Impacts of COVID-19 shelter in place across key life domains among immigrant farmworker Latina mothers and young adults.

Objective: Individuals and families from racial and ethnic groups experience social and economic disadvantage making them vulnerable to the disproportionate impact of the COVID-19 pandemic. This study sought to capture the impacts of Shelter in Place (SIP) across key life domains including family life, education, work, mental health, and coping strategies among a sample of Mexican-origin mothers who were currently engaged in agricultural work, or whose spouses were engaged in agricultural work, and young adults who had a parent working in agriculture.

Method: During the summer of 2020, while California was under SIP orders, we conducted three virtual focus groups using Zoom(r).

Risks of Intimate Partner Violence for Women Living with HIV Receiving Cash Transfers: A Qualitative Study in Shinyanga, Tanzania.

Cash transfers are increasingly used to motivate adherence to HIV care. However, evidence on cash transfers and intimate partner violence (IPV) is mixed and little is known about their safety for women living with HIV. We conducted in-depth interviews with women living with HIV who participated in a randomized trial providing 6 months of cash transfers (~$4.

Enacting competition, capacity, and collaboration: performing neoliberalism in the U.S. in the era of evidence-based interventions.

Funders increasingly encourage social and health service organizations to strengthen their impact on public health through the implementation of evidence-based interventions (EBIs). Local governments in the U.S.

Don't change who we are but give us a chance: confronting the potential of community health worker certification for workforce recognition and exclusion.

Background: For community health workers (CHWs) and promotores de salud (CHWs who primarily serve Latinx communities and are grounded in a social, rather than a clinical model of care), the process of certification highlights the tension between developing a certified workforce with formal requirements (i.e., certified CHWs) and valuing CHWs, without formal requirements, based on their roles, knowledge, and being part of the communities where they live and work (i.

Advancing health equity through a theoretically critical implementation science.

While implementation science is driven by theory, most implementation science theories, models, and frameworks (TMF) do not address issues of power, inequality, and reflexivity that are pivotal to achieving health equity. Theories used in anthropology address these issues effectively and could complement prevailing implementation science theories and constructs. We propose three broad areas of theory that complement and extend existing TMF in implementation science to advance health equity.

Barriers to Integrated Medication-Assisted Treatment for Rural Patients With Co-occurring Disorders: The Gap in Managing Addiction.

Objective: Guidelines for treatment of opioid use disorder stipulate for mental health assessment and the option for treatment alongside medication for opioid use disorder (MOUD). Yet efforts to expand MOUD treatment capacity have focused on expanding the workforce of buprenorphine providers. This article aims to describe the processes facilitating and impeding integrated care for rural patients with co-occurring opioid use disorder and mental health conditions.

System-level factors shaping the implementation of "hub and spoke" systems to expand MOUD in rural areas.

Hub and spoke systems (HSS) are increasingly promoted as a systems-level intervention to expand access to medication for opioid use disorders (MOUD), particularly in rural areas with limited treatment options. The HSS model consists of sub-systems in which "hubs" deliver specialized expertise to a regional network of office-based opioid treatment (OBOT) providers in "spokes," who together create a continuum of acute and chronic care. Yet, little is known about system-level factors (e.

Rural Perspectives Challenging Pharmacotherapy.

Depression pharmacotherapy is the predominant treatment available in the rural United States, yet little is known about the broader contextual factors that rural consumers and providers identify as shaping pharmacotherapy use. Thematic analysis was employed to identify emergent themes from interviews and focus groups about pharmacotherapy adherence, effectiveness, and treatment decisions conducted with Appalachian Kentucky women with depression (N = 37) and diverse healthcare providers who care for this population (N = 21). Pharmacotherapy was seen as inadequate to treat depression in the context of extensive socioeconomic burdens and other health comorbidities.

The developmental support hypothesis: adaptive plasticity in neural development in response to cues of social support.

Across mammals, cues of developmental support, such as touching, licking or attentiveness, stimulate neural development, behavioural exploration and even overall body growth. Why should such fitness-related traits be so sensitive to developmental conditions? Here, we review what we term the 'developmental support hypothesis', a potential adaptive explanation of this plasticity. Neural development can be a costly process, in terms of time, energy and exposure.

Understanding Open Defecation in the Age of : Agency, Accountability, and Anger in Rural Bihar.

Swachh Bharat Abhiyan, India's flagship sanitation intervention, set out to end open defecation by October 2019. While the program improved toilet coverage nationally, large regional disparities in construction and use remain. Our study used ethnographic methods to explore perspectives on open defecation and latrine use, and the socio-economic and political reasons for these perspectives, in rural Bihar.

Stakeholder perspectives on transition planning, implementation, and outcomes for students with autism spectrum disorder.

Little is known about factors impacting poor post-school outcomes for transition-age students with autism spectrum disorder. Guided by an implementation science framework that takes into account the multiple factors that influence transition outcomes, we sought to better understand the interdependent impacts of policy, organizational, provider, and individual factors that shape the transition planning process in schools, and the subsequent process through which transition plans are implemented as youth with autism spectrum disorder access services and gain employment after school. We conducted focus groups with individuals with autism spectrum disorder, parents, classroom teachers, school administrators, adult service providers, and state policymakers (10 groups,  = 40).

Rural women's first-person perspectives on the role of mental health in substance use.

Introduction: Some evidence suggests that co-occurring conditions may be more prevalent among rural populations. Rural women face limited behavioral health care, social barriers, and structural vulnerability that heighten their risk for co-occurring conditions. This qualitative study examines the first-person narratives of rural women to identify their perspectives on the co-occurrence of substance use and mental health symptoms.

The importance of shared language in rural behavioral health interventions: An exploratory linguistic analysis.

A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. Study findings indicated that in the context of delivering the intervention, use of a shared language, language pattern congruence, and communication styles can greatly augment the intent of the approach with vulnerable populations.

Building interventions when distress is under debate: a case study from Appalachia.

Scholarship on idioms of distress has emphasized cross-cultural variation, but devoted less attention to intra-cultural variation-specifically, how the legitimacy of distress may vary according to the context in which it is expressed, social position, and interaction with medical categories of distress. This variation can pose challenges for interventionists seeking to establish culturally acceptable ways of identifying distress and creating relevant resources for recovery. We describe efforts over three years (2014-2016) to identify and adapt a culturally appropriate evidence-based intervention for depressed rural Appalachian women.

Rural Adult Perspectives on Impact of Hearing Loss and Barriers to Care.

Adult hearing loss has a significant impact on communication and quality of life. In spite of effective methods of diagnosis and treatment, many rural adults face significant barriers and delays in accessing care. The purpose of this study is to characterize the impact of hearing loss and the barriers for hearing healthcare in rural adults.

Depression in a depressed area: Deservingness, mental illness, and treatment in the contemporary rural U.S.

People with mental illness face public scrutiny that provokes questions about their ability to cope, membership in society, and entitlement to state support. Less attention has been focused on how such scrutiny occurs at the community level, particularly when shared economic distress has generated a high burden of poor mental health. We employ theorizations of health-related deservingness to examine the local moral economies through which residents of an economically depressed area question who deserves to be depressed, how those with depression should cope, and what forms of treatment are sincere.

Adapting COMPASS for youth with ASD to improve transition outcomes using implementation science.

Implementation science provides guidance on existing evidence based practices (EBPs) by incorporating implementation concerns from the start. Focus-group methodology was used to understand barriers and facilitators of transition planning and implementation for students with autism spectrum disorder (ASD) who often experience disparate postsecondary outcomes compared to peers. Results were used to modify an evidence-based consultation intervention originally applied to young students with ASD, called the Collaborative Model for Promoting Competence and Success (COMPASS; Ruble, Dalrymple, & McGrew, 2012).

Randomized Control Trial of COMPASS for Improving Transition Outcomes of Students with Autism Spectrum Disorder.

The postsecondary outcomes of individuals with autism spectrum disorder (ASD) are significantly worse than peers with other disabilities. One problem is the lack of empirically-supported transition planning interventions to guide services and help produce better outcomes. We applied an implementation science approach to adapt and modify an evidence-based consultation intervention originally tested with young children called the Collaborative Model for Promoting Competence and Success (COMPASS; Ruble et al.

Are evidence-based, community-engaged energy balance interventions enough for extremely vulnerable populations?

Well-documented associations between lifestyle behaviors and disease outcomes necessitate evidence-based health promotion interventions. To enhance potential efficacy and effectiveness, interventionists increasingly respond to community priorities, employ comprehensive theoretical frameworks, invest heavily to ensure cultural fit, implement evidence-based programming, and deploy research gold standards. We describe a project that followed all of these recommended strategies, but did not achieve desired outcomes.

Negotiating the Interpretation of Depression Shared Among Kin.

Kinship processes contribute to the experience and interpretation of depression-generating empathy as well as silencing. We explore intersubjective experiences of depression among kin with the aim of understanding how depression can reveal kinship expectations and evolving concepts of distress. In interviews with 28 low-income rural Appalachian women about their depression, participants articulated depression as a social process that neither starts nor ends in themselves.

What Role Can Community Health Workers Play in Connecting Rural Women with Depression to the "De Facto" Mental Health Care System?

The prevalence of depression among rural women is nearly twice the national average, yet limited mental health services and extensive social barriers restrict access to needed treatment. We conducted key informant interviews with community health workers (CHWs) and diverse health care professionals who provide care to Appalachian women with depression to better understand the potential roles that CHWs may play to improve women's treatment engagement. In the gap created by service disparities and social barriers, CHWs can offer a substantial contribution through improving recognition of depression; deepening rural women's engagement within existing services; and offering sustained, culturally appropriate support.

Mental health treatment seeking patterns and preferences of Appalachian women with depression.

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia-a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants' perceptions of depression and treatment seeking.