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Al-Bkerat M, Martins DC, Schwartz-Barcott D. Nutritional Beliefs and Practices of Arabic-Speaking Middle Eastern Mothers Living in the United States. J Transcult Nurs 2024; 35:333-339. [PMID: 38770862 DOI: 10.1177/10436596241253873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Culture and acculturation influence nutritional beliefs. Little is known about the Arabic population in the United States. In this study, Arabic-speaking Middle Eastern mothers' perceptions of motherhood and childhood nutritional beliefs and practices are explored. METHOD Semi-structured interviews with 12 mothers from Arabic-speaking Middle Eastern countries. RESULTS Food and family are central to everyday life. Mothers worked hard to maintain traditional nutritional practices with their school-age children. DISCUSSION Findings can enhance school nurses' ability to collaborate with mothers in nutritional education and address any issues in the classroom.
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Sparks KS, Fialkowski MK, Dela Cruz R, Grandinetti A, Wilkens L, Banna JC, Bersamin A, Paulino Y, Aflague T, Coleman P, Deenik J, Fleming T, Novotny R. Acculturation and Health Status in the Children's Healthy Living Program in the Pacific Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:448. [PMID: 38673359 PMCID: PMC11050529 DOI: 10.3390/ijerph21040448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024]
Abstract
Acculturation/enculturation has been found to impact childhood health and obesity status. The objective of this study is to use cross-sectional data to examine the association between proxies of adult/caregiver acculturation/enculturation and child health status (Body Mass Index [BMI], waist circumference [WC], and acanthosis nigricans [AN]) in the U.S.-Affiliated Pacific Islands (USAPI), Alaska, and Hawai'i. Study participants were from the Children's Healthy Living (CHL) Program, an environmental intervention trial and obesity prevalence survey. Anthropometric data from 2-8 year olds and parent/caregiver questionnaires were used in this analysis. The results of this study (n = 4121) saw that those parents/caregivers who identified as traditional had children who were protected against overweight/obesity (OWOB) status and WC > 75th percentile (compared to the integrated culture identity) when adjusted for significant variables from the descriptive analysis. AN did not have a significant association with cultural classification. Future interventions in the USAPI, Alaska, and Hawai'i may want to focus efforts on parents/caregivers who associated with an integrated cultural group as an opportunity to improve health and reduce child OWOB prevalence.
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Affiliation(s)
- Kalanikiekie S. Sparks
- Public Health Division, Acute and Communicable Disease Section, Oregon Health Authority, Salem, OR 97301, USA;
| | - Marie K. Fialkowski
- Nutrition Support Shared Resource, University of Hawaiʻi Cancer Center, University of Hawaiʻi at Mānoa, Honolulu, HI 96813, USA
| | - Rica Dela Cruz
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA; (R.D.C.); (J.C.B.); (R.N.)
| | - Andrew Grandinetti
- Office of Public Health Studies, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA;
| | - Lynne Wilkens
- Biostatistics Shared Resource, University of Hawaiʻi Cancer Center, University of Hawaiʻi at Mānoa, Honolulu, HI 96813, USA;
| | - Jinan C. Banna
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA; (R.D.C.); (J.C.B.); (R.N.)
| | - Andrea Bersamin
- Department of Biology and Wildlife, College of Natural Sciences and Mathematics, University of Alaska Fairbanks, Fairbanks, AK 99775, USA;
| | - Yvette Paulino
- Margaret Perez Hattori-Uchima School of Health, University of Guam, Mangilao, GU 96913, USA;
| | - Tanisha Aflague
- Cooperative Extension and Outreach, College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96913, USA;
| | - Patricia Coleman
- Cooperative Research, Extension, and Education Services, Northern Marianas College, Saipan, MP 96950, USA;
| | - Jonathan Deenik
- Tropical Plant and Social Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA;
| | - Travis Fleming
- Agriculture, Community and Natural Resources Division, American Samoa Community College, Pago Pago, AS 96799, USA;
| | - Rachel Novotny
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA; (R.D.C.); (J.C.B.); (R.N.)
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Dao MC, Yu Z, Maafs‐Rodríguez A, Moser B, Cuevas AG, Economos CD, Roberts SB. Perceived intrinsic, social, and environmental barriers for weight management in older Hispanic/Latino adults with obesity. Obes Sci Pract 2022; 9:145-157. [PMID: 37034568 PMCID: PMC10073816 DOI: 10.1002/osp4.631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/07/2022] Open
Abstract
Background The burden of obesity and chronic disease is increasing in the older US Hispanic/Latino adult population. There is limited evidence on successful weight management strategies as perceived by this population. Assessing barriers and opportunities for weight management using mixed methods is a robust approach to collect in-depth information that can be applied to the development of well-tailored weight management interventions for this population. Objective The objective of this study was to assess perceived individual, interpersonal, and environmental factors that influence weight management in older Hispanic/Latino adults. Methods This community-based cross-sectional study included 23 Hispanic/Latino older (>50y) adults with obesity (BMI >30 kg/m2). Perceived barriers and opportunities for weight management were assessed through validated questionnaires and focus groups. Prospectively registered on ClinicalTrials.gov (NCT03978416) on 7 June 2019. Results In this demographically heterogeneous population, language acculturation was generally low, and the frequency of poor dietary behaviors was high. Participants linked financial strain to lower diet quality, as well as anxiety to uncontrolled eating and food cravings. Social support and trust in healthcare professionals were perceived as priorities for healthy eating. Structural and environmental barriers such as affordability and availability of culturally preferred foods were also identified as influences on food choices and eating behavior. Conclusions This study revealed opportunities for culturally tailored weight management interventions in older Hispanic/Latino adults with obesity. Clinical Trial Registry Number NCT03978416 (ClinicalTrials.gov).
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Affiliation(s)
- Maria Carlota Dao
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
- Department of Agriculture University of New Hampshire. Durham Nutritionand Food Systems NH United States Durham
| | - Zihan Yu
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
| | - Ana Maafs‐Rodríguez
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
- Friedman School of Nutrition Science and Policy Tufts University. Boston MA United States Boston
| | - Brandy Moser
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
| | - Adolfo G. Cuevas
- Department of Community Health School of Arts and Sciences Tufts University. Medford MA United States Boston
| | - Christina D. Economos
- Friedman School of Nutrition Science and Policy Tufts University. Boston MA United States Boston
| | - Susan B. Roberts
- Energy Metabolism Laboratory Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. Boston MA United States Durham
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Brown LD, Vasquez D, Lopez DI, Portillo EM. Addressing Hispanic Obesity Disparities Using a Community Health Worker Model Grounded in Motivational Interviewing. Am J Health Promot 2022; 36:259-268. [PMID: 34791885 PMCID: PMC8995140 DOI: 10.1177/08901171211049679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To determine whether Hispanic residents receiving the Healthy Fit intervention enhanced with Motivational Interviewing (MI) experienced greater improvements in body composition, relative to participants receiving the initial intervention. DESIGN Quasi-experimental evaluation. SETTING El Paso, Texas. SAMPLE Among 656 baseline participants, 374 (54%) completed the 12-month assessment. INTERVENTION In Healthy Fit, community health workers (CHWs) promote nutrition and exercise. To strengthen intrinsic motivation and help participants overcome barriers to change, we incorporated a 30-minute motivational interview into the baseline assessment. Follow-up phone calls at 1, 3, and 6 months were identical across conditions. MEASURES CHWs assessed body mass index (BMI) and body fat percentage (BFP) using a bioelectrical impedance scale. ANALYSIS Regression models estimated differences between intervention conditions on change in BMI and BFP from baseline to the 12-month assessment. RESULTS Participants receiving MI had 2.13 times higher odds of losing weight (OR = 2.14, 95% CI [1.30, 3.53], P = .003) and 2.59 times higher odds of reduced BFP (OR = 2.59, 95% CI [1.51, 4.41], P < .001), relative to initial intervention participants. MI participants lost an average of 1.23 kg (2.71 lbs.) and their BFP declined 2% over 12 months. CONCLUSION Findings suggest CHW use of MI is a promising approach for promoting incremental changes in diet and exercise, which Healthy Fit integrates into a low-cost intervention.
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Affiliation(s)
- Louis D. Brown
- School of Public Health, The University of Texas Health Science Center at Houston, El Paso, TX, USA
| | - Denise Vasquez
- School of Public Health, The University of Texas Health Science Center at Houston, El Paso, TX, USA
| | - Diane I. Lopez
- School of Public Health, The University of Texas Health Science Center at Houston, El Paso, TX, USA
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Ramírez AS, Wilson MD, Miller LMS. Segmented assimilation as a mechanism to explain the dietary acculturation paradox. Appetite 2022; 169:105820. [PMID: 34843752 PMCID: PMC8944242 DOI: 10.1016/j.appet.2021.105820] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/29/2021] [Accepted: 11/18/2021] [Indexed: 02/03/2023]
Abstract
Latinos have disproportionately high rates of diet-related diseases which are associated with acculturation to the U.S. This negative shift in dietary quality is paradoxical in light of gains in income and education that would be expected to lead to better diet. We examined the extent to which the dietary acculturation paradox among Mexican Americans can be explained by segmented assimilation, a theory that considers how immigrants' and their descendants' trajectories of integration are influenced by a complex interplay of individual, social, and structural factors. First, we performed confirmatory cluster analysis to identify three assimilation segments (classic, underclass, and selective) based on education, income, and an acculturation proxy derived from language, nativity, and time in the U.S. among Mexican-origin participants (N = 4475) of the 2007-2016 National Health and Nutrition Examination Survey (NHANES). These segments were then used as independent variables in linear regression models to estimate the relationship between cluster and dietary quality (assessed by the Health Eating Index (HEI)) and the interaction between cluster and gender, controlling for marital status. There were strong effects of cluster on dietary quality, consistent with hypotheses per segmented assimilation theory. The classic assimilation segment had the poorest diet, despite having higher income and education than the underclass segment. The selective segment had higher or similar dietary quality to the underclass segment. Consistent with expectations, this difference was driven by the relatively higher consumption of greens and beans and whole grains of those in the selective and underclass segments. Overall, women had better diets than men; however, the strongest gender contrast was in the underclass segment. This study advances understanding of dietary acculturation and potential disparities in diet-related health outcomes.
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Affiliation(s)
- A. Susana Ramírez
- Department of Public Health, University of California, 5200 North Lake Road, Merced, CA, 95340, USA.,Corresponding author:
| | - Machelle D. Wilson
- Department of Public Health Sciences, University of California, One Shields Avenue, Davis, CA, 95616, USA
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Marquez B, Benitez T. Individual and Family Factors in Disordered Eating Patterns of Mexican-American Women. Am J Health Behav 2021; 45:1050-1058. [PMID: 34969416 PMCID: PMC10005836 DOI: 10.5993/ajhb.45.6.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In this study, we examined the contribution of individual- (acculturation, body mass index, and body size satisfaction) and family- (maternal weight-related messages and disordered eating patterns) level factors in predicting bulimic and dieting behaviors in young Mexican-American women with overweight or obesity. METHODS We recruited adult Mexican- American mother-daughter dyads from the community. We conducted correlational analysis and hierarchical regression. RESULTS Daughters who were less satisfied with their body size reported higher symptoms of bulimic (r = -.34, p < .01) or dieting behavior (r = -.36, p < .01). Daughters who received more positive maternal messages on eating and weight had mothers with lower symptoms of bulimic (r = -.43, p < .01) or dieting behavior (r = -.30, p < .05). Maternal symptoms of bulimic behavior were the strongest predictor of daughters' bulimic behavior (ß = .379, p = .007), and body size satisfaction was the strongest predictor of daughters' dieting behavior (ß = -.372, p = .008) in adjusted models. CONCLUSION Mexican-American women who are less satisfied with their body size and have mothers with elevated symptoms of bulimic behavior are at risk for disordered eating patterns. Intervening at the individual level on body image and family level on maternal modeling of eating behavior may help support healthy weight management behaviors.
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Affiliation(s)
- Becky Marquez
- Becky Marquez, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, United States;
| | - Tanya Benitez
- Tanya Benitez, School of Public Health, Brown University, Providence, RI, United States
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Lopez DI, Chacon L, Vasquez D, Brown LD. Body composition outcomes of Healthy Fit and the role of acculturation among low-income Hispanics on the US-Mexico border. BMC Public Health 2021; 21:976. [PMID: 34034711 PMCID: PMC8147342 DOI: 10.1186/s12889-021-11015-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/09/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hispanic immigrants continue to experience higher rates of overweight and obesity compared to their non-Hispanic counterparts. Acculturation may contribute to unhealthy weight gain among immigrant populations by shifting dietary patterns from high fruit and vegetable consumption to unhealthier high fat diets. Healthy Fit, a culturally tailored community health worker (CHW) intervention, aims to reduce obesity related outcomes by providing physical activity and nutrition education and resources in a low-income Hispanic population. This study aims to evaluate outcomes of Healthy Fit participants and examine changes in body composition in relation to level of acculturation at baseline and follow-up. METHOD In this longitudinal observational study, CHWs recruited 514 participants from community events and agencies serving low-income Hispanic populations in El Paso, Texas from 2015 to 2016. Following an in-person health screening, eligible participants received nutrition and physical activity education guided by fotonovelas, comic-like educational books. Telephone follow-ups made at 1, 3, and 6 months by CHWs encouraged follow-through on referrals. 288 participants completed the screening again during the 12-month follow-up. RESULTS The sample was predominantly Hispanic (96%), female (82%), uninsured (79%), had a household income of less than $19,999 (70%), foreign-born (79%), preferred Spanish (86%) and few rated themselves as good or excellent for English proficiency (27%). Overall, Healthy Fit participants significantly improved (i.e., decreased) BFP by 0.71% (t = 2.47, p = 0.01) but not BMI (b = .01, t = - 0.14, p = .89). Contrary to expectations, acculturation was not associated with lower BMI (b = 0.09, p = 0.84) or BFP (b = 0.13, p = 0.85) at baseline. However, acculturation predicted changes in both BMI (b = 0.30, p = 0.03) and BFP (b = 1.33, p = 0 .01) from baseline to follow-up. Specifically, the low acculturation group improved in body composition measures over time and the high acculturation group did not improve in either measure. CONCLUSION Findings suggest Healthy Fit was most effective among less acculturated individuals. The influence of acculturation on the efficacy of nutrition and exercise interventions suggests that Hispanics should not be treated as a homogenous subgroup.
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Affiliation(s)
- Diane I Lopez
- The University of Texas Health Science Center at Houston, School of Public Health in El Paso, 5130 Gateway East Blvd., El Paso, TX, 79905, USA.
| | | | - Denise Vasquez
- The University of Texas Health Science Center at Houston, School of Public Health in El Paso, 5130 Gateway East Blvd., El Paso, TX, 79905, USA
| | - Louis D Brown
- The University of Texas Health Science Center at Houston, School of Public Health in El Paso, 5130 Gateway East Blvd., El Paso, TX, 79905, USA
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Aylward LL, Schneider KL, Sanchez-Johnsen L. Misreporting Weight and Height Among Mexican and Puerto Rican Men. Am J Mens Health 2021; 15:15579883211001198. [PMID: 33759632 PMCID: PMC7995458 DOI: 10.1177/15579883211001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 11/16/2022] Open
Abstract
Most obesity prevalence data rely on self-report, which typically differs when compared to objectively measured height, weight, and body mass index (BMI). Given that Latino men have high rates of obesity in the United States and demonstrate greater misreporting compared to Caucasian men, examining the factors that contribute to misreporting among Latino men is warranted. This study examined BMI, Latino ethnic background (Mexican or Puerto Rican), and social desirability in relation to misreporting of BMI, as defined as the discrepancy between self-reported and measured height and weight, in Latino men. Participants were 203 adult Mexican and Puerto Rican men, average age 39.41 years, who participated in a larger study. Participants self-reported their weight and height, had their weight and height objectively measured, and completed a measure of social desirability. Measured BMI was the strongest predictor of misreporting BMI, such that the greater the participants' BMI, the greater the discrepancy in BMI (p < .001). Misreporting of BMI did not vary based on ethnic background, and measured BMI did not moderate the relationship between social desirability and misreporting of BMI. When normative error was distinguished from misreporting in post-hoc analyses, results showed that only 34.5% of participants demonstrated misreporting. Findings highlight the importance of identifying normative error when examining misreporting in order to improve the accuracy of self-reported BMI data. Future research on misreporting for Latino men should include weight awareness, acculturation, and length of U.S. residency as these variables may be related to self-reported weight and height.
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Affiliation(s)
- Laura L. Aylward
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Kristin L. Schneider
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Lisa Sanchez-Johnsen
- Departments of Psychiatry, Surgery, and Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Lawson JL, Goldman RL, Swencionis C, Wien R, Persaud A, Parikh M. Examining Food Addiction and Acculturation Among a Hispanic Bariatric Surgery-Seeking Participant Group. Obes Surg 2020; 29:2151-2157. [PMID: 30830531 DOI: 10.1007/s11695-019-03799-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study examined food addiction (FA) and acculturation among a Hispanic bariatric surgery-seeking sample. SETTING University hospital. METHOD Four hundred forty-four (n = 215 English-speaking; n = 229 Spanish-speaking) Hispanic adults seeking bariatric surgery completed established self-report measures examining food addiction and acculturation. RESULTS 35.8% met criteria for FA, which was significantly associated with acculturation level to the USA. Participants who endorsed greater acculturation also endorsed a significantly higher level of FA symptoms compared with those who endorsed less acculturation. Acculturation level was significantly associated with FA and BMI. CONCLUSIONS FA rate in this bariatric surgery-seeking Hispanic patient group is similar to rates reported among bariatric candidates of varying ethnic backgrounds. Our results suggest a relationship between FA symptom expression and acculturation to the USA. Improving understanding of the onset and progression of severity of FA symptoms may have clinical implications for Hispanic patients seeking bariatric surgery.
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Affiliation(s)
- Jessica L Lawson
- Program for Obesity, Weight, and Eating Research, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.
| | | | - Charles Swencionis
- Ferkauf Graduate School of Psychology and Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | | | - Amrita Persaud
- Teachers College, Columbia University, New York, NY, USA
| | - Manish Parikh
- New York University School of Medicine, New York, NY, USA.,Bellevue Center for Obesity and Weight Management, New York, NY, USA
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Knerr S, Ceballos RM, Chan KCG, Beresford SAA, Bowen DJ. Women's beliefs about what causes obesity: variation by race/ethnicity and acculturation in a Washington State sample. ETHNICITY & HEALTH 2020; 25:243-254. [PMID: 29243503 PMCID: PMC6125226 DOI: 10.1080/13557858.2017.1414156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/19/2017] [Indexed: 06/07/2023]
Abstract
Objective: Individuals' beliefs about the causes of multifactorial health conditions (causal attributions) shape how they conceptualize and respond to health threats and are therefore important for health promotion. Studies of racial/ethnic and cultural variation in obesity causal beliefs, however, are scarce. To address this gap, this study described beliefs about the underlying causes of obesity (genetic inheritance, diet, and physical activity) in Hispanic and non-Hispanic White women participating in a longitudinal cohort study in South King County, Washington State (n = 1,002).Design: Analysis of baseline survey data. Self-reported obesity causal beliefs were compared by race/ethnicity and acculturation indicators (survey language and nativity) using marginal effect estimates generated from multinomial logistic regression models.Results: Hispanic women had a higher probability of not believing 'at all' in inheritance and physical activity as causes of obesity - an absolute increase of 33% and 5% over non-Hispanic White women, respectively. Both acculturation indicators were also associated with a higher probability of not believing 'at all' in inheritance as a cause of obesity, though Hispanic women who completed the survey in English and were born in the United States had genetic causal beliefs similar to non-Hispanic White women. Behavioral attributions did not vary by acculturation indicators in Hispanic women.Conclusions: Differences in obesity casual beliefs, particularly genetic attributions, exist and may be important for developing and delivering effective obesity-related health promotion interventions. Identifying the determinants and public health consequences of cultural variation in obesity attributions should be the focus of future research.
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Affiliation(s)
- Sarah Knerr
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | | | - Kwun Chuen Gary Chan
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
- Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA
| | - Shirley A A Beresford
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Deborah J Bowen
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA
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Madanat H, Hawks J, Gonzales A, Miranda E, Walsh-Buhi ER, Takemoto M, Gaida E. Assessing Evidence of Validity for the Intuitive Eating Scale-2 among Adult Latina Women. Health (London) 2020. [DOI: 10.4236/health.2020.124024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mojica CM, Liang Y, Foster BA, Parra-Medina D. The Association Between Acculturation and Parental Feeding Practices in Families With Overweight and Obese Hispanic/Latino Children. FAMILY & COMMUNITY HEALTH 2019; 42:180-188. [PMID: 31107728 PMCID: PMC6581037 DOI: 10.1097/fch.0000000000000226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examines the association between acculturation and parental feeding practices in low-income Latinos. Overweight/obese children (N = 117), aged 5 to 14 years, and their parents were recruited from a rural health clinic. Findings show that more acculturated parents have greater control over their child's eating behavior (P = .04). Parents who perceive their child as having a weight problem also have more control over their child's eating behavior (P = .02). Control measured from regulation of how much and when the child should eat to offering sweets and screen time for good behavior. Results underscore the need for interventions to consider parental acculturation and perceptions of child weight.
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Affiliation(s)
- Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis (Dr Mojica); Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore (Dr Liang); Division of Hospital Medicine, School of Medicine, Oregon Health & Science University, Portland (Dr Foster); and Director, Latino Research Institute, Mexican American and Latina/o Studies, University of Texas at Austin (Dr Parra-Medina)
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Guendelman S, Ritterman Weintraub M, Kaufer-Horwitz M. Weight Loss Success Among Overweight and Obese Women of Mexican-Origin Living in Mexico and the United States: A Comparison of Two National Surveys. J Immigr Minor Health 2017; 19:41-49. [PMID: 27002624 DOI: 10.1007/s10903-015-0315-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We assessed variations in and correlates of weight-loss success (WLS) among overweight/obese women in Mexico (WIMX) and Mexican-American women (MA). We used cross-national data from 2006 ENSANUT (Mexico) and NHANES (2001-2008) to compare 5061 WIMX with 550 MA's without known metabolic conditions. WLS was defined as losing ≥5 % of body weight over 1 year. MA's were more likely to attain WLS (OR 1.31; 95 % CI 1.01-1.70). WLS among WIMX was higher in those with at least high school, a provider screen of overweight and a lower BMI. Among MA's, an incomplete high school versus primary education reduced the odds of WLS. Among women who lost ≥10 lbs, weight-loss strategies such as eating less were higher among MA's. MA women were more likely than WIMX to attain WLS. Understanding these disparities can help design customized public health interventions that curb the obesity epidemic in these women in both countries.
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Affiliation(s)
- Sylvia Guendelman
- School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA, 94720-7360, USA
| | - Miranda Ritterman Weintraub
- School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA, 94720-7360, USA.,Public Health Program, Touro University California, Vallejo, CA, USA
| | - Martha Kaufer-Horwitz
- Obesity and Eating Disorders Clinic, Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15; Col. Belisario Domínguez Sección XVI, 14080, Tlalpan, Mexico, D.F., Mexico.
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Winters S, Martin C, Murphy D, Shokar NK. Breast Cancer Epidemiology, Prevention, and Screening. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2017; 151:1-32. [PMID: 29096890 DOI: 10.1016/bs.pmbts.2017.07.002] [Citation(s) in RCA: 285] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Globally, breast cancer is both the most commonly occurring cancer and the commonest cause of cancer death among women. Available data suggest that incidence and mortality in high-resource countries has been declining whereas incidence and mortality in low-resource countries has been increasing. This pattern is likely to be due to changing risk factor profiles and differences in access to breast cancer early detection and treatment. Risk factors for breast cancer include increasing age, race, menarche history, breast characteristics, reproductive patterns, hormone use, alcohol use, tobacco use, diet, physical activity, and body habitus. Mutations in the BRCA 1 and BRCA 2 tumor suppressor genes are significantly associated with the development of breast and ovarian cancer by the age of 70. Survival depends on both stage and molecular subtype. As there are few signs and symptoms early on, early detection is an important strategy to improve outcomes. Major professional organizations in the United States and elsewhere recommend screening with mammography with appropriate follow up for an abnormal screening test, although they differ somewhat by recommended ages and frequency of screening. Studies suggest a 15%-40% mortality reduction secondary to screening, however, there are also concerns about harms, such as overdiagnosis (5%-54%) and overtreatment leading to long term complications, and false negatives (6%-46%). Identification of women at risk for BRCA1 and BRCA 2 mutations is also recommended with referral for genetic testing. Preventive interventions, such as lifestyle, medical, and surgical options are available for women testing positive for BRCA mutations.
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Affiliation(s)
- Stella Winters
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States
| | - Charmaine Martin
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States
| | - Daniel Murphy
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States
| | - Navkiran K Shokar
- Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, El Paso, TX, United States.
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Marquez B, Murillo R. Racial/Ethnic Differences in Weight-Loss Strategies among US Adults: National Health and Nutrition Examination Survey 2007-2012. J Acad Nutr Diet 2017; 117:923-928. [PMID: 28330732 DOI: 10.1016/j.jand.2017.01.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/24/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dieting, exercising, and seeking professional help have been associated with intentional weight loss among adults. OBJECTIVE This study examined the use of diet (eg, ate less, ate less fat, or switched to low-calorie foods), exercise, diet and exercise, and professional help (eg, weight-loss program or prescribed diet pills) for weight loss among non-Hispanic whites, Mexican Americans, and non-Hispanic blacks. DESIGN Cross-sectional data from the 2007-2012 National Health and Nutrition Examination Survey were used. PARTICIPANTS Males and females (n=9,046) aged 20 to 65 years were included. MAIN OUTCOME MEASURE The weight history questionnaire assessed weight-loss attempts and use of weight-loss strategies in the past year. STATISTICAL ANALYSES PERFORMED Multivariate logistic regression models were used to estimate associations of race/ethnicity with strategies to lose weight. Models controlled for age, sex, education, and body mass index. In fully adjusted models, interactions of race/ethnicity by sex were tested. RESULTS Lower proportions of Mexican Americans (35%) and non-Hispanic blacks (35%) than non-Hispanic whites (39%) reported trying to lose weight. Among those who tried to lose weight, non-Hispanic blacks were less likely than non-Hispanic whites to use diet (odds ratio [OR] 0.78, 95% CI 0.67 to 0.90) or exercise (OR 0.83, 95% CI 0.70 to 0.99) for weight loss. Mexican Americans (OR 0.71, 95% CI 0.53 to 0.95) and non-Hispanic blacks (OR 0.71, 95% CI 0.52 to 0.95) were also less likely than non-Hispanic whites to use professional help for weight loss. The relationships between race/ethnicity and weight-loss strategy were stronger for females than males. CONCLUSIONS Targeted efforts are needed to address racial/ethnic disparities in weight-loss attempts and use of recommended strategies especially among females.
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Ragsdale C, Wright J, Shokar G, Salaiz R, Shokar NK. Hispanic Patient Perspectives of the Physician's Role in Obesity Management. J Clin Med Res 2016; 9:170-175. [PMID: 28090233 PMCID: PMC5215021 DOI: 10.14740/jocmr2868w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Little is known concerning Hispanic patients' perceptions about the role of the physician in obesity management. This study seeks to describe the perspectives of Hispanic patients toward weight loss, and what they believe their doctor's role should be in the management of obesity. METHODS A cross-sectional study utilizing semi-structured interviews was conducted in a university-based family medicine clinic. Open-ended questions explored beliefs about the relationship between weight and health, previous weight loss experience, perceptions about the role of the physician in weight loss, past experiences with their physician, and preferences for how a physician could help facilitate weight loss. The free recall listing technique was used to elicit responses. Common themes were identified by a group coding process. RESULTS Patients were open to discussion from physicians concerning weight loss but many had not been approached. They wanted assistance from their doctors in the form of dietician referrals, specific weight loss goals, and encouragement. Patients' knowledge about the implications of excess weight on health was lacking. CONCLUSION Hispanic patients want more help and advice from their doctors. General knowledge of the health implications of obesity was lacking, indicating a need for more health education by the healthcare team.
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Affiliation(s)
- Colton Ragsdale
- Department of Pediatrics, Greenville Hospital System, University of South Carolina, 701 Grove Road, Greenville, SC 29601, USA
| | - Justin Wright
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, 9849 Kenworthy St. El Paso, TX 79924, USA
| | - Gurjeet Shokar
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, 9849 Kenworthy St. El Paso, TX 79924, USA
| | - Rebekah Salaiz
- Department of Family and Community Medicine, Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, 9849 Kenworthy St. El Paso, TX 79924, USA
| | - Navkiran K Shokar
- Department of Family and Community Medicine & Biomedical Sciences, Texas Tech University Health Sciences Center, El Paso, Paul L Foster School of Medicine, 9849 Kenworthy St. El Paso, TX 79924, USA
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Cordero ED, Gutierrez A. Weight-Related Eating Among Less-Acculturated Latina College Students. J Immigr Minor Health 2016; 18:1032-1037. [PMID: 26976002 DOI: 10.1007/s10903-016-0387-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Less-acculturated Latinos have been found to have unique patterns of weight-related eating attitudes and behaviors. This study examined body mass index (BMI), body image, and various facets of emotional distress as contributors to weight-related eating among less-acculturated female Latina college students. It was hypothesized that unique combinations of BMI, body image, depression, anxiety, and stress would predict routine restraint, compensatory restraint, susceptibility to external cues, and emotional eating in less-acculturated Latina college students. Participants were 141 college students from a rural region in southeastern California who completed questionnaires. Preoccupation with being overweight, a body-image variable, significantly predicted routine and compensatory restraint whereas stress was an important correlate of reasons for eating other than hunger. Implications of the findings include the potential to inform models of weight-related eating among less-acculturated Latina college students. Limitations include homogeneity of sample pertinent to Latino descent. Future directions are discussed.
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Affiliation(s)
- Elizabeth Diane Cordero
- Department of Psychology, San Diego State University, Imperial Valley, 720 Heber Avenue, Calexico, CA, 92231, USA.
| | - Angelica Gutierrez
- Department of Psychology, San Diego State University, Imperial Valley, 720 Heber Avenue, Calexico, CA, 92231, USA
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Knerr S, Bowen DJ, Beresford SAA, Wang C. Genetic causal beliefs about obesity, self-efficacy for weight control, and obesity-related behaviours in a middle-aged female cohort. Psychol Health 2016; 31:420-35. [PMID: 26542069 DOI: 10.1080/08870446.2015.1115503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Obesity is a heritable condition with well-established risk-reducing behaviours. Studies have shown that beliefs about the causes of obesity are associated with diet and exercise behaviour. Identifying mechanisms linking causal beliefs and behaviours is important for obesity prevention and control. DESIGN Cross-sectional multi-level regression analyses of self-efficacy for weight control as a possible mediator of obesity attributions (diet, physical activity, genetic) and preventive behaviours in 487 non-Hispanic White women from South King County, Washington. MAIN OUTCOME MEASURES Self-reported daily fruit and vegetable intake and weekly leisure-time physical activity. RESULTS Diet causal beliefs were positively associated with fruit and vegetable intake, with self-efficacy for weight control partially accounting for this association. Self-efficacy for weight control also indirectly linked physical activity attributions and physical activity behaviour. Relationships between genetic causal beliefs, self-efficacy for weight control, and obesity-related behaviours differed by obesity status. Self-efficacy for weight control contributed to negative associations between genetic causal attributions and obesity-related behaviours in non-obese, but not obese, women. CONCLUSION Self-efficacy is an important construct to include in studies of genetic causal beliefs and behavioural self-regulation. Theoretical and longitudinal work is needed to clarify the causal nature of these relationships and other mediating and moderating factors.
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Affiliation(s)
- Sarah Knerr
- a Group Health Research Institute , Seattle , WA , USA.,b Department of Health Services, School of Public Health , University of Washington , Seattle , WA , USA
| | - Deborah J Bowen
- c Department of Bioethics and Humanities, School of Medicine , University of Washington , Seattle , WA , USA
| | - Shirley A A Beresford
- d Department of Epidemiology, School of Public Health , University of Washington , Seattle , WA , USA.,e Fred Hutchinson Cancer Research Center , Seattle , WA , USA
| | - Catharine Wang
- f Department of Community Health Sciences , Boston University , Boston , MA , USA
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Chang-Martinez C. Racial and ethnic-related differences in obesity and the migration factor. CAD SAUDE PUBLICA 2015; 31:1571. [DOI: 10.1590/0102-311xca010715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 05/06/2015] [Indexed: 11/22/2022] Open
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