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ETAC  Multi-site Qualitative Evaluation Plan ETAC  Multi-site Qualitative Evaluation Plan

ETAC Multi-site Qualitative Evaluation Plan - PowerPoint Presentation

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ETAC Multi-site Qualitative Evaluation Plan - PPT Presentation

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

social identity interventions cultural identity social cultural interventions care latino latinidad status language origin health political ethnicity minority elements

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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

businessesSlide7
Slide8

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 Slide22
Slide23

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.Slide24
Slide25

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