Immigrant Latinas Research Articles

Latina food patterns in the United States: a qualitative metasynthesis.

Obesity disproportionately affects Latinas living in the United States, and cultural food patterns contribute to this health concern. The aim of this study was to synthesize the qualitative results of research regarding Latina food patterns in order to (a) identify common patterns across Latino culture and within Latino subcultures and (b) inform future research by determining gaps in the literature. A systematic search of three databases produced 13 studies (15 manuscripts) that met the inclusion criteria for review. The Critical Appraisal Skills Program tool and the recommendations of Squires for evaluating translation methods in qualitative research were applied to appraise study quality. Authors coded through directed content analysis and an adaptation of the Joanna Briggs Institute Qualitative Assessment and Review Instrument coding template to extract themes. Coding focused on food patterns, obesity, population breakdown, immigration, acculturation, and barriers and facilitators to healthy eating. Other themes and categories emerged from this process to complement this approach. Major findings included the following: (a) Immigration driven changes in scheduling, food choice, socioeconomic status, and family dynamics shape the complex psychology behind healthy food choices for Latina women; (b) in Latina populations, barriers and facilitators to healthy lifestyle choices around food are complex; and (c) there is a clear need to differentiate Latino populations by country of origin in future qualitative studies on eating behavior. Healthcare providers need to recognize the complex influences behind eating behaviors among immigrant Latinas in order to design effective behavior change and goal-setting programs to support healthy lifestyles.

Promotoras as facilitators of change: Latinas' perspectives after participating in a lifestyle behaviour intervention program

To describe immigrant Latinas' perspectives of a lifestyle behaviour intervention, focusing on their interactions with and perceptions of the promotoras who delivered the program in the USA. Immigrant Latinas in the USA have high obesity rates, which contribute to increased risk for cardiovascular disease and other long-term diseases. Interventions using the promotora model appear to be effective in reducing cardiovascular disease risk by improving dietary habits, physical activity and selected clinical variables among Latinas. However, there has been very limited enquiry into what it is about these interventions and promotoras that facilitates behaviour change, from the perspective of participants. Grounded theory methodology guided the data collection and analysis. This qualitative study was completed in 2012 in California, after the end of a lifestyle behaviour intervention. Four focus groups and seven one-on-one interviews were conducted with a total of 18 immigrant Latina intervention participants. Women described promotoras as helping them change by motivating them through three interconnected elements: tools, support and knowledge. Latinas viewed their ability to make lifestyle changes as connected with their emotional and psychological health and saw promotoras as counsellors who gave emotional and social support. In this respect, the intervention was emotionally therapeutic for this sample of Latinas, although this was not the original intention of the program. Promotoras gave the backbone of the intervention and were crucial in motivating Latinas to implement lifestyle changes. Future lifestyle behaviour interventions should include a strong component of mental and emotional well-being.

Work organization and health among immigrant women: Latina manual workers in North Carolina.

We sought to describe work organization attributes for employed immigrant Latinas and determine associations of work organization with physical health, mental health, and health-related quality of life. We conducted a cross-sectional survey with 319 employed Latinas in western North Carolina (2009-2011). Measures included job demands (heavy load, awkward posture, psychological demand), decision latitude (skill variety, job control), support (supervisor control, safety climate), musculoskeletal symptoms, mental health (depressive symptoms), and mental (MCS) and physical component score (PCS) health-related quality of life. Three fifths reported musculoskeletal symptoms. Mean scores for depression, MCS, and PCS were 6.2 (SE = 0.2), 38.3 (SE = 0.5), and 42.8 (SE = 0.3), respectively. Greater job demands (heavy load, awkward posture, greater psychological demand) were associated with more musculoskeletal and depressive symptoms and worse MCS. Less decision latitude (lower skill variety, job control) was associated with more musculoskeletal and depressive symptoms. Greater support (supervisor's power and safety climate) was associated with fewer depressive symptoms and better MCS. Work organization should be considered to improve occupational health of vulnerable women workers. Additional research should delineate the links between work organization and health among vulnerable workers.

Intersectionality at Work: Determinants of Labor Supply among Immigrant Latinas.

This article borrows from the intersectionality literature to investigate how legal status, labor market position, and family characteristics structure the labor supply of immigrant Latinas in Durham, NC, a new immigrant destination. The analysis takes a broad view of labor force participation, analyzing the predictors of whether or not women work; whether and how the barriers to work vary across occupations; and variation in hours and weeks worked among the employed. I also explicitly investigate the extent to which family constraints interact with other social characteristics, especially legal status, in shaping women's labor market position. Results highlight that immigrant Latinas experience multiple, interrelated constraints on employment owing to their position as low-skill workers in a labor market highly segregated by gender and nativity, to their status as members of a largely undocumented population, and as wives and mothers in an environment characterized by significant work-family conflict.

Entertainment–Education? A Fotonovela? A New Strategy to Improve Depression Literacy and Help‐Seeking Behaviors in At‐Risk Immigrant Latinas

Research shows high risk for depression among immigrant Latinas known to increase during the acculturation process. Several barriers such as stigma and low health literacy result in an under-utilization of needed treatment among these women. In response, this study replicated the effectiveness of a Spanish language fotonovela, a form of Entertainment-Education (E-E), designed to increase depression literacy, decrease stigma, and increase help-seeking knowledge and behavior in Latinos. Specifically, this study evaluated a fotonovela delivered in a multifaceted approach to health education used by promotoras. A pretest-posttest randomized control group experimental design with 142 immigrant Latinas at risk for depression was employed. Results indicate significant posttest improvements in depression knowledge, self-efficacy to identify the need for treatment, and decreased stigma in experimental as compared to control group participants. Findings support the application of E-E health literacy tools such as fotonovelas, delivered in multifaceted approaches to health education used by promotoras, to Latinas at risk for mental health concerns.

Depressive symptoms of midlife Latinas: effect of immigration and sociodemographic factors.

Immigrant Latinas may have different cultural attitudes toward menopause and aging, and may experience higher levels of distress associated with adaptation to their new environment. The purpose of this secondary analysis was to describe the frequency of depressive symptoms experienced by premenopausal Latinas (40–50 years of age) living in the United States and compare Latinas born in the US with immigrant Latinas on stress and sociodemographic factors that influence depressive symptom experience. Analysis was conducted on a subsample of 94 self-identified Latinas who participated in a longitudinal study and completed the Center for Epidemiological Studies-Depression (CES-D) scale at enrollment and 6 months. Immigrant Latinas had a significantly higher CES-D (14.4 ± 11.1) than US-born Latinas (10.0 ± 7.9) and the difference remained at 6 months. There was no difference in age, body mass index (BMI), self-report of general health, or perceived stress. Higher BMI, work-related stress, and insufficient income for essential daily needs were associated with depressive symptom scores in immigrant Latinas. High BMI and less education were associated with depressive symptom scores in the US-born Latinas.

Educational barriers, social isolation, and stable romantic relationships among pregnant immigrant Latina teens.

Latina teen birth rates, particularly those of immigrant Latinas, surpass those of any major racial/ ethnic group. Little is known about how immigration experiences influence early childbearing. Fourteen pregnant Latina immigrant teens were interviewed regarding their feelings about pregnancy and birth control, educational and vocational expectations, and their partners' influences. Common themes included feelings of isolation, barriers to education and future opportunities, and a heavy reliance on partners as a stable source of emotional and financial support, all of which appeared to influence teens' desire for pregnancy. Findings suggest the need to help immigrant youth overcome barriers to education and work and to offer them culturally and linguistically appropriate clinical care including birth control information and services, preconception and prenatal care, and assistance navigating the system.

Household structure, family ties, and psychological distress among U.S.-born and immigrant Latino women.

Latino women endorse the highest rates of past-month depressive symptoms relative to Latino men and non-Latino White men and women. Yet, research into the specific domains of family life that reduce or engender psychological distress among Latinas is sparse. We examine the hypothesis that indicators of household structure and family ties will relate to psychological distress among Latinas in the United States, and that these associations will vary by nativity status. We employed nationally representative data of Latina adults (N = 1,427) from the National Latino and Asian American Study. Nativity-stratified regression analyses revealed that strained family ties (i.e., family burden, family cultural conflict) were associated with greater levels of past-month psychological distress for both U.S.-born and immigrant Latinas. Yet, the effect of household structures on psychological distress differed by nativity status. Adjusting for sociodemographic factors, lower levels of household income were associated with greater psychological distress; and having children in the household was associated with lower levels of psychological distress among U.S.-born Latinas. In contrast, for immigrant Latinas, being out of the labor force was associated with greater levels of psychological distress. Results suggest that dynamics of both the household and family context predict differential as well as similar mental-health outcomes across segments of the Latina population in the United States. These findings underscore the need to understand the pathways by which different facets of family life-structural and social domains-relate to mental-health status among subgroups of Latinas. Our results also have implications for the development of tailored interventions to meet the specific needs of Latinas.

Evaluation of Amigas Latinas Motivando el Alma (ALMA): a pilot promotora intervention focused on stress and coping among immigrant Latinas.

Recent immigrant Latinas are at increased risk of poor mental health due to stressors associated with adapting to life in the United States. This study evaluated Amigas Latinas Motivando el Alma, a promotora intervention to reduce stress and promote health and coping among recent immigrant Latinas. Using a pre- and post-test design, we evaluated mental health outcomes, specifically, in promotoras. Promotoras' knowledge levels related to role of promotora and stress management increased, depressive symptoms and stress levels decreased, and coping responses and perceived social support increased as well. Results suggest that promotora programs may be an effective way to improve mental health in recent immigrant Latinas.

Sociocultural Determinants of Breast and Cervical Cancer Screening Adherence: An Examination of Variation among Immigrant Latinas by Country of Origin

This paper seeks to examine differences in sociodemographic characteristics and culturally-relevant psychosocial and interpersonal factors across four sub-groups of immigrant Latinas, and how these factors are associated with adherence to age-specific breast and cervical cancer screening. Data come from a baseline survey using an electronic audience response system from a randomized controlled trial to test the effectiveness of a cancer screening program in New York and Arkansas (n=1,548). Mexican women were least likely to be adherent to cancer screening tests (clinical breast exam, mammogram, or Pap test). Mexican women also differed from the other sub-groups in terms of sociodemographics, barriers, and interactions within the health care system. Correlates of screening adherence differed by country of origin, with the exception of spouse/partner attendance at the program, which was negatively associated with adherence across several sub-groups. Findings provide important information about Latina sub-group variability that can help inform the development of breast and cervical cancer screening interventions.

Hispanics in Twenty-First Century America

going a remarkable demographic transformation as a result of immigration from Latin America and subsequent childbearing among immigrant Latinas. In the past 40 years, Hispanics have been transformed from a small, regionally isolated, ethnically divided population into a national demographic force of great social, economic, and political import. In 1970, the Hispanic population of the United States stood at just 9.6 million people and comprised only 4.7 percent of the U.S. population. Nearly threequarters were native born and the population was dominated by three disparate and regionally segmented groups. Sixty percent of all Hispanics were of Mexican origin and concentrated in the southwest, primarily Texas and California; 15 percent were Puerto Rican and lived in the northeast, mainly in and around New York City; another 7 percent were Cuban, who unlike the prior two groups were overwhelmingly foreign born and concentrated in South Florida, mostly in greater Miami. In 1970, very few Hispanics traced their origins to Central or South America and immigration from the Dominican Republic had only just begun. Occupying separate geographic spheres, members of the three principal Hispanic origin groups rarely came into contact with one another, except in Chicago, the one metropolitan area that housed significant numbers of all three origin groups. Over the next four decades, this small, regionally divided and ethnically segmented population was radically transformed by mass immigration to the point where in 2010 it had grown to 50.5 million people and constituted 16.3 percent of the U.S.

Using Community-Based Participatory Research (CBPR) to Develop a Community-Level HIV Prevention Intervention for Latinas: A Local Response to a Global Challenge

Introduction and BackgroundThe arsenal of interventions to reduce the disproportionate rates of HIV and sexually transmitted disease (STD) infection among Latinos in the United States lags behind what is available for other populations. The purpose of this project was to develop an intervention that builds on existing community strengths to promote sexual health among immigrant Latinas. MethodsOur community-based participatory research (CBPR) partnership engaged in a multistep intervention development process. The steps were to (1) increase Latina participation in the existing partnership, (2) establish an intervention team, (3) review the existing sexual health literature, (4) explore health-related needs and priorities of Latinas, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latinas’ lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. ResultsThe MuJEReS intervention contains five modules to train Latinas to serve as lay health advisors (LHAs) known as “Comadres.” These modules synthesize locally collected data with other local and national data, blend health behavior theory with the lived experiences of immigrant Latinas, and harness a powerful existing community asset, namely, the informal social support Latinas provide one another. ConclusionThis promising intervention is designed to meet the sexual health priorities of Latinas. It extends beyond HIV and STDs and frames disease prevention within a sexual health promotion framework. It builds on the strong, preexisting social networks of Latinas and the preexisting, culturally congruent roles of LHAs.

Reaching Latinas with Our Bodies, Ourselves and the Guía de Capacitación para Promotoras de Salud: Health Education for Social Change

As the cultural and linguistic diversity of the United States continues to grow and population shifts transform the communities where we live and work, health care providers continue to face challenges to deliver health services in demographically redefined terrains. This report describes the development of a Spanish-language training guide for community health workers (Guía de Capacitación para Promotoras de Salud) based on the book Nuestros Cuerpos, Nuestras Vidas (NCNV), the Spanish-language translation and cultural adaptation of the classic women's health book Our Bodies, Ourselves. The guide aims to 1) provide a tool for addressing the health education needs of immigrant Latinas and 2) facilitate the use of the book NCNV as a health education tool in Latino communities. Thirty telephone interviews with individuals working in agencies and organizations serving Latinos and 2 focus groups with Latinas were conducted to select the topics included in the training guide, all of which were drawn directly from NCNV. The guide contains 11 modules organized into 6 workshops. The modules address 11 topics related to women's health, ranging from sexuality and pregnancy to domestic violence and mental health. An ecological framework is used to deliver the health information. The materials acknowledge the roles of history, environment, culture, economic conditions, migration history, and politics as key determinants of health and illness. The workshops are designed to train community health workers on the women's health topics contained in the guide and to equip them for the delivery of health education among immigrant Latinas.

The influence of marianismo beliefs on physical activity of immigrant Latinas.

To verify and explicate the impact of marianismo beliefs on the physical activity behaviors of immigrant Latinas. Twenty-eight immigrant Latinas, aged 18 to 40 years, were recruited to participate in two focus group interviews. Data collection and analysis were driven by Spradley's Developmental Research Sequence. Two domain terms were identified: "Life is too fast here" and "The woman is the center of the family." Six included terms and five cultural themes were specified. A combination of marianismo beliefs, acculturation stress, loss of social support, and conflicts between collectivist and individualist values combine to adversely influence physical activity behaviors of immigrant Latinas. Physical activity interventions for Hispanic women should capitalize on the strengths of the marianista, address factors leading to acculturation stress among women and their families, and establish bridges of social support among new groups of immigrants.

The World of Physical Culture in Sport and Exercise: Visual Methods for Qualitative Research

Foreword Sarah Pink 1. Seeing the world of physical culture: the potential of visual methods for qualitative research in sport and exercise Cassandra Phoenix 2. Fell running in post-sport territories Michael Atkinson 3. Talking T-shirts: a visual exploration of youth material culture Clive C. Pope 4. Setting the scene: hailing women into a running identity Meridith Griffin 5. Power and focus: self-representation of female college athletes Vikki Krane, Sally R. Ross, Montana Miller, Julie L. Rowse, Kristy Ganoe, Jaclyn A. Andrzejczyk and Cathryn B. Lucas 6. Embodying understanding: drawing as research in sport and exercise Hannah M. Gravestock 7. 'What it was in my eyes': picturing youths' embodiment in 'real' spaces Laura Azzarito and Jennifer Sterling 8. The influence of marianismo beliefs on physical activity of mid-life immigrant Latinas: a Photovoice study Karen T. D'Alonzo and Manoj Sharma 9. Renewal, strength and commitment to self and others: older women's reflections of the benefits of exercise using Photovoice Joanie Sims-Gould, Laura Hurd Clarke, Maureen C. Ashe, John Naslund and Teresa Liu-Ambrose 10. Shooting a diary, not just a hoop: using video diaries to explore the embodied everyday contexts of a university basketball team Jim Cherrington and Beccy Watson 11. Seeing is believing: telling the 'inside' story of a beginning masters athlete through film Mary Ann Kluge, Bevan C. Grant, Lorraine Friend and Linda Glick

Abstract A14: Esperanza y Vida: A community-based approach to increasing breast and cervical cancer screening for immigrant Latinas

Abstract As health disparities continue to plague our nation it is imperative that we find ways to reduce and eliminate this public health issue. Further, as Latinos have become the largest minority group in the United States, we must address disparities in breast and cervical cancer screening rates as well as find ways to successful reduce disparities in cancer survival. Breast cancer is the most frequently diagnosed cancer among Latinas; often diagnosed at advanced stages. The incidence rates for cervical cancer are higher than non-Latina white women. Latinas have faced many difficulties within the medical care system, including accessing health services. Patient navigation has become increasingly common as a way to increase adherence to treatment and more recently, as a method of increasing cancer screening. Esperanza y Vida was developed as an intervention to reach groups of women from diverse Latino backgrounds, as a culturally and linguistically appropriate approach to cancer education and screening. Following the educational component of the program, women were contacted 2-months later to determine their age-specific screening adherence status (mammography, clinical breast exam and/or Pap test). Women who were still non-adherent to screening were offered navigational assistance. Navigational services included assistance in locating bilingual services as well as free and/or low cost screening programs, logistical assistance, encouragement for screening and additional education about the importance of screening. All women were again contacted 8 months post the educational program. This presentation will focus on the outcomes following navigation. The sample included women who were reached for both the 2- and 8-month follow up assessments and received navigational services. We will demonstrate the success of navigation; of women who were non-adherent to mammography, 63% became adherent. Univariate predictors include where the programs were conducted (Arkansas, New York City and Western NY) and concurrent screening. For clinical breast exams, 61% of non-adherent women became adherent with significant predictors of program location, years living in the US, conducting breast self exams, and concurrent other screening. For Pap test, 59% of the women became adherent with significant predictors of program location, marital status, current screening and not being afraid of hear the results of medical exams. In multiple regression analyses, significant predictors of each screening test included adherence to the other screening exams, at the same time point. This is very encouraging, in that it appears that once we can connect women with clinical services, they are able to access other exams. Next steps include understanding why 40% of women still remained unscreened. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A14.

Ethics and Cultural Competence in Research with Battered Immigrant Latina Women

This article addresses key issues in ethical and culturally competent research with battered immigrant Latinas. The discussion centers on the importance of having an understanding of the realities of the population studied in a research project as well as a commitment to engage in partnership and collaboration with the communities the participants represent. The objective of this article is to conceptualize how domestic violence should be assessed with underserved populations such as battered immigrant women. We illustrate this approach with examples from ethnographic research on immigrant Latina women experiencing domestic violence in the United States and from oral history research conducted in Mexico.

Exploring the Sexual Health Priorities and Needs of Immigrant Latinas in the Southeastern United States: A Community-Based Participatory Research Approach

Latinas living in the United States are disproportionately affected by HIV/AIDS and sexually transmitted infections. However, few effective interventions currently exist that are designed to meet the priorities and needs of recently arrived and less acculturated immigrant Latinas who are settling in the southeastern United States. To identify sexual health priorities, gaps in information and skills, and key intervention characteristics to improve sexual health among immigrant Latinas, a community-based participatory research partnership conducted four focus groups with Latinas, in central North Carolina. Findings revealed a lack of knowledge about sexual health, shame and embarrassment related to clinical exams and conversations about sex, multilevel barriers to sexual health, and disease transmission misinformation. Findings also suggested that interventions should include information about a broad range of sexual and reproductive health topics and skill building. Such interventions could serve to assist in diminishing health disparities experienced among this vulnerable population.

Exploring the Sexual Health Priorities and Needs of Immigrant Latinas in the Southeastern United States: A Community-Based Participatory Research Approach

Exploring the Sexual Health Priorities and Needs of Immigrant Latinas in the Southeastern United States: A Community-Based Participatory Research Approach

Abstract PR-9: Engaging immigrant Latinas in community-based interventions: Methods may be more important than messages for increasing screening

Abstract Background: Many Latina subgroups in the U.S. continue to be less likely to be screened with mammograms, clinical breast examinations (CBE), and Pap tests than non-Hispanic white women. These lower screening rates result in 20% higher breast and 50% higher cervical cancer death rates for Latinas. (ACS 2010; Reynolds 2004) The goal of this study was to investigate the effectiveness of Esperanza y Vida (Hope and Life) for reaching community-based groups of Latino immigrants to increase breast and cervical cancer knowledge and screening behaviors. Methods: The randomized control design compared the effectiveness of a cancer education intervention to increase breast and cervical cancer screening compared to a similar educational intervention that focused on diabetes education (control condition). The programs and methods were comparable, incorporating survivor/patient narratives, followed by telephone assessments at 2-and 8-months. The educational programs were conducted in community settings in New York and Arkansas for diverse Latino women and men, and data collection was enhanced through the use of an electronic audience response system. We hypothesized that women participating in the cancer intervention would increase screening significantly more than those in the diabetes programs. Results: This study recruited 2,339 participants, with response rates of 76% at 2-months and 66% at 8-months. Eighty-eight percent of the women attending the programs were immigrants, coming from four primary regions (Mexico, Puerto Rico, Central/South American and the Dominican Republic). Two-month results demonstrated no significant differences in breast and cervical screening outcomes among women attending the intervention compared to the control programs. More importantly, however, as it relates to the public health impact of our intervention, we found that an average of 43% of non-adherent women at all sites who participated in either the intervention or the control program obtained breast and cervical screening tests within 2 months. Negatively associated with mammogram adherence was being married or living with a partner (OR 0.48, p= 0.04), believing that “US doctors do not know what is best for me” (OR 0.42, p= 0.01), and “not knowing where to go for a mammogram” (OR 0.38, p= 0.02). Other positive and negative associations are available to be discussed. Conclusion: This study is a significant contribution to the field of behavioral sciences involving diverse Latino subgroups and cancer control. These results suggest that: 1) local outreach and health education that is conducted in a culturally and linguistically appropriate way with interactive opportunities to discuss health concerns with knowledgeable and approachable staff and volunteers is effective in increasing cancer screening; and 2) the development of relationships and trust with Latina immigrants through outreach may be a more important pathway to screening than simply improving cancer knowledge. Regardless of the specific health message, important social capital resources were “deployed” that resulted in women's ability to obtain screenings. (Burke et al. 2009) Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):PR-9.