Promoting Strong Latino Families Within an Emerging Immigration Context: Results of a Replication and Extension Trial of a Culturally Adapted Preventive Intervention.

We conducted a randomized controlled trial (RCT) of Nuestras Familias: Andando Entre Culturas, a culturally adapted evidence-based parent management training (PMT) preventive intervention, with a sample of 241 Spanish-speaking Latino parents and their middle-school-aged children residing in an emerging immigration context. Scientifically rigorous studies of programs designed for this setting are rare. The intervention was designed to promote prosocial parenting practices and to prevent youth substance use and related problem behaviors. The RCT was designed as an extension and replication of a prior trial (Martinez & Eddy in Journal of Consulting and Clinical Psychology, 73, 841-851, 2005) which was also conducted in an emerging immigration context. Two key issues were of primary interest: intervention feasibility and intervention efficacy. Intervention feasibility was assessed through weekly session attendance, participation, and parent-reported session satisfaction as well as overall program satisfaction. Intervention efficacy was assessed by comparing changes within the intervention and control groups on parenting practices and youth adjustment from pre-intervention baseline to post-intervention termination 6 months later. Results provided support for the feasibility of delivering the intervention on a large scale within communities. Consistent with the prior trial, positive effects of the intervention were detected on parenting practices and on youth outcomes. Differential effects of the intervention were detected based on youth gender and nativity status, such that girls benefited the most with respect to tobacco use likelihood, and foreign-born youth benefited the most with respect to decreased depressive symptoms.Findings provide additional evidence for Nuestras Familias as an efficacious family-based intervention for Latino families within communities that are sites of emerging immigration in terms of both improving parenting practices and decreasing risk for youth substance use and related problem behaviors.

Climbing the ladder of decline: Income and acculturation associated with chronic inflammation among Mexican immigrants.

OBJECTIVES: Financial hardship and immigrant status are often associated with poorer health as immigrant groups acculturate to life in the US. Known as the Latino health paradox, studies have shown that Latino/a immigrants in particular often experience declines in health the more they embrace ways of life considered "dominant" by US society. At present, critical biological pathways linking socioeconomic and acculturative processes remain to be better explained. The present study investigates associations among financial strain, acculturation, and chronic inflammation. METHODS: In our study of 129 Mexican-born immigrants living in the US, we used Pearson's correlations and multiple regression analyses to investigate links among income-to-poverty ratio (an indicator of financial strain), English language engagement (acculturation), and C-reactive protein (CRP), a measure of systemic inflammation. RESULTS: Results showed that for men, but not women, acculturation as defined by English language engagement moderated the association between an income-to-poverty ratio and CRP levels. CONCLUSIONS: Consistent with the Latino health paradox, more acculturated men with relatively higher income levels (compared with the study sample) had significantly higher levels of CRP.

Mind the Gap: Bridging the Divide Between Current Binge Drinking Prevention and the Needs of Hispanic Underage Emerging Adults.

In this article, we highlight the urgent public health need for prevention of heavy episodic drinking among underage Hispanic emerging adults in the USA. We outline the current state of binge drinking prevention programming and contrast it with the unique cultural, social, and developmental realities of this population using an ecodevelopmental framework (Szapocznik and Coatsworth 1999). Finally, we advance specific recommendations for the development and delivery of culturally tailored, multisystemic binge drinking prevention programs for underage Hispanic emerging adults.

Longitudinal effects of acculturation and enculturation on mental health: Does the measure matter?

A great deal of research has focused on acculturation and enculturation, which represent the processes of adapting to a new culture. Despite this growing literature, results have produced inconsistent findings that may be attributable to differences in terms of the instruments used to assess acculturation and enculturation. Utilizing a 3-year longitudinal data set (with 1-year lags between assessments), the present study explored the psychometric properties of the Bicultural Involvement Questionnaire-Short Version (BIQ-S) and the Acculturation Rating Scale for Mexican Americans II (ARSMA-II) and examined the overlap between changes in these measures as they relate to internalizing and externalizing problem behavior. The present sample consisted of 216 immigrant Latino youth (43% boys; mean age 13.6 years at baseline; SD = 1.44 years, range 10 to 17). Exploratory structural equation modeling identified factor structures for the BIQ-S and ARSMA-II that diverged from their hypothesized structure. Growth curve models also indicate divergence between the BIQ-S and ARSMA-II in terms of change in acculturation and enculturation processes. Finally, the present findings emphasized that measures of acculturation and enculturation are not equivalent in terms of their effects on internalizing and externalizing problems.

A tale of two measures: Concordance between the ARSMA-II and the BIQ acculturation scales among Latino immigrant families.

Acculturation refers to the extent to which an individual immigrant (or immigrant group) acquires the customs and characteristics of a new receiving society and/or retains the customs and characteristics of the person's or group's cultural heritage. Different acculturation measures are often assumed to be interchangeable, although this assumption is rarely tested empirically. The purpose of the present study was to examine the overlap between 2 commonly used measures of acculturation among individuals of Latino/Hispanic ancestry in the United States, the Acculturation Rating Scale for Mexican Americans II (ARSMA-II) and the Bicultural Involvement Questionnaire-Short Version (BIQ-S). Specifically, we examined the ways in which scores from the 2 measures relate to one another, as well as similarities versus differences in the ways they predict external variables of interest (e.g., family functioning, parenting, and youth adjustment) that acculturation is known to influence. Findings indicate distinct patterns of results for the 2 measures. For instance, though the BIQ-S focuses entirely on language use and other cultural practices, the ARSMA-II more consistently relates to language variables. Further, adolescent BIQ-S cultural heritage scores related negatively to risks for and engagement in alcohol use-supporting prior findings-whereas ARSMA-II scores were unrelated to alcohol use. Given the largely nonoverlapping set of relationships of the BIQ-S and the ARSMA-II subscale scores with measures of language dominance and conflict, measures of parenting, and measures of youth outcomes, we recommend that studies utilize both of these measures to fully appraise acculturation in this population. (PsycINFO Database Record

Food insecurity partially mediates associations between social disadvantage and body composition among older adults in india: Results from the study on global AGEing and adult health (SAGE).

OBJECTIVE: Our objective was to test whether food insecurity mediates cross-sectional associations between social disadvantage and body composition among older adults (aged 50+) in India (n = 6556). METHODS: Adjusting for key sociodemographic and dietary variables, we examined whether markers of social disadvantage (lower educational attainment, lower household wealth, belonging to a disadvantaged caste/tribe, and belonging to a minority religion) were associated with food insecurity. We then examined whether food insecurity, in turn, was associated with anthropometric measures of body composition, body mass index (BMI), and waist circumference (WC). We also tested whether food insecurity mediated the relationship between social disadvantage and body composition. RESULTS: In adjusted models, lower household wealth [lowest quintile (Q5) vs highest quintile (Q1): odds ratio (OR) = 13.57, P < .001], having less than a high-school education (OR = 2.12. P < .005), being Muslim (OR = 1.82, P < .001), and being in a scheduled caste (historically marginalized) (OR = 1.49, P < .005) were associated with greater food insecurity. Those who were severely food insecure had greater odds of being underweight (OR = 1.36, P < .01) and lower odds of high WC (OR = 0.70, P < .01). Mediation analyses estimated that food insecurity explained 4.7%-29.7% of the relationship between social disadvantage and body composition, depending on the variables considered. CONCLUSIONS: Our results are consistent with the hypothesis that food insecurity is a mechanism linking social disadvantage and body composition among older adults in India. These analyses contribute to a better understanding of processes leading to variation in body composition, which may help enhance the design of interventions aimed at improving population nutritional status.

Stress, Place, and Allostatic Load Among Mexican Immigrant Farmworkers in Oregon.

Cumulative exposure to chronic stressors has been shown to contribute to immigrants' deteriorating health with more time in US residence. Few studies, however, have examined links among common psychosocial stressors for immigrants (e.g., acculturation-related) and contexts of immigrant settlement for physical health. The study investigated relationships among social stressors, stress buffers (e.g., family support), and allostatic load (AL)--a summary measure of physiological "wear and tear"--among 126 adult Mexican immigrant farm workers. Analyses examined social contributors to AL in two locales: (1) White, English-speaking majority sites, and (2) a Mexican immigrant enclave. Our six-point AL scale incorporated immune, cardiovascular, and metabolic measures. Among men and women, older age predicted higher AL. Among women, lower family support related to higher AL in White majority communities only. Findings suggest that Latino immigrants' cumulative experiences in the US significantly compromise their health, with important differences by community context.

Diurnal cortisol rhythms among Latino immigrants in Oregon, USA.

One of the most commonly used stress biomarkers is cortisol, a glucocorticoid hormone released by the adrenal glands that is central to the physiological stress response. Free cortisol can be measured in saliva and has been the biomarker of choice in stress studies measuring the function of the hypothalamic-pituitary-adrenal axis. Chronic psychosocial stress can lead to dysregulation of hypothalamic-pituitary-adrenal axis function and results in an abnormal diurnal cortisol profile. Little is known about objectively measured stress and health in Latino populations in the United States, yet this is likely an important factor in understanding health disparities that exist between Latinos and whites. The present study was designed to measure cortisol profiles among Latino immigrant farmworkers in Oregon (USA), and to compare quantitative and qualitative measures of stress in this population. Our results indicate that there were no sex differences in average cortisol AUCg (area under the curve with respect to the ground) over two days (AvgAUCg; males = 1.38, females = 1.60; P = 0.415). AUCg1 (Day 1 AUCg) and AvgAUCg were significantly negatively associated with age in men (P<0.05). AUCg1 was negatively associated with weight (P<0.05), waist circumference (P<0.01) and waist-to-stature ratio (P<0.05) in women, which is opposite of the expected relationship between cortisol and waist-to-stature ratio, possibly indicating hypothalamic-pituitary-adrenal axis dysregulation. Among men, more time in the United States and immigration to the United States at older ages predicted greater AvgAUCg. Among women, higher lifestyle incongruity was significantly related to greater AvgAUCg. Although preliminary, these results suggest that chronic psychosocial stress plays an important role in health risk in this population.

Child and adolescent affective and behavioral distress and elevated adult body mass index.

Obesity rates throughout the world have risen rapidly in recent decades, and are now a leading cause of morbidity and mortality. Several studies indicate that behavioral and affective distress in childhood may be linked to elevated adult body mass index (BMI). The present study utilizes data from a 20-year longitudinal study to examine the relations between symptoms of conduct disorder, attention-deficit/hyperactivity disorder, and depression during late childhood and mid-adolescence and BMI during emerging adulthood. Data were analyzed using multiple regression. Results suggest that childhood and adolescent problems may influence adult BMI through direct impacts on adolescent overweight, a condition which then persists into adulthood.

Recruitment and retention of Latino immigrant families in prevention research.

The development and testing of culturally competent interventions relies on the recruitment and retention of ethnic minority populations. Minority immigrants are a population of keen interest given their widespread growth, needs, and contributions to communities in which they settle, and particularly recent immigrants from Mexico and Central and South American countries. However, recruitment and retention strategies for entirely immigrant samples are rarely discussed in the literature. The current article describes lessons learned from two family-focused longitudinal prevention research studies of Latino immigrants in Oregon-the Adolescent Latino Acculturation Study (ALAS) and the Latino Youth and Family Empowerment Project-II (LYFE-II). Social, legal, economic, and political contexts are considered that shape Latino immigrants' experiences in their home countries as well as in the United States. The implications of these contexts for effective recruitment and retention strategies are discussed.

Discrimination-related stress, blood pressure and epstein-barr virus antibodies among latin american immigrants in Oregon, us.

Perceived discrimination has been linked to poor health outcomes among ethnic and racial minorities in the United States, though the relationship of discrimination-related stress to immigrant health is not well understood. This article reports findings from a preliminary study that examined blood pressure and Epstein-Barr virus antibody levels in relation to self-reported indicators of stress, acculturation and social support among 79 adult immigrant Latino farm workers in Oregon, US. Findings show that increases in discrimination-related stress predicted elevated systolic blood pressure (SBP) and Epstein-Barr virus antibody levels among male participants. Though female participants reported similar levels of discrimination stress, this perceived stress was not reflected in biological measures. Among women, greater English language engagement was linked to higher SBP, and more years in the US was associated with higher diastolic blood pressure. Study results suggest that male and female immigrants' physiological responses to stress may be influenced in distinctive ways by processes of adjustment to life in the US. If replicated, the finding that discrimination stress predicts elevated SBP may have clinical and public health implications given that elevated SBP is an established risk factor for cardiovascular disease.

Discrimination, psychosocial stress, and health among Latin American immigrants in Oregon.

Chronic psychosocial stress related to discrimination has been shown to be associated with biological measures such as elevated systolic blood pressure (SBP), increased body fat, and higher fasting glucose levels. Few studies have examined these relationships in immigrant populations. The present study recruited a sample of 132 Oregon Latino immigrant adults to investigate the relationships between perceived discrimination and several health measures (blood pressure, body mass index [BMI], and fasting glucose). Results indicate that perceived discrimination stress predicted elevated SBP among men but not among women. Perceived discrimination was significantly higher among obese women than among women of normal BMI. The same pattern was not observed for men. Further, a strong trend relationship was detected: the higher women's reported discrimination stress, the higher their fasting glucose levels. Again, this pattern was not observed for men. These results suggest that chronic psychosocial stress plays an important role in disease risk among Latin American immigrants, and that male and female immigrants may have distinctive physiological responses. If confirmed, these findings may have important clinical and public health implications for chronic disease prevention among Latinos.

Language Brokering Contexts and Behavioral and Emotional Adjustment among Latino Parents and Adolescents.

This study examined behavioral and emotional adjustment in family contexts in which there was high versus low demand for adolescents to serve as language brokers in a sample of 73 recently immigrated Latino families with middle-school-aged adolescents. Language brokering was conceptualized as a family process rather than merely an individual phenomenon. Multiple agents were used to assess language brokering and parent and youth adjustment. Results indicated that high language brokering contexts had negative associations with family stress, parenting effectiveness, and adolescent adjustment in terms of academic functioning, socioemotional health, and substance use. The findings are particularly important given the limited and mixed findings from formative research on language brokering, particularly in areas within the United States with emerging immigrant populations. Findings suggest the need for advancing practices that increase language and cultural supports for immigrant families and support parents' efforts to foster positive youth and family adjustment.