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1.
Int J Qual Stud Health Well-being ; 19(1): 2348894, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38733143

ABSTRACT

PURPOSE: This study sought to understand family functioning surrounding weight in Mexican American women with obesity. METHODS: Semi-structured in-depth interviews were conducted with mothers and adult daughters (N = 116). RESULTS: Thematic analysis identified five themes. 1) The communication process drives perception of supportive messages. Messages perceived as non-supportive consist of directives as interventions, confirmation of faults, and critical compliments whereas supportive consist of compliments, encouragement, empathetic listening, and disclosure. 2) Acculturation differences interfere with intergenerational alliance. Differences involve dissonance in communication, behavioural expectations, and weight-related practices. 3) Maladaptive conflict responses contribute to relational strain. These responses include avoidance, withdrawal, and defensiveness. 4) Role transformations alter the generational hierarchical relationship. Daughters serve as role models, caregivers, or collaborators. 5) Low communal coping heightens psychological distress. It does so by challenging family roles, increasing social isolation, and compromising social support. CONCLUSION: Obesity interventions for Mexican American women may benefit from targeting relational skills to improve family functioning.


Subject(s)
Adaptation, Psychological , Mexican Americans , Mothers , Obesity , Social Support , Adult , Female , Humans , Middle Aged , Young Adult , Acculturation , Communication , Family Relations/psychology , Intergenerational Relations , Mexican Americans/psychology , Mothers/psychology , Obesity/psychology , Obesity/ethnology , Qualitative Research
2.
Prog Community Health Partnersh ; 18(1): 131-139, 2024.
Article in English | MEDLINE | ID: mdl-38661834

ABSTRACT

BACKGROUND: Behavioral models play a key role in identifying pathways to better health and provide a foundation for health promotion interventions. However, behavioral models based in epidemiological research may be limited in relevance and utility in practice. OBJECTIVES: We describe a participatory approach within a community-based participatory research partnership for integrating epidemiological and community perspectives into the application of the sociocultural resilience model (SRM). The SRM posits that cultural processes have a symbiotic relationship with health-promoting social processes, which contribute to the health advantages among Mexicanorigin and other Latinx populations. METHODS: Community action board members engaged with academic partners to interpret and apply the SRM to a community-clinical linkages intervention implemented in the context of three U.S.-Mexico border communities. In a two-day workshop, partners engaged in a series of iterative discussions to reach common definitions and measures for SRM constructs. RESULTS: Partners described daily cultural processes as the food they eat, how they communicate, and a collectivist approach to getting things done. For intervention activities, the partners opted for intergenerational storytelling, sharing of food, and artistic forms of expression. Partners included measures of cultural nuances such as border identity and the complexities that often arise from navigating bicultural norms. CONCLUSIONS: Collaborative approaches within community-based participatory research partnerships can facilitate the adaptation and measurement of conceptual health behavior models in community practice.


Subject(s)
Community-Based Participatory Research , Humans , Community-Based Participatory Research/methods , United States , Mexico/ethnology , Health Promotion/methods , Health Promotion/organization & administration , Resilience, Psychological , Mexican Americans/psychology , Hispanic or Latino/psychology , Female , Community-Institutional Relations
3.
Nurs Res ; 73(3): 203-215, 2024.
Article in English | MEDLINE | ID: mdl-38652692

ABSTRACT

BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.


Subject(s)
Disabled Persons , Mexican Americans , Osteoarthritis , Self-Management , Adult , Aged , Female , Humans , Male , Middle Aged , Disabled Persons/statistics & numerical data , Disabled Persons/rehabilitation , Mexican Americans/statistics & numerical data , Mexican Americans/psychology , Osteoarthritis/ethnology , Osteoarthritis/therapy , Pilot Projects , Qualitative Research , Self Care/statistics & numerical data , Self Care/methods , Self Care/psychology , Self-Management/methods , Texas
4.
J Clin Child Adolesc Psychol ; 53(1): 37-51, 2024.
Article in English | MEDLINE | ID: mdl-37036440

ABSTRACT

OBJECTIVES: In a sample of Mexican American adolescents (N = 398; 51% females; aged 13-17), we examined the associations between psychological distress, COVID-19 household economic stress, COVID-19 academic stress, and whether these associations varied by adolescents' gender and by parents/caregivers' essential worker status. METHOD: First, linear regression models assessed the main effects of household economic and academic stress on psychological distress. Second, the moderating effects of gender and parents/caregivers' essential worker status on the association between household economic and academic stress, and psychological distress were examined. Third, the three-way interaction effect of household economic stress, gender, and parents/caregivers' essential worker status on psychological distress as well as the three-way interaction effect of academic stress, gender, and parents/caregivers' essential worker status on psychological distress were calculated. RESULTS: Household economic and academic stress were associated with psychological distress. However, these associations did not vary based on adolescents' gender or parents/caregivers' essential worker status. The three-way interaction for household economic stress, parents/caregivers' essential worker status, and gender for psychological distress was significant. Specifically, the effects of household economic stress on psychological distress was worse for boys than girls whose parents/caregivers were essential workers. Furthermore, the three-way interaction among academic stress, parents/caregivers' essential worker status, and gender was significant. Particularly, the effects of academic stress when grades were worse on adolescents' psychological distress was worse for boys than girls whose parents/caregivers were essential workers. CONCLUSION: Parents/caregivers' essential worker status was salient among Mexican American adolescents' mental health outcomes during COVID-19, particularly for adolescent boys.


Subject(s)
COVID-19 , Mexican Americans , Stress, Psychological , Adolescent , Female , Humans , Male , Caregivers/economics , Caregivers/psychology , COVID-19/economics , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/psychology , Gender Identity , Mexican Americans/psychology , Parents/psychology , Stress, Psychological/economics , Stress, Psychological/ethnology , Stress, Psychological/psychology , Financial Stress/ethnology , Financial Stress/psychology , Employment/economics , Employment/psychology , Occupational Groups/psychology
5.
J Am Geriatr Soc ; 72(1): 226-235, 2024 01.
Article in English | MEDLINE | ID: mdl-37794825

ABSTRACT

BACKGROUND: Studies have investigated the association between pain and cognitive impairment among older adults, but the findings are mixed. We assessed the relationship of activity-limiting pain (pain interference) with incident cognitive impairment and the mediating effect of depressive symptoms among Mexican American adults aged ≥80. METHODS: Data were taken from the Hispanic Established Population for the Epidemiological Study of the Elderly (2010-2016). Pain interference, or pain that limited daily activities in the last 12 months, was categorized into none, untreated pain interference, and treated pain interference. Cognitive impairment was defined as scoring <21 on the Mini-Mental State Examination and difficulty with at least one instrumental activity of daily living. We used general estimation equations to assess this relationship between pain and incident cognitive impairment over the 6-year period (n = 313). RESULTS: Participants reporting both untreated and treated pain interference had higher odds of incident cognitive impairment than those reporting no pain or pain interference (untreated adjusted odds ratio [aOR]: 2.18; 95% confidence interval [CI]: 1.09-4.36; treated aOR: 1.99; 95% CI: 1.15-3.44). Depressive symptoms explained 15.0% of the total effect of untreated pain and 25.3% of treated pain. CONCLUSIONS: Among very old Mexican American adults, both treated and untreated pain interference was associated with incident cognitive impairment. This association was partially mediated by depressive symptoms, underscoring a need for depression screening in patients with chronic pain. Future work is needed to examine mechanistic/causal pathways between pain and subsequent cognitive impairment and the role of pharmacological and non-pharmacological treatments in these pathways.


Subject(s)
Cognitive Dysfunction , Mexican Americans , Aged , Humans , Mexican Americans/psychology , Cognitive Dysfunction/epidemiology , Pain
6.
J Couns Psychol ; 70(6): 645-656, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37917431

ABSTRACT

In this study, we used a psychosociocultural framework to examine whether cultural congruity was related to mental health indirectly via a sense of university belonging in a sample of 322 Mexican American undergraduates attending a Hispanic-serving institution (HSI). In line with literature on biculturalism and cultural values, we also examined whether Mexican American HSI students' adherence to the ethnic value of familismo and to White ethnoracial values jointly moderated this indirect association. Results of conditional process modeling indicated that greater cultural congruity was partially indirectly associated with greater university belonging, which, in turn, was associated with better mental health. This partial indirect effect was more pronounced among Mexican American students with higher levels of White ethnoracial values and weaker or nonsignificant among students with average or lower levels of these values, a moderation effect that persisted even at varying levels of familismo. Overall, our findings highlight the importance of examining the complex and interlocking associations among cultural congruity, university belonging, cultural values, and mental health for Mexican American students in an HSI context. Implications for theory, research, and practice are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Mental Health , Mexican Americans , Humans , Mexican Americans/psychology , Hispanic or Latino/psychology , Students/psychology , Universities
7.
J Aging Health ; 35(10): 819-825, 2023 12.
Article in English | MEDLINE | ID: mdl-37625170

ABSTRACT

Objectives: This manuscript is a descriptive exploratory study of the impact of the COVID-19 pandemic for caregivers of very old Mexican Americans. Methods: Using data from Wave 10 of the Hispanic Established Population for the Epidemiological Study of Elderly (2021), we examined the characteristics of caregivers of very old Mexican Americans by their perceived level of impact from the pandemic. We examined sociodemographic characteristics, COVID-19 testing and vaccination, stress and depression, and health of caregivers and care recipients. Results: Caregivers who reported the most impact were more likely to report financial and emotional stress. They reported more depressive symptoms and high levels of distress related to neuropsychological behavior symptoms of their care recipient. Discussion: High levels of depressive symptoms, financial stress, and neuropsychological behavior symptoms illustrate that the concerns of caregivers before the pandemic were heightened during the pandemic.


Subject(s)
COVID-19 , Caregivers , Humans , Aged , Caregivers/psychology , Mexican Americans/psychology , COVID-19 Testing , Pandemics
8.
Article in English | MEDLINE | ID: mdl-37297621

ABSTRACT

Using baseline data from three partnering federally qualified health centers, we examined factors associated with depressive symptoms among Mexican-origin adults at risk of chronic disease living in three counties in Southern Arizona (i.e., Pima, Yuma, and Santa Cruz). Multivariable linear regression models identified correlates of depressive symptoms for this population controlling for sociodemographic characteristics. Among 206 participants, 85.9% were female and 49% were between 45 and 64 years of age. The proportion of depressive symptoms was 26.8%. Low levels of physical pain and high levels of hope and social support were also reported. Physical pain was positively and significantly related to depressive symptoms (ß = 0.22; 95% CI = 0.13, 0.30). Conversely, hope was negatively and significantly associated with depressive symptoms (ß = -0.53; 95% CI = -0.78, -0.29). A better understanding of factors related to depressive symptoms among Mexican-origin adults is necessary to fulfill their mental health needs, as well as to achieve health equity and to eliminate health disparities in the US-Mexico border region.


Subject(s)
Depression , Mexican Americans , Pain , Adult , Female , Humans , Male , Arizona/epidemiology , Depression/epidemiology , Depression/ethnology , Mexican Americans/psychology , Mexican Americans/statistics & numerical data , Mexico/ethnology , Pain/epidemiology , Pain/ethnology , Pain/psychology
9.
J Lesbian Stud ; 27(3): 323-338, 2023.
Article in English | MEDLINE | ID: mdl-37287183

ABSTRACT

This essay introduces the embodied ceremonial practices of deep presence and sustained attentiveness as Chicana lesbian poetic devices that shape-shift Chicana lesbian subjectivities, socialities, and simultaneously the violence of colonial capitalist racial heteropatriarchies. My reading of the poem "If" in Carla Trujillo's rendering of Chicana lesbian desire in Chicana Lesbians: The Girls Our Mothers Warned Us About, delves into the shape-shifting and time-bending potentiation at the heart of Chicana lesbian poetics. Cherríe Moraga's "If" generously offers a map that stalls time with the magnificence of sustained attentiveness. The poet's observations entice the reader with a depth of presence that illuminate the subject, casting life-sustaining reimagined meanings onto otherwise commodified individuated bodies. Moraga's "If" refracts the meaning of loss, ghostly pasts, and unimaginable futures through embodiment, imbuing a vivid and deep presence capable of casting spells on futures yet to come. The poem posits total immersion in being-ecstasis, that blooms with the transformational potential of the ecstatic. This essay reads the poem "If" in the context of Moraga's oeuvre as ceremonial world-making incantation conjuring collective consciousness through Chicana lesbian po(i)esis.


Subject(s)
Homosexuality, Female , Love , Mexican Americans , Poetry as Topic , Female , Humans , Consciousness , Homosexuality, Female/psychology , Mexican Americans/psychology , Sexual and Gender Minorities
10.
J Lesbian Stud ; 27(3): 307-322, 2023.
Article in English | MEDLINE | ID: mdl-37280770

ABSTRACT

Introducing the 1991 publication of Chicana Lesbians: The Girls Our Mothers Warned Us About, editor and visionary Carla Trujillo identifies the seed planted by Juanita Ramos' 1987 anthology Compañeras: Latina Lesbians. Detailing her experiential arc from exuberant to unsettled, Trujillo explains: "Compañeras had only teased me. Not only did I want more, I needed more" (ix). Trujillo's editorial recognition of a lack-of presence, voice, power, visibility-as well as the need to foster spaces for the nurturing of more Chicana lesbian voices and work engage two key components of what I identify as "needing more," a critical engagement of Chicana lesbian desire as intervention and offering. Using analysis of queer, decolonial, and performance studies, I suggest that Chicana Lesbian desire as articulated in Trujillo's anthology can be seen as a critical unsettling that posits both a critique of existing norms and structures as well as an active envisioning of new modes of self and queer familia. Shifting from theory to literature, I offer an application of "needing more" to two original contributions from Chicana Lesbians by Monica Palacios and Diane Alcalá. My analysis illuminates the three key elements of "needing more"-a recognition of lack, a conscious and ongoing envisioning of "more," and an active renegotiation of familia within the context of queer desire and community. I close the essay with my letter testimonio in the spirit of Trujillo's "needing more" and the collection's enduring engagement with and impact on queer familia.


Subject(s)
Community Support , Homosexuality, Female , Mexican Americans , Personal Autonomy , Female , Humans , Hispanic or Latino/psychology , Homosexuality, Female/psychology , Mexican Americans/psychology , Sexual and Gender Minorities , Social Support/psychology , Community Support/psychology , Literature
11.
J Alzheimers Dis ; 92(4): 1323-1339, 2023.
Article in English | MEDLINE | ID: mdl-36872776

ABSTRACT

BACKGROUND: Accurately identifying cognitive changes in Mexican American (MA) adults using the Mini-Mental State Examination (MMSE) requires knowledge of population-based norms for the MMSE, a scale which has widespread use in research settings. OBJECTIVE: To describe the distribution of MMSE scores in a large cohort of MA adults, assess the impact of MMSE requirements on their clinical trial eligibility, and explore which factors are most strongly associated with their MMSE scores. METHODS: Visits between 2004-2021 in the Cameron County Hispanic Cohort were analyzed. Eligible participants were ≥18 years old and of Mexican descent. MMSE distributions before and after stratification by age and years of education (YOE) were assessed, as was the proportion of trial-aged (50-85- year-old) participants with MMSE <24, a minimum MMSE cutoff most frequently used in Alzheimer's disease (AD) clinical trials. As a secondary analysis, random forest models were constructed to estimate the relative association of the MMSE with potentially relevant variables. RESULTS: The mean age of the sample set (n = 3,404) was 44.4 (SD, 16.0) years old and 64.5% female. Median MMSE was 28 (IQR, 28-29). The percentage of trial-aged participants (n = 1,267) with MMSE <24 was 18.6% overall and 54.3% among the subset with 0-4 YOE (n = 230). The five variables most associated with the MMSE in the study sample were education, age, exercise, C-reactive protein, and anxiety. CONCLUSION: The minimum MMSE cutoffs in most phase III prodromal-to-mild AD trials would exclude a significant proportion of trial-aged participants in this MA cohort, including over half of those with 0-4 YOE.


Subject(s)
Alzheimer Disease , Mental Status and Dementia Tests , Mexican Americans , Aged , Aged, 80 and over , Female , Humans , Male , Alzheimer Disease/diagnosis , Alzheimer Disease/psychology , Educational Status , Mexican Americans/psychology , Texas , Reference Values , Adult , Middle Aged
12.
Transl Behav Med ; 13(7): 432-441, 2023 07 01.
Article in English | MEDLINE | ID: mdl-36999822

ABSTRACT

Racial and ethnic disparities in COVID-19 incidence are pronounced in underserved U.S./Mexico border communities. Working and living environments in these communities can lead to increased risk of COVID-19 infection and transmission, and this increased risk is exacerbated by lack of access to testing. As part of designing a community and culturally tailored COVID-19 testing program, we surveyed community members in the San Ysidro border region. The purpose of our study was to characterize knowledge, attitudes, and beliefs of prenatal patients, prenatal caregivers, and pediatric caregivers at a Federally Qualified Health Center (FHQC) in the San Ysidro region regarding perceived risk of COVID-19 infection and access to testing. A cross-sectional survey was used to collect information on experiences accessing COVID-19 testing and perceived risk of COVID-19 infection within San Ysidro between December 29, 2020 and April 2, 2021. A total of 179 surveys were analyzed. Most participants identified as female (85%) and as Mexican/Mexican American (75%). Over half (56%) were between the age of 25 and 34 years old. Perceived Risk: 37% reported moderate to high risk of COVID-19 infection, whereas 50% reported their risk low to none. Testing Experience: Approximately 68% reported previously being tested for COVID-19. Among those tested, 97% reported having very easy or easy access to testing. Reasons for not testing included limited appointment availability, cost, not feeling sick, and concern about risk of infection while at a testing facility. This study is an important first step to understand the COVID-19 risk perceptions and testing access among patients and community members living near the U.S./Mexico border in San Ysidro, California.


COVID-19 testing strategies that fail to incorporate culturally competent methods to reach traditionally underserved communities can lead to persistent transmission and increased infection rates. During the early stages of the COVID-19 pandemic, we surveyed 179 people living in a community with high burden of COVID-19 infection about their perception of infection risk and their experiences accessing testing. Capturing and understanding these community perceptions on COVID-19 risk are vital when developing a testing program that is accessible and appropriate for the target population. In our study, we found half of survey respondents thought their risk of COVID-19 infection as low to none and over half of respondents stated they had already been tested for COVID-19. These findings provide insight to the beliefs of individuals who live and seek health care in communities with high rates of COVID-19 infection and will help guide the design and implementation of culturally tailored testing strategies.


Subject(s)
COVID-19 Testing , COVID-19 , Health Knowledge, Attitudes, Practice , Health Services Accessibility , Adult , Child , Female , Humans , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/psychology , COVID-19 Testing/statistics & numerical data , Cross-Sectional Studies , Mexican Americans/psychology , Mexican Americans/statistics & numerical data , California/epidemiology , Risk , Health Knowledge, Attitudes, Practice/ethnology , Caregivers/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Pregnancy , Surveys and Questionnaires/statistics & numerical data
13.
Hisp Health Care Int ; 21(4): 184-194, 2023 12.
Article in English | MEDLINE | ID: mdl-36949611

ABSTRACT

Introduction: There is evidence that Mexican Americans are more likely to have cesarean birth than non-Hispanic White Americans. The purpose of this study was to identify factors related to acculturation along with psychological and sociodemographic factors associated with birth mode in a prospective cohort of Mexican American women in Texas. Methods: This secondary analysis included 244 Mexican American pregnant women. Women with a prior cesarean birth were excluded. Variable selection was guided by Berry's Theoretical Framework of Acculturation. Correlations and logistic regression were used to examine relationships and predict risk of cesarean birth. Mediators and moderators were also considered. Results: Eighty women birthed by cesarean. Analytic and parent samples were similar in all demographics. After controlling for parity in logistic regression, greater Spanish language-related acculturative stress (adjusted odds ratio [AOR], 1.06, 95% confidence interval [CI] [1.01, 1.11], p = .028) and experience of discrimination (AOR, 1.18, 95% CI [1.00, 1.38], p = .044) increased the odds of cesarean birth. The relationship between acculturative stress and birth mode was moderated by birth facility. Conclusion: Acculturative stress and discrimination may play a role in birth mode for Mexican American women birthing in Texas. Birth facility and acculturative stress may be interacting in ways that have clinical significance but are yet unexplored.


Subject(s)
Acculturation , Cesarean Section , Mexican Americans , Female , Humans , Pregnancy , Mexican Americans/psychology , Prospective Studies , Stress, Psychological , Texas
14.
J Immigr Minor Health ; 25(5): 1033-1042, 2023 Oct.
Article in English | MEDLINE | ID: mdl-36800140

ABSTRACT

Existing research on racial/ethnic differences in stress and coping is limited by small samples, single-item measures, and lack of inclusion of Mexican Americans. We address these gaps by analyzing data from the Texas City Stress and Health Study, a cross-sectional sample of Black (N = 257), White (N = 304), US-born (N = 689), and foreign-born (N = 749) Mexican Americans residing in proximity to a petrochemical complex. We compared active and avoidant coping by race/ethnicity and explored multivariable associations between coping and perceived stress. Black and foreign-born Mexican American respondents had the highest stressor exposure yet displayed different patterns of coping and perceived stress patterns. Active coping may be particularly effective for African Americans but may not offset extreme stress disparities. For Mexican Americans, the lack of association between coping and stress underscores the need for more work focused on the culturally diverse coping experiences.


Subject(s)
Adaptation, Psychological , Ethnicity , Neighborhood Characteristics , Racial Groups , Social Determinants of Health , Stress, Psychological , Humans , Black or African American/psychology , Cross-Sectional Studies , Ethnicity/psychology , Mexican Americans/psychology , United States , Stress, Psychological/ethnology , Stress, Psychological/psychology , Environment , Social Determinants of Health/ethnology , White/psychology , Emigrants and Immigrants/psychology , Cross-Cultural Comparison , Texas , Racial Groups/psychology
15.
Child Dev ; 94(3): 752-767, 2023 05.
Article in English | MEDLINE | ID: mdl-36805956

ABSTRACT

This paper used cross-lagged panel models to test the longitudinal interplay between maternal cultural socialization, peer ethnic-racial discrimination, and ethnic-racial pride across 5th to 11th grade among Mexican American youth (N = 674, Mage  = 10.86; 72% born in the United States; 50% girls; Wave 1 collected 2006-2008). Maternal cultural socialization predicted increases in subsequent youth ethnic-racial pride, and youth ethnic-racial pride prompted greater maternal cultural socialization. However, peer ethnic-racial discrimination was associated with subsequent decreases in ethnic-racial pride. The magnitude of these associations was consistent across 5th to 11th grades suggesting that maternal cultural socialization messages are necessary to maintain ethnic-racial pride across adolescence, thus families must continually support the development of ethnic-racial pride in their youth to counter the effects of discrimination.


Subject(s)
Mexican Americans , Mothers , Racism , Self Concept , Social Identification , Socialization , Adolescent , Child , Female , Humans , Male , Mexican Americans/psychology , Mothers/psychology , Racism/ethnology , Racism/psychology , United States , Peer Group , Culture
16.
J Alzheimers Dis ; 91(3): 1185-1195, 2023.
Article in English | MEDLINE | ID: mdl-36565125

ABSTRACT

BACKGROUND: Evidence from predominately non-Hispanic White populations indicates that emergency room (ER) admissions and hospitalizations by older adults with and without dementia are associated with caregiver stress and depressive symptoms. These results may not generalize to Hispanic populations because of cultural differences in caregiving roles, responsibilities, and perspectives about care burden. OBJECTIVE: Investigate the association between ER admissions and hospitalizations by Mexican American older adults with and without dementia and symptoms of depression and stress among family caregivers. METHODS: Data came from the 2010/11 wave of the Hispanic Established Populations for the Epidemiologic Study of the Elderly and Medicare claims files. The final sample included 326 older adults and their caregivers. Negative binomial regression was used to model the association between hospitalizations and ER admissions by older adults in the previous two years and caregivers' depressive symptoms and stress in 2010/11. RESULTS: The number of older adult ER admissions and hospitalizations was not associated with caregiver depressive symptoms. Two or more ER admissions (incident rate ratio [IRR] = 1.26, 95% CI = 1.05-1.51) and two or more hospitalizations (IRR = 1.32, 95% CI = 1.07-1.61) were associated with significantly higher caregiver stress. Additionally, ER admissions and hospitalizations for a circulatory disease or injury and poisoning were associated with significantly higher caregiver stress. These associations were not modified by the care recipient's dementia status. CONCLUSION: Hospitalizations and ER admissions by older Mexican Americans were associated with greater caregiver stress but not depressive symptoms. These associations were similar for caregivers to older adults with and without dementia.


Subject(s)
Dementia , Mexican Americans , Humans , Aged , United States , Mexican Americans/psychology , Caregivers/psychology , Mental Health , Medicare , Hospitalization , Dementia/epidemiology , Emergency Service, Hospital , Depression/epidemiology
17.
Arch Gerontol Geriatr ; 107: 104903, 2023 04.
Article in English | MEDLINE | ID: mdl-36584560

ABSTRACT

PURPOSE: To examine nativity differences in the relationship between handgrip strength (HGS) and cognitive impairment among Mexican Americans aged ≥ 65 years with normal or high cognitive function at baseline over a 20-year period. METHODS: Prospective cohort study of 2,155 non-institutionalized Mexican Americans aged ≥ 65 years from the Hispanic Established Population for the Epidemiological Study of the Elderly) who scored ≥ 21 in the Mini Mental State Examination (MMSE) at baseline. Measures included socio-demographics, body mass index, medical conditions, depressive symptoms, physical function, disability, HGS quartiles (sex-adjusted), and MMSE. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of cognitive impairment (MMSE < 21) as a function of HGS quartile by nativity and adjusted for covariates. RESULTS: US-born and foreign-born participants in the 4th quartile (highest) of HGS at baseline had lower odds of cognitive impairment over time compared with those in the 1st (lowest) HGS quartile (OR=0.95, 95% CI=0.90-0.99 and OR=0.93, 95% CI=0.89-0.98, respectively), after controlling for all covariates. When we analyzed HGS quartiles as time-varying, we found that US-born participants in the 3rd and 4th HGS quartile had 25% and 30% lower odds of cognitive impairment, respectively, while foreign-born participants in the 3rd and 4th HGS quartile had 27% and 49% lower odds of cognitive impairment over time, respectively, after controlling for all covariates. CONCLUSION: Foreign-born older Mexican Americans who performed high in HGS experienced 7% lower odds of cognitive impairment over time compared with US-born older Mexican Americans.


Subject(s)
Cognitive Dysfunction , Mexican Americans , Aged , Humans , Mexican Americans/psychology , Follow-Up Studies , Prospective Studies , Hand Strength
18.
Aging Ment Health ; 27(5): 896-903, 2023 05.
Article in English | MEDLINE | ID: mdl-35266850

ABSTRACT

OBJECTIVES: Caregivers play a key role in supporting older Mexican Americans, who are less likely to enter nursing facilities than other racial/ethnic groups in the US. However, there is little research on how Neuropsychiatric symptoms (NPS) affect relationship quality between caregivers and care recipients. METHOD: Using data from the 2015 wave of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (n = 416) study of older (age 85+) Mexican Americans, we examined relationship quality and NPS with ordered logistic regression. Relationship quality was measured using positive (enjoyment, appreciation) and negative (nerves, argue) assessments. NPS were categorized into hyperactivity, affective, and psychosis symptoms. RESULTS: Hyperactivity symptoms were associated with appreciation, arguing, and nerves. Psychosis symptoms were associated with arguing and nerves. Spousal caregivers were more likely to report arguing and nerves and less likely to report feeling appreciated. Enjoyment assessments were not associated with NPS. CONCLUSION: Relationship quality is related to behavioral changes in late life. Mexican American caregivers negatively evaluate their relationships, not in response to care tasks per se, but when the older person exhibits behavioral problems. The relationship between NPS and negative relationship assessments may be due to unanticipated behavior changes in late life and stigma around psychiatric symptomatology.


Subject(s)
Mental Disorders , Mexican Americans , Humans , Aged , Aged, 80 and over , Mexican Americans/psychology , Caregivers/psychology , Mental Disorders/epidemiology , Hispanic or Latino , Logistic Models
19.
Cultur Divers Ethnic Minor Psychol ; 29(2): 145-151, 2023 Apr.
Article in English | MEDLINE | ID: mdl-35446064

ABSTRACT

OBJECTIVES: Coronavirus disease (COVID-19) has had a disproportionately negative impact on communities of color across the U.S., including Mexican Americans. The present study examined the influence of the pandemic on family relationships among individuals living in the U.S.-Mexico border region and how changes in family relationships were related to both familism values and mental health. METHOD: Two hundred ninety-one college Latino students participated in a survey that asked about changes in family relationships and mental health since the beginning of the pandemic. RESULTS: Contrary to our initial hypothesis, the majority of respondents indicated their family relationships had not changed since the beginning of the pandemic. However, those who reported negative changes in their family relationships also reported worse mental health whereas those who reported positive changes reported higher familism values. Mediational models revealed an indirect effect of familism support values on depression via changes in family relationships. CONCLUSIONS: Although cross-sectional, these results provide preliminary evidence of the impact of the COVID-19 pandemic on the mental health of Mexican Americans in the border region, as well as cultural factors that promote resilience in times of stress. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
COVID-19 , Mexican Americans , Humans , Cross-Sectional Studies , Family Relations/psychology , Mexican Americans/psychology , Mexico , Pandemics , United States
20.
J Alzheimers Dis ; 90(2): 905-915, 2022.
Article in English | MEDLINE | ID: mdl-36189588

ABSTRACT

BACKGROUND: Despite tremendous advancements in the field, our understanding of mild cognitive impairment (MCI) and Alzheimer's disease (AD) among Mexican Americans remains limited. OBJECTIVE: The aim of this study was to characterize MCI and dementia among Mexican Americans and non-Hispanic whites. METHODS: Baseline data were analyzed from n = 1,705 (n = 890 Mexican American; n = 815 non-Hispanic white) participants enrolled in the Health and Aging Brain Study-Health Disparities (HABS-HD). RESULTS: Among Mexican Americans, age (OR = 1.07), depression (OR = 1.09), and MRI-based neurodegeneration (OR = 0.01) were associated with dementia, but none of these factors were associated with MCI. Among non-Hispanic whites, male gender (OR = 0.33), neighborhood deprivation (OR = 1.34), depression (OR = 1.09), and MRI-based neurodegeneration (OR = 0.03) were associated with MCI, while depression (OR = 1.09) and APOEɛ4 genotype (OR = 4.38) were associated with dementia. CONCLUSION: Findings from this study revealed that the demographic, clinical, sociocultural and biomarker characteristics of MCI and dementia are different among Mexican Americans as compared to non-Hispanic whites.


Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Male , Humans , Mexican Americans/psychology , Independent Living , White People , Risk Factors , Cognitive Dysfunction/diagnostic imaging , Cognitive Dysfunction/genetics
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