Who has low health literacy and does it matter for depression? Findings from aggregated and disaggregated racial/ethnic groups.

OBJECTIVES: Health literacy is an important factor related to health outcomes and, ultimately, health disparities. Of the research that has been done, results have been mixed, which may be a reflection of how previous research primarily explored these relationships within aggregated groups. Thus, the present study sought to fill this gap in literature by exploring the relationships between determinants, health literacy, and depression within both aggregated and disaggregated groups. METHOD: Data from the 2007 California Health Interview Survey (CHIS) was used, which included information collected from 51,048 adult participants. A model of the determinants of health, health literacy, and depression was constructed based on Andersen's Model of Health Utilization and fit within both an aggregated ethnic/racial and immigration status group, as well as within disaggregated groups. RESULTS: Results indicated that when comparing ethnic/racial groups, Latinx and AAPI groups had the lowest levels of health literacy. When comparing nativity groups, immigrants had lower health literacy levels than U.S.-born. Finally when looking at disaggregated groups, Latinx and AAPI immigrants had the lowest health literacy levels among all groups. Furthermore, health literacy determinants as well as the relationship between health literacy and depression differed depending on group demographics. CONCLUSIONS: This suggests that aggregated data analyses may obscure nuanced within-group differences, highlighting the importance of exploring health literacy within disaggregated groups. The results can be used to help inform the development of intervention or prevention-based programs that seek to improve health literacy and depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Health Literacy and Associated Factors Among Hmong American Immigrants: Addressing the Health Disparities.

Hmong Americans face a disproportionate health burden ranging from the high prevalence of diabetes to depressive disorders. Little research attention has been paid toward exploring contributing factors to this disparity. As such, the present study seeks to fill the gap in the literature by examining the health literacy levels in Hmong Americans and its associated factors. The present study employed Andersen's behavioral model of health service as the theoretical framework. A cross-sectional survey research design was used and information was gathered from 168 Hmong American immigrants. Participants were recruited using a purposive sampling strategy. A multiple regression analysis was conducted to identify the factors linked to health literacy. Approximately half of the participants had low health literacy and reported that they did not understand health information well. Health literacy levels were found to differ significantly based on the number of years participants have lived in the U.S., their social or religious group attendance, health status, and whether they had difficulties with activities of daily living. Our exploratory findings could be used prompt more research to help inform the development of interventions aiming to improve health literacy levels and address the health disparities in Hmong American Population.

A measure of perceived family stigma: Validity in a military sample.

The primary aim of the present study was to evaluate the reliability and validity of the newly developed Perceived Family Stigma Scale (PFSS) in a diverse sample of 623 military veterans. The PFSS is a 4-item scale that has acceptable internal consistency (α = .86) and strong interitem correlations (r = .51 to .76). Confirmatory factor analysis (CFA) indicated the single factor model was a good fit statistically (χ2[df = 2, N = 620] = .34, p = .84) and descriptively (CFI = 1.00, RMSEA < .001). Multigroup CFA was performed to test the measurement invariance of the PFSS across demographic indicators. The PFSS achieved full scalar invariance across deployment history, education level, urban/rural location, marital status, and military rank, and partial scalar invariance across gender, ethnicity/race, and income level. Results of a logistic regression analysis indicated significant relationships of mean PFSS scores and gender with likelihood of needing help for an emotional problem, above and beyond a measure of self- and public stigma. Specifically, each point increase in mean PFSS scores predicted an almost 4 times higher probability of reporting a need for help, and men were also 6 times more likely than women to report a need for help. However, there was a significant relationship between the PFSS and gender such that, for women, each 1 point increase in mean PFSS scores predicted a likelihood of reporting a need/desire for help for an emotional problem 3 times that of men. (PsycINFO Database Record

Testing the Invariance of the National Health and Nutrition Examination Survey's Sexual Behavior Questionnaire Across Gender, Ethnicity/Race, and Generation.

Federal and state policies are based on data from surveys that examine sexual-related cognitions and behaviors through self-reports of attitudes and actions. No study has yet examined their factorial invariance--specifically, whether the relationship between items assessing sexual behavior and their underlying construct differ depending on gender, ethnicity/race, or age. This study examined the factor structure of four items from the sexual behavior questionnaire part of the National Health and Nutrition Examination Survey (NHANES). As NHANES provided different versions of the survey per gender, invariance was tested across gender to determine whether subsequent tests across ethnicity/race and generation could be done across gender. Items were not invariant across gender groups so data files for women and men were not collapsed. Across ethnicity/race for both genders, and across generation for women, items were configurally invariant, and exhibited metric invariance across Latino/Latina and Black participants for both genders. Across generation for men, the configural invariance model could not be identified so the baseline models were examined. The four item one factor model fit well for the Millennial and GenerationX groups but was a poor fit for the baby boomer and silent generation groups, suggesting that gender moderated the invariance across generation. Thus, comparisons between ethnic/racial and generational groups should not be made between the genders or even within gender. Findings highlight the need for programs and interventions that promote a more inclusive definition of "having had sex."