Update Andrés Maiorana and Sophia ZamudioHaas Our presentation today Overview of qualitative evaluation Concepts about Latinoa identity and minority status that will inform the evaluation ID: 742665
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Slide1
ETAC Multi-site Qualitative Evaluation Plan Update
Andrés Maiorana and Sophia Zamudio-HaasSlide2
Our presentation todayOverview of qualitative evaluation
Concepts
about
Latino/a identity and minority status that will inform the evaluation
D
ialogue
and
critical thinking about concepts that will shape the interventions
Slide3
ObjectivesTo describe the interventions and the barriers and facilitators that affect their implementation
To identify best practices regarding community engagement, testing, linkage, and retention in care
To better understand the experiences of patients related to testing, linkage, and engagement in care
To assess
perspectives of interventionists on core components tailored for the appropriate transnational
population Slide4
Timeline
Phase 1
Phase 2
Phase 3
Secondary Data
Key informant interviews with
staff implementing the interventions
Client/Patient
interviews
Year 1
Years
2 and 4
Year 3Slide5
Domains to explore
Experiences participating in the interventions, barriers and facilitators to engagement in care
Perceptions
related to living with
HIV, being in HIV care, ongoing service needs
Health
seeking
experiences (beliefs
, behaviors and structural
barriers)
Self-identity
in relationship to health care: e
thnicity
, gender, sexual orientation, minority status and level of
acculturation)Slide6
Transnational FrameworkTransnationalism is a conceptual theory that explains and describes the cross-border interconnections between people, groups
and
businessesSlide7Slide8
How are the interventions grounded in self-identity, ethnicity, and understanding of minority status for persons of Mexican and Puerto Rican origin?Slide9
Cultural elements guiding engagement-in-care interventions
How do the interventions connect with persons of Mexican and Puerto Rican origin newly diagnosed or out of care?
How are cultural elements operationalized to make the interventions culturally competent?
What cultural factors are most effective to make the interventions relevant and effective?Slide10
Cultural elements guiding engagement in care interventions
Content is culturally bound
C
ore values, beliefs, norms and lifestyles
Form of delivery of intervention
Ex.
Promotore
/as
Characteristics of the interventionistsSlide11
IdentitySelf-identity is
the organized structure of cognitions or thoughts that we have about
ourselves, including perceptions of our
social identities and personal qualities,
and generalizations
about the self based on
experience.
Identity is the
meanings attached to the self by one's self and
others
Michener
, H. Andrew, John D.
DeLamater
, and Daniel J. Myers. 2004. Social Psychology. 5th ed. Belmont, CA: Wadsworth/Thompson LearningSlide12
Self-Identity
A set of beliefs and perceptions about oneself
Multiple layers:
Personal identity (Not fixed and stable but mutable and plural)
Ethnicity
Social identity (perceived by others)
Identity, community and ethnic boundariesSlide13
Ethnicity
“Aspects of relationships between groups which consider themselves, and are regarded by others, as culturally distinct.”
Hylland
Eriksen
, T. “Ethnicity and Nationalism: Anthropological Perspectives”. Pluto Press, 2002.Slide14
Latino Ethnicity
Defined by a shared
or common identity
from Spanish-speaking
countries of
North, Central and South America
,
and the Caribbean
S
hared
identity
expressed
through a s
ense
of belonging and
place
S
olidarity
and reciprocity ties in social
relationships
Common history
Spanish
as the native language of
originSlide15
Concept of Latinidad
The concept of
Latinidad
is mainly defined in the context of Latinos in the U.S. being a minority sharing historical, political, and cultural processes, united by race and language, and facing particular challenges such as stigma, racism, and immigration-related issues.
Miguel
, Guadalupe San. "Embracing
Latinidad
: Beyond Nationalism in the History of Education." Journal of Latinos & Education 10.1 (2011): 3-22.
Price
, P. L. "Cohering Culture on
Calle
Ocho
: The Pause and Flow of
Latinidad
." Globalizations 4.1 (2007): 81-99Slide16
Concept of Latinidad in U.S.
“As
Latinos living in the U.S., we have a truly multicultural experience. In this nation, through good fortune and necessity, the lines along country of origin that normally distinguish one Latino from the other are softened even as our common heritage is highlighted. While we still form strong organizations based on our home country, we also form very powerful and strategic alliances as well as deep personal relationships with a diverse group of Latin American peers
.”
“Como latinos radicados en Estados Unidos, nos desenvolvemos en un ambiente multicultural. En este país, por fortuna y necesidad, las líneas nacionales que nos pueden distinguir el uno del otro se hacen más suaves a la vez que nuestra herencia común se destaca. Eso nos lleva a construir fuertes lazos profesionales y sentimentales con personas de diversos países latinoamericanos
”
-NEXXOS, American Airlines Magazine, May, 2014Slide17
Latino Self-Identity
Balancing Intersecting Identities
Minority StatusSlide18
Intersecting or Overlapping Identities
Mexican Americans
Nuyoricans
Puerto Ricans of African descent
Indigenous migrants from Mexico
LGBTSlide19
A Queer Latinidad
View
into
the life
experiences of gay, bisexual, transsexual, and queer Latino/as
at
the confluence of race, ethnicity, and gender and sexual orientation.
Localized
in a time-space framework, in which the identities, history and desire of Latino/a LGBTQ
are expressed through political, social , cultural
and linguistic interactions, including
activism and
HIV
prevention.
Foster
, D. W. El Ambiente Nuestro,
Bilingual
Press
, Tempe, Arizona,
2006.
Rodriguez
, J. M. Queer
Latinidad
: Identity Practices, Discursive Spaces,
2003.Lima
, L.,
Picano
, F. (ed.)
Ambientes
, New Queer Latino Writing, Univ. of Wisconsin Press, 2011.Slide20
Factors that shape the experience of first generation Latino/as
Personal characteristics (
ex.SES
, agency, and ideology)
Reasons for living in the continental U.S.
Language
Length in the US
Sending community/place of origin (urban/rural)
Receiving community in the U.S
Neighborhood and social and gender networks of support
Political climateSlide21
Language Slide22Slide23
Spanish Language and Latino/as in the U.SCommunicate in native language
U
nderline
a representation of the
world
Protect
an identity against the acculturating and homogenizing effects of
English
Foster
, D. W. El Ambiente Nuestro,
Bilingual
Press
, Tempe, Arizona, 2006.Slide24Slide25
LanguageAbility
to communicate in English reflects levels of acculturation and easiness of functioning in mainstream U.S. society.
Interplay and switching between
English
and Spanish
an
expression of two different worlds with which they are
familiar.
Spanish used to
express
a nostalgia for real or idealized roots.
Foster
, D. W. El Ambiente Nuestro,
Bilingual
Press
, Tempe, Arizona, 2006
.Slide26
Latino Cultural “Ismos”
Machismo/
Caballerismo
Familismo
Personalismo
Confianza
(trust)
Marianismo
How
much do they apply to a specific individual
?Slide27
Other cultural elementsMistrust of the system and authority
Passive aggressiveness
“Si
pero
no”
How do the “
Ismos
” and other cultural elements need to be considered as part of the interventions to engage persons of Mexican and Puerto Rican origin in care? Slide28
Minority Status
Historical processes result in differential power dynamics
Economic, political and social inequities
Dwellings in inner cities with social and environmental ills
Social and economic isolation Slide29
Signifiers of Ethnic Identity and Markers of difference
Socioeconomic Status
Language
Skin color
An “ethnic”
name
Social, cultural and political factorsSlide30
Markers of DifferencePerceptions of the “foreign”
as
a
threat
Perceptions of the
“alien
” as outside the community of “
Americans”
Stigma and discrimination
Maiorana, A.; Rebchook, G.; Curotto, A.; Galindo, G.; Susan Kegeles, S
. “Adaptation of
the
Mpowerment
Project to
YoungLatino
MSM.” www.
m
powerment
. orgSlide31
Markers of Difference
“
My mind does not have an accent, my speech
does”
Maiorana, A.; Rebchook, G.; Curotto, A.; Galindo, G.; Susan Kegeles, S
. “Adaptation of
the
Mpowerment
Project to
YoungLatino
MSM.” www.mpowerment.org Slide32
Common Structural BarriersLack of financial resources
Limited job opportunities
Access to health services
Legal status
Lack of insurance
How does the interplay of barriers and cultural elements
impact
health
care utilization and health seeking behaviors? Slide33
Concept of Citizenship/ Concepto de Ciudadanía
Vastly used in Latin America
Framework of social justice
Achievement of equal political, economic, social, cultural, sexual rights
Access to health services as a basic right
Full participation in a democratic and plural society
Dagnino
, E
.
“Citizenship
in Latin America:
An Introduction.” Latin
American Perspectives 2003 30: 211Slide34
Concept of Citizenship
Cáceres, Frasca, Pecheny, Terto
.
Ciudadanía sexual en América Latina: abriendo el debate. Lima” Perú. 2004
.Slide35
To be continuedHealth seeking behaviorsAcculturation processes
Stigma