HPV Vaccine Misperceptions Among Hispanics/Latinos in Southern California.

BACKGROUND: Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites. METHODS: HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score. RESULTS: Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01). DISCUSSION: Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.

Association of Childhood Economic Hardship with Adult Height and Adult Adiposity among Hispanics/Latinos. The HCHS/SOL Socio-Cultural Ancillary Study.

The study examined the association of childhood and current economic hardship with anthropometric indices in Hispanic/Latino adults, using data from the HCHS/SOL Socio-cultural ancillary study (N = 5,084), a community-based study of Hispanic/Latinos living in four urban areas (Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA). Childhood economic hardship was defined as having experienced a period of time when one's family had trouble paying for basic needs (e.g., food, housing), and when this economic hardship occurred: between 0-12, 13-18 years old, or throughout both of those times. Current economic hardship was defined as experiencing trouble paying for basic needs during the past 12 months. Anthropometry included height, body mass index (BMI), waist circumference (WC), and percentage body fat (%BF). Complex survey linear regression models were used to test the associations of childhood economic hardship with adult anthropometric indices, adjusting for potential confounders (e.g., age, sex, Hispanic background). Childhood economic hardship varied by Hispanic background, place of birth, and adult socio-economic status. Childhood economic hardship during both periods, childhood and adolescence, was associated with shorter height. Childhood economic hardship was associated with greater adiposity among US born individuals only. Current economic hardship was significantly associated with all three measures of adiposity (BMI, WC, %BF). These findings suggest that previous periods of childhood economic hardship appear to influence adult height more than adiposity, whereas current economic hardship may be a better determinant of adult adiposity in Hispanics.

Agreement between the IPAQ and accelerometer for detecting intervention-related changes in physical activity in a sample of Latina women.

BACKGROUND: Even when objective physical activity (PA) measures are preferred, many intervention studies with Latina women rely on self-reports because they are more feasible and the type and domain of PA is of interest. PURPOSE: This study examined the sensitivity and specificity of the IPAQ for detecting intervention-related changes in physical activity compared with accelerometer measurement among Latinas. METHODS: In March 2007, a community sample of 94 women (mean age = 36.31 ± 9.1 yr; mean body mass index = 31.37 ± 7.13) participated in a 12-week pedometer-based intervention to increase moderate intensity physical activity (MPA). Participants completed the Spanish-language International Physical Activity Questionnaire (Sp-IPAQ; telephone, long form) and wore an Actigraph accelerometer for 7 days at baseline and postintervention. RESULTS: Both the IPAQ and the ActiGraph accelerometer detected intervention-related increases in MPA; however, these changes were largely uncorrelated. The IPAQ did not have acceptable level of sensitivity and specificity before and after the intervention when compared with objective assessments. CONCLUSIONS: Data suggest that it is important to improve the sensitivity and specificity of the IPAQ with Spanish-speaking participants and further research is needed to accurately measure intervention effectiveness using self-reports of PA in Latinas.

An examination of multilevel factors that may explain gender differences in children's physical activity.

BACKGROUND: Girls are less physically active than boys, yet no single study has examined the factors that may explain gender differences in children's physical activity (PA). METHODS: This study was a cross-sectional analysis of data from 116 caregivers and their children aged 5-8 years who participated in the MOVE study. Caregivers reported various factors that may relate to children's PA (eg, encouragement for child PA and PA equipment at home). Child PA was measured by 7-day accelerometry. Linear regression tested for the variance in moderate-to-vigorous physical activity (MVPA) explained by gender and several variables. Gender and ethnicity interactions were examined. RESULTS: Caregivers were mostly female (97%), mean age 38 ± 6 years, mean BMI 28 ± 6 (kg/m2). Child's mean age was 8.1 ± 0.7, 54% were female and 40% were overweight/obese. Girls were less physically active than boys (54.1 ± 19.7 vs. 65.2 ± 28.0 daily minutes of MVPA, respectively). Among girls, more days of PE/week was associated with greater MVPA. Among boys, greater parent support for PA, greater parent modeling for PA, and greater number of PA equipment in the home were associated with greater MVPA. CONCLUSIONS: This study supports that boys and girls have different correlates for MVPA, which may partly explain gender differences in PA.

Associations among parent acculturation, child BMI, and child fruit and vegetable consumption in a Hispanic sample.

The objective of this study was to investigate the association of parent acculturation with child fruit and vegetable consumption and obesity, as measured by body mass index (BMI). Participants included 250 Mexican-American and other Hispanic families living within San Diego County. Height and weight measurements were collected to calculate the age- and sex-specific BMI for each child and parent, and parents completed self-administered surveys. Child BMI z-score was significantly related to parent BMI after controlling for parent acculturation and parent birth place (ß = 0.05, p < 0.01). Child fruit consumption was significantly associated with parent acculturation (ß = -0.02, p = 0.01) and parent BMI (ß = 0.02, p = 0.04) after adjusting for the other variables in the model. Child vegetable consumption was not significantly related to parent acculturation. Findings suggest that parental weight status may be more predictive of child obesity than acculturation, and highlight the need to examine culturally relevant behavioral and psychosocial factors related to childhood obesity and dietary behaviors.

Results of a multi-level intervention to prevent and control childhood obesity among Latino children: the Aventuras Para Niños Study.

BACKGROUND: Community-based interventions are needed to reduce the burden of childhood obesity. PURPOSE: To evaluate the impact of a multi-level promotora-based (Community Health Advisor) intervention to promote healthy eating and physical activity and prevent excess weight gain among Latino children. METHODS: Thirteen elementary schools were randomized to one of four intervention conditions: individual/family level (Family-only), school/community level (Community-only), combined (Family + Community), or a measurement-only condition. Participants were 808 Latino parents and their children enrolled in kindergarten through 2(nd) grade. Measures included parent and child body mass index (BMI) and a self-administered parent survey that assessed several parent and child behaviors. RESULTS: There were no significant intervention effects on children's BMI z-score. The family intervention changed several obesity-related child behaviors (e.g., fruit/vegetable consumption) and these were mediated by changes in parenting variables (e.g., parent monitoring). CONCLUSION: A promotora-based behavioral intervention was efficacious at changing parental factors and child obesity-related health behaviors.

Predictors of change in sports participation in Latino and non-Latino children.

BACKGROUND: Few prospective studies have examined predictors of change in specific physical activity (PA) behaviours in different ethnic groups. PURPOSE: To assess predictors of change in sports participation in Latino and non-Latino 5-8 year-old children in San Diego, California. METHODS: Average sports participation frequency (days/week) was assessed by validated parent-report at baseline (Nov 2006-May 2008) and 1 year later in 541 children (45.0% male, 41.1% Latino; mean ± SD age: 6.6 ± 0.7 years) taking part in an obesity prevention study (Project MOVE). Biological (sex, age, Body Mass Index z-score), socio-cultural (ethnicity, income, care giver education), parental (PA rules, PA encouragement) and environmental factors (home PA equipment, PA location) were assessed at baseline. Associations between change in sports participation and potential predictors were studied using multilevel linear regression stratified by Latino ethnicity, adjusted for sex, baseline sport participation, study condition and recruitment area. RESULTS: Sports participation increased over 1 year (mean change: +0.5 days; p<0.001) and change was similar for boys and girls (p=0.95), but Latino children showed a greater increase (p=0.03). The number of locations used for PA (p=0.024) and the total frequency of PA location use (p=0.018) were positively associated with increased sports participation among Latinos. No predictors were identified for non-Latino children. CONCLUSIONS: Only factors relating to PA location were identified as predictors of change in sports participation for Latino children. Interventions targeting specific PA behaviours such as sports participation may need to consider PA locations for Latino children and be tailored for specific ethnic groups.

Socio-demographic disparities of childhood asthma.

Childhood asthma is particularly prevalent among disadvantaged children and is associated with greater functional consequences. This study described factors associated with childhood asthma in a sample of Latino and non-Latino children. Data were from baseline measures of 791 parent and child dyads involved in a childhood obesity prevention study. Parents completed a self-administered survey assessing childhood factors, demographics, acculturation and child asthma diagnosis. Multivariate mixed effects logistic regression analyses tested for correlates of child asthma and ethnicity interactions. Children were 4-10 years old, half were female, 86.0 percent were US-born and 45.7 percent were overweight or obese. The prevalence of childhood asthma was 11.5 percent. In multivariate analyses, the odds of childhood asthma were greater among children of non-Latino descent (OR = 4.1, CI: 1.8, 9.2), who had health insurance (OR = 11.1, CI: 2.7, 46.4), were male (OR = 1.8; CI: 1.1, 3.1) and born pre-term (OR = 3.0, CI: 1.4, 6.3). This study supports socio-demographic disparities in childhood asthma and evidence of their independent effects.

Leisure-time physical activity in elementary schools: analysis of contextual conditions.

BACKGROUND: Little is known about children's leisure-time physical activity (PA) at school and how it is associated with contextual variables. The purpose of this study was to objectively assess children's voluntary PA during 3 daily periods and examine modifiable contextual factors. METHODS: We conducted SOPLAY (System for Observing Play and Leisure Activity in Youth) observations before school, during recess, and at lunchtime in 137 targeted activity areas in 13 elementary schools over 18 months. During observations, each child was coded as Sedentary, Walking, or Vigorous, and simultaneous entries were made for area characteristics (accessibility, usability, presence of supervision, loose equipment, and organized activities). Logistic regression analysis was used to test associations between PA and area characteristics. RESULTS: Assessors made 2349 area visits and observed 36,995 children. Boys had more moderate-to-vigorous physical activity (MVPA; 66.2 vs 60.0%, p < .001) and more vigorous PA (29.8 vs 24.6%; p < .001) than girls. Areas were typically accessible and usable, but provided organized activities infrequently (16.5%). Odds of engaging in MVPA were greater during lunch and recess than before school and in areas with play equipment (p < .05). CONCLUSIONS: Children accrued a substantial amount of voluntary PA during leisure time at school. Their PA would likely be increased if school playground equipment was more readily available and if supervisors were taught to provide active games and promote PA rather than suppress it.

Longitudinal intervention effects on parenting of the Aventuras para Niños study.

BACKGROUND: Parenting interventions have achieved changes in factors associated with childhood obesity but few have tested the effects on multiple parental influences. PURPOSE: This study examined the efficacy of an intervention aimed at improving several dimensions of parenting related to childhood obesity. DESIGN: The study used a 2 x 2 factorial design. SETTING/PARTICIPANTS: In 2003, a sample of 13 Southern California schools was randomized to one of four conditions: micro-environment only, macro-environment only, micro-plus-macro-environment, and no treatment control condition. Participants included 811 predominantly Mexican immigrant/Mexican-American mothers with children in kindergarten through second grade. INTERVENTION: In both micro conditions, participants received monthly home visits by a promotora over a 7-month period plus monthly mailed newsletters. MAIN OUTCOME MEASURES: In 2008, intervention effects were examined on (1) parenting strategies, including limit setting, monitoring, discipline, control, and reinforcement related to children's diet and physical activity; (2) parental support for physical activity; (3) parent-mediated family behaviors such as family meals eaten together and TV watching during family dinners; and (4) perceived barriers and other parent cognitions related to children's eating and activity. RESULTS: At the 2-year follow-up, significant improvements were observed in three of five parenting strategies, parental support, and two of four parent-mediated family behaviors among parents receiving the micro intervention (i.e., those who received promotora visits and monthly newsletters), as compared with those in the macro-only and control conditions. CONCLUSIONS: Aspects of parenting related to children's risk for obesity and related health outcomes are modifiable with the support of a promotora and print media.

Environmental correlates of physical activity in Mexican American children at home.

BACKGROUND: Understanding home environments might shed light on factors contributing to reduced physical activity (PA) in children, particularly minorities. Few studies have used microlevel observations to simultaneously assess children's PA and associated conditions in homes. METHODS: Trained observers assessed PA and associated physical and social environmental variables in the homes of 139 Mexican American children (69 boys, 70 girls; mean age = 6 years) after school. RESULTS: Children spent most time indoors (77%) and being sedentary (74%). Reduced PA was associated with viewing media, being indoors, and parents being present. Increased PA was associated with prompts for PA and other children being present. PA prompts differed by child gender and location and prompter age status. CONCLUSIONS: Children are frequently sedentary at home. Microlevel observations showed PA is associated with potentially modifiable social and physical factors, including spending time outdoors. Studies to determine whether interventions on these correlates can improve children's PA are needed.