An evaluation of interventions to decrease intimate partner violence to pregnant women

Prevention of abuse to women is a national priority; however, research has focused on identification of abuse rather than evaluating interventions. To evaluate the differential effectiveness of three levels of intervention, Brief, Counseling, and Outreach, a longitudinal study with repeated evaluation interviews at 2-, 6-, 12-, and 18-months postdelivery was completed at two urban public health prenatal clinics. The participants were 329 pregnant, physically abused Hispanic women. Both physical abuse and women's use of community resources were measured. Repeated measures ANOVA showed that severity of abuse decreased significantly (p < 0.001) across time for all intervention groups. Violence scores at 2-months postdelivery were significantly lower for the Outreach group (p < 0.05) compared to the Counseling only group, but not significantly lower than the Brief intervention group. At 6-, 12-, and 18-month follow-up there were no statistically significant differences among the intervention groups. The use of lay outreach for abused pregnant women merits further research. Abuse screening by itself, however, may be the most effective intervention to prevent abuse to pregnant women.     

Acculturative stress, anxiety, and depression among Mexican immigrant farmworkers in the midwest United States

No previous studies have examined the psychological functioning of immigrant farmworkers in the midwest United States. The purposes of the present study were threefold: (1) to assess the prevalence levels of anxiety and depression in a sample of Mexican immigrant farmworkers in the midwest United States; (2) to explore the relationships among acculturative stress, anxiety, and depression; and (3) to examine the variables that best predict anxiety and depression. The overall sample revealed elevated levels of anxiety and depression. Immigrant farmworkers with heightened levels of acculturative stress reported high levels of anxiety and depression. Family dysfunction, ineffective social support, low self-esteem, lack of choice in the decision to immigrate and live a migrant farmworker lifestyle, high education levels, and low levels of religiosity were significantly associated with high levels of anxiety and depression. The overall findings suggest that Mexican immigrant farmworkers who experience elevated levels of acculturative stress may be at risk for experiencing high levels of anxiety and depression. The findings highlight the importance of establishing prevention and treatment services for migrant farmworkers that aim to increase levels of emotional support, self-esteem, and coping skills.     

Pediatric brain tumors in Non-Hispanics,Hispanics, African Americans and Asians: differences in survival after diagnosis

Background Racial differences in survival for children with brain tumors have not been well studied, particularly in Hispanics and Asians. The objective of this study was to assess racial differences in survival of children with brain tumors, focusing on Hispanics, African Americans and Asians compared to Non-Hispanics.Methods Subjects identified through the SEER Program were 2799 children, ≤19 years old at diagnosis, newly diagnosed between 1973 and 1996 with primary, malignant brain tumors. Chi-square tests were used to evaluate prognostic variables by race. Kaplan–Meier models and Cox proportional hazards models were used to assess racial differences in overall survival and in survival by histological type of tumor.Results The distribution histological type of tumor varied significantly by race. Overall survival was similar for Hispanics, African Americans, Asians compared to Non-Hispanics, although trends of increased risk of death for the minority groups were noted when stratifying by histological type of tumor.Conclusions Racial differences in survival could exist by histological type of tumor, but further work is necessary for a more complete understanding of these differences.     

Cigarette smoking and perceived health in school dropouts: a comparison of Mexican American and non-Hispanic white adolescents

OBJECTIVE: To examine the relations between educational attainment and health (cigarette smoking and perceived health) in Hispanic adolescents. METHOD: Participants included 3,360 Mexican American and non-Hispanic white adolescents ranging in age from 12 to 21 years. The sample included school dropouts, academically at-risk students, and control students. RESULTS: School dropouts were 6.46 times more likely and academically at-risk students were 2.80 times more likely to smoke heavily than were control students. In addition, school dropouts reported poorer health than did their peers. Results suggest that the relation between educational attainment and perceived health is mediated by cigarette smoking. CONCLUSIONS: Increased awareness of educational attainment as a significant risk factor for smoking in Hispanic adolescents will enable smoking cessation services to be targeted more effectively.     

Physical inactivity and percent breast density among Hispanic women

Results of epidemiologic studies suggest an inverse association between breast cancer risk and physical activity; this is one of the few modifiable breast cancer risk factors identified to date. However, only 2 previous studies assessed the association between physical activity and the extent of mammographically-detected fibroglandular breast density, a marker of breast cancer risk. Moreover, there has been no study of physical inactivity and percent breast density, nor a study of this relationship in Hispanic women, who are less physically active than non-Hispanic whites. In the Chicago Breast Health Project, we collected information on sociodemographic, reproductive, medical and lifestyle factors and percent breast density, assessed quantitatively using full-field digital mammography, from 294 Hispanic women. In our study, we examined the independent associations of hours per day of physical inactivity with percent breast density using multivariate linear regression analysis adjusting for age, education, body mass index, parity, menopausal status, use of hormone replacement therapy and smoking status. Overall, the mean percent breast density was low (i.e., 17.7%) and ranged from 1.9% to 54.6%. There was no difference in percent breast density for women who reported 1.5-3.0 hr of physical inactivity per day compared to women who reported 0-1 hr per day (beta = -0.08, p = 0.95), but percent density was marginally significantly higher for women who were reported at least 3.5 hr per day of physical inactivity (beta = 3.18, p = 0.056). Results were similar, albeit less statistically significant, in analyses of pre/perimenopausal and postmenopausal women separately. These results support the need for further research investigating the effect of physical activity on breast cancer risk.     

Racial differences in preventive practices of African-American and Hispanic women

OBJECTIVES: To compare the use of preventive practices of Hispanic- and African-American women aged 50 and older. DESIGN: A cross-sectional survey. SETTING: Inpatient and outpatient units of a teaching hospital located in South Central Los Angeles. PARTICIPANTS: Convenience sample of 337 women aged 50 and older. MEASUREMENTS: Demographic and lifestyle characteristics and selected preventive practices. Preventive practices reported were self-breast examination, mammography, Papanicolaou (Pap) smear, digital rectal examination and stool occult blood examination, sigmoidoscopy, chemoprophylaxis, and immunization. Information was obtained in a face-to-face interview. RESULTS: African-American women were more likely to have had a Pap smear ever and to have used aspirin prophylaxis than Hispanic women. CONCLUSION: There were no major differences in the use of preventive services by the two ethnic groups except for Pap smear and aspirin use. Immunization and colorectal cancer screening rates were low in African-American and Hispanic women.     

Priority Issues in Latino Mental Health Services Research

This paper identifies issues and trends affecting the quality and comprehensiveness of Latino mental health research and services. These issues include current patterns of need and services use, rapid expansion of the Latino population, extraordinary rates of uninsured, social and language barriers to care, transformation in treatment science and technology, and the sheer complexity and rapid changes in the delivery system. Progress in the field requires coordination and investments from both public and private sectors. Scientific journals should provide assistance for creating a high quality knowledge base and rapidly disseminating this information to students, practitioners, and policy makers. Vigorous activity is needed to (1) augment the supply of people entering the pipeline for researcher and practitioner training, and (2) support research in priority areas such as outcome studies for diverse treatments and different sectors of care, cultural competence, treatment models for youth and aging populations, quality of care, and barriers to mental health care.