Kudos to Rosa Gonzalez-Guarda, associate professor, and her entire team for the submission of her NIH R01 application entitled: “SER Comunidad: A Multilevel Intervention Addressing Acculturation Stress, Resilience, and Syndemic Outcomes Among Latino Immigrants." This proposal requests funding for a five-year period with a start date of April 1, 2022.

Latino immigrants in the U.S. are healthier than the general U.S. population when they first arrive; however this health advantage diminishes over time and across generations. Acculturation stress, the myriad of stressors associated with adapting to the U.S., is a key driver of decaying health among Latino immigrants and is the most robust predictor of the substance abuse, intimate partner violence, HIV, and mental health syndemic (co-occuring epidemics with common risks and protective factors). Despite chronic exposure to acculturation stress, many Latino immigrants are protected against the negative consequences of this stress through strong family and cultural ties and social support. This is particularly true for Latino immigrant families residing in resilient communities with multi-sector, equity-oriented initiatives that ensure access to needed social and health services. Yet few interventions exist to address the causes and consequences of acculturation stress. SER (Salud, Estrés y Resiliencia/Health, Stress, and Resilience) Comunidad is a multi-level intervention developed in partnership with community health workers that builds community, family, and individual capacity to address the causes and consequences of acculturation stress and promotes resilience across these levels. Our team will work in partnership with community-based organizations and other stakeholders to address the following specific aims: 1) Implement and determine the impact of SER Comunidad community-level intervention strategies (advocacy training, coalition building, expanded use of a state-wide electronic social and health referral system, and summits with key decision makers) on increasing community readiness, coordination, and navigation of systems that influence acculturation stress and resilience and link Latino immigrants to needed health and social services; and 2) Examine the efficacy of SER Comunidad family and individual-level intervention strategies (individual, group, and family sessions delivered by CHWs) in reducing acculturation stress, increasing resilience, decreasing syndemic outcomes (substance abuse, IPV, HIV risk behaviors, and depression), and improving access to health and social services among Latino immigrant families. To address Aim 1, we will use a quasi-experimental, matched-group design and mixed methods to integrate data from surveys (N= 208) and key informant interviews (n=40) with organization leaders, service providers, and community members sampled from two regions in North Carolina over a two-year period. To address Aim 2, we will conduct a quasi-factorial, randomized controlled trial (N= 388) to compare families randomized to the SER Comunidad Family/Individual intervention strategies to those receiving standard community services in these two regions, accounting for the exposure to community level strategies implemented in Aim 1. The findings from this study will inform health promotion strategies targeting Latino immigrants, the largest immigrant group in the U.S., who experience significant health disparities over time.