Anna Zamora-Kapoor

Challenges in conducting mHealth research with underserved populations: Lessons learned:

Previous studies have recognized the potential of mobile technology to improve health outcomes among underserved populations, but the challenges in conducting research into the use of mobile technology to improve health (mHealth) are not well understood. This manuscript identifies some of the most important challenges in conducting mHealth research with a sample of urban American Indian and Alaska Native mothers. We examined these challenges through an existing partnership with a community health agency. We conducted community consultations and a process monitoring phase for a pilot trial aimed at measuring the effect of a brief counselling session on participants’ adherence to use of a mobile app. We identify generalizable challenges in administrative, technological, and logistical domains that will be useful foreknowledge to other investigators planning to conduct mHealth research with underserved populations.

The Effects of the Crisis: Why Southern Europe?

The late 2000s economic crisis has transformed Europe. Scholars and politicians concur with the longstanding economic, political, and social consequences of this crisis. The financial meltdown shrunk traditionally large economies and left a few of them at the verge of bankruptcy. The South of Europe, in particular, is one of the regions in the world where the consequences of the crisis have become most salient. Governmental efforts to face the crisis have generated deep institutional changes and historical turning points for the welfare state, democratic representation, labor relations, and social protests. The economic crisis has shifted the structure of the political field, allowing the rise of new political actors and novel alignments on both new and old political issues. In the midst of these transformations, we have attempted to compile a collection of scholarly analyses that seek to examine the most important institutional and social shifts taking place today in Southern Europe. Greece, Italy, Portugal, and Spain have experienced two parallel crises of different types—an economic crisis and a political one. These two crises cannot be examined in isolation: the institutional response to face the former has provoked the latter. These economic and political crises are both national and transnational. Since 2009, the European Union has encouraged Southern European nations to implement a political agenda of austerity, in exchange for financial assistance. These policies have reduced the state’s participation in the economy and, in turn, increased unemployment rates. Moreover, a monetary policy aimed at maintaining a high euro–U.S. dollar parity has been especially detrimental to the primary and secondary sectors of Southern Europe. Low economic activity, high unemployment, low consumption, and the declining role of the state have generated a new economic scenario with unpredictable consequences. Increasing inequality, rising social unrest, weakening public institutions, and growing political disaffection question the extent to which Southern European democracies can

The Role of Language Use in Reports of Musculoskeletal Pain Among Hispanic and Non-Hispanic White Adolescents

Objective:This study examined the role of English language use in the reported frequency of musculoskeletal pain among Hispanic and non-Hispanic White youth. Method: This is a secondary data analysis using a cross-sectional sample of 12,189 Hispanic and non-Hispanic White adolescents recruited for the National Longitudinal Study of Adolescent to Adult Health. Respondents were classified into three groups: (a) English-speaking non-Hispanic Whites, (b) English-speaking Hispanics, and (c) Spanish-speaking Hispanics. Results: After controlling for body mass index and demographic, socioeconomic, and behavioral variables, Spanish-speaking Hispanics reported the least frequent musculoskeletal pain (OR = 0.415, 95% CI [0.361, 0.477]; p < .001), followed by English-speaking Hispanics (OR = 0.773, 95% CI [0.690, 0.865]; p < .001). Conclusion: The experience of musculoskeletal pain is a physiological as well as a cultural phenomenon. Implications for Practice: Health care providers should consider the role of language use in reports of pain in Hispanic and non-Hispanic White adolescents.

Suicidal ideation in American Indian/Alaska Native and White adolescents: The role of social isolation, exposure to suicide, and overweight.

Social isolation, exposure to suicide, and overweight increase suicidal ideation in adolescents, but no study to date has examined their relative significance in American Indian and Alaska Native (AI/AN) youth. Generalized estimating equations and path analyses were used to measure the significance and mediation of these variables in the suicidal ideation of 721 AI/ANs and 12,107 White adolescents. Social isolation, exposure to suicide, and overweight were risk factors for suicidal ideation in both races, and the associations among the variables of interest and suicidal ideation varied by race. Interventionists need to consider race in the prevention of suicidal ideation in AI/AN and White youth.

Risk factors for pre-diabetes and diabetes in adolescence and their variability by race and ethnicity

Adolescent risk factors for pre-diabetes and diabetes in young adulthood were examined in three minority groups and compared to those in non-Hispanic Whites. Retrospective cohort study with data on 8337 adolescent respondents from Add Health (1994-2008). Participants included 5131 non-Hispanic Whites, 1651 non-Hispanic Blacks, 1223 Hispanics, and 332 American Indians/Alaska Natives. Diabetes was defined as: hemoglobin A1C ≥ 6.5%, glucose > 125 mg/dl, self-reported diabetes, or self-reported diabetes medication use, in Wave 4 data. Pre-diabetes was defined as hemoglobin A1C ≥ 5.7%. Relative risk regression models were used to evaluate the association between risk factors and risk of diabetes and pre-diabetes, controlling for body mass index, sedentary and physical activity habits, fast food consumption, and parental education, parental diabetes status, and financial stability. 484 participants developed diabetes; 2878 developed pre-diabetes between 1994 and 2008. Pre-diabetes and diabetes were more prevalent in non-Hispanic Blacks (55% and 12%, respectively) than in American Indians/Alaska Natives (43% and 11%), Hispanics (37% and 6%), and non-Hispanic Whites (27% and 3%). In all races, higher body mass index and parental diabetes were associated with higher risk of pre-diabetes and diabetes, while female sex was associated with lower risk of pre-diabetes. Efforts to reduce the risk of pre-diabetes and diabetes in adolescents should emphasize parental diabetes and BMI in all races, independent of physical activity, sedentary behaviors, or fast food consumption. Future interventions might be interested in targeting households, rather than individuals, to prevent pre-diabetes and diabetes in adolescents and young adults.

Race and ethnicity in context: international migration, political mobilization, and the welfare state

ABSTRACT This manuscript reviews the literature on race and ethnicity in the political context. It discusses the most important scholarship on international migration, political mobilization, and the welfare state to date, to identify current gaps and emerging lines of inquiry. Future studies are needed to better understand the mobilization of immigrants by political parties, the role of local politics for a national electoral mobilization, and the relationship between local and national political areas for policy development.