Reconsidering acculturation in dietary change research among Latino immigrants: challenging the preconditions of US migration

Background. Dietary changes among Latino immigrants are often attributed to acculturation. Acculturation-diet research typically assumes that migration to the US is necessary for negative dietary changes to occur in Latino immigrants' diets.

Objective. The goal of this article is to demonstrate that extant acculturation research is not adequate in capturing changes in Latino immigrants' diets. This is due to the role of globalization and transnational processes in modernizing their diets in Latin America.

Design. Utilizing an interactionist cultural studies approach, this exploratory situational analysis based on 27 in-depth interviews with Latino immigrants, nutrition reports, and transnational food companies' websites, examines how Latino immigrants were already engaging in negative dietary practices in their former country.

Results. Latino immigrants who resided in urban areas in their former countries and migrated to the US on or after 2000 were fully engaged in negative dietary practices prior to migration. Such practices included consuming food outside of the home and integrating processed food into their cooking. Their dietary practices were also informed by nutrition discourses. The modernization of food production and consumption and the transnational transmission of nutrition are transnational processes changing Latino immigrants' diets prior to migration.

Conclusion. Researchers should approach the study of dietary change among Latino immigrants in the US through a transnational perspective in order to avoid overlooking potential confounders such as current food insecurity, new socioeconomic positions as undocumented, low-income persons, and increased hours worked outside of the home.     

Measuring acculturation among male Arab immigrants in the United States: an exploratory study

Given the absence of empirical measures that assess acculturation patterns among male Arab immigrants, a new acculturation instrument was developed and evaluated. One hundred and fifteen adult male Arab immigrants were administered the Male Arab Acculturation Scale (MAAS), and psychometrically established measures of ethnic identity and self-esteem. Satisfactory reliability is reported for the two acculturation scales, separation/assimilation and integration/marginalization. Ethnic identity, self-construal, personal self-esteem, and collective self-esteem appear to be differentially associated with acculturation patterns among male Arab immigrants.     

Immigrant status and acculturation influence substance use among New Zealand youth

Objective: To investigate the associations between generational status, acculturation and substance use among immigrant and non‐immigrant secondary school students in New Zealand. Methods: A nationally representative sample of secondary school students in New Zealand was selected using a two‐stage cluster sample design. Of the 8,999 students in the sample, 23.81% were first‐generation immigrants and 20.90% were second‐generation immigrants; the remaining 55.29% students are collectively referred to as ‘non‐immigrant’ peers. Logistic regression models adjusted the associations of interest for age, gender, ethnicity, socioeconomic status and experience of ethnic discrimination. Results: First and second‐generation immigrants showed significantly lower risks of smoking cigarettes compared with their non‐immigrant peers. Similar trends were apparent for consuming alcohol and marijuana weekly. The inclusion of some characteristics suggestive of acculturation in multivariable models did not influence the relationship between generational status and smoking cigarettes, but attenuated the apparent protective effect of being a first‐generation immigrant with regard to alcohol and marijuana use. Conclusions and implications: The study shows the lower likelihood of substance use among newer immigrants in a nationally representative sample of New Zealand youth. Policies and health programs that build on this positive profile and reduce the risk of adverse changes over time require attention.     

Changes in expectation of relationship permanence,pregnancy acceptability and desire,and contraceptive use over time among young Latino/a women and men: An exploratory analysis

ObjectiveWe longitudinally assess associations between changes in expectation of relationship permanence—a measure that incorporates both relationship duration and commitment—pregnancy desire and acceptability, and highly effective contraception use among young U.S. Latino/as.Study designWe used multivariable logistic regression to analyze associations between changes in relationship factors, pregnancy acceptability and desire, and contraceptive method use over 6 months among 299 U.S. Latino/a women and men (ages 18–34) in relationships in a longitudinal study (retention rate: 32.4%).ResultsRespondents who found a pregnancy less acceptable at endline than at baseline were more likely to use highly effective contraception at endline (OR 2.97, 95% CI 1.09, 8.08). Respondents estimating an increase in relationship permanence more than one standard deviation of the mean were 4.90 (95% CI 1.17, 20.55) times more likely to use highly effective contraception at endline, compared to those without a change in estimation of relationship permanence.ConclusionIn this longitudinal study of young adult Latino/as in relationships, we found associations between changes in respondents’ perceptions of the acceptability of a pregnancy and expectation of the permanence of their relationship and highly effective contraceptive use. Our findings reiterate the complicated, intertwined links between relationship dynamics, pregnancy orientation, contraception, and time.ImplicationsThe significance of decreased pregnancy acceptability (but not desire) for using highly effective contraception suggests the importance of acknowledging pregnancy acceptability in contraceptive counseling, particularly because providers are more likely to direct Latino/a young adults towards methods that may not fulfill their contraceptive desires. Including discussion of young people’s expectations of relationship permanence may also be meaningful in counseling.     

Development of a new scale for measuring acculturation: the East Asian Acculturation Measure (EAAM)

Given the paucity of appropriate measures to assess the acculturation patterns of East Asian immigrants in the United States, a new acculturation instrument was developed and evaluated. One-hundred and fifty nonclinical East Asian immigrants (75 males and 75 females) were administered the East Asian Acculturation Measure (EAAM) and provided demographic information concerning length of stay in the United States and gender. Satisfactory reliability is reported for the four acculturation scales: assimilation, separation, integration, and marginalization. Length of stay was not associated with separation but was significantly positively associated with assimilation and integration and significantly negatively associated with marginalization. Gender was not associated with any of the acculturation scales. The findings suggest that the EAAM may be a useful tool for researchers and clinicians to investigate the acculturation patterns of East Asian immigrants.     

Perceived discrimination as a risk factor for depressive symptoms and substance use among Hispanic adolescents in Los Angeles

Objectives: Discrimination has been associated with adverse psychological and physical health outcomes, but few studies have examined the effects of discrimination on Hispanic adolescents. This study assessed the relation of perceived discrimination with depressive symptoms and drug use. Covariates included immigrant generation status (GS). A second objective was to examine the potentially moderating effect of neighborhoods' ethnic composition as suggested by Mair et al.

Design: Secondary data analyses of a longitudinal survey examined self-reports of Hispanic adolescents in 9th grade (the first year of high school) and 11th grade at seven high schools in Los Angeles.

Results: (1) Perceiving discrimination in 9th grade significantly predicted depressive symptoms (β=0.23, p<0.01) and drug use (β=0.12, p<0.01) in 11th grade, even after controlling for socioeconomic status, gender, acculturation, and GS in the USA. The third GS group reported significantly higher perceptions of discrimination compared to newer immigrants. (2) Neighborhoods' ethnic composition was included as a moderator of the association between perceived discrimination and the outcomes, but did not moderate the relation.

Conclusion: Teaching Hispanic adolescents effective strategies for coping with discrimination, such as increasing their sense of belongingness in the American mainstream, may prove useful in preventing drug use and depressive symptoms.     

Mothers' acculturation and eating behaviors of Korean American families in California

OBJECTIVE: To compare eating behaviors of Korean American (KA) families with mothers of different acculturation stages with those of families in Korea. DESIGN: Survey research using a self-report questionnaire. Settings: Field survey on convenience sample in California and in Seoul, Korea. PARTICIPANTS: 225 KA and 216 Korean mothers. Main Outcome Measures: Frequency of eating at home, preparation of Korean foods, favorite dishes of families, and for special occasions. ANALYSIS: Chi-square, t test, and analysis of variance. RESULTS: Families of the more acculturated mothers dined out more frequently and had lower preferences for Korean foods than did the families with less acculturated mothers. The more acculturated mothers prepared Korean foods, including kimchi, less at home. Fewer Korean dishes were included among the 5 favored dishes, both for family and for special occasions, in KA families than in Korean families. The acculturation stage of the mothers affected preference for Korean dishes of the families but not for special occasions. CONCLUSIONS AND IMPLICATIONS: Mothers' acculturation stage influenced the family's eating habits. Changes of preference of typical Korean dishes varied by acculturation stage. Nutrition educators should be aware that dietary behaviors of KA families may differ by acculturation stage and tailor interventions appropriately.     

Feasibility and acceptability of a Mediterranean-style diet intervention to reduce cardiovascular risk for low income Hispanic American women

Objective: Evidence for the cardioprotective effects of a Mediterranean-style (Med-style) diet is strong, however few Med-style dietary interventions have been developed for and tested among Hispanic Americans (HAs), especially younger HAs of reproductive age whose dietary habits may strongly influence dietary intake for all family members.

Design: We adapted a previously tested and evidence-informed lifestyle intervention to reduce CVD risk and evaluated its feasibility, acceptability, and effects on self-reported lifestyle behaviors in this study enrolling low-income HA women attending a Title X family planning clinic in eastern North Carolina. The 3-month long intervention, given to all participants, promoted a Med-style dietary pattern with a focus on increasing consumption of foods commonly consumed by HA that have high quality dietary fats (polyunsaturated and monounsaturated fats primarily from plant sources and fish) and carbohydrates (fruits, vegetables, and whole grains). The intervention also recommended increasing physical activity and was given during 2 face-to-face counseling sessions and 2 telephone counseling sessions. Major outcomes were engagement with study activities and intervention acceptability; lifestyle behavior change at 3-month follow-up is also reported.

Results: Baseline characteristics (n?=?36) were: mean age 33 years, 35 (97%) without health insurance, 32 (89%) born in Mexico, and mean BMI 30?kg/m². Engagement was high among the 36 participants with 33 (92%) completing the intervention and follow-up measures. At follow-up, most participants thought the intervention was helpful (range: 85–100%) and acceptable (100% agreed ‘I would recommend the program to others’). The mean dietary fat quality score improved by 0.5 units (95% CI: 0.0–1.1) and the mean fruit-vegetable servings/day improved by 0.7/day (95% CI: 0.1–1.3).

Conclusion: Intervention engagement and acceptability were high and there was improvement in self-reported dietary behaviors. This type of Med-style dietary pattern intervention should be evaluated in randomized trials enrolling HAs at risk for CVD.     

Ethnic differences in types of social support from multiple sources after breast cancer surgery

Objectives. Diagnosis of and treatment for breast cancer (BCa) may require psychological adaptation and often involve heightened distress. Several types of social support positively relate to psychological adaptation to BCa, and negative support is associated with poorer adaptation. Although Hispanic women report greater distress than non-Hispanic White (NHW) women after diagnosis of BCa, no studies have examined ethnic differences in types of social support received from varying sources after surgery for BCa.

Design. Hispanic (N?=?61) and NHW (N?=?150) women diagnosed with early-stage BCa self-reported emotional, informational, instrumental, and negative support from five sources. Ethnic differences in levels of social support were compared using multiple regression analysis.

Results. When controlling for age, income, days since surgery, and stage of disease in multivariable models there were no ethnic differences in levels of emotional support from any source. Hispanic women reported greater informational support from adult women family members and children and male adult family members than did NHW women. Instrumental support from adult women family members was also greater among Hispanic than NHW women. Hispanic women reported higher negative support from husbands/partners and from children and male adult family members. When the number of years in the USA was controlled, Hispanic women showed greater informational support from adult women family members, children and male adult family members, and friends. Instrumental support from adult women family members remained greater in Hispanic women, but negative support no longer differed.

Conclusion. Family is a greater source of informational and instrumental support for Hispanic than NHW women. Hispanic women reported higher negative support from male sources than did NHW women. Level of support from different sources may also depend on time spent in the USA. Longitudinal studies are needed to determine whether patterns and sources of social support shift over the course of BCa treatment.     

Alcohol use among recent immigrant Latino/a youth: acculturation,gender, and the Theory of Reasoned Action

Objective. Latino/a youth are at risk for alcohol use. This risk seems to rise with increasing US cultural orientation and decreasing Latino cultural orientation, especially among girls. To ascertain how acculturation may influence Latino/a youth alcohol use, we integrated an expanded multi-domain model of acculturation with the Theory of Reasoned Action.

Design. Participants were 302 recent Latino/a immigrant youth (141 girls, 160 boys; 152 from Miami, 150 from Los Angeles) who completed surveys at 4 time points. Youth completed measures of acculturation, attitudes toward drinking, perceived subjective norms regarding alcohol use, intention to drink, and alcohol use.

Results. Structural equation modeling indicated that collectivistic values predicted more perceived disapproval of drinking, which negatively predicted intention to drink. Intention to drink predicted elevated alcohol use.

Conclusion. Although the association between collectivistic values and social disapproval of drinking was relatively small (β = .19, p < .05), findings suggest that collectivistic values may help protect Latino/a immigrant youth from alcohol use by influencing their perceived social disapproval of drinking, leading to lower intention to drink. Educational preventive interventions aimed at reducing or preventing alcohol use in recent Latino/a immigrant youth could promote collectivistic values and disseminate messages about the negative consequences of drinking.     

Bullying victimization as a mediator of associations between cultural/familial variables,substance use,and depressive symptoms among Hispanic youth

Objectives. This article examines the antecedents and consequences of bullying victimization among a sample of Hispanic high school students. Although cultural and familial variables have been examined as potential risk or protective factors for substance use and depression, previous studies have not examined the role of peer victimization in these processes. We evaluated a conceptual model in which cultural and familial factors influenced the risk of victimization, which in turn influenced the risk of substance use and depression.

Design. Data were collected as part of a longitudinal survey study of 9th and 10th grade Hispanic/Latino students in Southern California (n = 1167). The student bodies were at least 70% Hispanic/Latino with a range of socioeconomic characteristics represented. We used linear and logistic regression models to test hypothesized relationships between cultural and familial factors and depression and substance use. We used a mediational model to assess whether bullying victimization mediated these associations.

Results.Acculturative stress and family cohesion were significantly associated with bullying victimization. Family cohesion was associate d with depression and substance use. Social support was associated with alcohol use. Acculturative stress was associated with higher depression. The associations between acculturative stress and depression, family cohesion and depression, and family cohesion and cigarette use were mediated by bullying victimization.

Conclusion. These findings provide valuable information to the growing, but still limited, literature about the cultural barriers and strengths that are intrinsic to the transition from adolescence to emerging adulthood among Hispanic youth. Our findings are consistent with a mediational model in which cultural/familial factors influence the risk of peer victimization, which in turn influences depressive symptoms and smoking, suggesting the potential positive benefits of school-based programs that facilitate the development of coping skills for students experiencing cultural and familial stressors.     

Women’s beliefs about what causes obesity: variation by race/ethnicity and acculturation in a Washington State sample

ABSTRACT

Objective: Individuals’ beliefs about the causes of multifactorial health conditions (causal attributions) shape how they conceptualize and respond to health threats and are therefore important for health promotion. Studies of racial/ethnic and cultural variation in obesity causal beliefs, however, are scarce. To address this gap, this study described beliefs about the underlying causes of obesity (genetic inheritance, diet, and physical activity) in Hispanic and non-Hispanic White women participating in a longitudinal cohort study in South King County, Washington State (n?=?1,002).

Design: Analysis of baseline survey data. Self-reported obesity causal beliefs were compared by race/ethnicity and acculturation indicators (survey language and nativity) using marginal effect estimates generated from multinomial logistic regression models.

Results: Hispanic women had a higher probability of not believing ‘at all’ in inheritance and physical activity as causes of obesity – an absolute increase of 33% and 5% over non-Hispanic White women, respectively. Both acculturation indicators were also associated with a higher probability of not believing ‘at all’ in inheritance as a cause of obesity, though Hispanic women who completed the survey in English and were born in the United States had genetic causal beliefs similar to non-Hispanic White women. Behavioral attributions did not vary by acculturation indicators in Hispanic women.

Conclusions: Differences in obesity casual beliefs, particularly genetic attributions, exist and may be important for developing and delivering effective obesity-related health promotion interventions. Identifying the determinants and public health consequences of cultural variation in obesity attributions should be the focus of future research.     

Impact of peer nutrition education on dietary behaviors and health outcomes among Latinos: a systematic literature review

ObjectiveThis systematic review assesses the impact of peer education/counseling on nutrition and health outcomes among Latinos and identifies future research needs.DesignA systematic literature search was conducted by: (1) searching Internet databases; (2) conducting backward searches from reference lists of articles of interest; (3) manually reviewing the archives of the Center for Eliminating Health Disparities among Latinos; (4) searching the Journal of Nutrition Education and Behavior; and (5) directly contacting researchers in the field. The authors reviewed 22 articles derived from experimental or quasi-experimental studies.Outcome MeasuresType 2 diabetes behavioral and metabolic outcomes, breastfeeding, nutrition knowledge, attitudes and behaviors.ResultsPeer nutrition education has a positive influence on diabetes self-management and breastfeeding outcomes, as well as on general nutrition knowledge and dietary intake behaviors among Latinos.Conclusions and ImplicationsThere is a need for longitudinal randomized trials testing the impact of peer nutrition education interventions grounded on goal setting and culturally appropriate behavioral change theories. Inclusion of reliable scales and the construct of acculturation are needed to further advance knowledge in this promising field. Operational research is also needed to identify the optimal peer educator characteristics, the type of training that they should receive, the client loads and dosage (ie, frequency and amount of contact needed between peer educator and client), and the best educational approaches and delivery settings.     

Dietary acculturation and increasing rates of obesity in Ethiopian women living in Israel

Objective

Immigration from Third World countries to the developed world is characterized by modification of lifestyle and acculturation to local customs. This study investigated changes in nutritional status and eating behaviors in female Ethiopian immigrants in Israel.

Methods

Personal interviews, two 24-h dietary recalls, and anthropometric measurements were carried out in a random sample of 53 women 32 ± 6 y of age.

Results

After living in Israel for an average of 14 y, body mass index was similar to the general Israeli population, with 42% of participants with a body mass index greater than 24.9 kg/m², including 11% categorized as obese. This is in stark contrast to the body mass index measured at arrival in Israel (∼19-20 kg/m²). Less than optimal consumption of dietary fiber, calcium, folate, and B12 was documented. Analysis by food groups showed that intake of dairy products, fruits, and vegetables was negligible, whereas simple sugar intakes were high. The women continued to prepare traditional Ethiopian foods but also incorporated local, less healthy foods into their diets. Compared with the high energy expenditure in rural Ethiopia, participants reported minimal physical activity in Israel.

Conclusions

This immigrant community is at high risk for developing nutrition-related chronic diseases. Culturally sensitive nutrition education programs are urgently needed.     

Correlates of HIV Testing among African American and Latino Church Congregants: The Role of HIV Stigmatizing Attitudes and Discussions about HIV

Faith-based organizations can be key settings in which to reach African Americans and Latinos for HIV prevention, but little is known regarding factors that predict congregants’ HIV testing behaviors. We examined the extent to which sociodemographic factors, HIV-related cues to action (e.g., knowing someone who is HIV-positive), and the social climate surrounding HIV (stigma toward a hypothetical HIV-positive congregant, HIV-related discussions at church about abstinence, condoms, and testing) were associated with willingness to be tested in church and with ever having been tested among 1211 African American and Latino congregants. Multivariate analyses indicated that congregants were more open to church-based testing if they were younger and had discussed condoms at church. They were less open if they expressed stigmatizing attitudes toward a hypothetical congregant. Foreign-born Latinos with low English proficiency were more willing to be tested at church than were African Americans. Congregants were more likely to have ever been tested if they were younger, African American, female, or married; if they knew someone who was HIV-positive; and if they had discussed testing and condoms at church. They were less likely if they had discussed abstinence. Open dialogue around HIV may activate congregants to be more receptive to church-based prevention.     

The combined relations of gender,enculturation, and depressive symptoms with health risk behaviors in Mexican-Americans: a moderated mediation analysis

ABSTRACT

Objectives: The present study investigated the relationships of enculturation and depressive symptoms with health risk behavior engagement in Mexican-American college students and examined how these relationships differed by gender. Previous research has noted consistent gender differences in health risk behavior (e.g. alcohol use, substance use, and risky sexual behavior) among Latina/os, and emphasized the role of U.S. acculturation in this difference. Research examining the role of heritage cultural retention (i.e. enculturation), and including the added influence of mental health variables, such as depressive symptoms, is currently lacking. This study sought to address this gap.

Design: A large sample (N?=?677) of Mexican-American college students from four universities (located in New York, California, Florida, and Texas) completed an online questionnaire assessing health risk behaviors and corresponding variables.

Results: We found that males who endorsed more behavioral enculturation and depressive symptoms were more likely to engage in health risk behavior than all others in the sample. Contrary to previous literature, no relationship was found between behavioral enculturation and health risk behavior in females.

Conclusion: The current study found behavioral enculturation to be associated with depressive symptoms, and in turn with health risk behaviors among the males in our sample. Additional research will be needed to identify the mechanism underlying the relationship between enculturation and depressive symptoms as well as between depressive symptoms and risky behavior.