Health, stress, and resilience among Latino immigrant families (SER Familia): A protocol to evaluate a multi-level, family-based community prevention program.

BACKGROUND: Latinos, the largest racial and ethnic group in the US, experience declines in health while adapting to a new culture and context. Acculturative stress, the stress associated with this adaptation, and resilience, the ability to overcome difficulties during this process, play important roles in influencing declines in health for both adults and youth. In fact, acculturative stress is the strongest social driver of the substance use, intimate partner violence, HIV, and mental health syndemic, conditions that cluster in marginalized communities. Yet there are limited interventions addressing acculturative stress and resilience in this population. This paper describes the protocol for SER Familia, a community-based intervention that uses a Syndemic Prevention Framework to address acculturative stress and promote resilience among Latino immigrant families.

METHODS: A total of 380 immigrant parents and youth dyads are being enrolled and randomized to the SER Familia program (six sessions with families and groups) or a delayed intervention condition. The intervention is delivered by community health workers who work with families to improve family health by reducing acculturative stress and enhancing resilience (coping, ethnic pride, and social support). One parent and one child from each family will complete standardized and culturally specific measures four times (pre-intervention baseline and 3-, 6-, 12-month follow-ups) to determine the effectiveness in preventing or reducing syndemic outcomes (Aim 1) and to describe the mechanisms of change of the intervention (Aim 2) using mixed-methods.

DISCUSSION: Findings have important implications for health promotion and disease interventions for Latinos and other immigrant populations.