Abstract
Mechanisms of Acculturation in Hispanic Populations and Health Outcomes: A Theory-Driven Model for Public Health Interventions
Rossmary Marquez Lameda, BS
Texas A&M University. School of Public Health, College Station, TX
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
The question of the Hispanic Paradox has been widely debated in the public health field. Scholars such as Abraido-Laza and Hummer have studied the potential theories explaining it, while others still continue to argue the Paradox does not exist. The latter attributes the health advantage to extraneous factors. Overall, it has been determined that despite their low socio-economic profile, Hispanics show lower incidence rates of several cardiovascular diseases and a lower all-cause mortality rate. Latinas are also known to give birth to healthier babies when compared to other minority groups in the U.S. However, this health advantage seems to disappear over time as Hispanics grow roots in this country. It has been documented that the process of acculturation and time spent in the U.S. have a partial detrimental health effect on this minority group, but the mechanism of how acculturation affects health is still not well understood. An acculturation theory with a public health perspective could help us understand Latino health and the implication of acculturation on health outcomes. The purpose of this study is to utilize what has been published in the literature on Hispanic culture, acculturation theories and data from National Health Surveys (NHANES, NHIS, and BRFSS) to create a theory-driven acculturation model for public health. This theory-driven acculturation model could be used to develop better-suited public health interventions aimed at improving Hispanic health and to prevent the detrimental health effects product of acculturation.
Diversity and culture Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Can an intercambio be a real exchange? Lessons for research and practice from the 13 year partnership between a US university and an artisan collective in Arrazola, Oaxaca, Mexico
Kathleen M. Roe, DrPH, MPH1, German Blanco, MPH2, Maribel Martinez, MA3, Diana Victa, MA4 and Saúl Aragón Ramírez5
(1)San José State University, San Jose, CA, (2)Stanford Prevention Research Institute, San José, CA, (3)Office of LGBTQ Affairs, San José, CA, (4)Cesar Chavez Community Action Center, San José, CA, (5)Ecoalebrijes Association, Oaxaca, Mexico
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
San José State University in California, USA and the Ecoalebrijes Artisan Association of Arrazola, Oaxaca, Mexico have engaged in an enduring and authentic partnership since 2005. Designed from the start as an “intercambio” – an exchange – this seemingly unbalanced relationship between a well-established comprehensive university in the United States and an emergent artisan collective of 13 families in southern Mexico has grown, deepened, matured, and thrived precisely because of the “differences” and our commitment to being true partners. This presentation will address best and promising practices from our relationship with relevance to research with Latinx communities and programs embracing diversity, intercultural communication, and global exchange. Founding principles, their meanings and cultural contexts will be discussed, including respect/respeto, understanding/conocimientos, trust/confianza, and initiative/iniciativa. With particular relevance for research, perspectives on pacing, decision-making, communication style, and story-telling will be examined from the multiple perspectives of intercambio partners. Special consideration will be given to ethical questions of fair service, compensation, personal and community risk and benefit, and appropriate inquiry. The intersectionality of university and collective, California and Oaxaca, artisan and scholar/student, research/evaluation and the Zapotec principle of teqio will be explored. The impact of changing U.S. policies, particularly regarding immigration, climate change, and labor, will be discussed, along with the nature of intercambio partner commitments, even as our countries and contexts change. Implications for research and practice will be emphasized.
Administration, management, leadership Assessment of individual and community needs for health education Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Public health or related research Social and behavioral sciences
Abstract
Home environment influences on eating and physical activity habits of Latino preschool children: A qualitative study
Ana Lindsay, DDS, MPH, DrPH1, Mary L. Greaney, MPH, PhD2, Sherrie Lee Flynt Wallington, PhD3 and Julie A. Wright, PhD4
(1)Harvard T.H. Chan School of Public Health, Boston, RI, (2)University of Rhode Island, Kingston, RI, (3)Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, (4)University of Massachusetts Boston, Boston, MA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Latinos are the largest and most rapidly growing population group in the USA and children in low-income Latino families are at elevated risk of becoming obese. The home environment is an important early social environment for the development and maintenance of children’s early dietary and physical activity (PA) habits. Parents are influential in children developing healthful behaviors during early childhood, which is when diet and PA habits are formed. The purpose of this qualitative study was to examine Latino parents’ perceptions of their children’s eating and PA experiences while at home.
Methods: Qualitative study including six focus groups conducted in Spanish (n 36). Transcripts were analyzed using thematic analysis guided by the socio-ecological model to identify key concepts and themes.
Results: Analyses revealed daily life demands that impacted parents’ ability to create and maintain a home environment conducive to healthful eating and PA habits. This finding is important because previous studies indicate that children living in households with regular family routines (e.g. regularly eating meals as a family) are at lower risk of obesity than those who do not have household routines.
Conclusions: Understanding parental perceptions, attitudes and practices related to establishing and maintaining an environment conducive to children’s healthful eating and PA at home is essential for the design of successful interventions to promote children’s healthful behaviors in this setting. Findings highlight the importance of understanding and addressing the social day-to-day context of Latino families when designing interventions to promote healthy eating and PA among young children.
Diversity and culture Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences
Abstract
Bridges of Communication - A key to Improve Public Health on the U.S. - Mexico Border The Arizona-Sonora Example
Raquel Bravo-Clouzet, MD, MPH, Robert Guerrero, MBA, Mariana Casal, MD, MPH, Christine Cervantez, BS and Guadalupe Villaescusa, AA
Arizona Department of Health Services, Tucson, AZ
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
The Arizona-Sonora border comprises 389 miles and six ports of entry with an average of 14,814,033 people crossing monthly. With this important interchange, addressing health issues requires strong communication channels on both sides of the border. The Arizona Department of Health Services Office of Border Health (OBH) builds communication bridges that strengthen cross-border public health collaboration with Sonora, Mexico. In order to build bridges, the OBH utilizes the Border Infectious Disease Surveillance (BIDS) program, the U.S.-Mexico Border Health Commission (BHC) Arizona Outreach Office (AZ ORO), the Arizona-Sonora Tuberculosis (TB) Meet & Greet Program, and Binational Health Councils (COBINAS).
BIDS investigates an average of 425/year reportable binational infectious disease cases, sharing an average 395 cases/year with Sonoran colleagues. BIDS also conducts acute respiratory infections and, vector-borne disease surveillance.
The AZ ORO promotes initiatives and conducts activities of the BHC: Healthy Border 2020 Initiative and U.S.-Mexico Border Health Month reaching over 5,000 border community members through projects and events, and the Leaders across Borders training program facilitates binational communication/collaboration among public health & healthcare professionals.
The OBH facilitates continuity of treatment in Sonora for deported Mexican nationals with active/suspected tuberculosis through the Arizona-Sonora TB Meet & Greet Program and works with the COBINAS providing technical assistance. In conducting these programs binational communication and collaboration is advanced. This vast binational communication network of U.S. and Mexican federal, state and local agencies provides international leadership to optimize health & quality of life based on commitment and respect on both sides of the border.
Administration, management, leadership Communication and informatics Diversity and culture
Abstract
Salud Heroes: Lessons Learned from Empowering Advocates & Creating Community Capacity through Online Storytelling
Rosalie Aguilar, M.S.1, Amelie G. Ramirez, DrPH2, Kipling Gallion, MA3, Cliff Despres, B.J.3, Amanda Merck, MPH4, Lisa Ellis, BA4, Eric Moreno, BA4 and Rick Carrillo, MBA, BS4
(1)University of Texas Health Science Center, San Antonio, TX, (2)UT Health Science Center at San Antonio, Institute for Health Promotion Research, San Antonio, TX, (3)UT Health Science Center at San Antonio, San Antonio, TX, (4)University of Texas Health Science Center at San Antonio, San Antonio, TX
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Salud America! (SA!) a national on-line network comprised of 67,000 parents, educators and researchers, aims to bring healthy changes to Latino communities through obesity prevention efforts and policy change. SA! uses the power of storytelling at a grassroots level and e-communications to increase efficacy for advocacy related to Latino childhood obesity prevention.
methods: Between 2012-2016, over 225 individuals (Salud Heroes) from throughout the U.S. were interviewed by SA! content curators. Their stories were shared and featured in blog posts and videos on social media. Feedback from Salud Heroes was collected via email and a network survey. YouTube Analytics and Kissmetrics were used to explore video viewing and voting metrics.
results: Surveys were collected from 1,188 network members and 65 hub members. Approximately 30 emails were collected from Salud Heroes. Overall 51% (n=45) of hub members stated that Salud Hero stories were “very valuable” to their work. Salud Heroes stated that the stories helped them: (1) build momentum around policy work, (2) communicate policy in a way that is “digestible” to the community, (3) provide information for grant applications, (4) boost morale, and (5) connect with others on a national level to provide support and answer questions. Videos were viewed over 47,000 times and nearly 400 individuals voted for their favorite video.
conclusion: Salud Hero stories serve as both a didactic and motivational tool to encourage community wide participation in policy change. The role of Salud Hero video delivered via social media warrants further exploration.
Advocacy for health and health education Communication and informatics Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related education
Abstract
Differences in discrimination by racial identity and sex among Latinx and Caribbean youth
Isabel Martinez, PhD, MA1, Adedotun Ogunbajo, MPH, MHS, PhDc2, Miguel Paredes and Shayna Cunningham, PhD4
(1)Harvard T.H. Chan School of Public Health, Boston, MA, (2)Brown School of Public Health, Providence, RI, (3)Yale University, New Haven, CT
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Race and ethnicity are tied to disparities in various health outcomes, yet little is known about their intersectionality in youth. Discrimination is a known risk factor associated with adverse health where this intersectionality may be explored.
Methods: Using data from 2,393 Latinx and Caribbean adolescents from the Children of Immigrant Longitudinal Study (CILS), we compared differences in experiences of discrimination by racial identification, nativity and sex. Multiple logistic regression was used to compare differences among White and minority racially identifying Latinx and Caribbean youth.
Results: Bivariate (OR = 1.801, P<0.001) and multivariate analyses (OR = 1.400, P=0.001) show significant difference in odds of experiencing discrimination among both Latinx and Caribbean youth. Female adolescents were more likely to report experiencing discrimination in multivariate analyses (OR = 1.400, P<0.001) compared to males. When evaluating females and males separately, only female adolescents showed a significant effect for racial identity and experiencing discrimination (ORMale = 1.243, P=0.17; ORFemale = 1.539, P=0.002).
Conclusion: These findings suggest racial identification plays a significant role for discrimination experiences among diverse youth. Racial identity must be further explored within ethnic groups to better understand its role for health disparities and explore potential resiliency factors that can reduce discrimination particularly for diverse female adolescents.
Diversity and culture Social and behavioral sciences
Abstract
Impact of the MONARCAS as Popular Opinion Leaders in the Latino Community
Patricia Canessa, MA, MBA, PhD1, Karen Mancera-Cuevas, DrPH, MS, MPH, CHES2, Rosalind Ramsey-Goldman, MD, DrPH3 and Zorayda Avila-Toledo, BA4
(1)Northwestern University Feinberg School of Medicine, Chicago, IL, (2)Illinois Department of Public Health, Springfield, IL, (3)Northwestern University, Feinberg School of Medicine, Chicago, IL, (4)Casa Michoacan, Chicago,, IL
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Building community capacity to address complex chronic diseases, such as Systemic Lupus Erythematosus is an emerging priority among Latino communities. The MONARCAS program is based on an evidenced-based model designed and implemented through close collaboration between Northwestern University and a grassroots organization located in the predominantly Mexican Pilsen community in Chicago. As community residents became aware of the presence of several untreated lupus patients in the proximity, a community mobilization process began that resulted in funding through an Office of Minority Health grant. The program included a culturally-competent intervention facilitating knowledge about lupus, engaging patients during medical encounters, increasing awareness of culturally-sensitive approaches among clinical providers, and training community patient-advocates to overcome barriers of access to care and accessing affordable medications. The model integrates the social network and diffusion of innovations theories to educate, advocate, and address social perceptions of lupus. Eventually, one hundred twenty four Latino popular opinion leaders were trained to educate and saturate three communities with information about the significance of lupus, signs and symptoms, while providing community access to resources, creating culturally appealing messages, and hosting conversations. This was done by distributing palm cards with lupus information facilitating chronic disease management capacity, and aiming to improve quality of life. Locally referred clinics would serve as a linkage for care and treatment. The results demonstrated increased ACA enrollment, early diagnosis of rheumatic diseases and lupus, increased availability of specialized care in local clinics, and de-stigmatization of this complex, too often misunderstood and misdiagnosed condition affecting Latinos.
Administer health education strategies, interventions and programs Assessment of individual and community needs for health education Diversity and culture Implementation of health education strategies, interventions and programs Public health or related education Systems thinking models (conceptual and theoretical models), applications related to public health