Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees

PROJECT SUMMARY Graduate student Alejandra Lemus' long-term goal is to become a NIH-funded researcher engaged in high impact, innovative research that examines the effects of multilevel interventions (including policy change) on reducing social inequities and mental health disparities experienced by Latinx immigrants. Almost 14% of the U.S. population are immigrants (28% of the population when including U.S.-born children of immigrants), with Latinx immigrants comprising 40% of the immigrant population. Due to long-standing structural inequities, the COVID-19 pandemic has disparately impacted immigrants, particularly those who are Latinx and low-income. The parent grant aims to test a multilevel approach to reduce adverse consequences of the COVID-19 pandemic with disparate impacts on Latinx and Black immigrants and refugees by observing and implementing three nested levels of intervention. This Diversity Supplement will further advance mental health disparities research through intersectional analyses of the mental health, daily stressors, and economic distress of Latina immigrant mothers, which is critical because recent research that has shown that women have experienced more severe mental health, daily stressor, and economic impacts of the pandemic. These disparities are likely due to multiple factors, such as higher caregiving responsibilities and lower income compared to men, and high rates of exposure to political, structural, and intimate partner violence. These gendered experiences highlight the importance of intersectional approaches which focus on gender and caregiving responsibilities, in addition to immigration status, SES, and race/ethnicity, to understand the pathways and intersecting positionalities that are contributing to mental health disparities. The longitudinal mixed methods data collected from 1140 Latinx immigrants for the parent study will be leveraged to conduct a mixed methods study with an innovative sequential design, in which initial quantitative analyses to describe gender disparities in mental health, daily stressors, and economic precarity among Latinx immigrants (Aim 1) will be followed by qualitative analyses of interviews conducted with a subsample of participants to provide explanation and elaboration on differences in these outcomes (Aim 2), and then subsequent quantitative analyses to test potential moderators and mechanisms suggested by the qualitative findings that may be contributing to gendered disparities (Aim 3). In addition to the proposed research activities, Ms. Lemus will engage in a comprehensive training plan that advances her expertise in 4 key areas: mixed methods and advanced qualitative and quantitative analyses; policy and structural analyses; community-engaged research; and intersectional transnational gender analyses. Guided by a primary mentor and 4 co-mentors, her training includes directed readings, coursework, mentored research activities, and writing and submission of 3 conference abstracts, 4 first-authored papers, a bilingual policy brief and community report, and a F32 application. In sum, the proposed research and training experiences will provide critical opportunities for Ms. Lemus and enhance the impact of the parent grant.