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1.
J Acad Nutr Diet ; 121(3): 520-528, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33028510

RESUMO

Higher frequency of eating outside the home can be an unhealthy behavior that may contribute to higher rates of obesity among Latinas, a disproportionately affected group. There is a growing need to understand potentially modifiable factors (eg, dispositional mindfulness, self-efficacy, nutrition knowledge) associated with higher frequency of eating outside the home in this population. This study assessed associations of cognitive factors (ie, dispositional mindfulness, self-efficacy of eating and purchasing healthy foods, nutrition knowledge) with frequency of eating out among Latinas. A secondary analysis was performed of data from a cross-sectional study of Latinas between February and May 2015. The study comprised a convenience sample of 218 Spanish- or English-literate Latinas, between the ages of 18 and 55 years, who lived in South or East Los Angeles and self-identified as the primary person responsible for grocery shopping in the household. Most participants identified as foreign-born Mexican Americans. Frequency of eating out was assessed as the outcome variable, and three cognitive variables (mindfulness disposition, self-efficacy, nutrition knowledge) served as independent variables. Multinomial models assessed the association between cognitive factors and frequency of eating out. Models were adjusted for age, English-speaking ability, income, having an obesity-related disease (ie, overweight or obesity, diabetes, high blood pressure, cardiovascular disease), household size, and education level. For every 1-unit increase in mindfulness disposition, the risk of a participant eating out every week compared with every month decreased by a factor of 0.42 (relative risk ratio [RRR] = 0.58, P < 0.01). For every 1-unit increase in self-efficacy, the risk of a participant eating out every week compared with every month decreased by a factor of 0.32 (RRR = 0.68, P < 0.05), and the risk of a participant eating out every 2 weeks compared with every month decreased by a factor of 0.44 (RRR = 0.56, P < 0.05). For every 1-unit increase in nutrition knowledge, the risk of a participant eating out every week compared with every month increased by a factor of 1.42 (RRR = 1.42, P < 0.01). Lower dispositional mindfulness was associated with higher frequency of eating out when comparing individuals who ate out at least every week with those who ate out once a month or less or every 2 weeks. Lower self-efficacy was associated with eating out more when comparing those who ate out once a month or less with those who ate out at least every week or every 2 weeks. Lower nutrition knowledge was associated with lower frequency of eating out for participants who ate out once a month or less compared with those who ate out at least every week.


Assuntos
Cognição , Dieta , Hispânico ou Latino/estatística & dados numéricos , Refeições , Restaurantes , Adolescente , Adulto , Comportamento do Consumidor , Estudos Transversais , Dieta Saudável , Feminino , Preferências Alimentares , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Los Angeles , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Atenção Plena , Fenômenos Fisiológicos da Nutrição , Autoeficácia , Adulto Jovem
2.
Mayo Clin Proc ; 95(7): 1390-1403, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32622447

RESUMO

OBJECTIVE: To evaluate the race-stratified trends for prevalence, awareness, treatment, and control of hypertension in young American adults aged 18 to 44 years. PATIENTS AND METHODS: The National Health and Nutrition Examination Survey data from 2005-2016 for adults aged 18 to 44 years was used to calculate age-adjusted (using 2005, 2010, and 2015 US Census population proportions) weighted trends in prevalence, awareness, treatment, and control of hypertension among non-Hispanic white, non-Hispanic black, and Mexican-American participants as per the 2017 American College of Cardiology/American Heart Association guidelines. Trends were estimated by logistic regression models including demographic, socioeconomic, health care access, and Bonferroni correction for multiple comparisons as covariates. RESULTS: Among 15,171 young American adults, stable trends for the prevalence, awareness, treatment, and control of hypertension was seen in all racial groups (Plinear trend>.05 for all). The prevalence from 2013 to 2016 was highest in non-Hispanic blacks (30.7%; 95% CI, 27.3 to 34.0%), followed by non-Hispanic whites (21.9%; 95% CI, 19.6 to 24.1%), and Mexican Americans (21.9%; 95% CI, 18.6 to 25.1%). The awareness was stable at ∼43.2% in non-Hispanic blacks, ∼34.8% in non-Hispanic whites, and ∼28.4% in Mexican Americans from 2005 to 2008 through 2013 to 2016. The stable treatment rates at nearly 34.4%, 23.7%, and 20.6%, were seen in non-Hispanic black, non-Hispanic white, and Mexican-Americans, respectively. The optimal control of hypertension was seen in 14.5% (95% CI, 12.1 to 17.0%) non-Hispanic blacks, 12.2% (95% CI, 10.3 to 14.0%) non-Hispanic whites, and 10.3% (95% CI, 7.1 to 13.5%) Mexican Americans from 2013 to 2016. CONCLUSION: Nearly one in every three non-Hispanic young black and one in every five young Mexican American and non-Hispanic white adults have hypertension. Our race-stratified analyses highlight the categorical need to improve the abysmal control of hypertension which is approximately 1 in 10 young adults.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/etnologia , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Inquéritos Nutricionais , Prevalência , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricos , Adulto Jovem
3.
J Immigr Minor Health ; 22(1): 110-119, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30810968

RESUMO

In Mexico, tattooed migrants face discrimination and are at high-risk of incarceration, thus, we assessed whether receiving laser tattoo removal affected the likelihood of incarceration. In 2015-2016, 89 adults ages ≥ 18 years with visible tattoos were recruited at a free-clinic to receive laser tattoo removal or assigned to the wait-list; all completed baseline and 6-month questionnaires. Overall, 97.8% of participants ever migrated to the USA. In multivariate analyses restricted to migrants (n = 87), those receiving laser tattoo removal [Adjusted Odds Ratio (AOR) 0.27, 95% CI 0.07-0.89] and possessing a Mexican Voting card (AOR 0.14; 95% CI 0.03-0.58) were significantly less likely than wait-list participants to be incarcerated at 6-months. Previously incarcerated participants were significantly more likely to be incarcerated at follow-up. Tattoo removal may reduce incarceration among Mexican migrants. Future studies can assess other health and social benefits of tattoo removal for migrants/deportees returning to Mexico.


Assuntos
Terapia com Luz de Baixa Intensidade/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Prisioneiros/estatística & dados numéricos , Tatuagem/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Adulto , Fatores Etários , Feminino , Humanos , Relações Interpessoais , Lasers de Estado Sólido , Masculino , México/etnologia , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos , Fatores de Tempo , Estados Unidos/epidemiologia , Listas de Espera
4.
J Fam Psychol ; 33(7): 868-875, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30907607

RESUMO

Sibling relationship qualities and traditional family values (i.e., familism) are contextual factors relevant for early substance use risk among Mexican-origin adolescents. Yet limited research has examined whether familism moderates the effects of sibling relationship features on alcohol use. The present study examined whether familism enhanced or reduced the effects of sibling intimacy, negativity, and sibling deviance on later alcohol use, also testing whether sibling sex constellation (sisters, brothers, mixed) modified the patterns of influence. We analyzed two waves of data (N = 404) from the California Families Project, a longitudinal study of Mexican-origin youth. Using zero-inflated Poisson models, we examined unique and intersecting prospective influences of age 14 sibling contexts and familism on the likelihood of and degree of engagement in alcohol use at age 16. Results indicated a complex interplay of sibling features, familism values, and alcohol use patterns. Familism moderated the effects of sibling intimacy on later alcohol use patterns. For those with lower familism, increasing intimacy was associated with higher probability of any use, but decreasing degree of use (especially for brother pairs and sister pairs). Among those with higher familism, increasing intimacy predicted reduced probability of any use, but increases in the degree of use (for sister and mixed pairs). More sibling negativity was related to reduced alcohol use probability for brothers, and increased alcohol use in mixed sibling pairs. Sibling deviance was associated with greater age 16 alcohol use. This study highlights cultural considerations for including siblings in substance use prevention programs for Mexican-origin youth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Família/psicologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Relações entre Irmãos , Valores Sociais , Consumo de Álcool por Menores/psicologia , Adolescente , California , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Consumo de Álcool por Menores/estatística & dados numéricos
5.
BMC Oral Health ; 18(1): 37, 2018 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-29530026

RESUMO

BACKGROUND: Mexican immigrants in the United States suffer from poor oral health. The objective of the current study was to explore the utility of applying theory-based factors associated with seeking preventive dental care in a sample of Mexican American adults. METHODS: Data were collected from a cross-sectional survey of a sample of 157 people of Mexican origin (64% female; age 34 ± 11 years) recruited primarily from church congregations and lay community organizations in Central Indiana. Using the Integrative Model of Behavioral Prediction as the guiding framework, structural equation modeling was used to test factors associated with intention to seek preventive dental care. RESULTS: Attitude towards seeking preventive dental care (estimate = 0.37; p < .0001) and self-efficacy for seeking preventive dental care (estimate = 0.68; p < .0001) were associated with intention to seek preventive dental care. The association between dental beliefs and intention to seek preventive dental care was mediated by attitude and self-efficacy (indirect effect = 0.26, p = .002), and the association between past behavior and intention to seek preventive dental care was mediated by self-efficacy (indirect effect = 0.26, p = .003). CONCLUSIONS: These findings suggest that interventions to increase preventive dental care seeking behavior among Mexican Americans should focus on changing attitudes toward seeking preventive dental care and on increasing self-efficacy to seek preventive dental care. Findings also support the use of interventions to influence dental beliefs.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Americanos Mexicanos/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Odontologia Preventiva/estatística & dados numéricos , Adulto , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Indiana , Masculino , Americanos Mexicanos/psicologia , Modems
6.
Health Promot Int ; 33(4): 676-685, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-28369279

RESUMO

Alcohol use is considered less acceptable for women than men in the Mexican culture. However, recent studies of Mexican-American (MA) women show that prevalence and rates of alcohol use are escalating, particularly in those with high acculturation to Western standards. Building on recent studies that demonstrated that drinking-related identities (self-schemas) are important predictors of alcohol use in college populations, this secondary data analysis investigated the association between acculturation, MA cultural values, and acculturative stress, drinking-related self-schemas and heavy drinking over time in college-enrolled MA women. Data were drawn from a 12-month longitudinal study of self-schemas and health-risk behaviors in 477 college-enrolled MA women. Drinking-related self-schemas, acculturation, MA cultural values and acculturative stress were measured at baseline, and heavy drinking was measured at baseline, 3, 6, 9 and 12 months. Thirty-six percent of women had a non-drinker self-schema but only 3% had a drinker self-schema. Higher spirituality was protective against heavy drinking, and this effect can be partially explained by presence of a non-drinker self-schema. Interventions that emphasize the personal relevance of being a non-drinker and support the importance of spirituality may help to prevent heavy drinking in MA college women.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Estudantes/psicologia , Aculturação , Consumo de Álcool na Faculdade/etnologia , Avaliação Momentânea Ecológica , Feminino , Humanos , Estudos Longitudinais , Assunção de Riscos , Autoimagem , Espiritualidade , Estados Unidos , Universidades , Adulto Jovem
7.
Pain Med ; 17(6): 1001-9, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26814239

RESUMO

OBJECTIVE: Little is known about the burgeoning Mexican American (MA) population's pain experience. METHODS: Using 1999-2004 National Health and Nutrition Examination Survey (NHANES) data, prevalence of chronic pain, analgesic medication use, and substance use were examined among MA, non-Hispanic White (NHW), and non-Hispanic Black (NHB) respondents. Logistic and linear regression models examined racial/ethnic differences in: 1) chronic pain prevalence among all respondents, 2) location and number of pain sites among respondents with chronic pain, and 3) analgesic medication and substance use among respondents with chronic pain. RESULTS: Compared to NHWs and NHBs, MAs were less likely to report any chronic pain. Among respondents with chronic pain, MAs had higher odds of reporting headache, abdominal pain, and a greater number of pain sites than NHWs. Compared to NHWs, MAs with chronic pain had lower odds of reporting past-month analgesic medication and COX-2 inhibitor use. MAs with chronic pain had lower odds of being a current cigarette smoker and heavy alcohol drinker but had similar street drug/cocaine use relative to NHWs. CONCLUSIONS: Results suggest that: 1) MAs are less likely to develop chronic pain than NHWs, 2) MAs with chronic pain report greater headache and abdominal pain than NHWs, and 3) MAs with chronic pain are less likely to use analgesic medications and other substances compared to NHWs. These results suggest that providers should consider taking extra time to discuss analgesic medications with MAs. Future investigations should examine reasons underlying these racial/ethnic differences in chronic pain, as well as differences in the use of other substances, such as marijuana.


Assuntos
Analgésicos/uso terapêutico , Dor Crônica/tratamento farmacológico , Dor Crônica/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Negro ou Afro-Americano , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , Inquéritos e Questionários , Estados Unidos , População Branca , Adulto Jovem
8.
J Immigr Minor Health ; 18(2): 420-7, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25801449

RESUMO

Childhood poisoning is a leading public health concern in our society. The death rate from unintentional poisonings among children has increased by 80% from 2000 to 2009. Immigrant children are also at-risk. A qualitative study, consisting of a pile sort, was conducted among immigrant Mexican mothers to determine their safety perceptions of commonly used medicines, herbs, and cleaners. Participants (N = 35) were selected for semi-structured interviews from a pediatric primary care clinic in the Dallas/Fort Worth Metroplex. Some mothers over-estimated their children's ability to discern the dangers of substances, relied heavily on sensory skills of children, and perceived a medicine as safe after successful use in the past. Other mothers were more cognizant of allergic reactions, ingestion, and the need to store substances carefully. Brief interventions that incorporate culturally-appropriate safety messages are needed to assist Mexican mothers in creating a safe home environment.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Produtos Domésticos/intoxicação , Americanos Mexicanos/psicologia , Relações Mãe-Filho/etnologia , Preparações Farmacêuticas , Fitoterapia/estatística & dados numéricos , Aculturação , Adulto , Atitude Frente a Saúde/etnologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pesquisa Qualitativa , Reprodutibilidade dos Testes , Segurança , Estados Unidos
9.
J Health Care Poor Underserved ; 25(4): 1941-55, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25418251

RESUMO

PURPOSE: This study examines the use of complementary and alternative medicine (CAM) by ethnicity/race among patients with type 2 diabetes. SUBJECTS AND METHODS: Four hundred and ten (410) patients with type 2 diabetes recruited from an academic-medical center completed a survey assessing CAM use, diabetes status, and sociodemographic characteristics. RESULTS: Several significant ethnic/racial differences were observed in CAM use (both in the types of providers seen as well as in the herbs and dietary supplements used). Although White patients reported using CAM in addition to their diabetes medication (mean [SD] 4.9 [0.4] on a scale from 1=never to 5=always) more frequently than Mexican American patients (3.1 [1.6], p<.05), Mexican American patients (1.4 [1.1]) used CAM instead of their diabetes medications more frequently than non-Hispanic White patients (1.0 [0.1], p<.05). More Mexican American (66.7%) and Vietnamese American patients (73.7%) than non-Hispanic Whites (11.8%, p=.002) described CAM practitioners as being closer to their cultural traditions than Western practitioners, whereas Vietnamese [End Page 1941] patients were more likely to describe use of herbs and supplements as closer to their cultural traditions (84.5% versus 15.3% for White and 30.9% for Mexican American patients, p <.001). CONCLUSIONS: Considering the variability and perceptions in CAM use, providers should discuss with their patients how their CAM use may influence diabetes management behaviors.


Assuntos
Asiático/estatística & dados numéricos , Terapias Complementares/estatística & dados numéricos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Americanos Mexicanos/estatística & dados numéricos , População Branca/estatística & dados numéricos , California , Diabetes Mellitus Tipo 2/etnologia , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Entrevistas como Assunto , Masculino , Adesão à Medicação/etnologia , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Vietnã/etnologia
10.
Ann Epidemiol ; 24(10): 781-4, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25172233

RESUMO

PURPOSE: To investigate the relationship between body mass index (BMI) and vitamin D adequacy among US adults. METHODS: We used data for US adults aged 18 years or older (n = 12,927) who participated in the 2001 to 2006 United States National Health and Nutrition Examination Survey. Log-binomial regression was used to estimate the strength of association between BMI categories and the prevalence of serum 25-hydroxyvitamin D [25(OH)D] greater than or equal to 20 ng/mL before and after controlling for selected characteristics. An interaction term between race or ethnicity and BMI categories was tested. RESULTS: Among US adults, 67.2% had serum 25(OH)D greater than or equal to 20 ng/mL, a cut point suggested by the Office of Dietary Supplements for adequate bone and general health. Overweight and obese adults were 8% (95% confidence interval, 0.89-0.95) and 26% (95% confidence interval, 0.71-0.78), respectively, less likely to have serum 25(OH)D greater than or equal to 20 ng/mL than their normal weight counterparts after controlling for age, gender, race/ethnicity, nativity and marital status, as well as education and income. No heterogeneity of the association between BMI categories and the prevalence of 25(OH)D greater than or equal to 20 ng/mL was observed by race or ethnicity. CONCLUSIONS: The low prevalence of 25(OH)D greater than equal to 20 ng/mL among overweight and obese adults in the US population underscores the need to comparatively assess vitamin D intakes across different BMIs.


Assuntos
Obesidade/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adolescente , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Índice de Massa Corporal , Comorbidade , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/etnologia , Análise de Regressão , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Vitamina D/sangue , Vitamina D/fisiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/etnologia , População Branca/estatística & dados numéricos , Adulto Jovem
11.
Cult Health Sex ; 16(7): 820-34, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24866206

RESUMO

Latino men in the Southeastern USA are disproportionately affected by HIV, but little is known about how the migration process influences HIV-related risk. In North Carolina, a relatively new immigrant destination, Latino men are predominantly young and from Mexico. We conducted 31 iterative life history interviews with 15 Mexican-born men living with HIV. We used holistic content narrative analysis methods to examine HIV vulnerability in the context of migration and to identify important turning points. Major themes included the prominence of traumatic early-life experiences, migration as an ongoing process rather than a finite event, and HIV diagnosis as a final turning point in migration trajectories. Findings provide a nuanced understanding of HIV vulnerability throughout the migration process and have implications including the need for bi-national HIV-prevention approaches, improved outreach around early testing and linkage to care, and attention to mental health.


Assuntos
Emigração e Imigração/estatística & dados numéricos , Infecções por HIV/etnologia , Americanos Mexicanos/estatística & dados numéricos , Adulto , Infecções por HIV/epidemiologia , Infecções por HIV/etiologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , North Carolina/epidemiologia , Fatores de Risco , Adulto Jovem
12.
J Assoc Nurses AIDS Care ; 24(5): 396-410, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23122906

RESUMO

This article draws from a study investigating the influence of institutional and psychosocial factors on adherence to antiretroviral (ARV) medications by Mexican-origin persons living with HIV (PWLH) on the U.S.-Mexico border and seeking treatment at a clinic in El Paso, Texas. Among 113 participants, many individuals reported using complementary and alternative medicines (CAM) to support general health and their immune systems and to address symptoms of HIV-related diseases and ARV side effects. CAM were seen as complementing ARV treatment; however, CAM use was often not reported to health care providers out of concern about disapproval and loss of care privileges. This finding challenges researchers and providers to consider seriously how Hispanic populations, with their CAM use, may exhibit the hybridization of health and healing. Information on CAM use needs to be available to providers to assess the benefits and contraindications of use and to develop realistic and effective care strategies.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Terapias Complementares/estatística & dados numéricos , Infecções por HIV/terapia , Americanos Mexicanos/estatística & dados numéricos , Adaptação Fisiológica , Adulto , Idoso , Instituições de Assistência Ambulatorial , Fármacos Anti-HIV/administração & dosagem , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Grupos Focais , Infecções por HIV/etnologia , Humanos , Entrevistas como Assunto , Masculino , México , Pessoa de Meia-Idade , Fitoterapia/estatística & dados numéricos , Pesquisa Qualitativa , Apoio Social , Fatores Socioeconômicos , Estresse Psicológico , Texas , Estados Unidos , Adulto Jovem
13.
Public Health Nutr ; 16(5): 912-21, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23113948

RESUMO

OBJECTIVE: Hispanics with lower acculturation may be at higher risk for neural tube defects compared with those with higher acculturation due to lower total folic acid intake or other undetermined factors. Modelling has indicated that fortification of corn masa flour with folic acid could selectively target Mexican Americans more than other race/ethnicities. We assessed whether fortification of corn masa flour with folic acid could selectively increase folic acid intake among Mexican-American women with lower acculturation, as indicated by specific factors (language preference, country of origin, time living in the USA). DESIGN: We used dietary intake and dietary supplement data from the National Health and Nutrition Examination Survey 2001-2008, to estimate the amount of additional total folic acid that could be consumed if products considered to contain corn masa flour were fortified at 140 µg of folic acid per 100 g of corn masa flour. SETTING: USA. SUBJECTS: Non-pregnant women aged 15-44 years (n 5369). RESULTS: Mexican-American women who reported speaking Spanish had a relative percentage change in usual daily total folic acid intake of 30·5 (95 % CI 27·8, 33·4) %, compared with 8·3 (95 % CI 7·3, 9·4) % for Mexican-American women who reported speaking English. We observed similar results for other acculturation factors. An increase of 6·0 percentage points in the number of Mexican-American women who would achieve the recommended intake of ≥400 µg folic acid/d occurred with fortification of corn masa flour; compared with increases of 1·1 percentage points for non-Hispanic whites and 1·3 percentage points for non-Hispanic blacks. An even greater percentage point increase was observed among Mexican-American women who reported speaking Spanish (8·2). CONCLUSIONS: Fortification of corn masa flour could selectively increase total folic acid intake among Mexican-American women, especially targeting Mexican-American women with lower acculturation, and result in a decrease in the number of pregnancies affected by neural tube defects.


Assuntos
Aculturação , Farinha/análise , Ácido Fólico/administração & dosagem , Alimentos Fortificados , Americanos Mexicanos/estatística & dados numéricos , Zea mays , Adolescente , Adulto , Suplementos Nutricionais , Feminino , Humanos , Defeitos do Tubo Neural/epidemiologia , Defeitos do Tubo Neural/prevenção & controle , Política Nutricional , Inquéritos Nutricionais , Necessidades Nutricionais , Prevalência , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
14.
Matern Child Health J ; 16(4): 844-9, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-21512779

RESUMO

Lowered maternal weight gain and reduction in early pregnancy have been associated with risk of neural tube defects (NTDs) in offspring. We examined the association of self-reported maternal dieting behaviors on the occurrence of NTDs. We conducted a population based case-control study among Mexican-American women who were residents of the 14 Texas counties bordering Mexico. Case women had an NTD-affected pregnancy identified at birth or prenatally and had deliveries during the years 1995-2000. Control women were those who delivered live born infants without an apparent congenital malformation, randomly selected and frequency-matched to cases by year and facility. One hundred eighty-four case women and 225 control women were asked in person about the use of nutritional supplements, dieting to lose weight, and type of weight reduction supplements used during the 3 months before conception. Women who reported being on a diet to lose weight during the 3 months before conception had an NTD odds ratio (OR) of 1.9 (95% confidence interval (CI) = 1.1, 3.3) compared with those not reporting being on a diet. Neither consuming vitamin drinks (OR = 1.2) nor using diet pills (OR = 1.6) during the 3 months before conception had ORs that were different from the null, when compared to women not reporting those behaviors. The risk effect for dieting did not differ markedly among normal or underweight (OR = 2.0, 95% CI = 0.7, 5.6), overweight (OR = 1.9, 95% CI = 0.7, 5.0), or obese women (OR = 1.5, 95% CI = 0.6, 4.0). No effect was seen among dieting women who were consuming at least 1.0 mg/day of folate (OR = 1.1, CI = 0.3, 4.5). Maternal dieting prior to conception may increase the risk of NTDs in offspring.


Assuntos
Dieta/efeitos adversos , Americanos Mexicanos/estatística & dados numéricos , Defeitos do Tubo Neural/etnologia , Defeitos do Tubo Neural/etiologia , Sobrepeso/prevenção & controle , Adulto , Estudos de Casos e Controles , Dieta/etnologia , Feminino , Humanos , Lactente , Entrevistas como Assunto , Vigilância da População , Gravidez , Complicações na Gravidez/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Texas/epidemiologia , Adulto Jovem
15.
J Health Psychol ; 17(3): 443-52, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21900335

RESUMO

This study examined communication and culture in clinicians' interactions with Mexican immigrants in Texas. Specifically, we explore the unique interplay among levels of acculturation, beliefs about culturally-based medical practices, perceptions of medical encounters, and the likelihood of adherence to medical therapy recommendations from US providers. Results suggest that: (a) acculturation predicts perceptions of out-group membership in the patient-provider interaction; (b) beliefs about complementary and alternative medicine are negatively related to medical adherence; (c) quality of care mediates the relationship between physician accommodation and medical adherence; and (d) there exists a complex relationship between out-group perceptions and adherence.


Assuntos
Emigrantes e Imigrantes/psicologia , Americanos Mexicanos/psicologia , Cooperação do Paciente/etnologia , Aculturação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Saúde , Comunicação , Cultura , Feminino , Humanos , Masculino , Adesão à Medicação/etnologia , Adesão à Medicação/psicologia , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Relações Médico-Paciente , Texas/epidemiologia , Adulto Jovem
16.
J Immigr Minor Health ; 14(4): 596-601, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21909985

RESUMO

An understanding of health beliefs is key to creating culturally appropriate health services for Hispanic populations in the US. In this study we explore age-based variations in causal beliefs for heart disease and diabetes among Mexican origin adults in Houston, TX. This cross-sectional study included 497 adults of Mexican origin. Participants were asked to indicate the importance of biomedically defined and folk illness-related risk factors as causes for heart disease and diabetes. Biomedical risk factors were ranked highest as causes of diabetes and heart disease among all participants. Folk illness-related factors were ranked below biomedical factors as causes of heart disease among all age groups. Susto was ranked above the median as a risk factor for diabetes among older participants. Age-related differences in causal beliefs may have implications for designing culturally appropriate health services, such as tailored diabetes interventions for older Mexican origin adults.


Assuntos
Aculturação , Diabetes Mellitus/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Cardiopatias/etnologia , Americanos Mexicanos/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos Transversais , Diabetes Mellitus/etiologia , Feminino , Folclore , Cardiopatias/etiologia , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Fatores de Risco , Texas , Adulto Jovem
17.
J Nutr Gerontol Geriatr ; 30(1): 29-49, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-23286640

RESUMO

Previous studies have shown that acculturation factors are associated with dietary patterns of older Mexican Americans (MAs), but the association of these factors with post-fortification folate intake is unknown. We estimated usual folate intakes for U.S. MAs aged ≥60 years (N = 712) by acculturation factors using data from the National Health and Nutrition Examination Survey 2001-2006. Mean total folic acid and total folate, but not natural folate intakes, were lower for MAs with lower acculturation factors, and 16% of MAs had total folate intakes less than the estimated average requirement (EAR) of 320 µg/day. Most older U.S. MAs did not meet requirements from natural food folate intake alone, regardless of acculturation status, but their intakes were adequate when fortified foods and supplement sources were taken into account. Logistic regression models including age, sex, education, poverty, and acculturation factors indicated that low income, not acculturation, was significantly associated with intake below the EAR. Thus our findings indicate that the association of low acculturation with folate intake below the EAR is not independent of poverty. [Supplementary materials are available for this article. Go to the publisher's online edition of the Journal of Nutrition in Gerontology and Geriatrics for the following free supplemental resource: a table of the distribution of usual folate intake among Mexican Americans aged ≥60 years by sex, age, education level, poverty income ratio, and acculturation factors, from the National Health and Nutrition Examination Survey 2001-2006.].


Assuntos
Aculturação , Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Alimentos Fortificados , Americanos Mexicanos/estatística & dados numéricos , Inquéritos Nutricionais , Idoso , Grão Comestível , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
18.
J Nutr Gerontol Geriatr ; 30(1): 50-71, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-23286641

RESUMO

Acculturation factors have been found to affect dietary intakes of folate among older Mexican Americans (MAs) (≥60 years). The association of acculturation with folate biomarkers is unknown. We determined whether acculturation factors were associated with folate biomarkers (e.g., serum folate, red blood cell [RBC] folate, and total homocysteine concentrations) and whether this association could be explained by dietary folate. Using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2006, we estimated that 42.8% and 40.1% of older MAs reported speaking Spanish all or most of the time or being born in Mexico, respectively (lower acculturation factors). Lower acculturation factors were not associated with total homocysteine concentrations but were, in general, associated with lower serum folate and RBC folate concentrations, but these associations were not always independent of factors such as sex, education, and poverty, and possibly were mediated by dietary and supplemental folate. Thus, the lower folate status observed among older MA with lower acculturation factors may be modifiable by changes in the intake of folic acid. [Supplementary materials are available for this article. Go to the publisher's online edition of the Journal of Nutrition in Gerontology and Geriatrics for the following free supplemental resource: a table of the predictors of serum folate or red blood cell folate concentrations among Mexican Americans 60 years of age or older using country of origin or language preference, respectively, as acculturation factors, from the National Health and Nutrition Examination Survey 2001-2006.].


Assuntos
Aculturação , Suplementos Nutricionais , Ácido Fólico/sangue , Alimentos Fortificados , Americanos Mexicanos/estatística & dados numéricos , Inquéritos Nutricionais , Idoso , Dieta , Eritrócitos , Feminino , Ácido Fólico/administração & dosagem , Humanos , Modelos Lineares , Masculino , México , Pessoa de Meia-Idade , Estado Nutricional , Fatores Socioeconômicos
19.
Am J Geriatr Pharmacother ; 8(2): 161-9, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20439065

RESUMO

BACKGROUND: Current studies indicate that older Mexican Americans take fewer calcium or calcium/vitamin D supplements than do older non-Hispanic whites. Factors associated with calcium supplement use are not completely understood in this ethnic group. OBJECTIVE: The purpose of this article was to determine the prevalence of calcium or calcium/vitamin D supplementation and factors associated with their use in older Mexican Americans. METHODS: A cross-sectional survey was conducted in a random sample of older Mexican Americans residing in the southwestern United States who had participated in the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Self-identified Mexican Americans >or=75 years of age were enrolled through household interviews in 2004-2005. Each subject was asked to bring all prescription and nonprescription medications that they had used regularly during the previous 2 weeks to allow the interviewer to record the product names. Dosages were not recorded. Subjects were assigned to 1 of 3 categories based on their use of calcium or calcium/vitamin D supplements during the previous 2 weeks: (1) calcium supplement only, (2) calcium/vitamin D supplement, or (3) vitamin D supplement only. The subjects' sociodemographic and cultural factors, self-reported health and functional status, cognitive status, number of comorbidities, and use of antiosteoporosis medications were recorded. RESULTS: A total of 2069 older Mexican Americans (1272 women, 797 men; mean age, 81.9 years) were enrolled. The overall prevalence of calcium supplement use was 10.6% (weighted). Calcium supplements were used more often by women (odds ratio [OR] = 1.76; 95% CI, 1.17-2.63), subjects with multiple comorbidities (OR = 1.29; 95% CI, 1.10-1.50), those who interviewed in English (OR = 1.59; 95% CI, 1.06-2.40), and those who used antiosteoporosis medications (OR = 3.57; 95% CI, 1.85-6.89). CONCLUSIONS: Use of calcium or calcium/vitamin D supplements was low (<60%) among this group of older Mexican Americans. Men are particularly at risk. More should be done to raise awareness regarding the benefits of calcium supplementation in this ethnic group.


Assuntos
Cálcio/uso terapêutico , Suplementos Nutricionais , Vitamina D/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Coleta de Dados , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Nível de Saúde , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Fatores Sexuais , Sudoeste dos Estados Unidos
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