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Wong V, Franke T, McKay H, Tong C, Macdonald H, Sims-Gould J. Adapting an Effective Health-Promoting Intervention-Choose to Move-for Chinese Older Adults in Canada. J Aging Phys Act 2024; 32:151-162. [PMID: 37917970 DOI: 10.1123/japa.2023-0064] [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] [Received: 02/17/2023] [Revised: 07/04/2023] [Accepted: 08/07/2023] [Indexed: 11/04/2023]
Abstract
Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations.
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Affiliation(s)
- Venessa Wong
- Active Aging Research Team, Vancouver, BC,Canada
| | - Thea Franke
- Active Aging Research Team, Vancouver, BC,Canada
| | | | - Catherine Tong
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
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2
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Simpson CC, Boutté RL, Burnette CB, Weinstock M, Goel N, Mazzeo SE. Cultural adaptation of an integrated eating disorders prevention and healthy weight management program. J Eat Disord 2023; 11:232. [PMID: 38124164 PMCID: PMC10734179 DOI: 10.1186/s40337-023-00950-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Both eating disorder (ED) prevention and weight management interventions often focus on the thin ideal. Yet, many Black and Latina women do not view thinness as their body ideal. This study used focus groups to investigate the influence of race, ethnicity, and culture on appearance ideals and inform the cultural adaptation and integration of two established programs addressing EDs and weight management: the Body Project, and Healthy Weight Interventions. METHODS White (n = 10), Black (n = 14), and Latina (n = 6) women participated in racially and ethnically homogenous focus groups. RESULTS Thematic analysis identified several themes, including: (1) diverse beauty standards across groups, (2) lack of acknowledgement of racialized beauty standards in prevention and cultural appropriation, (3) culturally-specific impacts of standards, (4) harm of appearance-related comments, (5) limitations of available resources, (6) stigma/minimization of mental health, (7) barriers to inclusive programming, and (8) facilitators of inclusive programming. CONCLUSIONS Results suggested that current programs' emphasis on thinness limit their relevance for women of color, and perpetuate the misconception that EDs primarily affect White women. Findings highlight the need for culturally responsive prevention.
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Affiliation(s)
| | - Rachel L Boutté
- Department of Family and Preventive Medicine, Rush Medical College, Chicago, IL, USA
| | - C Blair Burnette
- Department of Psychology, Michigan State University, Lansing, MI, USA
| | - Madison Weinstock
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA
| | - Neha Goel
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA
| | - Suzanne E Mazzeo
- Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA, 23284-2018, USA.
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Leng J, Lui F, Narang B, Puebla L, Finik J, Wu M, Tonda J, Gany F. A Pilot Group-Based Lifestyle Intervention to Promote Weight Loss Among Mexican Immigrants. J Community Health 2022; 47:885-893. [PMID: 35902442 PMCID: PMC10105641 DOI: 10.1007/s10900-022-01124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 12/26/2022]
Abstract
Mexican Americans are at increased risk for obesity upon immigration to the U.S., increasing their risk for diabetes, cardiovascular disease, and cancer. Our pilot individual lifestyle intervention culturally tailored for Mexican Americans, COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), showed promising results. This paper presents outcomes from the group-based version of COMIDA. 129 overweight/obese Mexican Americans were enrolled in 'Group COMIDA'. Participants' weight (primary outcome), dietary intake and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Seventeen percent of participants experienced 5% weight loss at follow-up. Post-intervention, participants consumed more fruit and vegetables and fewer sweets and fried foods. A group-based, culturally adapted lifestyle intervention may be a more cost-effective approach than individual interventions to improve dietary behavior among underserved populations, though additional modifications may be considered to increase the intervention's effectiveness in promoting significant weight loss.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
- Immigrant Health and Cancer Disparities Service, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.
| | - Florence Lui
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Leslie Puebla
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Jacqueline Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Josana Tonda
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
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Crocker RM, Morrill KE, Villavicencio EA, Garcia DO. How Mexicans' Emotional Responses to Non-Alcoholic Fatty Liver Disease Can Help Inform Culturally Congruent Health Care. J Transcult Nurs 2022; 33:615-623. [PMID: 35684997 DOI: 10.1177/10436596221101923] [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: 11/16/2022] Open
Abstract
INTRODUCTION This article aims to increase understanding of how Mexican immigrants respond to learning about non-alcoholic fatty liver disease (NAFLD), a spectrum disease with a heavy burden among Mexican-origin people. METHODOLOGY This article presents findings from qualitative interviews (n = 26) that formed part of a mixed-methods study of foreign-born Mexican immigrants carried out in 2019 to 2020 in southern Arizona to assess NAFLD awareness. RESULTS We documented common experiences of surprise, fear, and hope during study participation, all of which motivated research participants to reduce their NAFLD risk by seeking additional information, sharing it with others, and making lifestyle changes. DISCUSSION Understanding how these emotional experiences are tied to cultural and historical factors-including Mexico's high rates of liver disease, participant's limited access to health care, and the ability to address the NAFLD risk with lifestyle changes-may promote the development of more effective and culturally congruent care in this population.
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Affiliation(s)
- Rebecca M Crocker
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | | | - Edgar A Villavicencio
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - David O Garcia
- Department of Health Promotion Sciences, University of Arizona, Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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Morrill KE, Crocker RM, Hingle MD, Thomson CA, Garcia DO. Awareness, Knowledge, and Misperceptions Related to Nonalcoholic Fatty Liver Disease in a Community Sample of Mexican-Origin Women: A Mixed Methods Study. Front Public Health 2021; 9:626428. [PMID: 34485209 PMCID: PMC8415027 DOI: 10.3389/fpubh.2021.626428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/16/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction: Mexican-origin women suffer disproportionate rates of nonalcoholic fatty liver disease (NAFLD) and research on how to tailor NAFLD treatment interventions for this population is lacking. Objectives: The purpose of this study was to assess awareness, knowledge, perceptions, and information sources related to NAFLD in a community-based sample of Mexican-origin women. Methods: This study employed a convergent parallel mixed-methods approach and consisted of a brief questionnaire (n = 194) and interviews (n = 26) among Mexican-origin women recruited from community-based settings including health fairs, churches, and community events. Participants were eligible if they identified as Mexican-origin, had a BMI ≥ 25 kg/m2, were 18-64 years of age, had the ability to speak, read, and write in English and/or Spanish, and provided informed consent. A purposeful sampling approach was used to recruit a subset of women (n = 26) with confirmed liver steatosis indicative of NAFLD (controlled attenuation parameter ≥280 dB/m) who completed the questionnaire. The twenty-six participants then completed one on one, in-depth semi-structured interviews to ascertain their knowledge and understanding of NAFLD. Results: Qualitative findings revealed low awareness of risk factors for liver disease, NAFLD specifically. Knowledge of liver disease tended to center around cirrhosis, a condition many participants reported was prevalent in their families. Quantitative and qualitative findings both found information sources for NAFLD and liver disease to be predominantly friends, family, and media. Interviews revealed a misperception related to NAFLD risk that liver disease was only caused by high alcohol intake. Conclusion: Low levels of NAFLD awareness and knowledge warrant the need for greater efforts to educate the general population, perhaps by integrating NAFLD education into existing type 2 diabetes educational campaigns and prevention interventions. Additionally, further elicitation research conducted in Mexican-origin adults is needed to elucidate key factors within behavioral-theory constructs that can be targeted in future interventions tailored to this unique population.
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Affiliation(s)
- Kristin E Morrill
- University of Arizona Cancer Center, University of Arizona, Tucson, AZ, United States
| | - Rebecca M Crocker
- Center for Border Health Disparities, Health Sciences, University of Arizona, Tucson, AZ, United States
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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Weight Loss Interventions for Hispanic Women in the United States: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:8714873. [PMID: 34457010 PMCID: PMC8397533 DOI: 10.1155/2021/8714873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/30/2021] [Indexed: 12/17/2022]
Abstract
Background Obesity rates in Hispanic women residing in the United States (U.S.) are disproportionately high, increasing the risk of obesity-related disease and mortality. The effectiveness of interventions targeting weight loss in this population remains largely unknown. Purpose The purpose of this review was to systematically evaluate the evidence related to the effectiveness of weight loss interventions conducted among U.S. Hispanic women and provide guidance for future research. Methods Bibliographic databases (n = 10, from each database's inception to July 2, 2019) were searched using the PRISMA guidelines for systematic reviews. Randomized controlled trials (RCTs) and quasi-experimental studies with weight change outcomes were included. Results were described in a narrative synthesis. Results 5,423 articles were assessed for eligibility based on inclusion criteria; 15 studies were included in the final review. Nine trials were RCTs and six were quasi-experimental studies; all but six were pilot studies. Most studies recruited overweight or obese women with no existing medical conditions and did not follow participants beyond the intervention. All trials were delivered in-person. Intervention strategies and content and weight change outcomes were highly variable. Conclusions RCTs with statistically powered sample sizes are needed to robustly test the effects of weight loss interventions in this population.
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Tien J, Lewis GD, Liu J. Prenatal risk factors for internalizing and externalizing problems in childhood. World J Pediatr 2020; 16:341-355. [PMID: 31617077 PMCID: PMC7923386 DOI: 10.1007/s12519-019-00319-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND A growing body of research has documented the effects of prenatal risk factors on a wide spectrum of adverse offspring health outcomes. Childhood behavior problems, such as externalizing and internalizing problems, are no exception. This comprehensive literature review aims to summarize and synthesize current research about commonly experienced prenatal risk factors associated with internalizing and externalizing problems, with a focus on their impact during childhood and adolescence. Potential mechanisms as well as implications are also outlined. DATA SOURCES The EBSCO, Web of Science, PubMed, Google Scholar, and Scopus databases were searched for studies examining the association between prenatal risk factors and offspring internalizing/externalizing problems, using keywords "prenatal" or "perinatal" or "birth complications" in combination with "internalizing" or "externalizing". Relevant articles, including experimental research, systematic reviews, meta-analyses, cross-sectional and longitudinal cohort studies, and theoretical literature, were reviewed and synthesized to form the basis of this integrative review. RESULTS Prenatal risk factors that have been widely investigated with regards to offspring internalizing and externalizing problems encompass health-related risk factors, including maternal overweight/obesity, substance use/abuse, environmental toxicant exposure, maternal infection/inflammation, as well as psychosocial risk factors, including intimate partner violence, and anxiety/depression. Collectively, both epidemiological and experimental studies support the adverse associations between these prenatal factors and increased risk of emotional/behavioral problem development during childhood and beyond. Potential mechanisms of action underlying these associations include hormonal and immune system alterations. Implications include prenatal education, screening, and intervention strategies. CONCLUSIONS Prenatal risk factors are associated with a constellation of offspring internalizing and externalizing problems. Identifying these risk factors and understanding potential mechanisms will help to develop effective, evidence-based prevention, and intervention strategies.
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Affiliation(s)
- Joyce Tien
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Gary D Lewis
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jianghong Liu
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Lindberg NM, Vega-López S, Arias-Gastelum M, Stevens VJ. Alternative Medicine Methods Used for Weight Loss and Diabetes Control by Overweight and Obese Hispanic Immigrant Women. HISPANIC HEALTH CARE INTERNATIONAL 2020; 18:49-54. [PMID: 31234651 DOI: 10.1177/1540415319858075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Middle-aged Hispanic women have the highest prevalence of overweight and lifetime risk for diabetes of all gender/racial groups. This study examines use of alternative medicine for weight loss and diabetes management among overweight and obese Mexican American women with or at risk for diabetes. METHOD As part of a diabetes risk-reduction intervention targeting overweight and obese Hispanic women at a federally qualified health center in Hillsboro, Oregon, we administered a survey of different treatment modalities, including alternative medicine, traditional Mexican medicine, and home remedies to 85 Hispanic women. We also asked participants how often they disclosed their use of alternative methods to their providers. RESULTS Nearly all participants with diabetes (97%) reported using at least one alternative strategy for diabetes control, with home remedies, commercial weight-loss products, and herbal teas being the most endorsed. Most participants with diabetes and half of those without diabetes reported never telling their provider. CONCLUSION This group of women reported a high prevalence of use of alternative methods for weight control and diabetes management. Yet most participants with diabetes never reported this use to a health care provider. To ensure patient safety, providers treating Hispanic women need to probe for complementary and alternative medicine practices.
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Affiliation(s)
- Nangel M Lindberg
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
| | | | | | - Victor J Stevens
- Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA
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Lindberg NM, Vega-López S, LeBlanc ES, Leo MC, Stevens VJ, Gille S, Arias-Gastelum M, Meenan R. Lessons Learned From a Program to Reduce Diabetes Risk Among Low-Income Hispanic Women in a Community Health Clinic. Front Endocrinol (Lausanne) 2020; 11:489882. [PMID: 33488511 PMCID: PMC7821047 DOI: 10.3389/fendo.2020.489882] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Diabetes Prevention Program (DPP) and Look AHEAD studies demonstrated that modest weight loss and increased physical activity can significantly reduce the incidence of diabetes among overweight individuals with prediabetes. However, these studies involved costly interventions, all of which are beyond the reach of most real-world settings serving high-risk, low-income populations. Our project, De Por Vida, implemented a diabetes risk-reduction intervention for Hispanic women in a Federally Qualified Health Center and assessed the program's efficacy. This report describes the methodology used to develop and implement De Por Vida, the cultural adaptations made, the community-academic partnership formed to carry out this program, and the barriers and challenges encountered through the implementation process. METHODS Our goal was to translate the DPP and Look AHEAD programs into an intervention to prevent diabetes and reduce diabetes complications among high-risk Hispanic women at a federally qualified health center in Hillsboro, Oregon, where more than half of clinic patients are Spanish-speaking, and nearly all live in poverty. This randomized clinical trial targeted overweight Spanish-speaking women at risk for, or diagnosed with, type 2 diabetes. We developed a 12-month behavioral diabetes risk-reduction intervention that was responsive to the cultural practices of the Hispanic population and that could be implemented in low-income clinical settings. Study planning and implementation involved close collaboration among the clinic leadership, a research team from the Kaiser Permanente Center for Health Research, and Arizona State University. DISCUSSION Creating a fully informed partnership between research and clinical institutions is the first step in successful cooperative research projects. The adoption of a bidirectional, rather than a top-down, approach to communication between researchers and health-care providers, and between clinic management and the clinic frontline staff, gave the research study team crucial information about barriers, constraints, and needs that clinic staff experienced in implementing the program. This allowed clinic management and front-line clinic staff to play an active role in study implementation, identifying problem areas, and collaborating in finding practical solutions. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov, NCT03113916.
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Affiliation(s)
- Nangel M. Lindberg
- Kaiser Permanente Center for Health Research, Portland, OR, United States
- *Correspondence: Nangel M. Lindberg,
| | - Sonia Vega-López
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Erin S. LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Michael C. Leo
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Victor J. Stevens
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Sara Gille
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | | | - Richard Meenan
- Kaiser Permanente Center for Health Research, Portland, OR, United States
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Thornton PL, Kumanyika SK, Gregg EW, Araneta MR, Baskin ML, Chin MH, Crespo CJ, de Groot M, Garcia DO, Haire-Joshu D, Heisler M, Hill-Briggs F, Ladapo JA, Lindberg NM, Manson SM, Marrero DG, Peek ME, Shields AE, Tate DF, Mangione CM. New research directions on disparities in obesity and type 2 diabetes. Ann N Y Acad Sci 2019; 1461:5-24. [PMID: 31793006 DOI: 10.1111/nyas.14270] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and low-income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scaling-up successful interventions and reaching at-risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.
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Affiliation(s)
- Pamela L Thornton
- Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, Maryland
| | - Shiriki K Kumanyika
- Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania
| | - Edward W Gregg
- Epidemiology and Statistics Branch, Division of Diabetes Translation, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Maria R Araneta
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, California
| | - Monica L Baskin
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Carlos J Crespo
- Oregon Health and Science University and Portland State University Joint School of Public Health, Portland, Oregon
| | - Mary de Groot
- Indiana University School of Medicine, Indianapolis, Indiana
| | - David O Garcia
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona
| | - Debra Haire-Joshu
- Washington University in St. Louis, School of Medicine and the Brown School, St. Louis, Missouri
| | | | - Felicia Hill-Briggs
- Johns Hopkins School of Medicine and Welch Center for Prevention, Epidemiology & Clinical Research, Baltimore, Maryland
| | - Joseph A Ladapo
- David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California
| | | | | | | | | | - Alexandra E Shields
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Deborah F Tate
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Carol M Mangione
- David Geffen School of Medicine at the University of California, and UCLA Fielding School of Public Health, Los Angeles, Los Angeles, California
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West DS, Dutton G, Delahanty LM, Hazuda HP, Rickman AD, Knowler WC, Vitolins MZ, Neiberg RH, Peters A, Gee M, Cassidy Begay M. Weight Loss Experiences of African American, Hispanic, and Non-Hispanic White Men and Women with Type 2 Diabetes: The Look AHEAD Trial. Obesity (Silver Spring) 2019; 27:1275-1284. [PMID: 31338998 PMCID: PMC6658112 DOI: 10.1002/oby.22522] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to characterize weight loss, treatment engagement, and weight control strategies utilized by African American, Hispanic, and non-Hispanic white participants in the Action for Health in Diabetes (Look AHEAD) Intensive Lifestyle Intervention by racial/ethnic and sex subgroups. METHODS Weight losses at 1, 4, and 8 years among 2,361 adults with obesity and type 2 diabetes randomized to intervention (31% minority; 42% men) are reported by subgroup. Multivariable models within subgroups examine relative contributions of treatment engagement variables and self-reported weight control behaviors. RESULTS All subgroups averaged weight losses ≥ 5% in year 1 but experienced regain; losses ≥ 5% were sustained at year 8 by non-Hispanic white participants and minority women (but not men). Session attendance was high (≥ 86%) in year 1 and exceeded protocol-specified minimum levels into year 8. Individual session attendance had stronger associations with weight loss among Hispanic and African American participants than non-Hispanic white participants at 4 years (P = 0.04) and 8 years (P = 0.001). Daily self-weighing uptake was considerable in all subgroups and was a prominent factor associated with year 1 weight loss among African American men and women. Greater meal replacement use was strongly associated with poorer 1-year weight losses among African American women. CONCLUSIONS Experiences of minority men and women with diabetes in lifestyle interventions fill important gaps in the literature that can inform treatment delivery.
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Affiliation(s)
- Delia Smith West
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| | - Gareth Dutton
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Linda M Delahanty
- Diabetes Research Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Helen P Hazuda
- Division of Nephrology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Amy D Rickman
- Department of Exercise & Rehabilitative Sciences, Slippery Rock University, Slippery Rock, Pennsylvania, USA
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, NIDDK, Phoenix, Arizona, USA
| | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rebecca H Neiberg
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Anne Peters
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Molly Gee
- Behavioral Medicine Research Center, Baylor College of Medicine, Houston, Texas, USA
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Garcia DO, Valdez LA, Aceves B, Bell ML, Humphrey K, Hingle M, McEwen M, Hooker SP. A Gender- and Culturally Sensitive Weight Loss Intervention for Hispanic Men: Results From the Animo Pilot Randomized Controlled Trial. HEALTH EDUCATION & BEHAVIOR 2019; 46:763-772. [PMID: 31216875 DOI: 10.1177/1090198119853011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background. Hispanic males have the highest rates of overweight and obesity compared with men of all other racial/ethnic groups. While weight loss can significantly reduce obesity-related health risks, there is limited research examining effective gender- and culturally tailored behavioral weight loss programs for Hispanic men. Objective. To assess the feasibility and preliminary efficacy of a 12-week gender- and culturally sensitive weight loss intervention (GCSWLI) as compared with a waist-list control (WLC) in sedentary, Hispanic males with overweight/obesity. Method. Fifty Hispanic males (age: 43 years [SD = 11]; BMI: 34 ± 5 kg/m2; 58% Spanish monolingual) were randomized to one of two groups: GCSWLI (n = 25) or WLC (n = 25). GCSWLI participants attended weekly in-person individual sessions with a bilingual, bicultural Hispanic male lifestyle coach, and were prescribed a daily reduced calorie goal and 225 minutes of moderate-intensity physical activity per week. The WLC were asked to maintain their usual diet and physical activity habits for 12 weeks. GCSWLI participants continued with 12 additional weeks of follow-up including biweekly phone calls with lifestyle coaches. Results. At Week 12, the mean weight loss in the GCSWLI was -6.3 kg (95% confidence interval [CI; -8.1, -4.4]) compared with -0.8 kg (95% CI [-2.5, 0.9]) for the WLC (difference = -5.5 kg, 95% CI [-8.0, -2.9], p < .01). At Week 24, weight loss in the GCSWLI was maintained. Conclusions. The GCSWLI appears to be a feasible strategy to engage Hispanic males in short-term weight loss. Our pilot study indicates preliminary evidence of efficacy, though confirmation of these findings is needed in a larger study.
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Portacio FG, Botero P, St George SM, Stoutenberg M. Informing the Adaptation and Implementation of a Lifestyle Modification Program in Hispanics: A Qualitative Study Among Low-Income Hispanic Adults. HISPANIC HEALTH CARE INTERNATIONAL 2018; 16:204-212. [PMID: 30426783 DOI: 10.1177/1540415318808831] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low-income Hispanics are a hard to reach population that face unique challenges in achieving behavior change. Understanding such challenges can inform the adaptation of lifestyle behavioral interventions and increase participant engagement. This descriptive qualitative study aimed to (1) inform lifestyle modification programs focused on improving the physical activity and healthy eating of low-income Hispanic adults and (2) explore potential gender differences necessary for consideration. Five gender-specific focus groups were conducted with Hispanic adults from a free community clinic (n = 45, 64% women, 53.1 ± 10.1 years). Sessions were audio-recorded, transcribed, and coded using a general inductive approach. The qualitative software program Dedoose was used to perform a content analysis. Emergent themes included topics of interest, methods of increasing engagement in healthy behaviors, and the delivery of lifestyle modification programs. Men expressed greater interest in physical activity, while women desired to learn about healthy eating. Men described the importance of physician communication, while women focused on the role of social support as facilitators for participating in such programs. Both genders described education as key to behavior change and viewed text messaging as a valuable complement. Results from this study can inform the adaptation of lifestyle modification programs and increase the engagement of low-income Hispanic populations.
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Affiliation(s)
- Francia G Portacio
- University of Miami, Miami, FL, USA.,University of Tennessee at Chattanooga, TN, USA
| | | | | | - Mark Stoutenberg
- University of Miami, Miami, FL, USA.,University of Tennessee at Chattanooga, TN, USA
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14
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Garcia DO, Valdez LA, Bell ML, Humphrey K, Hingle M, McEwen M, Hooker SP. A gender- and culturally-sensitive weight loss intervention for Hispanic males: The ANIMO randomized controlled trial pilot study protocol and recruitment methods. Contemp Clin Trials Commun 2018; 9:151-163. [PMID: 29696238 PMCID: PMC5898526 DOI: 10.1016/j.conctc.2018.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/24/2018] [Accepted: 01/31/2018] [Indexed: 01/27/2023] Open
Abstract
Hispanic men have the highest rates of overweight and obesity when compared to men of other racial/ethnic groups, placing them at increased risk for obesity-related disease. Yet, Hispanic men are grossly underrepresented in weight loss research. Tailored intervention strategies to improve obesity treatment programs for this vulnerable racial/ethnic subgroup are needed. This manuscript describes recruitment strategies, methodology, and participant characteristics of the ANIMO study, a 24-week randomized controlled pilot trial testing the effects of a gender- and culturally-sensitive weight loss intervention (GCSWLI) on body weight in Hispanic men compared to a wait-list control condition. The ANIMO study included two phases. The first phase was a 12-week GCSWLI. Participants attended weekly in-person individual sessions guided by a trained bilingual Hispanic male lifestyle coach, were prescribed a daily reduced calorie goal, and 225 min of moderate-intensity physical activity per week. In the second phase, GCSWLI participants received bi-weekly phone calls across a 12-week follow-up. Wait-list control (WLC) participants from phase 1 received the GCSWLI plus mobile health technology support. Recruitment strategies included face-to-face efforts at a swap meet (outdoor marketplace), family/friend referrals, printed advertisements and social media. Recruitment, screening, and participant enrollment occurred over three months. Overall, 143 men expressed interest in participation. Of these, 115 were screened and 78% (n = 90) were eligible to participate; 45% of enrolled participants (n = 52) completed baseline assessments and 43% (n = 50) were randomized (mean age of 43.3 ± 11.4 years; BMI: 34.1 ± 5.3 kg/m2; 58% Spanish monolingual). Parameter estimates from ANIMO will support future adequately powered trials for this health disparate population. Trial registration ClinicalTrials.gov: NCT02783521.
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Affiliation(s)
- David O Garcia
- University of Arizona Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, USA
| | - Luis A Valdez
- University of Arizona Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, USA
| | - Melanie L Bell
- University of Arizona Mel and Enid Zuckerman College of Public Health, Department of Epidemiology and Biostatistics, USA
| | - Kyle Humphrey
- University of Arizona Mel and Enid Zuckerman College of Public Health, Department of Epidemiology and Biostatistics, USA
| | - Melanie Hingle
- University of Arizona Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, USA.,University of Arizona College of Agriculture and Life Sciences, Department of Nutritional Sciences, USA
| | - Marylyn McEwen
- University of Arizona Mel and Enid Zuckerman College of Public Health, Department of Health Promotion Sciences, USA.,University of Arizona College of Nursing, USA
| | - Steven P Hooker
- Arizona State University, College of Health Solutions, Exercise Science and Health Promotion Program, USA
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15
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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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16
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Austin JL, Serier KN, Sarafin RE, Smith JE. Body dissatisfaction predicts poor behavioral weight loss treatment adherence in overweight Mexican American women. Body Image 2017; 23:155-161. [PMID: 29035748 DOI: 10.1016/j.bodyim.2017.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 11/24/2022]
Abstract
Poor adherence poses a major barrier to the success of behavioral weight loss (BWL) programs, particularly for overweight Mexican American women. Given the high prevalence and costs of overweight/obesity, factors that contribute to attendance and adherence problems should be identified, especially in ethnic minority populations. The current study examined the role of pre-treatment body dissatisfaction and depression in predicting attendance and adherence in a BWL intervention. Ninety-nine overweight/obese Mexican American women enrolled in the intervention and completed baseline measures. Eighty-one of the women attended at least one treatment session and provided measures of dietary and physical activity adherence. Simultaneous linear regression analyses suggested that although higher levels of body dissatisfaction and depression each played unique roles in predicting poorer attendance, only body dissatisfaction predicted adherence. Specifically, higher body dissatisfaction predicted poorer treatment adherence. Findings highlight the importance of addressing body dissatisfaction early in BWL treatment to increase attendance and adherence.
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Affiliation(s)
- Julia L Austin
- University of New Mexico, Department of Psychology, MSC03 2220, Albuquerque, NM 87131, United States
| | - Kelsey N Serier
- University of New Mexico, Department of Psychology, MSC03 2220, Albuquerque, NM 87131, United States
| | - Ruth E Sarafin
- University of New Mexico, Department of Psychology, MSC03 2220, Albuquerque, NM 87131, United States
| | - Jane Ellen Smith
- University of New Mexico, Department of Psychology, MSC03 2220, Albuquerque, NM 87131, United States.
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17
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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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18
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Healthy eating patterns associated with acculturation, sex and BMI among Mexican Americans. Public Health Nutr 2016; 20:1267-1278. [PMID: 28004615 DOI: 10.1017/s1368980016003311] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Examine relationships of healthy and unhealthy dietary patterns with BMI, sex, age and acculturation among Mexican Americans. DESIGN Cross-sectional. Participants completed culturally tailored Healthy and Unhealthy Eating Indices. Multivariable mixed-effect Poisson regression models compared food pattern index scores and dietary intake of specific foods by BMI, sex, age and acculturation defined by language preference and generational status. SETTING Participants recruited from the Cameron County Hispanic Cohort study, Texas-Mexico border region, between 2008 and 2011. SUBJECTS Mexican-American males and females aged 18-97 years (n 1250). RESULTS Participants were primarily female (55·3 %), overweight or obese (85·7 %), preferred Spanish language (68·0 %) and first-generation status (60·3 %). Among first-generation participants, bilingual participants were less likely to have a healthy eating pattern than preferred Spanish-speaking participants (rate ratio (RR)=0·79, P=0·0218). This association was also found in males (RR=0·81, P=0·0098). Preferred English-speaking females were less likely to consume healthy foods than preferred Spanish-speaking females (RR=0·84, P=0·0293). Among second-generation participants, preferred English-speaking participants were more likely to report a higher unhealthy eating pattern than preferred Spanish-speaking participants (RR=1·23, P=0·0114). Higher unhealthy eating patterns were also found in females who preferred English v. females who preferred Spanish (RR=1·23, P=0·0107) or were bilingual (RR=1·26, P=0·0159). Younger, male participants were more likely to have a higher unhealthy eating pattern. BMI and diabetes status were not significantly associated with healthy or unhealthy eating patterns. CONCLUSIONS Acculturation, age, sex and education are associated with healthy and unhealthy dietary patterns. Nutrition interventions for Mexican Americans should tailor approaches by these characteristics.
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McLaughlin EA, Campos-Melady M, Smith JE, Serier KN, Belon KE, Simmons JD, Kelton K. The role of familism in weight loss treatment for Mexican American women. J Health Psychol 2016; 22:1510-1523. [DOI: 10.1177/1359105316630134] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mexican American women are disproportionately affected by overweight/obesity and the health complications accompanying them, but weight loss treatments are less successful in this ethnic group. High levels of familism, a value reflecting obligation to family that supersedes attention to oneself, interfere with weight loss for Mexican American women. This mixed methods study investigated overweight Mexican American women’s beliefs about how familism, and Mexican American culture, might hinder weight loss success, and how treatments might be culturally adapted. Results suggest a need to support women in their commitment to family while also helping them make changes. Recommendations for culturally adapted treatments are made.
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20
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Reininger BM, Mitchell-Bennett L, Lee M, Gowen RZ, Barroso CS, Gay JL, Saldana MV. Tu Salud, ¡Si Cuenta!: Exposure to a community-wide campaign and its associations with physical activity and fruit and vegetable consumption among individuals of Mexican descent. Soc Sci Med 2015; 143:98-106. [PMID: 26347959 PMCID: PMC4642277 DOI: 10.1016/j.socscimed.2015.08.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 07/15/2015] [Accepted: 08/14/2015] [Indexed: 01/22/2023]
Abstract
Mexican Americans along the US-Mexico border have been found to be disproportionately affected by chronic diseases particularly related to lack of physical activity and healthful food choices. A community-wide campaign (CWC) is an evidence-based strategy to address these behaviors but with few examples of implementation in Mexican descent populations facing profound health disparities. We examined exposure to a CWC, titled Tu Salud ¡Sí Cuenta!, and its association with meeting the recommended minutes of moderate and vigorous physical activity weekly and consuming more portions of fruits and vegetables daily. A cross-sectional sample of 1438 Mexican descent participants was drawn from a city-wide, randomly-selected cohort interviewed between the years 2008 and 2012. Multivariable comparisons of participants exposed and not exposed to the CWC and meeting physical activity guidelines or their fruit and vegetable consumptions using mixed effects models were conducted. The community-wide campaign components included different forms of mass media and individually-focused components such as community health worker (CHW) home visits. After adjusting for gender, age, marital status, educational attainment, language preference, health insurance, and diabetes diagnosis, the strongest association was found between meeting physical activity guidelines and exposure to both CHW discussions and radio messages (adjusted OR = 3.83; 95% CI = [1.28, 6.21]; p = 0.0099). Participants who reported exposure to both radio and TV messages consumed more portions of fruits and vegetables than those who reported no exposure (adjusted RR = 1.30; 95% CI = [1.02, 1.66]; p = 0.0338). This study provides insights into the implementation and behavioral outcomes associated with exposure to a community-wide campaign, a potential model for addressing lifestyle modifications in populations affected by health disparities.
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Affiliation(s)
- Belinda M Reininger
- University of Texas Health Science Center, School of Public Health, Brownsville Regional Campus, Division of Health Promotion & Behavioral Sciences and Hispanic Health Research Center, One West University Blvd, Brownsville, TX 78520, USA.
| | - Lisa Mitchell-Bennett
- University of Texas Health Science Center, School of Public Health, Brownsville Regional Campus, Hispanic Health Research Center, One West University Blvd, Brownsville, TX 78520, USA
| | - MinJae Lee
- University of Texas Health Science Center at Houston, Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences, 6410 Fannin, Houston, TX 77030, USA
| | - Rose Z Gowen
- University of Texas Health Science Center, School of Public Health, Brownsville Regional Campus, Hispanic Health Research Center, One West University Blvd, Brownsville, TX 78520, USA
| | - Cristina S Barroso
- University of Tennessee, College of Education, Health, and Human Services Department of Public Health, 390 HPER 1914 Andy Holt, Knoxville, TN 37996, USA
| | - Jennifer L Gay
- University of Georgia, College of Public Health, Division of Health Promotion and Behavior, 311 Ramsey Center, 330 River Rd, Athens, GA 30602, USA
| | - Mayra Vanessa Saldana
- University of Texas Health Science Center, School of Public Health, Brownsville Regional Campus, Hispanic Health Research Center, One West University Blvd, Brownsville, TX 78520, USA
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21
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Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, Palaniappan L, Piña IL, Ramirez SM, Rodriguez B, Sims M. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation 2014; 130:593-625. [PMID: 25098323 PMCID: PMC4577282 DOI: 10.1161/cir.0000000000000071] [Citation(s) in RCA: 262] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE This American Heart Association (AHA) scientific statement provides a comprehensive overview of current evidence on the burden cardiovascular disease (CVD) among Hispanics in the United States. Hispanics are the largest minority ethnic group in the United States, and their health is vital to the public health of the nation and to achieving the AHA's 2020 goals. This statement describes the CVD epidemiology and related personal beliefs and the social and health issues of US Hispanics, and it identifies potential prevention and treatment opportunities. The intended audience for this statement includes healthcare professionals, researchers, and policy makers. METHODS Writing group members were nominated by the AHA's Manuscript Oversight Committee and represent a broad range of expertise in relation to Hispanic individuals and CVD. The writers used a general framework outlined by the committee chair to produce a comprehensive literature review that summarizes existing evidence, indicate gaps in current knowledge, and formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and the US Census data as secondary resources. Inductive methods and descriptive studies that focused on CVD outcomes incidence, prevalence, treatment response, and risks were included. Because of the wide scope of these topics, members of the writing committee were responsible for drafting individual sections selected by the chair of the writing committee, and the group chair assembled the complete statement. The conclusions of this statement are the views of the authors and do not necessarily represent the official view of the AHA. All members of the writing group had the opportunity to comment on the initial drafts and approved the final version of this document. The manuscript underwent extensive AHA internal peer review before consideration and approval by the AHA Science Advisory and Coordinating Committee. RESULTS This statement documents the status of knowledge regarding CVD among Hispanics and the sociocultural issues that impact all subgroups of Hispanics with regard to cardiovascular health. In this review, whenever possible, we identify the specific Hispanic subgroups examined to avoid generalizations. We identify specific areas for which current evidence was less robust, as well as inconsistencies and evidence gaps that inform the need for further rigorous and interdisciplinary approaches to increase our understanding of the US Hispanic population and its potential impact on the public health and cardiovascular health of the total US population. We provide recommendations specific to the 9 domains outlined by the chair to support the development of these culturally tailored and targeted approaches. CONCLUSIONS Healthcare professionals and researchers need to consider the impact of culture and ethnicity on health behavior and ultimately health outcomes. There is a need to tailor and develop culturally relevant strategies to engage Hispanics in cardiovascular health promotion and cultivate a larger workforce of healthcare providers, researchers, and allies with the focused goal of improving cardiovascular health and reducing CVD among the US Hispanic population.
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Yeom HA, Fleury J. A Motivational Physical Activity Intervention for Improving Mobility in Older Korean Americans. West J Nurs Res 2013; 36:713-31. [PMID: 24221953 DOI: 10.1177/0193945913511546] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There has been limited empirical support for interventions designed to promote physical activity targeting mobility in racially diverse older adults. This study aims to examine the effects of a Motivational Physical Activity Intervention (MPAI) on social resource, behavioral change process, physical activity, and mobility variables in sedentary older Korean Americans. A quasi-experimental, repeated-measure, pre- and post-tests design was used. Sixty-four community-dwelling, sedentary older Korean Americans (n = 33 for MPAI group, n = 31 for Attention Control group) participated in the study. There were significant improvements in social resources, including social support from family and friends; behavioral change process variables, including self-efficacy; motivational appraisal; and self-regulation for physical activity. There were significant intervention effects on physical activity, walking endurance, and flexibility. The MPAI is supported as improving mobility and physical activity, as well as increasing motivation for physical activity in older Korean Americans.
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Affiliation(s)
- Hye-A Yeom
- The Catholic University of Korea, Seoul, Korea Arizona State University, Phoenix, USA
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23
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Lindberg NM, Stevens VJ, Halperin RO. Weight-loss interventions for Hispanic populations: the role of culture. J Obes 2013; 2013:542736. [PMID: 23533725 PMCID: PMC3600335 DOI: 10.1155/2013/542736] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/28/2013] [Indexed: 11/17/2022] Open
Abstract
In the United States, ethnic minorities are overrepresented among the overweight and obese population, with Hispanic individuals being among the groups most at risk for obesity and obesity-related disease and disability. Most weight-loss interventions designed for the general population have been less successful with individuals from ethnic minorities and there is a pressing need to develop more effective interventions for these groups. This paper examines the importance of culture in the development of "culturally competent" weight-loss interventions for ethnic minority populations, and discusses specific culturally mediated factors that should be considered in the design and implementation of treatment interventions. While specifically focusing on Hispanic populations, we also address issues of relevance to other multiethnic societies.
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Affiliation(s)
- Nangel M Lindberg
- Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue Portland, OR 97227-1110, USA.
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