On 7 January 2020, the southern region of Puerto Rico was struck by a 6.4 magnitude earthquake, followed by continual seismic activity. Our team performed secondary analyses to explore the relationship between exposure to seismic activity, protection (support) received, and barriers to health care access for cancer patients. Methods: The research team collected data from the database of a longitudinal case-control cohort parent study concerning the impact of Hurricane Maria in Puerto Rican cancer patients. The participants from the parent study were recruited in community clinics. The extracted data was collected from 51 cancer patients who completed the parent study’s interviews from January–July 2020 (seismic activity period). Barriers to health care were assessed using the Barrier to Care Questionaries (BCQ), which is composed of five subscales: skills, marginalization, knowledge and beliefs expectations, and pragmatics. Exposure to seismic activity and protection was assessed using their respective subscales from the Scale of Psychosocial Impact of Disasters. Results: The results showed a significant relationship between exposure to seismic activity and barriers to health care (p < 0.001) and its five subscales (p < 0.01). These results shed light on potential access to care barriers that could hinder cancer patient treatment in the event of a natural disaster.

Objective: The present study explored the association between the losses incurred due to breast cancer diagnosis, symptoms of depression, PANIC/GRIEF, and contextual factors within the context of Hispanic/Latina (H/L) patients diagnosed with breast cancer (BC). Methods: This study was a cross-sectional study of adult H/L BC patients (n = 129). The participants were H/L women diagnosed with breast cancer (stages 0–4) in the past five years. Sociodemographic variables were assessed, as well as depression symptoms (Patient Health Questionnaire-9; Spanish version), grief (The Affective Neuroscience Personality Scales, Grief subscale; Spanish version), and general losses (Grief diagnostic instrument for general practice, loss categories section). Results: The mean age for the sample was 55.37 (SD = 11.57). The most frequent non-death-related losses were loss of liberty (f = 63, p = 48.8%), followed by fear of own death (f = 67, p = 51.9%) and loss of quality of life (f = 65, p = 50.4%). A higher mean rank was observed in depressive symptomatology scores for those who experienced loss of liberty (U = 73.91, p < 0.008), quality of life (U = 77.30, p < 0.001), and fear of their own death (U = 74.88, p < 0.002). The results indicate a significant positive relationship between the number of reported losses and depressive symptomatology (r = 0.340, p < 0.001). In terms of contextual factors, the participants who reported their income not being enough to cover their expenses reported a greater number of losses related to diagnosis (U = 74.67, p < 0.001) and more depressive symptomatology (U = 69.84, p = 0.041). Moreover, a relationship was observed between grief and academic levels (r = −0.234, p = 0.008). Likewise, a relationship was observed between age and the number of losses (r = −0.461, p < 0.001). Conclusions: Our results provide new evidence on how primary non-death-related losses due to a breast cancer diagnosis impact the mental health of H/L BC patients.

Background: Puerto Rico (PR) is highly vulnerable to hurricanes, which severely impact cancer survivors by causing healthcare disruptions and increasing stress. This study investigates the reliability and factor structure of the Hurricane Hazards Inventory (HHI) and its relationship with psychological distress among cancer survivors and non-cancer controls in PR. Methods: Using secondary data from a longitudinal study following Hurricane Maria (HM), the baseline assessment included sociodemographic data from participants, HHI, Patient Health Questionnaire (PHQ-8), and Generalized Anxiety Disorder (GAD-7). Statistical analyses involved descriptive statistics, Exploratory Factor Analysis (EFA), and Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: Among 260 participants, 78.7% were women, with a median age of 58.0 years. EFA reduced the HHI to 17 items grouped into three factors explaining 62.6% of the variance with excellent reliability (Cronbach’s alpha 0.91). The three factors also showed good to excellent reliability (alpha 0.81 to 0.92). The median HHI score was 11.0 (range 4.0–26.5) out of 68. PLS-SEM revealed a direct effect of being a cancer survivor and tertiary hazards on depression and anxiety. Conclusion: The HHI is a valid and reliable tool for assessing mental health impact in cancer survivors after hurricanes. However, the study had limitations, including its small sample size and lack of control for all confounding variables. Future research with larger and more diverse samples is needed to further validate the HHI and examine its generalizability.

Background/Objectives: Lay Community Health Workers (CHWs) play a critical role in reducing mental health disparities, particularly among underserved and vulnerable populations, by bridging gaps in care and promoting mental well-being. This narrative review aimed to identify and characterize training programs designed for CHWs, with a focus on those targeting cancer patients and individuals with chronic conditions. Methods: A comprehensive literature search was conducted across databases including PubMed, EBSCOhost, Scielo, Redalyc, and Google Scholar. From an initial pool of 10,372 references, 27 relevant articles were selected, encompassing research articles, training materials, curricula, and other resources. Results: The identified training methods included role-playing, instructional videos, and manuals designed to equip CHWs with skills in mental health intervention, prevention, management, education, and stigma reduction. Training programs also incorporated evidence-based interventions and psychological skill training. This review highlights a notable gap in research on CHW-led interventions in cancer palliative care and mental health. Conclusions: The findings support the development of a specialized mental health training program tailored for CHWs working with cancer survivors, to enhance their capacity to address mental health challenges, reduce stigma, and promote psychological well-being. Future efforts involve developing a training intervention for CHWs to support the needs of cancer survivors.

Background/Objectives: Chronic medical conditions may contribute to psychological burden among individuals with cancer. This study examined associations between chronic medical conditions and posttraumatic stress, depressive symptoms, anxiety, and perceived stress among Puerto Rican adults with a self-reported cancer diagnosis. Methods: This quantitative secondary analysis used baseline data from a longitudinal study (N = 402) conducted in Puerto Rico following Hurricane Maria. The analytic sample included 108 adults with a self-reported cancer diagnosis. Psychological outcomes were assessed using the PCL-5, PHQ-8, GAD-7, and PSS. Mann–Whitney U and chi-square tests were conducted, followed by multivariable logistic and linear regression models adjusting for co-occurring conditions, age, and gender. Results: Asthma was associated with higher posttraumatic stress, depressive symptoms, and perceived stress scores; arthritis with higher depressive symptoms, anxiety, and perceived stress; and thyroid disorders with higher anxiety symptoms. Unadjusted analyses showed associations between asthma and clinically significant posttraumatic stress symptoms (OR = 3.13) and thyroid disorders and anxiety symptoms (OR = 2.90). After adjustment, thyroid disorders remained associated with clinically significant anxiety (aOR = 2.70, p = 0.041), whereas asthma was no longer significantly associated with posttraumatic stress (aOR = 2.45, p = 0.116). Self-reported depression was associated with all psychological outcomes in adjusted models. Conclusions: Specific chronic medical conditions were associated with psychological burden among adults with cancer, supporting psychological screening and coordinated care.

Background: Adults with serious mental illness (SMI), type 2 diabetes, and obesity have elevated cardiovascular risk. Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) have established cardiometabolic benefits in the general population, but their effects in SMI are unclear. We evaluated whether GLP‐1RA use was associated with lower risks of incident myocardial infarction (MI), heart failure (HF), and all‐cause death. Methods: This was a retrospective propensity score–matched cohort study of 218 043 adults with SMI, type 2 diabetes, obesity, and active antipsychotic or antidepressant medications in the TriNetX database (73 health care organizations). Outcomes were incident MI, HF, and all‐cause death at 1 and 3 years. The primary exposure was GLP‐1RA use versus nonuse; secondary analyses examined semaglutide or tirzepatide. Exploratory analyses evaluated sex, race, and sodium–glucose cotransporter‐2 inhibitor and dipeptidyl peptidase‐4 inhibitor use. Results: GLP‐1RA use was associated with lower risks of incident MI, HF, and all‐cause death. Risk differences at 1 and 3 years were −0.007 and −0.010 for MI, −0.011 and −0.018 for HF, and −0.039 and −0.065 for death (all P <0.001). Semaglutide or tirzepatide use was also associated with lower risks of MI, HF, and death (all P <0.001). Findings were directionally consistent after accounting for sodium–glucose cotransporter‐2 inhibitor and dipeptidyl peptidase‐4 inhibitor use. Conclusions: Adults with treated SMI, type 2 diabetes, and obesity using GLP‐1RAs, particularly semaglutide or tirzepatide, had significantly reduced 1‐ and 3‐year risks of incident MI, HF, and all‐cause death versus nonusers. These pooled associations should be interpreted in the context of SMI's clinical heterogeneity and the limitations of administrative case ascertainment.