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Background: Through its influence on social interactions, simpatía may have a wide-ranging influence on Latinx health. Simpatía-which does not have a direct English translation-refers to being perceived as likeable, pleasant, and easygoing. Research to investigate the influence simpatía on Latinx health is limited, likely due to a lack of options for measuring simpatía among diverse Latinx populations., Objectives: The goal of this research was to develop a bilingual, survey-based simpatía scale for use among ethnically diverse Latinx adults in health-related settings., Methods: Data were obtained through a telephone survey data of 1,296 Mexican American, Puerto Rican, and Cuban American adults living in the United States. Interviews were conducted in English and Spanish. Exploratory factor analysis, item response theory analysis, confirmatory factor analysis, and computation of estimates of internal consistency reliability were conducted to inform the development of the final simpatía scale., Results: Results indicate that the final, nine-item, simpatía scale has high internal consistency (α = .83) and measurement invariance among Mexican American, Puerto Rican, and Cuban American adults. Two dimensions were identified, as indicated by a perceptions subscale and a behavior subscale. Cuban Americans were found to have the highest simpatía scores, followed by Puerto Ricans and Mexican Americans., Discussion: Culture is often identified as a powerful potential influence on health-related behaviors, but measures are often not available to assess specific cultural traits. By developing a new tool for measuring simpatía, this research advances opportunities for understanding and promoting Latinx health.

Study Objective: To assess the extent to which objective sleep patterns vary among U.S. Hispanics/Latinos., Methods: We assessed objective sleep patterns in 2087 participants of the Hispanic Community Health Study/Study of Latinos from 6 Hispanic/Latino subgroups aged 18-64 years who underwent 7 days of wrist actigraphy., Results: The age- and sex-standardized mean (SE) sleep duration was 6.82 (0.05), 6.72 (0.07), 6.61 (0.07), 6.59 (0.06), 6.57 (0.10), and 6.44 (0.09) hr among individuals of Mexican, Cuban, Dominican, Central American, Puerto Rican, and South American heritage, respectively. Sleep maintenance efficiency ranged from 89.2 (0.2)% in Mexicans to 86.5 (0.4)% in Puerto Ricans, while the sleep fragmentation index ranged from 19.7 (0.3)% in Mexicans to 24.2 (0.7)% in Puerto Ricans. In multivariable models adjusted for age, sex, season, socioeconomic status, lifestyle habits, and comorbidities, these differences persisted., Conclusions: There are important differences in actigraphically measured sleep across U.S. Hispanic/Latino heritages. Individuals of Mexican heritage have longer and more consolidated sleep, while those of Puerto Rican heritage have shorter and more fragmented sleep. These differences may have clinically important effects on health outcomes., (© Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.)

Introduction: In the present study, we investigated associations among cigarette smoking, smoking cessation treatment, and depressive symptoms in Hispanic/Latino adults., Methods: The multisite prospective population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL) enrolled a cohort of Hispanic/Latino adults (aged 18-74) from diverse backgrounds (n = 16,412) in 4U.S. communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified 2-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010U.S. Population Census. Hispanic/Latino individuals of Dominican, Central American, South American, Cuban, Mexican, and Puerto Rican background were considered. Cigarette smoking, smoking cessation treatment, and depressive symptoms were measured by self-report., Results: Results indicated that current smokers had greater odds for significant depressive symptoms (CES-D score ≥ 10) than never smokers in all Hispanic background groups [odds ratio (OR) > 1.5]. Depressed persons were not more likely to receive prescribed smoking cessation medications from a doctor (OR = 1.43, 95% CI = 0.98-2.08), take over-the-counter medications (OR = 1.11, 95% CI = 0.75-1.66), or receive psychotherapy (OR = 1.02, 95% CI = 0.57-1.85)., Conclusions: In conclusion, these findings suggest that the positive association between smoking status and depressive symptoms is present in all examined Hispanic/Latino background groups., (© The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Hispanics are the largest ethnic minority group in the USA and a fairly heterogeneous group. But this heterogeneity has usually been ignored by grouping them into a single category. The objective of this study is to challenge that practice by providing alcohol use disorders (AUD) incidence and risk estimates across Hispanic subgroups., Methods: A subsample of Hispanics (n = 2371) and non-Hispanic whites (n = 7741) at risk for AUD who participated in the first and second wave of the National Epidemiological Survey on Alcohol and Related Conditions was analyzed. Weighted incidence for AUD was calculated across Hispanic subgroups. A weighted modified Poisson generalized linear model was used to estimate relative risks., Results: Compared with non-Hispanic whites, Puerto Ricans have the highest AUD incidence (3.6%; 95% CI: 0.5, 6.7) followed by Mexican-Americans (2.5%; 95% CI: 1.5, 3.6), Other Hispanics (1.6%; 95% CI: 0.1, 3.1) and Cuban-Americans (0.6%; 95% CI: 0.1, 1.2). In contrast, weighted adjusted relative risk estimates for Mexican-Americans were (RR = 3.2; 95% CI: 1.7, 6.2) but for Puerto Ricans (RR = 2.2; 95% CI: 1.0, 5.0) it was somewhat attenuated but still significant (P = 0.049). No difference was found for Cuban-Americans or Other Hispanics., Conclusions: The annual incidence and risk for AUD varies greatly among Hispanic subgroups. Nonetheless, the practice of categorizing Hispanics as a homogenous ethnic group still continues. Our findings suggest that this practice is not only inappropriate, but also hinders a better understanding of AUD etiology, prevention, treatment and rehabilitation in the largest ethnic minority group in the USA., (© The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.)

Discrimination has been found to be detrimental to health, but less is known about the influence of discrimination in health care. To address this, the current study (1) compared levels of racial/ethnic discrimination in health care among four race/ethnic groups; (2) determined associations between this type of discrimination and health care outcomes; and (3) assessed potential mediators and moderators as suggested by previous studies. Multivariate logistic regression models were used within a population-based sample of 1,699 White, African American, Mexican, and Puerto Rican respondents. Overall, 23% of the sample reported discrimination in health care, with levels varying substantially by race/ethnicity. In adjusted models, this type of discrimination was associated with an increased likelihood of having unmet health care needs (OR = 2.48, CI = 1.57-3.90) and lower odds of perceiving excellent quality of care (OR = 0.43, CI = 0.28-0.66), but not with the use of a physician when not sick or use of alternative medicine. The mediating role of mental health factors was inconsistently observed and the relationships were not moderated by race/ethnicity. These findings expand the literature and provide preliminary evidence that can eventually inform the development of interventions and the training of health care providers.

Objectives: We determined the impact of premigration circumstances on postmigration psychological distress and self-rated physical health among Latino immigrants., Methods: We estimated ordinary least squares and logistic regression models for Latino immigrants in the 2002-2003 National Latino and Asian American Study (n = 1603)., Results: Mean psychological distress scores (range = 10-50) were 14.8 for women and 12.7 for men; 35% of women and 27% of men reported fair or poor physical health. A third of the sample reported having to migrate; up to 46% reported unplanned migration. In multivariate analyses, immigration-related stress was significantly associated with psychological distress, but not with self-rated health, for both Latino men and women. Having to migrate was associated with increased psychological distress for Puerto Rican and Cuban women respondents and with poorer physical health for Puerto Rican migrant men. Unplanned migration was significantly associated with poorer physical health for all Latina women respondents., Conclusions: The context of both pre- and postmigration has an impact on immigrant health. Those involved in public health research, policy, and practice should consider variation in immigrant health by migration circumstances, including the context of exit and other immigration-related stressors.

Qualitative data was collected from Mexican-American (MA) and Puerto Rican (PR) breast cancer survivors to gain their perspectives on the relevant issues surrounding breast cancer survivorship and exercise. Six focus groups, a total of 31 participants were convened (three in Puerto Rico and three in Texas). Responses were analyzed and compared between the MA and PR groups. Follow-up sessions were conducted at the sites to review the initial results and to validate a culturally adapted exercise intervention trial. A total of 900 responses were catalogued into 27 codes. Both groups had similar descriptions of exercise and barriers to exercise. Both groups expressed lack of information regarding their exercise capabilities. The groups differed in their responses to perceived safety in their community and how to deliver a culturally adapted exercise intervention in their community. We found important cultural differences and similarities in relevant factors of exercise and breast cancer survivorship.

This study examines the psychometric properties of alcohol expectancies among Hispanic subgroups. Face-to-face interviews were conducted as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS), which employed a multistage cluster sample design. A total of 5224 individuals (18+ years of age) representing four Hispanic national groups (Puerto Ricans, Cuban Americans, Mexican Americans, and South/Central Americans) were selected at random from the household population in five metropolitan areas (Miami, New York, Philadelphia, Houston, and Los Angeles). Alcohol expectancies included 18 items covering positive (e.g., laugh more, become more talkative) and negative dimensions (e.g., become aggressive, lose control) when alcohol is consumed. Confirmatory factor models replicated a previously proposed three-factor dimensional structure with a substantial majority of items exhibiting measurement invariance across Hispanic national group and gender. Items covering social extroversion were an exception, showing a lack of invariance for female Cuban and South/Central Americans. Latent mean differences across groups were detected for expectancies concerning emotional fluidity, and the pattern of differences largely mirrored known differences in alcohol consumption patterns. Results suggest that caution should be exercised in interpreting differences in expectancies concerning social extroversion across Hispanic groups, and additional work is needed to identify indices of this construct with invariant measurement properties. However, measures of emotional/behavioral impairment and emotional fluidity expectancies can be validly compared across gender and Hispanic national groups., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Existing research rarely considers important ethnic subgroup variations in violent behaviors among Latino youth. Thus, their risk for severe violent behaviors is not well understood in light of the immense ethnic and generational diversity of the Latino population in the United States. Grounded in social control theory and cultural analyses of familism, we examine differences in the risk for severe youth violence, as well its associations with family cohesion, parental engagement, adolescent autonomy, household composition, and immigrant generation among Mexican (n = 1,594), Puerto Rican (n = 586), Cuban (n = 488), and non-Latino Black (n = 4,053), and White (n = 9,921) adolescents with data from the National Longitudinal Study of Adolescent Health. Results indicate a gradient of risk; White youth had the lowest risk for severe violence and Puerto Rican youth had the highest risk compared to all other racial/ethnic subgroups. Within-group analysis indicates that family factors are not universally protective or risk-inducing. While family cohesion decreased the risk of severe violence among all groups, parental engagement was associated with increased risk among Blacks and Whites, and adolescent autonomy was associated with increased risk among Puerto Ricans and Cubans. In addition, Cuban and White adolescents who lived in single parent households or who did not live with their parents, had higher risk for severe violent behaviors than their counterparts who lived in two parent households. Among Latinos, the association of immigrant generation was in opposite directions among Mexicans and Cubans. We conclude that family and immigration factors differentially influence risk for violence among Latino subgroups and highlight the significance of examining subgroup differences and developing intervention strategies that are tailored to the needs of each ethnic subgroup.

Background: Multiple theoretical frameworks identify attitudes and expectancies as important predictors of alcohol behavior. Few studies have examined demographic predictors of these evaluative and belief-based cognitive mediators in the general population, and none have examined them in large-scale studies of Hispanics, a group at higher risk for drinking behavior and problems. This study probes the extent to which dimensions of attitudes and expectancies share common demographic predictors in a large sample of Puerto Ricans, Cuban-Americans, Mexican-Americans, and South/Central Americans., Methods: The 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS) used a multistage cluster sample design to interview 5,224 individuals randomly selected from households in Miami, New York, Philadelphia, Houston, and Los Angeles. This study focused on 2,773 respondents self-identified as current drinkers. Multiple linear regression was used to identify predictors of positive and negative dimensions of attitudes and expectancies, controlling for various background variables., Results: Religious affiliation selectively predicted alcohol attitudes, with Catholics having more positive and fewer negative attitudes than other religious groups. Hispanic group selectively predicted alcohol expectancies, with Cuban-Americans having less positive and less negative expectancies than other groups. Being U.S.-born or male predicted more positive attitudes and expectancies, but birthplace and gender did not predict negative dimensions of attitudes or expectancies. Higher acculturation and more education were linked to a decreased tendency to agree with any item. Age was positively and negatively associated with negative expectancies and positive attitudes, respectively, and having never been married, higher income, and unemployment were each linked to fewer negative attitudes., Conclusions: Although there is some overlap, attitudes and expectancies are influenced by different sociodemographic variables. Positive and negative dimensions of those constructs also show distinct patterns of relations. Prevention and treatment programs targeting cognitive mediators of behavior should be mindful of these differential determinants and future modeling endeavors should incorporate them.

Purpose: To examine knowledge about hereditary breast and ovarian cancer (HBOC) among Mexican, Puerto Rican, and Cuban women., Methods: Women (age range, 18-65 years) with a personal or family history of breast or ovarian cancer were recruited to a mixed methods study using community-based approaches. Fifty-three women participated in the study: 16 Mexicans, 20 Puerto Ricans, and 17 Cubans. The majority of women (64.2%) were born outside the United States. All questions were interviewer administered in Spanish or English. HBOC knowledge was measured using an 11-item instrument developed by the National Center for Human Genome Research. We evaluated whether differences in knowledge varied as a function of Hispanic subethnicity, demographic characteristics, and medical and acculturation characteristics using a series of one-way analysis of variances., Results: The percentage of correct responses on the knowledge instrument ranged from 9.4% to 73.6% (median number of correct responses = 45%). Knowledge did not significantly differ by Hispanic subethnicity (p = 0.51). Exploratory analysis revealed lower knowledge in women with a personal history of cancer (p = 0.03)., Conclusion: Our study provides important information about characteristics associated with lower levels of knowledge and specific areas related to HBOC where additional education may be warranted in the Hispanic community.

The relationship among acculturation-related variables, past sexual activity, and subsequent sexual behavior was examined for a sample of Latino youth in the United States over a 12-month period. A subsample from the National Longitudinal Study of Adolescent Health database was analyzed by means of a prospective design. History of sexual intercourse predicted subsequent sexual behavior over the ensuing 12 months. The acculturation-related variables were related to whether an adolescent reported being sexually active at Wave 1 but in a complex fashion. Among recent immigrants, youth from English-speaking homes were less likely to be sexually active than those from Spanish-speaking homes. The opposite was observed for youth who were born in the United States or who had resided in the United States most of their lives.

This study reports on community surveys of 160 representative Latino adults in Hartford, CT, Edinburg, TX, Guadalajara, Mexico; and in rural Guatemala. A 142-item questionnaire covered asthma beliefs and practices (e.g., causes, symptoms, and treatments). The cultural consensus model was used to analyze the agreement among respondents within each sample and to describe beliefs. Beliefs were then compared across the four samples. Analysis of the questionnaire data shows that there was overall consistency or consensus regarding beliefs and practices among individuals at each site (intraculturally) and to a lesser extent across respondents of all four different Latino cultural groups (i.e., interculturally). This pattern of response is indicative of a shared belief system among the four groups with regard to asthma. Within this shared belief system though, there is systematic variation between groups in causes, symptoms, and treatments for asthma. The most widely recognized and shared beliefs concerned causes of asthma. Notable differences were present between samples in terms of differences in beliefs about symptoms and treatments. The biomedical model is shown to be a part of the explanatory model at all sites; in addition to the biomedical model, ethnocultural beliefs such as the humoral ("hot/cold") aspects and the importance of balance are also evident. The Connecticut Puerto Ricans had a greater degree of shared beliefs about asthma than did the other three samples (p < 0.00005). It was concluded that the four Latino groups studied share an overall belief system regarding asthma, including many aspects of the biomedical model of asthma. In addition, traditional Latino ethnomedical beliefs are present, especially concerning the importance of balance in health and illness. Many beliefs and practices are site-specific, and caution should be used when using inclusive terms such as "Hispanic" or "Latino," since there is variation as well as commonality among different ethnic groups with regard to health beliefs and practices.

Objective: This study examines differences in adolescents' use of tobacco, alcohol, and illicit drugs by racial and ethnic groups., Methods: The authors analyzed questionnaire data from large, nationally representative samples of U.S. high school seniors to examine differences in drug use prevalence and trends among racial and ethnic groups between 1976 and 2000., Results: On average, American Indian seniors showed the highest levels of tobacco, alcohol, and illicit drug use. Cuban American and white seniors also tended to have relatively high levels of substance use, followed by Mexican American and Puerto Rican seniors. Other Latin American, African American, and Asian American seniors reported the lowest levels of drug use. Most of these differences are longstanding, but some have widened and others narrowed during the past 25 years., Conclusion: Significant differences exist in adolescent use of tobacco, alcohol, and illicit drugs by racial and ethnic groups, and these differences have changed over time. Future research should examine these differences and seek to identify the sources and consequences of the disparities.

Data from the 1985-1986 National Survey of Oral Health in U.S. Adults and Seniors showed that the oral health of Hispanic American adults and seniors was comparable to that of black adults and seniors. White adults and seniors had better oral health than their minority counterparts for all measures observed and were better able to afford dental care.

This study explores the relationship between stress and weight control behavior in four groups of women: African American, European American, Mexican/Mexican American, and Puerto Rican. Data were collected on 111 women between the ages of 23 and 75 using a between-methods triangulation approach in which interview and questionnaire data were collected. The women were involved in various types and levels of weight control behavior. Although all the women identified occupational and major life stressors, only European American women's weight control behavior was significantly related to stress.

The overall purpose of this study was to describe the developmental and functional status of young Latino children. We analyzed data from the Hispanic Health and Nutrition Examination Survey and estimated the percentages of young Mexican-American and mainland Puerto Rican children with indicators of developmental need for special services, i.e., low birth weight, use of neonatal intensive care, congenital problems, chronic conditions of developmental concern, functional limitations, and physician diagnoses of medical conditions. Estimates suggest that Puerto Rican children had substantially poorer status than Mexican-American children who, in turn, have indicators that are comparable with those reported for the general population. The difference in status between the two Latino groups merits further investigation.

Questionnaire data from almost 12,000 street-recruited drug injectors in 19 cities were analyzed to determine racial differences that may affect transmission of the human immunodeficiency virus (HIV). Self-reported sexual behaviors of drug injectors differ by city-type. White male drug injectors reported less unprotected vaginal sex than black or Latino males in multicultural--black/white/Mexican-origin and biracial cities. Black drug users of both sexes were less likely than white or Latino drug users to report unprotected and sex in multicultural--black/white/Mexican-origin and multicultural--black/white/Puerto Rican cities. The reported percentage of sex acts in which a condom was used was similar for black, white, and Puerto Rican men, and for black and white women, in all city types, but Puerto Rican women reported more condom use than black women. Mexican-origin drug injectors of each gender were least likely to report using condoms in multicultural--black/white/Mexican-origin cities. Black drug injectors are particularly likely to report having sex partners who do not inject drugs, as are Puerto Rican men and as are whites in multicultural--black/white/Mexican-origin cities. High-risk sex without condoms is widely reported among all groups of drug injectors studied: Each racial/gender group in each city-type averaged 15 or more episodes of unprotected vaginal sex per month, and 10% of most subgroups report having anal sex within the past 6 months. At least 45% of subjects in each city-type reported sex with noninjectors of the opposite gender. Without continued and expanded intervention, these data are consistent with HIV spreading to drug injectors, their sexual partners, and their future children, in all racial/ethnic groups.

Compared mental health characteristics of island Puerto Ricans to three groups from the Los Angeles Epidemiologic Catchment Area Study: Mexican American immigrants, U.S.-born Mexican Americans, and Non-Hispanic whites. The Diagnostic Interview Schedule was used to obtain both diagnostic and symptom scale information about affective disorders, alcohol abuse/dependence, somatization, phobic disorder, and psychotic disorder. Mexican American immigrants had the fewest mental health problems of all groups. Puerto Ricans had more somatization disorder, but less affective and alcohol disorders than U.S.-born Mexican Americans or non-Hispanic whites. Results are considered in the light of selection factors, relative disadvantage of groups and methodological problems.