Rebecca M Crocker

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• Crocker, R. M., Sanchez, J. D., & Cruz, G. A. (2025).

  No hay paso: barriers to nature access faced by Mexicans in southern Arizona

  . Frontiers in Public Health, 13(1654101). doi:https://doi.org/10.3389/fpubh.2025.1654101
• Crocker, R. M., Yeo, S., Cordova-Marks, F. M., Castro, I., Torres, E., & Carvajal, S. C. (2025). “Don't leave it all to science”: How Mexicans living along the US-Mexico border view health and care seeking. Wellbeing, Space and Society, 9(Issue). doi:10.1016/j.wss.2025.100288
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  The geographic and cultural distribution of the health beliefs that inform how people interpret disease etiologies, engage in the clinical arena, utilize traditional remedies, and respond to health promotion programming is an important and understudied topic. The impacts of place-based factors on health concepts may be especially critical among geographically displaced populations, who tend to face a similar and concerning host of barriers to medical care access and societal stressors. In this community-based participatory research study, we use qualitative interviews (n=30) among a sample of binationally mobile Mexicans living near the US-Mexico border in southern Arizona to explore how border residence shapes Mexicans’ health and healing world views and care-seeking practices. Findings centered around 1) participants’ binational mobility which reinforced their connections with Mexican healing practices and medical services and provided an escape valve in the face of US-based barriers to care; 2) their integrated mind-body-soul health concepts that grounded them in their ecological and social surroundings; 3) their commitment to taking a primary role in their own healing including localized health challenges and their views on the role of doctors, and 4) barriers to health management tied to labor conditions, border crossing stressors, and perceived ill effects of biomedical care. In conclusion, proximity to the border and binational mobility are shown here to reinforce Mexicans’ cultural health concepts and facilitate their ability to maintain a more active role in their own care-seeking practices and to circumvent some critical US-based barriers to medical services.
• 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(Issue). doi:10.3389/fpubh.2025.1528486
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  Introduction: 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. Methods: A cross-sectional study was conducted using a purposive community-based sample (n = 300) of Mexican immigrant adults. Poisson regression model was utilized to assess the relationship between perceived discrimination, importance of health care use, pre-existing chronic health conditions, years living in the U.S. and the number of OTC medications used in the U.S. while adjusting for demographics and number of OTC medications used in Mexico. Results: Acetaminophen, NSAID, and supplement use increased post-migration. The number of OTC medications used in Mexico was associated with OTC medication use in the U.S. (RR = 1.35, 95% CI: 1.26, 1.45). Men in the U.S. had a 24% lower rate of OTC medication use compared to women (RR = 0.76, 95% CI: 0.59, 0.97). Length of stay in the U.S. was significantly associated with OTC medication use (95% CI: 0.00, 0.38; p = 0.002). Divorced/separated individuals had a 29% lower rate of OTC use compared to married individuals (RR = 0.71, 95% CI: 0.53, 0.96). Discussion: This study is among the first to examine OTC medication use patterns among Mexican immigrants in Southern Arizona. Further research is needed to understand the factors driving these changes and their impact on health outcomes.
• Page-Reeves, J., Rivera, M., Lozano, E., Regino, L., Tellez, M., Mendivil-Aguayo, P., Moore, M., Perez Rodriguez, D., Kalvesmaki, A., Crocker, R., Aragon, A., Vasquez, C., Perez, J., Thomas, R. J., Bearer, E. L., & Murray-Krezan, C. (2025). Interpreting discordant results in mixed-method research: data triangulation, participant voices, and epistemic issues in health research. International Journal of Social Research Methodology. doi:10.1080/13645579.2025.2569682
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  In this article, we discuss unexpected methodological challenges revealed during interim analysis of data from a mixed-methods study with female Mexican immigrants. ‘Tertulias’ was a randomized controlled trial of an innovative peer support group model for reducing social isolation and depression among women immigrants from Mexico using a Community-Driven, Community-Engaged Research (CD-CEnR) approach. We describe discordant data obtained using different methods and how we went about triangulating and integrating analyses. In the process, we identified cultural, contextual, and methodological factors that influenced the nature and content of the data, and issues of power and epistemic justice in the broader research enterprise. Based on this experience, we offer insights for data integration to improve both scientific rigor and epistemic justice in health disparities research.
• Crocker, R. M. (2024). How Promotoras Put Community at the Heart of Research: Reflections from a Community-Based Participatory Research Study Along the US-Mexico Border. . Practicing Anthropology, 46(4), 221–236..
• Crocker, R., Duenas, K., Castro, I., Ingram, M., Torres, E., & Carvajal, S. (2024). Knowledge of the Stress–Health Link as a Source of Resilience Among Mexicans in the Arizona Borderlands. Qualitative Health Research, 35(Issue 2). doi:10.1177/10497323241251776
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  Mexicans who migrate to the United States endure significant stressors related to the migration process and social and environmental conditions of life in the United States. Given that chronic stress exposure has been linked to the onset of health conditions, these ecological factors may expose them to increased risk for poor health. However, Mexicans have many positive health outcomes compared to those monitored nationally, making it crucial to understand possible sources of resilience in this population. Here, we investigate Mexicans’ lay health knowledge in response to stress as a possible source of health-related resilience. Health knowledge is considered a central facet of practical and traditional knowledge as well as adaptive modes of intelligence and has a tangible impact on health. Using an ethnographically grounded community-based participatory research design informed by the theory of embodiment, our hybrid team of bilingual university and community-based researchers interviewed Mexican-origin residents (N = 30) living in rural southwestern Arizona about how they experienced and responded to stress and incorporated it into their etiological frameworks. Thematic analysis revealed that participants paid close attention to how stress presented itself in their bodies, which informed their understanding of its potentially harmful health impacts and motivated them to employ multiple stress reduction strategies. Our results highlight the breadth of Mexicans’ lay health knowledge, thereby challenging dominant narratives about low rates of health literacy in this population. Findings can be harnessed to optimize potential health protective effects in home and community settings as well as to inform preventive and clinical interventions.
• Crocker, R., Maldonado, A., Garcia, D., & Martínez, D. (2024). The maintenance of mexican traditional medicine practices among mexicans in southern Arizona. Social Science and Medicine, 351(Issue). doi:10.1016/j.socscimed.2024.116982
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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.
• Garcia, D. O., Garcia, D. O., Maldonado Gonzalez, A., Maldonado Gonzalez, A., Martinez, D. E., Martinez, D. E., Crocker, R. M., & Crocker, R. M. (2024).

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

  . Social Science & Medicine, 351.
• LeBaron von Baeyer, S., Crocker, R. M., Rakotoarivony, R., Ranaivoarisoa, J. F., Spiral, G. J., Pascart, T., Wheeler, V., Mairai, T., Gregersen, N. O., Castel, S. E., Yerges-Armstrong, L. M., Fox, K., & Wasik, K. A. (2024). Nothing about us without us: Sharing results with communities that provide genomic data. Cell, 187(20), 5483-5489.
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  Sharing genetic and other study results with the communities who participate in research falls under benefit-sharing and capacity-building initiatives that underpin a more equitable biomedical research relationship. Yet, which results to return and how remain fundamental challenges that persist in the absence of practical guidance and institutional policies. Here, we discuss how the return of results can be implemented across different geographies, study designs, and project budgets.
• LeBaron von Baeyer, S., Crocker, R., Rakotoarivony, R., Ranaivoarisoa, J. F., Spiral, G. J., Castel, S., Farnum, A., Vance, H., Collins, N., Fox, K., & Wasik, K. (2024). Why community consultation matters in genomic research benefit-sharing models. Genome research, 34(1), 1-6.
• LeBaron von Baeyer, S., Crocker, R., Rakotoarivony, R., Ranaivoarisoa, J., Spiral, G., Pascart, T., Wheeler, V., Mairai, T., Gregersen, N., Castel, S., Yerges-Armstrong, L., Fox, K., & Wasik, K. (2024). Nothing about us without us: Sharing results with communities that provide genomic data. Cell, 187(20). doi:10.1016/j.cell.2024.08.023
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  Sharing genetic and other study results with the communities who participate in research falls under benefit-sharing and capacity-building initiatives that underpin a more equitable biomedical research relationship. Yet, which results to return and how remain fundamental challenges that persist in the absence of practical guidance and institutional policies. Here, we discuss how the return of results can be implemented across different geographies, study designs, and project budgets.
• Maldonado, A., Martinez, D. E., Villavicencio, E. A., Crocker, R., & Garcia, D. O. (2024). Salud sin Fronteras: Identifying Determinants of Frequency of Healthcare Use among Mexican immigrants in Southern Arizona. Journal of racial and ethnic health disparities.
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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., Martinez, 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, 12(Issue 3). doi:10.1007/s40615-024-02024-x
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  Background: 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. Methods: A non-probabilistic convenience sample of 300 adult Mexican immigrants completed a telephone survey to assess healthcare practices. Multivariable logistic regressions were fitted to determine adjusted relationships between frequency of care and predisposing, enabling, need, and contextual factors as well as personal health practices. Results: Overall, participants had a 79% probability of receiving healthcare “at least once a year” after migrating to Southern Arizona. Receiving post-migration healthcare was associated with predisposing, enabling, need, contextual factors, and personal health practices (p < 0.05). Discussion: Consistent with BMHSU, our findings suggest that frequency of healthcare is not only a function of having post-migration health insurance but is also shaped by a complex array of other factors. The results of this study shed light onto potential areas to be leveraged by multifactorial sociocultural interventions to increase Mexican immigrants’ frequency of healthcare services use.
• von Baeyer, S. L., Crocker, R., Rakotoarivony, R., Ranaivoarisoa, J. F., Spiral, G. J., Castel, S., Farnum, A., Vance, H., Collins, N., Fox, K., & Wasik, K. (2024). Why community consultation matters in genomic research benefit-sharing models. Genome Research, 34(Issue 1). doi:10.1101/gr.278308.123
• Palmer, K. N., Crocker, R. M., Marrero, D. G., & Tan, T. W. (2023). A vicious cycle: employment challenges associated with diabetes foot ulcers in an economically marginalized Southwest US sample. Frontiers in Clinical Diabetes and Healthcare, 4(Issue). doi:10.3389/fcdhc.2023.1027578
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  Aim: To describe patients’ reported employment challenges associated with diabetic foot ulcers (DFUs). Methods: Fifteen patients from under-resourced communities in Southern Arizona, with a history of DFUs and/or amputations, were recruited from a tertiary referral center from June 2020 to February 2021. Participants consented to an audio-recorded semi-structured phone interview. Interviews were transcribed and thematically analyzed using the Dedoose data analysis platform. Results: Participants shared a common theme around the cyclic challenges of DFU prevention/management and employment. Those employed in manual labor-intensive jobs or jobs requiring them to be on their feet for long durations of time believed working conditions contributed to the development of their DFUs. Patients reported work incapacity due to declines in mobility and the need to offload for DFU management. Many expressed frustration and emotional distress related to these challenges noting that DFUs resulted in lower remuneration as medical expenses increased. Consequently, loss of income and/or medical insurance often hindered participants’ ability to manage DFUs and subsequent complications. Conclusion: These data illuminate the vicious cycle of DFU and employment challenges that must be addressed through patient-centered prevention strategies. Healthcare providers should consider a person’s contextual factors such as employment type to tailor treatment approaches. Employers should establish inclusive policies that support patients with DFUs returning to work through flexible working hours and adapted work tasks as needed. Policymakers can also mitigate employment challenges by implementing social programs that provide resources for employees who are unable to return to work in their former capacity.
• Villavicencio, E. A., Maldonado, A., Crocker, R. M., Guan, Y., Stallman, C., & Garcia, D. O. (2023). Communicating PNPLA3 genetic risk status for NAFLD among Mexican-origin men. Frontiers in Public Health, 10(Issue). doi:10.3389/fpubh.2022.1090101
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  Introduction: 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 (PNPLA3) 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 PNPLA3 risk carrier status. Methods: Semi-structured interviews were conducted with 17 Mexican-origin men whose NAFLD status and genetic predisposition were determined as part of a previous cross-sectional study. The interview guide included questions exploring participants' insights on how genetic risk status was delivered, how the information influenced their motivation for lifestyle modification to reduce NAFLD risk, and any knowledge sharing that occurred with family members after learning of their PNPLA3 risk status. Interviews were conducted and audio recorded in English (n = 6) and Spanish (n = 11) and uploaded into NVivo software for data analysis and interpretation. Guided by the Health Belief Model, a thematic analysis approach was used to identify primary themes. Results: Results highlighted men's preference for receiving this type of genetic risk information through a letter sent to their homes. General comprehension of PNPLA3 risk status was deemed high and most men stated sharing their genetic predisposition to NAFLD with their immediate family members. Participants also indicated that family and awareness of this genetic risk acted as primary motivators for implementing behavior changes (e.g., diet, physical activity) toward the prevention of more severe liver conditions. Discussion: Findings from this qualitative study suggest the feasibility of communicating genetic risk for NAFLD among Mexican-origin men. Future strategies for the dissemination of genetic risk results among Mexican-origin individuals should consider familial and cultural appropriate strategies.
• Crocker, R. M., & Gonzales, P. (2022). Santos Remedios: How Mexican Immigrants Use Authoritative Healing Knowledge to Survive Migration. Culture, Medicine and Psychiatry, 46(Issue 2). doi:10.1007/s11013-021-09734-5
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  Mexicans living in the United States frequently rely upon popular healing to address a broad spectrum of physical, psychological, and spiritual ailments. They practice Mesoamerican healing ways including using herbal remedies, employing nutritional health promotion and illness remediation, over the counter pharmaceuticals, prayer and religion, and visiting expert healers. In this article, we utilize Brigitte Jordan’s theory of “authoritative knowledge,” to show how Mexican immigrants’ ancestral and ecological-based healing knowledge travels with them through migration. Based on original ethnographic research in the Southwest borderlands, we expand an understanding of the factors that support the continuity of authoritative knowledge spatially and temporally. Mexicans’ healing knowledge persisted north of the border because it (1) incorporated a wide array of healing techniques and materials that remained accessible post-migration, (2) enabled immigrants to heal according to Mesoamerican worldviews that privileged natural modalities and a holistic approach to body, mind, and spirit, and (3) remained relevant by allowing immigrants to remedy daily health stressors inherent to Mexican migration, including the border crossing, detention and deportation, and daily fear provoked by undocumented status. While lay practices have often been interpreted as problematic by medical professionals, we conclude that Mexicans’ authoritative healing knowledge serves as a survival mechanism during the challenging circumstances of binational migration.
• Crocker, R. M., Duenas, K., Vázquez, L., Ingram, M., Cordova-Marks, F. M., Torres, E., & Carvajal, S. (2022). “Es Muy Tranquilo Aquí”: Perceptions of Safety and Calm among Binationally Mobile Mexican Immigrants in a Rural Border Community. International Journal of Environmental Research and Public Health, 19(Issue 14). doi:10.3390/ijerph19148399
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  Perceptions of community can play an important role in determining health and well-being. We know little, however, about residents’ perceptions of community safety in the Southwestern borderlands, an area frequently portrayed as plagued by disorder. The qualitative aim of this community-based participatory research study was to explore the perceptions of Mexican-origin border residents about their communities in southern Yuma County, Arizona. Our team of University of Arizona researchers and staff from Campesinos Sin Fronteras, a grassroots farmworker support agency in Yuma County, Arizona, developed a bilingual interview guide and recruited participants through radio adds, flyers, and cold calls among existing agency clientele. Thirty individual interviews with participants of Mexican origin who live in and/or work in rural Yuma County were conducted remotely in 2021. Participants overwhelmingly perceived their communities as both calm and safe. While some participants mentioned safety concerns, the vast majority described high levels of personal security and credited both neighbors and police for ensuring local safety. These perceptions were stated in direct contrast to those across the border, where participants had positive familial and cultural ties but negative perceptions regarding widespread violence. In conclusion, we argue that to understand environmental factors affecting health and well-being in Mexican immigrant populations, it is critical to examine the role of binational external referents that color community perceptions.
• Crocker, R. M., Garcia, D. O., Morrill, K. E., & Villavicencio, E. A. (2022). How Mexicans’ Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care. Journal of Transcultural Nursing, 33(5), 615-623. doi:10.1177/10436596221101923
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  Introduction: This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people. Methodology: This article presents findings from qualitative interviews ( n = 26) that formed part of a mixed-methods study of foreign-born Mexican immigrants carried out in 2019 to 2020 in southern Arizona to assess NAFLD awareness. Results: We documented common experiences of surprise, fear, and hope during study participation, all of which motivated research participants to reduce their NAFLD risk by seeking additional information, sharing it with others, and making lifestyle changes. Discussion: Understanding how these emotional experiences are tied to cultural and historical factors—including Mexico’s high rates of liver disease, participant’s limited access to health care, and the ability to address the NAFLD risk with lifestyle changes—may promote the development of more effective and culturally congruent care in this population.
• Crocker, R. M., Marrero, D. G., Palmer, K. N., & Tan, T. (2022). The patient's perspective of diabetic foot ulceration: A phenomenological exploration of causes, detection and care seeking. Journal of Advanced Nursing, 78(8), 2482-2494. doi:10.1111/jan.15192
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  Abstract Aims Diabetic foot ulceration can contribute to lowered life expectancy and quality of life for people with diabetes, and yet, scant attention has been given to improving preventive and educational measures. This article uses a phenomenological approach to explore individuals' lived experiences of diabetic foot ulcerations to explore factors that can be harnessed to achieve improved outcomes. Design This was a qualitative study using semi‐structured interviews grounded in a phenomenological framework to explore how patients perceive and understand their foot problems. Methods Study participants were recruited from February 2020 to February 2021 from a tertiary referral centre that treats foot problems in persons with diabetes. A total of 15 Hispanic, Native American and White patients participated in the study. We conducted in‐depth semi‐structured interviews which were audio recorded with the participant's consent. Interview data were transcribed and analysed with Dedoose data management software. Results Analysis revealed findings in two primary domains: (1) how patients perceive foot ulceration, with themes around limited understandings of foot ulceration, close sensory observation of foot problems and barriers to ulcer perception and (2) how patients experience the timing of foot ulceration, with themes on how time perceptions shifted as foot problems became more serious, which correlated closely to how patients responded to their foot problems. Conclusion Despite the close sensory observation of their feet, people with diabetes face an array of barriers to recognizing and understanding the implications of diabetic foot ulceration, which can lead to delayed care seeking. Nurses can play a critical role in promoting patient education and improving patient self‐management of foot ulcers. Impact This phenomenological study offers important lessons to guide nurses and other providers in enhancing patient self‐management of DFUs and improving care outcomes by expanding an understanding of DFU early warning signs, the imperative to seek medical care quickly, and addressing possible barriers.
• Duenas, K. R., Ingram, M., Crocker, R. M., Pace, T. W., de Zapien, J. G., Torres, E., & Carvajal, S. C. (2022). La vida en la frontera: protocol for a prospective study exploring stress and health resiliencies among Mexican-origin individuals living in a US-Mexico border community. BMC Public Health, 22(Issue 1). doi:10.1186/s12889-022-14826-x
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  Background: Mexican-origin adults living near the U.S.-Mexico border experience unique and pervasive social and ecological stressors, including poverty, perceived discrimination, and environmental hazards, potentially contributing to the high burden of chronic disease. However, there is also evidence that residents in high-density Mexican-origin neighborhoods exhibit lower prevalence rates of disease and related mortality than those living in other areas. Understanding the factors that contribute to health resiliencies at the community scale is essential to informing the effective design of health promotion strategies. Methods: La Vida en la Frontera is a mixed-methods participatory study linking a multi-disciplinary University of Arizona research team with Campesinos Sin Fronteras, a community-based organization founded by community health workers in San Luis, Arizona. This paper describes the current protocol for aims 2 and 3 of this multi-faceted investigation. In aim 2 a cohort of N≈300 will be recruited using door-to-door sampling of neighborhoods in San Luis and Somerton, AZ. Participants will be surveyed and undergo biomarker assessments for indicators of health and chronic stress at three time points across a year length. A subset of this cohort will be invited to participate in aim 3 where they will be interviewed to further understand mechanisms of resilience and wellbeing. Discussion: This study examines objective and subjective mechanisms of the relationship between stress and health in an ecologically diverse rural community over an extended timeframe and illuminates health disparities affecting residents of this medically underserved community. Findings from this investigation directly impact the participants and community through deepening our understanding of the linkages between individual and community level stress and chronic disease risk. This innovative study utilizes a comprehensive methodology to investigate pathways of stress and chronic disease risk present at individual and community levels. We address multiple public health issues including chronic disease and mental illness risk, health related disparities among Mexican-origin people, and health protective mechanisms and behaviors.
• Tan, T., Crocker, R. M., Palmer, K. N., Gomez, C., Armstrong, D. G., & Marrero, D. G. (2022). A qualitative study of barriers to care‐seeking for diabetic foot ulceration across multiple levels of the healthcare system. Journal of Foot and Ankle Research, 15(1). doi:10.1186/s13047-022-00561-4
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  Abstract Introduction The mechanisms for the observed disparities in diabetes‐related amputation are poorly understood and could be related to access for diabetic foot ulceration (DFU) care. This qualitative study aimed to understand patients' personal experiences navigating the healthcare system and the barriers they faced. Methods Fifteen semi‐structured interviews were conducted over the phone between June 2020 to February 2021. Participants with DFUs were recruited from a tertiary referral center in Southern Arizona. The interviews were audio‐recorded and analyzed according to the NIMHD Research Framework, focusing on the health care system domain. Results Among the 15 participants included in the study, the mean age was 52.4 years (66.7% male), 66.7% was from minority racial groups, and 73.3% was Medicaid or Indian Health Service beneficiaries. Participants frequently reported barriers at various levels of the healthcare system. On the individual level, themes that arose included health literacy and inadequate insurance coverage resulting in financial strain. On the interpersonal level, participants complained of fragmented relationships with providers and experienced challenges in making follow‐up appointments. On the community level, participants reported struggles with medical equipment. On the societal level, participants also noted insufficient preventative foot care and education before DFU onset, and many respondents experienced initial misdiagnoses and delays in receiving care. Conclusions Patients with DFUs face significant barriers in accessing medical care at many levels in the healthcare system and beyond. These data highlight opportunities to address the effects of diabetic foot complications and the inequitable burden of inadequately managed diabetic foot care.
• Crocker, R. M. (2021). The Impact of Binational Barriers to Medical Care on the Care-Seeking Practices of Mexican Immigrants.. Qualitative health research, 31(6), 1043-1055. doi:10.1177/1049732321992041
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  Barriers to health care access faced by Mexican immigrants in the United States have been well-documented, including lack of insurance, fear of deportation, and language barriers. However, little is known about this population's care-seeking experiences before migration. In this article, I use a life-course approach to explore binational isolation from health care and the ways in which early-life experiences pattern Mexicans' care-seeking practices in the United States. This ethnographic research project took place in Tucson, Arizona, between 2013 and 2014 and used semistructured interviews with service providers and first-generation Mexican immigrants. The majority of participants faced significant barriers to medical care in Mexico, which resulted in low rates of care utilization and heavy reliance on lay modalities. Immigrants faced an even broader array of barriers to care in the United States, and their lack of prior health care access further discouraged care utilization and compromised their medical care experiences after migration.
• Crocker, R. M., Garcia, D. O., & Villavicencio, E. A. (2021). A Qualitative Analysis of Mexican-Origin Men’s Knowledge and Cultural Attitudes Toward Non-Alcoholic Fatty Liver Disease and Interest in Risk Reduction. American Journal of Men's Health, 15(6), 155798832110633. doi:10.1177/15579883211063335
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  Mexican-origin men are at increased risk of developing non-alcoholic fatty liver disease (NAFLD). The purpose of this qualitative research was to assess Mexican-origin men's knowledge and cultural attitudes toward NAFLD and their interest in risk reduction. Semi-structured interviews were conducted with 11 Spanish-speaking Mexican-origin men who were considered high-risk of having NAFLD according to transient elastography (FibroScan®) continuous attenuation parameter (CAP) scores (≥280). Audio recordings of these interviews were transcribed and interpreted in their respective language to facilitate data analysis using NVivo 12. A thematic codebook was developed, from which the research team identified emerging themes. Findings demonstrated limited knowledge about NAFLD and in general chronic liver disease among Mexican-origin men. Cultural attitudes appeared to both enhance and mitigate their perceived risk for NAFLD. Interviews also revealed high interest levels for reducing NAFLD risk, with family and loved ones acting as the main motivators for engagement in healthier behaviors. Inclination toward family-based interventions was reported as a subject of interest for this high-risk population. This qualitative study suggests that the development of a NAFLD-specific intervention approach for Mexican-origin men may be feasible and should consider a familial and cultural context centered in improving lifestyle health behaviors.
• Crocker, R. M., Palmer, K. N., Marrero, D. G., & Tan, T. W. (2021). Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. Journal of Diabetes and its Complications, 35(Issue 8). doi:10.1016/j.jdiacomp.2021.107960
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  Aims: Diabetic foot ulcers (DFUs) and ulceration are complex and lifelong problems for patients with diabetes which dramatically increase mortality rates. This qualitative study sought to capture detailed personal accounts and insights from patients with a clinical history of DFUs and amputations to better understand patient experiences. Methods: Fifteen patients from a tertiary referral center that treats diabetic foot problems were approached for participation. Inclusion criteria included having at least one DFU and being of white, Native American, or Hispanic background. Interviews were conducted by telephone by study staff trained in qualitative data gathering and audio recorded. Results: The main themes that emerged around impacts included the heavy burden of managing care, significant loss of ambulatory function, economic stress due to medical care costs and job loss, and emotional suffering tied to these stressors. Conclusions: These data illuminate common social and personal impacts of diabetic foot problems across an ethnically and racially diverse and predominantly low-income US sample that expand our understanding of related declines in well-being. Our results indicate a need for proactive mental health assessment post DFUs diagnosis and the diversification of hospital and community-based support systems.
• Crocker, R. M., Reineke, R. C., & Ramos Tovar, M. E. (2021). Ambiguous Loss and Embodied Grief Related to Mexican Migrant Disappearances. Medical Anthropology: Cross Cultural Studies in Health and Illness, 40(Issue 7). doi:10.1080/01459740.2020.1860962
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  Since the 1990s, thousands of Latin Americans have died or disappeared along the US-Mexico border, following the funneling of migration through remote desert regions. The families of missing migrants face long-term “ambiguous loss,” a lived experience in which a loved one is physically absent but psychologically present. Mexican relatives of the missing in Arizona and Sonora report that these losses produce deep emotional suffering along a timeline–worrying about the crossing, learning of the disappearance, beginning to search, and finally, coping with the long-term impacts of unknowing. Close relatives experience embodied health effects including headaches, insomnia, anxiety, depression, and chronic disease.
• Morrill, K. E., Crocker, R. M., Hingle, M. D., Thomson, C. A., & Garcia, D. O. (2021). Awareness, Knowledge, and Misperceptions Related to Nonalcoholic Fatty Liver Disease in a Community Sample of Mexican-Origin Women: A Mixed Methods Study. Frontiers in Public Health, 9(Issue). doi:10.3389/fpubh.2021.626428
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  Introduction: Mexican-origin women suffer disproportionate rates of nonalcoholic fatty liver disease (NAFLD) and research on how to tailor NAFLD treatment interventions for this population is lacking. Objectives: The purpose of this study was to assess awareness, knowledge, perceptions, and information sources related to NAFLD in a community-based sample of Mexican-origin women. Methods: This study employed a convergent parallel mixed-methods approach and consisted of a brief questionnaire (n = 194) and interviews (n = 26) among Mexican-origin women recruited from community-based settings including health fairs, churches, and community events. Participants were eligible if they identified as Mexican-origin, had a BMI ≥ 25 kg/m2, were 18–64 years of age, had the ability to speak, read, and write in English and/or Spanish, and provided informed consent. A purposeful sampling approach was used to recruit a subset of women (n = 26) with confirmed liver steatosis indicative of NAFLD (controlled attenuation parameter ≥280 dB/m) who completed the questionnaire. The twenty-six participants then completed one on one, in-depth semi-structured interviews to ascertain their knowledge and understanding of NAFLD. Results: Qualitative findings revealed low awareness of risk factors for liver disease, NAFLD specifically. Knowledge of liver disease tended to center around cirrhosis, a condition many participants reported was prevalent in their families. Quantitative and qualitative findings both found information sources for NAFLD and liver disease to be predominantly friends, family, and media. Interviews revealed a misperception related to NAFLD risk that liver disease was only caused by high alcohol intake. Conclusion: Low levels of NAFLD awareness and knowledge warrant the need for greater efforts to educate the general population, perhaps by integrating NAFLD education into existing type 2 diabetes educational campaigns and prevention interventions. Additionally, further elicitation research conducted in Mexican-origin adults is needed to elucidate key factors within behavioral-theory constructs that can be targeted in future interventions tailored to this unique population.
• CROCKER, R. (2020). Border Brokers: Children of Mexican Immigrants Navigating U.S. Society, Laws, and Politics. Christina M.Getrich. Tucson: University of Arizona Press, 2019. 272 pp.. American Ethnologist, 47(3), 315-316. doi:10.1111/amet.12922
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  American EthnologistVolume 47, Issue 3 p. 315-316 Book Review Border Brokers: Children of Mexican Immigrants Navigating U.S. Society, Laws, and Politics. Christina M. Getrich. Tucson: University of Arizona Press, 2019. 272 pp. REBECCA CROCKER, REBECCA CROCKER University of ArizonaSearch for more papers by this author REBECCA CROCKER, REBECCA CROCKER University of ArizonaSearch for more papers by this author First published: 04 August 2020 https://doi.org/10.1111/amet.12922Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume47, Issue3August 2020Pages 315-316 RelatedInformation
• Crocker, R. M., & Pike, I. L. (2020). “My own corner of loneliness:” Social isolation and place among Mexican immigrants in Arizona and Turkana pastoralists of Kenya. Transcultural Psychiatry, 57(5), 661-672. doi:10.1177/1363461520938286
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  This article explores the intersection of two growing health concerns: the rising incidence of loneliness and the negative health impacts of migration and displacement. To better evaluate loneliness across diverse populations, we emphasize the cultural shaping of expectations for social lives and the ways in which structural vulnerability and violence can undermine these expectations. We draw on ethnographic research with two groups of migrants: Mexican immigrants living in southern Arizona and Turkana pastoralists of Kenya who experience displacement and unpredictable mobility as a result of low intensity violence. For Mexican immigrants, feelings of loneliness intertwine with the emotions of fear, trauma, and sadness, all closely associated with social isolation. The Turkana describe loneliness associated with the loss of their animals, or the shifting social landscapes they must traverse to keep their families safe. The culturally salient experiences described by these two communities highlight the complexity of defining loneliness. Given the pace of global migration and the number of refugees and displaced persons, closer scrutiny of how cultural expectations and structural violence interact to produce feelings of loneliness seems overdue.

Others

• Hernandez, C., Hernandez, T., Crocker, R. M., & Valdez, G. R. (2025, May).

  Botiquin Fronterizo

  . Interactive Mapping Project. https://sites.arizona.edu/botiquinfronterizo-lab/
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  Botiquín Fronterizo is an interdisciplinary mapping project aimed to document the availability of botanical, pharmaceutical, spiritual, and other materials utilized by Mexicans in lay healing practices on both sides of the US-Mexico border. The Botiquín Fronterizo project seeks to expand scholarship on the prevalence and significance of Mexican Traditional Medicine (MTM) along the borderlands by producing a culturally and historically grounded visual portrayal of where Mexicans access their healing supplies.