Context Matters: A Qualitative Study About the Perinatal Experiences of Latina Immigrant Women.

Although immigrants' health is better compared to their native-born counterparts, their wellbeing starts to deteriorate as they spend more time in the United States. To date, few qualitative studies investigate how migration can influence the perinatal period. This study qualitatively assesses Latina immigrant mothers' perinatal experiences. Thirty Latina women were recruited in 2015 to participate in interviews, all of which were conducted in Spanish. The data were analyzed using thematic analysis. Latina mothers' experiences during the perinatal period were impacted by the cultural expectations that may or may not depend on the context where they are located. Context-independent themes included: (1) Cravings and (2) Body dissatisfaction. Context-dependent themes included: (1) Breastfeeding and (2) Loss of extended social ties. In order to reduce health disparities in the perinatal period among Latina immigrant mothers and their children, it is necessary to provide interventions that promote healthy behaviors and increase social capital and peer support.

Childhood obesity risk factors by race and ethnicity.

OBJECTIVE: Childhood obesity is a public health concern that often worsens with age. Although several risk factors at the child and maternal levels have been identified in cross-sectional studies, less is known about their long-term contribution to racial/ethnic disparities in childhood obesity. This study examines child- and maternal-level factors associated with the growth trajectories of White, Black, and Latino children. METHODS: Group-based trajectory models were used to identify BMI z score trajectories from birth to 9 years of age among White, Black, and Latino children. The associations of child- and maternal-level factors with the trajectory group identified as at risk for obesity were examined using adjusted logistic regression analysis, stratified by race/ethnicity. RESULTS: Among White children, fast-food consumption (odds ratio [OR] = 1.66; 95% CI: 1.09-2.52) was associated with higher odds of following an at-risk trajectory. Among Black and Latino children, prepregnancy BMI was associated with following an at-risk trajectory (OR = 1.05; 95% CI: 1.03-1.08 for Black children, and OR = 1.12; 95% CI: 1.07-1.17 for Latino children). CONCLUSIONS: These findings showed racial/ethnic differences in the risk factors that influence the likelihood of obesity during childhood. Further research is needed to identify modifiable racial/ethnic specific risk factors to guide obesity-prevention interventions.

Racial and Ethnic Disparities in Childhood Growth Trajectories.

Childhood overweight and obesity are a primary social and public health concern. Over the past 30 years, rates of childhood overweight and obesity in the United States of America (USA) have drastically increased, particularly among Black and Latino/a populations. However, they tend to be underrepresented in the childhood obesity literature. This study expands previous literature by identifying different BMI growth trajectories for Black, Latino/a, and White children from birth to age nine. This study found a high prevalence rate of overweight and obesity in a predominantly low-income minority group. Using growth-based trajectory modeling, this study also found different growth trajectories by racial/ethnic groups, with Latino/a children having the most concerning growth trajectories from birth to 9 years. These findings demonstrate that ethnic/racial disparities in childhood overweight and obesity start as early as birth, indicating the need to devote more attention from researchers and health policy-makers to address these disparities as early as possible.

A systematic review examining the relationship between food insecurity and early childhood physiological health outcomes.

Food insecurity, or limited access to nutritious foods, is a significant public health concern especially among vulnerable populations including infants and young children in low-income households. While literature to date has thoroughly examined the psychological and behavioral impacts of food insecurity on children, no known study to date has specifically synthesized the literature exploring the relationship between food insecurity and physiological health outcomes during early childhood. The purpose of this study was to review the literature on physiological health outcomes associated with food insecurity during early childhood among children aged 0-5 years in developed countries. Our literature search sources included PubMed, PsycInfo, CINAHL, and Embase databases. A total of 657 articles published up to September 2019 were reviewed for eligibility by two coders, with a third reviewer in cases of disagreement. Eighty-three articles remained after screening by abstract, with a final 27 studies ultimately included in the final synthesis. This review is registered with PROSPERO and adhered to PRISMA guidelines. In total, 20 articles (74%) noted significant relationships between food insecurity and physiological health outcomes in young children. Findings included an association with overweight or obesity (n = 9), anemia (n = 3), poor child health (n = 3), low birth weight (n = 3), chronic illness (n = 1), special health care needs (n = 1), and increased cortisol (n = 1), in young children who experience food insecurity. Identifying relationships between food insecurity and health outcomes during early childhood has the potential to inform future prevention interventions to reduce health disparities in these vulnerable populations.

Feeding decision-making among first generation Latinas living in non-metropolitan and small metro areas.

BACKGROUND: Worldwide, overweight and obesity rates have more than tripled over the past three decades. Overweight and obesity rates are particularly high among Latinos. In order to determine some of the potential reasons, it is imperative to investigate how first-generation Latina mothers living in non-metropolitan and small metro areas decide how and what to feed their children. Using the Socio-Ecological Model, this study aimed to understand how Latina immigrant mothers make feeding decisions for their children. METHODS: A total of 29 semi-structured interviews were conducted with a purposive sample of immigrant mothers from Latin American countries whose preschoolers were enrolled in a Women, Infant, and Children supplemental nutrition program located in non-metropolitan and small metro areas. All interviews were recorded and transcribed verbatim in Spanish, and analyzed by a bilingual team. RESULTS: Multi-stage qualitative analysis was employed to analyze the data. Nineteen participants originated from Mexico, four from Central America, and six from South America. Five themes emerged that helped illuminate mother's decision-making around feeding choices: 1) culture as all-encompassing, 2) location and access to fresh and traditional foods, 3) disjunction between health provider advice and cultural knowledge 4) responsiveness to family needs and wants as determinants of food choices, 5) intrapersonal conflict stemming from childhood poverty and food insufficiency. CONCLUSION: Findings suggest that Latina immigrant mothers engage in a difficult and even conflicting process when deciding how to feed their children. Future interventions should focus on implementing hands-on activities that can help consolidate, promote, and encourage healthy feeding choices.

Perinatal depression screening in a Women, Infants, and Children (WIC) program: perception of feasibility and acceptability among a multidisciplinary staff.

OBJECTIVE: Best practices for addressing women's mental health and screening for depression in public health clinics are not available. Clinic staff are often responsible for screening for depression; however, few studies examine staff perceptions on feasibility and acceptability of using perinatal screening for mood disorders in ethnically diverse public health clinics. METHODS: During December 2012, we conducted four focus groups using a semistructured interview guide with public health clinic staff of varying disciplines (n=25) in a Special Supplemental Nutrition Program for Women, Infants, and Children. All interviews were audio recorded and analyzed using thematic analysis. RESULTS: We found five descriptive themes related to acceptability and feasibility of screening for perinatal depression in a public health clinic. The main themes include (1) literacy barriers, (2) need for referrals and follow-up with outside services, (3) training and capacity needs, (4) stigma of depression, and (5) location and privacy of screening. Although multiple barriers to universal depression screening in a public health clinic were identified, participants found value in practice of screening low-income women for depression. CONCLUSION: Factors for facilitating implementation of systematic depression screening in a public health clinic have been identified. Implications discuss how policy makers and public health clinic administrators can improve the universal depression screening process.