Level Of Acculturation Research Articles

Mental Health Attribution for Mexican-Origin Latinx and Non-Latinx Older Adults: A Latent Class Analysis.

Background and ObjectivesProviding appropriate and culturally sensitive care to the rapidly growing number of U.S. Latinx older adults with psychiatric conditions presents a major public health challenge. We know little about older Latinx adults’ perceived causes of mental health problems, offering clinicians limited insight to guide successful and culturally congruent treatment. Moreover, there is a paucity of mental health research examining heterogeneity in how Latinx individuals may attribute mental health symptoms. The present study sought to identify how Latinx and non-Latinx older adults attributed the sources of their mental health problems and how these types of attributions differ by ethnicity.Research Design and MethodsThis study analyzed data collected from a retrospective chart review and survey of 673 adults aged 55–95 years (430 Mexican origin and 244 non-Latinx) from a rural psychiatric outpatient clinic near the California–Mexico border. We conducted stratified latent class analysis (LCA) by race/ethnicity to explore the mental health attribution beliefs of Mexican-origin and non-Latinx clinic patients.ResultsDifferent LCA patterns for Mexican-origin Latinx versus non-Latinx groups were found. For non-Latinx adults, there was a class of individuals who attributed their mental health issues to social and financial problems. For Mexican-origin adults, there was a class of individuals who attributed their mental health issues to spiritual and/or supernatural factors, unaffected by acculturation level, depressive symptom severity, and time spent in the United States, but differing by gender. We found within-group heterogeneity: Not all Mexican-origin or non-Latinx older adults were alike in how they conceptualized their mental health.Discussion and ImplicationsMexican-origin Latinx and non-Latinx older adults attributed their mental health issues to different causes. More Mexican-origin older adults attributed their symptoms to spiritual causes, even after controlling for contextual factors. Further research is needed to determine whether attribution beliefs are affected by specific mental health diagnoses and other cultural factors not measured in this study.

It’s Not Rational It’s Complicated: Latina Mothers’ Choices of Childcare

ABSTRACT In order to understand Latina mothers’ choices of childcare for their children ages birth to five, a qualitative study of 42 Latina mothers (ages 18 to 43) from Southern California was conducted. Research has found that work status, school status, mother’s level of education, acculturation, household composition, income level, and neighborhood resources play a role in how mothers choose childcare for their children. A descriptive analysis based on these six factors is presented. In order to capture a more in-depth understanding of Latina mothers’ choices of childcare, a Funds of Knowledge framework was used. This research found that choices of childcare differed for infants and preschool-aged children with Latina mothers preferring to stay home and care for their infants while preferring a combination of care for their preschool-aged children where their child attends a preschool center to obtain academic and social experience. This study also found that Latina mothers’ childcare choices were complex and influenced by confianza (trust), the mothers’ upbringings, and value in their child’s education and socialization. While these factors were important, finding a balance meant financial sacrifices. Implications for practitioners, policymakers, and researchers are discussed.

P113 Relationship Between Acculturation and Diet Quality Among Hispanic Adolescents

<h3>Background</h3> Acculturation is a dynamic and complex process that adopts elements of the dominant culture, which include food, attitudes, beliefs, languages, art, music, rituals, and faith/religion. This melting pot vs. salad bowl framework may impact health. The melting pot advocates for assimilation into 1 dominant culture whereas the salad bowl encourages distinctions that contribute to unique aspects of every group. The salad bowl approach to health suggests that health promotion and disease prevention are broad goals that coincide with identity and heritage. <h3>Objective</h3> To determine whether there is a relationship between level of acculturation and diet quality among first- and second-generation Hispanic adolescents in the United States. <h3>Study Design, Setting, Participants</h3> We utilized the 2015-2016 National Health and Nutrition Examination Survey (NHANES) sample, consisting of 447 Hispanic adolescents ages 12 to 19 (46.5% male, 53.5% female) in the US. Diet quality from the Healthy Eating Index (HEI) was measured using 2-day food records. <h3>Measurable Outcome/Analysis</h3> Data was cleaned and analyzed using SAS version 4.0. Level of acculturation was scored via NHANES content of generational items for parental citizenship status and language items for frequency of native language spoken at home. HEI was scored as poor (0 to 49), moderate (50 to 79), and good (80 to 100). Multiple logistic regression measured acculturation vs. diet quality, and controlled for gender, age, and income. The Tukey test confirmed findings. <h3>Results</h3> Gender and income had no influence on HEI whereas older age groups were associated with higher HEI scores (<i>P</i> < .008). Level of acculturation was associated with HEI (<i>P</i> < .05). Among adolescents with poor diet quality, 38% with high acculturation had poor diet quality compared to 20.4% with medium acculturation and 6.8% with low acculturation (<i>P</i> < .009). <h3>Conclusions</h3> Findings suggest that Americanized Hispanic adolescents consume more standard American foods and fewer meals prepared at home. Future investigations should explore the impact of acculturation on diet quality among other ethnicities and evaluate culturally appropriate interventions in the US.

How values of individualism and collectivism influence impulsive buying and money budgeting: the mediating role of acculturation to global consumer culture

AbstractThis study examined the effects of individual‐level cultural values of individualism and collectivism on impulsive buying and money budgeting and the mediating role of acculturation to global consumer culture. By applying the person‐environment fit theory and acculturation theory, we argue that people who hold cultural values congruent with the culture they come into contact with are more likely to acculturate to it, and that those who acculturate to global consumer culture (GCC) are more likely to display consumption behaviors stimulated by GCC, namely impulsive buying and poor money budgeting. The findings show that consumers acculturated to GCC report higher impulsive buying and lower money budgeting, and that it is not the distinction between individualism and collectivism, but rather between the vertical and horizontal values that determines the acceptance of GCC and the studied consumption behaviors. Results revealed that vertical individualists (those who believe in competition between individuals and who prioritize their needs over the needs of others) and vertical collectivists (those who believe in the subordination of individuals to groups) were more likely to be acculturated to GCC. Thus, the acceptance of inequality between individuals among other individuals, or within groups, is related to the acceptance of GCC and impulsive buying and money budgeting. The level of acculturation to GCC mediates the relations between vertical individualism and collectivism values and impulsive buying and money budgeting. Theoretical contributions to the research on horizontal/vertical individualism/collectivism, acculturation to GCC, and person‐environment fit theory, as well as practical implications for marketers are discussed.

Applying Taiwanese indigenous health literacy for designing an elders’ prevention fall course: a statistical analysis and deep learning approach

This study aims at exploring the indigenous elders’ health literacy of chronic diseases, designing a fall prevention textbook needed for the cultural consistency of the ethnic group, and analyzing such elders’ performance of physical strength and activity stability through the teaching materials. The study consisted of two phases; first, it mainly explored the elders’ health literacy of chronic health. A structured questionnaire survey was conducted to collect 60 samples of the Bunun elders. To analyze the data, a statistical software, version 22.0, was employed. The results indicated: (1) The older the person the higher the level of cultural acculturation; (2) the higher the degree of traditional culture, the lower the health knowledge scores; (3) the higher the health knowledge score, the better the self-care behavior of chronic diseases; (4) the health knowledge and self-care behavior of chronic disease predictors include age, education level, and occupation. The second phase mainly uses the factors of the traditional culture to influence health and understand the common health issues of the indigenous elders on chronic disease management and fall prevention. We interviewed 12 elders to summarize the important indigenous traditions. Then, based on the core health concept, we designed the cultural care for 12 weeks, in line with the course for the fall prevention and treatment for such elders. The tribal intervention is carried out with a quasi-experimental design. Via purposive sampling, some Atayal and Tsou participants, aged 55 years and above, 60 people, 30 in each ethnic group, were selected. The data, collected from pre- and post-intervention, were analyzed with the SPSS 22.0. Results showed that after the 12-week intervention course, the intervention group had better health cognitive scores, and the Tinett gait time was shortened. Meanwhile, we selected statistically significant variables include mood adaptation, ADL, IADL, health cognition, POMA-G and POMA-B, plus an ANN model established to incorporate these variables into the input variables to test whether the course can predict the falls and physical activities of the two ethnic groups. Ultimately, we observed that DNN model could accurately predict that the indigenous elders could have better mood adaption, IADL, health cognitive scores, and balance and gait performance, with accuracy of 80% in Tsou elders and 100% in Atayal elders. It is suggested that, in the future, in caring for the elders with chronic diseases in Taiwan, health education should avoid excessive professional terminology or esoteric language. This can be presented in pictures or multimedia languages to enhance the indigenous elders’ health and life quality.

Palliative Care for the Asian American Adult Population: A Scoping Review.

The Asian American (AA) population is rapidly becoming one of the largest racial/ethnic groups in the United States. Despite this growth and advances in palliative care (PC) programs in the United States, the scope and nature of the literature regarding PC for AAs remains unclear. This review provides an overview of existing research on PC for AAs, identifies gaps in the research with recommendations for future research and delineates practice implications. A scoping review of studies published in English was conducted. Electronic Databases (PubMed, Embase, CINAHL, and PsycINFO databases) were searched up to December 2019. No starting date limit was set. Arksey and O'Malley's methodological framework was followed for scoping reviews. Of 2390 publications initially identified, 42 studies met our inclusion criteria for this review. Southeast AA subgroups remain understudied compared to East and South AAs. Most studies were descriptive; a few (n = 3) evaluated effectiveness of PC interventions for AAs. Research synthesized in this review addresses the following topics and includes considerations in PC related to care recipients and their relatives: treatment choice discussions (73%), coordination of care with health care providers (26%), symptom management (14%), and emotional support (10%). This review identified various factors around PC for AAs, specifically the influence of cultural aspects, including levels of acculturation, traditional norms and values, and religious beliefs. A culturally inclusive approach is vital to providing appropriate and accessible PC for AAs. Further research is needed concerning core PC components and effective interventions across diverse AA subgroups.

Weight Stigmatization and Binge Eating in Asian Americans with Overweight and Obesity.

Weight stigma and binge eating have been found to be associated in Western populations; however, this relationship is understudied among Asian Americans. The aims of the study were to (1) investigate the prevalence of binge eating and its relationship with experienced weight stigma in higher-weight Asian Americans, and (2) examine whether the level of acculturation moderates this relationship. Data were collected from a cross-sectional study with 166 higher-weight Asian American adults living in North Carolina, United States. Demographic data, the frequency of experiencing weight stigma, the severity of binge eating, the levels of acculturation, the perceived racism against Asians, and perceived stress were assessed via self-reported questionnaires. The results indicated that experienced weight stigma was a significant independent predictor over and above the effects of other stressors, such as racism and general stress. The level of acculturation did not influence the relationship between the experienced weight stigma and binge eating after adjusting for relevant covariates. Our findings contribute to the limited literature examining weight stigma and binge eating among Asian American populations, highlighting that higher levels of experienced weight stigma are associated with a greater degree of binge eating.

Abstract B010: Avanzando juntas: Adapting an evidence-based weight loss program for Hispanic breast and gynecologic cancer survivors

Abstract Background: Obesity increases risk for recurrence for many cancers. Hispanic breast and gynecological cancer survivors (BGCS) are more likely than Non-Hispanic White BGCS to have overweight/obesity. Weight management is challenging for many Hispanics due to a complex interaction of environmental, societal and policy-related factors. These factors also contribute to disparities in cancer recurrence risk, quality of life and comorbidities. This study informed the adaptation of the evidence-based Moving Forward weight loss intervention for Hispanic BGCS. Methods: Intervention adaptation was done in an iterative process with continuous engagement of BGCS and a community advisory committee. Hispanic BGCS with BMIs &amp;lt; 25 kg/m2 who had completed treatment at least 3 months prior were invited to participate in two focus groups offered in Spanish or English. Focus group I informed initial adaptations asking general questions about lifestyle support, interests and needs, family and community attitudes about weight and breast cancer. Focus group II was structured with participants reviewing intervention topics and materials to inform program refinement. All groups were audio-recorded and transcribed. Multi-faceted content analysis used a combination of inductive and deductive approaches, leading to codes which were then compiled into overarching themes. Results: 30 HBGCS participated in the first round of data collection. We conducted 4 focus groups (3 English, 1 Spanish) with 14 survivors. The other 18 HBGCS completed individual interviews, an approach found to be more accessible to these predominately Spanish-speaking women. For Focus Group II, 24 of the same 30 women participated. The majority completed a focus group and 8 completed interviews. Content analysis revealed 3 major themes related to survivorship, needs and wants in the intervention: Relationships and Support, Wellness, and Advocacy and Empowerment. A cross-cutting theme underlying all topics was acculturation. Focus Group II provided additional details including particular foods and cooking methods, beliefs and values, holidays, community assets and needs, and family roles and responsibilities. These data informed intervention adaptations. Conclusions: Level of acculturation was a defining factor for participants’ relationship and support dynamics, access to wellness resources, and self-advocacy versus relying on others to advocate for them. Next steps are to pilot the adapted program, Avanzando Juntas. Outcomes will include weight, metabolic syndrome risk factors and cancer recurrence biomarkers. Citation Format: AnaKaren Manriquez Prado, BA, Stacy Young, PhD, Sailaja Kamaraju, MD, Magdalisse Henderson, MS, Patricia Sheean, PhD, Melinda Stolley, PhD. Avanzando juntas: Adapting an evidence-based weight loss program for Hispanic breast and gynecologic cancer survivors [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B010.

Abstract B135: Health literacy disparities among Hispanic caregivers of children with newly diagnosed cancer

Abstract Objective: Health literacy (HL) is the ability to understand process and act on health-related information to function effectively in a healthcare environment. Thirty-six percent of U.S. adults have limited HL and Hispanics have the lowest among all racial/ethnic groups. Individuals with limited HL have higher healthcare utilization and poorer health status. Caregivers of children with cancer must process complex information about the disease to effectively navigate the healthcare system. Research on HL in the pediatric cancer setting is lacking. We assessed HL in Hispanic and non-Hispanic White (NHW) caregivers (primarily parents) of children with newly diagnosed cancer and the correlation of different measures of HL among each other. Additionally, we assessed socio-demographic factors and acculturation levels in Hispanic caregivers as covariates. Methods: Sixty-one caregivers of children with cancer (ages 0-17 y), newly diagnosed at Rady Children’s Hospital-San Diego were enrolled. To assess HL, we used the English or Spanish form of the 1) Short-form of the Test of Functional Health Literacy Assessment (S-TOFHLA), 2) Newest Vital Sign (NVS), 3) Parental Health Literacy Activities Test (PHLAT), 4) Rapid Estimate of Adult Literacy in Medicine (REALM) or Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50), and 5) Brief Health Literacy Screen (BHLS). To measure acculturation, we used the Hispanic Acculturation Questionnaire (SASH). Two-sample t-tests, univariate/multivariate linear regression, and Pearson-correlation analyses were used for statistical analysis. Results: Hispanic caregivers had significantly lower HL, as measured by the NVS, than NHWs (p&amp;lt;0.001). In caregivers, lower HL levels (measured by the NVS and S-TOFHLA) were positively correlated with older age (p&amp;lt;0.001), lower education level (p&amp;lt;0.001), informal employment (p&amp;lt;0.006), and Spanish primary language (p&amp;lt;0.001). Additionally, S-TOFHLA was significantly correlated with NVS (p&amp;lt;0.001). The odds of having adequate HL decreased by 94% in caregivers with low acculturation compared to caregivers with high acculturation (95% CI: 83%, 98%, p&amp;lt; 0.001). Conclusion: We show significant differences in HL levels between Hispanic and NHW caregivers of children with newly diagnosed cancer. NVS was correlated with S-TOFLHA and could serve as a rapid assessment of HL in the clinical setting for caregivers. Cancer treatment is complex, involving intensive treatments, enrollment in clinical trials, and requiring advanced caregiver knowledge about the disease. By identifying caregivers with limited HL, we can help them navigate cancer therapy effectively. Future research should test culture and language-appropriate interventions, including the systematic use of teach-back, pictorial instruction, and patient navigation. Effective HL interventions may improve cancer care for underserved children and help mitigate disparities in outcomes. Citation Format: M. Elena Martinez, Paula Aristizabal, Bianca Perdomo, Nassim Durali, Shilpa Nataraj, Jesse Nodora. Health literacy disparities among Hispanic caregivers of children with newly diagnosed cancer [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B135.

Abstract A055: A case study of co-occurring burdens experienced by a Hispanic mother diagnosed with cancer and its implications for a cancer education program in the U.S.-Mexico border region

Abstract Purpose: This study explored a cancer survivor’s description of the burdens she experienced in addition to her cancer diagnosis while participating in a cancer education program. While this case study’s primary aim was to identify these co-occurring burdens, the secondary aim was to develop responsive program protocols that would not interfere with program dosage and fidelity. Introduction: Several studies have assessed the significant burden that cancer poses to diagnosed individuals. While researchers have worked to develop programs that improve the survivorship experience, such efforts have largely been validated with non-Hispanic white patients who are more socially and economically privileged than cancer survivors from underserved populations. While there is some research on the cancer survivorship experiences of racial/ethnic minority groups, few programs are exclusively designed to address the burden that cancer poses in these already burdened groups. As researchers work to engage racial/ethnic minority participants in cancer education programs designed to improve cancer survivorship, they may encounter unexpected challenges when working with these new consumer groups. This case study explored the multiple burdens reported by a cancer diagnosed Hispanic woman participating in a cancer education program. Methods: The participant was a Spanish-speaking Hispanic mother diagnosed with cancer and residing on the U.S.-Mexico border. Baseline participant demographics, cancer fatalism, depression, anxiety, and acculturation levels were collected. In each of the five bi-weekly program sessions, the participant was asked to report any cancer-related emotional triggers she experienced since her last session. Each education session was audio recorded, transcribed, and translated to English. Two coders analyzed the translated transcriptions using inductive content analysis. The trustworthiness of the analysis was protected by coding to consensus, peer debriefing, and maintaining audit trails. Results: The participant exhibited clinical levels of both depression and anxiety, high cancer fatalism, and a low level of acculturation. Co-occurring burdens described by the participant included Low SES, Negative Cancer Effects, Domestic Violence, Family Concerns, and Issues with Communication and Isolation. This participant reported a variety of emotions and limited coping strategies in response to these burdens. Various protocols were developed to support participants with multiple burdens and to protect the fidelity of the original cancer education program. Conclusion: These findings revealed the excessive burden and challenges affecting the cancer survivorship of a Hispanic mother diagnosed with cancer. As other low-SES Hispanics cancer survivors may be facing similar challenges, researchers should be prepared to develop study protocols, particularly when implementing evidence-based programs validated with privileged populations. Citation Format: Adriena Hernandez, Isela Garcia, Clara Reyes, Rebecca Palacios. A case study of co-occurring burdens experienced by a Hispanic mother diagnosed with cancer and its implications for a cancer education program in the U.S.-Mexico border region [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A055.

Abstract A045: Racial/ethnic, language, and health literacy disparities on perception of voluntariness during informed consent for pediatric cancer clinical trials

Abstract Background: Valid consent for research requires that the decision for participation be both fully informed and voluntary. Previous studies on informed consent have shown that when presented with a clinical trial for their child, parents often do not understand the many components of informed consent, including voluntariness of participation. In addition, individuals with limited English proficiency have reported lower understanding and satisfaction during informed consent. There is limited research on factors associated with perception of voluntariness during participation in pediatric cancer clinical trials. Our aim was to examine contextual factors associated to perception of voluntariness in parents who had consented to participation of their child in a clinical trial for cancer treatment, focused on characterizing differences between non-Hispanics and Hispanics, as the latter is the fastest-growing ethnic group in the U.S. Methods: Parents (n=97) of children aged 0-17 years with newly diagnosed cancer, who had consented to participation of their child in a clinical trial for treatment at Rady Children's Hospital-San Diego, were prospectively recruited. Participants completed questionnaires assessing sociodemographics, health literacy, perception of voluntariness, decisional regret, satisfaction, and acculturation level, if Hispanic. Outcomes and their correlates were analyzed using logistic regression. Results: Fifty participants (51.5%) were Hispanic and 47 (48.5%) non-Hispanic. We found that parents who were Hispanic compared to non-Hispanics (p&amp;lt;0.001), Spanish-speaking compared to English-speaking (p=0.048), and those with lower health literacy (p&amp;lt;0.001) had lower perception of voluntariness. Decisional regret was overall low and satisfaction was overall high across all subgroups and neither measure was significantly impacted by sociodemographics, health literacy or acculturation. Conclusions: In this study, with equivalent numbers of Hispanics and non-Hispanics, we found that Hispanic parents of children with newly diagnosed cancer, and particularly Spanish-speakers and those with low health literacy, had inadequate perception of voluntariness. To our knowledge, this is the first study to associate lower health literacy with lower perception of voluntariness in parents of children with newly diagnosed cancer despite overall high rates of satisfaction with the informed consent process for pediatric cancer clinical trials. True voluntariness of participation is essential to the ethical practice of informed consent, and our study suggests that many participants with low health literacy, particularly Hispanics and Spanish-speaking individuals, are not making truly informed decisions. Tailored interventions can improve decision-making, reduce clinical trial participation inequities and, ultimately, eliminate survival disparities by effectively and equally translating discoveries and treatment benefits to diverse populations. Citation Format: Paula Aristizabal, Arissa MA, Bianca Perdomo, Jesse Nodora, Maria E. Martinez. Racial/ethnic, language, and health literacy disparities on perception of voluntariness during informed consent for pediatric cancer clinical trials [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A045.

Abstract D007: Mammographic breast density and acculturation: Longitudinal analysis in Chinese immigrants

Abstract Breast cancer is the most common cancer in women, regardless of race or ethnicity. Unlike other racial and ethnic groups, breast cancer rates in Asian American women have steadily increased over the past several decades. The increase among recent migrants might be partly due to the adoption of the behaviors and values of the mainstream culture. We tested the hypothesis that higher level of acculturation was associated with higher mammographic breast density (MBD), an indicator of breast cancer risk, using data from a 2006-2010 longitudinal study of 426 premenopausal Chinese immigrant women in Philadelphia. MBD, including dense area, non-dense area, and percent density, was calculated using a computer assisted method. An abridged version of the General Ethnicity Questionnaire – American version provided a measure of acculturation. We used generalized estimating equations (GEE) to account for repeated observations and adjusted for age, type of mammographic image (film or digital), body mass index, months of breastfeeding, number of live births, age at first birth, and menopausal stage (pre, early peri, late peri, and post). At baseline, the mean age of participants was 43.9 years (SD=4.5), mean length of U.S. residence was 7.5 years (SD=4.8), and mean age at migration was 36.4 years (SD=6.4). GEE models using 1,110 observations from the 426 participants showed no significant associations between acculturation and MBD (percent density β=0.32, p=0.54; dense area β=0.28, p=0.57; and non-dense area β=-0.42, p=0.60). Our findings are consistent with an emerging body of research suggesting that acculturation measures are insufficient to distinguish levels of breast cancer risk in immigrant women, given changes in immigration patterns and economic development in sending countries. Future work should consider other factors, including behavioral, environmental and epigenetic factors or changes in reproductive patterns, that may have a greater effect on MBD than acculturation-related behaviors in adulthood. Citation Format: Rebeca Almeida, Celia Byrne, Carolyn Y. Fang, Marilyn Tseng. Mammographic breast density and acculturation: Longitudinal analysis in Chinese immigrants [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D007.

Acculturation, Food Label Literacy and Use Among South Asian Americans

Abstract Objectives To examine the level of acculturation and its association with food label literacy and use among South Asian Americans. Methods Data were collected using an online cross-sectional survey of 269 South Asian Americans living across the United States, recruited via social media and snow-ball sampling method. The Short Acculturation Scale for Hispanics was adapted to measure acculturation amongst South Asian adults. The Newest Vital Sign health literacy assessment tool was used to measure food label literacy. Results In this sample of 196 South Asian Americans with complete data, mean age was 36 ± 11.4 y, the majority were born outside the U.S (84%), women (69%), married (69%), overweight/obese (65%) and had college degrees (86%). While most (82%) reported using food labels at least sometimes when purchasing a food product for the first time (82%), and that food labels influenced their purchase decisions (75%), only 35% demonstrated food label literacy (with maximum food label literacy score). Older (age ≥ 36y) South Asian Americans were more likely to be food label users (89.4% vs 73.6%, P = .006) and to report that food labels influence their food purchases (82.8% vs 69%, P = .034) than their younger counterparts. Mean acculturation was 3.14 ± 0.78 (scale 1 – 5). Higher acculturation (score &amp;gt;median) was not associated with food label use, but was significantly associated with food label literacy (43.6% vs 27.3%, P = 0.018). The association between higher acculturation and food label literacy remained significant after controlling for age, sex and education (adj OR = 2.22; 95% CI: 1.18, 4.14). Conclusions Nutrition education interventions are needed to improve food label literacy among South Asian Americans. Funding Sources None.

Cultural factors related to neuropsychological performance and brain atrophy among Hispanic older adults with amnestic Mild Cognitive Impairment (aMCI): A pilot study

Objectives This study examined the association of cultural factors and literacy to neuropsychological performance and measures of regional brain atrophy among Hispanic elders diagnosed with amnestic Mild Cognitive Impairment (aMCI). Method Acculturation and literacy levels were measured among 45 subjects tested in Spanish; their primary language. Scores for measures of memory, executive functioning, and verbal fluency, as well as volumetric analysis of MRI scans of left hemisphere structures commonly affected by Alzheimer’s disease (AD) were examined. Linear regression models were employed to examine the association of acculturation and literacy to neuropsychological performance and MRI measures. Results After controlling for age, higher literacy levels were associated with better performance on phonemic verbal fluency (r = 0.300, p < .05), while higher levels of acculturation to the U.S. was associated with poorer performance on category verbal fluency (r = 0.300, p < .05). There was a significant inverse relationship after controlling for age between literacy and the left entorhinal cortex (r = –0.455, p < .05), left precuneus (r = –0.457, p < .05), and left posterior cingulate (r = –0.415, p < .05). Conclusions Results of the current pilot study indicate that high acculturation to the U.S. among aMCI immigrants from Latin-American countries may hinder performance on verbal learning measures when they are administered in one’s primary language. Moreover, in this cohort, a higher literacy level, which is indicative of greater cognitive reserve, was associated with better performance in language measures, but with greater atrophy in brain regions susceptible to neurodegenerative disease. These preliminary findings should be further examined among larger cohorts and using more diverse measures, which capture other cultural constructs.

The Interactive Effect of Goal Attainment and Goal Importance on Acculturation and Well-Being.

The purpose of the present research is to shed light on whether and when migrants’ goal pursuit relates to their acculturation and well-being. Previous research has demonstrated the beneficial role of striving for and attaining intrinsic goals on well-being. Yet, the relationship between the pursuit of intrinsic goals and acculturation has hardly been addressed. To fill this void, we investigated whether migrants’ acculturation and well-being can be seen as a function of their pursuit of intrinsic goals. We posited that the attainment of intrinsic goals would positively predict migrants’ level of acculturation and subsequent well-being, particularly when migrants deemed these goals to be important. We tested our hypotheses in two scenario studies and two surveys. In all four studies we confirmed our hypothesis that migrants’ intrinsic goal attainment and well-being is mediated by their acculturation level. However, in only two of the four studies did we find support for our hypothesis that the relationship between intrinsic goal attainment and acculturation is moderated by intrinsic goal importance. We discuss the theoretical implications and the practical consequences of our findings. Furthermore, we outline future research directions that could deepen our understanding of the relationship between migrants’ goal pursuit and their acculturation.

The influence of acculturation on the risk of stillbirth in migrant women residing in Western Australia

ObjectiveTo investigate the influence of acculturation, demonstrated by age on arrival, length of residence, interpreter use and having an Australian-born partner, on disparities observed in the risk of stillbirth between migrant and Australian-born populations in Western Australia (WA).MethodsA retrospective cohort study using linked administrative health data for all non-Indigenous births in WA from 2005–2013 was performed. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Adjusted odds ratios (aOR) for stillbirth in migrants from six ethnicities of white, Asian, Indian, African, Māori, and ‘other’, with different levels of acculturation, were compared with Australian-born women using multivariable logistic regression analysis and marital status, maternal age group, socioeconomic status, parity, plurality, previous stillbirth, any medical conditions, any pregnancy complications, sex of baby, and smoking during pregnancy as the covariates.ResultsFrom all births studied, 172,571 (66%) were to Australian-born women and 88,395 (34%) to migrant women. Women from African, Indian and Asian backgrounds who gave birth in the first two years after arrival in Australia experienced the highest risk of stillbirth (aOR 3.32; 95% CI 1.70–6.47, aOR 2.71; 95% CI 1.58–4.65, aOR 1.93; 95% CI 1.21–3.05 respectively) compared with Australian-born women. This association attenuated with an increase in the length of residence in Asian and Indian women, but the risk of stillbirth remained elevated in African women after five years of residence (aOR 1.96 [1.10–3.49]). Interpreter use and an Australian-born partner were associated with 56% and 20% lower odds of stillbirth in migrants (p<0.05), respectively.ConclusionsAcculturation is a multidimensional process and may lower the risk of stillbirth through better communication and service utilisation and elevate such risk through increase in prevalence of smoking in pregnancy; the final outcome depends on how these factors are in play in a population. It is noteworthy that in women of African background risk of stillbirth remained elevated for longer periods after immigrating to Australia extending beyond five years. For migrants from Asian and Indian backgrounds, access to services, in the first two years of residence, may be more relevant. Enhanced understanding of barriers to accessing health services and factors influencing and influenced by acculturation may help developing interventions to reduce the burden of stillbirth in identified at-risk groups.

Travelling to the Motherland: relating acculturation to diaspora tourism experiences

ABSTRACTWhile India may attract international tourists with its mystique, different considerations come into play among Indian diaspora as potential travellers. Individuals’ levels of acculturation to their host country will arguably influence the extent to which ethnocultural elements form part of leisure travel motivations and desired experiences. With a long history of forced and free emigration, South Africa is used a case study to test these relationships through quantitative methodology. Results indicate that significant differences occur between three sub-groups. Levels of acculturation can potentially indicate the likelihood of sub-groups to engage with home country culture; give direction in experience design for the different markets; and identify complimentary diasporic tourism products. Recommendations for future research are presented.

The Effects of Family Financial Stress and Primary Caregivers' Levels of Acculturation on Children's Emotional and Behavioral Problems among Humanitarian Refugees in Australia.

The present study evaluated the application of the basic and extended (incorporated primary caregivers’ levels of acculturation) Family Stress Model (FSM) to understand the effect of family financial stress and primary caregivers’ levels of acculturation on children’s emotional and behavioral problems among refugees in Australia. A total of 658 refugee children aged 5–17 and their primary caregivers (n = 410) from the third wave of a nationwide longitudinal project were included in this study. We used multilevel structural equation models with bootstrapping to test the indirect effects of family financial stress and caregivers’ levels of acculturation (including English proficiency, self-sufficiency, social interaction, and self-identity) on children’s emotional and behavioral problems through caregivers’ psychological distress and parenting styles. The results showed that the extended FSM improved the model fit statistics, explaining 45.8% variation in children’s emotional and behavioral problems. Family financial stress, caregivers’ English proficiency, and self-identity had indirect effects on children’s emotional and behavioral problems through caregivers’ psychological distress and hostile parenting. The findings showed that interventions aimed at reducing caregivers’ psychological distress and negative parenting could be effective in alleviating the adverse effects of family financial stress and caregivers’ low levels of acculturation on refugee children’s mental health.

Does the Model Minority Image Work?: Consumer Responses to the Model Minority Stereotypes in Ads

This study examines how Asian American consumers respond to ads that use the “model minority” stereotypes of Asian Americans. Based on the theoretical explanations of the match-up effect between perceived spokesperson characteristics and product attributes, this study proposes that the existing association derived from model minority stereotypes between the model minority image and particular product types influences Asian Americans’ responses to advertising. This study further proposes that the level of acculturation influences Asian Americans’ responses to ads that use stereotype-consistent portrayals of Asians. Study 1, focusing on Asian Americans’ responses, indicated that Asian Americans responded more favorably to the stereotype-consistent match than they did to the stereotype-inconsistent match. Further, Asian Americans’ acculturation levels significantly and positively affected their evaluation of the ad featuring the stereotype-consistent match. In Study 2, examining Caucasian Americans’ responses, a significant two-way interaction was found, demonstrating that Caucasians responded more favorably to the stereotype-consistent match than the -inconsistent match in ads, similar to the responses of highly acculturated Asian Americans.

The effect of acculturation on cognitive performance among older Hispanics in the United States

The effect of acculturation on cognition was examined among 142 older Hispanics: cognitively normal [CN; n = 70], Mild Cognitive Impairment, amnestic [aMCI; n = 27], and Dementia [D; n = 45]. Acculturation levels (high vs. low) were determined using the Short Acculturation Scale for Hispanics (SASH). ANCOVAs used a wide variety of neuropsychological tests as independent variables controlling for age and education. Among CN subjects, the highly acculturated group performed better on Logical Memory delayed recall (LM-II) [F(1, 56) = 9.26, p < .001, = 0.14], Digit Span Forward [F(1, 56) = 4.37, p < .05, = 0.07], Trail Making Test A [F(1, 56) = 7.74, p < .05, = 0.12], and Trail Making Test B [F(1, 56) = 4.66, p = .03, = 0.08], indicating that high acculturation was associated with a better performance on tests of episodic memory, auditory attention, working memory, cognitive flexibility, and processing speed among CN Hispanics. ANCOVA analyses were not significant among the other groups. In the absence of acculturation scales in clinical practice, caution should be exerted when interpreting neurocognitive results.