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Acculturation and breast cancer screening among Hispanic women in New York City.

OBJECTIVES: This study investigated whether acculturation was associated with the receipt of clinical breast examinations and mammograms among Colombian, Ecuadorian, Dominican, and Puerto Rican women aged 18 to 74 years in New York City in 1992. METHODS: A bilingual, targeted, random-digit-dialed telephone survey was conducted among 908 Hispanic women from a population-based quota sample. Outcome measures included ever and recent use of clinical breast examinations and mammograms. Multivariate logistic regression models were used to assess the effect of acculturation on screening use. RESULTS: When demographic, socioeconomic, and health system characteristics and cancer attitudes and beliefs were controlled for, women who were more acculturated had significantly higher odds of ever and recently receiving a clinical breast examination (P < or = .01) and of ever (P < or = .01) and recently (P < or = .05) receiving a mammogram than did less acculturated women. For all screening measures, there was a linear increase in the adjusted probability of being screened as a function of acculturation. CONCLUSIONS: Neighborhood and health system interventions to increase screening among Hispanic women should target the less acculturated.

Acculturation↗

Acculturative stress, depression, and suicidal ideation among Mexican-American adolescents: implications for the development of suicide prevention programs in schools.

The present study explored the relationship of scores on acculturative stress with those on depression and suicidal ideation among 26 male and 28 female Mexican-American students from a southern California high school. Subjects completed the SAFE acculturative stress scale, the Reynolds Adolescent Depression Scale, and the Suicidal Ideation Questionnaire-Junior. Analyses suggested that acculturating Mexican-American adolescents who report high scores on acculturative stress may report elevated scores for depression and suicidal ideation. Researchers should assess suicide risk within this and other acculturating groups, and risk factors specific to acculturating groups should be considered in the development and implementation of suicide prevention programs in schools.

Acculturation↗

Central American adolescent acculturation and parental distress: relationship to ratings of adolescent behavior problems.

This study examined the relationship of acculturation and Central American adolescents' behavioral problems as reported by their parents. Cross-sectional survey data regarding demography, acculturation, and psychosocial functioning was examined among 112 urban adolescent immigrants, aged 12 to 17 years. Analysis indicated that, when parents and adolescents differed in acculturation, parents most frequently rated their adolescent with internalizing symptoms at a clinically elevated level. Parents' education and distress predicted parents' reports of adolescents' psychosocial problems beyond demographic factors, respondents' characteristics, and parents' and adolescents' acculturation. Higher relative acculturation among adolescents, but not parents, was the most robust predictor of parental distress scores, indicating that parental distress mediates the relationship between high relative acculturation of the adolescents and their psychosocial problems as reported by parents. Implications for research and clinicians conducting mental health interventions with Central American populations are briefly discussed.

Acculturation↗

Development of the Multidimensional Acculturative Stress Inventory for adults of Mexican origin.

The Multidimensional Acculturative Stress Inventory (MASI), a 36-item stress measure that was developed to assess acculturative stress among persons of Mexican origin living in the United States, was tested on a community sample of 174 adults (117 women, 57 men). Principal-components analyses yielded 4 stable and internally consistent factors: Spanish Competency Pressures (7 items), English Competency Pressures (7 items), Pressure to Acculturate (7 items), and Pressure Against Acculturation (4 items). These 4 factors accounted for 64.4% of the variance and correlated in the expected directions with criterion measures of acculturation and/or psychological adjustment. Further reliability and validity testing of the MASI is discussed as well as the utility of this measure in assessing acculturative stress among adults of Mexican origin.

Acculturation↗

A preliminary assessment of acculturation and its relationship to body size and glucose intolerance among Blacks in the US Virgin Islands.

OBJECTIVES: This study is a preliminary investigation of the relationship of acculturation to body size and glucose intolerance among African Caribbeans living in the United States Virgin Islands (USVI). METHODS: Focus groups were used to identify items for measuring acculturation, and validity and reliability procedures were performed on the items. The acculturation items were administered to a population-based sample of 740 individuals aged 20 years and older. Anthropometric measurements and blood pressure were taken and a fasting blood sample was also drawn. RESULTS: Factor analysis showed that the acculturation items clustered as 3 factors that appeared to represent: 1) the 'adoption' of USVI-American values; 2) 'integration' and practice of USVI customs; and 3) allegiance to 'traditional' African-Caribbean values and customs. Each factor exhibited relationships to demographic variables that were characteristic of acculturation, with the mean adoption (AD) score being significantly (P=.0002) higher for USVI-born persons than for African-Caribbean immigrants [AD=11.3 (95% CI=11.0-11.6) vs AD=10.6 (95% CI=10.4-10.8), respectively], while African-Caribbean immigrants had a higher (P=.0001) traditional score (TS) compared to USVI-born persons [TS=9.0 (95% C=8.8-9.2) vs TS=7.0 (95% CI=6.7-7.2), respectively]. In regression analyses adjusting for age, education, income, smoking, and alcohol consumption, the 'adoption' factor was independently and positively related to BMI (P=.02) among USVI-born African Caribbeans, and to fasting glucose (P=.005) among African-Caribbean immigrants. CONCLUSIONS: Acculturation is associated with increased body size and diabetes risk in African Caribbeans in the USVI and appears to bear a differential impact according to place of birth.

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Acculturation and the probability of use of health services by Mexican Americans.

How does level of acculturation affect the probability that Mexican Americans use general health, mental health, and human social services? We studied this question using data from a general population sample of Mexican Americans (N = 1,055). Data were elicited in face-to-face interviews. After controlling for sociodemographic and economic factors, health status, and insurance coverage, Mexican Americans who were less acculturated had significantly lower probabilities of an outpatient medical visit for physical health problems and of a visit to a mental health specialist or human service provider for emotional problems. The less acculturated with good perceived general health were especially unlikely to receive outpatient medical care. Having Medicaid coverage was associated with a larger increase in the probability of an inpatient medical admission for the more acculturated than for the less acculturated. Other individual characteristics had generally similar effects on use of medical and mental health services for both the more and the less acculturated Mexican Americans.

Acculturation↗

[Acculturation, stress and mental health in Lebanese immigrants in Montreal].

This cross-sectional study examined the effect of immigration and acculturative stress on the mental health of a sample of 197 Lebanese immigrants in Montreal. An Orthogonal Model of Cultural Identification was used to determine whether the acculturation style adopted by immigrants had any effect on mental health or on acculturative stress. Results revealed no significant differences in psychological distress between the Lebanese sample and a comparative group of Quebec native-born. Among the indices of acculturative stress, adaptation problems alone predicted psychological distress. Finally, acculturation styles did not have any effect on psychological distress or on acculturative stress indices, with discrimination excepted. Individuals who adopted the Assimilation style reported less discrimination than those in the Ethnocentric and Integration groups. Results are discussed with reference to findings reported in the literature on Canadian studies.

Acculturation↗

Dietary practices, alcohol consumption, and smoking behavior: ethnic, sex, and acculturation differences.

Current knowledge is scarce on Latino dietary practices. This study compared the dietary practices, alcohol consumption, and smoking behavior of Latinos and non-Latino whites in two randomly selected samples. Telephone surveys of adults 35-74 years of age from the Kaiser Permanente Medical Care Program (Latinos = 844; non-Latino whites = 510) and from census tract-based areas (Latinos = 806; non-Latino whites = 436) were conducted in the San Francisco Bay Area. Latino ethnicity was a significant predictor of dietary and alcohol consumption practices in multivariate logistic regression models after adjustment for sex, education, age, employment, health insurance, martial status, county of residence, and self-perceived health status. Compared with non-Latino whites, Latinos were significantly less likely to report eating vegetables and more likely to eat rice, beans, and fried foods and to drink whole milk. Less acculturated Latinos were more likely to eat fruits, rice, beans, meat, and fried foods and to drink whole milk than more acculturated Latinos. Latino men were significantly more likely to be binge drinkers, and Latina women were significantly more likely to abstain from drinking alcohol during the month prior to the interview. As Latina women acculturate to the U.S. mainstream, they report more cigarette smoking and alcohol consumption. Although Latinos reported higher levels of selected high-fiber foods, the low consumption of vegetables, widespread use of saturated fat, and the heavy drinking and smoking among Latino men, which are associated with the level of acculturation, may increase the risk for cancer. Educational messages targeting less acculturated Latinos should focus on maintaining their current healthy dietary practices of eating fruits, rice, and beans and decreasing their fat consumption. For more acculturated Latinos, emphasis should be placed on resuming the traditional diet.

Acculturation↗

The effect of African-American acculturation on neuropsychological test performance in normal and HIV-positive individuals. The HIV Neurobehavioral Research Center (HNRC) Group.

Two studies were conducted to examine the relationship of acculturation to neuropsychological test performance among (1) medically healthy, neurologically normal African Americans (N = 170); and (2) HIV positive (HIV+) subgroups of African Americans and Whites (Ns = 20) matched on age, education, sex, and HIV disease stage. Acculturation was measured through self report for all participants, and linguistic behavior (Black English use) was assessed in a subset of medically healthy individuals (N = 25). After controlling for the effects of age, education, and sex, medically healthy African Americans who reported less acculturation obtained lower scores on the WAIS-R Information subtest and the Boston Naming Test than did more acculturated individuals. Black English use was associated with poor performance on Trails B and the WAIS-R Information subtest. HIV+ African Americans scored significantly lower than their HIV+ White counterparts on the Category Test, Trails B, WAIS-R Block Design and Vocabulary subtests, and the learning components of the Story and Figure Memory Tests. However, after accounting for acculturation, ethnic group differences on all measures but Story Learning became nonsignificant. These results suggest that there are cultural differences within ethnic groups that relate to neuropsychological test performance, and that accounting for acculturation may improve the diagnostic accuracy of certain neuropsychological tests.

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Measuring acculturation among Central American women with the use of a brief language scale.

The purpose of this study was to test the reliability and validity of a brief language usage scale as a measure of acculturation in 197 Central American immigrant women. This study presents an analysis of cross-sectional survey data collected during face-to-face interviews conducted in Spanish as part of the program evaluation of the Infant Feeding for Hispanic Supplemental Nutrition Program for Women, Infants, and Children (WIC) Populations a Peer Education Model. The Short Acculturation Scale, a four-item language usage scale exploring the participants' language preferences, was used as a measure of acculturation. The participant's age, length of time in the United States, and perceived social support for breastfeeding were used as validation measures. Results demonstrated good internal reliability for the acculturation summary scale. Consistent with previous studies, significant correlations (p < 0.01) were found between acculturation and mother's age, perceived social support for breastfeeding, and mother's length of time in the United States. The reliability and validity data from this group of Central American immigrants support the continued use of this brief measure of acculturation in diverse Latino subpopulations when multidimensional measures are neither practical nor feasible.

Journal Article↗

The role of acculturation in the substance abuse behavior of African-American and Latino adolescents: advances, issues, and recommendations.

This article provides a review of the literature on the acculturation of Latino and African-American adolescents to traditional European-American cultural values, and the effect on their substance abusing behaviors. The review includes a critical analysis of studies that examine the effects of acculturation on the mental health and well-being of Latino adolescents. Recent findings documenting the association between acculturation and substance abuse among Latino adolescents are discussed. The article also examines the dearth of research on the role of acculturation in the substance-abusing behaviors of African-American adolescents. The authors assert that understanding the effects of acculturation on these behaviors could begin to explain why African-American adolescent substance abuse rates have been historically lower than those of European-American and Latino adolescents. Also included is an examination of research on the role of acculturation in treatment outcomes of Latino and African-American adolescents.

Adolescent↗

Relationship between safe sex and acculturation into the gay subculture.

There is some evidence, although conflicting, to suggest that socialization or acculturation into the gay community is associated with lower levels of unsafe sex. We attempted to determine the relationship between acculturation and sexual safety. We examined data from 282 men (from the Dallas AIDS Community Demonstration Project) who had sex with men and were not in a monogamous relationship to determine the associations between safer sex and indices of acculturation. The indices of acculturation included regular reading of local and national gay newspapers and magazines, and belonging to an organization for gay men. The data indicated that there were significant relationships between acculturation, talking to sexual partners about HIV risk reduction and sexual identity, and the dependent variable of frequency of condom use for anal sex. A regression equation indicated that 21% of the variance of anal condom use was predicted by these variables. These data suggest that acculturation into the gay community is associated with safer sexual behaviour, and we discuss the implications of these data for using role models and normative beliefs in HIV prevention programmes.

Adult↗

Acculturation and perinatal health outcomes among rural women of Mexican descent.

Research has shown that health outcomes for urban women of Mexican descent are related to acculturation. The purpose of this research was to compare perinatal outcomes of 773 women of Mexican descent who gave birth in three rural northern California hospitals, in relation to acculturation measured three different ways: by place of birth, by language spoken, and by the two factors combined as an Acculturation Index (AI). The prenatal and birth records of 773 Mexico-born or U.S.-born women of Mexican descent were reviewed. Results showed that language spoken was a less useful indicator of acculturation associated with perinatal complications than place of birth or the AI. The categorization of acculturation with the AI enhanced understanding of more specific groups of rural women and their particular health outcomes.

Acculturation↗

The development of eating pathology in Chinese-Australian women: acculturation versus culture clash.

OBJECTIVE: Recent research suggests there has been an increase in the incidence of eating pathology among Asian women residing in the West. Two alternate explanations for the development of this eating pathology have been proposed; acculturation versus culture clash. The current study was designed to further examine the influence of acculturation versus culture clash on the development of eating pathology in Chinese-Australian women. METHOD: Eighty-one Chinese-Australian women completed a questionnaire investigating their level of eating pathology, perceived sociocultural influences to lose weight, parental overprotection and care, self-perceptions of physical appearance, sociability and global self-worth, and the strength of their ethnic identity. RESULTS: It was found that, overall, low levels of satisfaction with physical appearance, high levels of parental overprotection, and high levels of perceived pressure from best female friends to lose weight predicted greater eating pathology in both acculturated and traditional women. However, acculturated women who perceived higher levels of pressure from their fathers and best male friends to lose weight and traditional women who experienced higher levels of parental care reported the greatest eating pathology. DISCUSSION: The findings suggest that there are both similarities and differences between the risk factors that correlate with eating pathology between acculturated and traditional women.

Acculturation↗

Acculturation and sexual function in Asian women.

Cultural effects on sexuality are pervasive and potentially of great clinical importance, but have not yet received sustained empirical attention. The purpose of this study was to explore the role of acculturation on sexual permissiveness and sexual function, with a particular focus on arousal in Asian women living in Canada. We also compared questionnaire responses between Asian and Euro-Canadian groups in hopes of investigating whether acculturation captured unique information not predicted by ethnic group affiliation. Euro-Canadian (n = 173) and Asian (n = 176) female university students completed a battery of questionnaires in private. Euro-Canadian women had significantly more sexual knowledge and experiences, more liberal attitudes, and higher rates of desire, arousal, sexual receptivity, and sexual pleasure. Anxiety from anticipated sexual activity was significantly higher in Asian women, but the groups did not differ significantly on relationship satisfaction or problems with sexual function. Acculturation to Western culture, as well as maintained affiliation with traditional Asian heritage, were both significantly and independently related to sexual attitudes above and beyond length of residency in Canada, and beyond ethnic group comparisons. Overall, these data suggest that measurement of acculturation may capture information about an individual's unique acculturation pattern that is not evident when focusing solely on ethnic group comparisons or length of residency, and that such findings may be important in facilitating the assessment, classification, and treatment of sexual difficulties in Asian women.

Acculturation↗

Informing cancer prevention strategies for African Americans: the relationship of African American acculturation to fruit, vegetable, and fat intake.

Acculturation has been associated with health-related behaviors in African Americans. We sought to determine if there is a relationship between acculturation and dietary intake in African Americans. African Americans in the PREMIER trial completed the African American Acculturation Scale (AAAS) and 2 nonconsecutive 24-h dietary recalls (n = 238). Analysis of variance (ANOVA) and canonical correlation were used to assess relationships between acculturation and dietary intakes. Canonical correlation (p = 0.05) showed that traditional African Americans had lower intakes of fruits/vegetables and milk/dairy with higher intakes of fats, meat, and nuts. This pattern was supported by differences in the ANOVA. African American acculturation is related to dietary intake. These findings have implications for the design of cancer-related public health messages targeted to African Americans.

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Measuring acculturation among male Arab immigrants in the United States: an exploratory study.

Given the absence of empirical measures that assess acculturation patterns among male Arab immigrants, a new acculturation instrument was developed and evaluated. One hundred and fifteen adult male Arab immigrants were administered the Male Arab Acculturation Scale (MAAS), and psychometrically established measures of ethnic identity and self-esteem. Satisfactory reliability is reported for the two acculturation scales, separation/assimilation and integration/marginalization. Ethnic identity, self-construal, personal self-esteem, and collective self-esteem appear to be differentially associated with acculturation patterns among male Arab immigrants.

Acculturation↗

Association of acculturation with cesarean section among Latinas.

OBJECTIVES: Examine the association of acculturation and cesarean section after adjusting for clinical and non-clinical factors that could influence clinical discretion in performing the surgery. METHODS: A sample of 2102 low-risk, low-income primarily Mexican Latinas in San Diego County was divided into two groups: primiparas and multiparas. For each parity group, logistic regression was used to assess the association of acculturation and cesarean section. RESULTS: Among multiparous Latinas, the risk of cesarean section for highly acculturated women exceeded the risk for the less-acculturated women, but the result was reverse for primiparous women. The adjusted relative odds of cesarean section were twice as high [OR 2.1, 95%CI 1.1-4.1] for multiparous US-born Latinas relative to multiparous Spanish-speaking women born in Mexico. While for primiparous women this same comparison showed US-born Latinas to be approximately half as likely to have a cesarean delivery [OR 0.4, 95%CI 0.2-0.7]. CONCLUSIONS: In order to reduce the chances of unnecessary cesarean sections among Latinas, the role of acculturation in women who have and have not already given birth needs to be investigated further.

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