Browsing by Subject "Hispanic Americans"
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Item Development of the Texas Spanish Naming Test: A Test for Spanish-Speakers(2005-08-11) Marquez de la Plata, Carlos; Cullum, C. MunroThe elderly Hispanic population is growing at a rapid pace, although very few neuropsychological measures are developed in Spanish, as most tests are translated versions of their English-language originals. The construct validity of these instruments with Spanish-speakers is virtually unexamined and bias may result due to cultural differences between the population the original tests were intended for and the Spanish-speaking populations they are used with. The current investigation used culturally salient words to develop the Texas Naming Test (TNT), a confrontation naming test for Spanish-speakers. Eighty-five (55 nondemented and 30 demented) Spanish-speaking primary care clinic patients were administered this test to determine its psychometric qualities. The TNT demonstrated very good internal consistency (alpha = 0.9) and good convergent validity, as it correlated highly with translated Spanish-naming tests commonly used in clinical practice (r > 0.80). Multivariate analysis of covariance and logistic regression demonstrated that performance on the TNT was not significantly influenced by acculturation, though the test did relate to both education (r = 0.48, p< .001) and acculturation (r = 0.41, p < .001). As predicted, the TNT effectively detected differences between demented and nondemented individuals, and demonstrated a high level of sensitivity (100%) for dementia when using an optimal cut score of < 23. Furthermore, ROC curve analysis demonstrated the overall discriminant utility of the TNT was comparable to a literal Spanish translation of the Boston Naming Test (MBNT-S), but better than a translated short form of the BNT (15-SNT). Data from this investigation suggest the TNT may be clinically useful where dementia among Spanish-speakers is suspected. Further exploration is needed to determine the extent to which culturally salient words contribute to greater sensitivity.Item Developmental Expectations and Adolescent Type 1 Diabetes Management in Latino and Caucasian Families(2013-12-30) Sundaram, Saranya Easwar; Wiebe, Deborah J.; Wetherington, Crista E.; Gross-Toalson, JamiBACKGROUND: Transfer of responsibility for diabetes management is important across adolescence. It may contribute to poorer adherence and family conflict if unmatched to adolescent development. Research has primarily studied Caucasian samples, which may have different expectations for autonomy compared to Latino samples. This study examined developmental expectations for independence in both general and diabetes-related tasks in age- and sex-matched samples of Caucasian and Latino youth with type 1 diabetes. SUBJECTS: Participants included 118 10- to 15-year-old Caucasian and Latino adolescents with type 1 diabetes [M (SD) = 13.24 (1.69) years; 54% female] and their mothers. METHOD: Participants independently completed questionnaires measuring expectations for independence, diabetes responsibility and conflict, and adherence to diabetes management. In addition, adolescents completed an inventory measuring depressive symptoms, and HbA1c levels were obtained through medical records. RESULTS: Mothers and adolescents held different expectations for the age at which adolescents should make independent decisions about general and diabetes-related activities. In the overall sample, adolescents expected independence at younger ages for prudential activities, but at older ages for diabetes activities than did parents. These mother-adolescent differences occurred in different domains across ethnicity; Caucasians displayed mother-adolescent differences in expectations for diabetes activities, while Latinos displayed differing expectations for prudential activities. In the overall sample, expectations were associated with mother-reported conflict, but were minimally correlated with parental diabetes responsibility. Younger age expectations for prudential items were associated with poorer diabetes outcomes, but age expectations for personal and diabetes items were generally unrelated to diabetes outcomes. In contrast to expectations, associations of developmental expectations with diabetes responsibility, conflict, and outcomes were similar across Caucasian and Latino youth. DISCUSSION: Findings support that there were differing age expectations between parents and adolescents in prudential and diabetes-related activities. Different factors may influence how these expectations were associated with parental responsibility, conflict, and diabetes outcomes.Item Diabetes in Latinas : Depression, Metabolic Control, and the Roles of Acculturation and Social Support(2005-12-20) Olvera, Anna E.; Stewart, Sunita M.Diabetes is steadily becoming an epidemic among Latinos. This study sought to more fully understand the rarely studied population of Latinas with diabetes and the associations between and among diabetes, depression, social support, metabolic control and acculturation. Ninety-six participants from a large publicly funded teaching hospital's community clinic took part in a brief interview that involved demographic questions, a depression screening toll, a measure for Latino and non-Latino acculturation, and a measure to assess perceived social support. The participants agreed to share their most recent metabolic blood sugar reading. The results demonstrated high levels of depression in the urban Latina with diabetes. A high number of the participants met the criteria for likely depression (32.3%). A one-tailed Pearson correlation yielded a strong significant relationship between perceived social support and depression (r = -0.63, p = 0.00). Additionally, CES-D and a recent HbA1c reading (within six months of the interview) were determined to be significantly related (r(N = 80) = 0.20, p = .03). Exposure to U.S. culture measured in years correlated significantly with diagnosis of depression by a medical professional (rs = 0.22, p = 0.04). There was an additional finding that years of living with diabetes was significantly correlated with being considered depressed (CES-D score = 24; [rs = 0.23, p = 0.03]). These and other findings support possible interventions to improve the quality of health for Latinas at an urban publicly funded clinic.Item Hispanic Ethnicity Is Associated with Early Presentation and Advanced Stage of Gastric Adenocarcinoma(2019-01-22) Paul, Subhadeep; Hester, Caitlin; Wang, Sam; Polanco, Patricio; Yopp, Adam; Augustine, Mathew; Mansour, John; Zeh, Herbert; Porembka, MatthewINTRODUCTION: Gastric adenocarcinoma (GA) is a heterogeneous disease with variable presentation and progression between ethnic groups. We aimed to assess factors related to the early age of GA presentation (< 45 years) between racial and ethnic groups. METHODS: Using the National Cancer Database, patients with GA and upfront surgery were selected. Those receiving neoadjuvant therapy were excluded to ensure accurate pathologic stage. Clinicopathologic data was correlated to factors associated with age at diagnosis. Ethnicity was classified into Non-Hispanic White (NHW), Hispanic (HS), African American (AA) and Asian (AS). Univariate and multivariate linear regression models were used to determine factors associated with age of presentation. Overall survival was estimated using the Kaplan-Meier method and compared using log-rank tests. RESULTS: Between 2006 and 2013, 13392 patients with GA and upfront surgery were identified. Median age was 67 years (IQR: 57-76) and 61% were male. Mean age at diagnosis was variable between ethnicity (NHW: 7609, 57%, 68 years, HS: 1720, 13%, 61 years, AA: 2727, 20%, 64 years and AS: 1336, 10%, 64 years; p<0.01). HS and AA presented with more advanced stage (Stage 4: HS 20.8%, AA 19.2%, NHW 17.8%, AS 16.2%; p<0.05). On univariate analysis, female gender, HS race, uninsured status, Medicaid, advanced pathologic stage, and poorly differentiated tumor grade were associated with young presentation (p<0.01). On multivariate analysis, factors associated with young presentation included female gender (1.52, 95%CI: 1.31-1.76), minority race compared to NHW (HS: 2.30 95%CI: 1.92-2.86; AA: 1.37 95%CI: 1.24-1.67), and poorly (2.40, 95%CI: 1.34-4.29) or undifferentiated grade (3.56, 95%CI: 1.84-6.99). Median survival was significantly different between races (NHW 23 months, HS 41 months, AA 26 months, AS 50 months, p<0.001). CONCLUSION: Young presentation of GA is associated with HS race, female gender, and advanced tumors. Despite HS presenting at a young age with more advanced disease, median survival was prolonged compared to AA/NHW. Further research is necessary to determine underlying biologic basis of ethnic variation observed in GA.Item Maternal Depressive Symptoms and Its Relationship to Outcomes of Adolescents with Type 1 Diabetes in a Diverse Sample of Caucasian and Latino Youth(2012-05-18) Godbey, Elida Isabel; Wiebe, Deborah J.; Chiu, Chung-Yi; Reed, GabrielaPURPOSE/BACKGROUND: Maternal depression can have deleterious effects on adolescents' psychosocial adjustment and management of type1 diabetes. These associations have been primarily studied among Caucasian middle-income families. Ethnic minority status and economic disadvantage may alter the experience of maternal depressive symptoms and their association with adolescent diabetes management. The purpose of this study was to determine if mothers' depressive symptoms are similarly associated with adolescent diabetes outcomes in Caucasian and Latino/a youth, and whether associations occur independent of socioeconomic factors. METHODS: Participants were Caucasian and Latina mothers and their adolescents with type I diabetes (N=118 dyads; 48% Latino; 54% female; 10 to 15 years old; illness duration > 1 year; 25% on insulin pump). Mothers completed surveys assessing depressive symptoms, household income and parental education. Adolescents reported treatment adherence and depressive symptoms. Metabolic control was determined from HbA1c from medical records. Socio-demographic information was collected through a combination of maternal report and census tract data. RESULTS: Although Latino participants had lower socioeconomic status (SES) than Caucasian participants, there were no ethnic group differences in terms of parental marital status, adolescent age, adolescent gender, illness duration, or insulin pump status. Latina mothers reported significantly more depressive symptoms than Caucasian mothers t (112) = 2.48, p = .015, and these differences were independent of lower SES among Latina mothers. Hierarchical regression analyses revealed maternal reports of depressive symptoms were associated with higher adolescent depression t(108) = 1.98, p = .05, but this association was moderated by both a two-way interaction with adolescent age, t(105) = 2.13, p = .036, and a three-way interaction with age and ethnicity, t(104) = -2.05, p = .043. Among older Latino adolescents, maternal depressive symptoms were positively associated with adolescent report of depression; this association was not found among older Caucasian participants or among younger participants. There were no significant associations between maternal depressive symptoms and adolescent adherence. All associations remained independent of SES indicators, which were generally unrelated to adolescent outcomes. CONCLUSION: Maternal depressive symptoms may undermine the psychosocial adjustment of adolescents with diabetes, but appears to have complex associations with diabetes management across ethnic groups. The finding that Latino youth did not experience heightened depression despite the risks of their mother's elevated depressive symptoms and lower SES is potentially quite important. If replicable, further research should explore potential protective factors that may be contributing to adolescent diabetes outcomes in Latino families.Item [News](1979-10-30) Spiegel, RichardItem The origins, genetics and diseases of Mexican-Americans(1990-07-05) Dietschy, John M.Item Prevalence of Melasma Among Premenopausal Latino Women in Dallas and Fort Worth, TX, USA(2007-12-03) Werlinger, Kelly D.; Pandya, AmitBACKGROUND: The prevalence of melasma in Latino women is unknown. OBJECTIVE: The purpose of this study was to develop a valid instrument for determining the presence of melasma in Latino women and to administer this instrument by telephone to premenopausal Latino women living in Dallas-Fort Worth, Texas. METHODS: A questionnaire to investigate rates of self-reported melasma was developed and validated. This questionnaire was used to interview 500 premenopausal Latino women by telephone. RESULTS: The questionnaire was found to have a sensitivity of 93% and a specificity of 82%. The prevalence of melasma in 500 premenopausal Latino women was 8.8%. Spanish as a primary language was found to be an important risk factor for self-reporting melasma. CONCLUSION: Melasma is common among premenopausal Latino women in the Dallas-Ft. Worth area, especially among Spanish-speakers. A validated English and Spanish instrument has been developed which can be used to determine the prevalence of melasma.Item Self-Management of Physical Activity in African Americans and Hispanics with Multiple Sclerosis: Mixed Methods(2013-05-17) Griffith, Desiree Nicole; Chiu, Chung-Yi; Rose, Lindsey; Frierson, GeoritaBACKGROUND: People with multiple sclerosis (MS) are prone to inactivity due to mobility impairments, which too often leads to obesity and other secondary conditions (e.g. depression, diabetes). Minorities with MS have health disparities when compared to Caucasians with MS, but the current health behavior theories were developed and validated mainly among the Caucasian population. There is a paucity of research considering multicultural perspectives for minorities with MS. The present study used the Health Action Process Approach (HAPA) as a theoretically driven framework to study how people with MS, specifically African Americans (AF) and Hispanics, self-manage their physical activity (PA). SUBJECTS: Eighteen AF (4 males, 14 females) with MS were recruited, ages 27-61 years old (M = 44.72, SD = 8.89). Three Hispanics (3 females) with MS were recruited, ages 27-54 years old (M = 38.33, SD = 14.01). They were all diagnosed with MS on average about 8 years prior (M = 7.83, SD = 5.58) and the majority of the participants (n = 18, 86%) lived in the Dallas-Forth Worth area. METHODS: Recruiting flyers were posted in the Multiple Sclerosis Clinic at UT Southwestern Medical Center, neurology clinics, churches in the community, and the National Multiple Sclerosis Society website. This study used a mixed methods research design. Qualitative data, used to gather minorities’ perspectives of their self-promotion of PA, was collected via focus groups and phone interviews; this data was transcribed verbatim and coded. For quantitative data, each participant filled out several HAPA surveys to assess severity of symptoms, self-efficacy, coping and planning, and PA engagement. RESULTS: An independent samples t-test was conducted to examine whether there was a significant difference between AF and Caucasians in self-evaluation of HAPA constructs, using an archived data of 170 Caucasians with MS as a norm for following comparisons. All measured HAPA constructs for PA were not significantly different between AF and Caucasians with MS. Interestingly, AF with MS had stronger intention to eat healthily (when comparing 18 Caucasians and 18 AF, t = -3.29, df = 34, p = 0.002; when comparing a norm database of 170 Caucasians and 18 AF, t = -2.31, df = 186, p = 0.02). However, Caucasians with MS had higher recovery self-efficacy for nutrition than the counterpart (comparing 170 Caucasians and 18 AF, t = 2.63, df = 186, p = 0.009). Qualitative analyses of transcriptions from six focus groups produced significant themes of self-motivated regulation of health promotion for minorities with MS. Significantly, modified item content on some HAPA-based measures is required to make the model more conducive to AF. For example, the study found that PA has been redefined for minorities with MS, self-efficacy is based on successful daily functional PA, it is not necessary to make a PA schedule because the course of MS is unpredictable, and self-defined PA goals vary according to daily MS course. DISCUSSION: Although many HAPA constructs were shared amongst AF, Hispanics, and Caucasians, this study discovered many new themes that were related to how minorities with MS approach PA. AF with MS redefined exercise as being any body movement costing physical energy. For AF, the fear of losing life roles and daily functioning was motivation to persevere and do any PA given the opportunity. In contrast to many studies on AF, this study showed AF with MS do not need social support from family or friends to do PA because they view it as self-responsibility and they have learned to be independent. For Hispanics, it appeared as though collective family thoughts regarding exercise were more influential on the intention to engage in PA. AF and Hispanics with MS agreed healthy eating habits had equal importance to PA for people with relatively severe MS status. Being AF commonly led to late treatment of MS among the focus group participants.Item [Southwestern News](1993-04-08) Abila, ReyesItem [Southwestern News](1997-07-18) Martinez, EmilyItem [Southwestern News](1993-09-17) Abila, ReyesItem A Spanish Version of the Experiences in Close Relationships Scale - Short Form (ECR-S) Adult Attachment Questionnaire(2018-06-20) Brasch, Anne Caroline; Robinson, Richard C.; LePage, James; Tucker, Christy; Cedeño Dávila, Roselyn; Stringer, Claude A.Despite a wealth of literature on attachment theory and its diverse implications across relational, psychological, and health domains (Sroufe, 2005), cross-cultural understanding of attachment has remained limited. This is, in part, a natural consequence of the considerable lack of validated attachment measures in non-English languages. The need for validated research measures in Spanish, in particular, has become especially apparent in recent years, as Hispanics now represent the largest and fastest growing minority population in the U.S. (Passel, Cohn, & Lopez, 2011). This study therefore aimed to validate a Spanish version of the Experiences in Close Relationships Scale - Short Form (ECR-S; Wei, Russell, Mallinckrodt, & Vogel, 2007). Hypotheses centered upon the assessment of the reliability, validity, and underlying factor structure of the Spanish ECR-S. Participants (N = 85) were Spanish-speaking women recruited from outpatient Ob/Gyn clinics, where they completed a battery of brief questionnaires to assess attachment style, psychological distress, and demographic information. Coefficient alphas were .80 and .60 for the anxiety and avoidance subscales of the Spanish version of the ECR-S, following removal of a problematic item. Test-retest reliability of the two subscales were r = .70 (p < .001) and r = .68 (p < .001), respectively. As expected, Spanish ECR-S anxiety (r = .81, p < .001) and avoidance (r = .72, p < .001) levels were found to correlate highly with those of the full-length Spanish ECR, as well as with symptoms of depression (r = .29 - .51, p < .05). Hypotheses of discriminant validity were not supported, with positive correlations found between ECR-S subscale scores and symptoms of ADHD (r = .24 - .46, p < .05) and psychosis (r = .28 - .45, p < .05). Although the Spanish ECR-S yielded two relatively independent factors, they were inconsistent with the expected underlying factor structure of two orthogonal dimensions of attachment anxiety and avoidance. Overall, this version of the Spanish ECR-S will require revision for validation and use in clinical and research settings; however, this study highlights the pressing and important need for more culturally sensitive measures of attachment in the Spanish language.Item Understanding the Stressful Challenges of Adolescent Type 1 Diabetes Management in Caucasian and Latino Youth(2013-12-30) Lee, Alyssa G.; Wiebe, Deborah J.; Lee, Simon Craddock; Hamann, HeidiBACKGROUND: Type 1 diabetes management poses many challenges and is a potential source of stress among adolescents with diabetes and their families. In primarily Caucasian samples, diabetes management outcomes (e.g., metabolic control) deteriorate across adolescence. A growing literature indicates that Latino youth have poorer diabetes control than do Caucasian youth. The broad objective of the present study was to examine ethnic differences in the experience and effects of stress on type 1 diabetes management during adolescence. SUBJECTS: Participants were Caucasian and Latina mothers and adolescents with type I diabetes (N=118 dyads; 48% Latino; 54% female; 10 to 15 years old; illness duration > 1 year; 25% on insulin pump). Adolescents were between 10 and 15 years of age (M = 12.74, SD = 1.64). METHOD: Demographic information was collected through maternal report, geographic identifiers from available census data, and medical records. Adolescents completed surveys measuring the occurrence of different types of stressful events relevant to a diverse population of Latino and Caucasian youth (i.e., stress dimensions of family conflict, peer hassles, school hassles, and economic stress), treatment adherence, and depressive symptoms. Metabolic control was determined from HbA1c recorded in medical records. Socio-demographic information was collected through a combination of maternal report and census tract data. RESULTS: On average, Latino participants were of a lower socioeconomic status (SES) than Caucasian participants. However, there were not significant ethnic group differences in terms of adolescent age, adolescent gender, illness duration, or insulin pump status. There were also no ethnic differences on adolescent report of different types of stress. In the full sample, heightened levels of each type of stress were associated with indicators of poorer diabetes management and poorer psychosocial adjustment. Hierarchical regression analysis revealed that the stresses of peer hassles, school problems, and family conflict were each associated with poorer outcomes regardless of ethnicity. However, ethnicity moderated associations of economic stress with both adherence and depressive symptoms. Economic stress was associated with poorer adherence and greater depression in Caucasian youth, but was unrelated in Latino youth. DISCUSSION: Latino and Caucasian youth in the sample for this study did not show significant differences in their report of the experience of stress, but Latino youth appeared resilient against the adversity of economic stress. This interaction pattern is consistent with the Latino paradox. Understanding resiliency factors in diverse populations may assist health care professionals in providing effective and culturally sensitive interventions.Item [UT Southwestern Medical Center News](2007-09-27) Piloto, ConnieItem The Wait for the Weight: Pediatricians' Communication about Weight to Overweight and Obese Latino Children and their Parents(2013-01-22) Montano, Sergio; Turer, Christy; Flores, Glenn; Hoang, KimBACKGROUND: Latinos are among the most overweight (OW) racial/ethnic groups of US children. It is unknown, however, whether language barriers impact the communication of childhood OW. Objective: To determine whether and how language incongruence is associated with communication about OW for Latino children. DESIGN/METHODS: Cross-sectional analysis of video- or audio-recorded primary-care visits with pediatricians and OW (body mass index ≥85th%) 6-12 year-old Latino children recruited from academic and community clinics. Language proficiency was assessed using US Census Bureau questions, with language incongruence (LI) defined as pediatrician limited Spanish proficiency combined with parent limited English proficiency (LEP). Recorded visits were analyzed and transcribed. Direct communication of OW, who broached the topic first, use of growth charts, and communication of a weight-management plan were determined by reviewing recordings and transcripts. RESULTS: The 26 visits (18 video and eight audio) included 26 participants and 15 pediatricians (including 10 resident/attending pairs). The mean child age was nine years old; 100% were OW and 84% were obese. 89% of parents were OW and 60% were LEP. 43% of pediatricians were Spanish-proficient. Pediatrician-parent language was incongruent in 24% of visits. Direct communication of OW occurred in 90% of language-congruent (LC) vs. 50% of LI visits (P=.03). Parents were the first to broach the topic of OW in 10% of LC vs. 50% of LI visits (P=.03). Pediatricians used growth charts in 80% of LC vs. 0% of LI visits (P<.001). Weight-management plans were conveyed in 55% of LC vs. 33% of LI visits (P=.4). One pediatrician stated, "You are not growing any taller, so you have to do the hard adult thing and [lose weight]." At least one culturally relevant dietary recommendation was made in 19% of visits. One pediatrician noted, "Less fat, less manteca, less avena, less sugar," and another, "No tacos. You need to buy fruit." CONCLUSIONS: Pediatrician-parent LI is associated with a lower likelihood of direct communication of child OW/obesity and use of growth charts, but a higher likelihood of parents, instead of doctors, being the first to broach the topic of OW. Regardless of LI, many OW Latino children do not receive weight-management plans or culturally relevant dietary recommendations.