Publications
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Young Hispanic Fathers During COVID‐19: Balancing Parenthood, Finding Strength, and Maintaining Hope
Abstract:This study examined how the effects of the COVID-19 crisis has impacted young Hispanic fathers. Using qualitative description, in-depth interviews were conducted among Hispanic fathers between the ages of 18 and 24 years, from community-based fatherhood program. The interviews of seven young Hispanic fathers were analyzed using qualitative content analysis. The participants’ initial and ongoing fears about COVID-19 resulted from not having adequate information about the severity of the disease and how easily one can contract and transmit it to others. They also expressed concerns about the threat of the pandemic on their family's well-being, finances, and employment status. Providing for their families was their main priority, with some continuing to work, despite the risks of becoming infected with COVID-19. Despite their many hardships, fathers found strength in their families and remained hopeful in overcoming the challenges during the pandemic. The pandemic has presented difficulties and loss for many. Nurses in the community are well positioned to serve young Hispanic fathers to ensure their needs are met. A family-centered approach is ideal for young fathers to provide them equal opportunity to be actively involved in promoting health for themselves and their families during the pandemic.
Citation:Recto, P., & Lesser, J. (2021). Young Hispanic Fathers During COVID‐19: Balancing Parenthood, Finding Strength, and Maintaining Hope. Public health nursing, 38(3), 367-373. https://doi.org/10.1111/phn.12857
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Supporting the Mental Health Needs of Adolescent Fathers During COVID-19: Opportunities for Nursing Practice and Community-Based Partnerships
Abstract:Public health crises, such as the coronavirus disease 2019 (COVID-19) pandemic, have led to significant community-wide disruptions in all sectors of public and private life. The pandemic also has revealed inequities in certain populations, amplifying social and economic factors that further contribute to poor mental health outcomes. What is commonly seen during national crises and disasters is that those who are impoverished, unemployed, marginalized, and represent ethnic minority groups are disproportionately harmed physically, emotionally, economically, and educationally. One such group that has been impacted by the pandemic is adolescent fathers.
Citation:Recto, P., Lesser, J., Moreno-Vasquez, A., Zapata, J., Jr, & Zavala Idar, A. (2021). Supporting the Mental Health Needs of Adolescent Fathers during COVID-19: Opportunities for Nursing Practice and Community-Based Partnerships. Issues in mental health nursing, 42(7), 702-705. https://doi.org/10.1080/01612840.2020.1850951
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Opioid Use Disorder ECHO: A Program Evaluation of a Project That Provides Knowledge and Builds Capacity for Community Health Workers in Medically Underserved Areas of South Texas
Abstract:Opioid use disorder is a growing public health concern in South Texas. To assist in mitigating the effects of this epidemic, staff produced a program that focused on replicating, modifying, and evaluating the impact of the "Opioid Addiction Treatment ECHO™ (Extension of Community Health Outcomes) for CHWs (community health workers) program" on 26 CHWs practicing in rural and other medically underserved areas through teleconferencing technology. CHWs trained on the topic of substance use disorder concentrated on behavioral health integration with a focus on opioid prescription misuse. The analysis found that knowledge attainment was increased above the pretest means. The ECHO™ model proved to be effective at linking subject matter experts and specialists at an academic "hub" with CHWs in local communities.
Citation:Zapata, J., Jr, Colistra, A., Lesser, J., Flores, B., Zavala-Idar, A., & Moreno-Vasquez, A. (2021). Opioid Use Disorder ECHO: A Program Evaluation of a Project That Provides Knowledge and Builds Capacity for Community Health Workers in Medically Underserved Areas of South Texas. Issues in mental health nursing, 42(4), 381-390. https://doi.org/10.1080/01612840.2020.1814911
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The Parenting Experiences of Hispanic Adolescent Fathers: A Life Course Theory Perspective
Abstract:Using a life course theory perspective, this qualitative descriptive study explored how Hispanic adolescent fathers view fatherhood, and how their perception of parenthood is shaped by critical life events. Hispanics are one of the largest ethnic groups, as well as one of the populations that is overrepresented in adolescent births in the United States. Despite this, Hispanic adolescent fathers are understudied and underrepresented in research. Participants were recruited from a community-based fatherhood program. Semi-structured interviews were conducted with Hispanic fathers, ages 16 years to 23 years. Participants conveyed their grief over fragmented family relationships and limited interactions with their own father. Some lived in hostile environments where they frequently experienced racism, discrimination, and neighborhood violence. The cumulative impact of these events resulted in substance use and emotional distress. Becoming a father was a sentinel event that helped resolve negative perceptions about fatherhood. Fatherhood also motivated participants towards a more productive, meaningful life.
Citation:Recto, P., & Lesser, J. (2020). The Parenting Experiences of Hispanic Adolescent Fathers: A Life Course Theory Perspective. Western journal of nursing research, 42(11), 918–926. https://doi.org/10.1177/019394592093559
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“Fathers Need Help Too”: Adolescent Fathers and Depression
Abstract:Perinatal mood disorders have been identified as a public health concern during pregnancy and postpartum (perinatal) period, particularly in mothers. In recent years, there has been a growing concern about the burden of ill health experienced by fathers. Estimates show that 1 in 10 fathers develop paternal depression after the birth of their child, with symptoms lasting up to five years postpartum. Symptoms of paternal depression have been described as having low mood, loss of interest or pleasure, weight gain/loss, sleep disturbance, fatigue or low energy, irritability, restlessness, negative thoughts, withdrawal, and social isolation. Depressive symptoms are generally similar between mothers and fathers; however, fathers are more likely to exhibit increased irritability and substance and alcohol use.
Citation:Recto, P., & Lesser, J. (2021). “Fathers Need Help Too”: Adolescent Fathers and Depression. Issues in mental health nursing, 42(5), 515-518. https://doi.org/10.1080/01612840.2020.1752866
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Using Mobile Health Tools to Engage Rural Underserved Individuals in a Diabetes Education Program in South Texas: Feasibility Study
Abstract:Access to diabetes education and resources for diabetes self-management is limited in rural communities, despite higher rates of diabetes in rural populations compared with urban populations. Technology and mobile health (mHealth) interventions can reduce barriers and improve access to diabetes education in rural communities. Screening, Brief Intervention, and Referral to Treatment (SBIRT) and financial incentives can be used with mHealth interventions to increase the uptake of diabetes education; however, studies have not examined their combined use for diabetes self-management in rural settings. This two-phase Stage 1 feasibility study aimed to use a mixed methods design to examine the feasibility and acceptability of an mHealth diabetes education program combining SBIRT and financial incentives to engage rural individuals. In Phase 1, we aimed to develop, adapt, and refine the intervention protocol. In Phase 2, a 3-month quasi-experimental study was conducted with individuals from 2 rural communities in South Texas. Study participants were individuals who attended free diabetes screening events in their community. Those with low or medium risk received health education material, whereas those with high risk or those with a previous diagnosis of diabetes participated in motivational interviewing and enrolled in the 6-week mHealth Diabetes Self-Management Education Program under either an unconditional or aversion incentive contract. The participants returned for a 3-month follow-up. Feasibility and acceptability of the intervention were determined by the rate of participant recruitment and retention, the fidelity of program delivery and compliance, and the participant's satisfaction with the intervention program. Of the 98 screened rural community members in South Texas, 72 individuals met the study eligibility and 62 individuals agreed to enroll in the study. The sample was predominately female and Hispanic, with an average age of 52.6 years. The feedback from study participants indicated high levels of satisfaction with the mHealth diabetes education program. In the poststudy survey, the participants reported high levels of confidence to continue lifestyle modifications, that is, weight loss, physical activity, and diet. The retention rate was 50% at the 3-month follow-up. Participation in the intervention was high at the beginning and dissipated in the later weeks regardless of the incentive contract type. Positive changes were observed in weight (mean -2.64, SD 6.01; P<.05) and glycemic control index (-.30; P<.05) in all participants from baseline to follow-up. The finding showed strong feasibility and acceptability of study recruitment and enrollment. The participants' participation and retention were reasonable given the unforeseen events that impacted the study communities during the study period. Combining mHealth with SBIRT has the potential to reach individuals with need to participate in diabetes education in rural communities
Citation:Yin, Z., Lesser, J., Paiva, K. A., Zapata, J., Jr, Moreno-Vasquez, A., Grigsby, T. J., Ryan-Pettes, S. R., Parra-Medina, D., Estrada, V., Li, S., & Wang, J. (2020). Using Mobile Health Tools to Engage Rural Underserved Individuals in a Diabetes Education Program in South Texas: Feasibility Study. JMIR mHealth and uHealth, 8(3), e16683. https://doi.org/10.2196/16683