CRISOL: Building Community Resilience and Integrating Efforts to Understand and Address Syndemic Health Conditions Afflicting Young LatinoImmigrants

项目摘要 拉丁裔占美国移民的47%，是美国社会经济最重要的移民之一。 弱势和边缘化群体。数据显示，一些拉丁美洲移民群体经历了一个 滥用药物、遭受家庭和社区暴力以及艾滋病毒/性传播感染的负担过重。 研究还表明，在拉丁美洲人中，抑郁、焦虑和创伤后应激综合征的发病率很高 移民.这些条件已被发现集群，相互作用协同，并源于共同的 某些社区内的社会生态决定因素，从而形成一种流行病。支持已经开始 药物滥用、暴力受害、艾滋病毒/艾滋病和精神健康状况不佳的综合流行模式 （SAVAME）在拉丁美洲人和其他弱势群体中。然而，Syndemic研究特别关注 拉丁裔移民一直很稀少，对社会，文化和背景因素的作用知之甚少 拉丁裔移民患上SAVAME的风险关于采取有效办法解决这一流行病的证据， 包括提高预防和治疗服务的利用率，也非常缺乏。这个社区- 学术合作的目的是增加我们的范围和决定因素的理解， 在费城的拉丁裔移民中，SAVAME是一种小型但快速的疾病， 越来越多的拉丁裔移民社区。这一形成性研究还试图扩大 关于解决导致这一流行病的因素的战略的证据，重点是促进 拉丁美洲移民服务组织之间的合作和伙伴关系，以增加利用 在拉丁美洲移民社区中提供SAVAME预防和治疗服务。在两年的时间里，我们 将完成深度访谈（N=30）、关键线人访谈（N=30）和社区调查（N=400）， 描述费城拉丁裔移民中SAVAME综合征的程度和影响， 确定可作为今后多层次干预目标的社会生态决定因素。我们还将 实施社区资源调查（N=40），以确定、绘制和描述社区服务， 其他可以参与、动员和利用的资源，以解决SAVAME综合征 未来的拉丁美洲移民我们将使用社会网络分析来调查的水平，性质和作用， 提供健康、社会、法律的和其他支持服务的组织和机构之间的协作 这是社区恢复力的一个关键因素。本研究的结果将为未来的R 01提供信息 或R34应用程序，旨在开发，实施和评估社区范围的干预措施， 加强机构间合作，增加预防和治疗服务的可及性， SAVAME对拉丁美洲移民的影响。

PROJECT SUMMARY Latinos make up 47% of immigrants living in the U.S. and represent one of the most socioeconomically disadvantaged and marginalized populations. Data suggest that some Latino immigrant groups experience a disproportionate burden of substance abuse, exposure to domestic and community violence, and HIV/STIs. Studies have also shown high rates of depression, anxiety, and post-traumatic stress syndrome among Latino immigrants. These conditions have been found to cluster, interact synergistically, and stem from common socio-ecological determinants within certain communities, thereby creating a syndemic. Support has begun to emerge for a syndemic model of Substance Abuse, Violence victimization, HIV/AIDS, and poor MEntal health (SAVAME) among Latinos and other vulnerable populations. Yet, syndemic research specifically focused on Latino immigrants has been scarce and little is known about the role of social, cultural, and contextual factors on Latino immigrants' risk of SAVAME. Evidence regarding effective approaches to tackle the syndemic, including increasing prevention and treatment service utilization, is also sorely lacking. This community- academic collaboration is aimed at increasing our understanding of the scope and determinants of the SAVAME syndemic among Latino immigrants in the City of Philadelphia, which is home to a small but fast- growing and increasingly diverse Latino immigrant community. This formative study also seeks to expand the evidence on strategies to address the factors contributing to this syndemic, with emphasis on promoting collaboration and partnerships between Latino immigrant-serving organizations to increase utilization of SAVAME prevention and treatment services among the Latino immigrant community. Over a 2-year period, we will complete in-depth interviews (N=30), key informant interviews (N=30), and a community survey (N=400) to characterize the extent and impact of the SAVAME syndemic among Latino immigrants in Philadelphia and to identify socio-ecological determinants that may serve as targets of future multilevel interventions. We will also implement a community resource survey (N=40) to identify, map, and characterize community services and other resources that can be engaged, mobilized, and leveraged to address the SAVAME syndemic afflicting Latino immigrants in the future. We will use social network analyses to investigate the level, nature, and role of collaborations across organizations and agencies that provide health, social, legal, and other support services to Latino immigrants –a key element of community resilience. Findings from this study will inform a future R01 or R34 application aimed at developing, implementing, and evaluating a communitywide intervention to strengthen interagency collaboration, increase access to prevention and treatment services, and reduce the prevalence and impact of SAVAME on Latino immigrants.