Mental Wellness and Stress: Bridging Gaps Through Cultural Awareness

A discussion with researchers from NAU’s Stress and Health Equity Lab

Welcome to a new year! We’re looking forward to sharing more health equity research stories from investigators, students, and community partners. To kick off the new year and celebrate Mental Wellness Month, we’re featuring Dr. Tara Bautista and students from the Stress and Health Equity Lab. Their research focuses on adapting mental health interventions to be culturally relevant and addressing the uneven distribution of stress with a focus on Latino communities.

About the Researchers

An assistant professor of Psychological Sciences, Dr. Tara Bautista is the principal investigator for the Stress and Health Equity Lab and is originally from the Imperial Valley area of Southern California. Daniela Castañeda Mendoza and Ayejah Rivera are undergraduate students and research assistants with the lab. Daniela is Guatemalan and was born and raised in Arizona. Ayejah, who joined the lab through the Interns to Scholars Program, was especially drawn to Dr. Bautista’s work because of her Puerto Rican and Salvadorian background. Veronica Rivas and Juliana Herrera-Arias are first year master’s students studying psychology and support the lab as project managers. Juliana is Colombian and spent part of her childhood in Florida before moving to Phoenix, AZ and Veronica grew up in Surprise, AZ.

About the Research: Addressing the Uneven Distribution of Stress Across Communities

TARA: The Stress and Health Equity Lab is founded on the shared understanding that stress is not evenly distributed throughout society and these inequities, stressors, and uneven distribution of resources for coping with stress create health disparities. If we can acknowledge that not all stress is equal and that populations are disproportionately affected by stressors, we can create tailored programs to address the stressors that affect different populations. Our work mostly focuses on Latino populations and our current projects focus on stress and alcohol or substance use.

We have three primary projects we’re working on right now. First, we’ve used funding from SHERC’s Pilot Project Program to develop a Community Advisory Board (CAB) of Latina women in Arizona. We are working with the CAB to adapt a mindfulness-based program to be more culturally relevant and useful to Latina women. We also have a second pilot project that we’re working on in partnership with Florida International University. Funded directly through NIMHD’s RCMI Program, the goal of this national survey is to look at risk and protective factors associated with alcohol and substance use. Additionally, I’m working on a Community Campus Partnership Support (CCPS) project with a partner in San Luis, Campesinos Sin Fronteras. The whole goal of this project is to not do research but to lay a foundation, build trust, and establish rapport with the community partners so that we can develop a research project together from the ground up.

Veronica, Juliana, Ayejah, and Daniela support both the CAB and RCMI projects, interacting directly with research participants. They’re gaining important skills and knowledge for doing research with community members. Veronica supports recruitment for the CAB project and connects with mothers who want to participate. Juliana has been involved with the RCMI project from the beginning and has supported survey development and data collection. Ayejah supports communication with the Community Advisory Board members and helps to create a safe environment where participants feel comfortable talking about stress and how culture can influence their health. Daniela helps to develop surveys for the CAB and RCMI projects and translated surveys and other research materials into Spanish.

Engaging with Cultural Diversity

JULIANA: What’s really important about the RCMI study, is that we’re looking at diverse groups of Latinos. We’re focusing on people living in the United States who come from different regions of Latin America and how stress may be distributed differently among different cultures. We often see Latinos as a homogeneous group, but that’s just not the truth. It’s important to see how these cultural factors affect stress and alcohol use depending on where people come from.

TARA: One thing that gets missed a lot – and we’re working towards this with the RCMI study – is that there are cultural protective factors (“cultural buffers”) that protect people even when they’re experiencing extreme amounts of stress and discrimination due to unjust systems. For example, traditional gender roles can sometimes be seen as a protective factor. The idea that women are more feminine can act as a protective factor because it limits alcohol consumption in communities where a woman drinking alcohol would be seen as outside of the social norm. Of course, protective factors can be very situational and we have to consider these nuances. Overall, it’s important not to overlook cultural strengths and protective factors just because they don’t exist in mainstream American culture. Researchers sometimes don’t measure these factors at all and it’s important to do so because they exist in our study populations.

A New Direction in the New Year

TARA: This semester, we’re working on developing a scale for another survey that’s part of the RCMI project. This scale will be used to look at and measure a concept known as acculturation. Acculturation describes the process of adapting to and adopting aspects of a dominant culture while maintaining one’s own cultural identity.

Here’s an example to illustrate the relationship between acculturation and stress. I grew up right along the US-Mexico border and we had road signs in English and Spanish. Store announcements came in both languages, church services were held in English and Spanish, and grocery stores stocked chiles and spices that are important to Latin American cuisine. It was an easier community to move into for someone with a Latinx background because it allows people to maintain their cultural identity without a lot of pressure to conform to a completely new culture. This is a very different experience for someone who moves from Latin America to North Dakota where it’s harder to find comfort foods and media (newspapers, television, radio, etc.) is frequently produced in English alone. The person in North Dakota will probably experience more stress because of the gap between their culture and that of the broader community they’ve joined. The scale we’re creating will help us measure acculturation and understand the relationship between an individual’s experience in a new culture and the broader community’s culture, and how this relates to stress.

Intersections of Personal Experiences and Research

TARA: I grew up in a very small rural town and was in high school during the Iraq and Afghanistan conflicts. There were few local job opportunities and going to college wasn’t common so many people went into the military. When people returned from duty, they would have to drive through the desert for over an hour to get mental health services. Many people experienced PTSD* related to explosions in desert settings during their time in duty and this drive was difficult for them. As a high schooler, I started thinking about why we didn’t have health services in our town and wondering why mental health wasn’t treated like any other kind of health condition.

I knew I wanted to go into psychology once I was in college, but quickly realized that being a clinician wasn’t where my heart was. I also recognized that many treatments and programs were very cookie cutter. Everyone got the same program and if it didn’t work for you, then you didn’t really have any other options. Additionally, I was seeing a lot of people in my community coping with stress through alcohol and substance use. I understood that many people didn’t want to use these substances, but they didn’t have access to better options to treat their pain. I’ve worked with different mentors over the years and learned different skills but these experiences are the root of my interest in the research I do.

*PTSD: PTSD (post traumatic stress disorder) is a mental health condition that some people develop after going through or seeing a traumatic event. 

VERONICA: I was initially interested in Dr. Bautista’s stress research so I joined the lab. From there, I’ve become interested in counseling and harm reduction practices. Research has really helped me understand what populations I want to work with.

JULIANA: For me, research is me-search. I come from an immigrant Latino household and have firsthand experience seeing how stress affects these communities. Stress from being an immigrant, not speaking the dominant language, and not having access to healthcare can lead to unhealthy coping strategies. Knowing that stress can differ across cultures, I joined the lab to learn more about how and why culture affects stress and how we can protect communities from harmful health outcomes.

DANIELA: I also come from an immigrant household and I’ve seen how afraid some people are to seek help when they need it. I decided to pursue this research so that I’m able to take back what I learn to my community and family members. Teaching them what I’ve learned about mindfulness and mental health and seeing how it can help the people I know and care about gets me excited about the research I’m doing.

AYEJAH: My grandma immigrated from El Salvador and my grandpa was born in Puerto Rico so I grew up with those cultures in my household. Reflecting on my personal experiences has made this research and everything I’m learning more exciting and meaningful. As I’ve gotten older, I’ve realized that culture isn’t just about music and food. Culture and social structures can also influence our health and I want to have an impact on creating healthy communities. With the CAB study, it was exciting to have discussions and make connections with the participants. For me, the personal connections create more passion for the work I’m doing.

What does mental wellness mean to you?

TARA: I think of mental health as being part of whole body health. It’s common for people to go to their doctor for an annual checkup or if they’re not feeling well; it’s less common for someone to have a mental health check unless something is really bad. It would be great to be able to promote mental health checkups and prevention efforts. I don’t think we talk about prevention in mental health wellness enough. We often wait for something catastrophic to happen and this in turn affects our physical health. At that point, people often start treating the physical health issues that were caused by mental health needs.

I teach health psychology which looks at mind-body interactions. Our brains are really powerful and when we tell our body that we’re unsafe, we’re telling our body to reduce resources to non-essential organs. In response to our thoughts, we turn down blood flow to our digestive and reproductive systems so that we can survive. We can’t live in survival mode and the only way to get out of survival mode is through mental processes. When I think about mental health wellness, I think about the experience of being in a safe space that allows your mind to tell your body that it’s safe. In the lab, we keep a self care basket that says “self-care is healthcare.” I will regularly send students home if they’re not taking care of their health. You can’t work, learn, or help others until you take care of yourself. I want my students to be healthy and thriving and in a good place. This is when we can get the most work done and be really productive together.

VERONICA: When I think about mental wellness I think about resilience. For me, having self-awareness of my strengths and understanding my limitations is really important. Sometimes you need to adapt your thinking and remind yourself to take a moment for yourself to be mindful, get outside, workout, cook, etc. Rather than being trapped in a static state where you’re telling yourself you can’t do something, you can change your mindset to ‘maybe I can’t do this now, but maybe in a few months I’ll be able to.’ It’s an active process of switching your thoughts.

JULIANA: To me, mental wellness has a lot to do with adaptive coping strategies. Nobody lives a stress-free life and we know how detrimental stress is to our physical health as well. I think it’s really important to not only prioritize coping strategies but to teach them to people in a way that’s understandable and attainable.

DANIELA: Mental wellness is also about listening to your body and being aware of your emotions. What’s causing them? When are you feeling them? Where are you feeling them? Being fully present during both negative and positive moments in your life is also important for mental wellness and understanding yourself.

AYEJAH: There are a lot of misconceptions about mental health. For example, people believe good mental health is about feeling happy all the time and not having any issues. In reality, mental health means that you’re checking in with yourself and allowing time to understand and resolve things when you’re feeling bad. We all study mindfulness and stress reduction, but I’m sure we’ve all caught ourselves not practicing what we preach. What’s important is that we’re remembering to check in with ourselves.

Taking Off Your Researcher Hat to Engage with Community Members

The team reflects on ways that they develop meaningful relationships with community members. Being culturally aware and reconceptualizing mental health concepts for research participants is an important part of doing research with Latino communities.

TARA: One way that I engage with the community is by participating in health fairs. I just got back last week from visiting with Campesinos sin Fronteras. They held their annual Dia del Campesino (Day of the Farmworker) celebration. This is an overnight health fair held for agricultural workers in San Luis, AZ. The event is held right at the US-Mexico border so that it is convenient and accessible to farmworkers. The fair had everything – vaccinations, dental exams, blood draws, blood pressure and blood sugar checks – and there were at least twenty different health agencies as well as lawyers who specialize in workers rights and immigration lawyers to assist with work visas. The point of the event was to provide resources to the farmworkers in a fun and inviting way and it was really cool to see everyone bringing their skills together.

My job during the event was to give out food. I really wasn’t there as a researcher, but as a person who cares. I believe this is really important. As researchers, we sometimes think that we’re supposed to always wear a researcher hat or that we sit on the opposite side of the table from the community. It’s really important to be in the community and not just show up when you’re collecting data. More locally, we participated in a health fair a few months ago at the Flagstaff Mall. We had flyers about our survey if people were interested, but we really focused on providing information about alcohol consumption.

Regarding advocacy and allyship, something I always talk about with students is that it is great to work with communities that you belong to, but the more educated you become the less you really are a part of that community. Even though we come from communities that we’re serving, we don’t always know what’s going on and we have to shift into becoming more of an ally or advocate of those communities. It’s important to remember that other people have different experiences.

VERONICA: Having a one-on-one connection with the CAB members has been an amazing experience. It’s been really meaningful to have conversations with the mothers outside of the sessions and to be able to ask about their day or their child’s graduation. It’s also been important to me to be able to connect with my family members about the research I’m doing. Most of them only speak Spanish so it can sometimes be difficult, but I feel like I’m advocating for them and supporting them through my work.

Additionally, I work with the Academic Success Center where I support first generation students by helping them develop study and time management skills. Working with the Stress and Health Equity Lab has highlighted the idea of intersectionality*. I try to bring this into my work by being mindful about who someone is and where they’re coming from, and how that might affect their needs.

*Intersectionality: The idea that a person’s combined identities (race, gender, sexual orientation, employment status, religion, etc.) interact to inform their experiences of privilege and oppression.

JULIANA: One thing I’ve learned about engaging in research with Latino community members is that we can’t just translate what we’re doing. There is no direct translation for some of the concepts we are studying – linguistically or culturally. We’ve done a lot of reconceptualizing terms like mindfulness and coping in a way that actually means something to our participants. I think this is an area where we can improve as Latino researchers.

DANIELA: This was also my experience as a facilitator with some of our sessions. While facilitating in Spanish I realized how much of our work doesn’t translate well. In particular, I’ve noticed that Latino mothers have a hard time talking about their mental health, stress, and substance use. Putting in the work as researchers to make these concepts make sense in Spanish is kind of the bare minimum, but it’s still really hard – but it’s worth it. Outside of research, I recently started a club at NAU. We’re talking about doing advocacy work, period drives to provide menstruation products to people in need, and other ways of giving back to our community.

AYEJAH: I’m the president of the Latina Student Union at NAU and I really appreciate being part of and contributing to this safe space. Something that I realized recently is that being Puerto Rican in Arizona is different than being Mexican. Like Veronica mentioned, it’s really important to be aware and incorporate this into our research. We can make something culturally adapted to Latinos but then you also need to take it a step further because our community is so diverse.

Interested in Collaborating?

TARA: I’m always open to meeting with students. If you’re a student, faculty member, or anyone else interested in collaborating, I would love to connect over coffee and discuss our overlapping work.

 

Interested in learning more about health equity research at NAU and in the community?

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