Project Summary More than three years after Hurricane Maria, close to 130,000 Puerto Ricans—4% of the island’s population— have permanently relocated to the U.S., with the majority settling in Florida. Many Maria survivors are relocating to new-growth communities in Florida in search of better job opportunities and affordable housing. Previous research has shown that rates of psychiatric disorders are markedly elevated among Puerto Ricans and a clear mental health disparity exists between Puerto Ricans and other Hispanic/Latino groups in the U.S. Research with Puerto Ricans living in Central Florida indicates that higher levels of cultural stress are associated with increased risk of psychological distress and depression. Initial evidence suggests that the mental health of survivors has been negatively impacted by the hurricane and the process of resettling in the U.S. Recent research has found that survivors who relocated to Florida had significantly higher rates of posttraumatic stress and were more likely to meet the criteria for PTSD diagnosis, compared to those who remained on the island. Hurricane Maria survivors are also more likely to experience cultural stress, strained family relations, and diminished access to resources. Yet, pressing questions remain regarding the mental health impact of the hurricane and displacement to the U.S., particularly among the Puerto Ricans relocating to new-growth communities outside of large urban areas. Through this study we will advance our understanding of Hurricane Maria survivor families by addressing the following aims: Aim 1: Use qualitative research to examine the mental health care needs of Maria survivor families, by location. We will conduct in-depth qualitative interviews with parent-youth (aged 10-20) dyads in new-growth communities and in communities with a history of Puerto Rican/Latin American migration. Aim 2: Employ prospective surveys to compare the mental health care needs of Maria survivor families living in new-growth communities to those in communities with a history of Puerto Rican/Latin American migration, thereby facilitating a test of cultural stress theory. Aim 3: Engage with mental health practitioners and community leaders in new-growth communities to disseminate our findings in an effort to address the mental health care needs of Maria survivor families. This study will use a convergent mixed- methods design to compare qualitative and quantitative data. We will collect quantitative and qualitative data simultaneously (in parallel), and conduct the data analyses separately. We will compare the quantitative and qualitative results to produce an integrated analysis and identify whether there was convergence or divergence between the results obtained. The overall goal of this proposal is to inform the development of evidence-based interventions to reduce mental health and alcohol misuse disparities among families who have been exposed to natural disasters. Given the expected rise...