Martinez-Cardoso Aresha, Monahan Emma, Garza Angela, Wallace Nola
Author Affiliations: Department of Public Health Sciences, University of Chicago, Chicago, Illinois (Dr Martinez-Cardoso and Ms Wallace); and Chapin Hall at the University of Chicago, Chicago, Illinois, USA (Dr Monahan and Ms Garza).
Fam Community Health. 2025;48(3):207-222. doi: 10.1097/FCH.0000000000000433. Epub 2025 Apr 29.
Social determinants of health (SDOH) interventions within clinical settings have been proposed to address health-related social needs, but few studies have explored intervention needs and challenges for Latinx families. This sequential mixed-methods study examined the effect of Developmental Understanding and Legal Collaboration for Everyone (DULCE), a 6-month SDOH intervention conducted in pediatric clinics in California and Florida.
Using survey data collected among Latinx caregivers who participated in the DULCE evaluation (n = 393), we examined changes in caregivers' depression, stress, and resilience, including differences by nativity. Qualitative interviews were conducted with DULCE participants (n = 16) across nativity to elucidate the components of the intervention that impacted caregiver outcomes.
DULCE led to significant increases in resilience among Latinx caregivers, especially immigrants, but no changes in depression or stress. Qualitative interviews illuminated that the following themes contributed to caregivers' resilience through the DULCE program: trusted relationship with family specialist caseworkers, connection to critical resources, addressing postpartum depression and social isolation, building caregivers' capacity to withstand challenges, and bolstering caregivers' confidence to seek resources independently.
Pediatric SDOH interventions are a promising strategy to support Latinx families in early childhood. Effective interventions for Latinx families, however, require strategies that pair resource connection with relationship building, address immigrants' and Latinx system avoidance, and incorporate additional supports or boosters for families experiencing extreme stress.
临床环境中的健康社会决定因素（SDOH）干预措施已被提议用于解决与健康相关的社会需求，但很少有研究探讨拉丁裔家庭的干预需求和挑战。这项序列混合方法研究考察了“人人发展理解与法律协作”（DULCE）的效果，这是一项在加利福尼亚州和佛罗里达州的儿科诊所开展的为期6个月的SDOH干预措施。
利用在参与DULCE评估的拉丁裔照料者中收集的调查数据（n = 393），我们考察了照料者在抑郁、压力和恢复力方面的变化，包括按出生地划分的差异。对不同出生地的DULCE参与者（n = 16）进行了定性访谈，以阐明影响照料者结果的干预措施组成部分。
DULCE使拉丁裔照料者，尤其是移民的恢复力显著提高，但在抑郁或压力方面没有变化。定性访谈表明，以下主题通过DULCE项目促进了照料者的恢复力：与家庭专家个案工作者的信任关系、与关键资源的联系、解决产后抑郁和社会孤立问题、增强照料者应对挑战的能力，以及增强照料者独立寻求资源的信心。
儿科SDOH干预措施是支持拉丁裔家庭幼儿期的一项有前景的策略。然而，针对拉丁裔家庭的有效干预措施需要将资源联系与关系建立相结合、解决移民和拉丁裔对系统的回避问题，并为经历极端压力的家庭提供额外支持或强化措施的策略。
