Adriana Maldonado

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Journals/Publications

• Loya, J., Garcia, D. O., Maldonado, A., & Villavicencio, E. (2025). A Culturally Tailored Physical Activity Intervention for Hispanic Adults Living With Type 2 Diabetes: Pre-Post Pilot Feasibility Study. JMIR diabetes, 10, e62876.
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  Type 2 diabetes mellitus (T2DM) is a metabolic disease that affects over 38 million adults in the United States, who are disproportionately Hispanic.
• Maldonado, A., Loya, J. C., Villavicencio, E. A., Torres, R., Sanchez, E., Luzanilla, E., Garcia, T., Vazquez, L., Hoffman, R. M., Torres, E., & Garcia, D. O. (2025). Understanding Drivers of Prostate Cancer Screening in Mexican-Origin Men Along the U.S./Mexico Border Region. American journal of men's health, 19(3), 15579883251343956.
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  The U.S. Preventive Services Task Force recommends individualized decision making about prostate cancer screening for men between 55 and 69 years of age. Compared to non-Hispanic Whites, Hispanic men are less likely to report having had a prostate-specific antigen test. While these differences have been attributed to individual- and system-level barriers in early detection and screening of prostate cancer (PCa), less is known about Mexican-origin men perceptions of barriers to PCa screening. Using a community-based participatory research approach, we conducted semistructured interviews (5 men with PCa history; 15 men without PCa history) to characterize Mexican-origin men's knowledge, beliefs, attitudes, and experiences with PCa screening in Yuma County, Arizona. Mexican-origin men viewed genetic predisposition as the main driver of PCa, yet participants highly endorsed PCa screening as reflected by the high rates of PCa screening in our study sample. Further, men spoke to how PCa is a taboo subject among Mexican-origin men and how getting screened for it is often perceived as a threat to their manhood. Finally, Mexican-origin men identified a variety of system-level barriers to PCa screening including lack of health insurance, elevated medical costs, and lack of transportation. The study findings add to an emerging body of literature on determinants of PCa screening among Mexican-origin men. The results of this study have significant implications for public health as they underscore the need for multifaceted interventions that target both individual behaviors and broader social influences to increase PCa screening rates among Mexican-origin men.
• Maldonado, A., Martinez, D. E., Villavicencio, E. A., Crocker, R., & Garcia, D. O. (2025). Salud sin Fronteras: Identifying Determinants of Frequency of Healthcare Use among Mexican immigrants in Southern Arizona. Journal of racial and ethnic health disparities, 12(3), 1951-1966.
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  Guided by Andersen's Behavioral Model of Health Services Use (BMHSU), this study aimed to identify determinants of post-migration healthcare use among a sample of Mexican immigrants in a US-Mexico border region in Southern Arizona, while considering pre-migration health and healthcare experiences.
• Maldonado, A., Torres, E., Flores, M., Rodriguez, M., Villavicencio, E. A., Torres, R., Castro, I., Torres, F., Loya, J. C., Alkhouri, N., Carvajal, S., & Garcia, D. O. (2025). The Association between Neighborhood Context, Allostatic Load, and Metabolic Dysfunction-Associated Steatosis Liver Disease in Mexican-origin Farmworkers along the Southern Arizona US/Mexico Border. Research square.
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  Mexican-origin farmworkers are at an increased risk of Metabolic dysfunction-associated steatosis liver disease (MASLD). They are also susceptible to living in neighborhoods with higher levels of unfavorable social, physical, and economic conditions. The effects on health due to these neighborhood conditions are suggested to be reflected through Allostatic Load (ALoad), the wear and tear of the body due to chronic stress. This study examined associations between perceived neighborhood environment, ALoad, and MASLD.
• Ochoa Mora, E., Maldonado, A., Flores, M., Rodríguez, M., Martínez, D. E., Crocker, R., & Garcia, D. O. (2025). Over-the-counter medication use among Mexican immigrants in Southern Arizona: a cross-sectional study. Frontiers in public health, 13, 1528486.
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  Over-the-counter (OTC) medication use is high among Mexican immigrants before migrating to the U.S. However, changes in OTC medication use during migration process remain unclear. This study describes OTC medication use patterns among Mexican immigrants in Southern Arizona, explores changes caused during the migration process, and examines the influence of sociodemographic factors on OTC medication use.
• Villavicencio, E. A., Serdjebi, C., Maldonado, A., Ochoa Mora, E., Besson, A., Alkhouri, N., & Garcia, D. O. (2025). Use of Hepatoscope 2DTE for non-invasive assessment of liver stiffness among Mexican immigrant adults in a community-based setting. Clinics and research in hepatology and gastroenterology, 49(5), 102581.
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  Mexican-origin adults have one of the highest rates of metabolic dysfunction-associated steatotic liver disease (MASLD) and its severe form metabolic dysfunction steatohepatitis (MASH) in the US. Given the costs and invasiveness of liver biopsy, this study assessed the application of Hepatoscope® 2DTE, the latest-generation transient elastography for liver stiffness in Mexican adult immigrants from Southern Arizona and compared it with FibroScan® VCTE™.
• Baquero, B., Novak, N., Sewell, D., Kava, C., Daniel-Ulloa, J., Pham, H., Askelson, N., Ashida, S., Laroche, H., Maldonado, A., Bucklin, R., Haines, H., & Parker, E. (2024). Effectiveness of implementing evidence-based approaches to promote physical actvity in a Midwestern micropolitan area using a quasi-experimental hybrid type I study design. BMC Public Health.
• Crocker, R. M., Martínez, D. E., Maldonado, A., & Garcia, D. O. (2024). The maintenance of mexican traditional medicine practices among mexicans in southern Arizona. Social science & medicine (1982), 351, 116982.
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  Mexicans in the United States have been reported to maintain practices of Mexican traditional medicine at comparably higher rates than most other populations, including other Latino sub-groups. In this cross-sectional study, we examined the pre- and post-migration traditional medicine practices of first-generation immigrants from Mexico living in southern Arizona. Our objective was to assess how migration affected Mexican immigrants' ethnomedical practices and to better understand the mechanisms and motivating factors for the post-migration maintenance of practice. We designed a survey instrument based off prior qualitative data on traditional medicine practices and translated it into Spanish. The survey measured the rates and frequency of six domains of lay healing practices: herbal medicine, healing foods, self-medication with over-the-counter medicine, and three types of specialty healers (curandero/a, and sobador/a, or partero/a), and asked questions about knowledge sources, reasons for maintaining practice post-migration, and to what extent participants believed the remedies were effective. The research team fielded the telephone-based survey from April 2022 to February 2023 to 300 first-generation adult Mexican immigrants residing in southern Arizona. A series of proportions tests were conducted to examine differences in reliance on lay healing pre- and post-migration as well as to assess differences between women's and men's lay practices. The data indicate a general, but moderated decline in lay medical practices post-migration, with the usage of expert healers declining at much higher rates than the three self-care domains. Women tend to use herbal medicine and healing foods at higher rates than men post-migration. This cross-sectional quantitative study confirms prior research indicating that traditional medicine practices are heavily relied upon by Mexican origin people both pre- and post-migration. These findings suggest that public health messaging and medical providers should better address and harness Mexican immigrants' lay medical practices in order to optimize health in this population.
• Crocker, R., Martinez, D., Maldonado Gonzalez, A., & Garcia, D. (2024). The Maintenance of Mexican traditional medicine practices among Mexicans in the US Southwest. Social Science and Medicine.
• Garcia, D. O., Maldonado Gonzalez, A., Martinez, D. E., & Crocker, R. M. (2024).

  The Maintenance of Mexican Traditional Medicine Practices Among Mexicans in Southern Arizona

  . Social Science & Medicine, 351.
• Maldonado Gonzalez, A., Martines, D., Villavicencio, E., Crocker, R., & Garcia, D. (2024). Salud sin Fronteras: Identifying determinants of frequency of healthcare use among Mexican immigrants in Southern Arizona. Journal of Racial and Ethnic Health Disparities.
• Maldonado, A., Laroche, H. H., Sewell, D. K., Afifi, R., Hoffman, R. M., Baquero, B., & Gilbert, P. A. (2024). The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States: A Multilevel Analysis. Family & community health, 47(2), 151-166.
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  This study sought to quantify the contributions of state-level factors including income inequality, state's legislature political control, and Medicaid expansion in new and established Latinx destination states on Latinx individuals' treated hypertension. Mixed-effects logistic regression analyses were conducted to analyze 2017 Behavioral Risk Factor Surveillance System data from 7524 Latinx adults nested within 39 states. Overall, 70% reported being pharmacologically treated for hypertension, and 66% resided in established destination states. Compared with Latinx people in established destination states, Latinx people in new destinations had lower odds of having treated hypertension (odds ratio [OR] = 0.72, 95% CI = 0.54-0.95). Within established Latinx destinations, the odds of treated hypertension were lower in states where legislatures expanded Medicaid than in states that did not expand Medicaid (OR = 0.84, 95% CI = 0.79-0.89). However, after controlling for the effects of individual-level factors, this association was no longer statistically significant. In new Latinx destination states, Medicaid expansion, legislatures' political control, and income inequality were not associated with treated hypertension. The study results highlight the importance of considering both individual- and state-level factors, as the interplay of such factors could hinder the successful implementation of cardiovascular risk reduction interventions.
• Maldonado, A., Gonzalez, R., Bufferd, S., Garcia, D. O., & D'Anna-Hernandez, K. (2023). Psychosocial Determinants of Mental Healthcare Use Among Mexican-origin Women from Farmworker Families in Southern California. The journal of behavioral health services & research, 51(1), 90-100.
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  Little is known about the contribution of psychosocial factors related to mental healthcare use among Mexican-origin women from farmworker families. Therefore, this study assessed relationships between acculturative stress, depressive symptoms, mental healthcare service use, and preferences for seeking care. Linear and logistic regression models and chi-square tests were performed to analyze survey data from 78 Mexican-origin women from farmworker families. Women were recruited in collaboration with promotoras and completed measures of acculturative stress, depressive symptoms, and mental healthcare use and preferences. Overall, 29.5% of the sample reported clinically significant depressive symptomatology. Acculturative stress was positively associated with depressive symptoms (b = 0.43, 95%CI = 0.27,0.59) after controlling for years in the U.S., primary language, and demographic characteristics. In addition, acculturative stress was associated with lower odds of mental healthcare use (OR = 0.96) after controlling for years in the U.S. and depressive symptoms. However, this association was no longer statistically significant when controlling for health insurance status and access to transportation. Mexican-origin women with high levels of acculturative stress were significantly more likely to seek care from a psychiatrist/psychologist than their peers (54.3% vs. 45.7%); however, this preference was not indicative of their use of mental healthcare services. Results suggest that acculturative stress is a risk factor for depressive symptoms and might contribute to a delay in seeking mental healthcare services in Mexican-origin women from farmworker families. Thus, interventions for this group should address aspects of acculturative stress as a strategy to increase mental health services use.
• Maldonado, A., Hoffman, R. M., Baquero, B., Sewell, D. K., Laroche, H. H., Afifi, R., & Gilbert, P. A. (2023). Identifying the Social Determinants of Treated Hypertension in New and Established Latino Destination States. Journal of immigrant and minority health, 25(1), 50-61.
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  Little is known about the influence of social and environmental contexts on Latino hypertension-related disparities. This study examined the influence of social determinants of cardiovascular health on medically treated hypertension, contrasting established vs. new Latino destination states. Logistic regression models were fitted to analyze 2017 Behavioral Risk Factors Surveillance Survey data from 8,999 Latinos. Overall, 70.4% indicated having treated hypertension. History of diabetes (OR = 2.60) and access to healthcare (OR = 2.38) were associated with treated hypertension, regardless of destination state. In established destinations, Latinos who graduated high school (OR = 1.19) or attended college (OR = 1.32) had higher odds of treated hypertension; whereas those who completed college were less likely to have treated hypertension (OR = 0.80). In contrast, in both new and non-destination states, the odds of treated hypertension were consistently lower across levels of educational attainment. Results highlight the need for cardiovascular-risk reduction interventions to incorporate the social and environmental context in the development process.
• Maldonado, A., Villavicencio, E. A., Vogel, R. M., Pace, T. W., Ruiz, J. M., Alkhouri, N., & Garcia, D. O. (2023). The association between perceived stress, acculturation, and non-alcoholic fatty liver disease in Mexican-origin adults in Southern Arizona. Preventive medicine reports, 32, 102147.
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  Although available evidence indicates that Mexican-origin (MO) adults experience unique stressful life events, little is known about how stress may influence risk for developing non-alcoholic fatty liver disease (NAFLD) for this high-risk group. This study investigated the association between perceived stress and NAFLD and explored how this relationship varied by acculturation levels. In a cross-sectional study, a total of 307 MO adults from a community-based sample in the U.S-Mexico Southern Arizona border region completed self-reported measures of perceived stress and acculturation. NAFLD was identified as having a continuous attenuation parameter (CAP) score of ≥ 288 dB/m determined by FibroScan®. Logistic regression models were fitted to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for NAFLD. The prevalence of NAFLD was 50 % (n = 155). Overall, perceived stress was high ( = 15.9) for the total sample. There were no differences by NAFLD status (No NAFLD:  = 16.6; NAFLD:  = 15.3; p = 0.11). Neither perceived stress nor acculturation were associated with NAFLD status. However, the association between perceived stress and NAFLD was moderated by acculturation levels. Specifically with each point increase in perceived stress, the odds of having NAFLD were 5.5 % higher for MO adults with an Anglo orientation and 1.2 % higher for bicultural MO adults. In contrast, the odds of NAFLD for MO adults with a Mexican cultural orientation were 9.3 % lower with each point increase in perceived stress. In conclusion, results highlight the need for additional efforts to fully understand the pathways through which stress and acculturation may influence the prevalence of NAFLD in MO adults.
• Villavicencio, E. A., Maldonado, A., Crocker, R. M., Guan, Y., Stallman, C., & Garcia, D. O. (2022). Communicating genetic risk status for NAFLD among Mexican-origin men. Frontiers in public health, 10, 1090101.
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  The burden of non-alcoholic fatty liver disease (NAFLD) continues to disproportionately impact under-resourced communities in the U.S., particularly Mexican-origin populations. Genetic polymorphisms such as the rs738409 C/G variant in patatin-like phospholipase domain-containing 3 () have been associated with higher prevalence of and progression along the NAFLD spectrum. This qualitative study conducted in the U.S. Southwest aimed to assess Mexican-origin men's experience receiving genetic testing for risk carrier status.

Presentations

• Maldonado Gonzalez, A. (2025, Summer).

  Meet a CPC Scientist. 

  . Student Transformative Experiences to Progress Under-Represented Professionals (STEP-UP) Program. Tucson, AZ: University of Arizona.
• Garcia, D., Villavicencio, E., Baird, C., Sun, X., Godfrey, T., Shea, K., Maldonado Gonzalez, A., Seaton, D., & Sanderson, P. (2024). Metabolic dysfunction-associated steatotic liver disease (MASLD) and associated risk factors in a community-based sample of American Indians. American Association for the Study of Liver Disease (AASLD) Annual Meeting.
• Maldonado Gonzalez, A. (2023). Mano a mano: Working together to promote community's well-being. AzCHOW 2023 Fall Symposium.
• Maldonado, A., Loya, J., Crocker, R., Martinez, D., Villavicencio, E., & Garcia, D. (2023). Salud sin Fronteras: Understanding how social context and geographical location influence access to healthcare among Mexican immigrant in Southern Arizona.. American Public Health Association.
• Maldonado, A., Zhang, X., & Garcia, D. (2023). The association between acculturation, allostatic load, and non-alcoholic fatty liver disease in Hispani adults: Analysis of the 2017-2020 National Health and Nutrition Examination Survey (NHANES).. American Public Health Association.

Poster Presentations

• Garcia, D., Maldonado Gonzalez, A., Villavicencio, E., Alkhouri, N., Mockbee, J., & Spegman, D. (2024). A multi-channel educational communication campaign to improve liver disease screening and awareness for clinical care in Southern Arizona along the United States/Mexico border. European Association for the Study of the Liver (EASL) Congress.
• Garcia, D., Maldonado Gonzalez, A., Villavicencio, E., Vogel, R., Baird, C., Gonzalez, A., Ochoa Mora, E., & Alkhouri, N. (2024). Use of FibroScan® to assess hepatic steatosis and fibrosis in community-based settings to promote clinical care linkages along the Southern Arizona United States/Mexico border. European Association for the Study of the Liver (EASL) Congress.
• Lindemer, S., Maldonado Gonzalez, A., Ochoa Mora, E., Gonzalez, A., Villavicencio, E., & Garcia, D. (2024). Risk factors associated with mild cognitive impairment among Mexican immigrant adults in Southern Arizona. Arizona Alzheimer's Consortium Annual Conference.
• Maldonado Gonzalez, A., Torres, E., Torres, R., Castro, I., Torres, F., Villavicencio, E., Hernandez, A., Loya, J., & Garcia, D. (2024). The Association between Neighborhood Context and Non-Alcoholic Fatty Liver Disease among Mexican-origin Farmworker. European Association for the Study of Liver Disease (EASL) Congress.
• Ochoa Mora, E., Maldonado Gonzalez, A., Flores, M., Rodriguez, M., Martinez, D., Crocker, R., & Garcia, D. (2024). Over the Counter Medication Use Among Mexican Immigrants in Southern Arizona: A Cross-sectional Study. Arizona Health Equity Conference.
• Villavicencio, E., Maldonado Gonzalez, A., Ochoa Mora, E., Gonzalez, A., Alkhouri, N., & Garcia, D. (2024). Comparison of Hepatoscope® and FibroScan® for non-invasive assessment of hepatic steatosis and fibrosis among Mexican immigrant adults along the Southern Arizona United States/Mexico border. European Association for the Study of the Liver (EASL) Congress.