Latino Childhood Research Articles

Latino grandparent opportunity to influence family health behaviors: The Healthy Us Grandparent Study (HUGS).

Latino children are the fastest growing population of obese children in the United States, the most obese group of children by race and a significant disparity in childhood obesity. Extended family, often grandparents, are traditionally involved in childcare in Latino family structure, yet their influence on family health behaviors is unclear. This study explored grandparent involvement in the care of Latino children in South Texas and their possible influence on child body mass index (BMI) and family health behaviors to determine if they present an opportunity to improve child obesity treatment plans. Partnering with the local school district, we surveyed parents (N = 174) and grandparents (N = 108) of 188 Latino, primary school-age children regarding grandparent care and family health behaviors. We weighed, measured, and interviewed children regarding grandparent care and their own health behaviors. All groups exceeded state and national obesity rates, with almost half the children in overweight or obese categories. Grandparents were routinely present in 30%-67% of the children sampled, dependent on respondent group. We found no significant relationship between grandparent involvement and child BMI, however grandparent cohabitation with the family was associated with less fast-food consumption by children (p = .001) and parents (p = .006) and healthier diet scores for children (p = .008) and grandparents (p = .004). More frequent exercise by parents (r = .33, p = .001) and grandparents (r = .25, p = .012) was associated with more frequent exercise by children. This study enhances understanding of grandparent involvement in the care of Latino children and illuminates opportunities to involve grandparents in family-focused, community-supported interventions, incorporating cultural understanding in decreasing Latino childhood obesity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Outcomes of Interprofessional Experiential Learning for Underrepresented Racial/Ethnic Minority Students to Address Latino Childhood Obesity

Addressing Latino childhood obesity requires effective health promotion programs and culturally resonant health professionals. The current profiles of public health professionals and registered dietitians point to the need to increase the number of Latino students trained in community-based participatory research and engagement of underserved populations. To address this workforce gap, the Center for Latino Community Health, Evaluation, and Leadership Training developed the Sanos y Fuertes: Healthy & Strong Graduate Research Fellowship to provide Latino graduate students with research training, professional development, and mentorship. Five cohorts of seven graduate students participated in a yearlong experiential learning program. Graduate research fellows received monthly research and professional development training from faculty, staff, and community health workers. Furthermore, fellows engaged in mentored research through the development and implementation of a Latino childhood obesity prevention curriculum and intervention. A mixed-method evaluation approach was used to assess the effectiveness of the program. Fellows completed baseline, posttraining, and follow-up assessments. Assessment surveys measured training experiences (e.g., research methods, community engagement), confidence (e.g., research methods, health education), and knowledge and skills (e.g., community health program skills). The training resulted in significant increases in skills and confidence between pre- and postassessments that were sustained at follow-up. Based on these findings, we recommend that student training programs include research as experiential learning with multidisciplinary, interprofessional teams and that community-based, community-engaged, or translational research teams include community health workers as integral members for research with marginalized, underserved populations.

Community partnerships in emerging immigrant communities: Lessons learned addressing Latino childhood weight disparities.

Latino children have disproportionately high childhood obesity rates, and U.S.-born Latino children of immigrant parents experience higher overweight/obesity rates than other Latino children. Community-based participatory research (CBPR) to engage Latino immigrant families and Latino-serving community organizations is one mechanism to address the lack of effective and practical interventions addressing childhood obesity disparities among Latino children. We present lessons learned from applying CBPR methods to a partnership focused on developing a child obesity treatment program for Latino immigrant families in an emerging Latino immigrant destination to inform the use of CBPR methods in other partnerships in emerging immigrant communities. We encountered challenges working within the partnership related to entrenched sociopolitical hierarchies that were not inclusive of immigrant community leaders, capacity building for partners with limited literacy and administrative experience, and how best to use complementary methods and frameworks to support a community-engaged research process. This work is one way to promote shared learning among the community of researchers using CBPR and other engagement methods to partner with emerging immigrant communities. Together with our community partners, we can identify strategies to more effectively partner to promote health equity and work toward social justice for all members of our communities.

Adaptation of an Intervention to Reduce Disparities in School HRQOL for Latino Childhood Cancer Survivors.

Survivors of childhood leukemia, especially those from low socioeconomic status households, often experience persistent neurocognitive and academic impairment. This study adapted an existing parent training intervention to improve outcomes for low-acculturated, Spanish-speaking Latino parents of children with leukemia and pilot tested that intervention for feasibility. Semistructured interviews were conducted with a focus group of 20 Latino parents of children treated for leukemia. Ten Latino families participated in a pilot study of the adapted parenting intervention, consisting of eight sessions over 6 months. Focus groups revealed that parents unanimously supported a parenting intervention but barriers to participation included time constraints, transportation issues, and anxiety in the hospital environment. The parents also highlighted cultural factors that could contribute to the health disparity, such as lack of knowledge and efficacy in facilitating their child's progress with learning and school. In the pilot study, adherence was 90%, establishing feasibility, and the adapted intervention was considered beneficial. The median parenting efficacy scores improved from preintervention to postintervention (median 3.40 vs. 3.94; p < .011), as did parent-reported school functioning of the child (median 50.00 vs. 60.00; p = .088). This study addressed a health disparity by culturally adapting a parenting intervention, which was designed to improve school functioning, to meet the needs and preferences of low-acculturated, Spanish-speaking families of children with leukemia in Southern California. The pilot study demonstrated that the adapted intervention is feasible and acceptable in the target population. A larger trial is underway to test the efficacy of this adapted parenting intervention.

Explanatory Model for Asthma Disparities in Latino Children: Results from the Latino Childhood Asthma Project.

BackgroundLittle research has been conducted that integrates, in one explanatory model, the multitude of factors potentially leading to disparities among Latino children.PurposeA longitudinal, observational study tested an explanatory model for disparities in asthma control between Mexican and Puerto Rican children with persistent asthma requiring daily controller medication use.MethodsMexican and Puerto Rican children aged 5–12 years (n = 267) and their caregivers (n = 267) were enrolled and completed interviews and child spirometry at baseline and 3, 6, 9, and 12 months postenrollment. A 12 month retrospective children’s medical record review was completed. Participants were recruited from two school-based health clinics and the Breathmobile in Phoenix, AZ, and two inner-city hospital asthma clinics in the Bronx, NY.ResultsStatistically significant differences in the social/contextual predictors of asthma illness representations (IRs) were noted between Mexican and Puerto Rican caregivers. The structural equation model results revealed differences in asthma control over time by ethnicity. This model accounted for 40%-48% of the variance in asthma control test scores over 12 months. Caregivers’ IRs aligned with the professional model of asthma management were associated with better children’s asthma control across 1 year. These results also supported the theoretical notion that IRs change over time impacting caregivers’ treatment decisions and children’s asthma control.ConclusionsThese findings extend a previous cross-sectional model test using a more comprehensive model and longitudinal data and highlight the importance of considering within-group differences for diagnosis and treatment of children coming from the vastly heterogeneous Latino umbrella group.Trial RegistrationTrial number NCT 01099800

The social construction of Latino childhood in the New South

Childhood in the United States, and in the American South more particularly, has several well-known and popularized constructions, typically divided by social class and ethnic identity. More specifically, Southern childhood is constructed as an either white or black experience, with one’s social world being extremely ethnically segregated in either case. Over the last several decades, as a post–North American Free Trade Agreement immigration boom has brought several generations of Latinos into the American South (in part because of these shifting demographics, the area is now often called the “New South”), this bifurcated popular conceptualization of childhood has been disrupted by the growing presence of Latino children in Southern schools and communities. Building upon Vygotsky’s premise that identity (including ethnic identity) is constructed through a cultural–historical lens, we here use the nascent literature on Latino education in the New South to outline an initial construction of Southern Latino childhood.

Advocacy, Efficacy, and Engagement in an Online Network for Latino Childhood Obesity Prevention.

Salud America! is a national network created to engage Latino researchers, health professionals and community leaders in actions to reduce Latino childhood obesity. An online survey of 148 Salud America! network members investigated relationships between (1) their levels of engagement with the network, (2) self- and collective-efficacy, and (3) behavioral intentions to engage in advocacy for policies that can help reduce Latino childhood obesity. Analyses of these data found that higher levels of Salud America! engagement was associated with collective-advocacy efficacy-greater confidence in organized group advocacy as a way of advancing policies to reduce Latino childhood obesity. A multiple regression analysis found that this sense of collective-efficacy moderately predicted intentions to engage in advocacy behaviors. Salud America! engagement levels were less strongly associated with members' confidence in their personal ability to be an effective advocate, yet this sense of self-efficacy was a very strong predictor of a behavioral intention to advocate. Based on these findings, new online applications aimed at increasing self- and collective-efficacy through peer modeling are being developed for Salud America! in order to help individuals interested in Latino childhood obesity prevention to connect with each other and with opportunities for concerted local actions in their communities.

Notes from the Field: Planting, Nurturing, and Watching Things Grow

Editors' Note: We invited a sample of AJPM's Editorial Board, supplement guest editors, and longtime colleagues and contributors to share their experiences and impressions of the impact of AJPM on their respective domains. We were particularly fond of Ken Powell's analogy to being "tenders of the planted seed"--as planters, weeders, and harvesters--watching and nurturing the growth of AJPM, and have elected to lead with his commentary.

Adolescent Obesity and Risky Sexual Behavior

To the Editor: The recent supplement to the American Journal of Preventive Medicine—Addressing Latino Childhood Obesity Through Research and Policy: Findings from the Salud America! Experience 1 Ramirez A.G. Ayala G.X. Addressing Latino Childhood Obesity Through Research and Policy: Findings from the Salud America! Experience. Am J Prev Med. 2013; 44: S173-S296 PubMed Google Scholar —was exciting and interesting to read. It is a constant reminder of the racial and ethnic disparities that exist in health outcomes that can be seen early in life. It has become clear that treating obesity requires a multifactorial approach. It is also becoming more apparent, and suggested by many of the reports in this supplement, that obesity can be difficult to treat and requires an approach with many different points of contact, including medical providers, parents, and community.

Neurocognitive and behavioral outcomes in Latino childhood cancer survivors

Children with brain tumors and leukemia are at risk for neurocognitive and behavioral late effects due to central nervous system-directed therapies. Few studies have examined these outcomes in ethnic minority samples, despite speculation that socio-demographic factors may increase vulnerability for adverse neurobehavioral outcomes. We evaluated the neurocognitive and behavioral outcomes and their impact on the health-related quality of life in survivors of childhood cancer drawn from Latino families in the Los Angeles region. Using culturally-relevant recruitment strategies, 73 predominantly Spanish-speaking parents of pediatric brain tumor or leukemia survivors completed standardized questionnaires, including the Conners parent-report and the Bidimensional Acculturation Scales. Clinical and socio-demographic factors influencing the development of neurocognitive and behavioral dysfunction were examined. Approximately 50% of the children placed at or above the "elevated" level for difficulties with attention, school-based learning, and peer relations. Younger age at diagnosis significantly predicted dysfunction in inattention, learning problems, and hyperactivity/impulsivity. Children whose parents were less adherent to the non-Hispanic white culture were more likely to have problems with peer relations and executive functioning. HRQL was significantly lower in survivors with neurocognitive and behavioral dysfunction relative to those with normal range scores on the Conners scale. In addition to the child's age at diagnosis, acculturation appears to predict select neurocognitive and behavioral outcomes in this socio-demographically homogeneous sample of Latino families. Further research is needed to understand the interaction of ethnic and cultural factors with therapeutic exposures in determining the adverse neurobehavioral outcomes, so as to optimally design interventions.

Seeking Environmental and Policy Solutions to Address Latino Childhood Obesity

s t t h m a R t The selection of research articles in this Salud America! supplement of the American Journal of Preventive Medicine features a variety of promisng strategies that aim to reduce obesity among Latino hildren. From family and consumer-directed health edcation, to improving environments and changing policies to promote healthy eating and physical activity, each article considers the context of Latino culture and/or conditions in places where Latinos live, work, learn, play, and pray. In this respect, the tone of this supplement is clear: anticipate long-term reduction in obesity rates by engaging the target population to foster behavior change and health-supportive social and physical environments. Latinos represent the nation’s largest at-risk group of children for overweight and obesity, and consequent chronic illnesses in later life. The primary culprit— nequities in social and physical environmental condiions that favor unhealthy nutrition and inactivity—puts illions of U.S. Latino children in jeopardy for developng type 2 diabetes, heart disease, certain cancers, and ore. The implications of high childhood obesity rates or decreased productivity, increased costs for health are, and decreased life span spell disaster, for the nation nd more so for Latinos. Primary prevention is, of course, the solution. Clinical xperience has taught us that working with individuals to ndo unhealthy behaviors and to endure barriers to healthy utrition and physical activity is notoriously difficult if not lusive. Prevention science signals the need for a multidisciplinary approach to address factors in the social and physical environments of children that underlie unhealthy behaviorsand that createbarriers.Communityexperience is showing us that changing these factors through policies and practices that promote healthy behaviors and lifestyles is both feasible and scalable. We expect behavior change nd social norms change to follow, over time. Overweight nd obesity rates decline, health improves. Articles in this supplement support the placeand popuation-level approach to prevention, and examinemodels in

Latino families, primary care, and childhood obesity: a randomized controlled trial.

Few successful treatment modalities exist to address childhood obesity. Given Latinos' strong identity with family, a family-focused intervention may be able to control Latino childhood obesity. To assess the feasibility and effectiveness of a family-centered, primary care-based approach to control childhood obesity through lifestyle choices. Randomized waitlist controlled trial in which control participants received the intervention 6 months after the intervention group. Forty-one Latino children with BMI >85%, aged 9-12 years, and their caregivers were recruited from an urban community health center located in a predominantly low-income community. Children and their caregivers received 6 weeks of interactive group classes followed by 6 months of culturally sensitive monthly in-person or phone coaching to empower families to incorporate learned lifestyles and to address both family and social barriers to making changes. Caregiver report on child and child self-reported health-related quality of life (HRQoL); metabolic markers of obesity; BMI; and accelerometer-based physical activity were measured July 2010-November 2011 and compared with post-intervention assessments conducted at 6 months and as a function of condition assignment. Data were analyzed in 2012. Average attendance rate to each group class was 79%. Socio-environmental and family factors, along with knowledge, were cited as barriers to changing lifestyles to control obesity. Caregiver proxy and child self-reported HRQoL improved for both groups with a larger but not nonsignificant difference among intervention vs control group children (p=0.33). No differences were found between intervention and control children for metabolic markers of obesity, BMI, or physical activity. Latino families are willing to participate in group classes and health coaching to control childhood obesity. It may be necessary for primary care to partner with community initiatives to address childhood obesity in a more intense manner. This study is registered at Clinicaltrials.partners.org 2009P001721.

Transdisciplinary Graduate Education and Training to Prevent Latino Childhood Obesity

Transdisciplinary Graduate Education and Training to Prevent Latino Childhood Obesity

Salud America! Developing a National Latino Childhood Obesity Research Agenda

U.S. childhood obesity has reached epidemic proportions, with one third of children overweight or obese. Latino children have some of the highest obesity rates, a concern because they are part of the youngest and fastest-growing U.S. minority group. Unfortunately, scarce research data on Latinos hinders the development and implementation of evidence-based, culturally appropriate childhood obesity interventions. In response, the Salud America! network conducted a national Delphi survey among researchers and stakeholders to identify research priorities to address Latino childhood obesity and compare differences by occupation and race or ethnicity. The resulting first-ever National Latino Childhood Obesity Research Agenda provides a framework to stimulate research and collaboration among investigators, providers, and communities, and inform policy makers about the epidemic's seriousness and specific needs for priority funding. The agenda ranks family as the main ecological level to prevent Latino childhood obesity--followed by community, school, society, and individual-and ranks top research priorities in each level.

Transitioning childhood cancer survivors to adult‐centered healthcare: insights from parents, adolescent, and young adult survivors

To determine Latino adolescent and young adults (AYA) cancer survivors' perceived barriers or facilitators to transition from pediatric to adult-centered survivorship care and to also assess the parents' perspective of care. Partnering with a community-based organization that serves Latino survivors, we conducted a qualitative, constant comparative analytic approach exploring in-depth themes that have salience for Latino pediatric cancer survivors seeking care in the adult healthcare setting. Twenty-seven Latino AYA survivors (>or=15 years of age) completed key informant interviews and 21 Latino parents participated in focus groups. Both AYA survivors and parents identified two major facilitative factors for survivorship care: Involvement of the nuclear family in the AYA's survivorship care in the adult healthcare setting and including symptom communication in late effects discussions. Barriers to care included: perceived stigma of a cancer history and continued emotional trauma related to discussions about the childhood cancer experience. Barriers to survivorship care include cancer stigma for both patient and nuclear family, which can impact on seeking survivorship care due to constraints placed on discussions because it remains difficult to discuss 'cancer' years later. Future research can evaluate if these findings are unique to Latino childhood cancer survivors or are found in other populations of AYA cancer survivors transitioning to adult-centered healthcare. This community-based participatory research collaboration also highlights the opportunity to learn about the needs of childhood cancer survivors from the lens of community leaders serving culturally diverse populations.