RESUMEN
The burden of HIV affects not only HIV-infected patients but also their families and caregivers. It is also known that family support is crucial for people living with HIV. A qualitative study was conducted to explore the life experiences, within the family context, of perinatally HIV-infected (pHIV-I) youth in Puerto Rico. Twenty in-depth interviews were performed and audio-recorded. Within the family context, study participants experienced acceptance, love and support but also stigma and discrimination. They reported that family is an essential component in their lives and treatment. Losing one or both parents at a young age was considered more difficult than having HIV. Most participants who lost their parents lived with other family members. This was a challenging situation for both pHIV-I youth and their caregivers. Participants described their healthcare providers as part of their families and would like to keep in touch as they transition to adult care. Despite the challenges, participants expressed a desire to have children. Services targeted to this population should stress social support, incorporate family members into the medical process, provide special guidance and support while transitioning to adult care, and provide them with the latest information regarding HIV and reproductive options.
Asunto(s)
Adaptación Psicológica , Cuidadores/psicología , Familia/psicología , Infecciones por VIH/psicología , Hispánicos o Latinos/psicología , Calidad de Vida/psicología , Apoyo Social , Adolescente , Adulto , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Amor , Masculino , Puerto Rico , Investigación Cualitativa , Estrés Psicológico , Adulto JovenRESUMEN
INTRODUCTION: The objective of our study was to evaluate the cost-effectiveness of a community-based intervention designed to improve physical activity levels and dietary intake and to reduce diabetes risk in a largely Hispanic population residing along the U.S.-Mexico border. METHOD: We forecasted disease outcomes, quality-adjusted life-years (QALYs) gained, and lifetime costs associated with actual and projected attainment of 2% and 5% weight loss taking a societal cost perspective. We extrapolated changes in beverage calorie consumption between baseline and 6-month follow-up to attain projected weight loss measures. Outcomes were projected 5, 10, and 20 years into the future and discounted at a 3.0% rate. RESULTS: The incremental cost-effectiveness ratio was $57,430 and $61,893, respectively, per QALY gained when compared with usual care for the 2% and 5% weight loss scenarios. The intervention was particularly cost-effective for morbidly obese participants. Cost-effectiveness improves when using 3-year weight loss projections based on changes in sugar-sweetened beverage caloric consumption to $49,478 and $24,092 for the 2% and 5% weight loss scenarios. CONCLUSIONS: This analysis demonstrates that a culturally sensitive community-based weight loss and maintenance intervention can be cost-effective even when healthy weight individuals participate.
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Promoción de la Salud/organización & administración , Americanos Mexicanos , Sobrepeso/economía , Sobrepeso/terapia , Pobreza , Adulto , Índice de Masa Corporal , Análisis Costo-Beneficio , Competencia Cultural , Diabetes Mellitus Tipo 2/etnología , Diabetes Mellitus Tipo 2/prevención & control , Dieta , Ejercicio Físico , Femenino , Conductas Relacionadas con la Salud , Promoción de la Salud/economía , Humanos , Masculino , Persona de Mediana Edad , Obesidad/terapia , Sobrepeso/etnología , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida , Estados Unidos , Programas de Reducción de PesoRESUMEN
The purpose of this study is to see if contact with the dead is associated with lower death anxiety among older Mexican Americans. The data come from a nationwide survey of older Mexican Americans (N = 1,005). The study model specifies that (a) older Mexican Americans who have experienced contact with the dead are more likely to see the connectedness that exists among all people; (b) seeing that all people are one promotes feelings of grateful to God; (c) gratitude toward God is, in turn, associated with lower death anxiety. The findings support each of these relationships.
Asunto(s)
Ansiedad/etnología , Actitud Frente a la Muerte/etnología , Americanos Mexicanos/etnología , Religión y Psicología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Estados Unidos/etnologíaRESUMEN
A manda is a religious quid pro quo whereby an older Mexican American promises to perform a religious act if the Virgin or one of the saints grants a request. The purpose of this study is to see whether making mandas is associated with health among older Mexican Americans. Findings from the study model suggest that making mandas is associated with a greater sense of personal control, and more personal control is associated, in turn, with better health.
Asunto(s)
Cristianismo/psicología , Estado de Salud , Control Interno-Externo , Americanos Mexicanos/psicología , Religión y Psicología , Anciano , Análisis Factorial , Femenino , Humanos , Masculino , Modelos Psicológicos , Sudoeste de Estados UnidosRESUMEN
Breast cancer is the main cause of cancer deaths for Hispanic women. This study analyzes the role of functional health literacy on mammography screening behavior and adherence of Hispanic women. Survey data from 722 Mexican American women age 40 and over residing in the Lower Rio Grande Valley of Texas in 2008 were used to estimate logistic regression models to assess the role of functional health literacy on mammography screening behavior and adherence. About 51% of survey respondents had a functional health literacy level deemed as inadequate or marginally functional. After adjusting for other factors, women with adequate health literacy levels were more likely to report to have ever had a mammogram (odds ratio [OR] = 2.92; 95% confidence interval [CI] = 1.62-5.28), to have had a mammogram within the last 2 years (OR = 1.70; 95% CI = 1.14-2.53) or to have had one within the last year (OR = 2.30; 95% CI = 1.54-3.43), compared to women with inadequate or marginally adequate functional health literacy levels. Inadequate/marginal functional health literacy is strongly associated with lower mammography screening. Large improvements in breast cancer control in this population may come from either basic advances in health literacy or by tailored approaches to help women with low literacy navigate local health care systems.
Asunto(s)
Neoplasias de la Mama/prevención & control , Detección Precoz del Cáncer/psicología , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Mamografía/estadística & datos numéricos , Americanos Mexicanos/psicología , Adulto , Anciano , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/psicología , Detección Precoz del Cáncer/estadística & datos numéricos , Femenino , Humanos , Mamografía/psicología , Persona de Mediana Edad , Proyectos Piloto , TexasRESUMEN
The purpose of this study is to see if there are differences in the social relationships that older African Americans, older whites, and older Mexican Americans form with the people where they worship. Data from two nationwide surveys are pooled to see if race differences emerge in eleven different measures of church-based social relationships. These measures assess social relationships with rank-and-file church members as well as social relationships with members of the clergy. The findings reveal that older African Americans tend to have more well-developed social relationships in the church than either older whites or older Mexican Americans. This is true with respect to relationships with fellow church members as well as relationships with the clergy. In contrast, relatively few differences emerged between older Americans of European descent and older Mexican Americans. However, when differences emerged in the data, older whites tend to score higher on the support measures than older Mexican Americans.
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The purpose of this study is to see if financial strain affects the religious involvement and life satisfaction of older Mexican Americans. In the process, an effort was made to explore the factors that promote financial strain in this ethnic group, including immigration status and English language use. The data come from a nationwide survey of older Mexican Americans. Support was found for the following core relationships in the study model: (1) older adults who were born in Mexico will have less schooling; (2) less education will be associated with less frequent use of English; (3) less frequent use of English will be associated with greater financial strain; (4) greater financial strain leads to less formal involvement in the church; (5) older people who are less involved in the church will have a diminished sense of religious meaning; and (6) older adults with a lower sense of religious meaning will be less satisfied with life.
RESUMEN
The purpose of this study is to explain how church-based emotional support influences the health of older Mexican Americans. This issue is evaluated with a theoretical model that contains the following core linkages: (1) older Mexican Americans who go to church more often will be more likely to receive emotional support from fellow church members; (2) older Mexican Americans who receive more support from their fellow church members will be more likely to feel they belong in their congregation; (3) older Mexican Americans who feel they belong in their congregation are likely to have a stronger sense of personal control; and (4) older Mexican Americans who have a stronger sense of personal control are likely to enjoy better health. Data from a recent nationwide survey of older Mexican Americans provide support for each of these relationships.
Asunto(s)
Salud , Relaciones Interpersonales , Americanos Mexicanos , Religión , Características de la Residencia , Apoyo Social , Historia del Siglo XX , Historia del Siglo XXI , Relaciones Interpersonales/historia , Americanos Mexicanos/educación , Americanos Mexicanos/etnología , Americanos Mexicanos/historia , Americanos Mexicanos/legislación & jurisprudencia , Americanos Mexicanos/psicología , Religión/historia , Características de la Residencia/historia , Conducta Social/historia , Identificación SocialRESUMEN
The purpose of this study was to evaluate a conceptual model that assesses whether praying to the saints or the Virgin is associated with the health of older Mexican Americans. A survey was conducted of 1,005 older Mexican Americans (Mean age = 73.9 years; SD = 6.6 years). Data from 795 of the Catholic respondents are presented in this study. The findings support the following relationships that are embedded in the conceptual model: (1) older Mexican Americans who attend church more often are more likely to believe in the efficacy of prayer to the saints or the Virgin; (2) stronger beliefs in the efficacy of intercessory prayer are associated with more frequent prayer to the saints or the Virgin; (3) frequent prayer is to the saints or the Virgin is associated with greater God-mediated control beliefs; (4) stronger God-mediated control beliefs are associated with greater optimism; and (5) greater optimism is associated with better self-rated health.
RESUMEN
OBJECTIVES: The purpose of this study is to examine the relationship between religiously based beliefs about suffering and health among older Mexicans. METHODS: A nationwide survey of older Mexican Americans was conducted (N=1,005). Questions were administered to assess beliefs about finding positive outcomes in suffering, the benefits of suffering in silence, other dimensions of religion, and health. RESULTS: The findings suggest that older Mexican Americans who use their faith to find something positive in the face of suffering tend to rate their health more favorably. In contrast, older Mexican Americans who believe that it is important to suffer in silence tend to rate their health less favorably. DISCUSSION: Moving beyond measures of church attendance to explore culturally relevant beliefs about suffering provides important insight into the relationship between religion and health among older Mexican Americans.
Asunto(s)
Adaptación Psicológica , Envejecimiento/psicología , Actitud Frente a la Salud , Catolicismo/psicología , Cultura , Americanos Mexicanos/psicología , Religión y Psicología , Estrés Psicológico/psicología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Acontecimientos que Cambian la Vida , Masculino , Modelos Psicológicos , Motivación , Calidad de Vida/psicología , Resiliencia PsicológicaRESUMEN
The purpose of the current study is to examine the relationship between religion and post death contact among older Mexican Americans. Four major themes emerged from 52 in-depth interviews that were conducted with Older Mexican Americans residing in Texas. First, many older study participants told us they had contact with the dead, but others indicated this was not possible. Second, the form in which contact with the dead was made varied greatly. Some older Mexican Americans reported they had visual contact with the dead, while others said they only made contact with the dead through dreams. Third, although some older Mexican American study participants believed that it was in the best interests of the dead to contact the living, others felt the dead should instead be in Heaven with God. Fourth, the participants in our study reported that having contact with the dead provides a number of important social and psychological benefits. In the process of discussing these themes, an emphasis is placed on how beliefs and experiences with the dead interface with religion. In addition, we also explore how post death contact may be associated with health and well-being in late life.
RESUMEN
Pain and suffering are deeply embedded in the ethos of Mexican American culture. Consequently, it is not surprising to find that many Mexican Americans turn to their faith in an effort to deal with the pain and suffering that arise in their lives. The purpose of the current study is to explore the interface between pain, suffering, religion, and health among older Mexican Americans. Three major themes emerged from in-depth qualitative interviews with 52 older Mexican Americans. The first is concerned with whether pain and suffering are a necessary part of religious life, the second has to do with the potential benefits that pain and suffering may provide, and the third involves whether it is necessary to bear pain and suffering in silence. In the process of reviewing these themes, an effort is made to show how they may be linked with the physical and mental health of older Mexican Americans.
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Conventional economic explanations for uninsurance should apply to all geographic regions in the United States. However, the border states of California, Arizona, New Mexico and Texas have the highest rates of uninsurance in the US, accounting for over 30% of the total US uninsured population. We use survey data from the fourth wave of the Border Epidemiologic Study on Aging (BESA), a survey from a predominantly Mexican American region of South Texas from 2005 to 2006, to analyze how health insurance coverage in the US is related to the use of health care services in Mexico. BESA includes data on the use of health care services in the US and Mexico. We estimate probit models to investigate the association between having insurance coverage in the US and having a regular doctor in Mexico, the independent variable of interest. Separate models are estimated with having private insurance, Medicare Part B insurance, and any type of public insurance as dependent variables. We deal with the endogeneity, due to reverse causality, of having a regular doctor in Mexico by using instrumental variables in a bivariate probit model. The instruments are dental care utilization in Mexico and a variable measuring frequently visiting Mexico. The results show that competition from Mexico lowers the demand for health insurance coverage in the US side of the border.
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Competencia Económica , Necesidades y Demandas de Servicios de Salud , Seguro de Salud/estadística & datos numéricos , Internacionalidad , Anciano , Femenino , Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Pacientes no Asegurados/estadística & datos numéricos , México , Persona de Mediana Edad , Modelos Teóricos , TexasRESUMEN
OBJECTIVES: We examined disparities in health care use among US-Mexico border residents, with a focus on the unique binational environment of the region, to determine factors that may influence health care use in Mexico. METHODS: Data were from 2 waves of a population-based study of 1048 Latino residents of selected Texas border counties. Logistic regression models examined predictors of health insurance coverage. Results from these models were used to examine regional patterns of health care use. RESULTS: Of the respondents younger than 65 years, 60% reported no health insurance coverage. The uninsured were 7 and 3 times more likely in waves 3 and 4, respectively, to use medical care in Mexico than were the insured. Preference for medical care in Mexico was an important predictor. CONCLUSIONS: For those who were chronically ill, old, poor, or burdened by the lengthy processing of their documents by immigration authorities, the United States provided the only source of health care. For some, Mexico may lessen the burden at the individual level, but it does not lessen the aggregate burden of providing highly priced care to the region's neediest. Health disparities will continue unless policies are enacted to expand health care accessibility in the region.
Asunto(s)
Accesibilidad a los Servicios de Salud , Servicios de Salud/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Cobertura del Seguro/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Comparación Transcultural , Femenino , Costos de la Atención en Salud , Servicios de Salud/economía , Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/economía , Humanos , Cobertura del Seguro/clasificación , Modelos Logísticos , Masculino , Pacientes no Asegurados/etnología , Pacientes no Asegurados/estadística & datos numéricos , Medicare , Americanos Mexicanos/psicología , Americanos Mexicanos/estadística & datos numéricos , México , Persona de Mediana Edad , Motivación , Práctica Privada , Texas , Estados UnidosRESUMEN
OBJECTIVE: To compare the mental health and well-being of Mexican immigrants with native-born Mexican Americans living in the Lower Rio Grande Valley of Texas. METHODS: A randomly stratified sample of 353 Hispanics aged 45 and older were interviewed. The immigrant group (n = 148) was compared with native-born Mexican Americans (n = 205). RESULTS: The findings showed that the native-born group was not significantly different from the immigrant group on measures of depression, health status, life satisfaction, or self-esteem. The immigrant group was found to report significantly more stress than the Mexican American group. Income, age, gender, and acculturation were significant predictors of well-being, whereas immigration status and years of residency were not. DISCUSSION: The well-being of Mexican immigrants in the United States is confounded by such variables as income, age, gender, and acculturation, along with various other contextual factors that characterize their life experiences in the United States.
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Aculturación , Depresión/etnología , Emigración e Inmigración , Americanos Mexicanos/psicología , México/etnología , Características de la Residencia , Estados Unidos/etnología , Factores de Edad , Anciano , Femenino , Estado de Salud , Humanos , Masculino , Salud Mental , Americanos Mexicanos/etnología , Autoimagen , Factores SexualesRESUMEN
Epidemiological studies indicate that minority populations in the US - including African Americans, Native Americans and Mexican Americans - are particularly at risk for diabetes and that their complications are more frequent and severe. Using microdata from a 1994-1999 population based study of middle aged and older Mexican Americans in the Southwest, this study analyzes the impact of diabetes on the employment and earnings outcomes of adults 45 years of age and older. The empirical results from estimating maximum likelihood employment and earnings models suggest that diabetes leads to lower productivity and earnings for women but has no statistically significant impact on their employment probability. In the case of men, however, diabetes leads to a lower employment propensity but has no effect on earnings. Thus, the problems associated with this condition could lead to potential future financial difficulties particularly for high-risk populations in their later years.