RESUMEN
Few studies have examined the socio-cultural determinants of alcohol and drug misuse trajectories among adult Latinas. To assess the associations between socio-cultural determinants and alcohol and drug misuse, we used a longitudinal design to follow a sample of adult Latina mother-daughter-dyads (N = 267) for ten years, and collected four waves of data. They were adult Latinas of Caribbean, South and Central American descent. Specifically, this study investigated the effects of the following factors: (1) Individual Determinants (e.g., socioeconomic conditions, mental health, and medical status); (2) Cultural Determinants (e.g., acculturation to US culture); (3) Interpersonal Determinants (e.g., interpersonal support, relationship stress, mother-daughter attachment, intimate partner violence); (4) Community Determinants (e.g., neighborhood related stress); and (5) Institutional Determinants (e.g., religious involvement, involvement with the criminal justice system). Using hierarchical modeling, we found that taking prescribed medication on a regular basis for a physical problem, religious involvement, and mother-daughter attachment were negatively associated with drug misuse, while involvement in criminal activity was positively associated with drug misuse. Regarding alcohol misuse, results showed that age at arrival in the United States, number of years in the United States, and religious involvement were negatively associated with alcohol misuse, while involvement in criminal activity was positively associated with alcohol misuse. Based on our findings, explicit implications are provided for culturally relevant interventions.
Asunto(s)
Hispánicos o Latinos/estadística & datos numéricos , Relaciones Madre-Hijo/etnología , Religión y Psicología , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/etnología , Adolescente , Adulto , Anciano , Alcoholismo/etnología , Región del Caribe/etnología , América Central/etnología , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , América del Sur/etnología , Estados Unidos/etnología , Adulto JovenRESUMEN
BACKGROUND: Perceived beliefs about breast cancer and breast cancer screening are important predictors for mammography utilization. This study adapted and validated the Champion's scale in Peru. This scale measures perceived susceptibility for breast cancer and perceived benefits and barriers for mammography. METHODS: A cross-sectional study was conducted among women ages 40 to 65 attending outpatient gynecology services in a public hospital in Peru. A group of experts developed and pre-tested a Spanish version of the Champion's scale to assess its comprehensibility (N=20). Factor analysis, internal consistency, and test-retest reliability analyses were performed (N=285). Concurrent validity compared scores from participants who had a mammogram and those who did not have it in the previous 15 months. T-test and multiple regression analysis adjusting for socio-demographic factors, mammography knowledge and other preventive behaviors were performed. RESULTS: The construct validity and reliability were optimal. Cronbach-Alpha coefficients were 0.75 (susceptibility), 0.72 (benefits) and 0.86 (barriers). Concurrent validity analysis showed an association between barriers and mammography screening use in bivariate (22.3±6.7 vs. 30.2±7.6; p<0.001) and multiple regression analysis (OR=0.28, 95% CI=0.18-0.43). Ages 50-60 years (OR=2.35, 95% CI=1.19-4.65), history of prior Papanicolaou test (OR=3.69, 95% CI=1.84-7.40), and knowledge about breast cancer and mammography (OR=3.69, 95% CI=1.84-7.40) were also independently associated with mammography screening use. CONCLUSION: Concurrent validity analysis showed that the Champion's scale has important limitations for assessing perceived susceptibility for breast cancer and perceived benefits for mammography among Peruvian women. There is still a need for developing valid and reliable instruments for measuring perceived beliefs about breast cancer and mammography screening among Peruvian women.