Puerto Rican Participants Research Articles

Prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the COVID-19 pandemic.

Hispanic/Latino populations experienced disproportionate exposure to depression risk factors during the COVID-19 pandemic. While aggregated data confirm the risks of depressive symptoms among Hispanic/Latino individuals, little research uses disaggregated data to investigate these risks based on ethnic subgroups. Using the "Understanding the Impact of the Novel Coronavirus (COVID-19) and Social Distancing on Physical and Psychosocial (Mental) Health and Chronic Diseases" survey, which was distributed nationally between May 13, 2021, and January 9, 2022 (N = 5413), we estimated the prevalence of depressive symptoms among Hispanic/Latino ethnic subgroups during the pandemic. We performed descriptive analysis on a 116-item survey, which collected disaggregated data from Hispanic/Latino individuals aged ≥ 18years (n = 1181). About one-third of the participants reported depressive symptoms (31.3%), with those who self-identified as other Hispanic/Latino/Spanish origin (40.2%) reporting the highest depressive symptom prevalence. Among participants who reported depression treatment before the pandemic, the highest reports of treatment were among Puerto Rican (81.8%) participants. More than one-third of participants receiving prior depression treatment (38.7%) reported treatment interference by the pandemic, mostly among Central American individuals (50.0%). This study highlights the need for integrating more disaggregated data into public health approaches which seek to target population subgroups and reduce racial/ethnic mental health disparities.

Genetic risk variants in New Yorkers of Puerto Rican and Dominican Republic heritage with Parkinson’s disease

There is a paucity of genetic characterization in people with Parkinson’s disease (PD) of Latino and Afro-Caribbean descent. Screening LRRK2 and GBA variants in 32 New Yorkers of Puerto Rican ethnicity with PD and in 119 non-Hispanic-non-Jewish European PD cases revealed that Puerto Rican participants were more likely to harbor the LRRK2-p.G2019S variant (15.6% vs. 4.2%, respectively). Additionally, whole exome sequencing of twelve Puerto Rican and Dominican PD participants was performed as an exploratory study.

29 Human Immunodeficiency Virus (HIV) Status, Injection Drug Use, and Cognitive Effects in a Spanish-Speaking Population

Objective:Injection drug use is a significant public health crisis with adverse health outcomes, including increased risk of human immunodeficiency virus (HIV) infection. Comorbidity of HIV and injection drug use is highly prevalent in the United States and disproportionately elevated in surrounding territories such as Puerto Rico. While both HIV status and injection drug use are independently known to be associated with cognitive deficits, the interaction of these effects remains largely unknown. The aim of this study was to determine how HIV status and injection drug use are related to cognitive functioning in a group of Puerto Rican participants. Additionally, we investigated the degree to which type and frequency of substance use predict cognitive abilities.Participants and Methods:96 Puerto Rican adults completed the Neuropsi Attention and Memory-3rd Edition battery for Spanish-speaking participants. Injection substance use over the previous 12 months was also obtained via clinical interview. Participants were categorized into four groups based on HIV status and injection substance use in the last 30 days (HIV+/injector, HIV+/non-injector, HIV/injector, HIV-/non-injector). One-way analysis of variance (ANOVA) was conducted to determine differences between groups on each index of the Neuropsi battery (Attention and Executive Function; Memory; Attention and Memory). Multiple linear regression was used to determine whether type and frequency of substance use predicted performance on these indices while considering HIV status.Results:The one-way ANOVAs revealed significant differences (p’s < 0.01) between the healthy control group and all other groups across all indices. No significant differences were observed between the other groups. Injection drug use, regardless of the substance, was associated with lower combined attention and memory performance compared to those who inject less than monthly (Monthly: p = 0.04; 2-3x daily: p < 0.01; 4-7x daily: p = 0.02; 8+ times daily: p < 0.01). Both minimal and heavy daily use predicted poorer memory performance (p = 0.02 and p = 0.01, respectively). Heavy heroin use predicted poorer attention and executive functioning (p = 0.04). Heroin use also predicted lower performance on tests of memory when used monthly (p = 0.049), and daily or almost daily (2-6x weekly: p = 0.04; 4-7x daily: p = 0.04). Finally, moderate injection of heroin predicted lower scores on attention and memory (Weekly: p = 0.04; 2-6x weekly: p = 0.048). Heavy combined heroin and cocaine use predicted worse memory performance (p = 0.03) and combined attention and memory (p = 0.046). HIV status was not a moderating factor in any circumstance.Conclusions:As predicted, residents of Puerto Rico who do not inject substances and are HIVnegative performed better in domains of memory, attention, and executive function than those living with HIV and/or inject substances. There was no significant difference among the affected groups in cognitive ability. As expected, daily injection of substances predicted worse performance on tasks of memory. Heavy heroin use predicted worse performance on executive function and memory tasks, while heroin-only and combined heroin and cocaine use predicted worse memory performance. Overall, the type and frequency of substance is more predictive of cognitive functioning than HIV status.

Chronic stress, omics, and asthma

The U.S. has the highest rate of firearm‐related deaths of all economically developed nations. Current evidence suggests that exposure to violence (ETV) and violence‐related distress may cause or worsen asthma. Indeed, violence‐related distress may affect asthma pathogenesis through direct effects including abnormal responses to catecholamines and glucocorticoid therapy, and altered immune responses resulting in airway inflammation. Violence‐related distress may also affect asthma through indirect effects such as decreased physical activity and weight gain.We previously showed that ETV is associated with asthma in a high‐risk population (Puerto Ricans), in whom ETV is also associated with methylation of a CpG site in the promoter of the gene for the pituitary adenylate cyclase activating polypeptide 1 type 1 receptor (ADCYAP1R1) in white blood cells. Moreover, we reported that such methylation is associated with childhood asthma in Puerto Ricans.Based on previous results, we hypothesized that ETV and violence‐related distress would be linked to asthma through airway epithelial methylation of genes regulating autonomic, neuroendocrine, and immune responses. To examine this hypothesis, we carried out a epigenome‐wide association study (EWAS) of ETV or chronic stress measures and nasal (airway) epithelial methylation in 487 Puerto Rican participants (aged 9 to 20 years) in the Epigenetic Variation and Childhood Asthma in Puerto Ricans study [EVA‐PR]). We evaluated four measures of ETV and chronic stress in children (ETV scale, gun violence, and perceived stress) and their mothers (perceived stress). Linear regression was used for each of the EWASs, with CpGs as dependent variables and the violence or stress scale as a predictor, adjusting for age, sex, principal components, and latent factors. We then selected the top 100 CpGs (by P‐value) associated with each scale in EVA‐PR. Since no replication cohort had data on stress or violence, we conducted a meta‐analysis of the selected CpGs and atopic asthma using data from EVA‐PR and two other cohorts (Project Viva and PIAMA).Three CpGs (in SNN, PTPRN2,and LINC01164) were associated with maternal stress or gun violence (P=1.28 to 3.36 ×10‐7), but not with atopic asthma, in EVA‐PR. In a meta‐analysis of three cohorts, which included the top CpGs associated with stress/violence measures in EVA‐PR, 12 CpGs (in STARD3NL, SLC35F4, TSR3, CDC42SE2, KLHL25, PLCB1, BUD13, OR2B3, GALR1, TMEM196, TEAD4 and ANAPC13) were associated with atopic asthma at FDR‐P< 0.05. PLCB1 has been associated with bronchodilator response and is differentially expressed in children with treatment‐resistant asthma compared with children with controlled persistent asthma or healthy controls.Pending confirmation in longitudinal studies, our results suggest that nasal epithelial methylation markers associated with ETV and chronic stress may be linked to atopic asthma in youth.

Knowledge, Attitudes, and Beliefs About Colorectal Cancer Screening in Puerto Rico

The purpose of this study was to describe the psychosocial factors influencing participation in colorectal cancer screening (CRCS) among Puerto Rican men and women. We conducted seven focus groups in metropolitan and rural areas of Puerto Rico (PR) with men and women (using gender specific groups) aged 50 to 80 years (n = 51) who were non-adherent to CRC guidelines. The focus group guide included questions related to colorectal cancer (CRC) and CRC screening knowledge, attitudes, and beliefs. We analyzed data using a modified grounded theory approach to identify emergent themes. Focus groups revealed seven major themes that represented barriers to CRCS: (1) lack of CRC knowledge, (2) lack of knowledge about colorectal cancer screening tests as well as the required preparation, (3) embarrassment, (4) low perceived benefit of CRCS and sense of fatalism, (5) transportation (mostly among participants in rural areas), (6) lack of time, and (7) financial burden. All participants understood the benefits of CRCS once the procedure was explained. Additionally, participants reported a lack of provider recommendation for CRCS. In this group of Puerto Rican participants who were non-adherent to CRCS, there were misconceptions about CRC, screening tests available, and preparation and testing procedures. Participants’ low levels of knowledge and negative attitudes concerning CRCS and low reported provider recommendation were important deterrents to screening. These findings suggest the need for educational efforts to increase knowledge and attitudes about CRCS and improved patient-provider communication to reduce missed opportunities to recommend.

Pain Prevalence, Chronicity and Impact Within Subpopulations Based on Both Hispanic Ancestry and Race: United States, 2010-2017

We provide national surveillance estimates of pain chronicity, severity and impact in adult subpopulations defined by both Hispanic Ancestry and Race. Data are from 144,434 adults who completed validated questionnaires in the 2010–2017 National Health Interview Survey asking about pain status within the last 3 (N = 84,664) or 6 months (N = 59,770). Multivariable logistic regression was used to assess the relationship between pain and ethnicity/race. Compared to White Puerto Rican participants, White participants with Central/South American and Mexican ancestry had reduced odds of reporting Category 3–4 pain and High-Impact Chronic Pain (HICP), while those of Cuban ancestry had reduced odds of only HICP - eg, White participants with Mexican ancestry had 32% lower odds of having Category 3-4 pain and 50% lower odds of having HICP. While no differences were seen between White Puerto Rican and White Non-Hispanic participants for Category 3-4 pain, White Non-Hispanics had 40% lower odds of reporting HICP. Asian Non-Hispanic and Black Non-Hispanic participants had significantly lower odds of reporting Category 3-4 pain and HICP compared to White Puerto Rican participants, eg, Black Non-Hispanic participants had 26% lower odds off having Category 3-4 pain and 42% lower odds of having HICP.Perspective: By examining pain status in discrete demographic groups based on Hispanic Ancestry and Race, this report further documents substantial difference in health status among underserved populations and provides a baseline for continuing surveillance research on pain, with the eventual goal of eliminating disparities in pain assessment and treatment.

Disparities in Smoking Behavior by Race/Ethnicity in 10 Diverse Communities in Chicago: Findings from Sinai Community Health Survey 2.0.

Disparities in smoking prevalence persist among and within racial/ethnic groups in the U.S. This study aimed to identify racial/ethnic smoking behavior disparities in Chicago between 2015 and 2016. We used data from the Sinai Community Health Survey 2.0, a population-based survey conducted among adults living in ten diverse communities in Chicago. A total of 1543 adults completed the survey. We estimated the prevalence of smoking behavior among participants who had smoked at least 100 cigarettes in their lives (N = 598). We stratified by race/ethnicity and sex, reporting statistically significant differences at p < 0.05 threshold. Current smoking was highest among NHBs (40%), followed by Puerto Ricans (28%), NHWs (24%), and Mexicans (13%). Among participants who had smoked 100 cigarettes in their life, over 60% of Puerto Rican (65%) and NHB (63%) participants were daily smokers. Although 72% of NHB smokers tried to quit smoking in the previous year, only 15% of them quit smoking for more than 12months. Among Puerto Rican current smokers, 44% smoked a pack of cigarettes per day or more while only 6% of NHBs smoked more than a pack a day. Only 20% of Mexican participants were advised by a health professional to quit smoking in the past year. Among Puerto Rican females, 55% started smoking before the age of 15. We found important differences in smoking behavior by race/ethnicity groups and sex. These disparities highlight the importance of implementing targeted evidence-based strategies to reduce tobacco use, particularly among those groups with the highest prevalence.

Targeting of protease activator receptor-2 (PAR-2) antagonist FSLLRY-NH2 as an asthma adjuvant therapy.

Asthma is a chronic inflammatory and multifactorial respiratory tract disease. It affects over 18 million adults and 6 million children in the USA with Puerto Ricans showing the highest prevalence (12%–19%). This airways illness can be triggered by an environmental stimulus such as grass pollen, fungi spores, cockroaches allergens, dust mites metabolic compounds, and importantly, by environmental proteases such as trypsin and tryptase. Because of the pivotal role of proteases in the onset of asthma pathophysiology, we focused this study on the serine Protease Activated Receptor-2 (PAR-2), a G-protein-coupled receptor widely expressed in cells across the respiratory tract. Herein, we measured the activation of PAR-2 on primary pulmonary bronchial/tracheal epithelial cells, human small airway epithelial cells, lung bronchial smooth muscle cells (with and without asthma). We tested human-derived eosinophils from 61 Puerto Rican participants (33 asthmatic and 28 non-asthmatic). As surrogate of PAR-2 activation or inhibition we used intracellular calcium mobilization assay. We hypothesized that following exposure of the PAR-2 agonist (AC264613), the studied human primary cell types will increase the mobilization of intracellular calcium levels. In contrast, we expected a decrease of the intracellular calcium levels upon exposure to a PAR-2 antagonist (FSLLRY-NH2). The Puerto Rican-derived eosinophils were analyzed for the proinflammatory markers MAPK/PI3K using flow cytometry (n = 8). As expected, the PAR-2 agonist significantly increased the activation of PAR-2 on the bronchial/tracheal epithelial cells, bronchial smooth muscle cells and human small airway epithelial cells (P = .01). The PAR-2 antagonist significantly decreased the intracellular calcium levels of these lung primary down to undetectable levels (P = .01). Remarkably, the asthmatic-derived eosinophils showed a striking 300% increase of intracellular calcium mobilization suggesting a severe response to the PAR-2 agonist stimuli in asthmatics. In contrast, there were no significant changes between groups after adding the PAR-2 antagonist. Our outcomes revealed that PAR-2 antagonist effectively inhibited the studied primary cells, expecting to decrease the immune response of eosinophils. Most importantly, our results reveal a promising role for the PAR-2 antagonist in targeting bronchial/tracheal epithelial cells, human small airway epithelial cells and bronchial smooth muscle cells with the potential to oblige an asthma adjuvant therapy.

Psychosocial Risk Factors for Food Insecurity in Puerto Ricans Living in the USA from Baseline to 5-Year Follow-Up

Food insecurity is prevalent among Puerto Rican adults in the USA and is associated with adverse psychosocial outcomes. However, the direction of this association has not been established in this understudied population. In this study, we aimed to examine the longitudinal association between a group of psychosocial risk factors and subsequent food insecurity in a cohort of Puerto Rican adults. Secondary analysis was conducted using data from the prospective Boston Puerto Rican Health Study. A total of 517 Puerto Rican participants aged 45-75 y in the Boston area who were food secure at baseline, and who completed food security surveys at baseline and 5 y were included. Psychosocial factors, including depressive symptoms, stress, tangible social support, and acculturation were assessed with validated instruments. Multivariable logistic regression models were used to examine the risk of food insecurity at 5 y, as a function of psychosocial factors at baseline and their changes over 5 y, adjusting for age, sex, education, baseline and change in total annual household income, and in family size. The cumulative incidence of food insecurity at 5 y was 12.6%. The odds of incident food insecurity was significantly associated with baseline depressive symptom score [OR=1.78 (1.16, 2.76) per each 10 score units], with change in depressive symptom score [OR=1.50 (1.07, 2.09) per each 10-unit increase], and with change in perceived stress [OR=1.59 (1.01, 2.51) per each 10-unit increase], after adjusting for potential confounders. In this cohort of Puerto Rican adults, depressive symptoms at baseline, and increases in depressive symptoms and perceived stress over 5 y were associated with a higher risk of food insecurity. Psychosocial health and environment appear to play important roles in predicting risk of food insecurity in the Puerto Rican community.

Text Messaging and Disaster Preparedness Aids Engagement, Re-Engagement, Retention, and Communication Among Puerto Rican Participants in a Human Immunodeficiency Virus (HIV) Self-Testing Study After Hurricanes Irma and Maria.

Hurricanes can interrupt communication, exacerbate attrition, and disrupt participant engagement in research. We used text messaging and disaster preparedness protocols to re-establish communication, re-engage participants, and ensure retention in a human immunodeficiency virus (HIV) self-test study. Participants were given HIV home test kits to test themselves and/or their non-monogamous sexual partners before intercourse. A daily text message-based short message service computer-assisted self-interview (SMS-CASI) tool reminded them to report 3 variables: (1) anal sex without a condom, (2) knowledge of partners' testing history, and (3) proof of partners' testing history. A disaster preparedness protocol was put in place for hurricanes in Puerto Rico. We analyzed 6315 messages from participants (N = 12) active at the time of Hurricanes Irma and Maria. Disaster preparedness narratives were assessed. All participants were able to communicate sexual behavior and HIV testing via SMS-CASI within 30 days following María. Some participants (n = 5, 42%) also communicated questions. Re-engagement within 30 days after the hurricane was 100% (second week/89%, third week/100%). Participant re-engagement ranged from 0-16 days (average = 6.4 days). Retention was 100%. Daily SMS-CASI and disaster preparedness protocols helped participant engagement and communication after 2 hurricanes. SMS-CASI responses indicated high participant re-engagement, retention, and well-being.

A field study to estimate inhalation rates for use in a particle inhalation rate exposure metric

Particle inhalation rate (PIR) is an air pollution exposure metric that relies on age-, sex-, and physical activity-specific estimates of minute respiratory volume (MRV; L/min-kg) to account for personal inhalation patterns. United States Environmental Protection Agency (USEPA)-generated MRV estimates derive primarily from relatively homogenous populations without substantial cardiorespiratory challenges. To determine if these MRV estimates are relevant to populations in generally poor cardiorespiratory health (e.g., the Boston Puerto Rican Health Study (BPRHS) population) or whether population-specific estimates are needed, we 1) estimated population-specific MRVs and compared them to USEPA MRV estimates, and 2) compared exposure distributions and health effect estimates using PIR with population-specific MRVs, PIR with USEPA MRVs, and ambient particle number concentration (PNC). We recruited 40 adults (80% Puerto Rican, mean age = 60.2 years) in Boston with health characteristics similar to the BPRHS population. We measured pulse, oxygen saturation, respiration rate, and inspiratory volume while participants walked, stood, sat, and lay down. Pulse, respiration rate, inspiratory volume, and MRV were greater when participants were walking/standing compared to sitting or lying down. We then calculated MRVs adjusted for age, sex, measured body weight, and physical activity using data from 19 Puerto Rican participants who wore a nose clip or held their nostrils closed. We applied the population-specific and USEPA MRVs to estimate ultrafine particle exposure for participants in the BPRHS (n = 781). We compared exposure distributions and health effect estimates using the PIR with population-specific MRV estimates, PIR with USEPA MRV estimates, and ambient concentrations. We found that while population-specific MRVs differed from USEPA MRVs, particularly for unhealthy participants, PIR exposure distributions and health effect estimates were similar using each exposure metric. Confidence intervals were narrower using the PIR metrics than ambient PNC, suggesting increased statistical efficiency. Even in our understudied population, using USEPA MRVs did not meaningfully change PIR estimates.

Sustainability science and education in Haiti and Puerto Rico

This paper reports on the results of a workshop in Haiti and Puerto Rico to capture what priorities may be important to build sustainability sciences and education. In 2015, approximately 35 individuals attended all or part of the workshop at each location. Participants included academic leaders, university faculty, secondary school teachers, representatives of non-profit organizations, and university and high school students. Haitian participants called attention to the need for reforestation training, systemic solutions for waste management, and sustainable marine resources management. In Puerto Rico, participants called for more training to link civic engagement with sustainable development, social determinants of health, and programming on tsunami preparation and recovery. Members of both workshops asked for sustainability science and education advances in renewable and alternative energy development, general disaster and climate change impact preparedness (e.g. drought), and sustainable agriculture. Haitian and Puerto Rican participants also shared the view that engaging sustainability requires higher educational institutions to partner with communities, primary and secondary school teachers, policy-makers, and especially young persons, to reinforce the values of sustainability, and collectively work across sectors to learn through trial and error together.

Recognizing Latinos' range of skin pigment and phototypes to enhance skin cancer prevention.

Latinos in the United States may have the mistaken assumption that their natural pigmentation protects them from developing skin cancer that, effectively, serves as a barrier to Latinos receiving education in primary and secondary prevention of skin cancer. Latino adults of Mexican or Puerto Rican heritage attending community health fairs in the greater Chicago area responded to a culturally informed and sensitive measure for sunburn and tan, which was previously adapted to capture skin irritation with tenderness from the sun occurring in darker skin types (n=350). By self-reported responses and spectrophotometry assessment of constitutive pigmentation, adapted Fitzpatrick skin types (FST) ranged from skin type I-IV in the Mexican American participants and from II to V in the Puerto Rican participants. The objectively measured proportion of adapted FST II skin type was greater than commonly perceived and demonstrated that many Latinos do indeed have sun-sensitive skin.

Joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s predicting generalized anxiety disorder

ABSTRACTThe current study examines longitudinal patterns of cigarette smoking and depressive symptoms as predictors of generalized anxiety disorder using data from the Harlem Longitudinal Development Study. There were 674 African American (53%) and Puerto Rican (47%) participants. Among the 674 participants, 60% were females. In the logistic regression analyses, the indicators of membership in each of the joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s were used as the independent variables, and the diagnosis of generalized anxiety disorder in the mid-30s was used as the dependent variable. The high cigarette smoking with high depressive symptoms group and the low cigarette smoking with high depressive symptoms group were associated with an increased likelihood of having generalized anxiety disorder as compared to the no cigarette smoking with low depressive symptoms group. The findings shed light on the prevention and treatment of generalized anxiety disorder.

Triple comorbid trajectories of tobacco, alcohol, and marijuana use as predictors of antisocial personality disorder and generalized anxiety disorder among urban adults.

We modeled triple trajectories of tobacco, alcohol, and marijuana use from adolescence to adulthood as predictors of antisocial personality disorder (ASPD) and generalized anxiety disorder (GAD). We assessed urban African American and Puerto Rican participants (n = 816) in the Harlem Longitudinal Development Study, a psychosocial investigation, at 4 time waves (mean ages = 19, 24, 29, and 32 years). We used Mplus to obtain the 3 variable trajectories of tobacco, alcohol, and marijuana use from time 2 to time 5 and then conducted logistic regression analyses. A 5-trajectory group model, ranging from the use of all 3 substances (23%) to a nonuse group (9%), best fit the data. Membership in the trajectory group that used all 3 substances was associated with an increased likelihood of both ASPD (adjusted odds ratio [AOR] = 6.83; 95% CI = 1.14, 40.74; P < .05) and GAD (AOR = 4.35; 95% CI = 1.63, 11.63; P < .001) in adulthood, as compared with the nonuse group, with control for earlier proxies of these conditions. Adults with comorbid tobacco, alcohol, and marijuana use should be evaluated for use of other substances and for ASPD, GAD, and other psychiatric disorders. Treatment programs should address the use of all 3 substances to decrease the likelihood of comorbid psychopathology.

Levels of antioxidant activity and oxidative stress in metabolic syndrome Puerto Rican participants (1138.9)

Metabolic syndrome (MetS) is defined as a of cluster factors that increase the risk of cardiovascular diseases. The criteria for diagnosis for MetS include increased triglycerides, reduced HDL cholesterol levels, raised plasma glucose concentration, and body mass index &gt; 30 kg/m2. In the Puerto Rican population the prevalence of MetS is estimated in approximately 43.3%. Some studies suggested that MetS is linked to higher levels of oxidative stress (OxS). However, there is no data available using OxS markers at Puerto Rican community. Our objective was to determine levels of oxidized lipids and the activity of antioxidant enzymes Glutathione Peroxidase (GPx) and lipid peroxidation. We further expect to evaluate if there is there exist an association between the obtained levels and the presence of MetS in a Puerto Rican population. We hypothesized GPx activity will be significantly lower in participants with MetS and that lipid peroxidation will be higher in these persons. Data was analyzed using Prism Graph Pad and SPSSv12.0 Softwares. Our preliminary results showed no significant differences in plasma lipid peroxidation (n=224; p=0.229) and GPx (n=70; p=0.163). This study is important because excessive accumulation of oxidative molecules may be prevented by ingesting antioxidant supplements and this may create awareness of the consequences of the MetS and the potential benefit of intaking antioxidants.Grant Funding Source: Support by R25GM096955 (NIH RISE Program)

Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases Among Hispanic/Latino Individuals of Diverse Backgrounds in the United States

Major cardiovascular diseases (CVDs) are leading causes of mortality among US Hispanic and Latino individuals. Comprehensive data are limited regarding the prevalence of CVD risk factors in this population and relations of these traits to socioeconomic status (SES) and acculturation. To describe prevalence of major CVD risk factors and CVD (coronary heart disease [CHD] and stroke) among US Hispanic/Latino individuals of different backgrounds, examine relationships of SES and acculturation with CVD risk profiles and CVD, and assess cross-sectional associations of CVD risk factors with CVD. Multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos including individuals of Cuban (n = 2201), Dominican (n = 1400), Mexican (n = 6232), Puerto Rican (n = 2590), Central American (n = 1634), and South American backgrounds (n = 1022) aged 18 to 74 years. Analyses involved 15,079 participants with complete data enrolled between March 2008 and June 2011. Adverse CVD risk factors defined using national guidelines for hypercholesterolemia, hypertension, obesity, diabetes, and smoking. Prevalence of CHD and stroke were ascertained from self-reported data. Age-standardized prevalence of CVD risk factors varied by Hispanic/Latino background; obesity and current smoking rates were highest among Puerto Rican participants (for men, 40.9% and 34.7%; for women, 51.4% and 31.7%, respectively); hypercholesterolemia prevalence was highest among Central American men (54.9%) and Puerto Rican women (41.0%). Large proportions of participants (80% of men, 71% of women) had at least 1 risk factor. Age- and sex-adjusted prevalence of 3 or more risk factors was highest in Puerto Rican participants (25.0%) and significantly higher (P < .001) among participants with less education (16.1%), those who were US-born (18.5%), those who had lived in the United States 10 years or longer (15.7%), and those who preferred English (17.9%). Overall, self-reported CHD and stroke prevalence were low (4.2% and 2.0% in men; 2.4% and 1.2% in women, respectively). In multivariate-adjusted models, hypertension and smoking were directly associated with CHD in both sexes as were hypercholesterolemia and obesity in women and diabetes in men (odds ratios [ORs], 1.5-2.2). For stroke, associations were positive with hypertension in both sexes, diabetes in men, and smoking in women (ORs, 1.7-2.6). Among US Hispanic/Latino adults of diverse backgrounds, a sizeable proportion of men and women had adverse major risk factors; prevalence of adverse CVD risk profiles was higher among participants with Puerto Rican background, lower SES, and higher levels of acculturation.

Abstract B57: Comparing determinants of physical activity in Puerto Rican, Mexican-American, and non-Hispanic white breast cancer survivors

Abstract Purpose: Among the plethora of benefits of moderate to vigorous levels of physical activity for breast cancer survivors is a link to reduced risk for cancer recurrence. However, after the experience of cancer, many breast cancer survivors who were not previously active will stay inactive; and, those who were active do not return to their previous level of activity. Latinas are among the least physically active segments of the U.S. population. Utilizing a Social Cognitive Theory (SCT) based model as a guide, we conducted a cross sectional survey to investigate similarities and differences in SCT variables associated with current level of physical activity in Puerto Rican, Mexican-American and non-Hispanic white breast cancer survivors. The results reported here are being used to culturally adapt an exercise intervention specific for Mexican-American and Puerto Rican breast cancer survivors. Methods: A total of 150 breast cancer survivors completed an interviewer-guided survey. Fifty Puerto-Rican (PR) participants completed the survey in San Juan Puerto Rico in the Oncologic Hospital. Fifty Mexican-American (MA) and fifty non-Hispanic (NHW) white breast cancer survivors completed the survey in the Breast Clinic at the University of Texas M. D. Anderson Cancer Center. The survey included information on: current physical activity (Godin Leisure Time Exercise Scale, [GLTES]); current health status; and, anthropometric measures of BMI (kg/m2) with hip and waist circumferences (W:H). SCT measures included: exercise self-efficacy (ESE), barriers self-efficacy (BSE), modeling (MOD), social support from friends (SSFR), and social support from family (SSFA). Descriptive statistics, one-way analysis of variance and correlation analyses were conducted for the three groups. Results: Participants were similar in age (M=56.75, SD=11.0), BMI (M=29.0, SD=5.7) and level of co-morbidity (M=1.63, SD=1.42). There were differences in GLTES score (p&amp;lt;.001) with the PR group having the lowest level (M=14.0, SD=19.1), MA lower level (M=33.5, SD=18.8) and NHW highest levels (M=43.7, SD=27.6) of activity. SCT variables that differed between groups were ESE (p=.05), MOD (p=.034) and SSAF (p=.052). SCT variables associated with current physical activity differed between the three groups: for NHW BSE (r=.58, p&amp;lt;.001) and SSFA (r=.26, p=.01); for PR ESE (r=.58, p&amp;lt;.001), BSE (r=.58, p&amp;lt;.001); and, for MA MOD (r=.41, p=.003) were associated with current physical activity. Conclusions: Consistent with current literature, Hispanic breast cancer survivors indicate that they are less physically active than non-Hispanic whites. Variables associated with current physical activity differ between Hispanic breast cancer survivor groups and non-Hispanic whites. Further research to understand culturally specific variables of exercise behaviors for ethnic breast cancer survivors are warranted in order to develop culturally competent interventions that can result in increased physical activity. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B57.

Anxious depression among Puerto Rican and African-American older adults

Objectives: To determine racial/ethnic differences in the prevalence and impact of anxious depression (i.e. major depressive disorder, MDD, occurring concomitant with generalized anxiety symptoms) among older adults. Method: Interviews were conducted with 218 Puerto Rican and 206 African American older (age ≥60) urban senior housing residents. Data were collected on diagnostic status, depression severity and psychosocial functioning. Results: Results indicated a higher prevalence of MDD and anxious depression among Puerto Rican participants. Anxious depression was associated with more severe ratings of distress and suicidality compared with MDD alone, and the impact of depression and anxiety was most pronounced for the Puerto Rican participants. Puerto Rican participants also reported poorer subjective health and more substantial disability; however, these effects were independent of depression or anxiety status. Conclusions: Anxious depression is common among older ethnic minority adults and the impact of these symptoms differs by race/ethnicity. These results highlight the importance of conducting culturally sensitive assessments of depression and anxiety among older adults.

Familial and non-familial smoking: Effects on smoking and nicotine dependence

Background This study examined the relative impact of familial and non-familial smoking on participant smoking and nicotine dependence. Methods This is a longitudinal study of 838 African American and Puerto Rican participants who were interviewed four times in their homes over a 15–16-year period (1990, 1994–1996, 2000–2001, and 2004–2006). Results Parental smoking during adolescence had a direct positive path to peer smoking during adolescence, which in turn had a direct positive path to participant smoking during the mid-twenties. In addition to the direct path between participant smoking in the mid-twenties and participant nicotine dependence during the late twenties, there was an indirect effect mediated by the partner's problems resulting from smoking during the late twenties. Conclusions This research demonstrates the key role the social environment plays in smoking and nicotine dependence. Both familial and non-familial smoking were significantly related to smoking and nicotine dependence. Public health implications suggest the importance of targeting prevention and treatment policies based on the participants’ stage of development. During adolescence the focus should be on parental and peer smoking, whereas during the twenties attention might be paid to their own smoking and that of their partners.