Patten, Christi

Abstract Background Immigrant women experience disproportionate psychosocial stress driven by acculturation, socioeconomic hardship, discrimination, and transnational responsibilities. Despite evidence supporting culturally tailored stress‑management interventions, limited formative research has examined program preferences across diverse immigrant communities. Methods Using a community‑based participatory research (CBPR) approach, we conducted three language‑concordant focus groups (Somali, Spanish, English; n = 18) and a mixed‑methods survey (n = 88) with immigrant women in southeast Minnesota. Qualitative data were analyzed using constant comparative methods; quantitative data were summarized descriptively. Results Participants described intersecting stressors including caregiving burdens, financial insecurity, immigration‑related fears, bicultural identity strain, and transnational obligations (e.g., “Every day you are being told of problems back at home”). Barriers to discussing stress included stigma, limited culturally concordant care, religious norms discouraging emotional disclosure, and structural constraints such as lack of insurance (e.g., “How are you gonna pay for a therapist if you don't have health insurance?”). Coping strategies varied culturally but consistently emphasized social support, spirituality, and practical stress‑reduction techniques. Survey findings indicated strong preference for education on stress, stigma reduction, culturally and linguistically aligned support groups, and flexible delivery formats (in‑person, hybrid). Conclusions Immigrant women experience multifaceted stress shaped by minority stress processes and structural inequities. Findings highlight the need for culturally responsive, community‑informed stress‑management interventions that integrate education, social support, and flexible delivery modalities. These results directly inform adaptation of a stress‑management program for Somali, Spanish‑, and English‑speaking immigrant women.

Background: Increased arterial stiffness, a marker of cardiovascular disease (CVD), is prevalent among African American (AA) adults and contributes to persistent CVD disparities. The Cardio-Ankle Vascular Index (CAVI) is a validated measure of arterial stiffness and predictor of adverse CVD outcomes. However, its relationship with the novel American Heart Association’s Life’s Essential 8 (LE8) cardiovascular health (CVH) construct has not been examined among AAs. Hypothesis: We hypothesized that increased arterial stiffness would be associated with lower CVH among AA adults. Methods: We analyzed baseline data from AA adults in the Techquity by FAITH! Trial, a 2-arm cluster randomized controlled trial conducted across 18 AA churches in Rochester and Minneapolis–St. Paul, Minnesota. Eligible participants (age ≥18 years with suboptimal diet or physical activity [PA]) completed validated electronic surveys (e.g., PA patterns) and clinical assessments (e.g., blood pressure [BP], lipids). CAVI was summarized as mean and categorized as normal (<8), borderline (8 to <9), or abnormal (≥9). CVH was assessed using the LE8 score (range 0-100 points) and categorized as low (<50), moderate (50-79), or high (≥80). Associations between CAVI and LE8 were assessed using multivariable linear regression adjusted for age, sex, and income (continuous) and Fisher’s exact test (categorical). LE8 components were compared across CAVI categories using Kruskal–Wallis tests. Results: Among 140 participants (mean age 53.0 years [SD 14.6]; 68% female), the mean LE8 score was 62.7 (SD 14.0). Nicotine exposure LE8 score was the highest (84.6 [SD 26.6]) and diet was the lowest (40.7 [SD 13.7]). Mean CAVI was 7.9 (SD 1.5), with 50% of participants classified as normal, 22% borderline, and 28% abnormal. No association between continuous CAVI and LE8 scores was observed after adjustment (unadjusted R 2 = 3.5%). All participants with high LE8 had normal CAVI, while abnormal CAVI was more prevalent among those with low (40%) and moderate (30%) LE8 scores (p<0.001). LE8 scores differed across CAVI categories for BP (median 50 in normal CAVI vs 30 in borderline/abnormal CAVI; p=0.003) and glucose LE8 scores (median 100 vs 60; p=0.014). Conclusions: Greater arterial stiffness was associated with lower CVH categories, with notable component-level differences in BP and glucose. Although not independently associated with overall LE8, integrating CAVI and LE8 categories may improve CVD risk stratification among AAs.