RESUMEN
Physical inactivity is a major public health concern because it is a determinant of obesity and obesity-related chronic diseases. Few longitudinal studies have examined the association between neighborhood socioeconomic (SES) environment and change in physical activity behaviors. Additionally, few studies have examined this association in immigrant groups or Hispanic subgroups such as Cubans. This research aimed to determine if neighborhood SES is associated with longitudinal change in moderate-to-vigorous physical activity (MVPA) among Cuban immigrants who participate in the Cuban Health Study in Miami, Florida. Data on 280 participants [mean age: 37.4 (± 4.6), 48.9% women, mean body mass index: 25.0 (± 2.5)] collected at baseline, 12 months and 24 months were analyzed. Minutes of MVPA were objectively measured during each data collection period using accelerometers. A neighborhood SES score was calculated for each participant's residential census tract from American Community Survey data on median household income, median housing value, educational attainment and occupation. The neighborhood SES score was grouped into tertiles, reflecting low, moderate and high neighborhood SES environment. Multilevel linear models were used to examine the relationship between neighborhood SES and change in MVPA over 24 months. At baseline, 94 (33.6%), 108 (38.6%) and 78 (27.9%) participants resided in low, moderate, and high SES neighborhoods, respectively. After adjusting for age, sex, and body mass index, no difference in average change in MVPA over time was observed between participants residing in low and moderate SES neighborhoods (p=0.48) or low and high SES neighborhoods (p=0.62). In Cuban immigrants, longitudinal change in MVPA may not vary by neighborhood socioeconomic environment.
RESUMEN
Guánica Bay, located in southwestern Puerto Rico, has suffered oil spills and other pollution discharges since the 1960s. Previous research showed elevated concentrations of polychlorinated biphenyls (PCBs) in coral reef and sediment. This research examined PCB concentrations in sediment and fish. Sediment and fish sampling in the bay was facilitated by community members. This study identified the second highest reported PCB level (129,300 ng/g) in sediment in the USA. Fish samples also showed elevated concentrations (1623 to 3768 ng/g), which were higher than the thresholds of safe levels of PCBs in fish for human consumption. The alarmingly high concentration of PCBs calls for proactive community engagement to bring awareness about contamination of the bay and more extensive sampling to test for the concentration of PCBs in seafood and the people of Guánica. This study also underscores the value of the involvement of local communities during sampling design aimed at identifying hot spots of contaminants.
Asunto(s)
Bahías/química , Monitoreo del Ambiente/métodos , Bifenilos Policlorados/química , Contaminantes Químicos del Agua/química , Animales , Peces , Sedimentos Geológicos/química , Humanos , Puerto RicoRESUMEN
Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States National Drug Abuse Treatment Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings. A technology transfer model was implemented and ran from 2011-2013. The Florida Node Alliance shared the "know how" for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.
Los países de ingresos bajos o medios (PIBM) carecen de una infraestructura de investigación y de la capacidad para llevar a cabo investigaciones clínicas rigurosas sobre la eficacia del tratamiento de la drogadicción y los problemas de salud mental que orienten la práctica clínica. Se estableció una asociación entre la Florida Node Alliance de la National Drug Abuse Treatment Clinical Trials Network de los Estados Unidos y el Instituto Nacional de Psiquiatría de México con objeto de mejorar la práctica en materia de tratamiento de la drogadicción en México. La finalidad de esta asociación fue la de crear una red nacional mexicana de investigaciones clínicas constituida por investigadores y proveedores de tratamiento de la drogadicción capaces de ejecutar ensayos clínicos aleatorizados de eficacia en entornos comunitarios. Se implantó un modelo de transferencia de tecnologías. La Florida Node Alliance compartió el el conocimiento y la experiencia para la creación de la infraestructura de investigación con objeto de ejecutar investigaciones clínicas aleatorizadas en programas comunitarios, por medio de módulos de capacitación común y específica, entrenamiento en funciones específicas, emparejamientos, modelado, vigilancia y retroalimentación. El proceso de transferencia de tecnología fue de tipo bidireccional en cuanto se basó en la retroalimentación sobre la viabilidad y la adecuación cultural para el contexto en el que se llevaron a cabo las prácticas. El Instituto, a su vez, lideró la iniciativa para crear la red nacional de investigadores y profesionales de México y llevar a cabo el primer ensayo. Un modelo colaborativo de transferencia de tecnología resultó útil para la creación de una red mexicana de investigadores y proveedores de tratamiento capaz de cambiar las prácticas nacionales de investigación y tratamiento en materia de drogadicción. Se exponen las consideraciones clave para la transferencia transnacional de tecnología.
Asunto(s)
Salud Mental , Tecnología Biomédica , Medicina de las Adicciones/organización & administración , MéxicoRESUMEN
Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States National Drug Abuse Treatment Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings. A technology transfer model was implemented and ran from 2011–2013. The Florida Node Alliance shared the “know how” for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.
Los países de ingresos bajos o medios (PIBM) carecen de una infraestructura de investigación y de la capacidad para llevar a cabo investigaciones clínicas rigurosas sobre la eficacia del tratamiento de la drogadicción y los problemas de salud mental que orienten la práctica clínica. Se estableció una asociación entre la Florida Node Alliance de la National Drug Abuse Treatment Clinical Trials Network de los Estados Unidos y el Instituto Nacional de Psiquiatría de México con objeto de mejorar la práctica en materia de tratamiento de la drogadicción en México. La finalidad de esta asociación fue la de crear una red nacional mexicana de investigaciones clínicas constituida por investigadores y proveedores de tratamiento de la drogadicción capaces de ejecutar ensayos clínicos aleatorizados de eficacia en entornos comunitarios. Se implantó un modelo de transferencia de tecnologías. La Florida Node Alliance compartió el el conocimiento y la experiencia para la creación de la infraestructura de investigación con objeto de ejecutar investigaciones clínicas aleatorizadas en programas comunitarios, por medio de módulos de capacitación común y específica, entrenamiento en funciones específicas, emparejamientos, modelado, vigilancia y retroalimentación. El proceso de transferencia de tecnología fue de tipo bidireccional en cuanto se basó en la retroalimentación sobre la viabilidad y la adecuación cultural para el contexto en el que se llevaron a cabo las prácticas. El Instituto, a su vez, lideró la iniciativa para crear la red nacional de investigadores y profesionales de México y llevar a cabo el primer ensayo. Un modelo colaborativo de transferencia de tecnología resultó útil para la creación de una red mexicana de investigadores y proveedores de tratamiento capaz de cambiar las prácticas nacionales de investigación y tratamiento en materia de drogadicción. Se exponen las consideraciones clave para la transferencia transnacional de tecnología.
Asunto(s)
Transferencia de Tecnología , Ensayos Clínicos como Asunto , Práctica Clínica Basada en la Evidencia , Trastornos Relacionados con Sustancias , Salud Mental , Transferencia de Tecnología , Ensayos Clínicos como Asunto , Práctica Clínica Basada en la Evidencia , Redes de Información de Ciencia y Tecnología , Trastornos Relacionados con Sustancias , Salud Mental , Investigación sobre Servicios de Salud , Métodos , México , Redes de Información de Ciencia y Tecnología , Investigación sobre Servicios de SaludRESUMEN
Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States National Drug Abuse Treatment Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings. A technology transfer model was implemented and ran from 2011-2013. The Florida Node Alliance shared the "know how" for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.
Asunto(s)
Salud Mental , Trastornos Relacionados con Sustancias , Transferencia de Tecnología , Ensayos Clínicos como Asunto , Conducta Cooperativa , Humanos , México , Trastornos Relacionados con Sustancias/terapiaRESUMEN
BACKGROUND: Planners have relied on the urban development boundary (UDB)/urban growth boundary (UGB) and central business district (CBD) to encourage contiguous urban development and conserve infrastructure. However, no studies have specifically examined the relationship between proximity to the UDB/UGB and CBD and walking behavior. PURPOSE: To examine the relationship between UDB and CBD distance and walking in a sample of recent Cuban immigrants, who report little choice in where they live after arrival to the U.S. METHODS: Data were collected in 2008-2010 from 391 healthy, recent Cuban immigrants recruited and assessed within 90 days of arrival to the U.S. who resided throughout Miami-Dade County FL. Analyses in 2012-2013 examined the relationship between UDB and CBD distances for each participant's residential address and purposive walking, controlling for key sociodemographics. Follow-up analyses examined whether Walk Score(®), a built-environment walkability metric based on distance to amenities such as stores and parks, mediated the relationship between purposive walking and each of UDB and CBD distance. RESULTS: Each one-mile increase in distance from the UDB corresponded to an 11% increase in the number of minutes of purposive walking, whereas each one-mile increase from the CBD corresponded to a 5% decrease in the amount of purposive walking. Moreover, Walk Score mediated the relationship between walking and each of UDB and CBD distance. CONCLUSIONS: Given the lack of walking and walkable destinations observed in proximity to the UDB/UGB boundary, a sprawl repair approach could be implemented, which strategically introduces mixed-use zoning to encourage walking throughout the boundary's zone.
Asunto(s)
Planificación Ambiental , Características de la Residencia/estadística & datos numéricos , Remodelación Urbana , Caminata/estadística & datos numéricos , Adulto , Estudios de Cohortes , Cuba/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Femenino , Florida , Estudios de Seguimiento , Humanos , Masculino , Estudios ProspectivosRESUMEN
Context of reception has been discussed widely in the sociological and anthropological literature, but no measures of this construct exist. We designed a measure of perceived context of reception and provide initial support for the factorial validity, internal consistency reliability, and incremental and discriminant validity of scores generated by this measure. A sample of 302 recent-immigrant Hispanic parent-adolescent dyads from Miami and Los Angeles completed the new perceived context of reception measure, as well as measures of perceived discrimination; Hispanic/American cultural practices, values, and identifications; and depressive symptoms. In Phase 1, exploratory and confirmatory factor analyses extracted a factor for negative perceived context of reception. A subscale corresponding to this factor was used in Phase 2; for parents and adolescents, negative perceived context of reception and perceived discrimination were differentially associated with acculturation-related variables-suggesting discriminant validity between perceived discrimination and negative perceived context of reception. For adolescents at both sites and for parents in Los Angeles only, the negative perceived context of reception dimensions were significantly associated with depressive symptoms 6 months later, over and above the contribution made by perceived discrimination--suggesting incremental validity. Results are discussed in terms of perceived context of reception as a new and emerging construct.
Asunto(s)
Aculturación , Depresión/psicología , Emigrantes e Inmigrantes/psicología , Americanos Mexicanos/psicología , Prejuicio/psicología , Distancia Psicológica , Adolescente , Adulto , Cuba/etnología , República Dominicana/etnología , Análisis Factorial , Femenino , Florida , Hispánicos o Latinos/psicología , Humanos , Los Angeles , Masculino , Persona de Mediana Edad , Percepción , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This study evaluated the immigrant paradox by ascertaining the effects of multiple components of acculturation on substance use and sexual behavior among recently immigrated Hispanic adolescents primarily from Mexico (35 %) and Cuba (31 %). A sample of 302 adolescents (53 % boys; mean age 14.51 years) from Miami (n = 152) and Los Angeles (n = 150) provided data on Hispanic and US cultural practices, values, and identifications at baseline and provided reports of cigarette use, alcohol use, sexual activity, and unprotected sex approximately 1 year later. Results indicated strong gender differences, with the majority of significant findings emerging for boys. Supporting the immigrant paradox (i.e., that becoming oriented toward US culture is predictive of increased health risks), individualist values predicted greater numbers of oral sex partners and unprotected sex occasions for boys. However, contrary to the immigrant paradox, for boys, both US practices and US identification predicted less heavy drinking, fewer oral and vaginal/anal sex partners, and less unprotected vaginal/anal sex. Ethnic identity (identification with one's heritage culture) predicted greater numbers of sexual partners but negatively predicted unprotected sex. Results indicate a need for multidimensional, multi-domain models of acculturation and suggest that more work is needed to determine the most effective ways to culturally inform prevention programs.
Asunto(s)
Aculturación , Conducta del Adolescente , Emigrantes e Inmigrantes/psicología , Hispánicos o Latinos/psicología , Psicología del Adolescente , Conducta Sexual , Trastornos Relacionados con Sustancias/psicología , Adolescente , California , Cuba/etnología , Femenino , Florida , Humanos , Masculino , México/etnología , Asunción de RiesgosRESUMEN
BACKGROUND: Walk Score® is a nationally and publicly available metric of neighborhood walkability based on proximity to amenities (e.g., retail, food, schools). However, few studies have examined the relationship of Walk Score to walking behavior. PURPOSE: To examine the relationship of Walk Score to walking behavior in a sample of recent Cuban immigrants, who overwhelmingly report little choice in their selection of neighborhood built environments when they arrive in the U.S. METHODS: Participants were 391 recent healthy Cuban immigrants (mean age=37.1 years) recruited within 90 days of arrival in the U.S., and assessed within 4 months of arrival (mean=41.0 days in the U.S.), who resided throughout Miami-Dade County FL. Data on participants' addresses, walking, and sociodemographics were collected prospectively from 2008 to 2010. Analyses conducted in 2011 examined the relationship of Walk Score for each participant's residential address in the U.S. to purposive walking, controlling for age, gender, education, BMI, days in the U.S., and habitual physical activity level in Cuba. RESULTS: For each 10-point increase in Walk Score, adjusting for covariates, there was a significant 19% increase in the likelihood of purposive walking, a 26% increase in the likelihood of meeting physical activity recommendations by walking, and 27% more minutes walked in the previous week. CONCLUSIONS: Results suggest that Walk Score is associated with walking in a sample of recent immigrants who initially had little choice in where they lived in the U.S. These results support existing guidelines indicating that mixed land use (such as parks and restaurants near homes) should be included when designing walkable communities.
Asunto(s)
Accesibilidad Arquitectónica/normas , Planificación Ambiental/normas , Proyectos de Investigación/normas , Transportes/normas , Caminata/psicología , Adulto , Índice de Masa Corporal , Emigrantes e Inmigrantes/psicología , Femenino , Hispánicos o Latinos/psicología , Humanos , Masculino , Actividad Motora , Evaluación de Procesos, Atención de Salud , Análisis de Regresión , Factores Socioeconómicos , Estados Unidos , Pesos y MedidasRESUMEN
PURPOSE: This study adapted the Structural Family Systems Ratings (SFSR), an observational measure of family interactions, for dementia caregivers. This article presents the development of the SFSR-Dementia Caregiver adaptation (SFSR-DC) and examines relationships between specific family-interaction patterns and caregiver distress. DESIGN AND METHODS: The families of 177 Cuban American and White non-Hispanic American caregivers of dementia patients were assessed at baseline, 6, 12, and 18 months. Structural family theory and clinical experience were used to identify family interaction patterns believed to be related to caregiver emotional functioning. Factor analysis was used to refine subscales and develop a multiscale measure. RESULTS: Six reliable subscales were related to caregiver distress and included in the SFSR-DC. There were two second-order factors. The SFSR-DC was provisionally cross-validated and showed invariance across the two ethnic groups. IMPLICATIONS: The SFSR-DC provides a method for examining specific and multiple interaction patterns in caregiver families and thus can advance knowledge regarding the role of the family in the stress processes of caregiving. These findings support the relevance of family interactions in caregiver distress and suggest that a treatment approach aimed at supporting family closeness and conflict resolution and reducing negativity might enhance caregiver well-being.
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Cuidadores/psicología , Demencia/enfermería , Relaciones Familiares , Estrés Psicológico/diagnóstico , Encuestas y Cuestionarios , Anciano , Cuba/etnología , Análisis Factorial , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Estrés Psicológico/psicología , Estados Unidos , Población BlancaRESUMEN
PURPOSE: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for Enhancing Alzheimer's Caregiver Health) program that examined the efficacy of a family therapy and technology-based intervention in reducing depressive symptoms (according to the Center for Epidemiological Studies Depression scale) among family caregivers of AD patients at 6 months and 18 months follow-up. DESIGN AND METHODS: There were 225 White American and Cuban American caregivers that were randomized into a structural ecosystems therapy, structural ecosystems therapy + computer-telephone integrated system, or minimal support control condition. RESULTS: Caregivers in the combined family therapy and technology intervention experienced a significant reduction in depressive symptoms at 6 months. The 18-month follow-up data indicated that the intervention was particularly beneficial for Cuban American husband and daughter caregivers. IMPLICATIONS: The results indicate that information technology has a promising role in alleviating distress and depression among groups of AD caregivers. The data also demonstrate that interventions have differential impacts according to ethnic group and the caregiver-patient relationship.
Asunto(s)
Enfermedad de Alzheimer/terapia , Cuidadores/psicología , Depresión/terapia , Terapia Familiar , Telemedicina , Anciano , Anciano de 80 o más Años , Computadores , Cuba/etnología , Depresión/etnología , Depresión/etiología , Etnicidad , Femenino , Hispánicos o Latinos , Humanos , Internet , Masculino , Estrés Psicológico , Teléfono , Estados Unidos , Población BlancaRESUMEN
To determine the prevalence of cognitive impairment and dementia in a multi-ethnic community, we examined a population sample of 2,759 elderly (65 years of age and older) African American, Hispanic-Cuban and white non-Hispanic men and women of Dade County, Florida. The Short Portable Mental Status Questionnaire (SPMSQ) was used as a screening test. The prevalence of cognitive impairment for African American men was 17.0% and women 16.7%; Cuban men 9.4% and women 11.4%; and white non-Hispanic men 9.0% and women 8.5%. Participants with cognitive impairment were referred to two Memory Disorder Clinics for diagnosis of dementia/Alzheimer's disease (AD). SPMSQ cutpoints took account of race and education. The prevalence of dementia/AD was adjusted for sensitivity and specificity of the SPMSQ in each sex/ethnic group. The prevalence of dementia among African American men (20.9%) was twice that among white non-Hispanic men (11.6%). White non-Hispanic and Cuban women had a similar prevalence of dementia (12.1% vs. 12.9%). Low SPMSQ specificity for Cuban men and African American women gave unstable dementia prevalence estimates. More than two thirds of all dementia cases had AD, and among white non-Hispanics, women had double the prevalence of AD among men (10.9% vs. 5.4%). The prevalence of AD among African American men was more than two and a half times greater than the prevalence among white non-Hispanic men (14.4% vs. 5.4%). Age (p = 0.001), family history of AD (p = 0.02) and African American (p = 0.0001) or Cuban (p = 0.006) ethnic group were directly and independently associated with the prevalence of AD.