The Influence of Immigrant Status and Acculturation on the Development of Overweight in Latino Families: A Qualitative Study

Exposure to obesogenic environments in the U.S. may foster development of overweight in immigrants with greater acculturation. Few studies document mechanisms of the acculturation process from immigrants’ own perspectives or describe implications on the children of immigrants. Focus groups and in-depth interviews were conducted with immigrant Latina mothers (N = 51) examining mothers’ beliefs, attitudes and practices related to early child feeding and weight. Focus group participants completing the Marin Acculturation Scale more closely identified with Latino culture, although the mean score (2.04, SD = 0.59) was close to “bicultural”. Analysis revealed seven themes when mothers compared lifestyles between their native countries and the U.S., related to changes in (1) diet, perceived food quality and availability, (2) food and eating practices, (3) breastfeeding practices, (4) beliefs about food, child feeding and weight status, (5) weight status of mothers and children, (6) physical activity and sedentary lifestyles, and (7) social isolation and support.     

Household Income, Maternal Acculturation, Maternal Education Level and Health Behaviors of Chinese-American Children and Mothers

Objective A cross-sectional study was conducted to examine factors associated with health behaviors, including physical activity and dietary intake, of Chinese women who have immigrated to the United States and their children. Participants Using convenience sampling, a total of 65 Chinese-American children and their mothers in the San Francisco Bay Area participated in the study. Measures Information related to children’s weight, height, level of physical activity (Caltrac accelerometer), and dietary intake (Kids’ food frequency questionnaire) was collected using standardized instruments. Mothers completed questionnaires regarding household income, their levels of education and acculturation (Suinn-Lew Asian Self-Identity Acculturation Scale), dietary intake (SWAN Food Frequency Questionnaire), and level of physical activity (Seven-day physical activity recall). Results 36.9% (n = 24) of the children were overweight (body mass index higher than the 85th percentile). A high household income was related to low maternal body mass index (R ² = .08, P = .04), high maternal fat intake (R ² = .21, P = .0001), and high maternal intake of sweets (R ² = .08, P = .033), and a high level of maternal acculturation was related to low body mass index in children (R ² = .07, P = .034). Conclusions The results suggest that an intervention aimed at reducing obesity and promoting health behaviors must be appropriate for different ethnic groups with various incomes and levels of acculturation.     

A Longitudinal Study of WIC Participation on Household Food Insecurity

We examined the association between women’s/children’s duration of WIC participation and household food security status. For mothers (n = 21,863) and their children (n = 57,377) participating in WIC (2001–2006), longitudinal measures of household food security status were collected using a subscale of the USDA Food Security Module. Using logistic regression, household food security status at the last WIC visit was associated with measures of WIC duration (number of trimesters on WIC for pregnant women, and number of WIC visits for children). Among women with prenatal household food insecurity with hunger, odds of any post-partum household food insecurity was reduced with first (AOR = 0.67, 95% CI = 0.48–0.94) or second trimester of entry (AOR = 0.64, 95% CI = 0.45–0.90) versus third. Among children with initial household food insecurity without hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.92, 95% CI = 0.90–0.94) and of household food insecurity with hunger (AOR = 0.94, 95% CI = 0.89–0.98) at the last visit. Among those with initial household food insecurity with hunger, an additional WIC visit reduced the odds of any household food insecurity (AOR = 0.96, 95% CI = 0.92–0.99) and of household food insecurity with hunger (AOR = 0.88, 95% CI = 0.83–0.94) at the last visit. Earlier and longer WIC participation may improve household food security status, particularly of vulnerable groups.     

Chinese and Korean immigrants' early life deprivation: an important factor for child feeding practices and children's body weight in the United States

This paper examines the associations between Chinese and Korean immigrant parents’ early life material and food deprivation and their concern about their child’s diet or weight, preferences for heavier children, and weight-promoting diet and child weight, alongside the moderating role of parents’ acculturation toward American culture. In 2010, Chinese and Korean immigrant parents of children ages 3–8 years in the United States (N = 130) completed interviews which asked about their perceived early life material deprivation and food insecurity, acculturation, child feeding practices, and evaluations of whether their child weighed more or less than the ideal, and child consumption of soda and candy. Independent measures of child and parent BMI were also obtained. Regression analyses revealed that parents’ early life food insecurity was associated with the evaluation that their child should weigh more than they do and greater consumption of soda and sweets by their child, among the least acculturated parents. Parental material deprivation was associated with more laissez-faire child feeding practices: less monitoring, less concern about the child’s weight or diet, and less perceived responsibility for the child’s diet, but only among less acculturated parents. Overall, the results suggest that immigrant parents’ child feeding practices and body size evaluations are shaped by material hardship in childhood, but these influences may fade as acculturation occurs.     

Development of a tool to assess past food insecurity of immigrant latino mothers

OBJECTIVE: The purpose is to describe the development and validation of a tool to measure the degree of past food insecurity in an immigrant US population. DESIGN: Focus group discussions and a structured interview. As a first step, focus group discussions were conducted among immigrant Latino mothers. Based on these discussions, an 8-item tool was developed and pilot-tested in a convenience sample of mothers. SETTING: California. PARTICIPANTS: Twenty-two low-income Latino mothers with children, ages 4 to 5 years, in the focus groups and 85 low-income Latino and white mothers of young children in the structured interviews. ANALYSES: Constant comparative analysis, Cronbach alpha, Spearman correlations, Chi-square, and Kruskal-Wallis test. RESULTS: Internal consistency of the remaining 7 items was good (Cronbach alpha = 0.84). Evidence of convergent validity included significant correlations between past food insecurity and maternal education (r = -0.45, p < .0001), crowding in the mother's childhood household (r = +0.30, p < .006), and past food insufficiency (r = +0.74, p < .0001). Foreign-born Latino mothers reported significantly greater levels of past food insecurity than US-born mothers, demonstrating discriminant validity (p < .01). CONCLUSIONS AND IMPLICATIONS: This tool may be useful to determine how past deprivation influences current food choices and other nutrition-related behaviors in low-income Latino immigrants.     

The Association of Acculturation and Health Literacy, Numeracy and Health-Related Skills in Spanish-speaking Caregivers of Young Children

Little is known about the relationship among acculturation, literacy, and health skills in Latino caregivers of young children. Latino caregivers of children < 30 months seeking primary care at four medical centers were administered measures of acculturation (SASH), functional health literacy (STOFHLA), numeracy (WRAT-3) and health-related skills (PHLAT Spanish). Child anthropomorphics and immunization status were ascertained by chart review. Caregivers (N = 184) with a median age of 27 years (IQR: 23–32) participated; 89.1 % were mothers, and 97.1 % had low acculturation. Lower SASH scores were significantly correlated (P < 0.01) with lower STOFHLA (ρ = 0.21), WRAT-3 (ρ = 0.25), and PHLAT Spanish scores (ρ = 0.34). SASH scores predicted PHLAT Spanish scores in a multivariable linear regression model that adjusted for the age of child, the age and gender of the caregiver, number of children in the family, the type of health insurance of the caregiver, and study site (adjusted β: 0.84, 95 % CI 0.26–1.42, P = 0.005). This association was attenuated by the addition of literacy (adjusted β: 0.66, 95 % CI 0.11–1.21, P = 0.02) or numeracy (adjusted β: 0.50, 95 % CI ?0.04–1.04, P = 0.07) into the model. There was no significant association between acculturation and up-to-date child immunizations or a weight status of overweight/obese. Lower acculturation was associated with worse health literacy and diminished ability to perform child health-related skills. Literacy and numeracy skills attenuated the association between acculturation and child health skills. These associations may help to explain some child health disparities in Latino communities.     

Associations among Food Insecurity, Acculturation, Demographic Factors, and Fruit and Vegetable Intake at Home in Hispanic Children

The purpose of this cross-sectional pilot study was to examine associations between food insecurity, acculturation, demographic factors, and children's fruit and vegetable intake among a sample of Hispanic children ages 5 to 12 years. A convenience sample of 184 parents of low socioeconomic status completed one-time, self-administered questionnaires assessing demographic information, acculturation, and food insecurity in the spring of 2006. In addition, children's fruit and vegetable intake at home was measured using a validated seven-item index. Parents were recruited through local elementary schools in San Antonio, TX. Pearson and Spearman correlations were used to examine the associations between the variables. t tests were used to explore the differences in means of children's fruit and vegetable intake at home for acculturation and food insecurity levels. Statistical significance was set at P<0.05. Significant correlations were found between demographic variables, acculturation, food insecurity, and children's fruit and vegetable intake at home. The overall mean fruit and vegetable intake at home was 1.04±0.63 (mean±standard deviation) servings per day. Higher rates of acculturation and higher rates of food insecurity were associated with lower fruit and vegetable intake at home. The findings reported in this study suggest a need for culturally tailored interventions targeting Hispanic children because fruit and vegetable intake at home among Hispanic children was low, regardless of the level of acculturation or food insecurity.     

Latino Fathers' Involvement in Their Children's Schools

Latinos make up the largest racial/ethnic minority group in the United States, yet we know very little about Latino fathers' involvement in their children's lives. This article adds school participation to conceptualizations of paternal involvement and contributes to an understanding of the role of immigrant acculturation in shaping Latino parenting practices. Drawing on nationally representative data, the author finds that U.S.‐born Latino fathers are just as likely as U.S.‐born White fathers to participate in children's school activities, after controlling for other covariates. The author also shows that indicators of immigrant acculturation account for some variation in parental school participation among Latino fathers. Findings point to recommendations for engaging Latino fathers in educational interventions that benefit their children and communities.     

Immigration and Sexual Partner Risk Among Latino Adolescents in San Francisco

Sexual partner characteristics increase risk for adverse reproductive health outcomes. Evidence is limited regarding whether choice of sexual partners among Latino adolescents changes with U.S. acculturation/adaptation. We used generalized estimating equations to assess the associations between immigrant generation (recent immigrant, 1.5 [immigrated prior to adolescence], 2nd and 3rd) and sexual partner risk in a prospective cohort study of 411 Latino adolescents aged 14–19. We examined three measures of partner risk and mediating effects of family influence (familism and parental monitoring). The odds of reporting a partner with frequent substance use increased with increasing immigrant generation (odds ratios (OR) [reference = recent immigrants]: 2.3, 3.4, and 5.6) as did having a partner who was in a gang/incarcerated (OR [reference = recent immigrants]: 2.4, 3.6, and 5.7). Though the odds of having high-risk partners decreased with higher parental monitoring, neither family influence measure mediated these relationships. Findings underscore the need for a prevention focus on partner choice with attention to increased risk with increasing U.S. generation.     

Food insecurity and food supplies in Latino households with young children

OBJECTIVE: To examine the relationship between food insecurity and food supplies in Latino households. DESIGN: Cross-sectional survey, conducted February to May 2001. SETTING: Six California counties. PARTICIPANTS: Convenience sampling was used to recruit 274 low-income Latino families with preschool children from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Head Start, and other community-based organizations. Complete data were available for 256 families. Variables Measured: Food security, household food scores. ANALYSIS: Pearson correlations, Kruskal-Wallis test, and logistics regression. Significance level at P <.05. RESULTS: Controlling for maternal education, food insecurity over the past 3 months was associated with lower household food supplies: dairy, r = -.18, P <.01; fruit, r = -.36, P <.001; grains, r = -.27, P <.0001; meats, r = -.22, P <.001; snack foods, r = -.23, P <.001; and vegetables, r = -.29, P <.001. CONCLUSIONS AND IMPLICATIONS: In Latino households, greater food insecurity is associated with a lower variety of most foods, particularly fruits and vegetables. Future research in Latino households should explore the effects of seasonal food insecurity and household food shortages on food intake of individual household members, especially young children.     

Interpersonal and social correlates of depressive symptoms among Latinas in farmworker families living in North Carolina

ABSTRACT

Little research is available about the mental health of Latina women in farmworker families living in the southern United States, where Latino immigrants are relatively recent arrivals. This study examined interpersonal correlates (family conflict, family’s outward orientation, and perceived discrimination) and social correlates (residential mobility and economic insecurity) of depressive symptoms and of meeting a threshold of depressive symptoms that could be clinically significant (a cut-point of 10 or higher in a short Center for Epidemiologic Studies-Depression Scale) among Latinas in farmworker families living in North Carolina. Data were collected from April 19, 2011 to April 20, 2012 as part of Niños Sanos, a prospective study of Latino women and children (N = 248). Regression models showed that exposure to family conflict, perceived discrimination, and economic insecurity were associated with more depressive symptoms. Likewise, perceived discrimination and economic insecurity were associated with a threshold of depressive symptoms that could be clinically significant, above and beyond family conflict. The findings suggested that policies that lessen the discrimination of farmworkers and their families and reduce economic insecurity, as well as interventions that support positive family functioning, might be beneficial for the mental health of Latinas in farmworker families living in new immigrant destinations.     

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.     

Food Insufficiency in Urban Latino Families

National level data show food insecurity/insufficiency is more common in Latino families than the dominant population, however local ethnic rates aren't often available, nor have there been many studies of food insufficiency/insecurity among Latino ethnic groups. This study presents food insufficiency data from three low income immigrant Latino Chicago communities. Data were collected as part of a larger study of ethnic Latino differences in health and nutrition attitudes/behaviors and child health services use. Face to face interviews were conducted with 320 mothers of Latino children entering school for the first time (mean age 5.5 years). Food insufficiency questions from the Radimer/Cornell and NHANES III instruments were used. Participants were 70% Mexican, 22% Puerto Rican and 8% other Latino, reflecting Chicago Latino distribution. Thirty percent (n = 96) reported household food insufficiency, although most was worry about obtaining food, and was due to lack of money or Food Stamps. Some families experienced more severe food access problems, namely adults and children skipping meals, and adults or children going without food for an entire day. Puerto Rican families reported more severe food insufficiency than Mexican families, but there were few other ethnic differences. Only 30% of these low income food insufficient families were Food Stamp participants although 90% of the children received school meals. These data point to the need for better screening and program outreach for low income, immigrant Latino families.     

Acculturation and Food Insecurity Among Puerto Ricans Living in Boston

Objective

To examine the associations among acculturation, food environment, and food insecurity among Puerto Ricans in Boston.

The Association between Parity and Inflammation among Mexican-American Women of Reproductive Age Varies by Acculturation Level: Results of the National Health and Nutrition Examination Survey (1999–2006)

IntroductionParity and acculturation are linked with cardiometabolic risk. Their joint association with cardiometabolic health among Mexican-American women is less established, even though immigrant Mexican-American women have the highest fertility rate in the United States. We examined the modifying role of acculturation on the association of parity with a cardiometabolic risk biomarker, C-reactive protein (CRP).MethodsParticipants (n = 1,002) were women of Mexican background, ages 16 to 39 years, in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2006. The association between parity and elevated CRP was examined using logistic regression adjusted for age, household food security, access to health care, hemoglobin A1c, total cholesterol, high-density lipoprotein cholesterol, waist circumference, physical activity, acculturation, and a product term of parity and acculturation. Acculturation was measured on a 6-point score based on nativity status and duration of residence in the United States (0, Mexico born, U.S. resident <10 years; 1, Mexico born, U.S. resident 10–19 years; 2-Mexico born, U.S. resident ≥20 years; and 3, U.S. born), and language used at home (0, Spanish; 1, bilingual; 2, English). Scores of 0 or 1, 2 or 3, and 4 or 5 represented low, moderate, and high acculturation, respectively.ResultsThe association of parity with elevated CRP varied by acculturation level (p_interaction = 0.10). Parity was associated with elevated CRP among women with low (adjusted odds ratio [OR], 2.26; 95% CI, 1.07–4.80) and moderate acculturation (adjusted OR, 2.79; 95% CI, 1.16–6.73), compared with nulliparous women.ConclusionsHigher odds of elevated CRP associated with parity in immigrant Mexican-American women of reproductive age indicate the need for greater use of maternal/women's health care services for cardiometabolic risk screening and interventions.     

The impact of holiday clubs on household food insecurity—A pilot study

This research investigates whether holiday clubs have the potential to reduce food insecurity among households in the United Kingdom. We survey parents (n = 38) of children attending seven different holiday clubs to estimate the percentage of children in those programmes who come from food insecure households. Results suggest that 42% (16 out of 38 respondents) of children come from households defined as “food insecure” and 24% (9 out of 38 respondents) come from households that are “food insecure with hunger.” When secure and insecure households are compared, we discover that food insecure households benefit the most from holiday clubs, which suggests that they may play an important role in mitigating household food insecurity.     

Multiple Measures of Physical Activity,Dietary Habits and Weight Status in African American and Hispanic or Latina Women

Compared measures of physical activity and dietary habits used in the Health Is Power (HIP) study, and described the associations of physical activity and dietary habits among African American and Hispanic or Latino women, adjusted for weight status. Cross-sectional baseline data were compared for community dwelling, healthy African American (N = 262) and Hispanic or Latina women (N = 148) who participated in HIP. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) long form, the Check And Line Questionnaire (CALQ) log and accelerometry. Dietary habits were measured using NCI 24-h recall screeners, vegetable and fruit (VF) logs and the NCI Diet History Questionnaire (DHQ). Differences in physical activity and dietary habits were assessed using simultaneous 2 (ethnicity) × 3 (weight status) ANCOVAs adjusted for age and socioeconomic status. Women (M age = 44.4 ± 10.9 years) were obese (M = 34.0 ± 9.7 kg/m²), did not meet physical activity guidelines as measured by accelerometry (M = 19.4 ± 19.1 min MVPA/day) and ate few VF (M = 2.8 ± 2.7 servings/day). DHQ variables differed by weight status. IPAQ was associated with CALQ, and CALQ with accelerometry (P < .05). IPAQ was not associated with accelerometry. Regardless of ethnicity, normal weight women did more physical activity, reported more VF consumption, and consumed more fat calories than overweight and obese women (Ps < .05). African American women did more MVPA than Hispanic or Latino women (P < .001). Relationships between behaviors and weight status suggest accelerometry and DHQ are preferable, regardless of ethnicity; and studies may capture different domains of physical activity and dietary habits depending on measure used.     

Household Density among Undocumented Mexican Immigrants in New York City

Background High household density increases exposure to communicable diseases, psychological distress in adults, and poor long-term health in children. High residential density, which may be a mediator of poor health, is common among immigrants. Methods We used data from a pilot survey among Mexican immigrants in New York City. Respondents were recruited through venue-based sampling in neighborhoods with large Mexican populations. Results Among respondents that reported being undocumented (N = 404), the mean number of people per room (PPR) of residence was 2.2. In multivariate analyses, living in conditions of >2 PPR was positively associated with living with one’s children (OR = 2.3, 95% CI = 1.4–3.9), having experienced food insecurity in the past 6 months (OR = 2.0, 95% CI = 1.1–3.6), and language discrimination (OR = 2.3 compared to other forms of discrimination, 95% CI = 1.2–4.4). Conclusions Undocumented Mexican immigrants, particularly those who are linguistically marginalized and experience food insufficiency, live in conditions of marked household density in NYC.     

The Mediating Effect of Adelante brand equity on Latino Immigrant Positive Youth Development Outcomes

This paper reports on mediation analysis of effects of the Adelante brand, an innovative program for Latino immigrant adolescents and their families, and positive youth development (PYD) outcomes. Specific objectives were to increase adolescent engagement and participation in a community-based program called Adelante, based on PYD theory, which sought to reduce substance use, sexual risk taking, and interpersonal violence among Latino immigrant youth. A total of 238 parent-child dyads were recruited from a predominantly low-income Latino immigrant community and followed for an average of 22 months. Measures included demographics; acculturation; stress and coping; social support; violence, substance use, and sexual risk attitudes; future expectations; the Adelante brand equity scale; and PYD asset measures. Multiple regression modeling shows that the leadership brand equity construct is associated with decreased proviolence and increased antiviolence attitudes. Additionally, having any program exposure (vs. none) is associated with improved substance abuse attitudes in models adjusting for the loyalty brand equity construct. In mediation analysis, we observed a mediating effect of the leadership brand equity construct on improved antiviolence attitudes among those exposed to the Adelante program. As found in previous research, Adelante brand equity operated as a mediator of program effects on Latino youth PYD outcomes.