Publications by authors named "Juliana Mejia Trujillo"

Research suggests that forced migration may lead to cultural stress and psychological distress. However, little is known about immigrant parents' pre- and post-migration concerns for their children's welfare. The present study examined the concerns of Venezuelan parents who migrated to the United States versus those who migrated to Colombia, and whether post-migration concerns were related to cultural stressors, mental health, and cultural identity.

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Background: Since 2015, ~ 8 million Venezuelans have fled what was once Latin America's most prosperous nation, with many relocating to nearby Colombia and others migrating to the United States (U.S.).

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Purpose: We present a psychometric evaluation of the Center for Epidemiologic Studies Depression Boston Form (CES-D-B) for use with different Latino subgroups as there is inconsistency regarding its performance across subgroups of Latinos, a large and rapidly growing cultural group in the United States.

Methods: We evaluated the reliability and structural validity of the scores generated by the CES-D-B using four distinct Latino samples residing in US: Mexicans, Venezuelans, Cubans, and "other Latinos" (total N = 1033). To further explore structural validity of CES-D-B scores, we conducted measurement invariance analyses across different countries of origin, gender groups, educational levels, and languages of assessment (English, Spanish).

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Objectives: A growing body of research points to a relationship between exposure to migration-related cultural stress and mental health problems. However, such research is often conducted with the tacit assumption that postmigration experiences are the primary-if not singular-driver of psychological distress. In the present study, we aim to extend the cultural-stress paradigm by examining the influences of both premigration crisis exposure and postmigration cultural stress on depression in a sample of Venezuelan crisis migrants in Colombia.

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Objective: Although prior research has shown that an array of distinct experiences related to crisis migration are associated with mental health, there is a pressing need for a theory-driven, multidimensional measure to assess the broad spectrum of crisis migration experiences. As such, the present study focused on developing and validating the Crisis Migration Experience Scale (CMES) with a sample of Venezuelan migrants in Colombia.

Method: Participants were adolescent (ages 12-17; = 430) and adult migrants from Venezuela (ages 18+; = 569).

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Emerging research provides insights into migration-related cultural stress experiences and mental health among Venezuelan migrants; however, prior studies have not considered the critical distinction between xenophobia and discrimination. To address this gap, we assess the psychometric properties of an abbreviated version of the Perceived Online Racism Scale (PORS) with Venezuelan migrant youth and examine the interplay between online xenophobia, in-person discrimination, and mental health. Survey data were collected from Venezuelan migrant youth ( = 319; ages 13-17, 49.

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Anxiety is the most prevalent mental health disorder among adults worldwide. Given its increased prevalence among migrants due to their marginalized position in the societies where they reside, psychometric evaluations of anxiety measures such as the Generalized Anxiety Disorder-7 (GAD-7) are needed for use with migrants. The present study is the first attempt to compare the structure of GAD-7 scores for (a) different Latino groups in the same country and (b) the same Latino group in two different countries.

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Researchers and practitioners recognise the importance of context when implementing healthcare interventions, but the influence of wider environment is rarely mapped. This paper identifies the country and policy-related factors potentially explaining the country differences in outcomes of an intervention focused on improving detection and management of heavy alcohol use in primary care in Colombia, Mexico and Peru. Qualitative data obtained through interviews, logbooks and document analysis are used to explain quantitative data on number of alcohol screenings and screening providers in each of the countries.

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Article Synopsis
  • The SCALA study found that training primary health care providers increased alcohol screening in Colombia, Mexico, and Peru, but both standard and shorter training sessions yielded similar results.
  • The research used a mixed-methods approach, collecting data from various sources to evaluate the impact of training on providers' alcohol screening practices.
  • Although participation was high, with nearly half of attendees screening for alcohol use, factors like the amount of training received and the provider's profession influenced the likelihood of conducting screenings, rather than satisfaction or perceived utility from the training.
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Background: Alcohol misuse is a serious problem among university students in Colombia as well as in other Latin American countries. Studies show consistently that this population presents the highest rates of alcohol use. Despite such a situation, there is a lack of preventive programs for university students in this region of the world.

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This paper describes the plan for a process evaluation of a quasi-experimental study testing the municipal level scale-up of primary health care-based measurement and brief advice programmes to reduce heavy drinking and comorbid depression in Colombia, Mexico, and Peru. The main aims of the evaluation are to assess the implementation of intervention components; mechanisms of impact that influenced the outcomes; and characteristics of the context that influenced implementation and outcomes. Based on this information, common drivers of successful outcomes will be identified.

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Since 2015, the Venezuelan diaspora has poured forth from the Venezuelan sending context into an array of (mostly) middle-income receiving countries and into the United States (US) as well. For many Venezuelan migrants, post-migration reception has been mixed, and multiple studies suggest that mental health is an important challenge with discrimination and negative context reception contributing to mental health burden in terms of depression, anxiety, and posttraumatic stress. Cross-national research points to important sociodemographic differences between Venezuelan migrants resettled in South American contexts and in the US, and suggests that-on average-migration-related cultural stress is lower and mental health outcomes are better among those resettling in South Florida and elsewhere in the US.

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Article Synopsis
  • The SCALA project aims to improve the identification of alcohol use disorders and depression in primary healthcare settings in Colombia, Mexico, and Peru by implementing effective strategies that have yet to be widely adopted in low- and middle-income countries.
  • The process of developing the intervention involved a four-stage cultural adaptation model, which included gathering information, refining materials with stakeholder feedback, and pilot testing with local trainers.
  • Adaptations continued through real-world implementation, responding to challenges such as the COVID-19 pandemic by transitioning materials for online training delivery.
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Background: During the COVID-19 pandemic, an increase of heavy alcohol use has been reported in several high-income countries. We examined changes in alcohol use during the pandemic among primary health care (PHC) patients in two middle income countries, Colombia and Mexico.

Methods: Data were collected during routine consultations in 34 PHC centres as part of a large-scale implementation study.

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Alcohol measurement in health care settings is an effective intervention for reducing alcohol-related harm. However, in many countries, costs related to alcohol measurement have not yet been transparently assessed, which may hinder its adoption and implementation. Costs of an alcohol measurement programme in three upper-middle-income Latin American countries were assessed via questionnaires and compared, as part of the quasi-experimental SCALA study.

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Article Synopsis
  • Alcohol measurement by healthcare providers is an effective means to reduce patient alcohol consumption but is not commonly practiced.
  • The study assessed the impact of community support in Colombia, Mexico, and Peru on the frequency of alcohol consumption measurement by healthcare providers over five months.
  • Results showed that community support significantly improved both the measurement rates and healthcare providers' confidence in delivering alcohol intervention, highlighting the importance of community involvement in healthcare practices.
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Article Synopsis
  • Brief alcohol advice can effectively prevent and manage alcohol-related health issues, but its implementation in primary healthcare is lacking.
  • To improve this implementation, community actions are proposed, focusing on enhancing the environment for healthcare providers.
  • The article outlines a protocol for these community actions in Colombia, Mexico, and Peru, which includes forming a Community Advisory Board, engaging a project champion, establishing support systems, and launching a communication campaign.
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Article Synopsis
  • Implementation of evidence-based care for heavy drinking and depression is low in global health systems, prompting a study in Latin American primary healthcare to assess various support and training interventions.
  • The study involved 58 healthcare units in Colombia, Mexico, and Peru, comparing usual care to different levels of training and community support for screening and managing depression among heavy drinkers.
  • Results showed high screening rates for depression among heavy drinkers (89.4%), but community support and clinical package intensity did not significantly impact depression activity rates; however, training providers increased screening rates among all consulting patients by 2.7 times.
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Objectives: Millions of Venezuelans have left their country in search of safety and stability in the United States (U.S.) and Colombia, two countries where recent increases in anti-immigrant rhetoric and sentiment have occurred.

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Reducing youth alcohol use is a public health priority that can be addressed by implementing evidence-based preventive interventions (EBPIs) with high fidelity. However, when EBPIs are delivered in a new geographical setting, lack of contextual fit might interfere with expected effects. The purpose of our study was to understand the contextual fit of the family preventive program, Guiding Good Choices (GGC), to inform its future adaptation in Zacatecas, Mexico.

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Screening for unhealthy alcohol use in routine consultations can aid primary health care (PHC) providers in detecting patients with hazardous or harmful consumption and providing them with appropriate care. As part of larger trial testing strategies to improve implementation of alcohol screening in PHC, this study investigated the motivational (role security, therapeutic commitment, self-efficacy) and organizational context (leadership, work culture, resources, monitoring, community engagement) factors that were associated with the proportion of adult patients screened with AUDIT-C by PHC providers in Colombia, Mexico and Peru. Additionally, the study investigated whether the effect of the factors interacted with implementation strategies and the country.

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The growing use of evidence-based preventive interventions for youth substance use in Latin American countries has prompted governments, researchers, and practitioners to ask if communities are ready for implementing these interventions, especially in light of the elevated costs and long-term commitment necessary for successful implementation. This study explores the construct validity of a measure of community readiness for prevention, using confirmatory factor and latent profile analyses of 7 measures theorized to be indicators of community readiness for implementing preventive interventions for youth substance use. Data were obtained from 211 community leaders in 16 communities in Colombia.

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Background: Providing alcohol screening and brief advice (SBA) in primary health care (PHC) can be an effective measure to reduce alcohol consumption. To aid successful implementation in an upper middle-income country context, this study investigates the perceived appropriateness of the programme and the perceived barriers to its implementation in PHC settings in three Latin American countries: Colombia, Mexico and Peru, as part of larger implementation study (SCALA).

Methods: An online survey based on the Tailored Implementation for Chronic Diseases (TICD) implementation framework was disseminated in the three countries to key stakeholders with experience in the topic and/or setting (both health professionals and other roles, for example regional health administrators and national experts).

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Purpose: We aimed to test the effects of providing municipal support and training to primary health care providers compared to both training alone and to care as usual on the proportion of adult patients having their alcohol consumption measured.

Methods: We undertook a quasi-experimental study reporting on a 5-month implementation period in 58 primary health care centres from municipal areas within Bogotá (Colombia), Mexico City (Mexico), and Lima (Peru). Within the municipal areas, units were randomized to four arms: (1) care as usual (control); (2) training alone; (3) training and municipal support, designed specifically for the study, using a less intensive clinical and training package; and (4) training and municipal support, designed specifically for the study, using a more intense clinical and training package.

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