Weight, Diet, and Physical Activity-Related Beliefs and Practices Among Pregnant and Postpartum Latino Women: The Role of Social Support

Objectives: Eating and physical activity patterns may contribute to excessive pregnancy weight gain and postpartum retention that increase the risks of obesity and diabetes for both Latino mothers and their children. Social support is an important health determinant and may affect health-related beliefs and behaviors. The objective of this study was to investigate the influence of social support on weight, diet, and physical activity-related beliefs and behaviors among pregnant and postpartum Latinas. Methods: A community-based participatory project, Promoting Healthy Lifestyles among Women, was conducted in southwest Detroit to plan interventions aimed at reducing risks of obesity and type 2 diabetes. Qualitative analyses of in-depth semistructured interviews with dyads of 10 pregnant and postpartum Latinas, and 10 people who influenced them were conducted. Results: Husbands and some female relatives were primary sources of emotional, instrumental, and informational support for weight, diet, and physical activity-related beliefs and behaviors for Latina participants. Holistic health beliefs and the opinions of others consistently influenced Latinas' motivation and beliefs about the need to remain healthy and the links between behavior and health. Absence of mothers, other female relatives, and friends to provide childcare, companionship for exercise, and advice about food were prominent barriers that limited women's ability to maintain healthy practices during and after pregnancy. Conclusion: The findings support evidence that low-income, recently immigrated pregnant and postpartum Latinas could benefit from community-based, family-oriented interventions that provide social support necessary to promote and sustain healthy lifestyles.     

Nutrition Beliefs and Weight Loss Practices of Lakota Indian Adults

Primary objectives were to describe beliefs about diet and health, weight perceptions, and weight loss practices among Lakota Indian adults. In-person interviews were conducted with a total of 219 adults from two reservations in South Dakota. Overall, 55.5% of the sample was overweight. When asked how they perceived their body weight, 6% felt they were “too thin,” 43.4% thought they were “about right,” and 50.2% felt they were “too fat.” When asked what they were doing about their weight, 74% said they were either trying to lose weight or trying to keep from gaining more weight. Reducing the amount of food eaten (90%), eating more fruits and vegetables (86%), increasing physical activity (84%), and skipping meals (82%) were reported to have been used by most of those who had dieted. Of those who felt they needed to lose weight, 78% said they would join a weight loss program if one were offered. Findings indicate that most Lakota adults are concerned about obesity and are attempting to either lose excess weight or avoid gaining weight. Intervention efforts for this population should focus on providing individuals with guidance on effective strategies for weight loss or obesity prevention. Weight loss programs should include features identified as important by survey participants, such as information on how to fit a healthful diet and exercise into daily life.     

Food Avoidance Beliefs and Behaviors Among Chinese Cancer Patients: Validation of a New Measurement Tool

Objective

Restrictive food avoidance behavior among Chinese cancer patients is common. Yet, to the authors’ knowledge, no study has investigated factors associated with such behavior. This study attempted to validate a new measurement tool, the Cancer Patients Food Avoidance Behaviors Scale (CPFAB), that assessed cancer patients’ belief regarding 5 perceived benefits of practicing food avoidance, and to test its applicability.

Depression and Poverty Among Rural Women: A Relationship of Social Causation or Social Selection?

ABSTRACT:  Context and Purpose: Depression among rural women is a major public health concern. The purpose of this study was to test the competing theories of social causation and social selection to assess the relationship between depression and economic status for a sample of rural, low-income women in the United States. Methods: Structural equation modeling was used to analyze data from Rural Families Speak, a US Department of Agriculture-funded multi-state, longitudinal study of rural low-income families (N = 413). Findings: Results indicated that the social causation theory yielded a better approximation of the relationship between economic status and depression (RMSEA = 0.50 for a model based on this theory) than the social selection theory (RMSEA = 0.067). Conclusions: The association between lesser economic status and depressive symptoms is pressing in rural areas, given the high prevalence of both depression and poverty. These findings further emphasize the need for improved mental health services in this vulnerable population .     

南昌市初中生自我和谐与社交回避及苦恼的关系

目的了解初中生自我和谐与社交回避及苦恼状况,探讨自我和谐对社交回避及苦恼的影响。方法采用自我和谐量表(SCCS)和社交回避及苦恼量表(SAD),对南昌市457名初中生进行评定。结果初中男生和女生在自我与经验的不和谐、自我的刻板性上差异有统计学意义(P0.05或P0.01),在自我的灵活性上差异无统计学意义(P0.05)。单因素方差分析显示,初中生社交回避及苦恼的性别差异有统计学意义(P0.05或P0.01);相关分析和回归分析表明,初中生自我和谐对社交回避及苦恼有显著的影响。结论初中生自我和谐与社交回避及苦恼具有显著性别差异,自我和谐对社交回避及苦恼有显著的影响。     

大学生社交回避及苦恼与领悟社会支持状况分析

目的了解大学生社交回避及苦恼、领悟社会支持状况,探讨社会支持与社交回避及苦恼的关系,为大学生健康教育工作提供依据。方法采用领悟社会支持量表(PSSS)、社交回避及苦恼量表(SAD)为调查工具,通过分层整群抽样,对河北师范大学1196名本科生进行调查。结果大学生的社交回避及苦恼(77.69±12.20)处中等偏下水平。领悟社会支持(62.84±11.78)处于中等偏上水平。在社交回避及苦恼方面,男生显著高于女生,二、三年级学生高于一、四年级学生,没有恋爱学生显著高于恋爱学生,非独生学生显著高于独生学生,农村学生显著高于城市学生;在领悟社会支持方面,男生显著低于女生,二、三年级学生低于一、四年级学生;文科生显著低于理科生,非独生显著高于独生学生;农村学生显著低于城市学生。性别和年级在社交苦恼因子、家内支持因子上均存在交互作用(P=0.026,0.001)。领悟社会支持与社交回避及苦恼呈显著负相关。结论大学生的社交回避及苦恼、领悟社会支持受性别、年级、专业、是否恋爱、是否独生、城乡来源等因素的影响,领悟社会支持是影响大学生社交回避及苦恼的个体内部心理因素。     

HIV Risk,Partner Violence,and Relationship Power Among Filipino Young Women: Testing a Structural Model

A person's ability to minimize HIV risk is embedded in a complex, multidimensional context. In this study, we tested a model of how relationship power impacts IPV victimization, which in turn impacts HIV risk behaviors. We analyzed data from 474 young adult women (aged 15–31) in Cebu Province, Philippines, using structural equation modeling, and demonstrated good fit for the models. High relationship power is directly associated with increased IPV victimization, and IPV victimization is positively associated with increased HIV risk. We highlight in this article the complex dynamics to consider in HIV risk prevention among these young women.     

Depressive Symptoms and Weight Status Among Women Recently Immigrating to the US

Objectives Depressive symptoms have been associated with obesity. Little is known about this relationship among immigrants. We examined relationships between depressive symptoms and weight status in immigrant women from three ethnic groups. Methods Participants were Brazilian, Haitian, and Latina women (n = 345) enrolled in Live Well, a community-based, randomized intervention designed to prevent weight gain in recent immigrants. Study data are from baseline when participants completed the Center for Epidemiological Studies Depression Scale (CES-D), Perceived Stress Scale, a physical activity questionnaire, and socio-demographic questions; BMI was calculated from measured height and weight. Results Forty-four percent of participants (36 % of Brazilians, 66 % of Haitians, 30 % of Latinas) had high depressive symptoms (CES-D ≥ 16), and 38 % (26 % of Brazilians, 49 % of Haitians, 42 % of Latinas) were obese (BMI ≥ 30.0). Those reporting more depressive symptoms were more likely to be obese (Wald Chi square = 4.82, p < .05). An interaction between depressive symptoms, ethnic group, and income was revealed (F(4,340) = 2.91, p < .05), such that higher depressive symptoms were associated with higher BMI among Brazilians earning ≥$30,000 per year and with lower BMI among Brazilians earning <$30,000. The relationship between depressive symptoms and obesity did not differ by income among Haitians or Latinas. Conclusions Depressive symptoms and obesity were highly prevalent among these recently-immigrated women. Positive relationships between these variables were consistent across ethnic and income groups, with the exception of lower-income Brazilians. While these findings suggest similar patterns and health needs across several groups of immigrants, cultural differences should be considered when addressing these health conditions.     

Preconception Health: Awareness, Planning, and Communication Among a Sample of US Men and Women

It is important to educate both men and women about preconception health (PCH), but limited research exists in this area. This paper examines men’s and women’s awareness of exposure to PCH information and of specific PCH behaviors, PCH planning, and PCH discussions with their partners. Data from Porter Novelli’s 2007 Healthstyles survey were used. Women and men of reproductive age were included in the analysis (n = 2,736) to understand their awareness, planning, and conversations around PCH. Only 27.9% of women and men reported consistently using an effective birth control method. The majority of men (52%) and women (43%) were unaware of any exposure to PCH messages; few received information from their health care provider. Women were more aware than men of specific pre-pregnancy health behaviors. Women in the sample reported having more PCH conversations with their partners than did men. PCH education should focus on both women and men. Communication about PCH is lacking, both between couples and among men and women and their health care providers. PCH education might benefit from brand development so that consumers know what to ask for and providers know what to deliver.     

Breastfeeding Practices in Relation to Country of Origin Among Women Living in Denmark: A Population-Based Study

The objective of this study was to describe breastfeeding practices and to compare the risk of suboptimal breastfeeding of women living in Denmark according to country of origin, and further to examine how socio-economic position and duration of stay in the country affected this risk. Information on breastfeeding of 42,420 infants born 2002–2009 and living in eighteen selected Danish municipalities was collected from the Danish Health Visitor’s Child Health Database. The data was linked with data on maternal socio-demographic information from Danish population-covering registries. Suboptimal breastfeeding was defined as <4 months of full breastfeeding as described by the Danish Health and Medicines Authority. We used logistic regression to model the crude associations between suboptimal breastfeeding and country of origin, and taking maternal age and parity, and a variety of parental socio-economic measures into account. Suboptimal breastfeeding was more frequent among non-Western migrant women than among women of Danish origin. Women who were descendants of Turkish and Pakistani immigrants had a higher risk of suboptimal breastfeeding as compared to the group of women who had migrated from the same countries, suggesting that acculturation did not favor breastfeeding. For all but the group of women who had migrated from Pakistan, adjustment for socio-demographic indicators (age, parity, education, attachment to labour market, and income) eliminated the increased risk of suboptimal breastfeeding. There was no evidence for differences in the breastfeeding support provided at hospital level according to migrant status. Suboptimal breastfeeding was more frequent among women who were non-Nordic migrants and descendants of migrants than among women with Danish origin.     

The Effects of Health Beliefs on Screening Mammography Utilization Among a Diverse Sample of Older Women

ABSTRACT

Screening mammography is particularly effective in detecting breast cancer in elderly women. Yet, although half of all breast cancers are diagnosed in older women, statistics show that women aged 65 and over tend to underutilize screening mammography. Prior research has used the constructs of the Health Belief Model to explore attitudes and beliefs relative to breast cancer screening. Prior studies have also identified health beliefs and concerns relative to screening mammography and race/ethnicity as some of the patient-related predictors of screening mammography utilization among younger women. This study uses the theoretical framework of the Health Belief Model to explore the effects of these variables on utilization in a multiracial, multiethnic, random sample of 1011 women, aged 65 and over. Race/ethnicity; belief that mammograms detect cancer, ease the mind, and provide accurate results; concern over the radiation, pain, and cost associated with receiving a mammogram; and other independent variables were tested as predictors of screening mammography utilization. Regression analysis identified that the belief that having a mammogram eases recipients' minds was the most significant predictor of screening mammography utilization. None of the other health beliefs or health concerns were significant predictors. Race/ethnicity had no direct effects on utilization nor was it a confounder in the relationship between health beliefs, concerns and utilization. These results indicate that, along with emphasizing the importance of mammograms in early detection of breast cancer, stressing the reassurance that mammography brings recipients may be an effective health education strategy for elderly women of different racial/ethnic backgrounds.     

Determinants of Appropriate Child Health and Nutrition Practices among Women in Rural Gambia

Health education and awareness involves providing knowledge about causes of illness and choices to promote a change in individual behaviour and, thus, improves survival of individuals. Studies have, however, shown that improved knowledge and awareness is not always translated into appropriate actions. This study aimed at exploring the factors determining mothers’ choices of appropriate child health and nutrition practices in the Gambia. Eight focus-group discussions (FGDs) were held with 63 women whose children had been seen at the Keneba MRC Clinic within the 12 months preceding the study. The FGDs were analyzed using a thematic framework. Gender inequality, presence or absence of support networks, alternative explanatory models of malnutrition, and poverty were identified as the main factors that would determine the ability of a mother to practise what she knows about child health and nutrition. The findings highlight the need to consider the broader social, cultural and economic factors, including the value of involving men in childcare, when designing nutritional interventions.Key words: Child health, Child nutrition, Child nutrition disorders, Gender, Health education, Interventions, Knowledge, attitudes, practices, The Gambia     

Relationship Between Past Food Deprivation and Current Dietary Practices and Weight Status Among Cambodian Refugee Women in Lowell, MA

Objectives. We investigated Cambodian refugee women''s past food experiences and the relationship between those experiences and current food beliefs, dietary practices, and weight status.Methods. Focus group participants (n = 11) described past food experiences and current health-related food beliefs and behaviors. We randomly selected survey participants (n = 133) from a comprehensive list of Cambodian households in Lowell, Massachusetts. We collected height, weight, 24-hour dietary recall, food beliefs, past food experience, and demographic information. We constructed a measure of past food deprivation from focus group and survey responses. We analyzed data with multivariate logistic and linear regression models.Results. Participants experienced severe past food deprivation and insecurity. Those with higher past food-deprivation scores were more likely to currently report eating meat with fat (odds ratio [OR] = 1.14 for every point increase on the 9-to-27–point food-deprivation measure), and to be overweight or obese by Centers for Disease Control and Prevention (OR = 1.28) and World Health Organization (OR = 1.18) standards.Conclusions. Refugees who experienced extensive food deprivation or insecurity may be more likely to engage in unhealthful eating practices and to be overweight or obese than are those who experienced less-extreme food deprivation or insecurity.Since 2000, almost 500 000 refugees have resettled in the United States, with tens of thousands arriving annually.¹ In addition to their high rates of mental health disease resulting from the turmoil they are fleeing,^2–4 refugees have higher rates of heart disease, hypertension, and diabetes than do other immigrant groups and native-born Americans.^2,3,5,6 The high rates of chronic disease are likely related to multiple factors. Refugees may have suffered physiological damage during stress and war,⁷ and traumatic stress may have increased their risk of cardiovascular disease and stroke.⁸The increased rates of chronic disease may also be related to changes in food consumption. In a postconflict environment with plentiful food, people may adopt harmful eating behaviors that affect health both directly and through increased weight.^9–14 World War II prisoners of war who experienced highest trauma and food deprivation also reported the highest rate of binge-eating behaviors 50 years after the war.¹⁵ Holocaust survivors reported lifelong binge eating and preoccupation with food, including worrying about food availability and hoarding.¹⁶Uneven access to food is associated with higher rates of overweight and obesity and weight gain in the United States,^9–13 possibly because it may lead to excessive consumption of food in times of plenty.^9,11,13,14 Refugees who experienced food deprivation or insecurity and who currently have abundant access to food may approach food in ways that increase risk for overweight and obesity. African refugees reported eating high-status foods, such as meat and steak, more often in the United States than in their native countries.¹⁷ Hmong refugees indicated that they purchased and ate food they knew to be unhealthful because it was very affordable in the United States.¹⁸ Studies of Vietnamese, Hmong, and Cambodian refugees reported high preference for steak.^19–21 Although food security has been well-defined,²² to our knowledge, there is no existing quantitative measure of variation in the past food deprivation experiences of refugees.Cambodian refugees stand out as a potential refugee model for examining how past experiences of food deprivation or food insecurity affect current food beliefs, dietary practices, and weight. Cambodian refugees survived high levels of trauma and food deprivation in their home countries,³ and both trauma²³ and food deprivation or insecurity are experienced by most refugees.²⁴ Cambodian refugees also have disproportionately high rates of chronic disease,⁵ as do other refugee groups.^3,6,25Our research sheds some light on the food experiences of Cambodian refugees from 1975 through arrival in the United States (1980s through mid-1990s), develops and validates a measure of past food deprivation to allow measurement of potential effects on current dietary practices, and tests for relationships between severity of past food deprivation and current food beliefs. We also discuss implications for refugee communities.     

Poor Knowledge and Practices Related to Iodine Nutrition during Pregnancy and Lactation in Australian Women: Pre- and Post-Iodine Fortification

A before-after review was undertaken to assess whether knowledge and practices related to iodine nutrition, supplementation and fortification has improved in Australian women since the introduction of mandatory iodine fortification in 2009. Surveys of pregnant (n = 139) and non-pregnant (n = 75) women in 2007–2008 are compared with surveys of pregnant (n = 147) and lactating women (n = 60) one to two years post-fortification in a regional area of New South Wales, Australia. A self-administered questionnaire was completed and dietary intake of iodine was assessed using a validated food frequency questionnaire. A generally poor knowledge about the role and sources of iodine in the diet remained after fortification. Post-fortification, iodine-containing supplements were being taken by 60% (up from 20% pre-fortification) and 45% of pregnant and lactating women, respectively. Dairy foods were the highest contributors to dietary iodine intake (57%–62%). A low intake of fish and seafood resulted in this food group contributing only 3%–8% of total intake. A low level of public awareness regarding the role of iodine in health supports the need for public health strategies in addition to fortification, such as an accompanying consumer education campaign, increased uptake of supplementation, and on-going monitoring.