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PubMed1998

When acculturation hurts: the case of immunization.

The study examined the relationship between the acculturation of Mexican American mothers in Texas and immunization status of their children between 3 and 24 months of age. Mothers' acculturation, demographic characteristics, and immunization status of their children were assessed in in-person interviews with a sample of Mexican American respondents representative for Texas (n = 2193). Acculturation was measured with ten scales assessing oral and written language use, proficiency, and preference, music and TV viewing preferences, ethnic identity, place where a person was reared, and contacts with Mexico. Immunization status, defined according to the recommendation of the CDC Advisory Committee on Immunization Practices, was determined from official shot records obtained directly from respondents or, for respondents without records, obtained from their health care providers. Regression analysis revealed that acculturation significantly contributed to inadequate immunization status, even when socioeconomic status and other demographic covariates of acculturation were statistically controlled. Mediational analysis revealed that acculturation contributed to inadequate immunization through less positive attitudes toward immunization, a diminished sense of parental responsibility for children's immunization, and more perceived barriers to immunization. It is concluded that culture-specific beliefs encouraging childhood immunization should be fostered among Mexican Americans.

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PubMedDate not supplied

Usefulness of psychosocial theory variables in explaining fat-related dietary behavior in Chinese Americans: association with degree of acculturation.

OBJECTIVE: To determine the usefulness of variables from psychosocial models of health behavior in explaining fat-related dietary behavior among a sample of Chinese Americans. DESIGN: A survey questionnaire was administered to a convenience sample of Chinese Americans and analyzed for descriptive statistics and relationships among variables. SUBJECTS/SETTINGS: Participants were 600 healthy individuals, ranging from 25 to 70 years of age, living in New York City. VARIABLES MEASURED: Demographic factors, degree of acculturation, food preferences, and 13 social psychological scales derived from the Theory of Planned Behavior, the Healthy Belief Model, and Social Cognitive Theory. Dependent measures assessed were intention to reduce dietary fat and behaviors related to the selection of reduced-fat diets. STATISTICAL ANALYSES: Descriptive statistics, Pearsons' correlation coefficients, t-tests, one-way analyses of variance, and multiple regression analyses were used. RESULTS: Attitude, overall health concern, and self-efficacy accounted for 58% of the variance in behavioral intention for the entire sample. Attitude, perceived barriers, and self-efficacy accounted for 19% of the variance in the prediction of dietary fat reduction behaviors. In general, a gradient was seen in the increased predictiveness of each regression model by degree of acculturation of the immigrants to American culture: predictiveness (R2) for behavior ranged from 15% for the least to 34% for the most acculturated. Acculturation was significantly related to declines in the influence of habit and of social norms. These effects were not seen by length of residency. IMPLICATIONS: Nutrition educators should assess the degree of acculturation of groups with whom they work and recognize that the degree of acculturation impacts the relative importance of various psychosocial variables in fat reduction behaviors.

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PubMed2004

African American acculturation and neuropsychological test performance following traumatic brain injury.

The present study examined the influence of African American acculturation on the performance of neuropsychological tests following traumatic brain injury (TBI). Seventy one participants already enrolled in a larger-scale study assessing the impact of TBI (i.e., the South Eastern Michigan Traumatic Brain Injury Model Systems project) completed a self-report measure of African American acculturation (African American Acculturation Scale-Short Form; Landrine & Klonoff, 1995) in addition to a standardized battery of neuropsychological tests. Hierarchical regression analyses were conducted to evaluate the relationship between level of acculturation and test performance after controlling for injury-related (initial Glasgow Coma Scale score, time since injury) and demographic variables (age, sex, years of education, and socioeconomic status). Lower levels of acculturation were associated with significantly poorer performances on the Galveston Orientation & Amnesia Test, MAE Tokens test, WAIS-R Block Design, Rey Auditory Verbal Learning Test, and Symbol Digit Modalities Test. Decreased levels of acculturation were also significantly related to lower scores on a composite indicator of overall neuropsychological test performance. In addition, the examiner's ethnicity (Black or White) was related with scores on a few of the tests (i.e., Block Design, Trail Making Test), but was not significantly associated with the overall neuropsychological test performance. Overall, these findings suggest that differences in cultural experience may be an important factor in the neuropsychological assessment of African Americans following TBI, and provide additional support for the hypothesis that cultural factors may partially account for the differences among ethnic/cultural groups on neuropsychological tests.

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PubMed2004

Marital conflict and acculturation among Mexican American husbands and wives.

This study examined the relationship between acculturation and multiple dimensions of marital conflict among Mexican American husbands and wives. Participants were 151 husbands and wives who were recruited from a health maintenance organization in northern California and individually interviewed. More acculturated husbands and wives engaged in less avoidance of conflict and were more expressive of their feelings in an argument. Husbands who were more acculturated reported more conflict concerning sex and consideration for the other. Bicultural and more acculturated husbands reported that their wives were more verbally and physically aggressive, compared with mono-Mexican husbands. The findings provide evidence that more acculturated husbands and wives are involved in more direct expressions of conflict in their marriages, compared with less acculturated husbands and wives.

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PubMed1997

Acculturation, socioeconomic status, and obesity in Mexican Americans, Cuban Americans, and Puerto Ricans.

OBJECTIVES: This study examined the relationship between acculturation and obesity in United States (US) Hispanics, controlling for socioeconomic status (SES). METHODS: The sample included 3141 Mexican American, 828 Cuban American, and 1211 Puerto Rican adults 18-74 y of age in the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). Acculturation was measured by language preference and generation; SES by income and education; and obesity by body mass index (BMI). RESULTS: Mean and standard deviations of BMI (kg/m2) were 25.9 +/- 4.4, 26.0 +/- 4.2, and 25.5 +/- 4.3 in men of Mexican American, Cuban American, and Puerto Rican origin, respectively. For women, the corresponding values were 26.6 +/- 5.8, 25.9 +/- 5.0, and 26.2 +/- 5.9. Linear regression models of BMI which included acculturation, income, education, and other covariates were carried out. Income and education were not associated consistently with BMI. Acculturation, but only among Mexican Americans, was associated with BMI. Specifically, greater preference for English was associated with reduced BMI among women (P < 0.01). Also, men and women of the second (P < 0.001 in both sexes) and third (P < 0.01 in men P < 0.001 in women) generation had greater BMIs. Relative to the first generation, the increase in BMI units was 1.15 +/- 0.34 in men and 1.76 +/- 0.39 in women in the second generation and 0.83 +/- 0.31 in men and 1.83 +/- 0.37 in women of the third generation. CONCLUSIONS: BMI was not associated with SES, an unexpected finding since the relationship is generally negative in women from developed countries. The relationship between BMI and acculturation was weak and conditional. BMI in Mexican Americans appeared to be somewhat more sensitive to the process of acculturation than among Cubans or Puerto Ricans.

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PubMed2000

Acculturation and breast self-examination among immigrant Latina women in the USA.

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self-examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low-income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.

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PubMed2006

Physical activity and acculturation among adult Hispanics in the United States.

Understanding the prevalence and demographic correlates of physical activity is important for public health and epidemiological research. This analysis examines the association between acculturation and physical activity in a large (approximately 5,000) sample of Hispanic adults from the 2000 National Health Interview Survey. Scores for eight questions concerning language use were summed to produce an acculturation index. Factor analysis indicated that these questions assessed a single underlying construct. Self-reported adherence to recommendations concerning leisure time physical activity increased from 22. 6% in the least acculturated tertile to 47% in the most acculturated tertile. In contrast, prevalence of walking or bicycling for errands decreased from 25.2 to 18.2%, and prevalence of standing or walking during most of the day decreased from 82.8 to 65.6% as acculturation increased. Thus, patterns of physical activity associated with leisure versus nonleisure time differed among Hispanics with varying acculturation levels. Alternatively, cultural factors may have differential effects on responses to questions concerning leisure and nonleisure time physical activity. In either case, assessing both types of activity is important for monitoring and understanding Hispanic health behaviors and interpreting epidemiological studies that involve physical activity in Hispanics.

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PubMed2005

Acculturation and manifestation of depressive symptoms among Korean-American older adults.

The present study examined the role of acculturation in manifestation of depressive symptoms among 230 Korean-American older adults (M age = 69.8, SD = 7.05) in Florida. Given the cultural emphasis on modesty and self-effacement in the traditional Korean society, we hypothesized that older Korean-Americans who were less acculturated to American culture, when compared to the more acculturated ones, would be more likely to inhibit positive affects in depressive symptom reports. Using two validated measures of depressive symptoms, the short forms of the Geriatric Depression Scale (GDS-SF) and the Center for Epidemiologic Studies-Depression Scale (CES-D), different response patterns for low and high acculturation groups were identified. First, there was low comparability in the factor structures for both the GDS-SF and the CES-D across low and high acculturation groups. A differential item function (DIF) analysis based on partial correlations indicated that older adults in the low acculturation group inhibited endorsing positive affect items; one item in the GDS-SF (#7 'feel happy') and two items in the CES-D (# 5 'felt hopeful' and # 8 'was happy'). The finding suggests the substantial cultural influences in expressing emotions, especially those related to positive affects. Implications are discussed from a cultural perspective.

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PubMed2005

Body image, acculturation, and substance abuse among boys and girls in the Southwest.

This study explored body image as measured by perceptions of weight and appearance and its impact on adolescent drug use among predominately Mexican American middle school students in the southwest. Outcomes analyzed included lifetime and recent alcohol, cigarette, and marijuana use and antidrug norms. Disliking one's looks was more of a risk factor for boys, whereas negative weight perceptions were more of a risk factor for girls. Relative to more acculturated (English-dominant) Latinos (N=903), non-Latino Whites (N=121), and other non-Latino youth (N=107), less acculturated (Spanish-dominant) Latino youth (N=212) reported the poorest body image. However, more acculturated Latino youth with poor body image had the greatest risk of substance use. More acculturated Latino boys who disliked their looks reported relatively greater amounts of recent alcohol use, and those who rated their bodies as too thin reported higher lifetime cigarette use, a greater amount and frequency of recent cigarette use, and weaker antidrug norms. More acculturated Latina girls who thought they were too fat reported a greater amount and frequency of recent cigarette use. These findings suggest that low levels of acculturation may protect some Latino youth with poor body image from coping via substance use. In addition, they suggest that poor body image among some Latinos may result less from adoption of American thinness ideals but rather from attitudes and behaviors that devalue the characteristics of Latino appearance.

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PubMed2002

Acculturation and Latino adolescents' substance use: a research agenda for the future.

This paper conducts a review of the literature on acculturation by Latino adolescents to traditional European-American cultural values and its effect on their substance-using behaviors. This review includes a critical analysis of studies that examine the effects of acculturation on the mental wellbeing of Latino adolescents. Recent findings documenting the association between acculturation and substance use among Latino adolescents are discussed. This paper also examines the limitations of the current research and proposes the development of acculturation scales that focus on measuring the role that predominant Latino and American values, attitudes, and norms play in the substance-use behavior of Latino adolescents. Additionally, the author proposes the development of a conceptual framework that accounts for the impact of acculturation-related stress and the mitigating factors affecting such stress on the substance-use behavior of Latino adolescents. The author asserts that understanding the effects of acculturation-related stress and accompanying mitigating factors could begin to explain the increasingly high rates of substance use reported for Latino adolescents. There is a discussion of research gaps and related research issues, and recommendations for future research are also made.

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PubMed1988

Effects of acculturation and socioeconomic status on obesity and diabetes in Mexican Americans. The San Antonio Heart Study.

The authors hypothesized that increased socioeconomic status and acculturation of Mexican Americans to mainstream US society would be accompanied by a progressive lessening of obesity and non-insulin-dependent diabetes mellitus. This hypothesis was tested in 1979-1982 in the San Antonio Heart Study, a population-based study of 1,288 Mexican Americans and 929 non-Hispanic whites, aged 25-64 years, randomly selected from three San Antonio neighborhoods: a low-income barrio, a middle-income transitional neighborhood, and a high-income suburb. Socioeconomic status was assessed by the Duncan Socioeconomic Index, a global measure of socioeconomic status based on occupational prestige. Acculturation was assessed by three scales which measure functional integration with mainstream society, value placed on preserving Mexican cultural origin, and attitude toward traditional family structure and sex-role organization. In Mexican-American men, increased acculturation was accompanied by a statistically significant, linear decline in both obesity and diabetes, while socioeconomic status had no significant effect on either outcome. In Mexican-American women, on the other hand, increased acculturation and increased socioeconomic status were accompanied by statistically significant, linear declines in both outcomes. However, the effects of acculturation on obesity and diabetes prevalence in women were stronger than the effects of socioeconomic status. In women, obesity also appeared to be a more important mediator of the relation between socioeconomic status and diabetes than of the relation between acculturation and diabetes. The results of this study suggest that culturally mediated factors exert a more pervasive influence on obesity and diabetes in Mexican Americans than do socioeconomically mediated factors. The influence of socioeconomic status in women, however, cannot be ignored, particularly with regard to obesity.

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PubMed2004

Acculturation and cardiovascular disease risk in midlife immigrant women from the former Soviet Union.

This study examines relationships among acculturation, depression, and cardiovascular risk factors in midlife women from the former Soviet Union and identifies factors predicting Framingham Risk Scores. Data were collected at baseline and 1 year later from 218 participants in a longitudinal study of postimmigration health. The leading risk factors were obesity, dyslipidemia, and depression. Older women had lower American Behavioral Acculturation subscale scores, higher Russian Behavioral Acculturation subscale scores, and higher depression scores. Length of residence was significantly correlated with American behavioral acculturation but not Russian behavioral acculturation. Baseline body mass index, both acculturation scores, and depression scores predicted Framingham Risk Scores after 1 year, but serum glucose did not. The results suggest that contrary to findings in other immigrant groups, women from the former Soviet Union may decrease their risk for coronary heart disease as they assume a more American lifestyle. Nursing interventions to address the high cardiovascular disease risk in this population are suggested.

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PubMed1999

Is acculturation a risk factor for early smoking initiation among Chinese American minors? A comparative perspective.

OBJECTIVE: To determine the extent to which Chinese American and white minors differ in age of smoking initiation, and to determine the effect of acculturation on smoking initiation. DESIGN: Cross-sectional telephone surveys. SETTING: Stratified random samples of the state of California, United States. SUBJECTS: 347 Chinese American and 10 129 white adolescents aged 12 through 17 years, from the California Tobacco Survey (1990-93) and the California Youth Tobacco Survey (1994-96). OUTCOME MEASURES: Hazards (risk) of smoking initiation by age, smoking initiation rate, cumulative smoking rate, mean age of smoking initiation, and acculturation status. STATISTICAL METHODS: Life table methods, proportional hazards models, and chi(2) tests. RESULTS: The risk of smoking initiation by age among Chinese American minors was about a third of that among white minors. The risk for Chinese Americans continued to rise even in later adolescence, in contrast to that for whites, which slowed after 15 years of age. Acculturation was associated significantly with smoking onset among Chinese Americans. Acculturation, smoking among social network members, attitudes toward smoking, and perceived benefits of smoking were associated with the difference in hazards of smoking onset between Chinese American minors and their white counterparts. CONCLUSIONS: Chinese American adolescents had a lower level and a different pattern of smoking onset than white adolescents. Levels of acculturation and other known risk factors were associated with the hazards of smoking initiation among Chinese American minors and with the difference in smoking initiation between the Chinese and white adolescents. Tobacco prevention policies, strategies, and programmes for ethnically diverse populations should take acculturation factors into account.

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PubMed2004

Effect of acculturation on objective measures of oral health in Haitian immigrants in New York City.

Acculturation is a complex phenomenon that can serve as a proxy for cultural norms and behaviors affecting care-seeking, prevention behaviors, and, ultimately, health outcomes. The purpose of this study was to assess the effect of acculturation on the oral health of Haitian immigrants in New York City. We hypothesized that acculturation would be a predictor of the oral health status of the participating individuals. An acculturation scale was specifically developed and validated for this study. A sample of 425 adult Haitian immigrants living in NYC was obtained through outreach activities. Oral health examinations were conducted, and a questionnaire was administered to the participants. After adjustment for age, sex, education, income, and marital status, acculturation was negatively associated with measures of decayed teeth, periodontal attachment loss of > or = 4 mm, and the number of missing teeth. Results suggest a positive impact of acculturation on the oral health status of these individuals.

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PubMed2000

Effects of acculturation on the MMPI-2 scores of Asian American students.

The use of the MMPI-2 (Butcher, Dahlstron, Graham, Tellegen, & Kaemmer, 1989) with minorities has been questioned due to potential misinterpretations related to cultural differences. This study examined acculturative differences among Asian American college students and their scores on the validity and clinical scales. A sample of Asian American students (n = 90) was assigned to groups based on acculturation level. Analysis of variance tests indicated that low-acculturated, bicultural, and high-acculturated Asian Americans yielded different profiles. Compared to a matched White student sample, low-acculturated Asian Americans scored significantly higher on 9 scales, and bicultural Asian Americans had 6 significantly different scores. These differences were clinically interpretable with a range from 6.46 to 21.65 T-score points. High-acculturated Asian Americans did not differ from Whites. Cultural variables to be considered when interpreting Asian American profiles are discussed.

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PubMed1996

Acculturation and cervical cancer: knowledge, beliefs, and behaviors of Hispanic women.

In a community-based sample of Hispanic women, this study examines differences in relation to level of acculturation in knowledge about the Pap examination, fear/fatalism towards cancer, and cervical cancer screening behaviors. Respondents were randomly chosen from 11 churches in the Phoenix metropolitan area (n = 566) and were categorized into three acculturation levels: low (35.2%), bicultural (26.3%), and high (38.5%). Interviews focused on family history of cancer as well as knowledge about cancer and utilization of screening techniques for breast and cervical cancers. OLS regression and probit analyses were conducted to examine the role of acculturation in differentiating. Hispanic subgroups in relation to knowledge, beliefs, and behaviors regarding cervical cancer. Findings of the present study indicate that Hispanic women in the Phoenix metropolitan area are utilizing cervical cancer screening services with over 90 percent of women in all three acculturation groups ever having had a Pap exam and more than 50 percent having had the examination during the past year. However, results also indicate that of the Hispanic subgroups examined, lower acculturated Hispanic women have less knowledge about Pap smears and exhibit lower utilization rates for cervical cancer screening. These results suggest that lower-acculturated Hispanic women comprise the subgroup of Hispanics that is at greatest risk of presenting with advanced stages of cervical cancer. Results have implications for cancer screening and education programs for Hispanic women as well as implications for health care professionals who serve this population.

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PubMed1998

Acculturation, alcohol consumption and AIDS-related risky sexual behavior among African American women.

The present study examined the relationship between acculturation, alcohol consumption and AIDS-related risky sexual behavior in a national probability sample of 533 African American women. Results indicated that women who were the heaviest drinkers were also the least acculturated. However, women most likely to engage in risky sexual behavior, including having multiple partners, being nonmonogamous or in a nonmonogamous relationship, and being nonmonogamous or in a nonmonogamous relationship and not using a condom consistently, were high in acculturation rather than low. Alcohol use proved related to risky sexual behavior when considered in conjunction with respondents' level of acculturation. Women at risk for contracting AIDS were not low acculturated African American women who drank heavily, but high acculturated African American women. Findings from this study extend our understanding of risk and contain implications for research and prevention efforts in the area of alcohol use and AIDS-related sexual behavior among African American women.

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PubMed1994

Pap smear and mammogram screening in Mexican-American women: the effects of acculturation.

OBJECTIVES: For Mexican Americans, acculturation is a multidimensional process of adopting attitudes, values, and behavior from the non-Hispanic White culture. This study examines the effects of different dimensions of acculturation on the cancer screening behavior of Mexican-American women. METHODS: Subjects were 450 randomly selected Mexican-American women age 40 years and older living in El Paso, Texas. Personal interviews solicited information on age, income, education, health insurance, Pap smear and mammogram use, and acculturation. Acculturation was measured with five scales that assessed English proficiency, English use, value placed on culture, traditional family attitudes, and social interaction. RESULTS: The 2-year prevalence of Pap smear and mammogram screening increased with each gain in acculturation on English proficiency and use. These associations disappeared when adjusted for age, income, insurance, and education. After adjusting for sociodemographic factors and other acculturation dimensions, a strong traditional Mexican attitude toward family was positively related to mammography use. CONCLUSIONS: Taking advantage of the positive influence of Hispanic familism on cancer screening behavior may increase the effectiveness of cancer control interventions in Mexican Americans.

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