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Background: Little research has been conducted that integrates, in one explanatory model, the multitude of factors potentially leading to disparities among Latino children., Purpose: A longitudinal, observational study tested an explanatory model for disparities in asthma control between Mexican and Puerto Rican children with persistent asthma requiring daily controller medication use., Methods: Mexican and Puerto Rican children aged 5-12 years (n = 267) and their caregivers (n = 267) were enrolled and completed interviews and child spirometry at baseline and 3, 6, 9, and 12 months postenrollment. A 12 month retrospective children's medical record review was completed. Participants were recruited from two school-based health clinics and the Breathmobile in Phoenix, AZ, and two inner-city hospital asthma clinics in the Bronx, NY., Results: Statistically significant differences in the social/contextual predictors of asthma illness representations (IRs) were noted between Mexican and Puerto Rican caregivers. The structural equation model results revealed differences in asthma control over time by ethnicity. This model accounted for 40%-48% of the variance in asthma control test scores over 12 months. Caregivers' IRs aligned with the professional model of asthma management were associated with better children's asthma control across 1 year. These results also supported the theoretical notion that IRs change over time impacting caregivers' treatment decisions and children's asthma control., Conclusions: These findings extend a previous cross-sectional model test using a more comprehensive model and longitudinal data and highlight the importance of considering within-group differences for diagnosis and treatment of children coming from the vastly heterogeneous Latino umbrella group., Trial Registration: Trial number NCT01099800., (© The Author(s) 2019. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

The aim of this study was to examine if family system dynamics (e.g., parent mental health, marriage quality, conflict, and cohesion) that have often been overlooked when studying Latino families play a more important role in predicting adolescent internalizing symptoms than acculturation processes. Data comes from the Latino Acculturation and Health Project, a longitudinal investigation of acculturation in Latino families in North Carolina and Arizona (Smokowski & Bacallao, 2006, 2010). Researchers conducted in-depth, community-based interviews with 258 Latino adolescents and 258 of their parents in metropolitan, small-town, and rural areas. Interviews were conducted at four time points at intervals of approximately 6 months. Parent and adolescent ratings of the adolescent's internalizing symptoms were used as the dependent variable in a longitudinal hierarchical linear model with a rater effects structure. Results showed that parent-adolescent conflict and parent mental health (fear/avoidance of social situations and humiliation sensitivity) were significant predictors of adolescent internalizing symptoms. Acculturation scales were not significant predictors; however, internalizing symptoms decreased with time spent in the United States. Females and adolescents from lower socioeconomic status families reported more internalizing symptoms, while participants who had been in the United States longer reported fewer internalizing symptoms. Implications were discussed.

Purpose: This study describes the epidemiology of epilepsy on the Arizona-Mexico border., Methods: Households in Southern Arizona were identified using two strategies. County-wide random digit dialing telephone surveys were supplemented with door-to-door recruitment in three Arizona border communities. Utilizing a two-step screening process, individuals with a seizure disorder or epilepsy were identified. A consensus diagnosis was arrived at after reviewing results from the detailed interview, medical records and clinical examination., Results: A total of 15,738 household individuals were surveyed. Two hundred and three individuals were identified as having had epilepsy at some point in their life; 25% of them were previously not diagnosed. The sex and age-adjusted prevalence estimate was 14.3 per 1000 (95% CI: 12.5-16.1) for lifetime epilepsy, and 11.8 per 1000 (CI: 10.2-13.5) for active epilepsy (seizures in the past 5 years or currently taking antiseizure medications). Non-Hispanic Whites were two times more likely to have active epilepsy than Hispanics. The majority of individuals with lifetime history of epilepsy had idiopathic or cryptogenic epilepsy; most were localization-related epilepsy although the exact location could not be determined for the majority. Although most individuals with epilepsy report receiving care from a neurology specialist, they were more likely to have visited a non-specialist in the past 3 months., Significance: The lower prevalence of epilepsy among Hispanics compared to non-Hispanics supports previous survey findings in the Southwest US and may be due to language, acculturation factors, stigma, or a reflection of the "healthy immigrant effect". The surprisingly high proportion of previously un-diagnosed individuals shows a need for further investigation as well as a need to increase community awareness., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Objective: To evaluate the effectiveness of gun-safety counseling, a gun-safety brochure, and a free gun lock in subsequent gun removal and safe storage., Methods: In a predominantly Hispanic pediatric clinic, gun-owning families were identified and assigned to either an intervention group (gun-safety counseling, gun-safety brochure, and a free gun lock) or a control group (usual anticipatory guidance). Families were resurveyed 1 month later for changes in the proportion of gun owners, changes in frequency of unloaded and locked gun storage, and changes to the use of locked storage., Results: Two hundred six (7.8%) of the 2649 parents initially surveyed kept guns in their households. At follow-up, 16% of the control group removed all guns from their homes as compared with 22% of the intervention group (P = .41). Among the families who received the intervention, 61.6% either removed all guns from their homes or improved their gun storage safety practice in some way. Only 26.9% of the families in the control group showed similar types of improvement (P<.001). In those households still with guns at follow-up, 50.9% of the intervention group had some type of improvement in safe gun storage compared with 12.3% of the control group (P<.001). More specifically, 25.0% in the intervention group improved the frequency of locked storage of guns compared with 4.8% of those in the control group (P = .003). Twenty-six percent of the intervention group improved the use of locked storage compared with 3.1% in the control group (P<.001)., Conclusions: A brief gun-safety counseling session supported with written information along with a gun lock giveaway resulted in significant improvements in safe gun storage behaviors. It did not significantly influence the removal of guns from the home. This study gives support to the recommendations of the American Academy of Pediatrics (Elk Grove Village, Ill) and other professional organizations to discuss gun safety with families and encourages research in this area. It also suggests that providing tools such as gun locks to enable the desired behavior may improve safe storage.