Language Acculturation Research Articles

The Relationship of Language Acculturation (English Proficiency) to Current Self-Rated Health Among African Immigrant Adults

Although over 1.5 million African immigrants live in the US, few studies have examined the relationship of language acculturation to health outcomes among African immigrant adults. The primary objective of this research was to investigate the relationship between English proficiency and current self-rated health among African immigrant adults. Using a cross-sectional design, a secondary data analysis was performed on baseline data from the African immigrant adult subsample (n = 763) of the 2003 New Immigrant Survey, a longitudinal study of lawful permanent residents. Limited English proficiency (LEP), increased duration of US residence, older age at immigration, being male, less than 12 years of education, poor pre-migration health, and chronic disease were associated with good/fair/poor current self-rated health. Findings support consideration of pre-migration health and chronic disease in future acculturation and health studies, and provision of linguistically competent interventions for LEP African immigrants at risk for poor health outcomes.

Gender difference in academic performance of nursing students in a Malaysian university college

To examine differences in academic performance between male and female nursing students, and to identify whether professional identity and language usage were explanatory factors of academic performance. Although the numbers of men entering the nursing profession are increasing, societal stereotypes and the lack of male role models in nursing may have a negative impact on motivation, and hence, academic performance. A total of 147 students who were enrolled in an undergraduate nursing programme in Peninsula Malaysia were surveyed in January 2011. In addition to demographic and academic data, three instruments were administered to measure language acculturation and professional identity. The mean age of participants was 20.0 (SD: 1.5) years with 81% being female. Almost all students spoke the Malay language at home. Although there were no differences between male and female nursing students in relation to professional identity (P=0.496), male nursing students reported a lower mean English language usage score (9.9 vs. 10.9, P=0.011) and a higher mean Malay language usage score (20.4 vs. 18.8, P=0.017). Males were also found to have lower academic performance than female students, as measured by grade point average (GPA) (2.7 vs. 3.2, P<0.001). Regression analysis revealed gender was the only significant predictor of academic performance (β=-0.44, P<0.001). Males represent less than 10% of the nursing workforce in developed countries, with some developing countries experiencing even lower participation rates. Promoting academic support of male nursing students may assist in increasing the number of male registered nurses in the nursing workforce.

Problem Drinking among Mexican-Americans: The Influence of Nativity and Neighborhood Context?

We examined the influence of nativity and community context (Hispanic neighborhood concentration) on two measures of problem drinking among Mexican-Americans. Cross-sectional study. Texas City Stress and Health Study conducted in Texas City, Texas during 2004-2006. A total of 1435 Mexican-Americans aged 25 years and older. Binge drinking (≥6 drinks per occasion by men and ≥4 drinks per occasion by women) and scoring positive on the CAGE (a four-item clinical measure of problem drinking) as dependent variables. Key independent variables included a measure of language acculturation, proportion of Hispanics in the participant's neighborhood according to 2000 U.S. Census data, and being foreign-born compared with being U.S.-born. Logistic regression analysis was used to predict being a binge drinker and being positive on the CAGE. RESULTS . Foreign-born women were less likely to be binge drinkers than U.S.-born women. Nativity was not significant among men. Moreover women were less likely to be binge drinkers if they lived in heavily Hispanic neighborhoods. No such effect was found among men. Similar results were obtained with the CAGE. We found a powerful influence of nativity (being U.S.-born compared with foreign born) and neighborhood Hispanic concentration on problem drinking among women but not among men. It is likely that cultural norms in heavily Hispanic environments discourage problem drinking among women but not among men.

Generation and Acculturation Status Are Associated with Dietary Intake and Body Weight in Mexican American Adolescents ,

Mexican American children are disproportionately affected by obesity. Data on how the acculturation process influences diet and body weight among adolescents are limited. We used the data from the 1999–2004 NHANES, restricting to 2286 Mexican American children between 12 and 19 y old. Acculturation was measured by generation status and language preference. Diet was assessed using 24-h diet recall. Multiple linear, Tobit, logistic, and quantile regression models were used. We found, after adjusting for socio-demographic factors, health, dietary intake, physical activity, and sedentary behaviors compared to the first generation, second and third generations had greater odds of overweight and obesity. Adolescents in the second generation had higher BMI Z-scores than adolescents in the first and third generations. Both second and third generation adolescents consumed less fruit, whole fruit, vegetables, grains, and meats but more sweetened beverages, whole grains, saturated fat, sodium, oil, and energy from discretionary foods. Higher language acculturation was associated with poorer diet and greater body weight. Our findings suggest that Mexican American adolescents face challenges in terms of poorer diet and excessive weight gain associated with their immigration experience.

Acculturation, physical activity and television viewing in Hispanic women: findings from the 2005 California Women's Health Survey

To assess the relationship of acculturation with physical activity and sedentary behaviours among Hispanic women in California. Data from the 2005 California Women's Health Survey (CWHS) - a cross-sectional telephonic survey of health indicators and health-related behaviours and attitudes - were used. Using a random-digit dialling process, data were collected monthly from January to December 2005. A total of 1298 women aged ≥18 years in California who self-identified as Hispanic. Of the participants included in the analysis, 49 % were adherent to physical activity recommendations (with 150 min of weekly activity signifying adherence). There was no significant association between language acculturation and moderate or vigorous physical activity after controlling for potential confounders such as smoking, age and employment status. There was also no association between duration of residence in the USA and moderate or vigorous physical activity. Language acculturation was positively associated with television (TV) viewing, with highly acculturated women reporting more hours of TV viewing compared with women with an intermediate acculturation score (P = 0·0001), and those with an intermediate score reporting more hours of TV viewing compared with those with a low score (P = 0·003). This relationship persisted after inclusion of smoking, employment status, age and education in the model. Higher levels of language acculturation may be associated with increased sedentary behaviours because of the influence of US culture on those women who have assimilated to the culture. Acculturation is an important factor to be taken into account when designing health education interventions for the Hispanic female population.

Determinants and beliefs of health information mavens among a lower-socioeconomic position and minority population

People of lower-socioeconomic position (SEP) and most racial/ethnic minorities face significant communication challenges which may negatively impact their health. Previous research has shown that these groups rely heavily on interpersonal sources to share and receive health information; however, little is known about these lay sources. The purpose of this paper is to apply the concept of a market maven to the public health sector with the aims of identifying determinants of high health information mavenism among low-SEP and racial/ethnic minority groups and to assess the information they may be sharing based on their own health beliefs. Data for this study were drawn from the baseline survey (n = 325) of a US randomized control intervention study aimed at eliciting an understanding of Internet-related challenges among lower-SEP and minority individuals. Regression models were estimated to distinguish significant determinants of health information mavenism among the sample. Similarly, bivariate and logistic multivariable models were estimated to determine the association between health information mavenism and accurate health beliefs relating to diet, physical activity and smoking. The data illustrate that having a larger social network, being female and being older were important factors associated with higher mavenism scores. Additionally being a moderate consumer of general media as well as fewer years in the US and lower language acculturation were significant predictors of higher mavenism scores. Mavens were more likely than non-mavens to maintain accurate beliefs regarding diet; however, there was no distinction between physical activity and smoking beliefs between mavens and non-mavens. These results offer a unique understanding of health information mavenism which could better leverage word-of-mouth health communication efforts among lower-SEP and minority groups in order to reduce communication inequalities. Moreover, the data indicate that health information mavens may serve as an ideal point of intervention in attempts to modify health beliefs with the goal of reducing health disparities among these populations.

Impact of acculturation on dietary habits of Latina immigrants

Latino immigrants present a major public health challenge as they have the second highest prevalence of obesity and related chronic in the U.S. Newly arrived Latinos are generally healthier than the overall U.S. population, a phenomenon known as the “Latino Health Paradox”. Acculturation has been strongly associated with higher rates of obesity. During the last decade, the Latino population increased by 71% in rural areas of Illinois. The Latino Needs Assessment project was developed to assist rural communities in recognizing the strengths and challenges of these immigrants. Our objective was to identify patterns of food intake in relationship to acculturation and acculturative stress. Data were gathered in 5 Central Illinois counties where 112 female participants were recruited for structured interviews. Questions addressed individual, social and contextual factors that affect immigrant families' wellbeing, including acculturation and nutrition measures. The consumption of flour tortillas was associated with language acculturation (r=0.22, p=0.02); length in the U.S. (r=0.20, p=0.04); consumption of salty snacks (r=0.20, p=0.04) and eating at fast food restaurants (r=.30, p=0.001). Corn tortilla consumption was significantly associated with fruit consumption (r=0.25, p=0.01) and stress about giving up cultural practices (r=0.19, p=0.04). Lower consumption of traditional food products, even when related positively to acculturation, was also associated with unhealthy dietary habits. In order to prevent obesity and obesity-related diseases, it will be important to encourage immigrants to maintain their traditional healthful foods and facilitate the availability of these. Support: IL DHS, Bureau of Child Care and Development, IL Network of CCR, USDA Hatch Act Funds.

Value of Web-Based Learning Activities for Nursing Students Who Speak English as a Second Language

There is an increasing need to address the educational needs of students with English as a second language. The authors assessed the value of a Web-based activity to meet the needs of students with English as a second language in a bioscience subject. Using telephone contact, we interviewed 21 Chinese students, 24 non-Chinese students with English as a second language, and 7 native English-speaking students to identify the perception of the value of the intervention. Four themes emerged from the qualitative data: (1) Language is a barrier to achievement and affects self-confidence; (2) Enhancement intervention promoted autonomous learning; (3) Focusing on the spoken word increases interaction capacity and self-confidence; (4) Assessment and examination drive receptivity and sense of importance. Targeted strategies to promote language acculturation and acquisition are valued by students. Linking language acquisition skills to assessment tasks is likely to leverage improvements in competence.

A comparison of social attitudes, professional and institutional identities and acculturative stress between podiatry and other health professional students

Methods Thirty-three out of forty-six enrolled first-year podiatry students completed surveys at a large, culturally diverse university in Sydney, Australia. Demographic data and standardised measures of English language acculturation, acculturative stress, universe diverse orientation and professional and institutional identities were collected. Surveys were also administered to first-year physiotherapy, occupational therapy, nursing and medical students at the same university. Data were entered into and analysed in SPSS version 18. Descriptive statistics and Kruskal-Wallis tests were used to describe and compare the student cohorts. Results Seventy-three percent of first-year podiatry students were born in Australia although 36% of these students speak a language other than English at home. Podiatry was the first course preference for 73% of students, and 34% of the cohort reported having a close friend in the same course. 64% were in paid employment at the time of the study, and of these 71% worked in a non-healthrelated area. Conclusions Trends were identified which differentiated the health professions. When compared with other health professional students, podiatry students had relatively low levels of acculturative stress and moderate levels of professional and institutional identity. This suggests that first-year podiatry students (after 12 weeks of study) have appropriate attitudes that will facilitate the development of cultural competence with further study. The data to date has shown similar trends for physiotherapy and occupational therapy students in the School of Biomedical and Health Sciences.

Learning preference as a predictor of academic performance in first year accelerated graduate entry nursing students: A prospective follow-up study

The growth of accelerated graduate entry nursing programs has challenged traditional approaches to teaching and learning. To date, limited research has been undertaken in the role of learning preferences, language proficiency and academic performance in accelerated programs. Sixty-two first year accelerated graduate entry nursing students, in a single cohort at a university in the western region of Sydney, Australia, were surveyed to assess their learning preference using the Visual, Aural, Read/write and Kinaesthetic (VARK) learning preference questionnaire, together with sociodemographic data, English language acculturation and perceived academic control. Six months following course commencement, the participant's grade point average (GPA) was studied as a measurement of academic performance. A 93% response rate was achieved. The majority of students (62%) reported preference for multiple approaches to learning with the kinaesthetic sensory mode a significant (p=0.009) predictor of academic performance. Students who spoke only English at home had higher mean scores across two of the four categories of VARK sensory modalities, visual and kinaesthetic compared to those who spoke non-English. Further research is warranted to investigate the reasons why the kinaesthetic sensory mode is a predictor of academic performance and to what extent the VARK mean scores of the four learning preference(s) change with improved English language proficiency.

Gender Differences in Language Acculturation Predict Marital Satisfaction: A Dyadic Analysis of Russian-Speaking Immigrant Couples in the United States

Immigration is a major life event that can create marital distress in couples who migrate together (Min, 2001 ). One instigator of this distress is differences in the rates of acculturation between husbands and wives (Chun and Akutsu, 2003 ; Darvishpour, 2002). Previous qualitative research (Ben-David and Lavee 1994) found that amongst Russian immigrant couples in Israel, marital discord resulted when wives acculturated faster to the host culture than their husbands. Building on this with a quantitative approach, we assessed a sample of Russian-speaking immigrants in the United States of America to examine whether gender differences in acculturation patterns predicted marital satisfaction. Fifty immigrant couples completed the Language, Identity and Behavior Acculturation Scale (Birman and Trickett, 2001) and the Revised Dyadic Adjustment Scale (Busby, Christensen, Crane, and Larson , 1995) as an indicator of marital satisfaction. Multilevel modeling revealed that husbands and wives were less satisfied in their marriages when husbands scored low on American language acculturation and wives scored higher. Differences in the other dimensions of acculturation (American and Russian identity and behavior) did not significantly predict marital satisfaction. To interpret these findings, we suggest that language acculturation is a pathway to economic success, and when women acculturate faster it violates traditional economic gender roles. Implications for therapists and community agencies who support immigrant families during this difficult transition are discussed.

Acculturation and healthy lifestyle habits among Hispanics in United States-Mexico border communities

To explore the relationship between acculturation and healthy lifestyle habits in the largely Hispanic populations living in underserved communities in the United States of America along the U.S.-Mexico border. A cross-sectional study was conducted from April 2006 to June 2008 using survey data from the Alliance for a Healthy Border, a program designed to reduce health disparities in the U.S.-Mexico border region by funding nutrition and physical activity education programs at 12 federally qualified community health centers in Arizona, California, New Mexico, and Texas. The survey included questions on acculturation, diet, exercise, and demographic factors and was completed by 2,381 Alliance program participants, of whom 95.3% were Hispanic and 45.4% were under the U.S. poverty level for 2007. Chi-square (χ2) and Student's t tests were used for bivariate comparisons between acculturation and dietary and physical activity measures. Linear regression and binary logistic regression were used to control for factors associated with nutrition and exercise. Based on univariate tests and confirmed by regression analysis controlling for sociodemographic and health variables, less acculturated survey respondents reported a significantly higher frequency of fruit and vegetable consumption and healthier dietary habits than those who were more acculturated. Adjusted binary logistic regression confirmed that individuals with low language acculturation were less likely to engage in physical activity than those with moderate to high acculturation (odds ratio 0.75, 95% confidence interval 0.59-0.95). Findings confirmed an association between acculturation and healthy lifestyle habits and supported the hypothesis that acculturation in border community populations tends to decrease the practice of some healthy dietary habits while increasing exposure to and awareness of the importance of other healthy behaviors.

Policy implications of early onset breast cancer among Mexican-origin women.

Overall, Latinas are more likely to be diagnosed with a more advanced stage of breast cancer and are 20% more likely to die of breast cancer than non-Hispanic white women. It is estimated that from 2003 to 2006, $82.0 billion in direct medical care expenditures, in addition to 100,000 lives annually, could be saved by eliminating health disparities experienced by Latinos and increasing the use of up to 5 preventive services in the United States. An additional 3700 lives could be saved if 90% of women aged ≥40 years were recently screened for breast cancer. The authors examined the risk for breast cancer in a case-control, population-based sample of Mexican-origin women in Harris County, Texas (n=714), where the rates of breast cancer mortality for Latina women have doubled since 1990. Half of breast cancer cases (n=119) were diagnosed in women aged <50 years. In a multivariate model, women who had a family history of breast cancer (odds ratio [OR], 4.3), who were born in Mexico and had high levels of language acculturation (OR, 2.5), and who did not have health insurance (OR, 1.6) had the highest risk for breast cancer. Because the current results indicated that Mexican-origin women are at high-risk for early onset, premenopausal breast cancer, the authors recommended policies that target screening, education, and treatment to prevent increased disparities in mortality. The authors concluded that the inclusion of community members and policymakers as partners in these endeavors would further safeguard against an increase in cancer health disparities and aid in formulating a policy agenda congruent with scientifically based, community-driven policy efforts that address breast cancer screening, education, and treatment in this vulnerable population.

Preventive Health Care Practices of Former Soviet Union Immigrant Women in Germany and the United States

Objectives: To examine the use of preventive health care practices of mammography, Pap smear, and breast self-exam in immigrant women from the former Soviet Union in Germany and the United States. Design: A descriptive cross-sectional exploratory study was used to examine the preventive health care practices of immigrant women in Germany and the United States. Sample: A convenience sample of 15 German immigrant women from the former Soviet Union were solicited from the Salztal Klinik in Germany and matched by age with 24 U.S. immigrant women from the former Soviet Union solicited from a community center for immigrants. Measurements: Data were collected using a demographic survey and the Language, Identity, and Behavior Acculturation Measure. Results: Significant differences were found between the German and U.S. immigrant groups in use of mammography (χ2 = 8.069, df = 1, p &lt; .005) and Pap smear (χ2 = 7.245, df = 1, p &lt; .008). Conclusion: The low use of mammography and Pap smear among German immigrant women may be related to differences in health care systems, age, and health beliefs. Further study is needed to determine the affects of age and health beliefs related to health promotion and disease prevention to better understand how to intervene and improve the health of immigrant women from the former Soviet Union.

Listen, listen, listen and listen: building a comprehension corpus and making it comprehensible

Listening comprehension input is necessary for language learning and acculturation. One approach to developing listening comprehension skills is through exposure to massive amounts of naturally occurring spoken language input. But exposure to this input is not enough; learners also need to make the comprehension corpus meaningful to their learning experience.

Immigrant Women's Cancer Screening Behaviors

Objectives: Investigate the relationship between the dependent variable health outcome (perceived health status) and the independent variables population characteristics, (predisposing, which includes age, acculturation, months in the United States; enabling, which includes availability of medical insurance) and health behavior (personal health practices, which includes engaging in cancer screening of mammography, Pap smear, and breast self-exam) among immigrant women from the former Soviet Union. Design: Descriptive correlational design was used with Andersen's Behavioral Model as the conceptual framework. Sample: Convenience sample of 99 women, 18 years of age and older, was obtained from a community center. Measures: Demographic Information for Immigrants from the Former Soviet Union Survey (DIFSU) and Language, Identity, and Behavior Acculturation Survey (LIB) were used to collect data. Results: Younger women were more likely to have a Pap smear and consider their health status as good or excellent; those with better English language skills were more likely to conduct breast self-exam but considered their health status as poor or fair; having insurance was positively correlated with having a Pap smear; the longer women were in the United States, the more likely they were to receive a mammogram. The model indicated that age and language acculturation significantly predicted health status. Conclusion: Given the incidence of breast cancer in the United States, the results highlight women in need of interventions to help them understand the value of cancer screening behaviors.

Association of depression, psycho-social stress and acculturation with respiratory disease among Puerto Rican adults in Massachusetts.

To assess associations between acculturation, depression, and self-reported stress score with reported diagnosis of respiratory disease (RD) in Puerto Rican adults, participants (N = 1,168) were identified from areas of high Hispanic density in the Boston, MA metropolitan area. Eligible participants were interviewed in the home by bilingual interviewers in either Spanish or English. Scales included topics ranging from general background to depressive symptomatology. Respiratory disease was self-reported and checked against prescribed medication. More than one-third (37.8%) of subjects reported doctor-diagnosed RD. A final binary logistical regression model (N = 850), which was adjusted for potential confounders (sex, age, education, poverty) showed that RD was significantly associated with psychological acculturation (OR = 1.97, P = 0.005), depressive symptomatology (OR = 1.52, P = 0.03) high perceived stress score (OR = 1.97, P = 0.009), and current smoking (OR = 1.61, P = 0.03). Significant inverse associations included a high level of language acculturation (OR = 0.65, P = 0.03), light (OR = 0.67, P = 0.01) and moderate to heavy physical activity versus sedentary physical activity (OR = 0.40, P = 0.03). We found self reported physician diagnosed RD was associated with high perceived stress and depression, as well as higher levels of psychological acculturation. Longitudinal research is needed to determine if there is a causal pathway for these associations.

What happened to familial acculturation?

While theoretical work focusing on immigrant language acculturation suggests that both parental and child's understanding of English are needed to measure acculturation, analysts have instead focused on child bilingualism. I develop a measure of familial acculturation and conceptually distinguish it from child bilingualism. I then determine whether several child and parental variables influence these measures differently, which would provide evidence supporting the conceptual distinction. Results show that child bilingualism is indeed independent of familial acculturation. Parental skills and resources significantly affect familial acculturation but not child bilingualism, whereas gender and Latino status affect child bilingualism but not familial acculturation. Additionally, modes of incorporation do not determine either child bilingualism or familial acculturation, suggesting that integrative forces external to the family may have little power to shape the internal workings that generate child or familial language acculturation. Together, these findings imply that researchers should avoid conflating child bilingualism with familial acculturation.

Treatment-related symptoms among underserved women with breast cancer: the impact of physician–patient communication

Low-income, minority women are more likely to be undertreated for breast cancer (BC) treatment-related symptoms than whites. This study assessed the impact of patient-physician communication on symptom resolution. A cross-sectional, California statewide survey was conducted among 921 low-income women with BC. Ethnic/racial differences in BC treatment-related symptoms (pain, nausea/vomiting, depression) reporting and physician' awareness of these symptoms were assessed by patient report. Multivariate logistic regression models were used to investigate the impact of patient-physician communication on symptom resolution. Depression was the most common symptom reported by patients (66%), yet physicians were the least aware of it (26.3%), especially among less-acculturated Latinas (18.9%) and Asian/Pacific Islanders (14%; P < 0.001). Greater patient-perceived self-efficacy in communication with physicians and greater physician awareness of the symptom positively predicted pain resolution, controlling for sociodemographic variables, comorbidity, and treatment received (AOR = 1.05, P < 0.0001; AOR = 6.12, P < 0.001). Physician awareness was a significant determinant of depression resolution (AOR = 13.46, P < 0.001). Yet patient-perceived self-efficacy played a much more important role than physicians' awareness in nausea resolution (AOR = 1.04, P = 0.0002). Less-acculturated Latinas tended to achieve less symptom resolution than whites, while this negative impact disappeared or was moderated after patient-physician communication was considered. This study suggests that physicians under-recognized depression, especially among Latinas. The resolution of BC treatment-related symptoms can be addressed by appropriate educational interventions targeted at patient-physician communication. Effective patient-physician communication can moderate disparities in symptom resolution among Latinas, regardless of language acculturation.

The Influence of Maternal Acculturation on Child Body Mass Index at Age 24 Months

Objective Obesity rates in preschool-aged children are greatest among Latinos. Studies of the relationship of acculturation to obesity among Latino immigrants have primarily focused on adults and adolescents. We examined the influence of maternal acculturation on child body mass index (BMI) at age 24 and 36 months among predominantly Latino, low-income mother–child pairs enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children. Design and methods Maternal characteristics were obtained from interviewer-administered surveys conducted in English or Spanish at 6 to 20 weeks postpartum among 679 participants in a randomized controlled trial of a health promotion intervention in two urban areas in the Northeast. Acculturation measures included: nativity (born in the United States vs foreign born), parents' nativity, years of US residence (<8 years vs ≥8 years), and exclusive use of native language vs nonexclusive use (mixed or English only). Following repeated mailings and telephone calls requesting permission to obtain their child's height and weight from Special Supplemental Nutrition Program for Women, Infants, and Children records, informed consent was obtained from 108 mothers. Multivariable linear regression models of maternal acculturation and child BMI z score at age 24 months and age 36 months were estimated among all mother–child pairs and within immigrant-only mother–child pairs, adjusting for relevant maternal characteristics. Results At age 24 months, children of mothers with exclusive use of native language had higher BMI z scores compared to children of mothers with nonexclusive use among 91 mother–child pairs (β=.74, P=0.02) and within 63 immigrant-only mother–child pairs (β=.92, P=0.009). Conclusions Exclusive use of native language was associated with greater BMI in children as young as age 24 months. Future research should examine the mechanisms by which mothers' language acculturation may affect proximal determinants of energy balance in preschool children, including breastfeeding practices, dietary intake, and physical activity.