Adriana Maldonado

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Journals/Publications

• 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. (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.