Spanish-speaking Mexican Americans Research Articles

Increasing Home Dialysis Among Spanish-Speaking Mexican American Patients: Challenges and Opportunities

Increasing Home Dialysis Among Spanish-Speaking Mexican American Patients: Challenges and Opportunities

Pathway to Trust: A Middle-Range Theory.

Background and Purpose: Trust is interpersonal, between two people, or institutional, in an institution or profession such as nursing. The patient developing interpersonal trust with the nurse is fundamental to nursing care. The purpose of this study was to develop a middle-range theory of interpersonal trust development in the nurse-patient relationship. Methods: The middle-range theory Pathway to Trust was synthesized from three grounded theory studies on the development of trust in the nurse-patient relationship with hospitalized patients. One study was conducted with English-speaking Mexican American adults, a second study with Spanish-speaking Mexican American adults, and the third study with non-Hispanic adults. The three models were synthesized into an empirically based middle-range theory of how interpersonal trust develops between the hospitalized patient and the nurse. Results: The Pathway to Trust has a beginning, middle, and end phase. At the beginning, the patient is vulnerable, relying on the nurse. In the middle, the nurse enters focused and available to the patient, perceived as caring about the patient. In the end, the patient develops trust, feeling comfortable with the nurse. A key consequence of trust is the patient allowing the nurse to help and confiding in the nurse. If the trust does not develop, the patient may avoid the nurse and not ask for help which is a patient safety concern. Implications for Practice: The Pathway to Trust is useful for advancing nursing practice, education, and research globally. Developing trust with the patient impacts patient safety and quality of care.

Stroke Outcomes Among English- and Spanish-Speaking Mexican American Patients.

We examined whether language preference was associated with 90-day poststroke outcomes among Mexican American (MA) patients. Patients with ischemic stroke and intracerebral hemorrhage from the population-based Brain Attack Surveillance in Corpus Christi project (2009-2018) were compared by language preference in 90-day neurologic, functional, and cognitive outcomes using weighted Tobit regression. Models were adjusted for demographics, initial NIH Stroke Scale (NIHSS), medical history, stroke characteristics, and insurance status. Of 1,096 stroke patients, 926 were English-speaking and 170 were Spanish-only-speaking. Spanish speakers were older (p < 0.01), received less education (p < 0.01), had higher initial NIHSS values (p = 0.02), had higher prevalence of atrial fibrillation (p < 0.01), and had lower prevalence of smoking (p = 0.01) than English speakers. In fully adjusted models, Spanish-only speakers had worse neurologic outcome (NIHSS, range 0-44 [higher worse], mean difference: 1.93, p < 0.01) but no difference in functional outcome measured by activities of daily living/instrumental activities of daily living or cognitive outcome compared with English speakers. This population-based study found worse neurologic but similar functional and cognitive stroke outcomes among Spanish-only-speaking MA patients compared with English-speaking MA patients.

Pain-Related Anxiety in Spanish-Speaking Mexican Americans Who Report Chronic Pain: Psychometric Evaluation of a New Spanish Adaptation of the 20-Item Pain Anxiety Symptom Scale (PASS-20)

The 20-item Pain Anxiety Symptom Scale (PASS-20) was adapted for Spanish-speaking Mexican Americans who report chronic pain (SSMACP). The instrument measures pain-related anxiety with fear, physiological, avoidance/escape, and cognitive anxiety as subtypes. In SSMACP, the Spanish PASS-20′s psychometric properties were evaluated while exploring relationships between pain-related anxiety with other variables. Using convenience sampling, 188 SSMACP (women = 108, men = 77; mean age = 37.20 years, standard deviation = 9.87) were recruited across the United States. Confirmatory factor analyses examined the structural validity of the hierarchical factor structure. Hierarchical multiple regression examined incremental validity. Correlational analyses examined convergent validity. Cronbach’s coefficient alphas and McDonald’s omegas examined internal consistency. Pearson’s r, t-tests, and analysis of variance tests examined relationships between demographic variables and PASS-20 scores. Confirmatory factor analyses supported the hierarchical factor structure (root mean square error of approximation = .061, standardized root mean residual = .038, comparative fit index = .940). Total and subscale PASS-20 scores had acceptable convergent validity and internal consistency (range = .75–.93). Hierarchical multiple regression found that total and subscale PASS-20 scores have adequate incremental validity, considering that they contributed uniquely to the prediction of generalized anxiety scores above and beyond other pain-related scores. Demographic variables were significantly related to total and subscale PASS-20 scores. Evidence supports the use of Spanish total and subscale PASS-20 scores in SSMACP. Exploratory evidence also informed on the possible consequences and predictors of their pain-related anxiety. The results also encourage pain research in specific populations from Latin America (eg, Mexican Americans). PerspectiveThe Spanish PASS-20 has adequate psychometric properties in SSMACP. This instrument can help catalyze pain research in SSMACP by informing on their pain-related anxiety and by helping evaluate other pain-related instruments. Evidence also informed on pain-related anxiety in SSMACP.

Abstract WP80: Stroke Outcomes Among English And Spanish Speaking Mexican Americans

Introduction: We examined if language preference was associated with differences in neurological, functional, and cognitive stroke outcomes among Mexican Americans (MAs). Methods: Ischemic or hemorrhagic stroke patients identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project (2009-2018). Poststroke outcomes at 90 days included neurological [National Institutes of Health Stroke Scale (NIHSS) range 0-44, higher worse], functional [activities of daily living/instrumental activities of daily living (ADL/iADL) range 1-4, higher worse], and cognitive [modified Mini-Mental State Examination (3MSE) range 0-100, lower worse]. Language was determined by which language participant preferred to complete outcome interview in. Differences in stroke outcomes by language were analyzed by weighted Tobit regression. Weights (baseline and outcome interview participation) were created by logistic regression to account for attrition. Age, education, initial NIHSS score, smoking status, BMI, insurance status, sex, and comorbidities were included in weighted Tobit regression models. Results: Of 1,096 patients, 1,001 preferred English and 95 Spanish. Spanish speakers were older (72 versus 66 years; p &lt; 0.01), received less education (p &lt; 0.01), and had higher prevalence of atrial fibrillation (p = 0.02) than English speakers. No other significant differences in baseline demographics or clinical factors were found. In fully adjusted models (Table 1) Spanish speakers had significantly better neurological and functional but worse cognitive outcomes compared with English speakers. Conclusion: This population-based study found better neurologic and functional stroke outcomes among Spanish speaking versus English speaking MAs. The difference in the cognitive outcome may be explained, at least in part, to lack of cultural equivalence of the test instrument. These data suggest further research into the resilience observed among Spanish speakers.

The contribution of positive affect and loneliness on readiness and self-efficacy to quit smoking among Spanish-speaking Mexican American smokers

ABSTRACT Background The existing research on affective and interpersonal determinants of smoking cessation largely under-represents minority smokers, such as Latinos. Objective The current study examined associations between affective and interpersonal factors with intermediary smoking cessation variables among Mexican-American smokers (N = 290; 60% male). Methods Measures of positive and negative affect, social support, and loneliness were each examined for associations with measures of motivational readiness to quit smoking, and smoking abstinence self-efficacy. Significant predictors were entered into models simultaneously to examine their unique associations. Covariates included gender, age, and educational attainment. Results Negative affect (b = .68, SE b = .14, p < .001) and loneliness (b = .20, SE b = .09, p < .05) were independently associated with motivation. Negative affect (b = .20, SE b = .06, p < .01) and positive affect (b = .34 SE b = .07, p < .001) were independently associated with self-efficacy. In the final models, only negative affect was associated with motivation (b = .68, SE b = .17, p < .001); whereas negative (b = .17, SE b = .06, p < .01) and positive (b = . 32, SE b = .07, p < .001) affect were associated with self-efficacy. Conclusion Results highlight the importance of resilience factors (e.g., positive affect) among Mexican-American smokers. Cessation interventions regularly target negative affect among smokers; additional focus on positive affect in cessation interventions with this population may be warranted.

Perceived discrimination and smoking lapse among Mexican Americans: An ecological momentary assessment study.

Racial/ethnic minorities face unique stressors, including perceived discrimination (PD), that may increase the difficulty of quitting smoking relative to the general population of smokers. The current study examines the impact of acute PD on smoking lapse during a quit attempt, as well as potential mechanisms linking PD to lapse among Spanish-speaking Mexican Americans. Participants (N = 169) were Spanish-speaking Mexican Americans living in the United States who completed ecological momentary assessments (EMAs) multiple times per day for 21 days postquit. A multilevel structural equation model decomposed the effect of PD on smoking lapse into indirect effects through negative affect, positive affect, smoking urge, motivation to quit, and self-efficacy. Results indicated that PD operated indirectly through negative affect, positive affect, and urge to smoke, above and beyond other mechanisms, to increase risk for smoking lapse. Findings have direct implications for intervention development among this population, including the potential for developing strategies to buffer the impact of PD, as well as skills to directly manage increased negative affect and urge to smoke. Just-in-time adaptive interventions (JITAIs) might be particularly useful, given they are designed to deliver treatment in real-time (e.g., delivery of strategies to build resilience and implement coping strategies) that could counter the impact of PD on smoking lapse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Relations of English and Heritage Language Proficiency to Response Inhibition and Attention Shifting in Dual Language Learners in Head Start

ABSTRACTThis study examined the concurrent relations of English (EL) and heritage language (HL) proficiency to executive functions (EF) among low-income dual language learners (DLLs) from immigrant families. In a sample of 90 children (age = 38–70 months) from Chinese-speaking Chinese American and Spanish-speaking Mexican American families recruited from Head Start preschools, children’s EL and HL proficiency was assessed using receptive and expressive vocabulary tests, and EF was assessed using behavioral tasks measuring response inhibition and attention shifting. Multiple regressions were conducted to test the unique and interactive relations of EL and HL vocabulary to EF, controlling for family socioeconomic status and other demographic characteristics. Higher EL and higher HL vocabulary were uniquely associated with higher attention shifting. By contrast, neither EL nor HL vocabulary was uniquely associated with response inhibition. Interaction effects of EL × HL in relation to EF were also found. The results provided some evidence for the dual benefits of EL and HL proficiency on EF (especially attention shifting) among DLLs from low-income, immigrant families.

Anhedonia and smoking cessation among Spanish-speaking Mexican-Americans.

Smoking cessation is associated with improved health and reduced risk of disease. Understanding specific factors that are associated with smoking cessation is important both for identifying those who may have the greatest difficulty quitting smoking and tailoring smoking cessation interventions accordingly. Low positive affect/anhedonia, a key transdiagnostic symptom of several psychiatric disorders, is associated with lower levels of smoking cessation in the general population, but to date, few studies have examined factors influencing smoking cessation among Spanish-speaking Mexican-American smokers. The current study examined whether low positive affect/anhedonia was inversely related to cessation status across 3 time points among Spanish-speaking Mexican-American smokers (N = 199) who were making a smoking quit attempt. Using multilevel modeling, the between-person low positive affect/anhedonia score was found to be inversely associated with smoking at quit day, 3 and 26 weeks after quit while controlling for relevant covariates (i.e., age, gender, education, income, relationship status, heaviness of smoking index) but not when controlling for other symptoms of depression. Contrary to prior research, the results of this study did not confirm the unique predictive role of low positive affect/anhedonia among Mexican Americans, suggesting that risk factors for this group may be different from other populations and cessation approaches may also need to differ. (PsycINFO Database Record

Supplemental Material for Anhedonia and Smoking Cessation Among Spanish-Speaking Mexican-Americans

Supplemental Material for Anhedonia and Smoking Cessation Among Spanish-Speaking Mexican-Americans

Texas Mexican American adult normative studies: Normative data for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)

ABSTRACTThe Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is an assessment of neuropsychological functioning commonly used in clinical and research settings. To our knowledge, normative data for the RBANS is not available for Hispanic, Mexican Americans, which the current study sought to establish. Data from 136 Hispanic, Mexican Americans from Project FRONTIER were analyzed. Approximately half of the sample was administered testing in Spanish. Normative tables were created for English and Spanish speaking Mexican Americans. Generated RBANS normative references are provided for unadjusted raw scores as well as output adjusted by education level.

Socioeconomic indicators as predictors of smoking cessation among Spanish-Speaking Mexican Americans

ABSTRACTObjective: Smoking-related illnesses are the leading cause of death among Latinos, and within this ethnic group, Mexican Americans are the largest subgroup in the U.S. Understanding the factors associated with successful smoking cessation could inform interventions for this population. Although socioeconomic status (SES) is a powerful predictor of cessation outcomes in the general U.S. population, it has generally been a poor predictor of quitting smoking among Latinos. Within a sample of Spanish-speaking Mexican Americans (n = 199), this study examined a broad array of objective and subjective indicators of SES (i.e. income, education, employment, subjective social status, financial strain, insurance status) as predictors of smoking cessation.Design: Data for the current study came from a longitudinal cohort study examining the pathways linking the social determinants of health with smoking cessation. Generalized estimating equation modeling examined the association of each predictor variable with smoking abstinence across quit day, and the 3 and 26-weeks post-quit time points.Results: Results indicated that both low financial strain and insurance status predicted an increased likelihood of abstinence when controlling for covariates in the intention-to-treat analyses (p = .02 and p = .01, respectively). However, these models only approached significance in the multiple imputation analyses (all ps > .05). Other indicators of SES (i.e. income, education, employment) that have been predictive of cessation in other populations were not predictive of abstinence in this sample.Conclusions: These findings suggest that SES may indeed influence smoking cessation among Spanish-speaking Mexican Americans similarly to its influence in other populations, but that capturing the construct of SES may require assessing a broader range of SES indicators. Specifically, low financial strain and having insurance predicted a greater likelihood of achieving smoking abstinence, whereas other indicators of SES (i.e. income, education) were not predictive.

Trust Development With the Spanish-Speaking Mexican American Patient: A Grounded Theory Study.

Interpersonal trust between patient and nurse is important in patient-centered care. Trust development may be more difficult if the patient and nurse do not speak the same language. In this grounded theory study, Spanish-speaking Mexican American adults ( n = 20) hospitalized on a medical-surgical or obstetric unit in the Midwestern United States were interviewed. Through data analysis, a model of how trust develops between nurse and patient revealed eight categories and the core category Caring for Me Well Even When Not Understanding Me. The beginning phase had four categories: Asking for Help, Bothering, Communicating, and Understanding. The middle phase had two categories: Platicando (chatting) and Being Available. The end point category was Having Trust, and outcomes were Feeling Comfortable and Feeling Supported. The language barrier was a hindrance to trust development but the nurse's way of being (personality) was more important. Therefore, the patient did develop trust with nurses who did not speak Spanish.

Rural Mexican-Americans' perceptions of family health history, genetics, and disease risk: implications for disparities-focused research dissemination.

Disseminating the results of transdisciplinary health disparities research will increasingly involve discussing family health history and/or genetic information with study participants and their communities. Often, individuals' familiarity and comfort with these topics will be unclear. To inform the dissemination activities of a Center for Population Health and Health Disparities (CPHHD) studying multilevel determinants of breast cancer disparities in Latinas, we talked with Spanish-speaking Mexican-Americans from a rural agricultural community about family health history, genetics, and disease risk. We found that participants had limited genetic literacy but were familiar with some concepts related to family health history. Participants emphasized the role of individual behavior in shaping health and expressed a strong desire for health-related information. This included genetic information about future disease risk, which participants were previously unaware of but thought could be useful for disease prevention. These findings suggest that for research dissemination to facilitate health promotion, gaps in knowledge, particularly genetic knowledge, will need to be overcome. Outreach to underserved Latino communities should take advantage of this existing knowledge of family health history and strong desire for health information, but also take care to not overstate the significance of unreplicated or low-penetrance genetic associations.

Lived experiences relating to pediatric surgery: the case of Mexican American mothers in a southern US border city.

This study examined the lived experiences of Mexican American mothers residing near a US/Mexico border town whose children underwent a surgical procedure requiring general anesthesia. Phenomenology was used to examine the lived experiences of the participants. Twelve Mexican American mothers were interviewed in the preoperative phase; 9 from the 12 participants were interviewed in the post-surgery phase. Giorgi's method of phenomenological analysis was used to identify the common themes. Thematic differences and commonalities were found in thelived experiences between bilingual and monolingual Spanish-speaking Mexican American mothers in the preoperative and post-surgery phase. The lived experiences of Mexican American mothers regarding their children's surgery are shaped by language barriers and sociocultural factors. The findings of this study could inform health care providers on how to prepare Mexican American mothers about their children's surgery requiring general anesthesia.

Evaluation of the Spoken Knowledge in Low Literacy in Diabetes Scale for Use With Mexican Americans

This article evaluates the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) questionnaire, a measure of essential knowledge for type 2 diabetes self-management, after it was modified for English- and Spanish-speaking Mexican Americans. We collected surveys (SKILLD, demographic, acculturation) and blood for A1C analysis from 72 community-recruited participants to analyze the SKILLD's internal consistency, interrater reliability, item analysis, and construct validity. Clinical experts evaluated content validity. The SKILLD demonstrated low internal consistency but high interrater reliability and content and construct validity. There were significant correlations in expected directions between SKILLD scores and acculturation, education, and A1C and significant differences in SKILLD scores between and within groups after an educational intervention and between high- and low-acculturated participants. The SKILLD generates useful information about Mexican Americans' diabetes knowledge. Lower SKILLD scores suggest less diabetes knowledge, lower health literacy, and participants' difficulties understanding items. Further modifications should improve use with low-acculturated Mexican Americans.

Validity and reliability of two brief physical activity questionnaires among Spanish-speaking individuals of Mexican descent.

BackgroundMexican Americans are the largest minority group in the US and suffer disproportionate rates of diseases related to the lack of physical activity (PA). Since many of these Mexican Americans are Spanish-speaking, it is important to validate a Spanish language physical activity assessment tool that can be used in epidemiology as well as clinical practice. This study explored the utility of two Spanish translated physical activity questionnaires, the Stanford Brief Activity Survey (SBAS) and the Rapid Assessment of Physical Activity (RAPA), for use among Spanish-speaking Mexican Americans.MethodsThirty-four participants (13 M, 21 F; 37.6 ± 9.5 y) completed each of the two PA surveys twice, one week apart. During that week 31 participants also wore an ActiGraph GT1M accelerometer for 7 days to objectively measure PA. Minutes of moderate and vigorous PA (MVPA) were determined from the accelerometer data using Freedson and Matthews cut points.ResultsValidity, determined by Spearman correlation coefficients between questionnaire scores and minutes of ActiGraph measured MVPA were 0.38 and 0.45 for the SBAS and RAPA, respectively. Test-retest reliability was 0.61 for the SBAS and 0.65 for the RAPA. Sensitivity and specificity were 0.60 and 0.47 for the SBAS, and 0.73 and 0.75 for the RAPA. Participants who were classified as meeting the 2008 National Physical Activity Guidelines by the RAPA engaged in significantly (p < 0.05) more minutes of MVPA than those who were not, while there were no significant differences in minutes of MVPA classified by the SBAS.ConclusionsThe SBAS and the RAPA are both reasonably valid measures for quickly assessing PA and determining compliance to the PA guidelines in Spanish-speaking Mexican Americans. Although the two questionnaires had comparable reliability, the RAPA was better able to distinguish between those who met and did not meet National PA Guidelines.

Adapting the distress thermometer for cross-cultural research: a method enhanced by Mexican American undergraduate research assistants.

Spanish-speaking Mexican Americans (MAs) need representation in cancer research studies to provide an empirical base for developing culturally relevant health care interventions. One factor that limits research with MAs is the lack of Spanish language measurement tools. Bilingual, bicultural student research assistants (RAs), working with faculty researchers and translation consultants, adapted the English version Distress Thermometer and Problem List (DT-PL) tool into the Spanish language. Additionally, RAs assessed tool feasibility with five MA women to determine its usefulness for a later study. The translation process resulted in a distress assessment instrument suitable for use in a low-literacy, Spanish-speaking population. RAs can enhance a process of adapting a measurement tool for use in research. Health care researchers should now pilot the Spanish DT-PL tool to assess its reliability and validity.

From Policy to Practice Change: Nursing Partnerships in Practice to Change Low-Income African American and Hispanic Initiation of Breastfeeding Rates

It has been well documented in previous research that a low-income African American pregnant women are less likely to initiate and continue breastfeeding for the recommended first year of the infant's life. According to National Health and Nutritional data, breastfeeding rates include the following: non-Hispanic White (61%), Spanish-speaking Mexican American (63%), and African American (26%). Mothers with higher levels of education and income have greater breastfeeding initiation and continuation rates than mothers with low-income and low levels of education.

Spanish Translation and Cross-Language Validation of a Sleep Habits Questionnaire for Use in Clinical and Research Settings

To translate, back-translate and cross-language validate (English/Spanish) the Sleep Heart Health Study Sleep Habits Questionnaire for use with Spanish-speakers in clinical and research settings. Following rigorous translation and back-translation, this cross-sectional cross-language validation study recruited bilingual participants from academic, clinic, and community-based settings (N = 50; 52% women; mean age 38.8 ± 12 years; 90% of Mexican heritage). Participants completed English and Spanish versions of the Sleep Habits Questionnaire, the Epworth Sleepiness Scale, and the Acculturation Rating Scale for Mexican Americans II one week apart in randomized order. Psychometric properties were assessed, including internal consistency, convergent validity, scale equivalence, language version intercorrelations, and exploratory factor analysis using PASW (Version18) software. Grade level readability of the sleep measure was evaluated. All sleep categories (duration, snoring, apnea, insomnia symptoms, other sleep symptoms, sleep disruptors, restless legs syndrome) showed Cronbach α, Spearman-Brown coefficients and intercorrelations ≥ 0.700, suggesting robust internal consistency, correlation, and agreement between language versions. The Epworth correlated significantly with snoring, apnea, sleep symptoms, restless legs, and sleep disruptors) on both versions, supporting convergent validity. Items loaded on 4 factors accounted for 68% and 67% of the variance on the English and Spanish versions, respectively. The Spanish-language Sleep Habits Questionnaire demonstrates conceptual and content equivalency. It has appropriate measurement properties and should be useful for assessing sleep health in community-based clinics and intervention studies among Spanish-speaking Mexican Americans. Both language versions showed readability at the fifth grade level. Further testing is needed with larger samples.