Proxy Measures Of Acculturation Research Articles

Association Between Birthplace and Time in the United States With Diet Quality in US Adolescents: Findings from the National Health and Nutrition Examination Survey, 2007 to 2018

During adolescence, diet quality reaches its lowest point compared to other childhood life stages. Acculturation is associated with decreased diet quality among many groups of US immigrant adults, but research is limited among adolescents. We investigated the associations between birthplace and length of time living in the United States, 2 proxy measures of acculturation, and diet quality among adolescents (12-19 years old). Data were from the NHANES (2007-2018), which included two 24-hour dietary recalls (n = 6113) to estimate Healthy Eating Index 2015 (HEI-2015) total scores and component scores. Multivariate linear regression and generalized linear models were performed to compare HEI-2015 total scores and component scores between US-born adolescents (n = 5342) and foreign-born adolescents with <5 years (n = 244), 5 to <10 years (n = 201), and ≥10 years (n = 290) of US residency. Foreign-born adolescents with <5 years (53.3 ± 1.2), 5 to <10 years (51.4 ± 1.5), and ≥10 years of US residency (49.9 ± 0.8) had higher HEI-2015 total scores than US-born adolescents (47.0 ± 0.3; P < 0.0001) and higher component scores for total vegetables, seafood and plant proteins, and added sugars (P values ≤ 0.0001). Foreign-born adolescents with more years of US residency had higher component scores for total fruits, whole fruits, and saturated fats than those with fewer years of US residency. A sensitivity analysis revealed this pattern held for Mexican-American and other Hispanic adolescents. Being born outside the United States and living in the United States for less time (among foreign-born adolescents) are associated with higher diet quality. Culturally informed health promotion programs may help to reduce diet-related disparities related to acculturation among adolescents.

Acculturation and Cardiometabolic Abnormalities Among Chinese and Korean Americans.

BackgroundStudies generally show that higher acculturation is associated with greater cardiovascular disease (CVD) risk among immigrants in the United States (US). However, few studies have compared how proxies of acculturation are differentially associated with metabolic abnormalities measured using objective biomarkers, self-reported diagnosis, and medication use, particularly among East Asian Americans.MethodsSurvey data and biomarker measurements collected from random (non-fasting) blood samples of Chinese and Korean immigrants in the US (n = 328) were used to examine the associations between two proxies for acculturation (years living in the US and English speaking proficiency) with three cardiometabolic abnormalities (high triglyceride levels, diabetes, and hypercholesterolemia). Poisson regression models estimated prevalence ratios adjusted for demographic characteristics, socioeconomic factors, and body mass index. Gender, Asian subgroup, and household income were tested as potential effect modifiers.ResultsLiving longer in the US was associated with greater likelihood of having high triglycerides. In addition, living longer in the US was associated with greater likelihood of diabetes for people with lower household income and greater likelihood of hypercholesterolemia for people with higher household income. Higher level of English proficiency was less consistently associated with higher cardiometabolic risk, although there was a significant association with greater likelihood of hypercholesterolemia.ConclusionsLonger time lived in the US is associated with higher risk of cardiometabolic abnormalities among Chinese and Korean Americans. Future studies of acculturation and cardiometabolic risk should carefully consider potential mechanisms and what proxy measures of acculturation capture.Trial Registration NumberNCT03481296, date of registration: 3/29/2018.

Prevalence and Patterns of Dental Care Utilization among US-Born and Non-US Born Hispanics in the Hispanic Community Health Study/Study of Latinos.

Access to routine dental services is important to maintaining good oral health. The aims of this study were to describe the dental care utilization patterns of a diverse group of Hispanic/Latino men and women and assess differences in dental care utilization by perceived need for dental care and proxy measures of acculturation. Data from 13,792 participants of the Hispanic Community Health Study were analyzed with SAS 9.4. Time since last dental visit was dichotomized into <1 and ≥1 y. Acculturation measures included the language and social subscales of the Short Acculturation Scale for Hispanics, the Multiethnic Study of Atherosclerosis nativity subscore, and immigrant generation. Survey logistic regression adjusted for demographic (age and sex) and health-related variables, estimated associations among perceived need for dental care, acculturation measures, and dental care utilization. About a quarter (23%) of the participants were born in the 50 US states, excluding territories, while 77% were non-US born. Overall, 74% perceived a need for dental care. Upon covariate adjustment, perceiving a need for dental care was associated with reduced odds of reporting a past-year dental visit (odds ratio, 0.32; 95% CI, 0.28 to 0.37), while there appeared to be no meaningful association between proxy measures of acculturation and past-year dental visit. Having health insurance was significantly associated with a past-year dental visit (odds ratio, 2.23; 95% CI, 1.99 to 2.49) for all groups combined and among the different Hispanic/Latino background groups. Acculturation affects general health and contributes to general health disparities; however, its role in dental care utilization remains questionable. Given that acculturation is a process that occurs over several years, longitudinal studies that evaluate oral health trajectories along the acculturation continuum are needed. The results of this study are valuable for dental public health program planning and implementation for minority groups, as it describes the varying patterns of dental care utilization among US-born and non-US born Hispanics/Latinos and identifies factors that may partly explain dental care utilization patterns, such as acculturation.

Associations Between Maternity Care Practices and 2-Month Breastfeeding Duration Vary by Race, Ethnicity, and Acculturation.

Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012-2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and categorized women as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White. We conducted bivariate analyses to compare rates of breastfeeding at 2 months and experiences of maternity care practices and logistic regression analysis to estimate the effects of these practices on breastfeeding duration for each group. Results Hispanic women were less likely than non-Hispanic women to breastfeed for at least 2 months (67.9% vs. 76.6%; p = 0.000); however, this varied significantly by acculturation level: 78.1% of Spanish-speaking Hispanic women compared to 66.1% of English-speaking Hispanic women breastfed for at least 2 months (p = 0.000). The effects of specific maternity care practices on duration varied across groups. Among non-Hispanic White, Native American, and English-speaking Hispanic women, breastfeeding while at the hospital had the strongest effect (AOR 2.09, 95% CI 1.67-2.61; AOR 2.71, 95% CI 2.08-3.52; and AOR 1.99, 95% CI 1.76-2.25, respectively). Among Spanish-speaking Hispanic women, being encouraged to breastfeed on demand had the strongest effect (AOR 5.179, 95% CI 3.86-6.94). Conclusions for Practice The effects of maternity care practices on breastfeeding duration vary by race, ethnicity, and acculturation level. Health care systems must acknowledge the diversity of their patient populations when seeking to develop and implement breastfeeding-friendly practices.

The Relation between Acculturation and Psychological Well-Being among Adolescents of Asian Origin

The current study aimed to test the direct and indirect effects of acculturation on the psychological well-being among the adolescent children of Asian origin. Subgroup analysis was conducted to compare these effects between Asian refugee and non-refugee children. Data were from the follow-up survey of the Children of Immigrants Longitudinal Study (CILS). The analytic sample included adolescents from Asian refugee families (N = 563) and non-refugee families (N = 779). Adolescent acculturation was assessed by three proxy measures: nativity, time in the United States, and U.S. preference. Family dynamics were measured by adolescents’ perceptions about parent-child conflict and family cohesion. Multi-group structural equation modeling was used to analyze the data. Findings suggested that the direct effects of acculturation on psychological well-being were dependent upon the proxy measure of acculturation and the immigration type. Mediation analyses showed that higher level of acculturation was generally related to higher parent-child conflict and lower family cohesion, which, in turn, were associated with lower psychological well-being in the refugee subsample, but not the non-refugee subsample. Our findings call for programs that can take advantage of the protective role of family cohesion and reduce the negative impact of parent-child conflict. Special attention needs to be paid to the refugee population from Asia.

A systematic review of acculturation, obesity and health behaviours among migrants to high-income countries

ObjectiveThere is extensive evidence for weight gain among people migrating from low/middle-income to high-income countries, which may be due, in part, to acculturation factors. This review aimed to identify associations between acculturation and body weight among immigrants to high-income countries and identify if studies accounted for the role played by health behaviours.MethodsA systematic literature search using keywords was performed with three databases (Medline, PsychINFO and EMBASE). The 35 studies were included that utilised quantitative methodology and presented empirical findings focused on acculturation and body weight among adult immigrants.FindingsThere was evidence presented across multiple studies for an association between acculturation (measured with standard measures or as duration of stay) and obesity. Most studies were cross sectional, which did not allow the exploration of drivers of change in health behaviours and weight gain.ConclusionThis is the first review to examine associations between acculturation and body weight among migrants utilising both acculturation scales and proxy measures of acculturation and to examine the role of health behaviours. Evidence from this review suggests that health interventions should target first generation migrants to promote retention of their original healthy behaviours. Recent migrant groups report healthier behaviours than comparative host country populations, and therefore interventions should be promoted at the initial stages following migration to avoid uptake of unhealthy behaviours.

Does acculturation affect the dietary intakes and body weight status of children of immigrants in the U.S. and other developed countries? A systematic review

ABSTRACTObjective: This paper reviews available studies on the relationship between acculturation and obesity among children of immigrants who have at least one foreign-born parent.Methods: A systematic review of relevant studies was undertaken using PubMed, Web of Science, and PsychInfo.Results: The initial search identified 1317 potentially relevant publications, of which 21 were retained after three rounds of screening. Most studies were conducted in the U.S. The majority of studies used BMI or overweight/obesity prevalence as the outcome variable, while two studies used dietary intake. Three studies used standardized acculturation scales, while most of the studies used generation, duration of residency in host country, and language as proxy measures of acculturation. The relationship between acculturation and outcomes varied between the host countries and origin countries for children of immigrants.Conclusion: This study suggests children of immigrants with different cultural backgrounds may interact with host countries to varying degrees, ultimately influencing their diet behaviours and body weight status. Researchers are encouraged to adopt standardized acculturation scales to compare the results across countries and populations.

Acculturation among Latino Youth and the Risk for Substance Use: Issues of Definition and Measurement

The purpose of this paper is to provide an overview of the acculturation literature with a specific focus on exploring acculturation as a concept as well as examining its measurement and relationship to substance use/abuse among Latino adolescents in the United States over the past 20 years. A brief overview of the development of theoretical models and instruments assessing acculturation over the past two decades is provided. In addition, studies examining the relationship between acculturation and substance use/abuse among these adolescents are reviewed. Findings indicate that the development of acculturation theory and measurement has been hampered by the lack of both clear terminology and consistency. In the majority of studies reviewed, acculturation appeared to be a risk factor for Latino adolescent substance use/abuse. A small majority of these studies utilized language as a sole measure of acculturation. Language preference, in combination with other proxy measures of acculturation were found to be a robust predictor of substance use/abuse outcomes for Latino adolescents. The findings are discussed in the context of recommendations for future research on the measurement of acculturation as well as on implications for preventive interventions.

A Longitudinal Study of the Use of Mental Health Services by Persons With Serious Mental Illness: Do Spanish-Speaking Latinos Differ From English-Speaking Latinos and Caucasians?

Reports of mental health care use by Latinos compared to Caucasians have been mixed. To the authors' knowledge, no large-scale studies have examined the effects of language on mental health service use for Latinos who prefer Spanish compared to Latinos who prefer English and to Caucasians. Language is the most frequently used proxy measure of acculturation. The authors used the administrative database of a mental health system to conduct a longitudinal examination of mental health service use among Spanish-speaking versus English-speaking Latinos and Caucasians with serious mental illness. There were 539 Spanish-speaking Latinos, 1,144 English-speaking Latinos, and 4,638 Caucasians initiating treatment for schizophrenia, bipolar disorder, or major depression during 2001-2004. Using multivariate regressions, the authors examined the differences among the groups in the type of service first used. The authors also examined the probability of use of each of four types of mental health services and the intensity of outpatient treatment. Spanish-speaking Latinos differed from both English-speaking Latinos and Caucasians on most measures. Compared to patients in the other groups, the Spanish-speaking Latinos were less likely to enter care through emergency or jail services and more likely to enter care through outpatient services. There were no group differences in the proportion that stayed in treatment or used inpatient hospitalization. This study suggests that for Latinos, preferred language may be more important than ethnicity in mental health service use. Future studies comparing mental health use may need to differentiate between Spanish- and English-speaking Latinos.

The longer you stay, the bigger you get: length of time and language use in the U.S. are associated with obesity in Puerto Rican women.

This cross-sectional study examined whether length of time in the U.S., language use, and birthplace (proxy measures of acculturation) were associated with body mass index (BMI) and obesity in a sample of 174 low-income Puerto Rican women from Hartford, Connecticut. The mean BMI for the total sample (N = 174) was 27.39 (S.D. = 5.07), and nearly 34% of the sample was considered obese (BMI > or = 30). There was a statistically significant increase in BMI with length of time in the U.S. (P = 0.012) and these differences were even greater among women born in Puerto Rico (P = 0.003). Moreover, obesity prevalence was highest among women who had been in the U.S. for 10 years or more (40%), as compared to those who had been in the U.S. less than 1 year (29%; P = 0.045). There were no statistically significant associations between language and BMI for the total sample. However, among bilingual speakers born in Puerto Rico, there were significant differences in BMI according to their level of English fluency. Those who spoke fluent or very good English had a significantly higher BMI (mean = 29.72; SD = 4.12) than women whose English was good to not-so-good (mean = 26.8; SD = 5.24; P = 0.016). The findings from this study point to the need for more research on the acculturation process and obesity, in order to design culturally tailored obesity prevention programs.

Migration and depression.

Migrants migrate for a number of reasons and varying duration. The objective in this paper is to review the findings to ascertain whether rates of depression among migrants are higher compared with the non-migrant populations. We used the published data to review the theoretical background for migration and to study the existing literature on rates of depression in various migrant and ethnic groups. The rates of depressive neurosis vary according to migrant status. Migrants in some groups are less likely to report symptoms of depression. Using fluency in language as a proxy measure of acculturation it appears that acculturated individuals are more likely to be depressed. The impact of migration on depression is not as clear and straightforward as for other psychiatric conditions. More work needs to be carried out in understanding the impact of migration on depression.