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Ryu S, Morey BN, Shi Y, Lee S. Acculturation and self-rated health among Chinese and Korean immigrants aged 49 to 75. Front Public Health 2023; 11:1272428. [PMID: 38179574 PMCID: PMC10766358 DOI: 10.3389/fpubh.2023.1272428] [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] [Received: 08/04/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Background Given the rapidly growing Asian populations in the U.S. due to immigration, and the aging demographic of Asian immigrants, it is crucial to understand how acculturation shapes health among older adult Asian immigrants. We study the relationship between acculturation and self-rated health (SRH) and moderating roles of age and Asian subgroup. Methods Our cross-sectional study consisted of 200 Chinese and 200 Korean immigrants aged 49-75 living in Baltimore-Washington DC metropolitan area, who were recruited from primary care physicians' clinics in Maryland and Northern Virginia. The participants completed the survey either in-person or by phone in their preferred language. Multidimensional proxies were used to measure acculturation: years living in the U.S. (≥23 years, <23 years), English proficiency (fluently/well, so-so, poorly/not at all), and ethnic identity (very Asian, mostly Asian, bicultural/westernized). SRH was measured using the question "How would you rate your general health?" (excellent/very good/good, fair/poor). Poisson regression models with robust error variance examined associations between acculturation and SRH, accounting for socioeconomic and health insurance factors. Results Speaking English so-so and fluently/well had 0.73 (95% confidence intervals (CI): 0.55-0.97) and 0.51 (95% CI: 0.30-0.87) times the prevalence of having fair or poor SRH compared to speaking English poorly/not at all, respectively. The magnitudes and statistical significance of these associations were stronger among Chinese participants than Korean participants. Moreover, individuals who self-identified as bicultural/westernized had 0.63 times the prevalence of having fair or poor SRH (95% CI: 0.43-0.92) as those who self-identified as very Asian. The association was more pronounced among older participants (≥58) compared to younger participants (<58). Conclusion Further research should identify the possible mechanisms linking acculturation with health to find effective strategies to enhance health among aging Asian immigrant populations.
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Affiliation(s)
- Soomin Ryu
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Brittany N. Morey
- Program in Public Health, Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Yuxi Shi
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, Irvine, CA, United States
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Park SH, Lee YQ, Müller-Riemenschneider F, Dickens BSL, van Dam RM. Acculturation as a Determinant of Obesity and Related Lifestyle Behaviors in a Multi-Ethnic Asian Population. Nutrients 2023; 15:3619. [PMID: 37630809 PMCID: PMC10459113 DOI: 10.3390/nu15163619] [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] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Limited attention has been given to the role of cultural orientation towards different ethnic groups in multi-ethnic settings without a dominant host culture. We evaluated whether acculturation levels, reflecting cultural orientation towards other ethnic groups, were associated with obesity and related lifestyle behaviors in a cosmopolitan Asian population. We conducted the current study based on data from the Singapore Multi-Ethnic Cohort (N = 10,622) consisting of ethnic Chinese, Malays, and Indians aged 21 to 75 years. Multivariable linear and logistic regression analyses were used to examine associations between the acculturation level (z-score), obesity, and related lifestyle behaviors, including dietary habits and physical activity. A higher acculturation level was directly associated with a higher prevalence of obesity among Chinese, whereas an inverse association was found for ethnic Indians, and no significant association in Malays. In ethnic Malays, greater acculturation was significantly associated with higher dietary quality and less sedentary time. Furthermore, a high acculturation level was significantly associated with higher sugar-sweetened beverage consumption and more leisure-time PA in all ethnic groups. Our findings suggest that greater cultural orientation towards other ethnic groups was associated with convergence in obesity levels. More research is required to understand how acculturation affects obesity-related lifestyle factors in multi-ethnic settings.
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Affiliation(s)
- Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
| | - Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
- Digital Health Center, Berlin Institute of Health, Charité-Universitäts Medizin Berlin, 10117 Berlin, Germany
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore; (Y.Q.L.); (F.M.-R.); (B.S.L.D.); (R.M.v.D.)
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
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Hasan MR, Tabassum T, Tabassum T, Tanbir MA, Kibria M, Chowduary M, Nambiar R. Navigating Cultural Diversity in the Selection of Cardiovascular Device Treatments: A Comprehensive Review. Cureus 2023; 15:e38934. [PMID: 37313070 PMCID: PMC10259755 DOI: 10.7759/cureus.38934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/15/2023] Open
Abstract
In cardiology, patients' cultural beliefs, linguistic differences, lack of knowledge, and socioeconomic status can create barriers to choosing device treatment. To address this issue, we conducted a thorough literature review using online databases such as PubMed, Google Scholar, and Texas Tech University Health Sciences Center's research portal. Our review found that cultural, religious, and linguistic barriers can contribute to patients' apprehension and reservations about device placement. These barriers can also impact patients' adherence to treatment and clinical outcomes. Patients from lower socioeconomic backgrounds may have difficulty accessing and affording device-based treatments. Additionally, fear and inadequate understanding of surgical procedures can deter patients from accepting device treatment in cardiology. To overcome these cultural barriers, healthcare providers must raise awareness about the benefits of device treatment and provide better training to overcome these challenges. It is crucial to address the unique needs of patients from different cultural backgrounds and socioeconomic statuses to ensure they receive the care they need.
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Affiliation(s)
- Md Rockyb Hasan
- Department of Internal Medicine, Amarillo Campus, Texas Tech University Health Sciences Center, Amarillo, USA
| | - Tahsin Tabassum
- Department of Public Health, School of Community Health and Policy, Morgan State University, Baltimore, USA
| | - Tanzin Tabassum
- Department of General Surgery, West Suffolk Hospital, Bury St Edmunds, GBR
| | - Mohammed A Tanbir
- Department of Internal Medicine, Amarillo Campus, Texas Tech University Health Sciences Center, Amarillo, USA
| | - Mahzabin Kibria
- Department of Medicine, Sir Salimullah Medical College, Dhaka, BGD
| | - Mahidul Chowduary
- Department of Internal Medicine, Interfaith Medical Center, Brooklyn, USA
| | - Rajesh Nambiar
- Department of Cardiology, Amarillo Campus, Texas Tech University Health Sciences Center, Amarillo, USA
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Suh YI, Kim J, Lee S, Han S, Park SH. A qualitative investigation of leisure benefits for social and psychological health among international volleyball players living in South Korea. Int J Qual Stud Health Well-being 2022; 17:2131216. [PMID: 36203401 PMCID: PMC9553148 DOI: 10.1080/17482631.2022.2131216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose The proportion of foreign players in global sports industries has steadily increased in the last decade. This qualitative study aims to capture the benefits of leisure activities for the social and psychological health of international volleyball players affiliated with South Korean volleyball leagues. Method A purposeful criterion sampling strategy was employed in this qualitative study. Findings: Based on semi-structured interviews with 12 participants, in this study three major themes pertaining to leisure benefits are identified: (a) new leisure opportunities and coping, (b) inter-intra group friendships, and (c) acculturation. Conclusions These benefits can contribute to social and psychological health for the participants. Practical implications of this study and suggestions for health professionals, sports psychologists, and team counsellors are discussed.
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Affiliation(s)
- Young Ik Suh
- Department of Sport Management, Wellness, and Physical Education, University of West Georgia, Carrollton, GA, USA
| | - Junhyoung Kim
- Department of Health & Wellness Design, Indiana University, Bloomington, IN, USA
| | - Sanghak Lee
- School of Business, Korea Aerospace University, Seoul, South Korea
| | - Sua Han
- Department of Health & Wellness Design, Indiana University, Bloomington, IN, USA
| | - Se-Hyuk Park
- Department of Sport Sciences, Seoul National University of Science and Technology, Seoul, South Korea,CONTACT Se-Hyuk Park Department of Sport Sciences, Seoul National University of Science and Technology, 232 Gongneung-ro, Nowon-gu, Seoul 01811, South Korea
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Zhu X, Liu J, Sevoyan M, Pate RR. Acculturation and leisure-time physical activity among Asian American adults in the United States. ETHNICITY & HEALTH 2022; 27:1900-1914. [PMID: 34538159 DOI: 10.1080/13557858.2021.1979193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
ABSTRACTObjectives: To examine the association between acculturation and leisure-time physical activity among Asian Americans.Design: Data came from the 2011-2016 National Health and Nutrition Examination Survey, restricting to non-Hispanic Asian adults aged 20 years and older (n = 1989). Acculturation was assessed by language preference at home, birth locations, and length of residency in the United States (US). Self-reported physical activity was used to estimate leisure-time moderate-to-vigorous physical activity (MVPA) in MET-minutes/week and meeting the World Health Organization's physical activity guidelines. Multiple linear and logistic regression models were used to model MVPA as continuous and categorical variables, respectively.Results: A quarter of Asian Americans spoke only English and 47.8% spoke only non-English at home; 13.0% were born in the US. Asians who spoke only English (adjusted prevalence ratio [aPR]:1.5) and Asians who spoke both English and non-English at home (aPR: 1.4) had greater proportions of meeting physical activity guidelines compared to those who spoke only non-English at home. The US-born Asians had higher a proportion of meeting the physical activity guidelines (aPR:1.4) and performed 547.6 more MET-minutes of MVPA each week than foreign-born Asians; they also had a higher proportion of meeting the physical activity guidelines than foreign-born Asians who stayed in US for ≤10 years (aPR:1.5). Length of time staying in the US was associated with a higher proportion of meeting physical activity guidelines. Among foreign-born Asian Americans, higher acculturation measures were also positively associated with meeting physical activity guidelines.Conclusions: Acculturation was positively associated with physical activity levels among Asian Americans. More acculturated Asian Americans such as those who spoke more English at home and US-born Asians, performed more MVPA than less acculturated Asian Americans. Interventions are needed to promote physical activity among non-English speaking Asian immigrants and recent immigrants.
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Affiliation(s)
- Xuanxuan Zhu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Maria Sevoyan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Ra CK, Pehlivan N, Kim H, Sussman S, Unger JB, Businelle MS. Smoking prevalence among Asian Americans: Associations with education, acculturation, and gender. Prev Med Rep 2022; 30:102035. [PMID: 36531113 PMCID: PMC9747624 DOI: 10.1016/j.pmedr.2022.102035] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
There is evidence that smoking prevalence rates are related to acculturation, education, and gender among Asian Americans. However, no studies have examined how smoking rates among Asian Americans vary based on acculturation, education, and gender together. This study used National Health Interview Survey (NHIS) data (2010-2018) to examine cigarette smoking prevalence among Asian American men and women aged 18 and older (N = 14,680). Multivariate logistic regression models were used to estimate associations between educational attainment (i.e., college graduate or higher vs some college or lower), years spent in the United States (U.S.) as a proxy for acculturation (i.e., less than 10 years (less acculturated) vs 10 years or more (more acculturated) vs U.S.-born), and cigarette smoking prevalence across gender controlling for age, marital status, poverty (at/above vs below poverty threshold), country of origin (Chinese vs Filipino vs Asian Indian vs Other Asian), and the survey year. Current smoking prevalence was 9.0 % among all Asian Americans - 5.0 % among women and 13.5 % among men. Among respective gender-specific subgroups, U.S.-born Asian women without a college degree and more acculturated Asian immigrant men without a college degree had the highest odds of smoking (OR: 4.096 [95 % CI: 2.638, 6.360] and 1.462 [95 % CI: 1.197, 1.774], respectively). Findings indicated that less educated U.S.-born Asian women and less educated Asian immigrant men are at greatest risk for smoking. Smoking prevalence among Asian Americans is highly related to acculturation, education, and gender. Findings may inform development of policies and programs that are targeted toward smoking cessation among Asian Americans.
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Affiliation(s)
- Chaelin K. Ra
- Rutgers Cancer Institute of New Jersey, Division of Medical Oncology, Robert Wood Johnson Medical School, Rutgers University, NJ, United States,TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States,Corresponding author
| | - Nazife Pehlivan
- Graduate School of Public Health, Department of Public Health, Seoul National University, Seoul, South Korea
| | - Ho Kim
- Graduate School of Public Health, Department of Public Health, Seoul National University, Seoul, South Korea
| | - Steve Sussman
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, CA, United States
| | - Jennifer B. Unger
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, CA, United States
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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7
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Park C, Nam S, Redeker NS, Shebl FM, Dixon J, Jung TH, Whittemore R. The effects of acculturation and environment on lifestyle behaviors in Korean immigrants: the mediating role of acculturative stress and body image discrepancy. ETHNICITY & HEALTH 2022; 27:157-173. [PMID: 31535571 DOI: 10.1080/13557858.2019.1658182] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Despite high rates of cardiometabolic diseases in Korean immigrants (KIs), little is known about cultural and environmental factors contributing to lifestyle behaviors. The purpose of this cross-sectional study was to examine the relationships among acculturation, environment, and lifestyle behaviors (dietary behavior, physical activity, and sedentary behavior) through culturally sensitive psychological mediators, body image discrepancy and acculturative stress in middle-aged KIs. DESIGN A cross-sectional study was conducted. KIs aged 30-65 years were recruited online and at Korean community centers and churches in the Northeastern US Participants completed validated measures of dietary behavior (the Nutrition Subscale of the Health Promoting Lifestyle Profile (HPLP) II), physical activity (the International Physical Activity Questionnaire (IPAQ) - short form), and sedentary behavior (the Sedentary Behavior Questionnaire). Acculturative stress was measured by the Acculturative Stress Index and body image discrepancy was measured by the Stunkard Figure Rating Scale. Acculturation was defined as a latent variable measured by Korean and American orientation (Vancouver Index of Acculturation), age of immigration to the US, length of residency in the US, and English proficiency. Data were analyzed with structural equation modeling (SEM). RESULTS The sample included 361 KIs (mean age = 41.77 ± 10.28 years, 48.1% female, and 46.4% overweight or obese). In the SEM model, acculturation had significant indirect effects on dietary behavior, physical activity, and sedentary behavior through body image discrepancy. Acculturative stress mediated the relationship between acculturation and sedentary behavior. Greater environmental support for physical activity and better healthy food accessibility were related to higher levels of physical activity and healthier dietary behavior, respectively. CONCLUSION In our study, acculturation and environmental support for physical activity and healthy food simultaneously influenced KIs' lifestyle behaviors. Addressing an unhealthy body image and acculturative stress may be additional strategies for lifestyle intervention programs to prevent cardiometabolic diseases in KIs.
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Affiliation(s)
- Chorong Park
- School of Nursing, Vanderbilt University, Nashville, TN, USA
- School of Nursing, Yale University, Orange, CT, USA
| | - Soohyun Nam
- School of Nursing, Yale University, Orange, CT, USA
| | | | - Fatma M Shebl
- School of Public Health, Yale University, New Haven, CT, USA
| | - Jane Dixon
- School of Nursing, Yale University, Orange, CT, USA
| | - Tae Hyun Jung
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA
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Jang SH. Relationship between Employment Type and Self-Rated Health among Korean Immigrants in the US: Focusing on Gender and Number of Years in the US. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1654. [PMID: 33572336 PMCID: PMC7916112 DOI: 10.3390/ijerph18041654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
Although Korean immigrants report worse self-rated health and a higher self-employment rate than other Asian immigrant groups, the relationship between their employment type and self-rated health is understudied. This study examines the relationship between employment type and self-rated health among Korean immigrants in the US. Survey data of 421 first-generation working-age (18-64 years old) Korean immigrants in the New York-New Jersey area were analyzed. The self-administrated survey questionnaire included 39 items (e.g., sociodemographic characteristics, self-rated health, and health insurance status). A logistic regression analysis was conducted to examine the relationship between the dependent variable-self-rated health (e.g., bad/not bad vs. good/very good)-and independent variable-employment type (e.g., work at non-ethnic firms, work at co-ethnic firms, self-employed, and unemployed)-by focusing on differences regarding gender and number of years living in the US. Self-employed and unemployed Korean immigrants were less likely to report good health compared to those working in non-ethnic firms. After controlling for sociodemographic characteristics (age, gender, marital status, education, health insurance status, membership in any Koran association, religion, and English proficiency), the relationship between employment type and self-rated health remained significant among female and recent Korean immigrants. More worksite interventions by occupational health nurses that target self-employed Korean immigrants, especially women and recent immigrants, are necessary.
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Affiliation(s)
- Sou Hyun Jang
- Department of Sociology & Convergence Program for Social Innovation, Sungkyunkwan University, Seoul 03063, Korea
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Kim J, Mowen AJ, Hickerson BD, Graefe A, Bopp M. Relationship of perceived environmental characteristics to self-efficacy and leisure time physical activity among Asian immigrants in the U.S. Health Promot Perspect 2020; 10:366-372. [PMID: 33312932 PMCID: PMC7723007 DOI: 10.34172/hpp.2020.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/29/2020] [Indexed: 01/03/2023] Open
Abstract
Background: Given the high prevalence of physical inactivity among Asian immigrants and its potential negative effects on health, more attention should be paid to identifying factors that might affect their participation in leisure time physician activity (LTPA). This study examined how perceived environmental characteristics are related to self-efficacy and LTPA among Asian immigrants in the United States. Methods: This cross-sectional study collected data from an on-line survey administered through Qualtrics, a web-based survey software company. In the data analysis, 512 Asian immigrants were included. As independent variables, we assessed perceived environmental characteristics with regard to the perceived accessibility of LTPA-related sites and neighborhood quality. As mediating and outcome variables, we measured self-efficacy and LTPA, respectively. Using AMOS version 22, a path analysis was conducted to measure model fit. Results: The perceived accessibility of the LTPA-related sites (b = 0.10, P = 0.04) and self-efficacy(b = 0.26, P = 0.001) were positively related to LTPA. Perceived neighborhood quality (b = 0.11,P = 0.012 was positively associated with self-efficacy, yet not directly associated with LTPA. Self-efficacy mediated the relationship between the perceived accessibility of LTPA-related sites and LTPA (estimate=0.036, 95% CI=0.015–0.067, P = 0.003). Conclusion: This study suggests that perceiving easy access to LTPA-related sites and living in quality neighborhoods can encourage people to participate in LTPA more often by increasing their self-efficacy toward LTPA. These findings highlight a need for public infrastructural investments to improve accessibility to LTPA-related resources and neighborhood quality, which can potentially increase self-efficacy and promote LTPA among Asian immigrants.
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Affiliation(s)
- Jaehyun Kim
- Department of Recreation, Therapeutic Recreation, and Tourism, State University of New York, College at Brockport, Brockport, NY
| | - Andrew J Mowen
- Department of Recreation, Park, and Tourism Management, The Pennsylvania State University, University Park, PA, USA
| | - Benjamin D Hickerson
- Department of Community and Therapeutic Recreation, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Alan Graefe
- Department of Recreation, Park, and Tourism Management, The Pennsylvania State University, University Park, PA, USA
| | - Melissa Bopp
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
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Miao S, Xiao Y. Does acculturation really matter for internal migrants' health?Evidence from eight cities in China. Soc Sci Med 2020; 260:113210. [PMID: 32693311 DOI: 10.1016/j.socscimed.2020.113210] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/14/2020] [Accepted: 07/08/2020] [Indexed: 01/18/2023]
Abstract
It is widely recognized that China has experienced the largest internal migration in its history and that these internal migrants are largely excluded from urban services, posing major challenges to their health outcomes. This paper attempts to address this issue from a socio-ecological lens, examining John W. Berry's conceptual framework of acculturation on internal migrants' health in China. We employed the National Migrant Dynamic Monitoring Survey (MDMS; 2014) data, with around 16,000 samples from eight cities. Our results showed that compared to their hometown culture, where migrants can successfully integrate into the mainstream culture of the destination area, mental health stress can be prevented and self-assessed health status is improved. Well-integrated migrants showed the best self-reported health (SRH) and mental health status, while segregated or marginalized migrants received lower health scores. It was interesting to see that the origin culture only protected SRH whereas the local culture could promote both mental health and SRH. This evidence may be alarming. Local government must respect origin cultures when carrying out social integration policy. In addition, macro-migration policies should encourage local mobility within the same cultural areas to minimize the negative effects of migration.
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Affiliation(s)
- Siyu Miao
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai, 200092, China.
| | - Yang Xiao
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai, 200092, China.
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Al-Sofiani ME, Langan S, Kanaya AM, Kandula NR, Needham BL, Kim C, Vaidya D, Golden SH, Gudzune KA, Lee CJ. The relationship of acculturation to cardiovascular disease risk factors among U.S. South Asians: Findings from the MASALA study. Diabetes Res Clin Pract 2020; 161:108052. [PMID: 32113027 PMCID: PMC7445080 DOI: 10.1016/j.diabres.2020.108052] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/23/2020] [Accepted: 01/31/2020] [Indexed: 12/22/2022]
Abstract
AIM We investigated the association between acculturation strategies and cardiometabolic risk among South Asian (SA) immigrants in the US. METHODS In this cross-sectional analysis of data from 849 SA participants in the Mediators of Atherosclerosis in SAs Living in America (MASALA), we performed multidimensional measures of acculturation to categorize the participants into three acculturation classes: separation (preference for SA culture), assimilation (preference for US culture), and integration (similar preference for both cultures). Differences in glycemic indices, blood pressure, lipid parameters and body composition by acculturation strategy were examined. RESULTS Women in the integration class had the lowest prevalence of diabetes (16.4%), prediabetes (29.7%), fasting and 2-h glucose compared to women in the separation class with the highest prevalence of diabetes (29.3%), prediabetes (31.5%), fasting and 2-h glucose and 2-hr insulin (all p < 0.05). Women in the assimilation class had significantly lower triglycerides, BMI, and waist circumference and higher HDL compared to women in the separation class after adjusting for age, study site, and years in the US. After additionally accounting for socioeconomic/lifestyle factors, women in the assimilation class had significantly lower triglyceride and higher HDL levels compared to women in the separation class (p < 0.01). There was no significant association between acculturation strategies and cardiometabolic risk in SA men. CONCLUSION SA women who employed an assimilation or integration strategy had a more favorable cardiometabolic profile compared to women using a separation strategy. Future research should investigate the behavioral and psychosocial pathways linking acculturation strategies with cardiometabolic health to inform preventive interventions among SAs living in America.
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Affiliation(s)
- Mohammed E Al-Sofiani
- Division of Endocrinology, Diabetes & Metabolism, King Saud University, Riyadh, Saudi Arabia; Division of Endocrinology, College of Medicine, The Johns Hopkins University, Baltimore, MD, United States; Strategic Center for Diabetes Research, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Susan Langan
- Division of Endocrinology, College of Medicine, The Johns Hopkins University, Baltimore, MD, United States
| | - Alka M Kanaya
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Namratha R Kandula
- Feinberg School of Medicine, Division of General Internal Medicine, Northwestern University, Chicago, IL, United States
| | - Belinda L Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI, United States
| | - Catherine Kim
- Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Dhananjay Vaidya
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Sherita H Golden
- Division of Endocrinology, College of Medicine, The Johns Hopkins University, Baltimore, MD, United States; The Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, United States
| | - Kimberly A Gudzune
- Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, United States; The Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, United States
| | - Clare J Lee
- Division of Endocrinology, College of Medicine, The Johns Hopkins University, Baltimore, MD, United States.
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Bratter J, Campbell ME, Saint Onge JM. Living race together: the role of partner's race in racial/ethnic differences in smoking. ETHNICITY & HEALTH 2020; 25:141-159. [PMID: 29096536 DOI: 10.1080/13557858.2017.1398316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 10/16/2017] [Indexed: 06/07/2023]
Abstract
Objective: Crossing racial lines provides a unique context for understanding racial patterns in smoking. This research explores whether adults whose unions cross racial lines behave more similarly to their own group or their partner'sDesign: Using a sample of respondents from the National Health Interview Survey (2001-2011), we compare the likelihood of current smoking and quitting smoking among adults in mixed-race unions to adults in same-race unions.Results: Adults with different-race partners generally mirror their partner's group; people of color with White partners have a higher likelihood of being current smokers, similar to Whites, while Whites partnered with Asians and Latina/os are, like other Asians and Latino/as, less likely to smoke. There are fewer differences in the likelihood of quitting smoking.
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Affiliation(s)
- Jenifer Bratter
- Sociology DepartmentProgram for the Study of Ethnicity Race and CultureKinder Institute for Urban Research, Rice University, Houston, TX, USA
| | - Mary E Campbell
- Sociology Department, Texas A&M University, College Station, TX, USA
| | - Jarron M Saint Onge
- Sociology DepartmentDepartment of Health Policy and Management, University of Kansas, Lawrence, KS, USA
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Toselli S, Rinaldo N, Gualdi-Russo E. Length of residence and obesity risk among North African immigrant women in Italy. ECONOMICS AND HUMAN BIOLOGY 2019; 34:74-79. [PMID: 30928330 DOI: 10.1016/j.ehb.2019.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/12/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
Obesity is one of the major risks for chronic health conditions. Immigrants from low- and middle-income to high-income countries show a tendency to weight gain, with the country of origin, lifestyle habits, socioeconomic status and length of residence as the main factors involved. Thus, the aim of this study was to analyze the association between fat distribution and obesity with length of residence and other socio-demographic variables in a sample of North African women migrated to Italy. Socio-demographic variables were collected by structured face-to-face interview. For the assessment of weight status and body composition, various anthropometric traits were directly measured by an expert anthropometrist. Data were analyzed using ANCOVA adjusted for age to test the differences between length of residence (divided into three groups) and logistic regression models adjusted for covariates to test the association between overweight and/or obesity and length of residence. Significant differences between the three groups were observed in waist circumference (p = 0.004), waist-to-hip ratio (p = 0.001), and upper arm muscularity (p = 0.025), with higher values in those with longer duration of residence. In the crude logistic regression model length of residence resulted positively associated with obesity with the odds of being obese increased by 2.4 times in long term immigrants [OR 2.364 (0.766; 7.296)]. After adjusting for covariate the association remained significant [OR 3.584 (0.779; 16.480)], and being poorly educated [OR 5.737 (0.641; 51.363)], unemployed [OR 6.892 (0.940; 50.528)] and not practicing regular physical activity [OR 17.736 (1.569; 200.418)] increased the odds ratio of being obese. In conclusion, length of residence, socioeconomic status, and physical activity were significantly correlated with obesity, with a longer duration of residence being positively associated with central fat adiposity and upper arm muscle area in North African migrant women.
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Affiliation(s)
- Stefania Toselli
- Department of Biomedical and Neuromotor Science, University of Bologna, via Selmi 3, 40126, Bologna, Italy
| | - Natascia Rinaldo
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy.
| | - Emanuela Gualdi-Russo
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Corso Ercole I d'Este 32, 44121, Ferrara, Italy
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Sutaria S, Mathur R, Hull SA. Does the ethnic density effect extend to obesity? A cross-sectional study of 415 166 adults in east London. BMJ Open 2019; 9:e024779. [PMID: 31154296 PMCID: PMC6549644 DOI: 10.1136/bmjopen-2018-024779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To examine the prevalence of obesity by ethnic group and to examine the association between ethnic density and obesity prevalence. DESIGN AND SETTING Cross-sectional study utilising electronic primary care records of 128 practices in a multiethnic population of east London. PARTICIPANTS Electronic primary care records of 415 166 adults with a body mass index recorded in the previous 3 years. OUTCOME MEASURES (1) Odds of obesity for different ethnic groups compared with white British. (2) Prevalence of obesity associated with each 10% increase in own-group ethnic density, by ethnic group. RESULTS Using multilevel logistic regression models, we find that compared with white British/Irish males, the odds of obesity were significantly higher among black ethnic groups and significantly lower among Asian and white other groups. Among females, all ethnic groups except Chinese and white other were at increased odds of obesity compared with white British/Irish. There was no association between increasing ethnic density and obesity prevalence, except among black Africans and Indian females. A 10% increase in black ethnic density was associated with a 15% increase in odds of obesity among black African males (95% CI 1.07 to 1.24) and 18% among black African females (95% CI 1.08 to 1.30). Among Indian females, a 10% increase in Indian ethnic density was associated with a 7% decrease in odds of obesity (95% CI 0.88 to 0.99). CONCLUSION Wider environmental factors play a greater role in determining obesity than the ethnic composition of the area for most ethnic groups. Further research is needed to understand the mechanism through which increasing ethnic density is associated with increased odds of obesity among black Africans and decreased odds of obesity among Indian females.
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Affiliation(s)
- Shailen Sutaria
- Clinical Effectiveness Group, Queen Mary University of London, London, UK
| | - Rohini Mathur
- Clinical Effectiveness Group, Queen Mary University of London, London, UK
| | - Sally A Hull
- Clinical Effectiveness Group, Queen Mary University of London, London, UK
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15
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Ko J, Timmerman GM, Kim KB, Kim MT. Food Sources of Sodium in Korean Americans With Type 2 Diabetes: Implications for Cardiovascular Disease. J Transcult Nurs 2019; 30:154-162. [PMID: 29974818 PMCID: PMC6312756 DOI: 10.1177/1043659618785226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Excess sodium intake can increase the risk of high blood pressure and cardiovascular disease, common comorbidities for those with type 2 diabetes mellitus (T2DM). The purpose of this study is to describe sodium intake and high sodium food sources among Korean Americans (KAs) with T2DM. METHOD This study, a descriptive, secondary analysis of baseline data from a clinical trial for diabetes, recruited KAs with T2DM ( n = 232) from the community. RESULTS Average dietary sodium intake was 3,433 mg. Major sources of dietary sodium were from bicultural diets: noodles and dumplings, Korean-style soups, kimchi, breads and snacks, and boiled or seasoned vegetables. Participants who consumed excessive sodium were more likely to consume more calories and be male, married, and more recently diagnosed with T2DM. DISCUSSION High consumption of sodium among KAs with T2DM supports the need to develop effective, tailored interventions addressing dietary sodium that incorporates the individual's culture.
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Affiliation(s)
- Jisook Ko
- The University of Texas at Austin, Austin, TX, USA
| | | | - Kim B. Kim
- Korean Resource Center, Ellicott City, MD, USA
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16
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Garcia AF, Wilborn K, Mangold DL. The Cortisol Awakening Response Mediates the Relationship Between Acculturative Stress and Self-Reported Health in Mexican Americans. Ann Behav Med 2018; 51:787-798. [PMID: 28337601 DOI: 10.1007/s12160-017-9901-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The assessment of acculturative stress as synonymous with acculturation level overlooks the dynamic, interactive, and developmental nature of the acculturation process. An individual's unique perception and response to a range of stressors at each stage of the dynamic process of acculturation may be associated with stress-induced alterations in important biological response systems that mediate health outcomes. Evidence suggests the cortisol awakening response (CAR) is a promising pre-clinical biomarker of stress exposure that may link acculturative stress to self-reported health in Mexican Americans. PURPOSE The aim of the current study was to examine whether alterations in the CAR mediate the relationship between acculturative stress and self-reported health in Mexican Americans. METHODS Salivary cortisol samples were collected at awakening, 30, 45, and 60 min thereafter, on two consecutive weekdays from a sample of adult Mexican Americans. Acculturative stress and self-reported health were assessed. Data were aggregated and analyzed (n = 89) using a mixed effects regression model and path analysis. RESULTS Poorer self-reported health was associated with attenuated CAR profiles (primarily due to a diminished post-awakening rise in cortisol) predicted by both moderate and high levels of exposure to acculturative stress. Stress-induced alterations in the CAR mediated the relationship between exposure to acculturative stressors and self-reported health. CONCLUSIONS Findings demonstrate that different levels of acculturative stress are associated with distinct CAR profiles and suggest the CAR is one possible biological pathway through which exposure to culturally unique stressors may be linked to health disparities.
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Affiliation(s)
- Antonio F Garcia
- Department of Psychology, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA
| | | | - Deborah L Mangold
- Department of Psychology, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249, USA.
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Abstract
North Korea suffered from severe famine in the mid-1990s; this impacted many areas, including people's transnational movement, child growth, and mortality. This review carefully examined nutritional status trends of children in North Korea using published reports from national nutrition assessment surveys. Nutritional adaptation of North Korean child refugees living in South Korea was also studied with their growth and food consumption, using published researches. The nutritional status of children in North Korea has recovered to a "low" level acute malnutrition status and a "medium" level chronic malnutrition status. Large disparities by geographic region still remain. North Korean child refugees in South Korea were significantly shorter and lighter than their age- and sex-matched South Korean counterparts (P<0.05); however, North Korean child refugees were catching up, and weight was improving faster than height. Linear growth retarded (height for age Z-score < -1) North Korean children showed a significantly higher respiratory quotient than nonlinear growth retarded children, indicating metabolic adaptation responding to the food shortage. These changes, accompanied by abundant access to food in South Korea, have led to the elimination of significant differences in the obesity ratio between North Korean and South Korean children living in South Korea after approximately 2 years of residency. This nutritional adaptation may not be beneficial to North Korean child refugees, especially given the prediction of Barker's theory. The lack of studies prevented a better understanding of this issue; therefore, large cohort studies, preferably with random sampling strategies, are needed to further understand this issue and to design appropriate interventions.
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Affiliation(s)
- Soo-Kyung Lee
- Address for correspondence: Soo-Kyung Lee, PhD, RD https://orcid.org/0000-0002-1975-7076 Department of Food and Nutrition, Inha University, 100, Inha-ro Namgu, Incheon 22212, Korea Tel: +82-32-860-8121 Fax: +82-32-860-8120 E-mail:
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18
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Park SH, Park CG, McCreary L, Norr KF. Cognitive Interviews for Validating the Family Nutrition Physical Activity Instrument for Korean-American Families With Young Children. J Pediatr Nurs 2017; 36:1-6. [PMID: 28888488 DOI: 10.1016/j.pedn.2017.04.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/28/2017] [Accepted: 04/29/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE Childhood obesity is a growing health concern for Korean-Americans (KA). The purpose of this study was to develop a culturally appropriate Korean-language version of the Family Nutrition Physical Activity (FNPA) instrument and evaluate its comprehensibility and cultural appropriateness of the FNPA for KAs. DESIGN AND METHODS The FNPA was translated into Korean and cognitive interviews were conducted with 19 KA mothers in the Chicago metropolitan area. RESULTS Overall, participants reported that the FNPA is easy to understand and said they had no difficulty answering items using a 4-point Likert scale. Six out of 20 items had minor revisions due to: items that were not specific enough, had confusing wording, or led to incorrect interpretations. CONCLUSIONS Cognitive interviews confirmed the cultural appropriateness of the translated FNPA in the KA context. It is crucial that child's age and cultural aspects of a child's household routines should be taken into consideration when the original FNPA is being used with culturally diverse populations. PRACTICE IMPLICATIONS Health care professionals may use the FNPA when assessing family environment in their efforts to prevent and control childhood obesity among KAs.
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Affiliation(s)
- So Hyun Park
- College of Nursing, Florida State University, Tallahassee, FL United States.
| | - Chang Gi Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL United States.
| | - Linda McCreary
- College of Nursing, University of Illinois at Chicago, Chicago, IL United States.
| | - Kathleen F Norr
- College of Nursing, University of Illinois at Chicago, Chicago, IL United States.
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19
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Kim SS, Fang H, Bernstein K, Zhang Z, DiFranza J, Ziedonis D, Allison J. Acculturation, Depression, and Smoking Cessation: a trajectory pattern recognition approach. Tob Induc Dis 2017; 15:33. [PMID: 28747857 PMCID: PMC5525352 DOI: 10.1186/s12971-017-0135-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 07/06/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Korean Americans are known for a high smoking prevalence within the Asian American population. This study examined the effects of acculturation and depression on Korean Americans' smoking cessation and abstinence. METHODS This is a secondary data analysis of a smoking cessation study that implemented eight weekly individualized counseling sessions of a culturally adapted cessation intervention for the treatment arm and a standard cognitive behavioral therapy for the comparison arm. Both arms also received nicotine patches for 8 weeks. A newly developed non-parametric trajectory pattern recognition model (MI-Fuzzy) was used to identify cognitive and behavioral response patterns to a smoking cessation intervention among 97 Korean American smokers (81 men and 16 women). RESULTS Three distinctive response patterns were revealed: (a) Culturally Adapted (CA), since all identified members received the culturally adapted intervention; (b) More Bicultural (MB), for having higher scores of bicultural acculturation; and (c) Less Bicultural (LB), for having lower scores of bicultural acculturation. The CA smokers were those from the treatment arm, while MB and LB groups were from the comparison arm. The LB group differed in depression from the CA and MB groups and no difference was found between the CA and MB groups. Although depression did not directly affect 12-month prolonged abstinence, the LB group was most depressed and achieved the lowest rate of abstinence (LB: 1.03%; MB: 5.15%; CA: 21.65%). CONCLUSION A culturally adaptive intervention should target Korean American smokers with a high level of depression and a low level of biculturalism to assist in their smoking cessation. TRIAL REGISTRATION NCT01091363. Registered 21 March 2010.
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Affiliation(s)
- Sun S Kim
- University of Massachusetts, Boston, Boston, MA 02125 USA
| | - Hua Fang
- University of Massachusetts Dartmouth and Medical School Dartmouth, Dartmouth, MA 02747 USA
- Department of Computer and Information Science, College of Engineering, University of Massachusetts Dartmouth, Dion Building, Room 317 285 Old Westport Road Dartmouth, Dartmouth, MA 02747-2300 USA
- Division of Biostatistics and Health Services Research Department of Quantitative Health Sciences, University of Massachusetts Medical School, Albert Sherman Bldg, Office: AS8-2061, 368 Plantation St. Worcester, Dartmouth, MA 01605-0002 USA
| | - Kunsook Bernstein
- Hunter College, City University of New York, New York, New York 10010 USA
| | - Zhaoyang Zhang
- University of Massachusetts Dartmouth and Medical School Dartmouth, Dartmouth, MA 02747 USA
| | - Joseph DiFranza
- University of Massachusetts Dartmouth and Medical School Dartmouth, Dartmouth, MA 02747 USA
| | - Douglas Ziedonis
- University of California San Diego, Deparetment of Psychiatry, 9500 Gilman Drive #0602, La Jolla, CA 92093-0602 USA
| | - Jeroan Allison
- University of Massachusetts Dartmouth and Medical School Dartmouth, Dartmouth, MA 02747 USA
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20
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Commodore-Mensah Y, Ukonu N, Obisesan O, Aboagye JK, Agyemang C, Reilly CM, Dunbar SB, Okosun IS. Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey. J Am Heart Assoc 2016; 5:JAHA.116.004059. [PMID: 27815269 PMCID: PMC5210341 DOI: 10.1161/jaha.116.004059] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cardiometabolic risk (CMR) factors including hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia are high among United States ethnic minorities, and the immigrant population continues to burgeon. METHODS AND RESULTS Hypothesizing that acculturation (length of residence) would be associated with a higher prevalence of CMR factors, the authors analyzed data on 54, 984 US immigrants in the 2010-2014 National Health Interview Surveys. The main predictor was length of residence. The outcomes were hypertension, overweight/obesity, diabetes mellitus, and hyperlipidemia. The authors used multivariable logistic regression to examine the association between length of US residence and these CMR factors.The mean (SE) age of the patients was 43 (0.12) years and half were women. Participants residing in the United States for ≥10 years were more likely to have health insurance than those with <10 years of residence (70% versus 54%, P<0.001). After adjusting for region of birth, poverty income ratio, age, and sex, immigrants residing in the United States for ≥10 years were more likely to be overweight/obese (odds ratio [OR], 1.19; 95% CI, 1.10-1.29), diabetic (OR, 1.43; 95% CI, 1.17-1.73), and hypertensive (OR, 1.18; 95% CI, 1.05-1.32) than those residing in the United States for <10 years. CONCLUSIONS In an ethnically diverse sample of US immigrants, acculturation was associated with CMR factors. Culturally tailored public health strategies should be developed in US immigrant populations to reduce CMR.
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Affiliation(s)
| | - Nwakaego Ukonu
- Counseling Psychology, Department of Psychology, University of Florida, Gainesville, FL
| | | | | | - Charles Agyemang
- Department of Public Health, Academic Medical Center, University of Amsterdam, the Netherlands
| | - Carolyn M Reilly
- Nell Hodgson Woodruff, School of Nursing Emory University, Atlanta, GA
| | - Sandra B Dunbar
- Nell Hodgson Woodruff, School of Nursing Emory University, Atlanta, GA
| | - Ike S Okosun
- Department of Epidemiology & Biostatistics, School of Public Health Georgia State University, Atlanta, GA
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Kim J, Kim M, Henderson KA, Han A, Park SH. Serious engagement in sport and health benefits among Korean immigrants in the USA. Int J Qual Stud Health Well-being 2016; 11:31340. [PMID: 27492152 PMCID: PMC4974494 DOI: 10.3402/qhw.v11.31340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 11/14/2022] Open
Abstract
There is a dearth of information pertaining to ethnicity and serious leisure among immigrants. The purpose of our study was to explore the health benefits of serious engagement in sports among Korean immigrants who are part of club activities. Using semi-structured in-depth interviews, we identified three themes associated with the benefits of serious leisure: (a) coping with acculturative stress, (b) creating ethnic strength, and (c) personal benefits. Participants gain personal and social benefits by pursuing leisure activities in a serious manner within their ethnic in-group.
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Affiliation(s)
- Junhyoung Kim
- Recreation, Parks, and Leisure Services Administration, Central Michigan University, Mount Pleasant, MI, USA;
| | - May Kim
- Department of Physical Education, Anam-dong, Seongbuk-gu, Seoul, Korea University, Seoul, South Korea
| | - Karla A Henderson
- Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, NC, USA
| | - Areum Han
- Korea University Center for Curriculum and Institute of Studies, Korea University, Seoul, South Korea
| | - Se-Hyuk Park
- Department of Sports Sciences, Seoul National University of Science and Technology, Seoul, South Korea
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Abstract
This study examined whether a unidimensional model or a bidimensional model better explained acculturation of Korean Americans on two levels: (a) separate domains of acculturation and (b) “overall” acculturation. Also, the study examined whether there were meaningfully different forms of acculturation in Korean Americans. Additionally, associations between the acculturation forms and exogenous variables were investigated. On both domain and overall levels, a bidimensional model appeared to more completely explain acculturation of Korean Americans. Three distinct forms of acculturation (assimilation, integration, and segregation) were identified. The three forms were different in acculturation domains as well as in exogenous variables. More research is needed to compare the unidimensional model and the multidimensional model on domain and overall acculturation level.
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Chao SM, Wakeel F, Nazinyan Y, Sun S. Does Preconception Health Differ by Nativity?: Findings from the Los Angeles Mommy and Baby (LAMB) Study. Matern Child Health J 2016; 20:769-77. [PMID: 26728899 PMCID: PMC4794372 DOI: 10.1007/s10995-015-1907-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To compare certain preconception health (PCH) behaviors and conditions among US-born (USB) and foreign-born (FB) mothers in Los Angeles County (LAC), regardless of race/ethnicity, and to determine if any identified differences vary among Asian/Pacific Islanders (API's) and Hispanics. METHODS Data are from the 2012 Los Angeles Mommy and Baby study (n = 6252). PCH behaviors included tobacco use, multivitamin use, unintended pregnancy, and contraception use. PCH conditions comprised being overweight/obese, diabetes, asthma, hypertension, gum disease, and anemia. The relationship between nativity and each PCH behavior/condition was assessed using multivariable logistic regression models. RESULTS USB women were more likely than FB women to smoke (AOR 2.12, 95 % CI 1.49-3.00), be overweight/obese (AOR 1.57, 95 % CI 1.30-1.90), and have asthma (AOR 2.04, 95 % CI 1.35-3.09) prior to pregnancy. They were less likely than FB women to use contraception before pregnancy (AOR 0.59, 95 % CI 0.49-0.72). USB Hispanics and API's were more likely than their FB counterparts to be overweight/obese (AOR 1.57, 95 % CI 1.23-2.01 and AOR 2.37, 95 % CI 1.58-3.56, respectively) and less likely to use contraception (AOR 0.58, 95 % CI 0.45-0.74 and AOR 0.46, 95 % CI 0.30-0.71, respectively). USB Hispanic mothers were more likely than their FB counterparts to smoke (AOR 2.47, 95 % CI 1.46-4.17), not take multivitamins (AOR 1.30, 95 % CI 1.02-1.66), and have asthma (AOR 2.35, 95 % CI 1.32-4.21) before pregnancy. CONCLUSIONS US nativity is linked to negative PCH among LAC women, with many of these associations persisting among Hispanics and API's. As PCH profoundly impacts maternal and child health across the lifecourse, culturally-appropriate interventions that maintain positive behaviors among FB reproductive-aged women and encourage positive behaviors among USB women should be pursued.
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Affiliation(s)
- Shin M Chao
- Los Angeles County Department of Maternal, Child and Adolescent Health Programs, 600 Commonwealth Avenue, 8th Floor, Los Angeles, CA, 90095, USA.
| | - Fathima Wakeel
- Public Health Programs, College of Health Professions, Ferris State University, Big Rapids, MI, USA
| | | | - Stacy Sun
- Department of Obstetrics and Gynecology, Johns Hopkins Hospital, Baltimore, MD, USA
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Étémé G, Girard A, Massé JC, Sercia P. Do acculturation strategies have impacts on the self-declared health, well-being and lifestyle of first-generation allophone immigrants in Montreal, Canada? INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2016. [DOI: 10.1108/ijmhsc-06-2014-0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to understand to what extent, the process of acculturation and the strategies which ensue from it can affect the self-declared health as regards the lifestyle, the physical activity, the diet and the well-being of first-generation immigrants living in the Montreal region (Quebec, Canada).
Design/methodology/approach
– A supervised survey was administered to adult allophones immigrants attending French-language courses, autumn 2011 (506 valid surveys). The authors discuss the concept and the validation of their acculturation model and its relevance in regard of the purposes of the research.
Findings
– The indicator allowed to clearly identify three groups that differentiate on numerous variables of the survey. Independently of the acculturations strategies adopted by the respondents, the authors observe a deterioration of the self-declared overall state of health, development of sedentary living, a fairly high level of stress and depressive episode within the entire sample. However, the group isolated as “retention” has consistently the lowest scores on all these variables. In terms of public health and health social inequalities issues these results are worrisome. The “assimilation” group have the highest scores and the “integration” group consistently shows and intermediate “balancing” position.
Originality/value
– The authors claim that the strategies of acculturation are not always the expression of a free will. They are also the product of constraints specific to the host society and are just as much the result of the pre-migratory socialization. This is especially the case of the “retention” group and more specifically of women. The negative effects of social, cultural and economic constraints of the host society on overall health, well-being and lifestyle as well as adaptation strategies should be monitored in a more systematic manner in recent immigrant populations and be specifically addressed in immigrant integration policies and programmes.
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Chang SJ, Im EO. Testing a Theoretical Model of Immigration Transition and Physical Activity. Res Theory Nurs Pract 2015; 29:177-88. [PMID: 26502554 DOI: 10.1891/1541-6577.29.3.177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purposes of the study were to develop a theoretical model to explain the relationships between immigration transition and midlife women's physical activity and test the relationships among the major variables of the model. A theoretical model, which was developed based on transitions theory and the midlife women's attitudes toward physical activity theory, consists of 4 major variables, including length of stay in the United States, country of birth, level of acculturation, and midlife women's physical activity. To test the theoretical model, a secondary analysis with data from 127 Hispanic women and 123 non-Hispanic (NH) Asian women in a national Internet study was used. Among the major variables of the model, length of stay in the United States was negatively associated with physical activity in Hispanic women. Level of acculturation in NH Asian women was positively correlated with women's physical activity. Country of birth and level of acculturation were significant factors that influenced physical activity in both Hispanic and NH Asian women. The findings support the theoretical model that was developed to examine relationships between immigration transition and physical activity; it shows that immigration transition can play an essential role in influencing health behaviors of immigrant populations in the United States. The NH theoretical model can be widely used in nursing practice and research that focus on immigrant women and their health behaviors. Health care providers need to consider the influences of immigration transition to promote immigrant women's physical activity.
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Park SH, Kim MJ, Park CG, McCreary L, Patil C, Norr KF. Family Factors and Body Mass Index Among Korean-American Preschoolers. J Pediatr Nurs 2015. [PMID: 26211715 DOI: 10.1016/j.pedn.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to examine family factors related to BMI z-scores and overweight/obesity among Korean-American (KA) preschoolers. METHODS A cross-sectional study was conducted with 104 KA preschoolers and their mothers in the Chicago metropolitan area. KA mothers completed questionnaires and their preschool-age children's weights and heights were measured. Hierarchical multiple linear regression and multiple logistic regression were performed. RESULTS Twenty-two percent of preschoolers were overweight or obese (BMI ≥85th percentile). Family factors explained 30% of the variance in the children's BMI z-scores, with parenting feeding style and family functioning contributing most. In logistic regression, children were more likely to be overweight/obese if: a family had more children, the mother perceived her child as overweight/obese, and the family had regular child routines. CONCLUSION Health care providers should consider the family as one unit of care and use that unit to implement culturally appropriate childhood overweight/obesity prevention for Korean-American preschool-aged children. Parental feeding style and parents' attitudes about child weight should be considered when advising Korean-Americans about reducing children's overweight/obesity.
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Affiliation(s)
- So Hyun Park
- College of Nursing, Florida State University, Tallahassee, FL.
| | - Mi Ja Kim
- College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Chang Gi Park
- College of Nursing, University of Illinois at Chicago, Chicago, IL.
| | - Linda McCreary
- College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Crystal Patil
- College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Kathleen F Norr
- College of Nursing, University of Illinois at Chicago, Chicago, IL
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Baron-Epel O, Hofstetter CR, Irvin VL, Kang S, Hovell MF. Lifestyle Behaviors Predict Negative and Positive Changes in Self-reported Health. Asia Pac J Public Health 2015; 27:775-84. [DOI: 10.1177/1010539515601481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Studies of changes in health following immigration are inconsistent, and few are based on longitudinal designs to test associations based on change. This study identified factors that predicted changes in self-reported health (SRH) among California residents of Korean descent. A sample of California residents of Korean descent were interviewed and followed-up 2 or 3 times by telephone during 2001-2009. The questionnaires dealt with SRH, lifestyle behaviors (smoking, physical activity, and fast food consumption), and socioeconomic measures. Statistical analysis included random-intercepts longitudinal regression models predicting change in SRH. A similar percentage of respondents reported improved and deteriorating SRH (30.3% and 29.1%, respectively). Smoking, consumption of fast foods, age, percentage of life spent in the United States, and being female were predictors of deteriorating SRH, whereas physical activity, education, and living with a partner were predictive of improvement in SRH. The effect of immigration on SRH is influenced by socioeconomic factors and lifestyle practices. Results support promotion of healthy lifestyle practices among immigrants.
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Affiliation(s)
| | | | | | - Sunny Kang
- San Diego State University, San Diego, CA, USA
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When you have lived in a different culture, does returning 'home' not feel like home? Predictors of psychological readjustment to the heritage culture. PLoS One 2015; 10:e0124393. [PMID: 25970185 PMCID: PMC4430208 DOI: 10.1371/journal.pone.0124393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 03/13/2015] [Indexed: 11/19/2022] Open
Abstract
Many repatriates find it challenging to readjust to their heritage culture after spending a significant period of time abroad. Research on predictors of readjustment, however, remains limited. The present study in particular investigated the identification of third culture individuals (TCIs) – that is, individuals who spent their formative years outside of their heritage culture - with an abstract, third culture. Our findings demonstrated that TCIs’ identification with the third culture was empirically distinct from that of the heritage and host cultures. The present study further examined whether several variables – sojourner type (TCI vs. non-TCI), perceived conflict between heritage and host culture, perceived cultural distance, and cultural identification with heritage and other cultures – predicted psychological readjustment (stress, anxiety, depression and overall psychological readjustment). The results showed that strong heritage culture identification was associated with better psychological readjustment, whereas cultural conflict was generally associated with poorer readjustment. Furthermore, sojourner type significantly moderated the latter association, such that cultural conflict predicted the stress aspect of psychological readjustment for non-TCIs, but not for TCIs. As the present investigation is the first study to empirically establish identification with a ‘third culture’ we discuss implications for the literature on third culture individuals and psychological adjustment upon re-entry.
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Gotay CC, Reid MS, Dawson MY, Wang S. Acculturation and smoking in North Americans of Chinese ancestry: A systematic review. Canadian Journal of Public Health 2015; 106:e333-40. [PMID: 26451998 DOI: 10.17269/cjph.106.4762] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 05/27/2015] [Accepted: 03/29/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Many North American immigrants come from China. Given the critical impact of tobacco use on health, it is important to understand rates and correlates of smoking in this population. This systematic review addressed the question: based on current research, what is the association between acculturation and smoking behaviours in Chinese immigrants to North America? METHODS The search was conducted in PubMed, Medline, Web of Science, and Academic Search Complete for papers published from 2005 to 2014. Data were extracted from Canadian and American studies for population characteristics, study design, measures of smoking and acculturation, and findings regarding smoking rates and associations between smoking and acculturation. SYNTHESIS The literature search identified 147 articles, and 14 met inclusion criteria. Three studies were based on Canadian samples and the remaining 11 were from the United States. Of the 14 papers, 3 reported findings for youth and 11 for adults. Among adults, daily smoking rates were consistently much higher in men than women; for men, rates varied from 9% to 30%. Language use and time in North America were the most common indicators of acculturation. Almost all studies found a relationship between acculturation and smoking, such that more acculturated men smoke less and more acculturated women smoke more. CONCLUSION The findings suggest that the association between acculturation and smoking is gender-specific. This correlation is found in youth and adults and in both Canada and the US. Increased acculturation has a protective effect on smoking for Chinese North American men, but a harmful effect for women. Tobacco control interventions need to develop targeted strategies appropriate to these different populations.
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Delavari M, Sønderlund AL, Mellor D, Mohebbi M, Swinburn B. Migration, acculturation and environment: determinants of obesity among Iranian migrants in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:1083-98. [PMID: 25648171 PMCID: PMC4344656 DOI: 10.3390/ijerph120201083] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 12/23/2014] [Accepted: 01/13/2015] [Indexed: 12/04/2022]
Abstract
While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants’ perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors.
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Affiliation(s)
- Maryam Delavari
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria 3125, Australia.
| | - Anders Larrabee Sønderlund
- School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QJ, UK.
| | - David Mellor
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria 3125, Australia.
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Melbourne, Victoria 3125, Australia.
| | - Boyd Swinburn
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria 3125, Australia.
- School of Population Health, University of Auckland, Auckland 1142, New Zealand.
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Koca C, Lapa TY. Analysis of physical activity and acculturation among Turkish migrants in Germany and England (.). Percept Mot Skills 2014; 119:698-716. [PMID: 25387040 DOI: 10.2466/06.pms.119c29z7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent literature shows that migrant populations in Western countries are generally less physically active than their host populations. The purpose of the present study was to expand research investigating associations between physical activity (PA) and acculturation and their relationship with several socio-demographic factors among Turkish migrants in Germany and England. The sample consisted of 521 Turkish migrants. Migrant generation, length of residence, and language proficiency were used as indicators of acculturation. Acculturation was not associated with PA among migrants in Germany and England. PA of migrants was significantly associated with migrant's host country, age, sex, marital status, and education. The total PA of migrants in Germany was higher than that of migrants in England; the large majority of females in both Germany and England had low PA, whereas most males had moderate PA. Seemingly, PA in Turkish migrant populations will not necessarily increase as a result of greater acculturation to the host society.
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Affiliation(s)
- Canan Koca
- 1 Faculty of Sport Sciences, Hacettepe University, Beytepe, Ankara, Turkey
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32
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A bi-national comparative study of health behaviors of Koreans in South Korea and Korean Americans in California. J Immigr Minor Health 2014; 15:1073-81. [PMID: 22918692 DOI: 10.1007/s10903-012-9706-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Few studies have compared health behaviors of Koreans in their home country and Korean Americans. Using 2009 data from the Community Health Survey (South Korea) and the California Health Interview Survey (USA), we compared native Koreans and Korean Americans, grouped by level of acculturation, on prevalence of specific health behaviors and self-rated health, and conducted multiple logistic regression comparing the odds of these behaviors among the groups adjusted for demographic variables. While Korean Americans exhibit healthier behaviors than Koreans in some areas (e.g., reduced smoking and binge drinking in men, increased utilization of flu vaccinations), we also identified problem behaviors (e.g., increased body weight in Korean American men, uptake of alcohol drinking and smoking among Korean American women). Findings support the critical need for health promotion programs addressing these health behaviors to prevent future health problems among Korean Americans.
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Rigg KK, Cook HH, Murphy JW. Expanding the scope and relevance of health interventions: moving beyond clinical trials and behavior change models. Int J Qual Stud Health Well-being 2014; 9:24743. [PMID: 25053530 PMCID: PMC4107301 DOI: 10.3402/qhw.v9.24743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2014] [Indexed: 11/28/2022] Open
Abstract
An overemphasis on clinical trials and behavior change models has narrowed the knowledge base that can be used to design interventions. The overarching point is that the process of overanalyzing variables is impeding the process of gaining insight into the everyday experiences that shape how people define health and seek treatment. This claim is especially important to health decision-making and behavior change because subtle interpretations often influence the decisions that people make. This manuscript provides a critique of traditional approaches to developing health interventions, and theoretically justifies what and why changes are warranted. The limited scope of these models is also discussed, and an argument is made to adopt a strategy that includes the perceptions of people as necessary for understanding health and health-related decision-making. Three practical strategies are suggested to be used with the more standard approaches to assessing the effectiveness and relevance of health interventions.
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Affiliation(s)
- Khary K Rigg
- Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, USA;
| | - Hilary H Cook
- Social Sciences Department, Miami-Dade College, Miami, FL, USA
| | - John W Murphy
- Department of Sociology, University of Miami, Coral Gables, FL, USA
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Gray WN, Szulczewski LJ, Regan SMP, Williams JA, Pai ALH. Cultural Influences in Pediatric Cancer. J Pediatr Oncol Nurs 2014; 31:252-71. [DOI: 10.1177/1043454214529022] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To review the literature on cultural factors influencing clinical care and family management of pediatric cancer. Methods: A literature review including 72 articles related to cultural issues in pediatric cancer was conducted. Information was organized around several clinically driven themes. Results: Cultural factors influenced many aspects of the cancer experience including illness representations, reaction to diagnosis, illness disclosure patterns, complementary and alternative medicine use, management of medical procedures, coping strategies, and end of life issues. Conclusion: Increased awareness of cultural factors is needed to improve clinical care and reduce health disparities. Specific strategies to approach cultural differences are provided to enhance patient and family care from diagnosis to cure/end of life.
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Affiliation(s)
| | | | | | | | - Ahna L. H. Pai
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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35
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Delavari M, Sønderlund AL, Mellor D, Mohebbi M, Swinburn B. Exploring obesogenic environments: the design and development of the migrant obesogenic perception of the environment questionnaire (MOPE-Q) using a sample of Iranian migrants in Australia. BMC Public Health 2014; 14:567. [PMID: 24906418 PMCID: PMC4068171 DOI: 10.1186/1471-2458-14-567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 06/02/2014] [Indexed: 12/05/2022] Open
Abstract
Background Although there are a number of studies examining the effect of migration on obesity, these studies tend to focus on the role of acculturation in this relationship. However, there are indications that the change in environment may also be an important factor. Indeed, there is a considerable lack of psychometric tools designed to assess the association between environment and migrant health behaviour. The current study aimed to assess the literature on the link between environment and health for migrants, and on the basis of this information, design and develop the Migrant Obesogenic Perception of the Environment questionnaire (MOPE-Q). The MOPE-Q is the first comprehensive measure of the impact of environmental factors on migrant health behaviour related to physical activity, food habits and body image concern, as well as weight change. Methods Using a systematic approach, an initial pool of items for the questionnaire was developed and refined on the basis of rigorous content and face validity assessments and factor analysis. Further, reliability tests and test re-test studies were undertaken. Differences between Iranian and Australian environmental factors as they relate to obesogenic behaviour were explored using the developed measure. Results A total of 36 items were developed for the MOPE-Q. Principal factor analysis identified three similar factor structures of environmental factors related to obesity (categorized in terms of facilitators, barriers and pressures) for each country. The final questionnaire consisted of four distinct subscales pertaining specifically to the Australian environment and five subscales pertaining to the Iranian environment, accounting for 59% and 63%, respectively, of the total variance in obesity rates. Data suggests that the MOPE-Q is a reliable and valid self-report measure for assessing the relationship between environmental factors linked to obesity and obesogenic behaviour for this particular migrant group. Conclusion The variations in environmental factors linked to obesity behaviour between home (Iran) and host (Australia) countries have been incorporated into the MOPE-Q instrument which has shown good psychometric properties. The MOPE-Q can be adapted and applied to other environments and populations to help explain changes in diet, physical activity patterns and body weight in migrant groups as they acculturate.
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Affiliation(s)
- Maryam Delavari
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Australia.
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36
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Kim J, Heo J, Kim J. The benefits of in-group contact through physical activity involvement for health and well-being among Korean immigrants. Int J Qual Stud Health Well-being 2014; 9:23517. [PMID: 24875239 PMCID: PMC4038719 DOI: 10.3402/qhw.v9.23517] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 11/14/2022] Open
Abstract
This qualitative study is designed to examine the benefits of physical activity involvement with members of the same ethnic group. For this study, Korean immigrants who were members of Korean physical activity clubs such as badminton and tennis were selected as participants. Using a constructive grounded theory methodology, three themes were identified as benefits of physical activity involvement: (1) the experience of psychological well-being, (2) the creation of a unique cultural world, and (3) the facilitation of physical activity involvement. The findings of this study suggest that Korean immigrant participants gained various social, cultural, and psychological benefits by engaging in activities with other Korean immigrants.
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Affiliation(s)
- Junhyoung Kim
- Department of Recreation, Parks, and Leisure Services Administration, Central Michigan University, USA
| | - Jinmoo Heo
- Department of Recreation, Park and Tourism Sciences, Texas A&M University, College Station, Texas, USA
| | - Jun Kim
- Department of Recreation, Parks, and Leisure Services Administration, Central Michigan University, USA;
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Gender, acculturation, and smoking behavior among U.S. Asian and Latino immigrants. Soc Sci Med 2014; 106:110-8. [PMID: 24561772 DOI: 10.1016/j.socscimed.2014.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 12/03/2013] [Accepted: 02/01/2014] [Indexed: 11/20/2022]
Abstract
In this paper we examine smoking prevalence and frequency among Asian and Latino U.S. immigrants, focusing on how gender differences in smoking behavior are shaped by aspects of acculturation and the original decision to migrate. We draw on data from 3249 immigrant adults included in the 2002-2003 National Latino and Asian American Study. Findings confirm the gender gap in smoking, which is larger among Asian than Latino immigrants. While regression models reveal that gender differences in smoking prevalence, among both immigrant groups, are not explained with adjustment for measures of acculturation and migration decisions, adjustment for these factors does reduce gender differences in smoking frequency to non-significance. Following, we examine gender-stratified models and test whether aspects of migration decisions and acculturation relate more strongly to smoking behavior among women; we find that patterns are complex and depend upon pan-ethnic group and smoking measure.
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38
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Wen M, Kowaleski-Jones L, Fan JX. Ethnic-immigrant disparities in total and abdominal obesity in the US. Am J Health Behav 2013; 37:807-18. [PMID: 24001630 DOI: 10.5993/ajhb.37.6.10] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine sex-specific disparities in total and abdominal obesity prevalence across 6 ethnic-immigrant groups and explore whether the observed differences were attributable to diet and physical activity (PA). METHODS Data were from 4331 respondents age 18-64 from the 2003-2006 National Health and Nutrition Examination Survey. Sex-specific multiple logistic regression analyses were performed. RESULTS Regardless of race-ethnicity, immigrants exhibited lower prevalence of total and abdominal obesity than natives. Among the US-born, Whites had the lowest total obesity prevalence followed by Hispanics and then Blacks; but racial-ethnic disparities for immigrants were different. In abdominal obesity, US-born white men had the highest prevalence. PA helped explain some ethnic-immigrant disparities. CONCLUSIONS Complex interactions of sex by race-ethnicity and nativity exist for obesity prevalence.
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Affiliation(s)
- Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, UT, USA.
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Change in self-reported health status among immigrants in the United States: associations with measures of acculturation. PLoS One 2013; 8:e76494. [PMID: 24098515 PMCID: PMC3788132 DOI: 10.1371/journal.pone.0076494] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 08/28/2013] [Indexed: 12/03/2022] Open
Abstract
Although acculturation may have positive effects for immigrants, including better socioeconomic profiles and increased occupational opportunities, their health profiles deteriorate with longer duration in the U.S. Prior research indicates that increasing acculturation is associated with some poorer health outcomes among immigrants in the U.S. However, most of these studies have used length of stay or English language proficiency as proxies for acculturation, and have mainly examined self-reported “current” health outcomes. This study advances knowledge on associations between acculturation and health among immigrants by explicitly examining self-reported “change” in health since immigration, in relation to acculturation-related variables. We use data from the New Immigrant Survey (NIS; 2003-2004), a cross-sectional study of legal immigrants to the U.S. In addition to testing more conventionally examined proxies of acculturation (length of stay and English proficiency), we also examine English language use and self-reported change in diet. Multivariable logistic regression analyses on 5,982 participants generally supported previous literature indicating a deleterious impact of acculturation, with increasing duration of stay and greater self-reported change in diet being associated with a poorer change in health since moving to the U.S. Although English language proficiency and use were associated with greater odds of reporting a worse change in health when examined individually, they were non-significant in multivariable models including all acculturation measures. Findings from this study suggest that when taking into account multiple measures of acculturation, language may not necessarily indicate unhealthy assimilation and dietary change may be a pathway leading to declines in immigrant health. Increasing duration in the U.S. may also reflect the adoption of unhealthy behaviors, as well as greater exposure to harmful sources of psychosocial stress including racial and anti-immigrant discrimination. Our study suggests that multiple indicators of acculturation may be useful in examining the effect of acculturation on changes in health among immigrants.
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40
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Fang L, Schinke SP. Two-year outcomes of a randomized, family-based substance use prevention trial for Asian American adolescent girls. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2013; 27:788-798. [PMID: 23276322 PMCID: PMC4135055 DOI: 10.1037/a0030925] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Asian Americans have been largely ignored in the prevention outcome literature. In this study, we tested a parent-child program with a sample of Asian American adolescent girls and their mothers, and evaluated the program's efficacy on decreasing girls' substance use and modifying risk and protective factors at individual, family, and peer levels. A total of 108 Asian American mother-daughter dyads recruited through online advertisements and from community service agencies were randomly assigned to an intervention arm (n = 56) or to a test-only control arm (n = 52). The intervention consisted of a nine-session substance abuse prevention program, delivered entirely online. Guided by family interaction theory, the prevention program aimed to strengthen the quality of girls' relationships with their mothers while increasing girls' resilience to resist substance use. Intent-to-treat analyses showed that at 2-year follow-up, intervention-arm dyads had significantly higher levels of mother-daughter closeness, mother-daughter communication, maternal monitoring, and family rules against substance use compared with the control-arm dyads. Intervention-arm girls also showed sustained improvement in self-efficacy and refusal skills and had lower intentions to use substances in the future. Most important, intervention-arm girls reported fewer instances of alcohol and marijuana use and prescription drug misuse relative to the control-arm girls. The study suggests that a culturally generic, family-based prevention program was efficacious in enhancing parent-child relationships, improving girls' resiliency, and preventing substance use behaviors among Asian American girls.
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Affiliation(s)
- Lin Fang
- University of Toronto, Factor-Inwentash Faculty of Social Work
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41
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Lee S, Chen L, He X, Miller MJ, Juon HS. A cluster analytic examination of acculturation and health status among Asian Americans in the Washington DC metropolitan area, United States. Soc Sci Med 2013; 96:17-23. [PMID: 24034947 DOI: 10.1016/j.socscimed.2013.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 07/01/2013] [Accepted: 07/05/2013] [Indexed: 11/28/2022]
Abstract
Previous studies reported mixed findings on the relationship between acculturation and health status among Asian Americans due to different types of acculturation measures used or different Asian subgroups involved in various studies. We aim to fill the gap by applying multiple measures of acculturation in a diverse sample of Asian subgroups. A cross sectional study was conducted among Chinese, Korean and Vietnamese Americans in Washington D.C. Metropolitan Area to examine the association between health status and acculturation using multiple measures including the Suinn-Lew Asian Self-Identity Acculturation (SL-ASIA) scale, clusters based on responses to SL-ASIA, language preference, length of stay, age at arrival in the United Sates and self-identity. Three clusters (Asian (31%); Bicultural (47%); and American (22%)) were created by using a two-step hierarchical method and Bayesian Information Criterion values. Across all the measures, more acculturated individuals were significantly more likely to report good health than those who were less acculturated after adjusting for covariates. Specifically, those in the American cluster were 3.8 times (95% Confidence Interval (CI): 2.2, 6.6) more likely and those in the Bicultural cluster were 1.7 times more likely (95% CI: 1.1, 2.4) to report good health as compared to those in the Asian cluster. When the conventional standardized SL-ASIA summary score (range:-1.4 to 1.4) was used, a one point increase was associated with 2.2 times greater odds of reporting good health (95% CI: 1.5, 3.2). However, the interpretation may be challenging due to uncertainty surrounding the meaning of a one point increase in SL-ASIA summary score. Among all the measures used, acculturation clusters better approximated the acculturation process and provided us with a more accurate test of the association in the population. Variables included in this measure were more relevant for our study sample and may have worked together to capture the multifaceted acculturation process.
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Affiliation(s)
- Sunmin Lee
- 2234C School of Public Health Building, College Park, MD 20742, USA.
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Delavari M, Sønderlund AL, Swinburn B, Mellor D, Renzaho A. Acculturation and obesity among migrant populations in high income countries--a systematic review. BMC Public Health 2013; 13:458. [PMID: 23663279 PMCID: PMC3654930 DOI: 10.1186/1471-2458-13-458] [Citation(s) in RCA: 192] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 05/03/2013] [Indexed: 11/23/2022] Open
Abstract
Background There is evidence to suggest that immigrant populations from low or medium-income countries to high income countries show a significant change in obesogenic behaviors in the host society, and that these changes are associated with acculturation. However, the results of studies vary depending on how acculturation is measured. The objective of this study is to systematically review the evidence on the relationship between acculturation - as measured with a standardized acculturation scale - and overweight/obesity among adult migrants from low/middle countries to high income countries. Methods A systematic review of relevant studies was undertaken using six EBSCOhost databases and following the Centre for Reviews and Dissemination’s Guidance for Undertaking Reviews in Health Care. Results The initial search identified 1135 potentially relevant publications, of which only nine studies met the selection criteria. All of the studies were from the US with migrant populations from eight different countries. Six studies employed bi-directional acculturation scales and three used uni-directional scales. Six studies indicated positive general associations between higher acculturation and body mass index (BMI), and three studies reported that higher acculturation was associated with lower BMI, as mainly among women. Conclusion Despite the small number of studies, a number of potential explanatory hypotheses were developed for these emerging patterns. The ‘Healthy Migrant Effect’ may diminish with greater acculturation as the host culture potentially promotes more unhealthy weight gain than heritage cultures. This appears particularly so for men and a rapid form of nutrition transition represents a likely contributor. The inconsistent results observed for women may be due to the interplay of cultural influences on body image, food choices and physical activity. That is, the Western ideal of a slim female body and higher values placed on physical activity and fitness may counteract the obesogenic food environment for female migrants.
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Affiliation(s)
- Maryam Delavari
- WHO Collaborating Centre for Obesity Prevention, Department of Health, Deakin University, Melbourne, Australia.
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Allem JP, Ayers JW, Unger JB, Irvin VL, Hofstetter CR, Hovell MF. Smoking trajectories among Koreans in Seoul and California: exemplifying a common error in age parameterization. Asian Pac J Cancer Prev 2013; 13:1851-6. [PMID: 22901135 DOI: 10.7314/apjcp.2012.13.5.1851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Immigration to a nation with a stronger anti-smoking environment has been hypothesized to make smoking less common. However, little is known about how environments influence risk of smoking across the lifecourse. Research suggested a linear decline in smoking over the lifecourse but these associations, in fact, might not be linear. This study assessed the possible nonlinear associations between age and smoking and examined how these associations differed by environment through comparing Koreans in Seoul, South Korea and Korean Americans in California, United States. Data were drawn from population based telephone surveys of Korean adults in Seoul (N=500) and California (N=2,830) from 2001-2002. Locally weighted scatterplot smoothing (lowess) was used to approximate the association between age and smoking with multivariable spline logistic regressions, including adjustment for confounds used to draw population inferences. Smoking differed across the lifecourse between Korean and Korean American men. The association between age and smoking peaked around 35 years among Korean and Korean American men. From 18 to 35 the probability of smoking was 57% higher (95%CI, 40 to 71) among Korean men versus 8% (95%CI, 3 to 19) higher among Korean American men. A similar difference in age after 35, from 40 to 57 years of age, was associated with a 2% (95%CI, 0 to 10) and 20% (95%CI, 16 to 25) lower probability of smoking among Korean and Korean American men. A nonlinear pattern was also observed among Korean American women. Social role transitions provide plausible explanations for the decline in smoking after 35. Investigators should be mindful of nonlinearities in age when attempting to understand tobacco use.
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Affiliation(s)
- Jon-Patrick Allem
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
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Abstract
Although research on acculturation and its effects on Latino health continue to grow, there is a dearth of knowledge on how acculturation levels shape health literacy. Health literacy is an important aspect of health to consider with the Latino population because a number of studies have found that this group has the lowest levels of health literacy in the United States. The purpose of this study was to examine how acculturation and sociodemographic characteristics contribute to the health literacy of Latinos adults. Cross-sectional data was collected from a nonprobability sample of 123 Latinos living in various Arkansas communities. Multiple regression results suggest that Latinos who were more acculturated and were educated beyond high school were significantly more likely to have increased levels of health literacy. Findings also show that age, gender, income, and citizenship status were not significant predictors of health literacy. Implications and future research are discussed.
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Affiliation(s)
- Javier F Boyas
- Department of Family Studies and Social Work, College of Education, Health, and Society, Miami University, Oxford, OH 45056, USA.
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Lim JW. Linguistic and ethnic disparities in breast and cervical cancer screening and health risk behaviors among Latina and Asian American women. J Womens Health (Larchmt) 2012; 19:1097-107. [PMID: 20507210 DOI: 10.1089/jwh.2009.1614] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study intends to (1) describe breast and cervical cancer screening patterns and health risk behaviors for Latina and Asian American women, with consideration for their language, and (2) investigate the impact of health risk behaviors on breast and cervical cancer screenings after controlling for demographic characteristics and language. METHODS Data derived from the California Health Interview Survey 2007, which was a random-digit-dial population-based survey, were used. Latina (n = 3513) and Asian American (n = 2538) women were included in this study. Breast and cervical cancer screenings were measured by recent mammography and Pap smear examinations, respectively. Physical activity, smoking habits, alcohol consumption, and body mass index (BMI) were measured to assess health risk behaviors. RESULTS This study demonstrated that Asian Americans have better outcomes in health risk behaviors in general. However, Latinas were more likely than Asian Americans to receive mammograms and Pap smears. English-speaking Latinas and Asian Americans showed better outcomes in cancer screening and health risk behaviors, but BMI patterns differed based on language. Unhealthy risk behaviors were related to low screening rates, except for BMI and drinking, among Latina women. CONCLUSIONS The findings reveal unique ethnic and linguistic patterns that are relevant to health risk behaviors and cancer screening and that influence overall health outcomes. These findings suggest that health risk behaviors and cancer screening for ethnic minority populations may be framed by cultural contexts. Intervention strategies designed to promote healthy lifestyles and cancer screening may have greater sustainable benefits.
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Affiliation(s)
- Jung-won Lim
- Center of Community Alliance for Research and Education, City of Hope National Medical Center, Duarte, California, USA.
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Abstract
The objective of this study is to examine the association between acculturation and BMI among Asian Americans using multiple measures of acculturation. Data of 847 Chinese, Korean and Vietnamese recruited for a health education program in Maryland during 2009 to 2010 were used. Acculturation was measured by the short version of Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA) and its individual components. Height and weight were measured by trained staff. Multiple linear regressions were used to estimate the association between acculturation and BMI. After adjusting for age, gender, education, income, marital status, and ethnicity, SL-ASIA (β = 0.71, SE = 0.28), having education in the US (β = 0.56, SE = 0.28), younger age of arrival (0-5 years: β = 3.32, SE = 0.76, 6-10 years: β = 1.55, SE = 0.78), self identified as Americans (β = 1.51, SE = 0.77) and equal preference of Asian/American food in restaurants (β = 0.92, SE = 0.28) were significantly associated with increased BMI. The association between acculturation and BMI was stronger among men than women, strongest among Chinese and weakest among Vietnamese. Acculturation was moderately associated with increased BMI among Asian Americans and this association varied by measures of acculturation. The association of acculturation and BMI was moderated by sex and ethnicity groups.
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Wong SS, Dixon LB, Gilbride JA, Kwan TW, Stein RA. Measures of Acculturation are Associated with Cardiovascular Disease Risk Factors, Dietary Intakes, and Physical Activity in Older Chinese Americans in New York City. J Immigr Minor Health 2012; 15:560-8. [DOI: 10.1007/s10903-012-9669-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Personal Views about Aging among Korean American Older Adults: The Role of Physical Health, Social Network, and Acculturation. J Cross Cult Gerontol 2012; 27:139-48. [DOI: 10.1007/s10823-012-9165-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Biculturalism (having two cultures) is a growing social phenomenon that has received considerable attention in psychology in the last decade; however, the issue of what impact (if any) biculturalism has on individuals’ adjustment remains empirically unclear. To answer this question, we conducted a meta-analysis that included 83 studies, 322 rs, and 23,197 participants. Results based on the random-effects approach show a significant, strong, and positive association between biculturalism and adjustment (both psychological and sociocultural). This biculturalism- adjustment link is stronger than the association between having one culture (dominant or heritage) and adjustment. Thus, our results clearly invalidate early sociological accounts of this phenomenon, which portrayed bicultural individuals as “marginal” and stumped between two worlds. Analyses also indicate that the association between biculturalism and adjustment is moderated by how acculturation is measured, the adjustment domain, and sample characteristics.
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Affiliation(s)
| | - Verónica Benet-Martínez
- ICREA (Catalan Institute for Advanced Research and Studies) and Pompeu Fabra University, Barcelona, Spain
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Lee SK, Nam SY. Comparison of Food and Nutrient Consumption Status between Displaced North Korean Children in South Korea and South Korean Children. ACTA ACUST UNITED AC 2012. [DOI: 10.5720/kjcn.2012.17.4.407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Soo-Kyung Lee
- Department of Food and Nutrition, Inha University, Incheon, Korea
| | - So-Young Nam
- Department of Food and Nutrition, Inha University, Incheon, Korea
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