Relationships or connections with caring pro-social others (e.g., parents, teachers, school, friends, neighborhood, religion) serve as pro-resilience assets that may enhance children's abilities to cope with bullying. The purpose of this research study was to explore the roles of connectedness and religiosity as potential factors that could enhance resiliency against bullying among preadolescents in Puerto Rico (PR). This doctoral dissertation also addressed several gaps in the children's bullying, resilience and religiosity research literature. A sample of 426 community-based afterschool program preadolescents (ages 10-12 years old) participated in this exploratory, cross-sectional study, by completing a quantitative questionnaire in paper and pencil format. Data was analyzed overall, by location (i.e., San Juan Metropolitan Area (SJ Metro), Other Municipalities within PR), gender, age, and church attendance. Twenty percent of all participants were victimized by bullying at least 2-3 times per month. On the other hand, 5% of participants said they had been a bully 2-3 times per month. The most frequent type of bullying perpetration and victimization reported was verbal. Participants reported the highest levels of connectedness to school and the community, followed by connectedness to parents, teachers, mothers, religion, fathers, and friends. Most participants (71%) said they attended church regularly, but only 35% did so every week. Statistically significant differences were found by location, gender, age and church attendance. Connectedness and religiosity were correlated significantly to the participants' involvement in bullying at different roles. Surprisingly, having strong prosocial connections do not appear to have a reduction impact on participants' bullying victimization. Connectedness overall, to mothers, teachers and school was positively and significantly correlated to victimization, whereas connectedness to school was negatively correlated to perpetration. Bully-victimization was negatively correlated to connectedness overall, to parents, mothers, friends, teachers, and school. Multiple linear regression analyses found that higher levels in connectedness to mother and connectedness to the community accounted for a 60% decrease and a 45% increase, respectively, in bullying perpetration among non-church attending participants. In terms of religiosity, analyses distinguished between participants' engagement in private and public religiosity practices. Private religiosity was negatively correlated to being a bullying perpetrator, and positively correlated to being a bystander. Public religiosity was positively correlated to bullying victimization. The self-report of religiosity did not affect the odds of being a perpetrator, victim or bully-victim. Specifically among SJ Metro participants, the self-report of private religiosity or the combination of both private and public religiosity reduced the odds of being a bystander. Multiple linear regression analyses found that among non-church attending participants, a 1-unit change in public religiosity acccounted for a 62% increase in bullying perpetration. While the religiosity-related findings from this study's correlation analyses were consistent with the literature, regression analyses' findings were unexpected and warrant additional research. This study goes beyond solely school-based approaches to bullying research and prevention, by utilizing a non-school sample of low-income preadolescents who attend afterschool programs at local community-based organizations. Furthermore, its focus on a younger age group (i.e., preadolescents) is consistent with the resiliency literature and the need to enhance resilience factors earlier in childhood. Findings also consider the multiplicity of actors involved in bullying (i.e., perpetrators, victims, bully/victims, or bystanders), and distinguishes between direct and indirect types of bullying. Consistent with recommendations from previous research, a socio-ecological approach was followed to explore the role of connectedness to others at the individual, family, school, peer, religious and community levels, as well as the role of religiosity as an external asset to enhance resilience in preadolescents. This exploratory study contributes to our understanding of bullying among PR preadolescents, and serve to inform the development of prevention programs, strategies and policies at the school and community level. Research on bullying in PR is limited, making it increasingly challenging for PR schools, community- and faith-based organizations to collaborate in multilevel interventions that specifically address the needs of PR's children.

Purpose: Hispanic or Latino older adults in the US are 1.5 times more likely to have Alzheimer’s and related dementias (ADRD) than white older adults. Nearly one third of all skilled home health (HH) patients and nearly one half of hospice patients have ADRD diagnoses. In ADRD’s long trajectory of decline, patient care transitions bring risks for poor outcomes. Minoritized patients are at high risk for live discharge from hospice, but little is known about those who transition from hospice to skilled HH, the fastest-growing long-term care setting in the US. Aims: to determine demographic and diagnostic variables among patients with ADRD who transition from hospice to skilled HH. Methods: We used Medicare claims data and descriptive statistics including Chi-Square to determine demographic differences in frequency of care transitions from hospice to skilled HH for (a) older adults with ADRD and (b) older adults with co-occurring ADRD and cardiovascular disease (CVD). Results: In N = 272,323 hospice episodes, we found that Hispanic or Latino older adults with co-occurring ADRD and CVD had significantly higher rates of care transitions from hospice to skilled HH (P=0.037) than other racial and ethnic groups with both diagnoses. Conclusions: This is the first study to our knowledge that provides evidence on disparities in care transitions from hospice to skilled HH for Hispanic or Latino older adults with ADRD and CVD. Multiple factors may impact this result. Implications include policy change and greater coordination across systems of care, with specific attention to health equity.

Gifted programs, designed to enhance engagement and rigor for students exhibiting talent or potential beyond their peers in the general education classroom, are not equitably identifying and serving Hispanic/Latino students. This qualitative study explored gifted programming at a Title I elementary school located in a largely Hispanic/Latino community. Very few students received gifted services at the school, despite equity measures in place. Using a framework of educational capital, this study highlighted the cultural capital and community cultural wealth of gifted Hispanic/Latino students and provided suggestions for enhancing programming for this historically underidentified population of learners. Data were collected through semistructured interviews of parents and teachers of students receiving gifted services. Questions were aligned with concepts of capital, and a priori codes were used to analyze participant perspectives. Findings identified embodied cultural capital as the dominant gifted paradigm, but inequitable opportunities to learn hinder students’ ability to embody giftedness. Also, the linguistic capital of other cultures has been unrecognized by gifted testing, impacting access for gifted emergent bilingual students. Finally, barriers to success (e.g., low levels of rigor and engagement at the school, lack of opportunity to test for the gifted program, and lack of navigational capital for parents and teachers) threaten the vibrant hopes and dreams parents and teachers have for these students. Findings support the need for increased gifted programming in Title I schools and updated gifted policy to reflect culturally inclusive values.

PURPOSE: To determine the influence of race/ethnicity on outcomes in the Childhood Cancer Survivor Study (CCSS). PATIENTS AND METHODS: Of CCSS adult survivors in the United States, 443 (4.9%) were black, 503 (5.6%) were Hispanic and 7,821 (86.6%) were white. Mean age at interview, 26.9 years (range, 18 to 48 years); mean follow-up, 17.2 years (range, 8.7 to 28.4 years). Late mortality, second malignancy (SMN) rates, health care utilization, and health status and behaviors were assessed for blacks and Hispanics and compared with white survivors. RESULTS: Late mortality rate (6.5%) and 15-year cumulative incidence of SMN (3.5%) were similar across racial/ethnic groups. Minority survivors were more likely to have lower socioeconomic status (SES); final models were adjusted for income, education, and health insurance. Although overall health status was similar, black survivors were less likely to report adverse mental health (females: odds ratio [OR], 0.6; 95% CI, 0.4 to 0.9; males: OR, 0.5; 95% CI, 0.3 to 0.8). Differences in health care utilization and behaviors noted: Hispanic survivors were more likely to report a cancer center visit (females: OR, 1.5; 95% CI, 1.1 to 2.0; males: OR, 1.7; 95% CI, 1.2 to 2.3); black females were more likely (OR, 1.6; 95% CI, 1.1 to 2.4), and Hispanic females less likely to have a recent Pap smear (OR, 0.7; 95% CI, 0.5 to 1.0); black and Hispanic survivors were less likely to report smoking; black survivors were less likely to report problem drinking. CONCLUSION: Adjusted for SES, adverse outcomes in CCSS were not associated with minority status. Importantly, black survivors reported less risky behaviors and better preventive practices. Hispanic survivors had equitable access to cancer related care.