RESUMEN

Objective: Completion of human papillomavirus (HPV) vaccine series among Texas Hispanic adolescents is low compared to national data. We examined the association between HPV vaccine initiation and completion among Hispanic adolescents in a rural, Texas-Mexico border county and specific individual and neighborhood-level characteristics. Design: Cross-sectional analysis of data from a broader cancer prevention program. Setting: Underserved colonias communities in a Texas-Mexico border county. Participants: Hispanic mothers or caregivers (n=712) and adolescents aged 11-17 years (n=1120) linked to publicly available data about their neighborhood. Main Outcome Measures: HPV vaccine adherence (ie, initiation and completion) as reported in either the Texas Immunization Registry or adolescents' electronic medical records, measured at the end of the cancer prevention program. Methods: Logit and multi-level mixed-effects logistic regression of individual- and neighborhood-level data. Results: Factors associated with HPV vaccine initiation and completion were female gender (P<.01), adolescent insurance status (P<.001), and receipt of required vaccines (P<.001). After controlling for neighborhood-level characteristics, only receipt of required vaccines remained significant. Conclusions: Findings indicate a relationship between Hispanic adolescents' receiving the required vaccine series for school admission and HPV vaccine initiation and completion. In resource-limited settings like federally qualified health centers, further efforts should focus on implementing best practices at both the provider level (eg, education on bundled vaccine recommendation) and practice-level (eg, outreach and support by trained immunization navigators).

Asunto(s)

RESUMEN

In the United States, the Latinx population has the highest prevalence of physical inactivity compared with other ethnicities. Research shows that work-based physical activity interventions have been widely implemented in the non-Latinx population and effectively increase physical activity in the non-Latinx population. In an effort to improve physical activity and reduce obesity among the Latinx population, we conducted 10,000 Steps for 100 Days, an employer-based walking challenge campaign, to increase walking engagement among Latinx employees located in El Paso, Texas. Participants reported their number of steps using a pedometer or smartphone. Step counts were collected at baseline, 2 weeks post challenge, and 6 months post challenge. Screenshots of the tracking device were uploaded to an online tracker. Regression analysis was conducted to identify covariates associated with baseline and 2-week and 6-month average daily steps. Generalized estimating equations (GEE) were performed to predict steps over time by demographic characteristics. Participation in the 10,000 Steps for 100 Days walking challenge was associated with a sustained increase in average daily steps. Participants with less than 7000 steps per day demonstrated the greatest increase in average daily steps (921 steps at 2 weeks; 1002.4 steps at 6 months). Demographic characteristics were not significant predictors of average steps, except that married participants had higher average steps. Participants with 10,000 or more daily steps had a 51% (p = 0.031) higher chance of having a professional occupation than a non-professional one compared to those with 7000 or fewer daily steps. We provided initial evidence that the walking challenge is an effective approach for improving physical activity in the Latinx population.

Asunto(s)

RESUMEN

The purpose of this study was to analyze occupational and personal stressors, mental health indicators, perceived discrimination and help-seeking behaviors among healthcare workers and providers (HCWPs) serving socially vulnerable groups such as immigrants, refugees, farmworkers, homeless individuals, people living in poverty, and other disadvantaged populations in the United States (U.S.) during the COVID-19 pandemic. Using a cross-sectional descriptive approach, we gathered information between July and September 2020, from a sample of 407 affiliates of two national organizations of clinic-based HCWPs who worked at federally funded and community safety-net clinics. Informed consent was obtained from all participants who completed a self-administered online survey available in English and Spanish. Our results indicated that the HCWPs serving vulnerable groups in the midst of the pandemic experienced high levels of occupational and personal stressors as well as anxiety and depressive symptomology. Major occupational stressors were excessive workload, long working-hours, and institutional barriers to refer and follow-up on their clients' access to needed social services. High-rated personal stressors included sleep disorders, lack of and child-care, partner's loosing job, and other family related situations. Our findings suggest that HCWPs working with vulnerable populations need specialized interventions that bolster their mental health and well-being as the pandemic continues to unfold. We recommend implementing initiatives that encourage HCWPs' to be actively involved in clinic decisions regarding employee safety and protection as well as in management decisions to improve work place infrastructure and capacity to respond to the social needs of their clients. Lessons learned from the pandemic are useful tools in designing protocols for addressing the mental-health needs of HCWPs in health-care organizations that attend to socially underprivileged populations.

Asunto(s)

RESUMEN

Introduction. Prior to 1980, U.S. national demographic and health data collection did not identify individuals of Hispanic/Latina/o heritage as a population group. Post-1990, robust immigration from Latin America (e.g., South America, Central America, Mexico) and subsequent growth in U.S. births, dynamically reconstructed the ethnoracial lines among Latinos from about 20 countries, increasing racial admixture and modifying patterns of health disparities. The increasing racial and class heterogeneity of U.S. Latina/os demands a critical analysis of sociodemographic factors associated with population health disparities. Purposes. To determine the state of available Latina/o population demographic and health data in the United States, assess demographic and health variables and trends from 1960 to the present, and identify current strengths, gaps, and areas of improvement. Method. Analysis of 101 existing data sets that included demographic, socioeconomic, and health characteristics of the U.S. Latina/o population, grouped by three, 20-year intervals: 1960-1979, 1980-1999, and 2000-2019. Results. Increased Latina/o immigration and U.S. births between 1960 and 2019 was associated with increases of Latino population samples in data collection. Findings indicate major gaps in the following four areas: children and youth younger than 18 years, gender and sexual identity, race and mixed-race measures, and immigration factors including nativity and generational status. Conclusions. The analysis of existing ethnoracial Latina/o population data collection efforts provides an opportunity for critical analysis of past trends, future directions in data collection efforts, and an equity lens to guide appropriate community health interventions and policies that will contribute to decreasing health disparities in Latina/o populations.

Asunto(s)

RESUMEN

Prior studies investigating the association between acculturation and adolescent adjustment have often focused on specific acculturation domains rather than examining these domains collectively in a profile typology. Here, we investigate stability and change patterns in Mexican American adolescent acculturation profiles over time, using a two-wave longitudinal dataset spanning 5 years. Using latent profile analysis, three adolescent acculturation profiles were identified at Waves 1 and 2: integrated; moderately integrated; and moderately assimilated. Using latent transition analysis, four acculturation transition profiles were identified across time: stable integrated; stable moderately integrated; progressive; and regressive. Over half of all adolescents were identified as belonging to the stable integrated and stable moderately integrated transition profiles. Adolescents classified in the stable integrated profile reported the highest levels of adjustment (academic competence and socioemotional well-being) relative to those with other transition profiles. Findings from this study contribute to a comprehensive understanding of the dynamic process of acculturation among Mexican American adolescents, and provide useful insights to inform interventions and policies aimed at improving Mexican-origin adolescents' adaption to US culture while maintaining their heritage Mexican culture.

Asunto(s)

RESUMEN

There is increasing evidence that depression may affect diet. However, little is known about the association between depression and diet quality among foreign-born Latinas. We hypothesized that depressive symptoms would be associated with poorer diet quality in foreign-born Latinas. Furthermore, we believed that physical activity (PA) would have a protective effect on diet quality for individuals experiencing depressive symptoms. Our study evaluated the diet (Healthy Eating Index) and PA (Actigraph GT3X activity monitors) of 534 foreign-born Latinas with and without depressive symptoms (Center for Epidemiological Studies Depression Scale). A series of logistic regression models were estimated to examine our hypotheses. As predicted, Latinas who were depressed had significantly lower odds of having a high-quality diet than non-depressed Latinas. Unexpectedly, among Latinas who met PA guidelines, depressed Latinas had a significantly lower probability of having higher-quality diets than their non-depressed counterparts. Our findings support current research stating that depressive symptoms are associated with lower Healthy Eating Index scores. More research is necessary to elucidate the relationship between PA and dietary quality of depressed Latinas. Innovative approaches to address mental health and the stressors that can compound its severity are needed to improve diet quality among foreign-born Latina women.

Asunto(s)

RESUMEN

BACKGROUND: The purpose of this study was to determine physical activity (PA) preferences associated with increases in moderate-to-vigorous physical activity (MVPA) and decrease in sedentary time in Mexican American (MA) women participating in a Promotora (community health worker)-led intervention on the U.S.-Mexico border. METHODS: Enlace ('to link' in Spanish) was a randomized clinical trial to increase PA in low-income, MA women living in South Texas on the U.S.-Mexico border. A total of 620 participants were recruited into the study. The primary outcome was increase in moderate to vigorous physical activity (MVPA) using the Actigraph GT3X 16 Mb accelerometer. A modified version of the Community Health Activities Model Program for Seniors Physical Activity (CHAMPS) instrument was used to predict MVPA. Adjusted and unadjusted logistic regression models predicted change in MVPA by change in CHAMPS activities. ANOVA analysis determined the variance explained in change in MVPA by change in time engaged in activity. Individual effect sizes were then calculated for significant activity type change on MVPA increase. RESULTS: There were significant increases in all CHAMPS activities except aerobic machines and errand walking. An increase in leisure walking (O.R. = 2.76, p = .046), errand (O.R. = 3.53, p = .051), and brisk walking (O.R. = 4.74, p = .011), dance (O.R. = 8.22, p = .003), aerobics class (O.R. = 32.7, p = .001), and light housework (O.R. = 6.75, p = .000), were associated with a decrease in sedentary time. Significant effect sizes for MVPA were observed for jogging (1.2, p = .050), general exercise (1.6, p = .024), and other exercise not specified (2.6, p = .003). Significant effect sizes for sedentary time were detected for leisure time (.031, p = .036), errands (.017, p = .022), brisk walking (.022, p = .003), dance (.042, p = .005), and aerobics class (.013, p = .009). DISCUSSION: Participants who engaged in walking and aerobic activities through this intervention significantly increased their engagement in MVPA and decreased their sedentary time. These findings are novel, since preferences have not been examined in relation to MVPA or sedentary time in MA women. CONCLUSION: PA preferences need to be considered when aiming to promote activities that reduce sedentary time and increase PA participation among marginalized groups, such as MA women. TRIAL REGISTRATION: NCT02046343 .

Asunto(s)

RESUMEN

OBJECTIVES: To determine the relationships between physical activity (PA), the neighborhood environment support for PA, and social support for PA among Mexican-American women living in South Texas. The Enlace study was a randomized controlled trial that tested the effectiveness of a promotora-led PA intervention among low-income Mexican origin women (n=614) living in colonias. METHODS: The dependent measures included accelerometer-measured average moderate to vigorous physical activity (MVPA) and sedentary breaks and the Community Health Activities Model Program for Seniors PA 41-item questionnaire. The independent measures included the Physical Activity and Neighborhood Environment Scale (PANES) and the 13-item Physical Activity Social Support (PASS) scale. RESULTS: Enlace participants were on average 40.4 (standard deviation, 10.3) years old, born in Mexico (86.1%), and uninsured (83.1%). Adjusted linear regression results indicated that each 1-point increment in the PANES overall score was associated with 0.050 (p<0.001) unit increase in sedentary break and a -0.043 (p=0.001) unit decrease in sedentary break duration. Both PANES (ß=0.296; p=0.002) and PASS scores (ß=0.076; p<0.001) were associated with weekly average self-reported MVPA. Interaction effects were observed between PASS scores and accelerometer-measured frequency of sedentary breaks and sedentary time duration. CONCLUSIONS: The findings of this study indicate that the relationships between PA and built environment and social support are measure-dependent and suggest that reducing sedentary time in this population may require a closer assessment of social support for PA.

Asunto(s)

RESUMEN

Adolescents from Mexican immigrant families are often embedded in a challenging social environment and experience multiple contextual stressors, including economic stress, discrimination, and foreigner stress. We consider how the effects of these contextual stressors may be amplified or diminished for adolescents who function as language brokers, interpreting and mediating for their English-limited parents. Using two waves of survey data collected from a sample (N = 604 at Wave 1; N = 483 at Wave 2) of Mexican American adolescents with ages ranging from 11 to 15 (Mage = 12.41, 54% female), four distinct brokering-stress profiles were identified. Latent profile analyses revealed that with moderate levels of contextual stress, adolescents with more positive language brokering experiences (protective group) demonstrated more favorable outcomes than those with neutral language brokering experiences (moderate group) and those who did not involve themselves as frequently in language brokering activities (less-involved group). In contrast, high levels of contextual stress, coupled with more negative language brokering experiences (risk group), produced the least favorable outcomes among adolescents.

Asunto(s)

RESUMEN

Few Texas Latino girls initiate and complete the human papillomavirus (HPV) vaccine series, but few studies have examined predictors of initiation and completion in this group. Mothers are crucial to vaccine uptake. Using self-reported data from mothers of unvaccinated girls (n = 317), we examined the association between predictors (HPV and HPV vaccine knowledge, vaccine self-efficacy) and outcomes (initiation and completion). Despite an increase in HPV and HPV vaccine knowledge from baseline to follow-up (n = 195), we found no association between the predictors and the outcomes. Findings showed that health insurance status and study group participation (Entre Madre e Hija program or brochure only) were associated with initiation and completion.

Asunto(s)

RESUMEN

OBJECTIVE: To determine the relationship between obesity, food insecurity and perceived stress in very low income Mexican American women. DESIGN: Cross-sectional baseline data analysis of a randomized clinical trial. SETTING: Texas-Mexico border region of South Texas. SUBJECTS: Very Low Income Mexican American Women. RESULTS: The relationship between obesity and food insecurity in a sample of very low income Hispanic women living in South Texas depends on the measure of obesity and the dimension of food insecurity. The only measure of food insecurity associated with all measures of obesity was often not having enough money to afford to eat balanced meals. Waist circumference was associated with the most dimensions of food insecurity, while BMI had the least associations. Finally, perceived stress was not significantly associated with BMI, waist circumference or percent body fat when adjusted for other covariates. CONCLUSIONS: We have found a strong and significant relationship between food insecurity related to having enough resources to eat a balanced diet and BMI, waist circumference, and percent body fat in low-income Mexican American women. While behavioural change is an important strategy for reducing obesity, consideration may need to be made as to how food access with high nutritional value, may be in and of itself a contributing factor in obesity in low income populations.

RESUMEN

OBJECTIVES: To examine the relationship between English language proficiency (ELP), physical activity, and physical activity-related psychosocial measures (i.e., exercise self-efficacy, exercise social support, perceptions of environmental supports) among Mexican-origin women in South Carolina and Texas. DESIGN: Adjusted robust regression and interaction modeling to evaluate baseline questionnaire data on self-reported ELP with CHAMPS leisure-time moderate-to-vigorous physical activity (MVPA), accelerometry data, Physical Activity Self-Efficacy, Physical Activity Social Support, and Environmental Support for Physical Activity in 118 Mexican-origin women. RESULTS: The adjusted regression revealed a significant association between ELP and perceived physical activity self-efficacy (ß = 234.2, p = .004), but not with physical activity social support. In South Carolina, CHAMPS leisure-time MVPA (411.4 versus 114.3 minutes, p < .05) was significantly different between women in the high ELP quartile and those in the very low quartile. Among high ELP Mexican-origin women, participants in Texas reported significantly higher MVPA measured by accelerometry (p = .042) than those in South Carolina. CONCLUSION: Our findings indicate that ELP was associated with physical activity and that contextual factors may also play a role.

Asunto(s)

RESUMEN

Interventions to improve physical activity levels among Latinos must take into consideration the social, cultural, economic, and environmental contexts of Latino communities. We report findings of formative assessments related to Mexican-origin women's levels of readiness, willingness, and ability to participate in regular leisure time physical activity in two diverse locations, the Texas Lower Rio Grande Valley and the South Carolina Midlands. The ENLACE project employed a Community-Based Participatory Research approach. Formative assessment activities focused on identification of community assets and resources and exploration of community members' experiences, opinions, values, preferences, and perceived needs related to physical activity. Data sources included windshield tours, walkability assessments of local neighborhoods; community inventory exercises, focus groups, and individual interviews. Barriers to regular physical activity included the dominance of work and family responsibilities, social norms, lack of social support, social isolation, environmental constraints, economics, and low levels of personal knowledge and motivation.