María Luisa Zúñiga

Background: Noise-induced hearing loss is permanent yet preventable. Agricultural workers routinely experience hazardous noise exposure, and hearing protection use remains low. Existing interventions emphasize individual knowledge and intentions and have rarely been tested using objective outcome measures. This protocol describes the adaptation and pilot evaluation of an individual-level component of a multilevel noise-induced hearing loss prevention intervention for farmworkers. This pilot focuses on refining and testing a brief digitally delivered novella. Objective: The objectives of this study are to (1) culturally and linguistically adapt a digitally delivered, Spanish-language entertainment-education hearing protection training (digital novella with facilitated discussion and coached earplug fitting) for farmworkers in the Southwest United States, using community-based participatory research; and (2) pilot test the adapted intervention to assess acceptability, feasibility, and appropriateness and to estimate preliminary effect sizes for changes in objective hearing protector fit. Methods: This is a single-arm, pre-post, Hybrid Type 1 effectiveness-implementation pilot study. Phase 1 includes formative interviews with farmworkers and farm supervisors (n=30), informed by the Consolidated Framework for Implementation Research, to guide adaptation of training content and delivery. Phase 2 involves a single training session delivered to farmworkers not involved in the formative work (n=15). The primary exploratory outcome is pre-post change in the Personal Attenuation Rating, an objective measure of hearing protector fit. Secondary outcomes include changes in hearing protection beliefs and implementation outcomes (acceptability, feasibility, and appropriateness). Results: Funding for this study was obtained in July 2025, and the study was registered on ClinicalTrials.gov in December 2025 (NCT07271290). Phase 1 recruitment began in July 2025, and data collection concluded in January 2026, with 30 participants enrolled. Phase 2 pilot recruitment began in July 2026, and 1 participant had been enrolled as of July 2026. Phase 2 data collection is expected to conclude in Spring 2027. Data analysis will follow completion of data collection, and study findings are expected to be published in 2028. Conclusions: This protocol describes a community-engaged adaptation and pilot evaluation of a culturally tailored, digitally delivered hearing protection microtraining for farmworkers. By pairing objective fit testing with pragmatic implementation measures and systematic adaptation tracking, the study will assess feasibility and estimate preliminary effect sizes to inform a subsequent multilevel trial that integrates supervisor and organizational components.

Introduction: Low-income individuals with a history of international migration are at risk for poor mental health due to social and economic adversity. This study examined associations of neighborhood adversity with depression and anxiety symptoms and explored whether social support moderated this relationship in a low-income U.S.-Mexico border population. Methods: This study recruited U.S-Mexico border residents in Tijuana, Mexico. Neighborhood adversity was measured using a validated scale with five subscales. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-8 and the Generalized Anxiety Disorder-7 scale. Social support was measured using the 12-item Interpersonal Support Evaluation List. Multivariable linear regression models examined the associations of neighborhood adversity with depression and anxiety symptoms. Results: Participants (N=206) were 77% male and 76% reported history of prior migration to the U.S. Prevalence of clinically significant depression and anxiety symptoms were 37% and 33%, respectively. Individuals with higher neighborhood adversity had higher depression (B=0.051, CI=(0.011–0.091) and (B=0.045, CI=(0.004–0.086) anxiety symptoms. Poorer aesthetic quality was associated with depression and anxiety symptoms, and higher crime/unsafety was associated with anxiety symptoms. Social support did not moderate these relationships. Conclusion: Neighborhood adversity is a potentially modifiable correlate of poor mental health in low-income individuals along the U.S.-Mexico border.

Background: Drug overdoses are a significant public health concern, but there is limited research on the associated factors among patients presenting to the Emergency Department (ED). We investigated the sociodemographic and clinical characteristics associated with drug overdoses among patients with substance-related diagnoses (SRD) in a Southern California healthcare system’s ED. Methods: A cross-sectional study employed EPIC electronic medical records from a sample of 13,477 adults (18–90 years of age) diagnosed with an SRD ICD-10 classification and had an ED encounter within the UCSD Health system in Southern California during the period from January 1, 2020, to December 31, 2023. Bivariate and multiple logistic regression analyses were utilized to ascertain sociodemographic and clinical characteristics correlated with overdoses. Results: The odds of experiencing an overdose were higher among individuals with a cannabis-related diagnosis (aOR = 1.21, p < 0.05) in comparison to those lacking such a diagnosis, among individuals with an Opioid-related diagnosis (aOR = 1.14, p < 0.05) when compared to those without an Opioid-related diagnosis. Individuals aged 40–54 had higher odds (aOR = 1.37, p < 0.05) of experiencing an overdose compared to those aged 18–24. Additionally, the odds were more pronounced among Black or African American (aOR = 1.31, p < 0.001) individuals compared to whites, among individuals of Hispanic/Latinx origin (aOR = 1.22, p < 0.001) compared to those of non-Hispanic/Latinx origin, among those with public health insurance (aOR = 1.40, p < 0.001) compared to those with commercial health insurance, and among individuals with any mental health diagnosis (aOR = 1.13, p < 0.05) compared to those without such a diagnosis. In contrast, individuals experiencing overdose were less likely to be female (aOR = 0.78, p < 0.001) compared to male, and less likely to be married/living as married/having a significant other (aOR = 0.69, p < 0.001) compared to those who were single. Conclusion: Our research showed that individuals with cannabis or Opioid-related diagnoses had higher odds of experiencing an overdose. Patients with an overdose were typically middle-aged, Black or African American, and Hispanic/Latinx, had public health insurance, and had comorbid mental health diagnoses. They were less likely to be female, married, or in a significant relationship. These findings highlight the importance of sociodemographic and clinical factors in identifying at-risk individuals for targeted interventions.

Nitrite inhalants (poppers) are associated with HIV transmission and commonly used among young men who have sex with men (YMSM), a group at increased risk for HIV. Significant research gaps exist in understanding the context in which YMSM use poppers. Qualitative interviews were conducted with 15 YMSM (22–31 years) with HIV to better understand the context in which poppers are used and their impacts on HIV care outcomes, such as care retention and antiretroviral adherence. The Social Ecological Model was applied to understand intrapersonal, interpersonal, community, and system level influences on popper use. Factors influencing popper use included: ubiquity of popper use in sexual settings, introduction to poppers by casual sexual partners, patient-HIV provider communication surrounding poppers, neighborhood, substance use and HIV care systems, and the legal status of poppers. Implications for clinical care, public health, policy, and future research are discussed.

Background: Parental migration is common in Mexico and Latin America, where individuals pursue work to improve their family’s economic opportunities and children remain home in their community under the care of the remaining parent or extended family. A research gap remains about the impact of parental migration on mental health and substance use in children who remain at home. The current study explored risk and resilience factors relating to mental health and substance use among Mexican youth remaining at home when one or more parents migrate.Methods: This qualitative study applied attachment theory and thematic analysis to analyze 26 in-depth interviews with youth (17-21 years old), parents, and a focus group with high-school teachers in a town with history of migration both domestically and internationally (Yucatan, México).Results: Respondents across groups perceived that parental migration was related to 1) less parental/caregiver oversight and support due to family demands on the remaining parent and 2) the deterioration of youth mental health. Lack of youth oversight and the poor mental health of youth were perceived as drivers of youth seeking out and consuming alcohol and substances. In terms of parental remittances, youth reported observing among their peers increased access to material goods such as clothing and technology (e.g., smartphones) and increased access to alcohol. Resilience factors included parental awareness of the role of good communication with youth and teachers and youth access to and utilization of self-care resources such as mutual aid meetings for substance use recovery.Conclusion: Poor mental health and substance use among youth and parents were perceived to be related to parental absence, stressors on the remaining parent or family, and undermined healthy parent-child attachment. Youth themselves are a source of insight for recommendations on interventions to reduce youth isolation and substance use risk. We recommend the intentional engagement of youth in developing intervention research and tailoring evidence-based interventions to mitigate parental absence’s impact and promote parent-child attachment for youth and families remaining at home.

To explore the feasibility and acceptability of Proyecto Mariposa, a culturally-tailored survivorship care program for rural Latina breast cancer patients.Single group mixed-method approach.Feasibi...

Suicide and driving under the influence of alcohol and other drugs are US public health epidemics. Research exploring the associations between driving under the influence and suicide presents a res...

This article aimed to evaluate whether a substance-related diagnosis (SRD; i.e., alcohol, opioids, cannabis, stimulants, nicotine) predicts the likelihood and co-occurrence of preterm (20–37 weeks’...