A Hispanic/Latino Community Health Worker Intervention Addressing Acculturative Stress and Resilience: Feasibility, Acceptability, and Preliminary Effectiveness.

Abstract

Among Hispanic/Latino immigrants, substance abuse, intimate partner violence, HIV, and mental health form a syndemic that exacerbates health inequities. Promotoras (community health workers) play a critical role in reaching these vulnerable populations by providing culturally relevant healthcare connections. This study examines the feasibility, acceptability, and effects of an intervention by promotoras addressing acculturative stress and resilience among Hispanic/Latino immigrants to the US. The intervention consisted of four virtual sessions- two one-on-one and two group sessions- delivered by Latino/a community health workers, known as promotoras, using motivational interviewing and group coaching strategies to enhance resilience and reduce health risk behaviors. Feasibility and acceptability were assessed through study logs and post-intervention participant feedback, while a pre-post assessment measured intervention effects. A single-group, longitudinal pilot intervention design was employed. Participants included 30 young adult (18-44 years) immigrants from Latin America or the Caribbean residing in the US for ≥ 1 year. Measured variables included acculturative stress, depressive symptoms, emotional and instrumental support, pandemic stress, COVID-19 knowledge, and COVID-19 risk behaviors. Multiple analytic methods (paired sample t-test, Wilcoxon signed-rank test, McNemar's test) were applied to assess the feasibility, acceptability, and effects of the intervention. Findings indicate high intervention satisfaction, with participants recommending increased social engagement for enhanced impact. Acculturative stress (p = .041), depressive symptoms (p = .005), and risk behaviors (p = .021) showed significant reductions, while COVID-19 knowledge and pandemic stress remained unchanged. This study supports the feasibility and scalability of the intervention in addressing syndemic behavioral and mental health conditions, with broader implications for reducing health inequities among Hispanic/Latino immigrants. Clinical Trial Registration: NCT03527654.