Recipe4Health participants and partner organization staff. Linear mixed effects models examined changes in mental health and related outcomes. Interviews were analyzed using codebook thematic analysis.Program participants were middle-aged, primarily women, and from diverse racial/ethnic backgrounds (majority Latine and Black). At baseline, moderate or severe depression and/or anxiety symptoms were reported by 77/188 (41%) of Food Farmacy-only participants, and 113/284 (40%) of Food Farmacy +GMV participants. Among Food Farmacy-only participants, post-intervention depression and anxiety symptoms significantly improved only among those who did not have baseline depression/anxiety (PHQ9: -1.7 [95% CI: -2.8, -0.6]; GAD7: -1.8 [95% CI: -2.9, -0.8]). Among Food Farmacy +GMV participants, mental health symptoms improved regardless of baseline mental health; among those with baseline depression/anxiety: PHQ9: -2.4 (95% CI: -3.6, -1.2); GAD7: -0.9 (95% CI: -2.0, 0.1); among those without: PHQ9: -2.2 (95% CI: -3.2, -1.2); GAD7: -2.2 (95% CI: -3.1, -1.2). Improvements in social needs (food insecurity, loneliness) and health-related behaviors (fruit/vegetable intake, physical activity) varied by intervention arm and baseline depression/anxiety symptom level. In interviews, staff and patients endorsed produce prescriptions for improving nutrition and food insecurity, and GMVs for increasing social support.Social care interventions providing vegetables and fruit, with or without group medical visits, may concurrently address mental health symptoms and social needs.

  View details for DOI 10.1111/1475-6773.14431

  View details for PubMedID 39775914

• Community-Based Participatory Research to Address the Disproportionate Burden of Breast Cancer in Black Women. Psycho-oncology Hailu, H., Gay, S., Chen, W., Tuttle, C., Waugh, J., Guillory, R., Williams-Omenka, L., Love, B., Hollis, T., Spinzi, S., Rosas, L. G. 2025; 34 (1): e70073

  Abstract

  OBJECTIVE: Black/African American women with breast cancer have disproportionately higher mortality rates and report experiencing a lower quality of life during survivorship compared to non-Hispanic white women. Despite support for the integration of peer navigation in cancer care and survivorship to address these inequities, Black/African American women often have limited access to culturally tailored peer navigation programs. We aimed to investigate the unique needs and strengths of Black/African American women with breast cancer and survivors to inform the development of a culturally tailored peer navigation program for Black/African American women.METHODS: We developed a community-university partnership based on best practices of community-based participatory research. The partnership conducted storytelling sessions with Black/African American survivors of breast cancer and their caregivers and key informant interviews with community partners and applied thematic analysis.RESULTS: A total of 14 survivors and 4 caretakers took part in storytelling sessions and 6 community partners took part in key informant interviews. Themes from the storytelling sessions included spirituality, social support, information seeking, and relationship with care team. These themes were then incorporated into developing the theoretical basis, structure, and content of the BLACC peer navigation program. The key informant interviews were instrumental in building new partnerships to support the implementation of the peer navigation program.CONCLUSIONS: The community-university partnership successfully identified the unique needs and strengths of Black/African American women who either had breast cancer or were survivors of breast cancer, identified valuable resources, and secured buy-in from community leaders to develop a comprehensive peer navigation program.

  View details for DOI 10.1002/pon.70073

  View details for PubMedID 39865518

• The Effectiveness of Recipe4Health: A Quasi-Experimental Evaluation. American journal of preventive medicine Rosas, L. G., Chen, S., Xiao, L., Baiocchi, M., Ng, E., Emmert-Aronson, B. O., Chen, W. T., Thompson-Lastad, A., Martinez, E., Perez, J., Melendez, E., Markle, E., Radtke, M. D., Tester, J. 2024

  Abstract

  Food as Medicine is increasingly recognized as an important strategy for addressing the related challenges of food insecurity and nutrition-related chronic conditions. Food as Medicine refers to integration of food-based nutrition interventions into healthcare to prevent and treat disease. However, there is limited evidence to understand the effectiveness of Food as Medicine.Recipe4Health, a comprehensive Food as Medicine program, was implemented in 4 Federally Qualified Health Centers in California for patients with food insecurity and/or nutrition-related chronic conditions. Patients were referred by a healthcare provider to a 'Food Farmacy' (16 weekly produce home deliveries) alone or in combination with a 'Behavioral Pharmacy' (16 weekly group visits). A quasi-experimental study with pre/post surveys (4 months) and propensity score matched controls for Electronic Health Record (EHR) outcomes over 12 months was conducted. Participants were 2,643 Recipe4Health patients and 2,643 controls identified from 1/2020 to 12/2022; data were analyzed from 2023-2024.There was a significant increase in produce consumption from baseline to four months (0.41 servings/day [0.11, 0.72], p=0.007) in the Food Farmacy in combination with Behavioral Pharmacy. Compared to controls, there were improvements in non-HDL cholesterol for the Food Farmacy alone (-17.1 mg/dl[-26.9, -7.2], p<0.001) and in combination with Behavioral Pharmacy (-17 mg/dl [-28.3, -5.8], p=0.003) at 12 months. Compared to controls, HbA1c significantly decreased in the Food Farmacy alone at 12 months (-0.37%, 95% CI [-0.65, -0.08]; p=0.01), but not the Food Farmacy with Behavioral Pharmacy.Recipe4Health resulted in improvements in diet and multiple clinical health outcomes, such as non-HDL cholesterol and HbA1c.

  View details for DOI 10.1016/j.amepre.2024.10.020

  View details for PubMedID 39491775

• 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

• 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

• EXAMINING THE IMPACT OF FOOD AS MEDICINE: PRODUCE PRESCRIPTIONS WITH AND WITHOUT A BEHAVIORAL INTERVENTION Rosas, L. G., Tester, J., Chen, S., Xiao, L., Baiocchi, M., Chen, W., Ng, E., Emmert-Aronson, B., Martinez, E., Perez, J. A., Melendez, E., Thompson-Lastad, A., Markle, E. OXFORD UNIV PRESS INC. 2024: S272

  View details for Web of Science ID 001271352800545

• 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

• Addressing food insecurity and chronic conditions in community health centres: protocol of a quasi-experimental evaluation of Recipe4Health. BMJ open Rosas, L. G., Chen, S., Xiao, L., Emmert-Aronson, B. O., Chen, W., Ng, E., Martinez, E., Baiocchi, M., Thompson-Lastad, A., Markle, E. A., Tester, J. 2023; 13 (4): e068585

  Abstract

  INTRODUCTION: Chronic conditions, such as diabetes, obesity, heart disease and depression, are highly prevalent and frequently co-occur with food insecurity in communities served by community health centres in the USA. Community health centres are increasingly implementing 'Food as Medicine' programmes to address the dual challenge of chronic conditions and food insecurity, yet they have been infrequently evaluated.METHODS AND ANALYSIS: The goal of this quasi-experimental study was to evaluate the effectiveness of Recipe4Health, a 'Food as Medicine' programme. Recipe4Health includes two components: (1) a 'Food Farmacy' that includes 16 weekly deliveries of produce and (2) a 'Behavioural Pharmacy' which is a group medical visit. We will use mixed models to compare pre/post changes among participants who receive the Food Farmacy alone (n=250) and those who receive the Food Farmacy and Behavioural Pharmacy (n=140). The primary outcome, fruit and vegetable consumption, and secondary outcomes (eg, food security status, physical activity, depressive symptoms) will be collected via survey. We will also use electronic health record (EHR) data on laboratory values, prescriptions and healthcare usage. Propensity score matching will be used to compare Recipe4Health participants to a control group of patients in clinics where Recipe4Health has not been implemented for EHR-derived outcomes. Data from surveys, EHR, group visit attendance and produce delivery is linked with a common identifier (medical record number) and then deidentified for analysis with use of an assigned unique study ID. This study will provide important preliminary evidence on the effectiveness of primary care-based strategies to address food insecurity and chronic conditions.ETHICS AND DISSEMINATION: This study was approved by the Stanford University Institutional Review Board (reference protocol ID 57239). Appropriate study result dissemination will be determined in partnership with the Community Advisory Board.

  View details for DOI 10.1136/bmjopen-2022-068585

  View details for PubMedID 37024257

• 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

• A QUALITATIVE EXPLORATION OF THE SCALABILITY OF PRODUCE PRESCRIPTION PROGRAMS USING THE CONSOLIDATED FRAMEWORK FOR IMPLEMENTATION RESEARCH (CFIR) Parks, C. A., Espinosa, P., Thompson-Lastad, A., Chen, W., Martinez, E., Reynolds, M., Yaroch, A. L., Rosas, L. G. OXFORD UNIV PRESS INC. 2023: S117

  View details for Web of Science ID 001042977900231

• PARTNERING WITH LATINX COMMUNITY HEALTH WORKERS TO PROMOTE HEALTH EQUITY DURING AND BEYOND THE COVID-19 PANDEMIC Espinosa, P., Accion, P., Mulet, Y., Chen, W., Rosas, L. G. OXFORD UNIV PRESS INC. 2023: S110

  View details for Web of Science ID 001042977900218

• COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms. Frontiers in public health Liu, Y. E., LeBoa, C., Rodriguez, M., Sherif, B., Trinidad, C., Del Rosario, M., Allen, S., Clifford, C., Redding, J., Chen, W. T., Rosas, L. G., Morales, C., Chyorny, A., Andrews, J. R. 2022; 10: 854343

  Abstract

  Carceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities.Between July 8, 2020 and April 30, 2021, we performed SARS-CoV-2 rapid antibody testing and administered a questionnaire among residents and staff of four Northern California jails. We utilized multivariable logistic regression, adjusting for demographic and carceral characteristics, to analyze factors associated with prior infection, including perceived likelihood of prior infection and access to new masks. We additionally assessed the implementation of, perceptions toward, and impacts of COVID-19 policies in practice. We engaged stakeholder representatives, including incarcerated individuals, to guide study design, procedures, and results interpretation.We enrolled 788 jail residents and 380 jail staff. Nearly half of residents and two-thirds of staff who were antibody-positive had not previously tested positive for COVID-19. Among residents without a prior COVID-19 diagnosis, antibody positivity was significantly associated with perceived likelihood of prior infection (adjusted OR = 8.9; 95% CI, 3.6-22.0). Residents who had flu-like illness in jail cited inadequate responses to reported illness and deterrents to symptom reporting, including fears of medical isolation and perceptions of medical neglect. Residents also disclosed deficient access to face masks, which was associated with antibody positivity (adjusted OR = 13.8, 95% CI, 1.8-107.0). Worsened mental health was pervasive among residents, attributed not only to fear of COVID-19 and unsanitary jail conditions but also to intensified isolation and deprivation due to pandemic restrictions on in-person visitation, programs, and recreation time.Carceral settings present significant challenges to maintaining infection control and human rights. Custody officials should work diligently to transform the conditions of medical isolation, which could mitigate deterrents to symptom reporting. Furthermore, they should minimize use of restrictive measures like lockdowns and suspension of visitation that exacerbate the mental health harms of incarceration. Instead, custody officials should ensure comprehensive implementation of other preventive strategies like masking, testing, and vaccination, in conjunction with multisector efforts to advance decarceration.

  View details for DOI 10.3389/fpubh.2022.854343

  View details for PubMedID 35774562

  View details for PubMedCentralID PMC9237366

• ADDRESSING COVID-19 INEQUITIES IN THE LATINX COMMUNITY: A COMMUNITY OF PRACTICE MODEL Espinosa, P., Chen, W., Mulet, Y., Rosas, L. OXFORD UNIV PRESS INC. 2022: S106

  View details for Web of Science ID 000788118600230

• RECIPE4HEALTH: PRIMARY CARE-BASED APPROACHES FOR ADDRESSING FOOD INSECURITY AND CHRONIC DISEASE Rosas, L., Chen, S., Emmert-Aaronson, B., Chen, W., Thompson-Lastad, A., Sherman, S., Ben-Moshe, K., Chen, X., Xiao, L., Espinosa, P., Martinez, E., Tester, J. OXFORD UNIV PRESS INC. 2022: S78

  View details for Web of Science ID 000788118600168

• BUILDING AND SUPPORTING A STATEWIDE COALITION ACROSS SITES AND DISCIPLINES FOR EMERGENCY PUBLIC HEALTH RESPONSE AuYoung, M., Espinosa, P., Chen, W., Juturu, P., Young, M., Casillas, A., Adkins-Jackson, P., Hopfer, S., Kissam, E., Kawaiopua, A., Vargas, R., Brown, A. OXFORD UNIV PRESS INC. 2022: S242

  View details for Web of Science ID 000788118600510

• 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

• Corrigendum: COVID-19 preventive measures in Northern California jails: Perceived deficiencies, barriers, and unintended harms. Frontiers in public health Liu, Y. E., LeBoa, C., Rodriguez, M., Sherif, B., Trinidad, C., Del Rosario, M., Allen, S., Clifford, C., Redding, J., Chen, W., Rosas, L. G., Morales, C., Chyorny, A., Andrews, J. R. 2022; 10: 1002199

  Abstract

  [This corrects the article DOI: 10.3389/fpubh.2022.854343.].

  View details for DOI 10.3389/fpubh.2022.1002199

  View details for PubMedID 36052012

• ENGAGING ETHNICALLY DIVERSE MID-LIFE AND OLDER ADULTS IN A MULTILEVEL PARTICIPATORY PHYSICAL ACTIVITY INTERVENTION: EVALUATING IMPACTS USING RIPPLE EFFECTS MAPPING Rosas, L., Espinosa, P., Campero, M. I., Blanco-Velazquez, I., Chen, W., King, A. C. OXFORD UNIV PRESS INC. 2021: S569

  View details for Web of Science ID 000648922701351

• The Impact of the first COVID-19 shelter-in-place announcement on social distancing, difficulty in daily activities, and levels of concern in the San Francisco Bay Area: A cross-sectional social media survey. PloS one Elser, H. n., Kiang, M. V., John, E. M., Simard, J. F., Bondy, M. n., Nelson, L. M., Chen, W. T., Linos, E. n. 2021; 16 (1): e0244819

  Abstract

  The U.S. has experienced an unprecedented number of orders to shelter in place throughout the ongoing COVID-19 pandemic. We aimed to ascertain whether social distancing; difficulty with daily activities; and levels of concern regarding COVID-19 changed after the March 16, 2020 announcement of the nation's first shelter-in-place orders (SIPO) among individuals living in the seven affected counties in the San Francisco Bay Area.We conducted an online, cross-sectional social media survey from March 14 -April 1, 2020. We measured changes in social distancing behavior; experienced difficulties with daily activities (i.e., access to healthcare, childcare, obtaining essential food and medications); and level of concern regarding COVID-19 after the March 16 shelter-in-place announcement in the San Francisco Bay Area versus elsewhere in the U.S.In this non-representative sample, the percentage of respondents social distancing all of the time increased following the shelter-in-place announcement in the Bay Area (9.2%, 95% CI: 6.6, 11.9) and elsewhere in the U.S. (3.4%, 95% CI: 2.0, 5.0). Respondents also reported increased difficulty obtaining hand sanitizer, medications, and in particular respondents reported increased difficulty obtaining food in the Bay Area (13.3%, 95% CI: 10.4, 16.3) and elsewhere (8.2%, 95% CI: 6.6, 9.7). We found limited evidence that level of concern regarding the COVID-19 crisis changed following the announcement.This study characterizes early changes in attitudes, behaviors, and difficulties. As states and localities implement, rollback, and reinstate shelter-in-place orders, ongoing efforts to more fully examine the social, economic, and health impacts of COVID-19, especially among vulnerable populations, are urgently needed.

  View details for DOI 10.1371/journal.pone.0244819

  View details for PubMedID 33444363

• Participants' Experiences of the 2018-2019 Government Shutdown and Subsequent Supplemental Nutrition Assistance Program (SNAP) Benefit Disruption Can Inform Future Policy. Nutrients Gosliner, W., Chen, W., Johnson, C., Esparza, E. M., Price, N., Hecht, K., Ritchie, L. 2020; 12 (6)

  Abstract

  The federal government shutdown from 22 December 2018 to 25 January 2019 created an unprecedented disruption in Supplemental Nutrition Assistance Program (SNAP) benefits. We conducted a cross-sectional qualitative study to begin to capture how the disruption affected food security and wellbeing among a small sample of California SNAP participants. We collected data from 26 low-income adults in four focus groups in four diverse California counties. We found that participants routinely struggle to secure an adequate and healthy diet in the context of high costs of living, the shutdown and benefit disruption added to participants' stress and uncertainty and exacerbated food insecurity, and it diminished some participants' faith in government. Participants reported that, while having additional benefits in January felt like a relief from typical end-of-month deprivation, the subsequent extended gap between benefit distributions and a lack of clarity about future benefits caused cascading effects as participants later had to divert money from other expenses to buy food and faced added uncertainty about future economic stability. Additionally, the shutdown highlighted challenges related to the availability, timing, and tone of communications between participants and SNAP agencies. Participants recommended that SNAP adjust benefit and eligibility levels to better address costs of living, improve customer service, and avoid future disruptions.

  View details for DOI 10.3390/nu12061867

  View details for PubMedID 32585839

• Implications of the COVID-19 San Francisco Bay Area Shelter-in-Place Announcement: A Cross-Sectional Social Media Survey. medRxiv : the preprint server for health sciences Elser, H. n., Kiang, M. V., John, E. M., Simard, J. F., Bondy, M. n., Nelson, L. M., Chen, W. T., Linos, E. n. 2020

  Abstract

  The U.S. has experienced an unprecedented number of shelter-in-place orders throughout the COVID-19 pandemic. There is limited empirical research that examines the impact of these orders. We aimed to rapidly ascertain whether social distancing; difficulty with daily activities (obtaining food, essential medications and childcare); and levels of concern regarding COVID-19 changed after the March 16, 2020 announcement of shelter-in-place orders for seven counties in the San Francisco Bay Area.We conducted an online, cross-sectional social media survey from March 14 - April 1, 2020. We measured changes in social distancing behavior; experienced difficulties with daily activities (i.e., access to healthcare, childcare, obtaining essential food and medications); and level of concern regarding COVID-19 after the March 16 shelter-in-place announcement in the San Francisco Bay Area and elsewhere in the U.S.The percentage of respondents social distancing all of the time increased following the shelter-in-place announcement in the Bay Area (9.2%, 95% CI: 6.6, 11.9) and elsewhere in the U.S. (3.4%, 95% CI: 2.0, 5.0). Respondents also reported increased difficulty with obtaining food, hand sanitizer, and medications, particularly with obtaining food for both respondents from the Bay Area (13.3%, 95% CI: 10.4, 16.3) and elsewhere (8.2%, 95% CI: 6.6, 9.7). We found limited evidence that level of concern regarding the COVID-19 crisis changed following the shelter-in-place announcement.These results capture early changes in attitudes, behaviors, and difficulties. Further research that specifically examines social, economic, and health impacts of COVID-19, especially among vulnerable populations, is urgently needed. =.

  View details for DOI 10.1101/2020.06.29.20143156

  View details for PubMedID 32637974

  View details for PubMedCentralID PMC7340200

• From "Junk Food" to "Treats" HOW POVERTY SHAPES FAMILY FOOD PRACTICES FOOD CULTURE & SOCIETY Chen, W. 2016; 19 (1): 151-170

  View details for DOI 10.1080/15528014.2016.1145008

  View details for Web of Science ID 000372719200008