Hispanic Parents Research Articles

EHealth Familias Unidas: Pilot Study of an Internet Adaptation of an Evidence-Based Family Intervention to Reduce Drug Use and Sexual Risk Behaviors Among Hispanic Adolescents.

This paper describes the Internet adaptation of an evidenced-based intervention for Hispanic families, eHealth Familias Unidas, and explores whether an Internet-based format is feasible and acceptable to Hispanic families. Core intervention components from the evidence-based intervention, Familias Unidas, were transposed into a video format and edited for content. Additionally, interactive exercises and a soap opera series were incorporated to reinforce intervention content and optimize participant engagement and retention. To understand the feasibility and acceptability of eHealth Familias Unidas, we conducted a pilot study and examined findings from: (1) session completion rates for both e-parent group sessions and family sessions (n = 23 families); and (2) qualitative data collected from Hispanic parents (n = 29) that received the eHealth intervention. Engagement and attendance in the intervention showed that 83% of families engaged in the intervention and that there was an overall session completion rate of 78%. Qualitative interviews were conducted mid and post intervention with a combined total of 29 participants. A general inductive approach was used to derive themes from the collected data. Overall, parents expressed positive feedback in regards to the intervention and stated that there were multiple lessons learned from participating in eHealth Familias Unidas. Findings indicate that an Internet-based family intervention is not only feasible and acceptable for Hispanic families, but also offers a viable option to ameliorate barriers to participation and implementation of preventive interventions.

Abstract C53: Human papillomavirus (HPV) and cervical cancer: Exploring knowledge, attitudes, and cultural taboos among Mexican American families along the Texas-Mexico border

Abstract Background: Hispanic women living along the Texas-Mexico border have higher cervical cancer mortality and incidence rates compared to other Hispanic women in the U.S. The human papillomavirus (HPV) causes the majority of cervical cancers. Although cervical cancer can be prevented through HPV vaccination and prevented or detected early through Pap test screening and follow-up treatment, they are all underutilized by Hispanic females. Research indicates that beliefs, misconceptions, and taboos regarding sexuality may contribute to the low perceived risk for HPV and cervical cancer, thus contributing to the underutilization of vaccination and Pap test screening. Since beliefs are often transmitted through parents, it is critical to elucidate parents' and young women's (aged 18-26 years) beliefs about HPV and cervical cancer. In this study, we explored knowledge, attitudes, and perceptions about HPV and cervical cancer among Hispanic parents and young women living along the Texas-Mexico border. Methods: We conducted eight focus groups in two counties along the Texas-Mexico border. Research staff recruited family members - fathers, mothers, and young women (aged 18-26 years) who were eligible for HPV catch-up vaccination - from local community centers, health centers, and colleges. Research staff audio-recorded focus groups for accuracy, transcribed recordings word-for-word, and uploaded transcripts into Atlas(ti) 5.0 for analysis. After open and axial coding, the research team analyzed the data for content, meaning, patterns, frequency, and themes by applying the constant comparison method to guide analysis and generation of themes. Results: Although misconceptions existed across all participant groups, the type of misconception varied. Mothers, fathers, and young women held different beliefs. Misconceptions among parents centered heavily on sexual risk with fathers linking HPV risk to promiscuity. On the other hand, mothers linked HPV risk to adultery and indiscretion of male partners. Young women's beliefs were about transmission of the virus via unclean surfaces and beliefs that medications can cure HPV. Conclusions: Results uncovered important differences in knowledge and risk beliefs concerning HPV and cervical cancer among Hispanic parents and young women living along the Texas Mexico border. Our findings highlight critical knowledge areas that can be addressed through interventions to overcome barriers to HPV prevention in Hispanic women, as well as to create culturally appropriate prevention messages that may ultimately help reduce disparities in HPV and cervical cancer among Hispanic women along the Texas-Mexico border. Citation Format: Daisy Y. Morales-Campos, Shedra Amy Snipes, Maria E. Fernandez. Human papillomavirus (HPV) and cervical cancer: Exploring knowledge, attitudes, and cultural taboos among Mexican American families along the Texas-Mexico border. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C53.

Abstract A27: Evaluation of two HPV vaccination educational interventions for Hispanic parents

Abstract Background: We examined effectiveness of two lay health worker-delivered educational interventions for parents to increase HPV vaccination among Hispanic girls. Methods: Twenty-nine clinics were randomized to standard care or one of two interventions: a print fotonovela or an tailored interactive multimedia intervention (TIMI). Lay health workers delivered the interventions to parents. Data collectors completed follow-up assessments at 6 and 12 months. We assessed vaccine initiation at first follow-up and series completion by end of the study. Data were analyze using hierarchical logistic regression. Results: Among all participants recruited at baseline (576= fotonovela intervention group; 389=TIMI intervention group; 433=control group) intent-to-treat analysis indicated significant differences in vaccine initiation between TIMI and control at 6-month follow-up (OR: 1.63, 95% CI: 1.13-2.35, p=0.01), and between fotonovela and control (OR: 1.67, 95% CI: 1.20-2.32, p=0.002). Per protocol analyses (including only parents who completed follow-up surveys or whose daughter's vaccination status was ascertained through medical records) showed significant differences in initiation at 6 month follow-up: between TIMI and control (OR: 1.79, 95% CI: 1.21-2.70, p=0.004) and between fotonovela and control (OR: 1.65, 95% CI: 1.17-2.34, p=0.004). There were no statistically significant differences between TIMI and fotonovela (OR: 1.08 CI: 0.76-1.55, p=0.66). Conclusion: Hispanic parents receiving education - either the fotonovela or the TIMI - were more likely to initiate HPV vaccination within 6 months than parents in the comparison group. We will determine education effectiveness on completion of the 3-dose HPV series at 12-month follow-up. Citation Format: Maria E. Fernandez, Lara Savas, Roncancio Angelica, Myrna Khan, Natalie Fernandez-Espada, Serena Rodriguez, Sally Vernon. Evaluation of two HPV vaccination educational interventions for Hispanic parents. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A27.

Exploring Mindful Eating and Weight Status Among Underserved Youth and Their Parents Living in Public Housing

There is growing interest on the effects of mindfulness techniques, particularly mindful eating (ME), on eating behaviors and weight status. This study aimed to (1) evaluate whether the ME practices of adult parents and adolescents were associated to their respective weight status and (2) assess the relationship between a parent’s ME behaviors and those of their adolescent child. Data was collected as part of a secondary data analysis from a cross-sectional observational study conducted with primarily Hispanic parent and youth dyads (n = 57) from public housing sites in Phoenix, Arizona. Participants completed the Mindful Eating Questionnaire (MEQ) and research staff collected anthropometric data. Adjusted multivariate linear regressions were used in data analysis. No associations were observed between ME and weight status for either parents or youth. However, parent overall MEQ scores were associated with adolescent overall MEQ scores (r = 0.47, p < .01). Analysis using adjusted regressions confirmed the findings: overall adolescent MEQ score was associated with overall parent MEQ score (p < .01). These findings suggested that there may not be a relationship between weight status and ME among this low-income population. However, the relationship between parent and youth ME scores highlights the need for further research on the long-term impact ME has on weight status of youth over time.

Family, Schools, or Culture: What Explains Differences in U.S. Student Achievement Across Ethnic Groups on PISA 2012?

U.S. students in different ethnic groups have very different average scores on the PISA 2012 mathematics and reading tests, with Blacks and Hispanics showing negative gaps relative to White students and Asians showing a positive gap. I investigate whether a student’s family characteristics or the school attended can explain these differences. I find that Hispanic parents’ low average education explains the largest share of the Hispanic achievement gap. In contrast, most of the larger negative gap for Blacks and the positive gap for Asians cannot be explained by family characteristics or the school they attend. Attendance at “bad” schools explains relatively little of the negative gaps, but Black students’ mathematics scores are substantially lower when they compose more than 50% of the class, which is not the case for Hispanic students. This evidence suggests that ethnic group culture is an important cause of Black and Asian student achievement gaps.

Decisional Regret Among Parents of Children With Cancer.

Purpose Decision making is one of the ways in which parents serve as stewards of their children with cancer, but barriers to informed decision making among parents of children with cancer have been identified. We sought to evaluate the extent to which parents feel satisfied with, or regretful of, decisions made for their child's cancer treatment and to identify factors associated with heightened regret. Methods We surveyed 346 parents of children with cancer within 12 weeks of their initial cancer treatment decision and the children's physicians at Dana-Farber Cancer Institute/Boston Children's Hospital and the Children's Hospital of Philadelphia. Our main outcome measure was heightened regret as measured by the Decisional Regret Scale. Results Sixteen percent of parents (N = 54) met our definition of heightened decisional regret. In a multivariable logistic regression model, race/ethnicity was associated with regret, with black (odds ratio [OR], 6.55; 95% CI, 2.30 to 18.7), Hispanic (OR, 2.15; 95% CI, .69 to 6.65), and other race parents (OR, 4.68; 95% CI, 1.58 to 13.8) at increased risk for regret relative to whites ( P = .001 across all categories). In contrast, parents who reported receiving high-quality information (OR, .45; 95% CI, .23 to .91; P = .03) and detailed prognostic information (OR, .48; 95% CI, .24 to .96; P = .04), who trusted the oncologist completely (OR, .32; 95% CI, .17 to .63; P = .001), and who held their ideal role in decision making (OR, .49; 95% CI, .25 to .95; P = .04) were less likely to experience regret. Conclusion Although many parents are satisfied with decisions made for their children with cancer, racial and ethnic minority parents are at heightened risk for regret. Clinicians may be able to reduce this risk by providing high-quality information, including prognostic information, involving parents in decision making in the ways they wish, and serving as trusted providers.

Exploring U.S. Hispanic parents’ length of time in the United States: Influences on obesity outcomes among U.S. Hispanic children

ABSTRACTThe 2009 California Health Interview Survey was used to examine effects of Hispanic immigrant parents’ length of stay (less or more than 10 years) in the United States on the overweight and obesity outcomes among their children (N = 956, aged 6–11). The socio-ecological model of health was used to conceptualize health risk behaviors and associations with overweight/obesity outcomes among children. Weight (using body mass index) among children was influenced by parents’ length of stay, country of origin, income, and urban/rural residence. Future directions for social work professionals working with obese Hispanic children and their families are discussed.

Racial/Ethnic Differences in the Prevalence of Anxiety Using the Vanderbilt ADHD Scale in a Diverse Community Outpatient Setting

Pediatric anxiety is prevalent but frequently underdiagnosed compared with other behavioral conditions in primary care practice. Pediatricians routinely screen for attention-deficit hyperactivity disorder using the Vanderbilt Rating Scale, which includes a short screen for anxiety. We sought to examine the prevalence of potential anxiety among patients whose parents originally had concerns of disruptive behavior in a diverse setting and examine differences in anxiety across ethnic groups using the Vanderbilt ADHD Diagnostic Rating Scale (VADRS). This was a cross-sectional analysis of medical records data of children between the ages of 5 to 12 years whose parents had concerns of disruptive behavior and received primary care from May 25, 2010, to January 31, 2014 at 2 pediatric community health clinics in Indianapolis. Sixteen percent of children whose parents had concerns for disruptive behavior screened positive for anxiety based on the VADRS screen. Hispanic parents were less likely to report symptoms of anxiety (Spanish speaking: adjusted odds ratio (AOR) 0.4, 95% confidence interval (CI), 0.2-0.8; English speaking: AOR 0.3, 95% CI, 0.1-0.9) compared with white and black families. Anxiety is detected at a lower rate among Hispanic pediatric patients using the VADRS. This may suggest differences in the performance of the VADRS among Spanish-speaking families.

Socioeconomic and Racial-ethnic Disparities in Prosocial Health Attitudes: The Case of Human Papillomavirus (HPV) Vaccination for Adolescent Males.

Research on prosocial attitudes, social networks, social capital, and social stratification suggest that lower-socioeconomic status (SES), Hispanic, and nonwhite individuals will be more likely than their higher-SES and non-Hispanic white counterparts to engage in health behaviors that serve a social good. Analyzing data from the University of North Carolina Human Papillomavirus (HPV) Immunization in Sons Study, we test whether SES and race-ethnicity are associated with willingness to vaccinate via prosocial attitudes toward HPV vaccination among adolescent males (n = 401) and parents (n = 518). Analyses revealed that (a) parents with lower education and (b) black and Hispanic parents and adolescent males reported higher prosocial vaccination attitudes, but only some attitudes were associated with higher willingness to vaccinate. We discuss these findings in terms of how prosocial attitudes may motivate certain health behaviors and serve as countervailing mechanisms in the (re)production of health disparities and promising targets of future public health interventions.

Choice, Preferences, and Constraints

Does ‘‘choosing a home’’ still matter for ‘‘choosing a school,’’ despite implementation of school choice policies designed to weaken this link? Prior research shows how the presence of such policies does little to solve the problems of stratification and segregation associated with residentially based enrollment systems, since families differ along racial/ethnic and socioeconomic lines in their access to, and how they participate in, the school choice process. We examine how families’ nearby school supply shapes and constrains their choices. Drawing on a unique dataset consisting of parents’ ranked preferences from among one urban district’s full menu of public schools, we find that Hispanic, white, and black parents share a strong preference for academic performance, but differences in their choices can be traced to variation in nearby supply. Our findings illustrate how the vastly different sets of schools from which parents can choose reproduce race-based patterns of stratification.

Parenting style and perceptions of children's weight among US Hispanics: a qualitative analysis.

Parental perceptions of their children's weight status may limit their willingness to participate in or acknowledge the importance of early interventions to prevent childhood obesity. This study aimed to examine potential differences in Hispanic mothers' and fathers' perceptions of childhood obesity, lifestyle behaviors and communication preferences to inform the development of culturally appropriate childhood obesity interventions. A qualitative study using focus groups was conducted. Groups (one for mothers and one for fathers) were composed of Hispanic parents (n = 12) with at least one girl and one boy (≤ 10 years old) who were patients at a pediatric clinic in Tennessee, USA. Thirteen major themes clustered into four categories were observed: (i) perceptions of childhood obesity/children's weight; (ii) parenting strategies related to children's dietary behaviors/physical activity; (iii) perceptions of what parents can do to prevent childhood obesity and (iv) parental suggestions for partnering with child care providers to address childhood obesity. Mothers appeared to be more concerned than fathers about their children's weight. Fathers expressed more concern about the girls' weight than boys'. Mothers were more likely than fathers to congratulate their children more often for healthy eating and physical activity. Parents collectively expressed a desire for child care providers (e.g. caregivers, teachers, medical professionals and food assistance programs coordinators) to have a caring attitude about their children, which might in turn serve as a motivating factor in talking about their children's weight. Parental perceptions of their children's weight and healthy lifestyle choices are of potential public health importance since they could affect parental participation in preventive interventions.

Strategies Low-Income Parents Use to Overcome Their Children's Food Refusal.

Introduction Parents play a key role in the development of eating habits in preschool children, as they are the food "gatekeepers." Repeated exposure to new foods can improve child food preferences and consumption. The objective of this study was to determine parent feeding strategies used to influence child acceptance of previously rejected foods (PRF). Methods We conducted eighteen focus groups (total participants=111) with low-income African American and Hispanic parents of preschool children (3- to 5-year-olds) in Texas, Colorado, and Washington. Through thematic analysis, we coded transcripts and analyzed coded quotes to develop dominant emergent themes related to strategies used to overcome children's food refusal. Results We found three major themes in the data: parents most often do not serve PRF; parents value their child eating over liking a food; and parents rarely use the same feeding strategy more than once for a PRF. Desiring to reduce waste and save time, parents said they most often intentionally decided not to purchase or serve PRF to their children. Discussion Because parents' primary goal in child feeding is getting children to eat (over acceptance of a variety of foods), strategies to help parents promote consumption of less easily accepted foods could help parents with child feeding struggles and improve children's dietary quality.

Acne Knowledge of Hispanic Parents of Teenagers with Mild to Moderate Acne.

We performed a cross-sectional study of Hispanic and non-Hispanic parents of children with acne using a survey designed to determine their level of awareness of acne and its treatment; 82% of Hispanic parents and 40% of non-Hispanic parents agreed that a health care provider should treat mild acne (p < 0.001). Hispanic parents of adolescents with acne agreed more frequently than non-Hispanic parents that children with mild and moderate acne should be taken to a health care provider for treatment, but they tended not to visit health care providers. Future studies should aim to determine the reasons for this discrepancy, after which culturally sensitive educational programs can be developed to address this disparity.

The development of an educational video to motivate teens with asthma to be more involved during medical visits and to improve medication adherence

Objectives: Our objective was to develop a series of short educational videos for teens and parents to watch before pediatric visits to motivate teens to be more actively involved during their visits. Methods: The development of the short educational videos was theoretically guided by Social Cognitive Theory. First we conducted four focus groups with teens (ages 11 to 17) with asthma, four focus groups with the teens' parents, and seven focus groups with pediatric providers from four clinics. The research team, which included two teens with asthma and their parents, analyzed the focus group transcripts for themes and then developed the initial video script. Next, a visual storyboard was reviewed by focus groups with parents and four with teens to identify areas of the script for improvement. The English videos were then produced. Focus groups with Hispanic parents and teens were then conducted for advice on how to modify the videos to make a more culturally appropriate Spanish version. Results: Based on focus group results, teen newscasters narrate six one- to two-minute videos with different themes: (a) how to get mom off your back, (b) asthma triggers, (c) staying active with asthma, (d) tracking asthma symptoms, (e) how to talk to your doctor and (f) having confidence with asthma. Each video clip has three key messages and emphasizes how teens should discuss these messages with their providers. Conclusions: Teens, parents, and providers gave us excellent insight into developing videos to increase teen involvement during medical visits.

The Father's Race and Origin Has a Significant Influence on Prematurity Risks [11C

INTRODUCTION: Premature births increase neonatal morbidity and mortality. Previous studies have only looked at risks associated with the mother's race. The objective of this study was to determine risks of prematurity based on combinations of maternal and paternal origin for Hispanic, non-Hispanic white, non-Hispanic black, and Asian parents. METHODS: This is a retrospective cohort analysis of the 2013 CDC birth certificate data for nulliparous, singleton pregnancies. Prematurity risks (delivery under 37 weeks gestation) were calculated for 16 parental combinations for Hispanic (H), non-Hispanic white (NHW), non-Hispanic black (NHB), and Asian (A) mothers and fathers. Infants born to parents that were both non-Hispanic white served as reference (RR=1). RESULTS: The study population consisted of 1,246,140 deliveries. The distribution among mothers was: NHW: 762,195; H: 252,730; NHB: 137,973; A: 93,242 and among fathers: NHW: 746,644; H: 251,870; NHB: 161,170; A: 86,456. The risk of prematurity nearly doubled when both parents were non-Hispanic black as compared to mothers that were NHW and fathers that were A (14.9% versus 7.37%; RR 1.9; 95% CI 1.76–2.03, P<.0001). Across all maternal groups, prematurity risks dropped significantly when the father was Asian (Range: 7.37%–11.56%) and increased when the father was non-Hispanic black (Range: 10.74%–14.9%). CONCLUSION: Our study shows that the father's race and origin significantly determines the risk of prematurity. Across all groups, infants of Asian fathers had consistently lower prematurity risks while infants of non-Hispanic black fathers had significantly increased prematurity risks. A father's race and origin should be included when assessing prematurity risks.

Socio-Demographic Differences in Parental Monitoring of Children in Late Childhood and Adolescents’ Screen-Based Media Use

According to a social cognitive theory, children may learn to function through processes of modeling and observational learning, with parents and the media being the significant sources of socialization and learning in the home environment. Adolescence is a period when children progressively look for autonomy and independence. One of the important research questions is whether adolescents utilize screen-based media with or without parental monitoring and limit-setting. This exploratory study examines socio-demographic factors associated with parenting (i.e., co-using, limit setting on the amount, limit setting on contents, and active mediation) in regards to television and video game usage during adolescence. Participants were 799 adolescents (5th to 12th graders) and their parents. Results indicate no gender differences in parental monitoring, but age/grade differences were found with less parental monitoring (more autonomy or independence) of older children. Parental monitoring also differed by ethnicity and by household income. Asian parents were the most restrictive while Hispanic parents were the least restrictive. Parents also reported more active mediation or engagement in families with higher household income. Findings initiate consideration of parenting styles in adolescent media usage, which have implications for adolescent adjustment and developmental outcomes.

Hispanic parents' perceptions of their preschool children's weight status.

The purpose of this study was to examine the accuracy of Hispanic parents' perceptions of their preschool children's weight status. A cross-sectional descriptive design with Hispanic parent-child dyads (n = 83) from a Head Start setting was used to compare parents' perceptions of their children's weight status with their 2- to 5-year-old children's body mass index (BMI) and weight categories. Methods included a word choice from five response options, and varying body size silhouettes presented in a linear fashion and a random circular pattern. Parents' perceptions were compared with the children's BMI, and in relationship to parents' demographic characteristics and BMI. Approximately half of parents underestimated their child's weight status, and overweight/obese parents tended to underestimate their overweight/obese children's weight status. Eliciting parent perception of their child's weight is one way providers can engage in obesity prevention dialogue.

Factors that Influence Autism Knowledge in Hispanic Cultures: a Pilot Study.

Although the diagnosis of autism spectrum disorder (ASD) is rising, Hispanic children are diagnosed at a disproportionately lower rate compared to other ethnic and racial groups. Lack of ASD knowledge in the Hispanic community may contribute to this disparity. The study objective was to determine whether sociocultural and environmental factors linked to ASD diagnostic disparities were related to Hispanic parents' ASD knowledge. A 60-item survey assessing demographic information, acculturation, religiosity, social support, and ASD knowledge was administered to 64 Hispanic patients (84% female; 76% uninsured; 82% Catholic) visiting a southwest clinic. Socioeconomic status (SES), social support, language of questionnaire, spiritual attribution of child diagnosis, and religious importance predicted ASD knowledge, accounting for 43% of variance. Results contribute to understanding how sociocultural and environmental factors influence ASD knowledge within at-risk Hispanic individuals, which can be used to improve information dissemination and ultimately reduce disparity in ASD services.

Hispanic Parents’ Views on Physician-Instructed Reproductive Health Education

Hispanic Parents’ Views on Physician-Instructed Reproductive Health Education

Reaching Back Strategy: Using Mirroring, Trust, and Cultural Alignment in a Service-learning Course to Impact Hispanic Parents’ Perception of College—A Case Study

ABSTRACTThirty-four undergraduate public relations majors participating in a problem-based service-learning project at a Hispanic-Serving Institution executed an event that attracted more than 100 low-income Hispanic families to campus. The purpose was to help parents prepare their children for college. From primary and secondary research, the students identified 3 dimensions for reaching the targeted audience—mirroring, trust, and cultural alignment—which were dubbed the Reaching Back strategy. Our purpose is to describe how the Reaching Back strategy works, the benefits of problem-based service-learning projects for both students and community participants, and how this strategy can be replicated.