Project Summary
Latino adults have higher age-adjusted rates of many chronic disease relative to overall US trends, while also
having health advantages. Exposure to stress contributes to some of these disparities, with implications for
diabetes, cardiovascular disease, cancer, and mental illness. This project will clarify reported stressors
experienced by Mexican-origin adults in a low-income, medically under-served, border community. This
community participatory research will: 1) elucidate our knowledge of stress and culturally-bounded protective
factors through intensive, ethnographically-grounded interviews (N = 50); and, 2) examine relationships
between reported stressors to objective measures of physiological stress, systemic inflammation, and chronic
disease risk. The latter will be achieved through a representative household survey of Mexican-descent adults
(N = 320). Each of two yearly follow ups will assess biomarkers and self-reports on several factors: valid
psychosocial scales (e.g., socially embedded stressors); protective social and culturally-tied factors; and,
culturally-relevant coping resources (e.g., perceived individual support available and persons' openness to
receive support). Objective health metrics include markers of inflammation and systemic dysregulation (i.e.,
hsCRP, Il-6; cortisol) and Life's Simple 7 (i.e., A1c; cholesterol; blood pressure; adiposity; smoking; physical
activity; diet). Longitudinal models will be used to predict biomarker and chronic disease risk, and test for
differential sub-group patterns. Innovative, minimally invasive, and community responsive methods will be
used for biomarker data collection--specifically from dried blood spot, immediately available assessments of
A1c, BMI and BP, and cortisol from hair. Cortisol in hair and nails reflect more chronic stress indicators than
more commonly studied measures, and have particular promise as endpoints in stress management
interventions. Cortisol in keratin samples better parallels expected lengths of behavioral intervention trials
compared with highly transient levels observed in saliva, serum and urine. Analysis of the cohort data will also
directly inform sub-population targeting for a series of focus groups (N = 90). A minimum of 4 groups for each
biologically identified sub-populations will be conducted: those for persons of uniform high stress (high
reported stress and high biologic stress), those of uniform low stress, and those that appear resilient (high in
reported stress but lower than expected biologic stress). The adaptability of a promising stress-management
CHW intervention recently tested with Latinos in Connecticut will be explored. Key informant interviews with
community stakeholders and a community advisory board leveraged from a five-year prevention research
center beginning October of 2019 will further prepare us to submit a clinical trial to reduce and mitigate
stressors. Thus the data generated from this study will be invaluable to conducting a prevention trial to reduce
stress and chronic disease in our community, and in determining methods and models for other populations.