Stages of change and carotene intake in the Paso del Norte region: Que Sabrosa Vida

Understanding a population's dietary behavior is important to promote behaviors which have the most beneficial impact on health. The most recent Dietary Guidelines for Americans (2005) identifies carotenoids as a key nutrient to be consumed through increased intake of fruits and vegetables (FV). While some studies have included or focused on the Hispanic population, few have focused only on Mexican-American populations and staged its intake of FV. Stage of change behavior theory has been used to understand the adoption and promotion of healthy behaviors such as increased intake of FV. It has been shown to effectively aid interventionists' understanding of dietary behavior. Intake patterns of FV of older women, rural residents, and adolescents of Mexican American descent have been conducted but not by stages of change. This study aimed to determine the relationship between stages of change for fruits and vegetables (SOC-FV) and total carotene intake to assess the quality of SOC-FV as a surrogate measure of total carotene. ^ Data from the 2000 Qué Sabrosa Vida Community Nutrition Survey (QSV-CNS) were analyzed to identify the SOC-FV and sources of carotenes in a Mexican American population 18-60 yrs. of the Paso del Norte region. A 107 item interviewer administered food frequency questionnaire (FFQ) specifically calibrated for a Mexican American population was used to collect usual intake of total carotene. The QSV survey study population included 963 participants, 590 (61.3%) women and 373 (38.7%) men. A statistically significant mean difference in caloric intake between men and women was found (p-value = <0.01). When total carotene intake was adjusted for energy, there were significant differences between men and women (p-value = <0.0001) with women consuming a higher amount of total carotene (406 RE/kcal 1,000) than men (332 RE/kcal 1000). The food sources of total carotene for both genders included many items found in a traditional Mexican American diet. Chile, after carrots, was the highest contributor of dietary carotene. Total carotene intake was not associated with stages of change among women or men and their distributions were not linear. Mean differences of total carotene by stages of change were significant for women for pre-contemplation/contemplation (p-value = 0.04) and preparation (p-value = 0.0004) but not for men. ^ SOC-FV may serve as a surrogate measure for dietary carotene intake. This study's Mexican American population had a high carotene quality diet derived from traditional food items irrespective of their stage of change for fruits and vegetables. To better understand this population's dietary intake a measure for acculturation should be included. Interventions aimed at Mexican American populations should aim to promote traditional diets consistent with cultural practices.^ ^

A cross-sectional analysis of the association between polycyclic aromatic hydrocarbons and diesel particulate matter exposures and hypertension among individuals of Mexican origin residing in Houston, TX

Background. Research has shown that elevations of only 10 mmHg diastolic blood pressure (BP) and 5 mmHg systolic BP are associated with substantial (as large as 50%) increases in risks for cardiovascular disease, a leading cause of death, worldwide. Epidemiological studies have found that particulate matter (PM) increases blood pressure (BP) and many biological mechanisms which may suggest that the organic matter of PM contributes to the increase in BP. To understand components of PM which may contribute to the increase in BP, this study focuses on diesel particulate matter (DPM) and polycyclic aromatic hydrocarbons (PAHs). To our knowledge, there have been only four epidemiological studies on BP and DPM, and no epidemiological studies on BP and PAHs. ^ Objective. Our objective was to evaluate the association between prevalent hypertension and two ambient exposures: DPM and PAHs amongst the Mano a Mano cohort. ^ Methods. The Mano a Mano cohort which was established by the M.D. Anderson Cancer Center in 2001, is comprised of individuals of Mexican origin residing in Houston, TX. Using geographical information systems, we linked modeled annual estimates of PAHs and DPM at the census track level from the U.S. Environmental Protection Agency's National-Scale Air Toxics Assessment to residential addresses of cohort members. Mixed-effects logistic regression models were applied to determine associations between DPM and PAHs and hypertension while adjusting for confounders. ^ Results. Ambient levels of DPM, categorized into quartiles, were not statistically associated with hypertension and did not indicate a dose response relationship. Ambient levels of PAHs, categorized into quartiles, were not associated with hypertension, but did indicate a dose response relationship in multiple models (for example: Q2: OR = 0.98; 95% CI, 0.73–1.31, Q3: OR = 1.08; 95% CI, 0.82–1.41, Q4: OR = 1.26; 95% CI, 0.94–1.70). ^ Conclusion. This is the first assessment to analyze the relationship between ambient levels of PAHs and hypertension and it is amongst a few studies investigating the association between ambient levels of DPM and hypertension. Future analyses are warranted to explore the effects DPM and PAHs using different categorizations in order to clarify their relationships with hypertension.^

Association of processed red meat and prostate cancer stage in Mexican-Americans: A population based case-control study

Objective: The objective of this study is to investigate the association between processed and unprocessed red meat consumption and prostate cancer (PCa) stage in a homogenous Mexican-American population. Methods: This population-based case-control study had a total of 582 participants (287 cases with histologically confirmed adenocarcinoma of the prostate gland and 295 age and ethnicity-matched controls) that were all residing in the Southeast region of Texas from 1998 to 2006. All questionnaire information was collected using a validated data collection instrument. Statistical Analysis: Descriptive analyses included Student's t-test and Pearson's Chi-square tests. Odds ratios and 95% confidence intervals were calculated to quantify the association between nutritional factors and PCa stage. A multivariable model was used for unconditional logistic regression. Results: After adjusting for relevant covariates, those who consume high amounts of processed red meat have a non-significant increased odds of being diagnosed with localized PCa (OR = 1.60 95% CI: 0.85 - 3.03) and total PCa (OR = 1.43 95% CI: 0.81 - 2.52) but not for advanced PCa (OR = 0.91 95% CI: 1.37 - 2.23). Interestingly, high consumption of carbohydrates shows a significant reduction in the odds of being diagnosed with total PCa and advanced PCa (OR = 0.43 95% CI: 0.24 - 0.77; OR = 0.27 95% CI: 0.10 - 0.71, respectively). However, consuming high amounts of energy from protein and fat was shown to increase the odds of being diagnosed with advanced PCa (OR = 4.62 95% CI: 1.69 - 12.59; OR = 2.61 95% CI: 1.04 - 6.58, respectively). Conclusion: Mexican-Americans who consume high amounts of energy from protein and fat had increased odds of being diagnosed with advanced PCa, while high amounts of carbohydrates reduced the odds of being diagnosed with total and advanced PCa.^

Sociocultural context of knowledge and beliefs about cardiovascular disease among Latino women

We formed an academic-community partnership with the Salsa Caliente program to undertake a project to better understand how Latina women with cardiovascular disease (CVD) or at risk of CVD view and understand CVD. This study's research question examines the sociocultural factors that influence and inform Latino women's perceptions and beliefs about CVD. Seven out the eleven participants in the Salsa Caliente program consented to be interviewed. The data was collected through recorded interviews, which were transcribed and then analyzed for common themes found among all the participants' narratives. The content analysis looking into common themes yielded four: 1) increased awareness of CVD, 2) trust in doctor, 3) delay in doctor visits, and 4) awareness of health. Implications for interventions and further research are discussed.^

An investigation of pertussis cases in a Texas county from 2008 through 2012

Background: Once thought to be eradicated, pertussis is now making a steady comeback throughout Texas and the United States. Pertussis can have an effect on all demographics, but infants have the greatest health concern as they suffer the highest case-fatality rate. The objective of this study was to create and report a comprehensive summary of confirmed or probable pertussis cases in a Texas County during the 2008 through 2012 time period.^ Methods: A cross-sectional study design was used to show at risk populations in a Texas county using descriptive statistics of data from probable and confirmed pertussis cases in this Texas County from 2008-2012. Data was collected during routine pertussis investigations conducted by the local health department of this Texas County.^ Results: There was a sharp increase in pertussis cases seen in this county in 2012. Hispanics made up the majority of cases (74.9%) as compared to 12.8% of cases among Whites, 3.1% of cases among Blacks and 9.2% of cases among unknown/other. The population of Hispanics within this county was 58.9%. Almost a quarter of cases (24.2%) in this study were hospitalized. There was no difference identified in the proportion of male sources of exposure (48.9%) as compared to female (51.1%). Household contacts were the main sources of exposure: siblings (29.2%), fathers (14.5%), children (14.6%), and mothers (12.5%).^ Conclusion: Prevention intervention needs to be designed to target vulnerable populations and reduce the effect of this sometimes fatal disease. These results show pertussis proportionally has a greater effect on Hispanics. Additional research needs to be conducted on risk factors such as household crowding and immunization status among Hispanics to identify if ethnicity plays a role in risk of transmission of pertussis. The results were limited due to the large amount of missing data in vaccination history and identification of source of exposure.^

Associations of perceived body image and subjective social status with levels of physical activity in Mexican American adolescents

The current study is a secondary data analysis of a prospective cohort study that examined demographic and psychosocial variables and their associations with physical activity levels in Mexican-American adolescents in Houston, Texas. Body image, subjective social status, and anxiety were the main variables of interest. The sample included 952 unrelated Mexican-American adolescents in Houston, Texas. The majority (84.2%) of the study population did not meet physical activity standards prescribed by the CDC.^ In a multivariate model controlling for age, socioeconomic status, gender, general body image, preferred body image, subjective social status, and anxiety, gender and subjective social status were found to be the strongest determinants of physical activity levels. Males and those with a high subjective social status were more likely to participate in physical activity than those with low subjective status. Lower levels of anxiety and a more positive body image were also found to be associated with higher levels of physical activity. In multivariate analyses gender and subjective social status showed the strongest associations with physical activity.^

¿Es su casa mi casa? Latinos, Socialization, and the Catholic Church

Thesis (Ph.D.)--University of Washington, 2016-06

The development and testing of a multivariate model of differentiation of self among Hispanics

Individuals of Hispanic origin are the nation's largest minority (13.4%). Therefore, there is a need for models and methods that are culturally appropriate for mental health research with this burgeoning population. This is an especially salient issue when applying family systems theories to Hispanics, who are heavily influenced by family bonds in a way that appears to be different from the more individualistic non-Hispanic White culture. Bowen asserted that his family systems' concept of differentiation of self, which values both individuality and connectedness, could be universally applied. However, there is a paucity of research systematically assessing the applicability of the differentiation of self construct in ethnic minority populations. ^ This dissertation tested a multivariate model of differentiation of self with a Hispanic sample. The manner in which the construct of differentiation of self was being assessed and how accurately it represented this particular ethnic minority group's functioning was examined. Additionally, the proposed model included key contextual variables (e.g., anxiety, relationship satisfaction, attachment and acculturation related variables) which have been shown to be related to the differentiation process. ^ The results from structural equation modeling (SEM) analyses confirmed and extended previous research, and helped to illuminate the complex relationships between key factors that need to be considered in order to better understand individuals with this cultural background. Overall results indicated that the manner in which Hispanic individuals negotiate the boundaries of interconnectedness with a sense of individual expression appears to be different from their non-Hispanic White counterparts in some important ways. These findings illustrate the need for research on Hispanic individuals that provides a more culturally sensitive framework. ^

Tocqueville in Miami: Political culture and political organizing in Miami's Cuban community

This study examines the effectiveness of civic organizations focusing on leadership and the role of culture in politics. The study is based on a quasi-experimental research design and relies primarily on qualitative data. The study focuses on Miami's Cuban community in order to examine the role of public initiative in grassroots civic and community organizations. ^ The Miami Cuban community is a large, institutionally complex and cohesive ethnic community with dense networks of community organizations. The political and economic success of the community makes it an opportune setting for a study of civic organizing. The sheer number of civic organizations to be found in Miami's Cuban community suggests that the community's civic organizations have something to do with the considerable vibrancy and civic capacity of the community. How have the organizations managed to be so successful over so many years and what can be learned about successful civic organizing from their experience?^ Civic organizations in Miami's Cuban community are overwhelmingly ethnic-based organizations. The organizations recreate collective symbols that come from community members' memories of and attachments to the place of origin they hold dear as ethnic Cubans. They recreate a collective Cuban past that community members remember and that is the very basis of the community to which they belong.^ Cuban Miami's ethnically based civic organizations have generally performed better than the literature on civic organizations says they should. They gained greater access to community ties and social capital, and they exhibited greater organizational longevity. The fit between the political culture of civic organizations and that of the broader political community helps to explain this success. Yet they do not perform in the same way or in support of the same social purposes. Some stress individual agency rather than community agency, and some pursue an externally-oriented social purpose, whereas others focus on building an internal community.^

Relationships among dietary intake, dietary patterns, dietary quality and nutrient adequacy and substance use in Latina mother/daughter dyads

This study examined the relationships among dietary intake, substance use, socioeconomic and acculturation-related factors among Latinas in Miami-Dade County. Substance abuse is rising among Latinas. A fuller understanding of this problem is needed given the rise of the Hispanic population and the role of women in Latin society. A better understanding between substance use and dietary intake can guide nutrition interventions to reduce negative substance-related health consequences. A purposeful sample of 320 Latina mother/daughter dyads were recruited and interviewed face-to-face as part of the Latino Women's Study. Dietary intake was collected via a 24-hour recall and examined by (1) nutrient intake, (2) dietary patterns using cluster analysis, (3) quality of diet using the Healthy Eating Index (HEI) and (4) the Dietary Reference Intakes to determine nutrient adequacy. Substance use was measured with the Drug Use Frequency and the Healthy and Daily Living Form. Acculturation was measured with the Cultural Identity Scale. Three dietary patterns emerged based on the number of servings from the food groups established in MyPyramid. None were associated with substance use. Latinas who reported using cannabis, cocaine, sedatives without prescription and/or more than five alcoholic drinks on an occasion at least once a month during the previous twelve months had significantly lower HEI scores (64 vs. 60; F = 7.8, p = .005) and consumed fewer fruits (F = 16, p < .001) than non-users. Latinas classified as mothers whom reported consuming cannabis at least 1-7 times a week had significantly lower HEI scores (F = 4.23, p = .015, η2 = .027) than daughters with the same frequency of substance use. One dimension of acculturation, greater familiarity with Latin culture, was associated with good dietary quality (β = .142, p = .012) regardless of any type of substance used or income level. There was a high prevalence of inadequacy of folic acid intake (50-75%) regardless of substance use. Substance users consumed significantly more energy (1,798 vs. 1,615; p = .027) than non-users. Although effect sizes were small, associations between dietary intake and substance use among Latinas deserve further exploration while acknowledging the combined association with acculturation. ^

Placing immigrant incorporation: Identity, trust, and civic engagement in Little Havana

Immigrant incorporation in the United States has been a topic of concern and debate since the founding of the nation. Scholars have studied many aspects of the phenomenon, including economic, political, social, and spatial. The most influential paradigm of immigrant incorporation in the US has been, and continues to be, assimilation, and the most important place in and scale at which incorporation occurs is the neighborhood. This dissertation captures both of these integral aspects of immigrant incorporation through its consideration of three dimensions of assimilation – identity, trust, and civic engagement – among Latin American immigrants and American-born Latinos in Little Havana, a predominantly immigrant neighborhood in Miami, Florida. Data discussed in the dissertation were gathered through surveys and interviews as part of a National Science Foundation-funded study carried out in 2005-2006. The combination of quantitative and qualitative data allows for a nuanced understanding of how immigrant incorporation is occurring locally during the first decade of the twentieth century. Findings reveal that overall Latin American immigrants and their American-born offspring appear to be becoming American with regard to their ethnic and racial identities quickly, evidenced through the salience and active employment of panethnic labels, while at the same time they are actively reshaping the identificational structure. The Latino population, however, is not monolithic and is cleaved by diversity within the group, including country of origin and socioeconomic status. These same factors impede group cohesion in terms of trust and its correlate, community. Nevertheless, the historically dominant ancestry group in Little Havana – Cubans – has been able to reach notable levels of trust and build and conserve a more solid sense of community than non-Cuban residents. With respect to civic engagement, neighborhood residents generally participate at rates lower than the overall US population and ethnic subpopulations. This is not the case for political engagement, however, where self-reported voting registration and turnout in Little Havana surpasses that of most benchmarked populations. The empirical evidence presented in this dissertation on the case of Latinos in Little Havana challenges the ways that identity, trust, and civic engagement are conceptualized and theorized, especially among immigrants to the US.

Living positive: Life in community among Puerto Rican men living with HIV in Boston

Negative experiences of stigmatization, discrimination, and rejection are common among people living with HIV in the United States, and particularly when they are also members of a minority group. Some three decades after the first cases of AIDS were identified, people infected with HIV continue to be perceived and characterized negatively. While an HIV/AIDS diagnosis is typically associated with negativity, this study investigates the extent to which collective experiences among HIV-positive people result in healthy responses and positive social adjustment. This study is focused on the ways in which HIV-positive Puerto Rican men in Boston live positive despite being diagnosed with HIV. Rather than wrapping themselves in the social stigma of HIV and the isolation that entails, they participate in processes that affirm themselves and their peers. In so doing, they help generate both healthy and meaningful lives for themselves and others. The study examines the process in which Puerto Rican men living with HIV in Boston participate, promote, and reaffirm an HIV community, la comunidad, as a social entity with a unique culture and identity. This study also investigates how this community influences, supports, and encourages the adoption of positive transformations for living long term with HIV. On the basis of nine months of field research, this qualitative study employed both focus groups and interviews with fifty HIV-positive Puerto Rican men in Boston. These men were recruited, using convenience sampling, from different community-based organizations (CBOs) that provide HIV/AIDS services in Boston. The study finds that HIV-positive Puerto Rican men in Boston build community, not in response to social exclusion, but built on shared positive practices and strategies for living healthy with HIV. These men come together to negotiate and form a unique cultural community expressed in norms, beliefs, and practices that, although centered on HIV, are designed for living healthy. These expressions reaffirm a sense of community in everyday settings and transform the lives of these men with positive behaviors and healthy lifestyles. The findings reveal that this transformation takes place in the context of a community, with the support, encouragement, and at times, policing of others. La comunidad is where the lives of these men are transformed as they learn, adopt, and experience living positive with HIV.

The role of neighborhood organizations in the production of gentrifiable urban space: The case of Wynwood, Miami's Puerto Rican barrio

Partnerships between government and community-based actors and organizations are considered the hallmark of contemporary governance arrangements for the revitalization and gentrification of economically distressed, inner city areas. This dissertation uses historical, narrative analysis and ethnographic methods to examine the formation, evolution and operation of community-based governance partnerships in the production of gentrifiable urban space in the Wynwood neighborhood of Miami, FL between 1970 and 2010. This research is based on more than four years of participant observation, 60 in-depth interviews with respondents recruited through a purposive snowball sample, review of secondary and archival sources, and descriptive, statistical and GIS analysis. This study examines how different organizations formed in the neighborhood since the 1970s have facilitated the recent gentrification of Wynwood. It reveals specifically how partnerships between neighborhood-based government agencies, nonprofit organizations and real estate developers were constructed to be exclusionary and lead to inequitable economic development outcomes for Wynwood residents. The key factors conditioning these inequalities include both the rationalities of action of the organizations involved and the historical contexts in which their leaders’ thinking and actions were shaped. The historical contexts included the ethnic politics of organizational funding in the 1970s and the “entrepreneurial” turn of community-based economic development and Miami urban politics since the 1980s. Over time neighborhood organizations adopted highly pragmatic rationalities and repertoires of action. By the 2000s when Wynwood experienced unprecedented investment and redevelopment, the pragmatism of community-based organizations led them to become junior partners in governance arrangements and neighborhood activists were unable to directly challenge the inequitable processes and outcomes of gentrification.

Too Much to Belong: Latina/o Racialization, Obesity Epidemic Discourse, and Unassimilable Corporeal Excess

This project examines the discursive constructions of Latina/o bodies as excessive in order to examine how Latinas/os are excluded from belonging to the U.S. nation-state. By approaching Latina/o Studies from a Fat Studies perspective, it works to more adequately address the role of embodiment in determining processes of racialization that directly impact Latinas/os in the United States, especially in light of the role of race and racism in “obesity epidemic” discourse. This dissertation argues that cultural and even physiological explanations about the Latina/o propensity for “overweight” and “obesity” create a discourse that marks the Latina/o body as demonstrating an unassimilable corporeal excess. In turn, the rhetoric of “diversity” and “multiculturalism” are rendered inapplicable to Latinas/os, as demonstrated by both nativist and seemingly pro-immigrant discourses that posit Latina/o physical excess in the form of fatness as detrimental and even dangerous to the U.S. nation-state.

"Natural Enemies" or Intentional Allies? Teachers' & Parents' Perspectives on Middle School Boys of Color

This study examined the perspectives and “shared knowledge” of parents and teachers of boys of color. The following overarching research question guided this study: “What do parents and teachers want each other to know about their middle school son or student of color regarding academics, engagement, and behavior?” Additionally, it explored the challenges and opportunities for shared knowledge and understanding of their (respective) son’s’ or students’ academics and engagement. The methodology was qualitative in nature and the intent in conducting this case study was to describe, interpret, and explain the “shared knowledge” between these stakeholders at a predominantly minority middle school. A sample of seven parents and seven teachers from one school in a mid-Atlantic state participated in interviews and focus groups. Results indicated that parents and teachers of boys of color viewed each other as “intentional allies.” Results further showed that parents and teachers were aware of the challenges faced by boys of color in and out of school. That awareness was reflected in strategies that both groups employed to support, prepare, and protect their son/students. Lastly, the study found that teachers received no formal training in building parent-teacher partnerships, but gathered experimental knowledge on how to build those relationships. These findings have implications for teacher education programs, schools, parents, and teachers.