This community-based participatory study examines how campesinos (small rural landholders) understand and act upon their understandings regarding their food pattern change in the context of a transnational family life and fiscal remittances. It examines food pattern negotiation using in-depth interviews, focus groups, filmic ethnography, participant observation and Food Pattern Analysis with rural small landholders from two communities in northern Guanajuato, México. Rural food pattern shift between pre-migration and current times are explained according to the broader economic frame of rural livelihoods, the local social context, as well as through the particularities of individual's consumption. As of the 1980's newer fluid income-based livelihoods including remittances, formal employment and cash transfers coincide with campesino's increasing access to and interaction with the commercial food system. In terms of change particularities between pre-migration and current times, it is evidenced by consumption frequency changes of key foods, the manner in which dishes are served and eaten, the freshness of the staple ingredient/s used, and the resulting food pattern diversity. Food shifts are shown to ebb and flow through time and are not linear and rigid. In regard to the question of how campesinos negotiate their food patterns in rural spaces, campesino's explanations of their consumption commonly refer to three motivating factors; these include taste preference, social returns motivation, and newer notions of time and convenience. These mechanisms taken together inform the notion that fluid income through remittances, implies not only benefits among the rural sector but costs as well. For example, while remittances enhance women's and children's agency related to their food activities and negotiation of social relations, they also support enhanced access to commercial foods, and often to highly processed foods that are high in sugar, salt and fat; they also reduce rural family production capacity as a result from displaced labor. Taken together, remittances may imply an exposed risk to nutrition-related disease and potential food insecurity. Furthermore, remittances are known to foster a sense to attain an elevated standard of living which supports an "need" to consume status foods, while also encouraging the avoidance of stigmatized regional foods. However, there is no evidence to suggest that campesinos intend to permanently sever their food production capacity; a majority of respondents still produce food.

This dissertation explores academic persistence among Latinx students at City College of San Francisco (CCSF), using cultural-historical activity theory (CHAT) to emphasize the culturally-mediated nature of goal directed human activity. The study investigates factors related to persistence within the context of CCSF’s Metro Transfer Program (Metro), a student support program (SSP), including Latinx-relevant subconstructs and related questions, to explore what is working and potential areas of improvements within Metro. Structured in-depth interviews with Metro staff and Latinx Metro enrolled students were conducted to assess how the SSP supports persistence. Findings reveal significant constraints related to lack of Latinx staff and a dedicated academic counselor within Metro. Metro’s effort to build a personalized sense of family and community is recognized by students as supporting their persistence. Other standout findings include Metro students and their parents pushing back against stereotypic Latinx gender roles, underscoring sociocultural norms actively evolving within the context of family acculturation and the pursuit of higher education. Concerningly, findings reveal constraining tensions on the part of Central American students that feel erased in a predominately Mexican student college and greater environment (i.e., lack of representation in Chicano studies courses and even reports of being bullied by Mexican peers in locally shared neighborhoods). Study’s findings highlight the critical need for culturally responsive student support programs to address the unique and diverse experiences and challenges faced by Latinx community college students. Metro is well positioned to implement such programming. By doing so, Metro and other support program can improve persistence and success rates by fostering a more inclusively supportive environment that engages the diverse backgrounds and experiences of Latinx students.

Sexual minority men (SMM) have historically been exposed to stressors that translate into poor social and health outcomes. Methamphetamine use is an outcome representing a powerful health disparity for SMM. Sexual compulsivity (SC) has been centered in SMM’s health research; however, its role in SMM’s methamphetamine use remains underdeveloped. Guided by syndemics theory, intersectionality, and revised stress and coping theory, the purpose of this mixed methods study is to contextualize the role of SC in the methamphetamine-using behaviors of SMM living with HIV. Data were collected from 2014-2019 through an RCT testing a positive affect intervention in San Francisco. Cross-sectional survey data (N= 129) were used for quantitative analyses and participants (n = 24) were purposively sampled to take part in semi-structured interviews for qualitative analyses. Narrative analysis revealed that most participants experienced adverse events as youths, specifically related to sexuality. Additionally, they reported that sex was related to methamphetamine initiation and subsequent use, and that methamphetamine was disruptive to relationships. Narrative analyses surfaced a sequential pattern of disconnection at foundational, relational, and recovery levels, revealing themes of negative affect, isolation, SC, depression, trauma, and other mental health issues across the life-course. Network analysis suggests two specific significant positive associations: between depression and negative affect and between PTSD and depression. Constructivist grounded theory analysis highlighted six themes regarding participants’ relationships with/on methamphetamine. Findings highlight the influence of life-long experiences of syndemically related psychosocial factors in the methamphetamine-using behaviors of SMM. Findings suggest peer-based interventions focus on holistic, integrated approaches to tend to SMM’s histories of adverse events and mental health issues, which diminish relational capabilities. SC should be understood as a potentially maladaptive coping strategy developed by SMM as a response to stigmatization and discrimination. Taken together, these findings can help inform cutting-edge methamphetamine use and mental health interventions for SMM.

Despite high lifetime risk for depressive disorder, Latinos under-utilize mental health services as compared to non-Latino Whites, and are more likely to seek treatment for depression in primary care medical settings. Integrated behavioral health (IBH) in primary care is a promising service model for facilitating access to mental health care among Latinos. Yet, while IBH is a mandate of the Affordable Care Act (ACA), research has not addressed whether IBH facilitates entry into needed behavioral health services for Latinos. The aims of this mixed methods study are: (1) To identify specific sociodemographic and contextual factors in the referral processes that predict psychotherapy initiation for depressed Latinos within an IBH setting; and (2) To qualitatively explore why Latino patients decide to follow-up or not with behavioral health treatment upon referral. To achieve Aim 1, predictor analysis was performed on medical records data (N=431). To achieve Aim 2, qualitative semi-structured interviews were conducted with a sub-sample of depressed Latino patients (N=16) referred for IBH depression treatment. Results point to differences in treatment uptake based on referral type between English-speaking and Spanish-speaking Latinos. English-speaking Latinos were four times less likely to attend an initial visit if they received a personal introduction from their medical provider to the behavioral health provider ("warm handoff"), as compared to those who did not receive a personal introduction during referral. Qualitative findings suggest that not all warm handoff referrals are experienced as "warm", and that the strength of the patient-provider relationship is a key component affecting patients' experience of the referral, and subsequent decision to engage in depression treatment or not. Future studies should explore specific dimensions contributing to the quality of referral to better address the spectrum of psychosocial and cultural needs of depressed Latinos and engage them into care.

Recent studies find a high risk of depression among immigrant Latinas known to increase during the acculturation process. Several barriers, such as stigma and low health literacy, frequently separate Latinas from treatment. In response this study aimed to replicate the effectiveness of Entertainment-Education (E-E), in the form of a Spanish language fotonovela, in increasing depression literacy among immigrant Latinas at risk for depression. This study specifically sought to assess if exposure to the fotonovela, delivered in a multifaceted approach to health education used by promotoras, improved depression knowledge, the self-efficacy to identify the need for treatment, and the intent to seek treatment while reducing stigma towards depression treatment. Additional exploratory research assessed the participants' response to the fotonovela. Through a mixed methods approach comprised of quantitative data (employing a pretest-posttest randomized control group experimental design) and qualitative data (composed of structured follow- up interviews) 142 immigrant Latinas in a large urban setting were included in this study. Results indicate statistically significant posttest differences in depression knowledge, self-efficacy to identify the need for treatment, and antidepressant stigma between control and experimental group participants. Results also suggest a positive response to the fotonovela reflected in the participants' identification and engagement with the story and its characters. Follow-up interviews detect most participants discussed the content of the fotonovela with friends whom they identified as depressed. Findings suggest use of cost effective E-E health literacy tools, in combination with the multifaceted approach to health education used by promotoras, may increase mental health knowledge and intention to share knowledge among underserved populations. Further mixed methods research is recommended in the continued assessment of mental health literacy among Latinos and development of culturally competent mental health literacy tools.

Thousands of noncitizens are incarcerated in immigration detention centers daily despite extensive research demonstrating a multitude of adverse outcomes associated with the practice. However, many effective alternatives remain available that employ varying levels of restriction and surveillance without resorting to the prison-like conditions of immigration detention. The community-based case management model is most promising, which strives to maximize noncitizens’ liberty and human dignity while achieving optimum rates of compliance with immigration legal proceedings. Numerous scholars, activists and social movement organizations have increasingly implored lawmakers to adopt case management alternatives, yet mass detention continues to expand. Incentivizing change has been hampered by an absence of public opinion data among constituents, allowing elected officials a degree of plausible deniability. Progress is further impeded due to the inherent disenfranchisement of the affected population. Given these structural, political, and cultural challenges, how then might the voting public be mobilized to act on behalf of noncitizens impacted by mass detention? Grounded in principles of interest convergence and collective action framing theories, the current study builds upon promising political science messaging research to learn whether race-class narrative framing can influence attitudes about immigration, detention, and supporting community-based alternatives. To meet these aims, this dissertation study employs an online, between-groups survey experiment with a representative sample of the American electorate. Findings suggest that the race-class narrative may be ineffective with matters concerning undocumented immigration but shows promise when addressing legal immigration issues. Implications for future research and the ‘undocumented penalty’ are discussed.

This study explores the immigration-related family separation and reunification experiences of 7 Mexican and Central American families. The data collection methods included participant observation and in-depth interviews with teenagers and their mothers. The study also incorporated longitudinal data collected on participants as part of the Longitudinal Immigrant Student Adaptation study (LISA). These longitudinal data included participant observation notes, semi-structured interviews with children and their parents, and schooling outcome data. Data were synthesized to create 7 detailed case studies that bring to life the experiences of immigrant families as they manage complex reunifications during a span that averages 8 years. While reunifications posed a number of challenges for all families, many families were able to manage these events over time. For some families, however, the challenges posed by difficult reunifications were insurmountable and resulted in strained mother-child relationships and maladaptive behaviors in children. The use of case study methodology allowed the inclusion of contextual factors generally overlooked in studies on immigration-related family separations and were found to have a significant impact on how these events are experienced. The longitudinal perspective highlighted the importance of examining reunification processes over time as reunification outcomes can change over the course of time as families adjust to these events and to their host environment. Furthermore, by exploring these events both contextually and longitudinally, this study addresses existing gaps in the literature and moves beyond current frameworks.