Despite the challenges in their home countries, during the migration journey, and following resettlement in the US, Latinx immigrants evidence a relative health advantage compared to US-born counterparts, known as the Immigrant Paradox. As they navigate the process of immigration and adaptation, immigrants and refugees face a myriad of challenges such as language barriers, family separations and reunification, and discrimination, which are known as acculturative stressors. The longer Latinx immigrants reside in the US and to cope with this unique configuration of acculturative stressors, the more they engage in unhealthy behaviors, ultimately giving rise to a range of physical and mental health conditions. These health declines contribute to health inequities experienced by this population.

Preliminary efforts to develop and test interventions targeting acculturative stress are underway, yet they are not making a significant impact on the health of Latinx immigrants. Thus, there is an urgent unmet public health need to develop evidence-based interventions that can be easily scalable across diverse clinical settings and geographically distinct immigrant communities. Cultivating Resilience (Cultivando Fortaleza, in Spanish) has been developed synergizing evidence-based clinical science, community-engaged methods, human-centered design, and implementation science. Broadly, the targets of this weekly, 8-session group intervention focus on reducing acculturative stress and increasing resilience (at individual, familial, social, and community levels). This model holds promise for reducing health inequities facing immigrant and refugee communities.

We are pilot testing this intervention with immigrants and refugees from Latin America. To determine the preliminary clinical impact of the intervention, we are relying on quantitative and qualitative methods, grounded in implementation science. We are currently enrolling participants. If you or someone you know would like to participate in the Cultivating Resilience intervention, please contact the Principal Investigator, Dr. Gabriela Nagy at ganagy@uwm.edu.

Though a sizeable segment of Latinx immigrants are in need of specialized psychiatric services to manage acculturative stressors, they experience a range of barriers to care (e.g., lack of bilingual mental health care providers, long waitlist times, cost/lack of insurance, difficulty navigating the complex US healthcare system, stigma). Reducing the impact of acculturative stress and preventing the onset of related health conditions represents an important public health problem. Thus, there is a critical need to develop evidence-based interventions for acculturative stress that are easily accessible, disseminable, and sustained across diverse immigrant communities. Community health worker-led interventions hold such promise.

We are interested in determining the types of implementation strategies that could be helpful in delivery of the Cultivating Resilience intervention by community health workers. Some of these include, but are not limited to: interventionist education, performance feedback, peer-consultation, clinical supervision, motivation and self-efficacy enhancement strategies.

We are working with a multidisciplinary panel to determine those implementation strategies that will be optimal in this regard, relying on community-engaged methods, human-centered design, and implementation science. Our panel will include community health workers, professionals working in distinct sectors serving Latinx immigrants, and Latinx immigrant community members. We will use these findings to adapt the intervention and test it.

The Cultivating Resilience intervention is a complex intervention drawing on contemporary cognitive-behavioral therapies. It has been developed by our research team to comprehensively tap into the areas identified through our formative research alongside our community partners. However, to increase our ability to disseminate this intervention and make it more accessible for highly stressed Latinx immigrants across the US, our research team is interested in identifying the core vs. adaptable components of this intervention. We will do so by working alongside a multidisciplinary panel and our collaborators utilizing modified Delphi groups (consensus-building methods) and human-centered design sessions. These findings will inform ways that we may streamline the intervention to have a wider reach and therefore make an even greater impact on the reduction of health disparities affecting Latinx immigrants.