A descriptive study of comprehensive and categorical services for pregnant and parenting adolescents in West Dallas

This study evaluates the effectiveness of the Children and Youth Projects' Adolescent Family Life Program, a comprehensive program serving pregnant and parenting adolescents in the economically disadvantaged area of West Dallas. The underlying question asked is what are the relative contributions of the comprehensive, school-linked Adolescent Family Life (AFL) Program compared with the Maternal Health and Family Planning Program (MHFPP), a categorical provider of family planning and reproductive services, towards meeting the immediate and intermediate term needs of adolescent mothers. Also addressed are the protective effects of participation in the Dallas Independent School District Health Special Program, a segregated school for pregnant adolescents.^ A cohort of 339 West Dallas adolescent mothers who delivered babies during a two-year period, 1986 through 1987, are monitored by linking records from Parkland Hospital, the primary provider to hospital services to indigent women in Dallas, the Dallas Independent School District, and the prenatal care providers, the AFL and MHFP Programs. Information is collected on each teen describing her demographic, fertility, service utilization and educational characteristics.^ The study tests the hypothesis that adolescents receiving services from the comprehensive AFL program will be less likely to have a repeat birth and to discontinue school during the 24 month study period, compared with categorical provider clients. Although the study finds that there are no statistically significant differences in repeat deliveries, using survival analysis, or in school continuation between programs, important findings are revealed about the ethnic differences. Black and Hispanic fertility and educational behaviors are compared, and their implications for program design and evaluation discussed. ^

Patterns of homicide Houston: Texas, 1987

The situational and interpersonal characteristics of homicides occurring in Houston, Texas, during 1987 were investigated. A total of 328 cases were ascertained from the linking of police computer data, medical examiner's records, and death certificate information. The medical examiner's records contained all of the ascertained cases. The comparability ratio between the medical examiner's records and police and vital statistic data was 1.03 and 0.966, respectively. Data inconsistencies were found between the three information sources on Spanish surname, age, race/ethnicity, external cause of death coding, alcohol and drug involvement, weapon/method used, and Hispanic immigration status. Recommendations for improving the quality of homicide information gathered and for linking homicide surveillance systems were made.^ Males constituted 82% of all victims. The age-adjusted homicide rate for Blacks was 31.1 per 100,000 population, for Hispanics 19.2, and for Anglos 5.4. Among males, Blacks had an age-adjusted rate of 54.5, Hispanics, 31.0, and Anglos 7.5. Among females, Blacks had an age-adjusted rate of 9.3, Hispanics 6.1, and Anglos 3.1. Black males, ages 25-34, had the highest homicide rate, at 96.5.^ Half of all homicides occurred in a residence. Among Hispanic males, homicides occurred most often in the street. Firearms were used to commit 64% of the homicides. Arguments preceded 58% of all cases. Nearly two-thirds of the victims knew their assailant. Only 15% of males compared to 62% of females were killed by a spouse, an intimate acquaintance, or a family member. Blacks (93%) and Hispanics (88%) were more likely than Anglos (70%) to have been killed by persons of the same race/ethnicity. Nearly three-fourths of all Houston Hispanic homicide victims were foreign born.^ Alcohol was detected in 47% of the victims tested. Nearly one-third of those tested had blood alcohol concentrations (BACs) greater than 100 mg%. Males (53%) were more likely than females (20%) to have positive BACs. Hispanic males (64%) were more likely to have detectable BACs than either Black (51%) or Anglo (44%) males.^ Illegal drugs were detected in 20% of the victims tested. One-fourth of the victims who tested positive for drugs had more than one drug in their system at death. The stimulant cocaine was the most commonly detected drug, comprising 53% of all illegal drugs identified.^ Recommendations for the primary, secondary, and tertiary prevention of homicide and for future homicide research are made. ^

Satisfaction with medical care among Mexican-Americans (Hispanic HANES, 1982--1984)

This research focussed on the extent to which the characteristics of a sample of 8,554 Mexican-Americans affected their satisfaction with medical care by: (1) describing satisfaction with medical care among the population, (2) examining the relationships between satisfaction with health services and personal characteristics of the population, and (3) comparing the results of the research with the results of studies of personal health services in other times, places, and populations.^ The distribution of sex among this population was close to even with men representing 50.4%, however respondents over age 50 years represent 11.3% of the sample. The highest grade attended was found in the Elementary (37.9%), and 70% responded they have a good health. Ninety-three percent of the sample were attended to within thirty minutes they arrived at their clinic/health center. Eighty-two percent of the sample were "Very Satisfied" with the care they received during their last visit.^ Ten hypotheses were tested in this research. Females tend to be more satisfied than males; age was found to correlate with satisfaction with respondents over 40 years reporting more satisfaction levels; there was no correlation between education and satisfaction with the educated expressing more skepticism about medical care; respondents covered by Medicare or Medicaid were more satisfied; perceived health status rating was highly correlated with satisfaction; respondents who spent less than 30 minutes traveling to the clinic/health center were more satisfied while 82% of respondents who had less than 30 minutes waiting time expressed more satisfaction.^ As remarked by Hulka and Aday that responses to client satisfaction questionnaire often provided socially acceptable answers, the results found in this sample was therefore not surprising. The author recommends that instruments for the collection of information on client satisfaction should be studied and modified where applicable to reduce what John Ware termed Acquiescent Response Set (ARS)--a tendency to agree with statement of opinion regardless of content. ^

The epidemiology of uterine cervical cancer among Anglo and Hispanic women in Texas

This study describes the incidence and mortality of uterine cervical cancer among Texas Anglo and Hispanic women, compares these data with respective data from the U.S. SEER Program, and determines factors which explain observed differences between the Texas ethnic groups and between Texas and SEER women. A total of 1,052 invasive and 1,852 in situ cervical cancer cases diagnosed during 1976-1985 among Texas residents were identified from the Texas Cancer Registry for study.^ The effect of ethnicity on the incidence of cervical cancer was found to be strongly modified by age. Texas Hispanic women 35 years and older were found to be at significantly greater risk (two- to four-fold) of invasive cervical cancer than Texas Anglos, and the risk was greatest among women 55-69 years. Compared with SEER females, both Texas ethnic groups exhibited excess risks of invasive cancer, but the magnitude varied with age. In contrast, Texas females were diagnosed less frequently with in situ cervical cancer than SEER females, and Hispanics had the largest differentials.^ As an indicator of differences in screening utilization between Texas and SEER ethnic groups, comparisons of in situ with invasive rates revealed both Texas ethnic groups in all age groups to have lower ratios than respective SEER females. Texas Hispanics had the lowest ratios. A larger percentage of squamous cell tumors were diagnosed among SEER females compared with Texas females, also supporting the finding of less screening. Texas invasive cases did not differ by ethnic group in the distribution of cell types. Hispanics 35-54 years had higher rates than Texas Anglos and SEER Hispanics for all four cell types.^ Declines in the incidence of invasive tumors over time were seen among Texas Anglos 35-54 years and Hispanics 55+ years. The mortality of cervical cancer also declined among Texas Anglo and Hispanic females 55+ years, but the rates still remained highest among these groups.^ In summary, these data indicate increased risks of invasive cervical cancer and less screening among subgroups of Texas females. Prevention efforts should be directed toward these Texas women at high risk of invasive cervical tumors. ^

Hispanic incorporation and access to health care in Houston and Harris County, Texas: Adopting an Hispanic perspective to the Aday and Andersen model

This study examines Hispanic levels of incorporation and access to health care. Applying the Aday and Andersen framework for the study of access, the study examined the relationship between two levels of Hispanic incorporation into U.S. society, i.e., mainstream versus ethnic, and potential and realized measures of access to health care. Data for the study were drawn from a 1992 telephone survey of 600 randomly selected Hispanics in Houston and Harris County.^ The hypotheses tested were: (1) Hispanics who are incorporated into mainstream society are more likely to have better potential and realized access to health care than those who are incorporated into ethnic-group enclaves regardless of their socioeconomic status (SES), health status and health needs, and (2) there is no interaction between the levels of incorporation (mainstream or ethnic) and SES, health status, and health needs in predicting potential and realized access.^ The data analysis supported Hypothesis One for the two measures of potential access. The results of bivariate and multiple logistic regression analyses indicated that for Hispanics in Houston and Harris County, being in the "mainstream" incorporation category increased their potential access to care, having "health insurance" and a "regular place of care". For the selected measure of realized access, having a "regular check-up", the analysis did not demonstrate statistically significant differences in having a regular check-up among Hispanics incorporated in the ethnic or mainstream incorporation categories.^ Hypothesis Two, that there is no interaction between the levels of incorporation and socioeconomic characteristics, health status, and health needs in predicting potential and realized access among Hispanics was supported by the data. The results of the logistic regression analysis showed that, after adjusting for socioeconomic status, health status, and health needs, the association between "level of incorporation" and the two measures of potential access ("health insurance" and having a "usual place of care") was not modified by the control variables nor by their interaction with level of incorporation. That is, the effect of incorporation on Hispanics' health insurance coverage, and having a usual place of care, was homogenous across Hispanics with different SES and health status.^ The main research implication of this dissertation is the employment of a theoretical framework for the assessment of cultural factors essential to research on migrating heterogeneous subpopulations. It also provided strategies to solve practical and methodological difficulties in the secondary analyses of data on these populations. ^

Risk factors for diabetic retinopathy in Mexican Americans in Starr County, Texas

The prevalence of diabetes in Mexican Americans is disproportionately higher than in non-Hispanic whites. The rate of diabetic retinopathy resulting from prolonged diabetes is also greater in Mexican Americans than in non-Hispanic whites. A longitudinal study was carried out on data collected from Mexican Americans in Starr County, Texas to assess the association between socioeconomic and acculturation factors with diabetic retinopathy prevalence, incidence, and progression in those free of diabetic retinopathy or who had only early non-proliferative diabetic retinopathy. A multivariable analysis was done. ^ The incidence rate was 12.78 cases per year and the progression rate was 8.55 cases per year. The baseline characteristics of the population revealed that more people with occupations synonymous with lower income jobs like trade workers and machine operators had early non-proliferative diabetic retinopathy. A multivariable analysis revealed that those with early non-proliferative diabetic retinopathy were more likely to have been born in Mexico as compared to those free of diabetic retinopathy. Surprisingly, a multivariable analysis also showed that those that progressed in diabetic retinopathy disease status were more likely to have been employed as compared to those that did not. ^ This analysis reveals that Mexican Americans are heterogeneous in socioeconomic and acculturation factors that may be used to deter the incidence and progression of diabetic retinopathy severity. These findings could be targeted to create culturally sensitive intervention programs that will improve the detection and treatment of diabetic retinopathy in the work arena in addition to programs that will impact those that do not work. Workplace preventative health screenings and dissemination of language-specific informational brochures is warranted to curb the rates of progression in those employed. ^ A limitation of this study is the narrow surrogates used for assessing socioeconomic and acculturation status. To fully evaluate these variables, a study using a questionnaire with a multitude of surrogates for socioeconomic and acculturation factors should be employed.^

Correlates of prenatal care initiation among low -income Hispanic women

Because Hispanic women are even less likely than women of other ethnic groups to receive early prenatal care, the purpose of this study was to identify factors that may influence these women to initiate care. After giving consent, 300 Hispanic women (100 who initiated first trimester care, 100 who initiated second trimester care, and 100 who initiated third trimester care or received no care) were interviewed in the post partum unit of a local public hospital. The interview included recollection of events leading to the first prenatal appointment, including first physical indicators of pregnancy, confirmation of pregnancy, feelings about the pregnancy, appointment making behavior, and system barriers encountered. The Health Belief Model was used as the theoretical framework for determining psychosocial variables. Using this model, perceived susceptibility to problems during pregnancy, perceived seriousness of possible problems, perceived benefits of prenatal care, perceived barriers to care, and cues to action were assessed. Time of entry into prenatal care was assessed by interview.^ In this sample of low-income Hispanic women, a higher perception of barriers to care was associated with later initiation of care and non-use of care, higher perceived benefits of care for the baby were associated with earlier care, especially in women without a card to access hospital district services, and having a card to access hospital district services was associated with earlier care. Several barriers to care were mentioned by women on open-ended questioning including long waiting times, embarrassment, and lack of transportation.^ Recommendations for practice included decreasing the number of visits for low-risk women while increasing the time spent with the provider, decreasing the number of vaginal exams for low-risk women, increasing the use of midwives, training lay workers to do risk assessment, giving specific messages about benefits of care to baby, and increasing general health motivation through community intervention methods. More research on the psychosocial and cultural factors associated with initiation of care is needed. In the meantime, the recommendations for practice can be implemented now to increase the use of prenatal care by low-income Hispanic women. ^

Rapport à l’espace, rapport à l’autre : constructions des discours sur l’immigration dans la banlieue lavalloise

Ce mémoire se penche sur les discours citoyens des Lavallois lorsqu’il est question de l'altérité ethnoculturelle dans leur quartier de banlieue. Cela implique de poser un regard sur le contexte spécifique de la ville de Laval pour y déchiffrer les arrimages entre rapport à l'espace et rapport à l'altérité ethnique dans l'expérience des répondants. Cette recherche qui se situe donc à la croisée des domaines des relations ethniques, de la géographie sociale et des études urbaines permet d’ancrer les représentations de l’altérité ethnoculturelle dans l’espace social et physique de la banlieue. Dans ce cadre, le discours de citoyens lavallois issus de deux quartiers ayant connu différents processus de croissance urbaine et de diversification ethnique sont analysés. Pour une majorité de répondants, les changements urbains récents témoignent d'une diversification de l'espace habité, ce qui est généralement mal perçu. Les manifestations d’altérité ethnoculturelle dans l’espace public et privé lavallois sont aussi associées à une détérioration du lien social dans la communauté du quartier. Au terme de cette étude, je soutiens que la présence d'immigrants est imbriquée dans les récents changements urbains dans la ville de Laval et que ces derniers sont directement associés à la perte du statut convoité de banlieue idéale.

Rapport à l’espace, rapport à l’autre : constructions des discours sur l’immigration dans la banlieue lavalloise

Ce mémoire se penche sur les discours citoyens des Lavallois lorsqu’il est question de l'altérité ethnoculturelle dans leur quartier de banlieue. Cela implique de poser un regard sur le contexte spécifique de la ville de Laval pour y déchiffrer les arrimages entre rapport à l'espace et rapport à l'altérité ethnique dans l'expérience des répondants. Cette recherche qui se situe donc à la croisée des domaines des relations ethniques, de la géographie sociale et des études urbaines permet d’ancrer les représentations de l’altérité ethnoculturelle dans l’espace social et physique de la banlieue. Dans ce cadre, le discours de citoyens lavallois issus de deux quartiers ayant connu différents processus de croissance urbaine et de diversification ethnique sont analysés. Pour une majorité de répondants, les changements urbains récents témoignent d'une diversification de l'espace habité, ce qui est généralement mal perçu. Les manifestations d’altérité ethnoculturelle dans l’espace public et privé lavallois sont aussi associées à une détérioration du lien social dans la communauté du quartier. Au terme de cette étude, je soutiens que la présence d'immigrants est imbriquée dans les récents changements urbains dans la ville de Laval et que ces derniers sont directement associés à la perte du statut convoité de banlieue idéale.

Who cares about human relations? A selective and critical bibliography deeply concerned with the human relations of family, community, ethnic, and racial groups, religion, education, business, and industry.

Mode of access: Internet.

Social and cultural influences in the formation of identity: A cross-national/cultural study

This multi-site, multi-ethnic/cultural study examined the effects of variation between ethnic/cultural groups and the effects of institutional variation within ethnic/cultural groups on identity formation. The participants were 892 late adolescent college students from six sites in 5 countries (Brazil, China, Costa Rica, US, and Sweden) representing different linguistic and ethnic/cultural traditions living in the context of varied social conditions. As hypothesized, there were significant differences in the proportion of identity statuses between sites in the Personal domain, $\chi\sp2$(20, N = 858) = 164.78, $p<.001,$ the Interpersonal domain, $\chi\sp2$(20, N = 858) = 145.69, $p<.001,$ and the World View domain, $\chi\sp2$(20, N = 858) = 120.89, $p<.001,$ but the distribution of the differences was more complex than expected. In addition, there were significant differences in Identity Satisfaction among sites, F(15, 2325) = 12.65, $p<.001.$ Further univariate analyses revealed that differences among sites were found on Identity Satisfaction in the personal, interpersonal and world view domain. The direction of the differences, however, were more complex than hypothesized.^ The second hypothesis was confirmed but only with the world view identity status and not for each of the six sites. Stepwise discriminant analyses showed that Identity status in the world view domain was predicted by Institutional Support in Nebraska, gender and Institutional Change in Brazil, and Institutional Access in China. Lastly and as hypothesized, some Institutional Attributes significantly predicted Overall Identity Satisfaction in all sites as revealed by multivariate regression analyses, except in Sweden, F (5, 79) =.660, p =.65. These findings extend the literature on identity formation not only by having investigated how culture influences the process of identity formation with samples representing different ethnic/cultural and linguistically different populations but also by empirically testing the role that social processes play in identity formation at the cross-cultural level. ^

Safety habits promoted by Hispanic parents for school-aged and adolescent children

Accidents are the leading cause of death among children. Compliance with safety measures have been shown to reduce morbidity and mortality in children. However, Hispanic parents and children have not been adequately studied in the literature in regard to trauma and safety habits utilized. In this exploratory-descriptive study, a convenience sample of 48 Hispanic parents were questioned about their child's activities. The purpose was to determine what safety equipment was used during these activities and how often they were used. Responses to an English/Spanish questionnaire were summarized by frequencies and percentages. Findings suggested that these Hispanic children were at risk for injury due to a low percentage of children wearing the necessary protective equipment. Therefore, education must stress consistent use of safety equipment if injuries are to be prevented. ^

Equity policy, educational practice, and limited English proficient (LEP) students in two high schools in Miami

Most studies of language minority students' performance focus on students' characteristics. This study uses qualitative methodology to examine instead how educational policies and practices affect the tracking of language minority students who are classified as limited English proficient (LEP). The placement of LEP students in core courses (English, Math, Social Studies, and Science) is seen as resulting from the interaction between school context and student characteristics. The school context includes factors such as equity policy requirements, overcrowding, attitudes regarding immigrants' academic potential, tracking, and testing practices. Interaction among these factors frequently leads to placement in lower track courses. It was found that the absence of formal tracks could be misleading to immigrant students, particularly those with high aspirations who do not understand the implications of the informal tracking system. Findings are discussed in relation to current theoretical explanations for minority student performance. ^

Comparative analysis of a moderating and mediating model of stress, appraisal, and coping in Hispanic and non-Hispanic Alzheimer's disease caregivers

This dissertation utilizes a cross-sectional study to examine the phenomenon of caregiving within a theoretically grounded stress, appraisal, and coping model. Hispanic and non-Hispanic caregivers were studied to examine the factors associated with variance in caregiver appraisal, coping, and outcomes of caregiving strain (depression and somatic complaints) and caregiving gain (life satisfaction, mastery, and personal gain). A purposive sampling strategy was used to recruit 204 Alzheimer's disease caregivers in South Florida. A self-report questionnaire was used to collect demographic data, and to measure stress, appraisal, coping, and psychological well-being of caregivers. Regression equations were developed to compare moderating and mediating models of appraisal and coping. Emotion-focused coping skills were found to significantly moderate the effects of stress (F [1,195] = 4.62, p < .05), explaining approximately 21% of the variance in satisfaction was found to moderate the effects of stress (F [1,195] = 7.09; p < .05), explaining approximately 27% of the variance in personal gain and approximately 8% of the variance in life satisfaction (F [1,195] = 4.14; p < .05). Appraisal of Burden was found to significantly mediate the effects of stress, explaining approximately 30% of the variance in somatic complaints (F [1,196] = 31.60; p < .001) and 32% of the variance in depression (F [1,196] = 38.18; p < .001). The results of the analyses indicate that appraisal and coping skills are important variables in the stress process. The results of this study underscore the importance of accounting for positive and negative outcomes in providing a fuller understanding of the stress, appraisal and coping process of Alzheimer's Disease caregivers. ^

The Jose Movement: A new phenomenon in Cuban spiritualism

Rather than focus on the Afro-Catholic syncretism in Santeria, which other scholars have explored extensively, this thesis treats a related but relatively obscure area of study: a syncretic religious movement that arose in Havana, Cuba in the second half of the twentieth century. The José Movement revolves around the belief in José, a spirit who communicated with people through an acclaimed medium named Leocadia Pérez. Since Pérez's death in 1962, however, the legacy of José has not only spread to Miami among the exile Cuban community, but it has taken on a new direction in Cuba. Given the scarcity of literary sources that contain references to José or Leocadia, the principal methodology used in this investigation is based on oral accounts of those who met and/or knew the leaders, as well as on field observations of those who continue to venerate the spiritual forces these charismatic figures reflect. ^