Search

Postmenopausal Hispanic/Latina (N = 254) women with a body mass index (BMI) ≥ 25 kg/m2 were randomized to an intervention to reduce sitting time or a comparison condition for 12 weeks. The standing intervention group received three in-person health-counseling sessions, one home visit, and up to eight motivational interviewing calls. The heart healthy lifestyle comparison group (C) received an equal number of contact hours to discuss healthy aging. The primary outcome was 12-week change in sitting time measured via thigh-worn activPAL. Group differences in outcomes were analyzed using linear mixed-effects models. Participants had a mean age of 65 (6.5) years, preferred Spanish language (89%), BMI of 32.4 (4.8) kg/m2, and sat for an average of 540 (86) minutes/day. Significant between-group differences were observed in reductions of sitting time across the 12-week period [Mdifference (SE): C − 7.5 (9.1), SI − 71.0 (9.8), p < 0.01]. Results demonstrate that coaching models to reduce sitting are feasible and effective. [ABSTRACT FROM AUTHOR]

The purpose of the study was to explore differences in Google search autocompletes between English and Spanish‐speaking users during the first wave of the coronavirus disease 2019 (COVID‐19) pandemic. Twenty‐nine individuals who were in areas with shelter‐in‐place state orders participated in a virtual focus group meeting to understand the algorithm bias of COVID‐19 Google autocompletes. The three focus group meetings lasted for 90–120 minutes. A codebook was created and transcripts were coded using NVivo qualitative software with a 95% intercoder reliability between two coders. Thematic analysis was used to analyze the data. Among the 29 participants, six self‐identified as White, seven as Black/African American, five as American Indian or Alaska Native, four as Asian Indian, and three as Native Hawaiian or Pacific Islander. In terms of ethnicity, 21 participants identified as Hispanic/Latino. The themes that emerged from the study were: (1) autocompletes evoked fear and stress; (2) skepticism and hesitation towards autocomplete search; (3) familiarity with COVID‐19 information impacts outlook on autocomplete search; (4) autocompletes can promote preselection of searches; and (5) lesser choice of autocomplete results for Spanish‐speaking searchers. Spanish speakers expressed concerns and hesitation due to social factors and lack of information about COVID‐19. [ABSTRACT FROM AUTHOR]

Latinos engage in high levels of occupational physical activity, yet low levels of leisure-time physical activity. Limited research has examined specific work-based activities that may contribute to leisure-time physical activity for meeting current physical activity recommendations among Latinos. The purpose of our study was to examine associations between frequency of work-related exertion and standing/walking with meeting the aerobic and muscle-strengthening physical activity guidelines among Latinos and whether associations varied by nativity. We used cross-sectional 2015 National Health Interview Survey data on Latinos ≥18 years of age (n = 3162). Logistic regression models were used to estimate associations between the frequency of work-related activities with meeting the aerobic and muscle-strengthening physical activity guidelines. Models were adjusted for age, sex, education, Latino subpopulation, shift work, and nativity. We also examined whether associations varied by nativity. In adjusted models, compared with those never engaging in exertion at work, participants always exerting themselves were significantly less likely to meet the aerobic activity guideline (Odds Ratio [OR]: 0.66, 95% Confidence Interval [CI]: 0.51–0.87). Compared with those never standing/walking at work, participants seldom standing/walking were also less likely to meet the aerobic activity guideline (OR: 0.57, 95% CI: 0.34, 0.95). Models were adjusted for age, sex, education, Latino subpopulation, shift work, and nativity. When stratified by nativity, the patterns in the strength of the associations were similar, while differences were observed in the associations of work-related activities with meeting guidelines. Our findings suggest that engaging in higher frequency of exertion and standing/walking at work are associated with being less likely to meet the aerobic physical activity guideline during leisure time among Latinos, with variation observed in meeting guidelines by nativity. Insight into physical activities performed at work could inform efforts aimed at promoting recommended levels of physical activity among Latinos. [ABSTRACT FROM AUTHOR]

COVID-19 continues to disproportionately impact the health of Hispanics/Latinos. While Hispanics/Latinos are considered one of the fastest-growing racial/ethnic groups, media news coverage in Spanish concerning COVID-19 is stunningly low. The Hispanic/Latino population comprises close to 25% of COVID-19 cases and 17% of COVID-19 deaths. Lack of access to Spanish news coverage and limited attention to Spanish-speaking Hispanics/Latinos has created inconsistent messaging about COVID-19. Improving public health media initiatives for the Hispanic/Latino population should focus on increasing Spanish news coverage to respond against systematic discrimination, misinformation, fear, and vaccine hesitancy. [ABSTRACT FROM AUTHOR]

Objective: This study explored Hispanic/Latino aging adults' interest in and preferences for intergenerational physical activity programming. Methods: We used an exploratory sequential (Qual-QUAN) mixed methods design consisting of three focus groups (N = 13 participants; M age = 62.5 years old) and a quantitative survey (N = 105 participants; M age = 57.3 years old). Results: We found that most participants were interested in intergenerational physical activity programs: (1) to promote overall health and well-being, (2) increase opportunities for socialization and relationships, and (3) foster motivation and energy. Preferences for programming included cultural tailoring, bilingual and Spanish-language offerings, and being conducted in-person. Barriers to physical activity included cost, scheduling, transportation, and limited awareness of community resources. Discussion: Innovative public health initiatives incorporating an intergenerational approach may promote physical activity among aging adults. This study has implications for developing and refining intergenerational programming with Hispanic/Latino communities. [ABSTRACT FROM AUTHOR]

This study aims to adapt a video-based, multimedia chemotherapy educational intervention to meet the needs of US Latinos with advanced gastrointestinal malignancies. A five-step hybrid adaptation process involved (1) creating a multidisciplinary team with diverse Latino subject experts, (2) appraising the parent intervention, (3) identifying key cultural considerations from a systematic literature review and semi-structured Latino patient/caregiver interviews, (4) revising the intervention, highlighting culturally relevant themes through video interviews with Latino cancer patients, and (5) target population review with responsive revisions. We developed a suite of videos, booklets, and websites available in English and Spanish, which convey the risks and benefits of common chemotherapy regimens. After revising the English materials, we translated them into Spanish using a multi-step process. The intervention centers upon conversations with 12 Latino patients about their treatment experiences; video clips highlight culturally relevant themes (personalismo, familismo, faith, communication gaps, prognostic information preferences) identified during the third adaptation step. The adapted intervention materials included a new section on coping, and one titled "how to feel the best you can feel," which reviews principles of side effect management, self-advocacy, proactive communication, and palliative care. Ten Latinos with advanced malignancies reviewed the intervention and found it to be easily understandable, relatable, and helpful. A five-step hybrid model was successful in adapting a chemotherapy educational intervention for Latinos. Incorporation of video interviews with Latino patients enabled the authentic representation of salient cultural themes. Use of authentic patient narratives can be useful for cross-cultural intervention adaptations. [ABSTRACT FROM AUTHOR]

Background The objectives were to assess (a) the association between poor oral health and mild cognitive impairment (MCI) in Hispanic/Latino immigrants and (b) potential modification effects on this association by age at immigration. Methods Data were from the Hispanic Community Health Study/Study of Latinos and its ancillary study—the Study of Latinos–Investigation of Neurocognitive Aging. MCI, a binary outcome variable, defined by the National Institute on Aging-Alzheimer's Association criteria. The main exposure was significant tooth loss (STL), defined as a loss of 8 or more teeth, and periodontitis, classified using the Centers for Disease Control and Prevention and American Academy of Periodontology case classification. Multiple logistic regression was used to assess the association between STL/periodontitis and MCI and test moderation effects of age at immigration. The analytical sample comprised 5 709 Hispanic/Latino adult immigrants. Results Hispanic/Latino immigrants with STL (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI]: 1.01–1.85) were more likely to have MCI than those with greater tooth retention. Overall, migration to the United States after age 18 was associated with greater odds of MCI than migration at a younger age. A significant interaction effect between STL and age at immigration revealed that the effect of STL on MCI is even higher in those who immigrated to the United States at ages 35–49 years. Conclusions STL is a significant risk factor for MCI and age at immigration had a modification effect on the association between STL and MCI. Better access to dental care, health education on risk factors of MCI, and promotion of good oral health may mitigate the burden of cognitive impairment in Hispanics/Latinos. [ABSTRACT FROM AUTHOR]

To examine whether Andersen's model explains health care utilization among Middle Eastern immigrants and to examine gender and ethnic differences in health care utilization of Middle Eastern, Hispanic/Latino, and Asian immigrants in the United States. Using data from the 2000–2017 National Health Interview Surveys (NHIS), this study compares patterns of health care utilization among Middle Eastern (ME) immigrants to those among Hispanic/Latino and Asian immigrants in the U.S. Specifically, we use Andersen's Behavioral Model of Health Care Utilization to model the likelihood of seeing a doctor in the past 12 months for these three immigrant groups. Additionally, the current study emphasizes the predisposing factor of gender and its differences across and within these groups. Andersen's behavioral framework is partially suited to predict the likelihood of seeing a doctor in the past 12 months among ME immigrants. Immigrant women, regardless of their ethnicity, are significantly more likely than men to report seeing a doctor in the past 12 months. Moreover, the effects of the predisposing, need, and enabling characteristics for Hispanics and Asians are significantly different from those for ME immigrants. Additionally, although Asians are significantly less likely to utilize the health care system than ME immigrants, there are no significant differences comparing Hispanics/Latinos to ME immigrants. Furthermore, Andersen's behavioral framework explains ethnicity and gender differences particularly when comparing Asian men to ME men and Asian women to ME women. This study highlights the importance of considering ethnicity and gender differences when examining health outcomes of immigrants. [ABSTRACT FROM AUTHOR]

Introduction: Blood metabolomics‐based biomarkers may be useful to predict measures of neurocognitive aging. Methods: We tested the association between 707 blood metabolites measured in 1451 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), with mild cognitive impairment (MCI) and global cognitive change assessed 7 years later. We further used Lasso penalized regression to construct a metabolomics risk score (MRS) that predicts MCI, potentially identifying a different set of metabolites than those discovered in individual‐metabolite analysis. Results: We identified 20 metabolites predicting prevalent MCI and/or global cognitive change. Six of them were novel and 14 were previously reported as associated with neurocognitive aging outcomes. The MCI MRS comprised 61 metabolites and improved prediction accuracy from 84% (minimally adjusted model) to 89% in the entire dataset and from 75% to 87% among apolipoprotein E ε4 carriers. Discussion: Blood metabolites may serve as biomarkers identifying individuals at risk for MCI among US Hispanics/Latinos. [ABSTRACT FROM AUTHOR]

Objective: This was a cross-sectional study associating vitamin D, calcium, magnesium, and potassium intakes with markers of glucose metabolism in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: HCHS/SOL is a multicenter, prospective, population-based cohort study on Hispanics/ Latinos aged 18–74 years in the US. For this analysis, we included 10,609 participants who were free of diabetes. Analysis of covariance was used to assess associations of a range of micronutrient intake on the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Hemoglobin A1c (HbA1c), and 2-hour post-oral glucose tolerance test (2h-plasma glucose) separately for normoglycemic and with pre-diabetes, after controlling for important confounders. All analyses accounted for the complex sample design and sampling weights. Results: HOMA-IR levels were significantly lower among adults with intakes in the highest quartile for vitamin D, magnesium, and potassium compared to the respective lowest quartiles, for those with normoglycemia and pre-diabetes, even after adjusting for confounders, such as diet quality (p < 0.05). For those with pre-diabetes, HOMA-IR levels were also significantly lower for those in the highest quartile of calcium intake. However, 2h-plasma glucose was significantly higher in those with intakes higher than quartile 1 for vitamin D and calcium among those with normoglycemia and significantly higher in quartile 3 of potassium intake for those with pre-diabetes, p < 0.05. No significant associations were found for HbA1c in either group. Conclusions: Higher consumption of vitamin D, magnesium, and potassium are associated with optimal levels of HOMA-IR among participants with normoglycemia and pre-diabetes. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown an association between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD), but it is unclear whether the association is independent of metabolic syndrome.Methods: Data from 13,006 participants aged 18 to 74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) without viral hepatitis, excessive alcohol consumption, or high transferrin saturation levels were analyzed. Suspected NAFLD was defined as presence of sex-specific elevations in serum aminotransferase levels (aspartate aminotransferase (AST) > 37 U/L or alanine aminotransferase (ALT) > 40 U/L for men and AST or ALT > 31 U/L for women). Logistic regression was used to examine cross-sectional associations of elevated serum aminotransferase levels with low estimated glomerular filtration rate (eGFR < 60 ml/min/1.73 m2 based on cystatin C), and with high urinary albumin-to-creatinine ratio (UACR) (> 17 mg/g in men and > 25 mg/ g in women) in separate models adjusting for demographic characteristics and metabolic syndrome.Results: Mean (SD) age was 41 (0.27) years, and 45 % were male. Elevated serum aminotransferase levels were noted in 18.8 % of the population and were associated with greater odds of high UACR (OR = 1.31; 95 % CI = 1.10, 1.56) after adjusting for demographic characteristics; this association became non-significant after adjustment for metabolic syndrome (OR = 1.11, 95 % CI = 0.92, 1.33). In contrast, elevated serum aminotransferase levels were not associated with low eGFR (odds ratio (OR) = 0.73; 95 % confidence interval (CI) = 0.45, 1.18) after adjusting for covariates.Conclusions: In this sample of diverse U.S. Hispanic Latino adults, elevated serum aminotransferase levels were not independently associated with measures of CKD. [ABSTRACT FROM AUTHOR]

Objective: To compare diet quality and its association with excess body weight (EBW: overweight/obesity), central adiposity (CA) and CVD risk factors (CVDR) among adolescents from Brazil and USA.Design: Data from two cross-sectional surveys: Health Survey of São Paulo (ISA-Nutrition) and Hispanic Community Health Study/Study of Latino Youth (SOL-Youth). Dietary intake was assessed from 24-h recalls, and diet quality using the Alternate Healthy Eating Index-2010 (AHEI) developed in the USA and the Revised Brazilian Healthy Eating Index (BHEI-R). CVDR was defined as ≥3 of: obesity, elevated blood pressure, dyslipidaemia, high plasma glucose and insulin resistance. Adjusted OR for EBW, CA and CVDR by diet quality were tested using logistic regression.Setting: São Paulo, Brazil; and Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA.Participants: Adolescents (12-16 years) living in São Paulo (n 189) and USA (n 787).Results: ISA-Nutrition individuals with EBW (v. without) had marginally lower (unhealthier) scores for whole grains using BHEI-R and sugary beverages using AHEI. SOL-Youth individuals with EBW had lower scores of nuts/legumes using AHEI, and Na using BHEI-R, but higher scores of whole grains and dairy using BHEI-R. In ISA-Nutrition, BHEI-R was inversely associated with EBW (OR = 0·87; 95 % CI 0·80, 0·95) and CVDR (OR = 0·89; 95 % CI 0·80, 0·98). In SOL-Youth, AHEI was inversely associated with EBW (OR = 0·93; 95 % CI 0·87, 0·99).Conclusions: Dietary improvements should be made by adolescents in both USA and Brazil. Healthier diet quality as measured with the country-specific index was associated with lower odds of EBW in Brazilian and USA-Hispanic/Latino adolescents, and with lower CVDR in Brazilian adolescents. [ABSTRACT FROM AUTHOR]

Background: Previous diet findings in Hispanics/Latinos rarely reflect differences in commonly consumed and culturally relevant foods across heritage groups and by years lived in the United States.Objectives: We aimed to identify and compare a posteriori heritage-specific dietary patterns (DPs) and evaluate their associations with "healthfulness" [using the Alternative Healthy Eating Index-2010 (AHEI-2010)] and years living in the United States.Methods: We used baseline data from a population-based cohort of 14,099 Hispanics/Latinos aged 18-74 y in the Hispanic Community Health Study/Study of Latinos. We performed principal factor analysis using two 24-h recalls to derive DPs, separately, in each heritage group (Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American), and identified overarching DPs based on high-loading foods shared by ≥2 groups. We used multivariable linear regression to test associations of DPs with AHEI-2010 and years living in the United States.Results: We identified 5 overarching DPs (Burgers, Fries, & Soft Drinks; White Rice, Beans, & Red Meats; Fish; Egg & Cheese; and Alcohol). All Burgers, Fries, & Soft Drinks DPs were inversely associated with AHEI-2010, whereas all Fish DPs (except Dominican) were positively associated with this index (all P-trend < 0.001). White Rice, Beans, & Red Meats DPs showed inverse associations in Cuban and Central American groups and positive associations in Mexican-origin individuals (all P-trend < 0.001). Fewer years living in the United States was associated with higher scores for White Rice, Beans, & Red Meats DPs in Cuban and Mexican heritage groups and lower scores on Burgers, Fries, & Soft Drinks DPs in Cuban, Mexican, and Puerto Rican groups (all P-trend < 0.01).Conclusions: Our findings show substantial variation in DPs across Hispanics/Latinos and adherence to DPs by time in the United States, which could inform dietary interventions targeting this diverse US population. This trial was registered at clinicaltrials.gov as NCT02060344. [ABSTRACT FROM AUTHOR]

Objectives: In this paper, we examine if serious psychological distress (SPD), binge drinking, and self-rated health predict dual-use of tobacco cigarette and e-cigarette compared with no use or the use of only one product among Hispanics/Latinos (H/L). By increasing our understanding of determinants of dual-use, we can identify the most vulnerable groups and intervention targets. Methods: We used data from H/L who were current tobacco/nicotine users in the Houston Health Survey 2018 (N = 188; representing 158,369 individuals). We conducted descriptive, bivariate, and multinomial logistic regression analyses, and moderation by age and sex. Results: H/L with SPD were more likely to be dual-users than non-users (Odds Ratio [OR] = 1.97), cigarette users (OR = 1.12), or e-cigarette users (OR = 2.44). Individuals who binge drank were more likely to be dual-users than non-users (OR = 2.66) or e-cigarette users (OR = 9.30), but more likely to be cigarette users compared to dual-users (OR = 2.05). Poorer self-rated health predicted an increased likelihood of being a non-user (OR = 1.19), cigarette user (OR = 1.36), and e-cigarette user compared to a dual-user (OR = 1.04). Conclusions: Behavioral health and self-rated health are important predictors of tobacco cigarette, e-cigarette, and dual-use among H/L. These relationships differ by age and sex. [ABSTRACT FROM AUTHOR]

Recent macro-level trends have created a gendered context of assimilation for second-generation Latinos, pointing to favourable condition among Latina women and potential vulnerability among Latino men. This article examines second-generation assimilation in young adulthood for the top ten Latino groups using gendered reference groups to benchmark their integration into American society. We find a significant female advantage on individual-level indicators, but no clear gender differences on household-level indicators among Latinos. We also document significant heterogeneity in achievement among the top ten Latino ethnic groups, with Mexicans being the most disadvantaged group. In contrast, Cubans and South Americans are the most advantaged and have achieved parity with native whites. These findings point to the emerging significance of gender as a key dimension of stratification in the assimilation of Latinos into American life. [ABSTRACT FROM AUTHOR]

We aimed to examine the retention of Hispanics/Latinos participating in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study of 16,415 adults in 4 US cities who were enrolled between 2008 and 2011. We summarized retention strategies and examined contact, response, and participation rates over 5 years of annual follow-up interviews. We then evaluated motivations for participation and satisfaction with retention efforts among participants who completed a second in-person interview approximately 6 years after their baseline interview. Finally, we conducted logistic regression analyses estimating associations of demographic, health, and interview characteristics at study visit 1 (baseline) with participation, high motivation, and high satisfaction at visit 2. Across 5 years, the HCHS/SOL maintained contact, response, and participation rates over 80%. The most difficult Hispanic/Latino populations to retain included young, single, US-born males with less than a high school education. At visit 2, we found high rates of motivation and satisfaction. HCHS/SOL participants primarily sought to help their community and learn more about their health. High rates of retention of Hispanics/Latinos can be facilitated through the employment of bilingual/bicultural staff and the development of culturally tailored retention materials. [ABSTRACT FROM AUTHOR]

Purpose: To examine cross-sectional associations between perceived neighborhood environment and cognitive function among middle-aged and older Hispanic/Latino women and men.Methods: Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) and its Sociocultural Ancillary Study (2009-2010) were used. Participants were Hispanic/Latino women (n = 1812) and men (n = 1034) aged 45-74 years. Survey-weighted linear regression models were used to examine associations between self-reported perceived neighborhood environment (i.e., neighborhood social cohesion and problems categorized as quintiles, and neighborhood safety from crime categorized as low, medium, or high) with cognitive function (i.e., global cognition, verbal learning, memory, verbal fluency, and processing speed scores) in women and men. Final model adjusted for age, Hispanic/Latino background, language, field site, household income, education, years lived in neighborhood, and depressive symptoms.Results: Women in the lowest quintile of perceived neighborhood problems (vs. highest quintile) had higher global cognition (β 0.48, 95% CI 0.03, 0.94, p trend 0.229) and memory scores (0.60, 95% CI 0.11, 1.09, p trend: 0.060). Women in the highest quintile of perceived neighborhood social cohesion (vs. lowest quintile) had lower global cognition (β - 0.56, 95% CI - 1.02, - 0.09, p trend 0.004), verbal learning (B - 1.01, 95% CI - 2.00, - 0.03, p trend 0.015), verbal fluency (B - 2.00, 95% CI - 3.83, - 0.16, p trend 0.006), and processing speed (B - 2.11, 95% CI - 3.87, - 0.36, p trend 0.009). There was no association between perceived neighborhood safety from crime and cognition among women, or between any perceived neighborhood environment measure and cognition among men.Conclusions: Middle-aged and older Hispanic/Latina women living in neighborhoods with the lowest perceived problems had higher global cognition and memory. Women living in neighborhoods with the highest perceived social cohesion had lower global cognition, verbal learning, verbal fluency, and processing speed. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic (SES) factors underlying disparities in the prevalence of metabolic syndrome (MetSyn) and consequently, type 2 diabetes among Hispanics/Latino populations are of considerable clinical and public health interest. However, incomplete and/or imprecise measurement of the multidimensional SES construct has impeded a full understanding of how SES contributes to disparities in metabolic disease. Consequently, a latent-variable model of the SES-MetSyn association was investigated and compared with the more typical proxy-variable model. Methods: A community-based cross-sectional probability sample (2008–2011) of 14,029 Hispanic/Latino individuals of Puerto Rican, Cuban, Dominican, Central American, South American, and Mexican ancestry living in the USA was used. SES proxy's education, income, and employment were examined as effect indicators of a latent variable, and as individual predictors. MetSyn was defined using 2009 harmonized guidelines, and MetSyn components were also examined individually. Results: In multivariate regression analyses, the SES latent variable was associated with 9% decreased odds of MetSyn (95% confidence interval: 0.85, 0.96, P <.001) and was associated with all MetSyn components, except diastolic blood pressure. Additionally, greater income, education, and employment status were associated with 4%, 3%, and 24% decreased odds of having MetSyn, respectively (Ps <.001). The income-MetSyn association was only significant for women and those with current health insurance. Conclusions: Hispanic/Latinos exhibit an inverse association between SES and MetSyn of varying magnitudes across SES variables. Public health research is needed to further probe these relationships, particularly among Hispanic/Latina women, to ultimately improve healthcare access to prevent diabetes in this underserved population. [ABSTRACT FROM AUTHOR]

Objective: We examined the association between volunteerism and favorable cardiovascular health (CVH) among Hispanics/Latinos living in the US. Methods: We used data from the Hispanic Community Health Study/Study of Latinos (2008-2011) Sociocultural Ancillary Study (N = 4926; ages 18-74 years). Favorable CVH was defined as positive profiles of all major CVD risk factors: low total serum cholesterol, blood pressure, and body mass index, not having diabetes, and not smoking. We adjusted survey-weighted logistic regression models for sociodemographic, lifestyle, and psychological factors. In secondary analyses, we tested whether the volunteerism- CVH association was modified by sex, age, or years lived in the US (<10 vs =10 years; a proxy acculturation measure). Results: Prevalence of volunteerism was 14.5%. Compared to non-volunteers, volunteers had 1.67 higher odds of favorable CVH in the fully adjusted model (OR = 1.67, 95% CI = 1.11, 2.52). There was evidence of effect modification by acculturation; only volunteers living in the US =10 years had 2.41 higher odds of favorable CVH (OR = 2.41, 95% CI = 1.53, 3.80). There was no evidence of effect modification by sex or age. Conclusions: Volunteerism was associated with favorable CVH among US Hispanics/Latinos. [ABSTRACT FROM AUTHOR]

Background: Transcription factor 7-like 2 (TCF7L2) genetic variants that predispose individuals to type 2 diabetes (T2D) show inconsistent associations with anthropometric traits. Interaction between TCF7L2 genotypes and dietary factors may help explain these observations.Objective: We aimed to examine the potential modulation of TCF7L2-rs7903146 and rs12255372 on anthropometric markers by a Mediterranean diet (MedDiet).Methods: Cross-sectional analysis was conducted in 1120 participants (aged 45-75 y) of the Boston Puerto Rican Health Study. Anthropometric variables were measured, and polymorphisms were genotyped using standardized protocols. Diet was assessed using a validated FFQ. The MedDiet was defined based on adherence to 9 food and nutrient components using sex-specific population-based median cut-offs; high adherence was defined as meeting ≥4 components. Haplotypes were tested for association with obesity traits, independently and via interaction with the MedDiet.Results: TCF7L2-rs7903146 showed significant interaction with the MedDiet influencing BMI, weight, and waist circumference. The T risk-allele carriers (CT + TT) with a high MedDiet score had lower weight (77.3 ± 1.0 compared with CC 80.9 ± 1.0 kg; P = 0.013) and waist circumference (99.2 ± 0.9 compared with CC 102.2 ± 0.9 cm; P = 0.021), when compared with CC participants. A low MedDiet score resulted in no significant differences between genotypes. For TCF7L2-rs12255372, we found significant interactions with the MedDiet for weight (P-interaction = 0.034) and BMI (P-interaction = 0.036). The T allele carriers with a higher MedDiet score showed a trend of lower but no significant differences when compared with CC participants for BMI (P = 0.19), weight (P = 0.09), and waist circumference (P = 0.11). We found significant interactions between the 2 risk-carrying haplotypes and the MedDiet compared with the common haplotype (GC), with lower BMI (β ± SE, TT: -1.53 ± 0.68; P-interaction = 0.024), weight (TT: -4.16 ± 1.77; P-interaction = 0.019), and waist circumference (GT: -5.07 ± 2.50; P-interaction = 0.042) at a high MedDiet score.Conclusion: Puerto Ricans with the TCF7L2-rs7903146 and rs12255372 T2D risk genotypes, although still high, had better anthropometric profiles when adhering to a MedDiet, suggesting that this diet may offset unfavorable genetic predisposition. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is linked to cognitive decline and disorders (e.g., dementia). The evidence is based largely on older non-Latino White cohorts.Objective: Examine the association between global vascular risk and cognitive function among Hispanics/Latinos in the United States.Methods: We used data from a large sample of stroke- and cardiovascular disease-free, middle-aged and older Hispanics/Latinos with diverse backgrounds (n=7,650) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We compared associations between two measures of cardiovascular risk (CVR), the Framingham Cardiovascular Risk Score (FCRS) and the multiethnic Global Vascular Risk Score (GVRS), and cognitive performance using measures of global and domain specific cognitive function, and tested for modification by sex and age.Results: Higher FCRS and GVRS were associated with lower global cognition and higher probability of low mental status, after covariates adjustment. Both CVR indices were associated with lower performances in learning and memory, verbal fluency, and psychomotor speed. Higher GVRS presented stronger associations with lower cognitive function compared to the FCRS. Women and younger age (45-64 years) exhibited more pronounced associations between higher CVR and worse cognition, particularly so with the GVRS.Discussion: CVR is also a risk for compromised cognitive function and evident in middle-age among Hispanics/Latinos. The multiethnic GVRS, tailored to specific risks based on racial/ethnic background, is feasible to use in primary care settings and can provide important insight on cognitive risk. Even modest shifts in population toward cardiovascular health in the high-risk Hispanic/Latino population can have important positive impacts on healthy cognitive aging. [ABSTRACT FROM AUTHOR]

Background: Sparse data exist to describe national population-level trends in short sleep duration among Latinos. Because short sleep duration is associated with several health conditions that are common in Latinos, such as obesity, diabetes, and hypertension, understanding sleep trends among this population may be key to reducing their disease burden. This study aimed to document Latino subgroup differences in self-reported sleep duration by nativity and country of origin relative to Whites.Design and Setting: Pooled cross-sectional analysis of self-reported data from the National Health and Interview Survey (NHIS), 2004-2017.Participants: 303,244 respondents, aged 18 to 84 years, who self-identified as non-Latino US-born White, US-born Mexican, foreign-born Mexican, US-born Puerto Rican, island-born Puerto Rican, US-born Cuban, foreign-born Cuban, US-born Dominican, foreign-born Dominican, US-born Central/South American, foreign-born Central/South American, US-born "other" Latino, and foreign-born "other" Latino.Methods: Multinomial logistic regression models were used to predict sleep duration controlling for demographics, acculturation, socioeconomic, and health-related factors.Results: We found that all Latino subgroups (except US-born Cubans) were more likely to report poor sleep duration relative to non-Latino Whites, net of demographic, acculturation, socioeconomic, and health-related characteristics. However, the magnitude of disadvantage varies by Latino subgroup. We also found that poor sleep duration is concentrated among certain age groups for the various Latino subpopulations.Conclusions: Given that Latinos in the United States are at higher risk for obesity, diabetes, and hypertension, understanding the patterns of sleep among this population can help identify strategies to improve sleep habits in order to reduce disease burden. [ABSTRACT FROM AUTHOR]

Background: Latinos have the lowest leisure-time physical activity (LTPA) rates. However, measurement of only LTPA might underestimate total physical activity. This study compares the objective physical activity of Latinos reporting high or low levels of LTPA and also compares gender differences. Methods: Data were obtained from 148 Latinos (n = 83 women, n = 65 men). Freedson cut points were employed to determine daily minutes of activity. Results: Latinos reporting high LTPA engaged in more daily minutes of vigorous and very vigorous activity than Latinos reporting low LTPA (P values < .05). There was no difference in daily minutes of moderate-intensity activity (P = .12), with both groups of Latinos meeting Centers for Disease Control and Prevention/American College of Sports Medicine guidelines. Men engaged in more daily minutes of moderate activity than women (P < .01). Conclusions: Many Latinos met physical activity guidelines even when reporting low levels of LTPA. Future studies should determine whether equivalent health benefits are achieved by meeting guidelines through LTPA and non-LTPA. [ABSTRACT FROM AUTHOR]

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Sixty percent of Hispanics/Latinos are bilingual which research suggests may confer certain cognitive advantages. Female sex confers cognitive advantages in verbal learning and memory compared to male sex, regardless of race or ethnicity. Understanding the independent and interactive associations of bilingualism and sex with cognition may aid in predicting cognitive aging in Hispanics/Latinos. We examined baseline (2008-2011) data from the Hispanic Community Health Study/Study of Latinos, a multicenter, prospective community-based study. Our analyses included 6,110 males and females ≥45 years old who self-reported birth and parents' origin outside of the continental US, Spanish as their first language, and were evaluated in Spanish. Bilingualism was assessed along a Likert scale (1 = only Spanish to 4 = English>Spanish) for language proficiency (reading/spoken) and patterns of use (thinking/socializing). Cognitive testing included verbal learning, memory, fluency, and Digit Symbol Substitution (DSS). Linear regression models adjusted for relevant confounders, the complex survey design, and sampling weights. Participants' self-reported language proficiency was Spanish better than English, while patterns of use suggested more Spanish than English. Higher language proficiency was associated with higher performance on all cognitive indices while higher patterns of use associated with higher fluency and DSS scores (p-values < 0.01). Female sex was associated with higher performance on all cognitive indices (p-values < 0.05). There were no significant interactions with bilingualism (regardless of metric) by sex on cognition. For Hispanics/Latinos residing in the continental US and reporting birth and parents' origin elsewhere, bilingualism and female sex have independent cognitive benefits that are important to consider when evaluating cognitive performance. [ABSTRACT FROM AUTHOR]

Objectives: To examine the association between diabetes and cognitive function within U.S. Hispanics/Latinos of Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American background. Method: This cross-sectional study included 9,609 men and women (mean age = 56.5 years), who are members of the Hispanic Community Health Study/Study of Latinos. We classified participants as having diabetes, prediabetes, or normal glucose regulation. Participants underwent a neurocognitive battery consisting of tests of verbal fluency, delayed recall, and processing speed. Analyses were stratified by Hispanic/Latino subgroup. Results: From fully adjusted linear regression models, compared with having normal glucose regulation, having diabetes was associated with worse processing speed among Cubans (β = −1.99; 95% CI [confidence interval] = [−3.80, −0.19]) and Mexicans (β = −2.26; 95% CI = [−4.02, −0.51]). Compared with having normal glucose regulation, having prediabetes or diabetes was associated with worse delayed recall only among Mexicans (prediabetes: β = −0.34; 95% CI = [−0.63, −0.05] and diabetes: β = −0.41; 95% CI = [−0.79, −0.04]). No associations with verbal fluency. Discussion: The relationship between diabetes and cognitive function varied across Hispanic/Latino subgroup. [ABSTRACT FROM AUTHOR]

In the United States (U.S.), Hispanics experience breast cancer disparities. Breast cancer is the leading cause of cancer-related death among Hispanic women, and Hispanic women receive mammography screening at lower rates than some other ethnic groups. This low rate of screening mammography is associated with increased risk for possible late-stage diagnosis and lower survival rates. Educational interventions could play a role in increasing screening mammography rates among Hispanic women. This systematic review synthesized the current literature on educational interventions to increase mammography screening among Hispanic women. The review included studies published between May 2003 and September 2017 with experimental and quasi-experimental interventions to increase mammography screening among Hispanics in the U.S. Five studies out of an initial 269 studies met inclusion criteria for the review. All studies employed an interpersonal intervention strategy with community health workers, or promotoras, to deliver the mammography screening intervention. For each study, odds ratios (OR) were calculated to estimate intervention effectiveness based on similar follow-up time periods. The study ORs resulted in a narrow range between 1.02 and 2.18, indicating a low to moderate intervention effect for these types of interpersonal cancer education interventions. The summary OR for the random effects model was 1.67 (CI 1.24-2.26). Hispanics exhibit lower levels of adherence to screening mammography than non-Hispanic whites. Interpersonal cancer education interventions such as the use of promotoras may help to mediate the impact of barriers to receiving a mammogram such as low health literacy, deficits in knowledge about the benefits of screening, and low awareness of the availability of screening services. [ABSTRACT FROM AUTHOR]

Racial/ethnic minorities, rural populations, and those with low socioeconomic status income are underrepresented in research in the United States (U.S.). Assessing preferences for recruitment, participation, and the role of beliefs about biomedical research in specific and unique underserved communities represents a potentially critical step in reducing barriers to biomedical research participation. We developed a culturally informed survey to measure factors related to participation, knowledge, expectations, and barriers to biomedical research participation among Latinos living in a U.S. border community. We employed a multidisciplinary team approach to a sequential, three-phase qualitative study that included interviews (n = 35), focus groups (n =24), and "think-aloud" cognitive interviews (n = 5). Our study demonstrates the value of applying multiple qualitative approaches to inform a culturally relevant quantitative survey incorporating words and constructs relevant to the population of interest. The study contributes to qualitative method research paradigms by developing a research protocol that integrates the expertise and perspectives of researchers and community members from multiple disciplines and institutions. [ABSTRACT FROM AUTHOR]

Objectives: Maintaining two active languages may increase cognitive and brain reserve among bilingual individuals. We explored whether such a neuroprotective effect was manifested in the performance of memory tests for participants with amnestic mild cognitive impairment (aMCI). Methods: We compared 42 bilinguals to 25 monolingual on verbal and nonverbal memory tests. We used; (a) the Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L), a sensitive test that taps into proactive, retroactive, and recovery from proactive semantic interference (verbal memory), and (b) the Benson Figure delayed recall (nonverbal memory). A subsample had volumetric MRI scans. Results: The bilingual group significantly outperformed the monolingual group on two LASSI-L cued recall measures (Cued A2 and Cued B2). A measure of maximum learning (Cued A2) showed a correlation with the volume of the left hippocampus in the bilingual group only. Cued B2 recall (sensitive to recovery from proactive semantic interference) was correlated with the volume of the hippocampus and the entorhinal cortex of both cerebral hemispheres in the bilingual group, as well as with the left and right hippocampus in the monolingual group. The memory advantage in bilinguals on these measures was associated with higher inhibitory control as measured by the Stroop Color-Word test. Conclusions: Our results demonstrated a superior performance of aMCI bilinguals over aMCI monolingual on selected verbal memory tasks. This advantage was not observed in nonverbal memory. Superior memory performance of bilinguals over monolinguals suggests that bilinguals develop a different and perhaps more efficient semantic association system that influences verbal recall. (JINS, 2019, 25, 15-28) [ABSTRACT FROM AUTHOR]

Although increasing emotional well-being has been proposed as a potential pathway to drive cardiac health, emotional well-being interventions for people with cardiac risk are underdeveloped, particularly among Hispanic/Latino adults. Our objective was to pilot a well-being intervention drawing on positive psychology concepts to determine feasibility and acceptability in Hispanics/Latinos at risk for cardiovascular disease (CVD). We developed a Spanish-language positive psychological intervention, with cultural tailoring informed by formative qualitative work, to promote emotional well-being and its antecedents in Hispanics/Latinos. Hispanic/Latino adults (n = 19) self-reporting two or more CVD risk factors were enrolled in our single-arm 8-week pilot trial. The group intervention consisted of 8 weekly 90-min sessions delivered by a bilingual licensed clinical social worker. Mean age was 54.1 years, 68.8% were female, and 50% had ≤eighth-grade education. Eleven of 19 Hispanic/ Latino adults completed the 8-week program for a 57.89% retention rate, with a majority of factors leading to dropout unrelated to program content or mode of delivery. Most participants felt satisfied overall with each session (97.1%). Largest increases relative to baseline after receiving the intervention were found in engagement in happiness-inducing behaviors (e.g., meditation), emotional vitality, and subjective happiness using metrics of reliable change and effect sizes. This single- arm trial documented adequate feasibility and acceptability, although strategies to increase retention are warranted. Future studies should test our intervention using a randomized trial design with a larger sample size and inclusion of biomarkers (e.g., C-reactive protein) to document impact of our intervention on cardiac-related health. [ABSTRACT FROM AUTHOR]

Background: The role of acculturation in dietary behaviors among Hispanics/Latinos in the United States remains unclear. Discrepancies may be explained by variations in acculturation constructs or ethnicity-specific dynamics.Objective: We aimed to compare relations between 3 different acculturation constructs with dietary quality and patterns among Puerto Ricans in the mainland United States.Methods: We analyzed cross-sectional data with 1194-1380 Puerto Ricans, aged 45-75 y. Acculturation was measured with the use of a language-based scale (0-100; higher score denotes more English use), a psychological-based scale (0-50; higher score denotes stronger US orientation), and years living in the mainland United States. Diet quality scores (higher scores denote healthier diet) were defined with the use of the Alternate Healthy Eating Index-2010 (AHEI) and the Mediterranean Diet Score (MeDS). Three dietary patterns were previously derived with the use of principal components analysis. Adjusted multivariable regression models tested the association of each acculturation construct with diet quality score or pattern. Interaction terms were included for income or education status.Results: Psychological-based acculturation, but not the other constructs, was positively associated with AHEI (β ± SE: 0.013 ± 0.004; P = 0.002) and MeDS (0.009 ± 0.005; P = 0.041). Income, but not education, moderated this association (P = 0.03), with higher diet quality observed with higher income (>$25,000) and stronger US orientation. All constructs were inversely associated with a traditional dietary pattern, with the language-based scale being stronger (z score β ± SE: -0.160 ± 0.032; P < 0.0001) than the psychological-based scale (-0.097 ± 0.028; P = 0.001) or years living in the mainland United States (-0.058 ± 0.028; P = 0.041). No associations were observed for the Western or sweets/desserts patterns.Conclusions: In Puerto Rican adults, stronger psychological US orientation was associated with higher diet quality, particularly with higher income. More Spanish use, stronger psychological Puerto Rican orientation, and shorter length of mainland-US residency were associated with traditional dietary patterns. Appropriate diet-related acculturation constructs should be carefully considered among Hispanics/Latinos. This trial was registered at clinicaltrials.gov as NCT01231958. [ABSTRACT FROM AUTHOR]

Objective(s): Cross-sectional and longitudinal studies have yielded inconsistent findings on the associations of social support networks with cardiovascular health in Hispanic/Latino adults with diabetes. We examined the cross-sectional associations of structural social support and traditional cardiovascular disease (CVD) risk factors in a diverse sample of Hispanic/Latino adults with diabetes. Research Design and Methods: This analysis included 2994 adult participants ages 18-74 with diabetes from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL - 2008-2011). Select items from the Social Network Inventory (SNI) were used to assess indices of structural social support, i.e. network size (number of children, parents, and in-laws) and frequency of familial contact. Standardized methods were used to measure abdominal obesity, BMI, hypertension, hypercholesterolemia, and smoking status. Multivariate regression was used to examine associations of structural support with individual CVD risk factors with demographics, acculturation, physical health, and psychological ill-being (depressive symptoms and anxiety) included as covariates. Results: There were no significant cross-sectional associations of structural support indices with abdominal obesity, hypertension, hypercholesterolemia, or smoking status. There was a marginally significant (OR: 1.05; 95%CI 0.99-1.11) trend toward higher odds of obesity in participants reporting a larger family unit (including children, parents, and in-laws) and those with closer ties with extended family relatives (OR: 1.04; 95%CI 0.99-1.09). Conclusions: Structural social support was marginally associated with higher odds of obesity in Hispanic/Latino adults with diabetes. Alternate forms of social support (e.g. healthcare professionals, friends, peers) should be further explored as potential markers of cardiac risk in Hispanics/Latinos with diabetes. [ABSTRACT FROM AUTHOR]

Objective: We examined the association between depressive symptoms and cognitive functioning in older Hispanics/Latinos enrolled in an exercise intervention. Method: We analyzed baseline, 1-year, and 2-year in-person interview data collected from Hispanics/Latinos aged ≥60 years participating in an exercise intervention across 27 senior centers (N = 572). Results: Mean age was 73.13 years; 77% female. At baseline, older adults screening positive for depression were 1.58 times more likely to experience cognitive impairment (p = .04); controlling for demographics and comorbid chronic conditions. Compared to peers with little to no depressive symptoms, lower cognitive functioning scores were evident at each follow-up assessment point where elevated depressive symptoms were present, but baseline depression was not associated with cognitive function in longitudinal analyses. Discussion: In older Hispanics/Latinos enrolled in an exercise intervention, though baseline depression did not predict cognitive function over time, elevated symptoms of depression were associated with greater cognitive impairment at every point in this study. [ABSTRACT FROM AUTHOR]

Hispanic women suffer disproportionately from cervical cancer incidence and mortality compared with non-Hispanic Whites in the United States. Peer-led health education and coaching via charlas (talking circles) may improve cervical cancer screening and early detection rates among specific sub-groups such as farmworker communities. This pilot study sought to collect preliminary evaluation data about the feasibility of implementing a promotora-led cervical cancer education intervention among women from a farmworker community. The study took place between April 2014 and November 2014. Created based on an established network (Tampa Bay Community Cancer Network, TBCCN), in partnership with a local farmworker organization (Farmworkers Self-Help, Inc.), the project entailed refinement of a curriculum guide including Spanish-language educational resources (teaching cards). Social Cognitive Theory and the Health Belief Model provided the conceptual framework for the study. Six women from the farmworker community helped to refine the intervention and were trained as promotoras. They successfully delivered the program via charlas to a total of 60 participants who completed baseline and post-intervention measures on knowledge (cervical cancer/HPV), beliefs, self-efficacy, and intentions. Findings demonstrated gains in knowledge and self-efficacy among charla participants (P<.0001), and support the promise of a community-driven intervention that is delivered by promotoras who use their cultural knowledge and trustworthiness to educate women about cancer screening practices. Results also add to the literature on the use of a charla approach for cancer prevention education within a farmworker community to prompt discussions about health. Future research should evaluate peer-led programs on a larger scale and among other at-risk groups in other community settings. [ABSTRACT FROM AUTHOR]

Objective: Prominent addiction theories predict that Hispanic smokers should have more success at quitting than White smokers due to less physical dependence on average, but extant findings are mixed. This might be due in part to a lack of attention to confounding demographic and acculturation-related variables. Our study compared likelihood of lifetime cessation between White and Hispanic men and women of different language proficiency, nativity and residency status, controlling for age, education, and poverty level.Method: Data from 123,574 White and Hispanic participants in the 2011-2015 National Health Interview Surveys were used. Logistic regression analyses examined ethnic differences in odds of being a former smoker. Predicted probabilities of being a former smoker were calculated from these models.Results: In unadjusted analyses, White men demonstrated higher odds of being a former smoker compared with Hispanic men, Hispanic women, and White women. In adjusted analyses, Hispanics demonstrated higher odds of being a former smoker compared with Whites, and differences by acculturation proxies emerged.Conclusions: Not accounting for demographics may suppress ethnic differences in likelihood of smoking cessation. Among Hispanics, demographics may be more important determinants of lifetime quitting than acculturation-related characteristics. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The aim of this study was to assess the impact of health literacy (HL) and health insurance literacy (HIL) on health insurance status and access to health care services for Spanish‐speaking communities living in Massachusetts. Methods: A total of 139 surveys (descriptive, knowledge‐based HIL questions, and Short Assessment of Health Literacy in Spanish) and 30 semi‐structured interviews were collected and analyzed using chi‐square, Mann‐Whitney U test, and logistic regression analysis. Results: The majority of participants had inadequate HL (56%) and HIL (93%). There were differences in HL scores (t = 4.1; p < .0001) between the insured (M = 12.3, SD = 5.7) and uninsured (M = 7.9, SD = 6.7) and differences (t = 1.9; p = .05) between those with adequate HIL (M = 14.3, SD = 4.3) and inadequate HIL (M = 10.2, SD = 6.6). Participants who were uninsured (MW U = 37.6; p < .0001) and who had inadequate HL (MW U = 5.2; p = .02) were more likely to have never accessed health care in the U.S. Participants who had never accessed health care were 93% less likely to be insured and those with adequate HL were three times more likely to be insured. Conclusions: Health literacy and HIL are closely associated with insurance status and access to health care for Spanish‐speaking communities, indicating the need for further research and enhanced public health efforts to improve knowledge and awareness around navigating health care systems. [ABSTRACT FROM AUTHOR]

Background: Away-from-home foods (AFHFs) influence diet quality, a modifiable obesity risk factor, with limited generalizable evidence in Hispanic/Latino adults.Objective: We investigated associations between AFHF intake with diet quality and overweight or obesity among US Hispanic/Latino adults.Methods: Cross-sectional baseline (2008-2011) analyses included adults (n = 16,045) aged 18-74 y in the national Hispanic Community Health Study/Study of Latinos. Participants self-reported AFHF consumption frequency from 10 different settings and dietary intake (2-d 24-h recall). The Alternate Healthy Eating Index-2010 (AHEI-2010) was used to measure diet quality; higher scores indicated a healthier diet and scores were categorized into tertiles. WHO classifications categorized overweight [body mass index (BMI; kg/m2): 25.0-29.9] and obesity (BMI ≥30). Multivariate-adjusted associations of AFHF frequency or type with AHEI-2010, overweight, or obesity were assessed by using complex survey logistic regression (ORs and 95% CIs).Results: Almost half of participants (47.1%) reported eating AFHFs ≥5 times/wk. The mean ± SE AHEI-2010 score was 47.5 ± 0.2. More than one-third (37.2%) were classified as overweight and 39.6% classified as obese. Compared with consuming AFHFs ≥5 times/wk, consuming AFHFs <1 time/wk or 1-2 times/wk was associated with greater odds of being in higher AHEI-2010 tertiles, indicating a healthier diet [<1 time/wk-tertile 2: OR (95% CI): 1.6 (1.4, 1.9); tertile 3: 2.5 (2.1, 3.1); 1-2 times/wk-tertile 2: OR (95% CI): 1.4 (1.2, 1.6); tertile 3: 1.5 (1.2, 1.8)]. Consumption of AFHFs ≥1 time/wk from each AFHF setting, compared with consumption of any AFHFs <1 time/wk was associated with lower odds of being in higher AHEI-2010 tertiles. Increasing AFHF intake frequency was not associated with odds of overweight or obesity. Eating from on-street vendors ≥1 time/wk was associated with obesity (OR: 1.5; 95% CI: 1.1, 2.0).Conclusions: Consumption of AFHFs was prevalent among Hispanic/Latino adults and was associated with poorer diet quality. Findings may help to identify dietary targets to improve diet quality and prevent obesity in US Hispanics/Latinos. [ABSTRACT FROM AUTHOR]

This study examined the feasibility and efficacy of Salud es Vida-a promotora-led, Spanish language educational group session on cervical cancer screening (Pap tests)-self-efficacy (belief in ability to schedule and complete a Pap test), and knowledge among immigrant Hispanic/Latina women from farmworker backgrounds. These women are disproportionately burdened with cervical cancer, with mortality rates significantly higher than non-Hispanic whites. The two-arm, quasi-experimental study was conducted in four rural counties of Southeast Georgia in 2014-2015. Hispanic/Latina immigrant women aged 21-65 years and overdue for a Pap test were included as intervention (N = 38) and control (N = 52) group participants. The intervention was developed in partnership with a group of promotoras to create the toolkit of materials which includes a curriculum guide, a brochure, a flipchart, a short animated video, and in-class activities. Twelve (32 %) intervention group participants received the Pap test compared to 10 (19 %) control group participants (p = 0.178). The intervention group scored significantly higher on both cervical cancer knowledge recall and retention than the control group (p < 0.001). While there was no statistically significant difference in cervical cancer screening self-efficacy scores between the group participants, both groups scored higher at follow-up, adjusting for the baseline scores. The group intervention approach was associated with increased cervical cancer knowledge but not uptake of Pap test. More intensive interventions using patient navigation approaches or promotoras who actively follow participants or conducting one-on-one rather than group sessions may be needed to achieve improved screening outcomes with this population. [ABSTRACT FROM AUTHOR]

This study evaluated whether a self-administered stress management training (SSMT) could improve quality of life (QOL) and reduce distress among Hispanics receiving chemotherapy across multiple community clinical settings. Participants were randomized to receive SSMT (n = 106) or usual care (UCO) (n = 113). The primary outcome-QOL (SF-36) and secondary outcomes depression (CES-D), and anxiety (STAI) were assessed longitudinally over four chemotherapy cycles. Acculturation (BAS) and patients' intervention adherence were assessed. About 63% of participants reported distress after the initial chemotherapy cycle. Hispanics with lower acculturation reported greater STAI-Trait scores (p = .003). No significant treatment effects on outcomes measures were observed for participants receiving SSMT. SSMT intervention techniques were reported useful and improved mental health scores were observed with patients on a psychotropic agent (p = .04). Hispanics experience an elevated level of distress, yet SSMT did not significantly improve primary outcomes. SSMT may be potentially effective when combined with a psychotropic agent. SSMT enhancing strategies are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hypertension control in Hispanics/Latinos lag behind general US trends by 10-15%. Intensive systolic blood pressure (SBP) management <120 mm Hg may significantly reduce morbidity/mortality risk in adults with hypertension; less is known about cognition. We investigated cross-sectional associations of cognition with observed hypertension control at currently recommended (SBP < 140 mm Hg) and more intensive (SBP < 120 mm Hg) levels using baseline data from the Hispanic Community Health Study/Study of Latinos. METHODS: From this multicenter cohort study, we focused on 1,735 Hispanic/Latino men and women ages 45-74 years with hypertension and verified antihypertensive use. Verbal fluency, information processing speed, learning, and memory were tested in Spanish or English. RESULTS Separate linear regressions revealed that being on 1 vs. >1 antihypertensive medication was not associated with cognition; however, individuals with SBP controlled to currently recommended levels outperformed individuals with uncontrolled SBP on verbal fluency [Beta = 1.44 (0.52), P < 0.01] and information processing speed [Beta = 3.01 (0.89), P < 0.001] in age-adjusted regression analyses; only information processing speed remained significant (P < 0.05) after additional adjustments including acculturation, health insurance, and other cardiovascular disease risk factors. When regrouping individuals based on more intensive SBP control, individuals with levels <120 mm Hg outperformed individuals with higher SBP on verbal fluency regardless of adjustments (P < 0.01). More intensive rather than currently recommended levels of control associated with higher verbal fluency performance regardless of adjustments (P < 0.05). CONCLUSIONS: Individual cognitive test scores related to distinct SBP management with more intensive management appearing more robust against confounders. While cognitive associations with hypertension in Hispanics/Latinos may be multifactorial, different levels of SBP control should be considered in future prospective intervention studies. [ABSTRACT FROM AUTHOR]

Background: Multiple diet quality scores have been used to evaluate adherence to specific dietary recommendations or to consumption of healthful foods and nutrients. It remains unknown which score can more strongly predict longitudinal changes in cardiometabolic risk factors.Objective: We aimed to determine associations of 5 diet quality scores [AHA diet score (AHA-DS), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI)-2005, Mediterranean diet score (MeDS), and Alternative Healthy Eating Index (AHEI)] with 2-y changes in cardiometabolic risk factors in adults 45-75 y old.Methods: Data from the Boston Puerto Rican Health Study were analyzed (n = 1194). Diet quality scores were calculated from a baseline-validated food-frequency questionnaire. Multivariable-adjusted, repeated-subjects, mixed-effects models, adjusted for baseline measures, estimated associations between each z score and 14 individual cardiometabolic factors measured at 2 y.Results: MeDS was significantly associated with lower 2-y waist circumference (β coefficient ± SE: -0.52 ± 0.26, P = 0.048); body mass index (BMI; -0.23 ± 0.08, P = 0.005); log-insulin (-0.06 ± 0.02, P = 0.005); log-homeostasis model assessment of insulin resistance (HOMA-IR; -0.05 ± 0.02, P = 0.030), and log-C-reactive protein (-0.13 ± 0.03, P = 0.0002). Similar but weaker associations were observed for the AHEI with BMI, insulin, and HOMA-IR. The AHA-DS was inversely associated with BMI (-0.17 ± 0.08, P = 0.033). Neither the HEI-2005 nor DASH was significantly associated with any variable. Traditional Puerto Rican foods consumed by individuals with high MeDSs included vegetables and meats in homemade soups, orange juice, oatmeal, beans and legumes, fish, whole milk, corn oil, and beer.Conclusions: The MeDS comprises food components and scores associated with a favorable cardiometabolic profile over 2 y in Puerto Rican adults. An overall healthy diet may be particularly beneficial for maintaining a lower BMI. These results can help identify suitable measures of diet quality in epidemiologic studies and craft meaningful nutritional messages and dietary recommendations for the intended population. This study was registered at clinicaltrials.gov as NCT01231958. [ABSTRACT FROM AUTHOR]

Uric acid (UA) is the end product of the metabolic breakdown of purine nucleotides. Recent studies have measured UA in saliva in relation to obesity and chronic disease risk. Given the increasing prevalence of metabolic syndrome among Latino youth, we examined gender and age differences in salivary uric acid (sUA) and weight in a sample of Mexican-origin children ( n = 65, 2 months to 18 years, 49% female) and adults ( n = 46, 19-58 years, 72% female). We measured weight, height, waist, and hip circumference and collected saliva samples (later assayed for sUA). Structural equation models estimated the relationship between age, developmental stage, and weight outcomes in relation to sUA levels between genders, while controlling for race. Results demonstrate that increased sUA levels were related to higher BMI percentiles in females of all ages ( β = 0.43, p < .001). There were significant differences in sUA levels between developmental stages for girls, with female toddlers having the highest sUA levels ( β = .28, p = .02). In an interaction between BMI z-score and gender between youth and adults, BMI has a larger effect on increasing sUA levels among younger girls ( β = 0.27, p < .03) and adult women ( β = 0.33, p = .02). Levels of sUA may be gender-specific in relation to BMI and developmental stage. [ABSTRACT FROM AUTHOR]

ObjectiveMeasurement error in self-reported total sugars intake may obscure associations between sugars consumption and health outcomes, and the sum of 24 h urinary sucrose and fructose may serve as a predictive biomarker of total sugars intake.DesignThe Study of Latinos: Nutrition & Physical Activity Assessment Study (SOLNAS) was an ancillary study to the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) cohort. Doubly labelled water and 24 h urinary sucrose and fructose were used as biomarkers of energy and sugars intake, respectively. Participants’ diets were assessed by up to three 24 h recalls (88 % had two or more recalls). Procedures were repeated approximately 6 months after the initial visit among a subset of ninety-six participants.SettingFour centres (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA) across the USA.SubjectsMen and women (n 477) aged 18–74 years.ResultsThe geometric mean of total sugars was 167·5 (95 % CI 154·4, 181·7) g/d for the biomarker-predicted and 90·6 (95 % CI 87·6, 93·6) g/d for the self-reported total sugars intake. Self-reported total sugars intake was not correlated with biomarker-predicted sugars intake (r=−0·06, P=0·20, n 450). Among the reliability sample (n 90), the reproducibility coefficient was 0·59 for biomarker-predicted and 0·20 for self-reported total sugars intake.ConclusionsPossible explanations for the lack of association between biomarker-predicted and self-reported sugars intake include measurement error in self-reported diet, high intra-individual variability in sugars intake, and/or urinary sucrose and fructose may not be a suitable proxy for total sugars intake in this study population. [ABSTRACT FROM AUTHOR]

Digital storytelling is an emergent method in health promotion. It addresses health inequities by combining technology with the voices of members of vulnerable, often underrepresented populations. The overall goal of this pilot project was to explore if digital storytelling could be a culturally relevant health promotion tool for Hispanics/Latinos to share their experiences with cancer, or other diseases. Promotores participated in a train-the-trainer workshop. Community members worked with trained promotores to create digital stories through community workshops. We conducted one-on-one interviews with digital story creators to elicit perspectives and assess their experience. One overarching theme among storytellers was the power of storytelling. Supporting subthemes that emerged in the interviews were (1) connection and communication, (2) lack of opportunities and barriers to telling stories, and (3) potential for disease prevention awareness and education. This study found digital storytelling to be culturally relevant for Hispanics/Latinos of Mexican origin. For these storytellers it was a uniquely valuable tool for sharing personal stories of overcoming or managing health issues. Participants found the digital story experience to be positive and beneficial. It provided a healing outlet to reflect on a difficult experience and find support within one’s own community. [ABSTRACT FROM AUTHOR]

Background. Intermittent smoking is prevalent amongHispanics, but little is known about whether this smoking pattern associates with increased chronic kidney disease (CKD) risk in this population. The objective of the present study is to identify patterns of exposure associated with CKD in US Hispanics. Methods. We used cross-sectional data on 15 410 participants of the Hispanics Community Health Study/the Study of Latinos, a population-based study of individuals aged 18-74 years, recruited in 2008 to 2011 from four US field centers (Bronx, NY; Chicago, IL; Miami, FL; San Diego, CA). Smoking exposure was obtained through a questionnaire. CKD was defined by an estimated glomerular filtration rate of <60 mL/min/ 1.73 m² or a urine albumin-to-creatinine ratio of ≥30 mg/g. Results. Approximately 14% of individuals were daily and 7% were intermittent smokers, and 16% were past smokers. There was a significant interaction between smoking status and packyears of exposure (P = 0.0003). In adjusted models, therewas an increased odds of CKD among daily, intermittent and past smokers by pack-years compared with never smokers. The association of intermittent smokers was significant at 10 pack-years [odds ratio (OR) = 1.38, 95% confidence intervals (CI) 1.06, 1.81], whereas for daily smokers this association was observed at 40 pack-years (OR = 1.43, 95% CI 1.09, 1.89). Conclusions. Our findings of increased risk of CKD among Hispanics who are intermittent smokers support screening and smoking cessation interventions targeted to this population for the prevention of CKD. It also suggests novel mechanistic pathways for kidney toxicity that should be further explored in future studies. [ABSTRACT FROM AUTHOR]

Major theories informing conceptions of psychological well-being draw heavily from Western-centric perspectives, which often neglect culturally bound frameworks. We investigated how US Hispanics/Latinos conceptualize well-being, how psychosocial and behavioral aspects may increase well-being, and how psychosocial stressors may impact positive emotional states. Spanish-speaking Hispanic/Latino adults were recruited from a church in an urban city in the US and invited to participate in focus groups. Two groups of women (n = 19) and one group of men (n = 8) participated. The importance of harmonious social relationships emerged as a theme with the central family unit as the fundamental force influencing long-lasting emotional well-being. Additional correlates of well-being included: faith/religiosity; physical health; self-love and -esteem; effective/open communication with family and friends; and financial security. Programs aimed at increasing well-being may need to be adapted before administration in Hispanics/Latinos to include a heightened focus on interpersonal factors. Delivery in religious institutions may also be particularly beneficial. [ABSTRACT FROM AUTHOR]

Objective: This study examined perceived satisfaction among Hispanic/Latino individuals who participated in a baseline examination for the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large cohort study of 16,415 adults living in four selected communities.Method: An estimated 22% (n= 3,584) of participants completed a questionnaire regarding satisfaction with staff attention, the overall experience during the study examination, and the influence of the informed consent digital video disc (DVD).Results: The majority of participants who completed the questionnaire expressed overall satisfaction with the study. Most participants reported that staff were friendly, courteous and respectful and study test procedures were clearly explained. Participants who preferred to complete the interview in Spanish felt that the informed consent DVD positively influenced their ability to make an informed decision to enroll in the study. Participants who preferred to complete the interview in English tended to report that the baseline examination was longer than expected compared with participants who completed the interview in Spanish.Conclusion: Results demonstrate that culturally and linguistically trained staff and the use of the study's informed consent DVD were effective in explaining study procedures and positively influenced decisions to participate in the HCHS/SOL study. These results can inform recruitment and enrollment strategies for future participation of minority groups into longitudinal cohort studies. [ABSTRACT FROM AUTHOR]

Objective: Given the disproportionate impact of neurologic disorders such as HIV on racial/ethnic minorities, neuropsychologists are increasingly evaluating individuals of diverse linguistic backgrounds. This study compares the utility of two brief and one comprehensive language measure to account for variation in English neuropsychological performance within a bilingual population. Method: Sixty-two HIV+ English/Spanish bilingual Latino adults completed three language measures in English and Spanish: Self-Reported Language Ability; Verbal Fluency (FAS/PMR); and the Woodcock Munoz Language Survey-Revised (WMLS-R). All participants also completed an English language neuropsychological (NP) battery. Results: It was hypothesized that the comprehensive English/Spanish WMLS-R language dominance index (LDI) would be significantly correlated with NP performance, as well as the best predictor of NP performance over and above the two brief language measures. Contrary to our hypothesis, the WMLS-R LDI was not significantly correlated to NP performance, whereas the easily administered Verbal Fluency and Self-Report LDIs were each correlated with global NP performance and multiple NP domains. After accounting for Verbal Fluency and Self-Report LDI in a multivariate regression predicting NP performance, the WMLS-R LDI did not provide a unique contribution to the model. Conclusions: These findings suggest that the more comprehensive WMLS-R does not improve understanding of the effects of language on NP performance in an HIV+ bilingual Latino population. [ABSTRACT FROM AUTHOR]

Although dietary supplement use is common, its assessment is challenging, especially among ethnic minority populations such as Hispanics/ Latinos. Using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (n = 16,415), this report compares two strategies for capturing dietary supplement use over a 30-day period: a medication-based inventory and a nutrition-based dietary supplement interview. Age-standardized prevalence was calculated across multiple dietary supplement definitions, adjusted with survey/nonresponse weights. The prevalence of dietary supplement use was substantially higher as measured in the dietary supplement interview, compared to the medication inventory: for total dietary supplements (39% vs 26%, respectively), for nonvitamin, nonmineral supplements (24% vs 12%), and for botanicals (9.2% vs 4.5%). Concordance between the two assessments was fair to moderate (Cohen's kappa: 0.31-0.52). Among women, inclusion of botanical teas increased the prevalence of botanical supplement use from 7% to 15%. Supplement assessment that includes queries about botanical teas yields more information about patient supplement use. [ABSTRACT FROM AUTHOR]

This article considers how cancer education research programs affect the lives of research participants in terms of their cancer screening and diagnosis experiences. Using examples from research with Latina immigrant women in rural Georgia and Quechua women in rural Andean Peru, the author explains how cervical cancer education research can produce meaningful and empowering change in women's lives. [ABSTRACT FROM AUTHOR]