Luis Arturo Valdez, PhD, MPH

Dr. Valdez is an Assistant Professor in the Department of Health Promotion and Policy at the School of Public Health and Health Sciences at the University of Massachusetts, Amherst. A co-founder of the Nosotros Comprometidos a Su Salud program, Dr. Valdez currently serves as faculty at the Center for Community Health Equity Research at UMass Amherst.

El Dr. Valdez es profesor en el Departamento de Promoción y Política de la Salud en la Universidad de Massachusetts: Amherst. El Dr. Valdez también es cofundador de Nosotros Comprometidos a Su Salud y actualmente también es facultad del Centro de Investigación sobre Equidad en la Salud Comunitaria.

Adriana Maldonado, PhD

Dr. Adriana Maldonado is a Postdoctoral Research Associate in the Department of Health Promotion Sciences at the University of Arizona Mel and Enid Zuckerman College of Public Health. Dr. Maldonado received her Ph.D. in Community and Behavioral Health from the University of Iowa. Her research focuses on the intersection of health equity and Latino health. She is currently involved in the Nosotros Comprometidos a Su Salud public health program which aims to reduce health disparities faced by the Latino community in the Southern Arizona region. Dr. Maldonado’s recent work utilizes a mixed-methods approach to understand the impacts of social and environmental contexts on Latinos’ hypertension-related disparities. Her areas of focus include psychosocial determinants of health, health disparities, mental health, and chronic diseases.

La Dra. Adriana Maldonado es investigadora asociada posdoctoral en el Departamento de Ciencias de Promoción de la Salud de la Facultad de Salud Pública Mel and Enid Zuckerman de la Universidad de Arizona. La Dra. Maldonado recibió su PhD. en Salud Comunitaria y del Comportamiento de la Universidad de Iowa. Su investigación se enfoca en la intersección de la equidad en salud y la salud de los latinos. Actualmente participa en el programa de salud pública Nosotros Comprometidos a Su Salud, cuyo objetivo es reducir las disparidades de salud que enfrenta la comunidad latina en la región del sur de Arizona. El trabajo reciente del Dr. Maldonado utiliza un enfoque de métodos mixtos para comprender los impactos de los contextos sociales y ambientales en las disparidades relacionadas con la hipertensión de los latinos. Sus áreas de enfoque incluyen los determinantes psicosociales de la salud, las disparidades en la salud, la salud mental y las enfermedades crónicas.

Rosi M. Vogel, CCHW, CHC

Rosi graduated from Anahuac University in Mexico City, Mexico. She is a Certified Health Coach and a certified Community Health Worker in the State of Arizona with over 20 years of experience in community building. Rosi serves as Community Building Liaison and a Program Coordinator.

Rosi M. Vogel se graduó de la Universidad Anáhuac en la Ciudad de México. Rosi es una entrenadora de salud certificada, así como una promotora de salud certificada en el estado de Arizona, con más de 20 años de experiencia en extensión comunitaria. Rosi es la Coordinadora del Programa.

Edgar Villavicencio, MPH

Edgar Villavicencio is the Research Director of Nosotros, and is a recent graduate of a Master of Public Health degree in Health Behavior Health Promotion from the Mel & Enid Zuckerman College of Public Health at the University of Arizona. Edgar has been engaged with Nosotros taking on different roles from volunteering, becoming an undergraduate and graduate research assistant, and now as a staff member. Edgar has extensive experience in recruitment and community outreach and engagement efforts, assisting clinical visits, in addition to qualitative data methodologies including conducting interviews in English and Spanish and data analysis and interpretation. Edgar’s research interest encompasses a need to understand the root of health disparities in vulnerable populations and how to equitably diminish them in Southern Arizona and U.S.-Mexico border. Other of his research interests include chronic disease prevention, physical activity, autism, border health, and community-based participatory research (CBPR).

Edgar Villavicencio es el Director de Investigación de Nosotros, se graduó recientemente de una Maestría en Salud Pública con un énfasis en Promoción y Comportamiento de la Salud de la Facultad de Salud Pública Mel & Enid Zuckerman de la Universidad de Arizona. Edgar ha estado comprometido con Nosotros asumiendo diferentes roles desde trabajo voluntario, convirtiéndose en asistente de investigación de pre y posgrado, y ahora como miembro del personal. Edgar tiene una amplia experiencia en reclutamiento y esfuerzos de participación y alcance comunitario, asistencia en visitas clínicas, además de metodologías de datos cualitativos que incluyen la realización de entrevistas en inglés y español como también el análisis e interpretación de datos. El interés y enfoque de la investigación de Edgar abarca la necesidad de comprender la raíz de las disparidades de salud en las poblaciones más vulnerables y cómo disminuirlas de manera equitativa en el sur de Arizona y el área fronteriza entre Estados Unidos y México. Otros de sus intereses de investigación incluyen la prevención de enfermedades crónicas, actividad física, el autismo, la salud fronteriza y la investigación participativa basada en la comunidad (CBPR).

Ana Gonzalez, BS

Ana recently graduated from the University of Arizona with her BS in Public Health. She is currently a student in the Masters of Public Health program, with an emphasis in Health Behavior Health Promotion, at the Mel and Enid Zuckerman School of Public Health. Ana started with Nosotros during the summer of 2021 as a research intern and has recently become a staff member. Her research interests include addressing and understanding health disparities, specifically among the Hispanic population and border communities, and enabling positive health behavior through education and lifestyle.

Ana se graduó recientemente de la Universidad de Arizona con su título en Salud Pública. Actualmente es estudiante del programa de Maestría en Salud Pública, con énfasis en la Promoción de la Salud y Comportamiento de Salud, en la Escuela de Salud Pública Mel and Enid Zuckerman. Ana comenzó con Nosotros durante el verano de 2021 como pasante de investigación y recientemente se convirtió en miembro del personal. Sus intereses de investigación incluyen abordar y comprender las disparidades de salud, específicamente entre la población hispana y las comunidades fronterizas, y apoyar comportamientos de salud positivos a través de la educación y el estilo de vida.

Estefania Ochoa Mora, MD

Estefania completed medical school at the College of Medicine from Universidad de Sonora in Hermosillo, Sonora. She is a second-year Master of Public Health in Epidemiology student at the University of Arizona Mel and Enid Zuckerman College of Public Health. Estefania joined the Nosotros team as a volunteer in fall of 2022 and has now become part of the research staff. Her research interests include the relationship of social factors and health behavior, health disparities, and the relationship of infectious and chronic degenerative diseases.

Estefanía completó sus estudios en la carrera de medicina del Colegio de Medicina de la Universidad de Sonora, campus Hermosillo, Sonora. Actualmente se encuentra cursando su segundo año de la Maestría en Salud Pública con enfoque en Epidemiología en la Universidad de Arizona Mel and Enid Zuckerman College of Public Health. Inicialmente, Estefanía se unió al equipo de Nosotros como voluntaria en otoño del 2022, y recientemente se convirtió en miembro del personal de investigación. Sus intereses de investigación incluyen la relación de los factores sociales y el comportamiento de salud, disparidades de salud, y la relación de las enfermedades infecciosas y crónicas degenerativas. 

Community Outreach and Engagement for Liver Disease Prevention and Treatment in Southern Arizona

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the U.S. and one of the greatest risk factors for liver cirrhosis, liver failure, and hepatocellular carcinoma. Relevant to Southern Arizona, rates of NAFLD are highest among individuals of Mexican-origin descent. Unfortunately, symptoms of NAFLD generally do not occur until the progression of disease becomes irreversible. Our early efforts to improve early detection and screening for NAFLD have focused on using a Fibroscan® in community-based settings. The Fibroscan® is a non-invasive device used to determine the amount of steatosis (fat) and fibrosis (scarring) levels in the liver. Working with promotoras, community partners, and the community itself, the proposed project will expand on previous efforts and provide individuals with the knowledge to spread awareness of NAFLD. It will also provide more educational support to individuals getting a Fibroscan® to ultimately reduce their risk and potentially reverse this condition through lifestyle changes, particularly with improving diet behaviors.

For more information or to schedule your free scan, please contact us:
Rosi Vogel: 526-7279 - office
Ana Gonzalez: 520-282-2785 call/ text / WhatsApp

A Gender and Culturally Specific Approach to Reduce NAFLD in Mexican-American Men

The Mexican-American population accounts for 64.3% of the U.S. Hispanic population and is the fastest growing Hispanic subgroup. Non-alcoholic fatty liver disease (NAFLD) is a chronic disease associated with obesity, and the highest rates of NAFLD among populations in the United States occur among Mexican-American men. NAFLD includes a spectrum of conditions, ranging from fatty liver to cirrhosis and liver cancer. Lack of physical activity and sugar-sweetened beverage consumption are major risk factors for NAFLD and are highly evident among Mexican-American males. Additionally, Mexican-American men are at increased risk of NAFLD and liver cancer if they carry of a specific version of a gene that has been shown to increase risk and severity of NAFLD. 

In the absence of prescription medications, weight loss due to changes in diet and physical activity is highly recommended for the prevention and treatment of NAFLD. Changes in lifestyle that result in >5% body weight loss have been shown to reduce levels of liver fat and even reverse the condition. Despite the clear need to develop effective intervention strategies for Mexican-American men, at this time no studies have explored the use of health risk assessment strategies, including genetic risk, to motivate behavior changes that would reduce the risk of NAFLD in Mexican-American men. Consequently, this research will be the first to evaluate the knowledge, attitudes, and beliefs around NAFLD risk, including genetic risk, for Mexican-American men. In addition, this project could be the first weight loss intervention for Mexican-American men to incorporate genetic predisposition and lifestyle risk factors associated with NAFLD (e.g., dietary sugar consumption), as a strategy to improve engagement in weight loss and weight maintenance behaviors.

Cosechando la Salud: Understanding the Root Causes of Non-Alcoholic Fatty Liver Disease in Migrant/Seasonal Farmworkers

PI: Dr. Adriana Maldonado
Research Team: Dr. Julio Loya and Dr. David O. Garcia
Funding Agency: Community Foundation for Southern Arizona

Non-alcoholic fatty liver disease (NAFLD) affects approximately 43% of Mexican-origin adults in the U.S. Despite the disproportionate burden of NAFLD experienced by Mexican-origin adults, studies exploring NAFLD risk among migrant/seasonal farmworkers do not exist. This is surprising given migrant/seasonal farmworkers experience higher rates of hypertension, type 2 diabetes (T2D), hypercholesterolemia, and obesity, all of which are risk factors for NAFLD. Further, despite compelling evidence that the social and built environment affect health outcomes as much as individual-level characteristics, a neighborhood’s social and built environment factors have rarely been considered in cancer-related research. A neighborhood’s social and built environment can impact an individual’s health through allostatic load (AL), which is the wear and tear on the body due to stress. Thus, in partnership with Campesinos sin Fronteras, a non-profit organization dedicated to educating Yuma County residents to prevent chronic disease, injury, and illness associated with farmwork, Cosechando la Salud aims to (1) Examine associations between neighborhood context, allostatic load, and NAFLD in a cross-sectional sample of Mexican-origin migrant and seasonal farmworkers and (2) Conduct a participatory research process with Mexican-origin migrant and seasonal farmworkers using photovoice to identify neighborhood characteristics that influence allostatic load and NAFLD risk. Cosechando la Salud will have an important positive impact as the reduction of allostatic load and NAFLD risk can significantly decrease liver cancer risk for migrant/seasonal farmworkers.

Advancing Liver Cancer Prevention for Arizona American Indian Communities

PIs: Dr. David O. Garcia and Dr. Priscilla R. Sanderson
Funding: National Institutes of Health/National Cancer Institute
Research team: Drs. Timian M. Godfrey, Kimberly Shea, Sun Xiaoxiao, and Morgan Vigil-Hayes

American Indian (AI) communities experience higher rates of liver cancer incidence and mortality than the general United States population, particularly in the Southwest Region. Common risk factors for liver cancer include having hepatitis B or hepatitis C, cirrhosis, excessive alcohol consumption, lack of physical activity, non-alcoholic fatty liver disease (NAFLD), and obesity. Notably, a disproportionate prevalence of obesity-related diseases is experienced by AI people in the U.S. when compared to all other racial/ethnic groups, making their health status a key public health issue. Despite the clear need to develop effective liver cancer prevention strategies, a gap remains among AI communities and the scientific literature. To address these significant gaps, the interdisciplinary team and community partners will explore strategies to improve liver cancer prevention and health equity for AI communities by applying integrated scientific approaches and community engaged research methods. This high impact effort will advance research for liver cancer prevention in a high-risk group that carries a disparate liver cancer burden. To address these issues, this research will be the first to explore knowledge, attitudes, and beliefs of NAFLD health risk including lifestyle behaviors, held by community members from Navajo and Tohono O’odham nations. Our study will also determine risk factors for liver cancer, including NAFLD status in adults from Navajo and Tohono O’odham. Lastly, we would also like to evaluate the feasibility of a culturally and clinically appropriate telehealth assessment for liver and other cancer related risk factors.

Equity in Liver Cancer Treatment in Hispanic Americans

PI: Dr. David Garcia
Research Team: Drs. Adriana Maldonado, Kristin Morrill, Patrick Wightman, Paul Hsu, Celina Valencia, Geoffrey Block, Diego Leal, Melissa Flores, and Julio Loya
Funding Agency: American Cancer Society

Mexican-origin communities are disproportionately impacted by liver cancer. Compared to the U.S. population, the rates of liver cancer incidence and mortality are higher in Mexican-origin communities, particularly in the Southwest Region. Common risk factors for liver cancer include having hepatitis B or hepatitis C, non-alcoholic fatty liver disease (NAFLD), cirrhosis, excessive alcohol consumption, lack of physical activity, and obesity. Notably, Mexican-origin adults in the U.S. experienced a high prevalence of obesity-related diseases, making their health status a key public health issue. Despite the excessive burden of liver cancer experienced by Mexican-origin adults, to date, the influence of socio-environmental factors influencing liver cancer treatment disparities and advanced liver disease treatment for Mexican-origin adults remains to be determined. Using a health equity lens, a multidisciplinary team of investigators and community partners will explore strategies to improve liver cancer prevention for Mexican-origin communities with the goal of advancing research for liver cancer prevention in a high-risk group that carries a disparate liver cancer burden. The Specific Aims are to: (1) Assess whether neighborhood social deprivation predicts liver cancer treatment disparities between Hispanics and NHWs; (2) Identify social network characteristics of Mexican-origin adults that influence liver disease care; and (3) Inform the development of an integrated collaborative care model to improve health care access for Mexican-origin adults identified with liver disease. Our efforts are centered in developing a sustainable research agenda for Mexican-origin communities that fosters interdisciplinary, collaborative research, education, and outreach.