Urban Latinas Research Articles

Identifying the Complexity of Multiple Risk Factors for Obesity Among Urban Latinas

The prevalence of obesity is rising rapidly among Hispanics/Latinas. We evaluated the prevalence of being obese or overweight and associated risk factors among 630 low-income, Latina women from ambulatory care clinics in Upper Manhattan. Overall, 37 % of the sample was overweight and 41 % of the sample was obese, and yet, almost half of women who are overweight considered their weight “just about right.” After adjusting for socio-demographic, behavioral, and biological risk factors, being obese was strongly associated with having hypertension [relative risk ratio (RRR) 3.93, 1.75–8.82], pre-hypertension (RRR 2.59, 1.43–4.67), diabetes (RRR 2.50, 1.21–5.14) and moderate/moderately severe/severe depression (RRR 2.09, 1.03–4.26). Women who reported that finding time was a barrier to physical activity were also more likely to be obese (RRR 1.78, 1.04–3.02). Chronic financial stress was associated with lower risk of being overweight (RRR 0.47, 0.28–0.79) or obese (RRR 0.51, 0.31–0.86), as well as eating out at restaurants (RRR 0.75, 0.62–0.89). Opportunities for intervention relate to understanding cultural factors around perceptions of weight and helping women find the time for physical activity.

Breastfeed Today, Even If You Can't Tomorrow [12H

INTRODUCTION: The decision between breastfeeding and formula feeding is complex both for low-income urban Latinas and for clinicians. This study provides a glimpse into the real-world experiences of Latinas who initially wanted to breastfeed and who had received instruction, but who eventually decided to use formula instead. Implications for Patient-Centered Care in these cases are explored. METHODS: A retrospective qualitative study design. Data were from a subset of focus groups on breastfeeding out of a larger study of Latina hospital experiences, involving 42 Latina women (both Spanish and English dominant) who had given birth at a community-based teaching hospital located in East Los Angeles. Data were analyzed utilizing a constructivist grounded theory method to generate constructs and dimensions of the patients' experiences. RESULTS: Participants described their initial desires to breastfeed, their knowledge of its benefits, as well as, their experiences with the hospital's breastfeeding instruction and support. They then described how their situation as low-income workers with complex family responsibilities influenced their decision to switch from breastfeeding to formula feeding. CONCLUSION: While a laudable goal would be to have all mothers breastfeed their infants, a Patient-Centered Care approach for low-income urban Latinas may require a goal modified to fit their lived experiences.

Against All Odds: Latinas Activate Agency to Secure Access to College

This qualitative study seeks to understand Latinas’ college-going behaviors by examining their agency and role in securing opportunity for college. The authors examine the activation of agency among 16 urban Latinas when navigating the structures influencing college opportunity through a cultural ecological model. Examples of agency are represented as Latinas resist educational inequities and navigate their educational, familial, communal, and out-of-class environments. In some cases, individuals and systems within these environments serve as agents of resistance; in other environments, they serve as agents of support for Latinas. We specifically were interested in understanding how Latinas activate agency and make sense of how their college-going behaviors influenced college opportunity and transition.

The Incidence of Depression by Fertility Status in Overweight and Obese Latina Women

The link between depression, obesity, and fertility status is poorly understood among Latina women. The Patient Health Questionnaire 9 (PHQ-9) is routinely administered in the Diabetes and Obesity in Reproductive Age women Clinic. We describe median PHQ-9 score and PHQ-9 score ≥10 [indicative of Major Depressive Disorder (MDD)] by fertility status. Of the 76 eligible new patients seen between June 2008 and 2009, 18.4% (n = 14) had PHQ-9 scores indicative of MDD. Infertile women had marginally significantly higher PHQ-9 scores than non-infertile women (p = 0.08). 26.5% of infertile women and 12.2% of non-infertile women had a PHQ-9 score indicative of MDD (p = 0.14). Number of previous births was inversely correlated with PHQ-9 score (R = -0.34, p = 0.002), those with no previous births had higher PHQ-9 scores (p = 0.001) and were more likely to have a PHQ-9 score indicative of MDD than those with previous births (28.6 vs. 9.8%, p = 0.04). Among non-infertile women, postpartum women had significantly lower PHQ-9 scores than non-postpartum women (p = 0.002). 4.6% of postpartum women and 21.1% of non-postpartum women had a PHQ-9 indicative of MDD (p = 0.19). Further investigation is needed to determine if reproductive success is protective against MDD among overweight and obese urban Latinas. Overall, depression is common among overweight and obese reproductive-age Latinas and thus routine screening is recommended.

Characteristics Related to Effective Contraceptive Use Among a Sample of Nonurban Latinos

A better understanding of effective contraceptive use among Latinos is needed to reduce their high rate of unintended pregnancy. Most research has focused on urban Latinas and has overlooked the relationship context of effective contraceptive use. Interviews were conducted among a sample of 450 Latino women and men aged 18-25 in sexual relationships, who were recruited from community sites in four rural Oregon counties in 2006. Bivariate and multinomial logistic regression analyses were used to examine the associations between effective contraceptive use and -individual, cultural and relationship characteristics. Half of participants reported effective contraceptive use in their primary relationships: Thirty-six percent consistently used a female method, and 15% consistently used condoms. Acculturation and confidence in one's -ability to practice contraception with a primary partner were associated with female method use rather than no effective use (risk ratios, 0.7 and 1.7, respectively). Participation in sexual decision making was positively associated with condom use rather than no effective method use (2.2) or female method use (1.9); partner involvement in birth control was positively associated with condom use rather than female method use (1.8). Variations in effective contraceptive use among nonurban Latinos appear related to relationship characteristics and dynamics. Contraceptive counseling and unintended pregnancy prevention programs that are tailored to reflect relationship contexts and to include male partners where appropriate could improve the quality and cultural relevance of services among nonurban Latinos.

Time to pregnancy in a cohort of low-income, urban Latinas: does diabetes matter?

Time to pregnancy in a cohort of low-income, urban Latinas: does diabetes matter?

Factors Influencing the Acceptability of Coitus Interruptus Among Latina Teens and Young Adults

ABSTRACT Objectives: The purpose of this study was to examine factors associated with the acceptability of coitus interruptus, or withdrawal, as a contraceptive method among a cohort of Latinas. Method: We conducted face-to-face interviews with a cohort of young, urban Latinas in Chicago to assess factors associated with willingness to use withdrawal. Findings: Two hundred seventy-three sexually experienced women aged 13–25 years were included in the analysis. Respondents were predominately Mexican American (83.9%) and born in the United States (69.2%) or Mexico (27.1%). One hundred sixty-two women expressed willingness to use withdrawal. In a multivariable analysis, factors associated with willingness to use withdrawal included belief in its efficacy, having communicated with one's partner about waiting to have sex, and lack of knowledge of oral contraceptives. Conclusion: Beliefs, knowledge, partner variables and contraceptive attitudes were important factors related to the acceptability of withdrawal among a cohort of Latinas.

Un Corazón Saludable: Factors Influencing Outcomes of an Exercise Program Designed to Impact Cardiac and Metabolic Risks among Urban Latinas

A high prevalence of physical inactivity, metabolic risk factors, and depression place Latinas in peril of developing cardiovascular disease. "Un Corazón Saludable: A Healthy Heart" was developed to engage urban Latinas in physical activity and increase awareness of cardiac and metabolic risk factors. Two hundred and twenty-five Latinas enrolled in the program that included salsa aerobics and culturally sensitive health education modules. Cardiac and metabolic risk factors measured in this study were body mass index (BMI), waist-to-hip ratio, abdominal obesity, and blood pressure. Psychosocial risk factors measured included depressive symptoms and perceived social support. Fifty-two percent of the enrollees completed the program. Results indicated decreases in BMI, abdominal obesity, and symptoms of depression among Latinas who completed the program. Those who did not complete the program were younger, had greater depressive symptomatology, reported poorer social support, and they tended to be caregivers and U.S. born. Focus groups of program participants ascertained that caregiving and family obligations were major barriers to exercise while social support was a major facilitator of exercise. This research indicates that programs developed to recognize and address cultural barriers can impact physical and psychosocial risk factors among urban Latinas who are able to attend. Program retention may improve if future exercise programs conducted through community-base organizations offered support to Latinas regarding issues that interfere with self-care and health promotion. Future programs should consider including mental health and social service case management as part of comprehensive exercise/educational programs.

Personal, social, and physical environmental correlates of physical activity levels in urban Latinas

Background Nationwide, Hispanic women report low levels of physical activity and bear excess health risk associated with inactivity. This study investigated the relationship between physical activity levels and sociodemographic, social environmental, and physical environmental factors. Design A cross-sectional, community-based convenience sample of 285 Hispanic/Latino women completed a face-to-face survey administered in Spanish. Main outcome measures The following categories of physical activity were used in analyses: “meets current national recommendations,” which includes women who reported engaging in moderate activity at least 5 days per week for at least 30 minutes or who engaged in vigorous activity at least 3 days per week for at least 20 minutes; “insufficiently active” for women not meeting moderate or vigorous objectives; and “inactive” for women who report no moderate or vigorous physical activity. Results The majority of women (46%) were aged 20 to 29 years, 48% have less than or equal to a high school education, 72% are employed, 43% speak Spanish, and 76% are from Central or South America. A total of 37% of the women met physical activity recommendations, 23% were inactive, and 40% were insufficiently active. Personal and physical environmental factors were not statistically significant correlates of activity level comparison groups; however, most indicated trends in the hypothesized direction. Social environmental factors that showed statistically significant relationships with various physical activity comparison groups included the following: Women were significantly less likely to be active if they reported knowing people who exercise (odds ratio [OR]=0.42; 95% confidence interval [CI], 0.23–0.76), reported that there are people in the neighborhood who exercise (adjusted OR=0.19; 95% CI, 0.09–0.42), belonged to community groups (OR=0.32; 95% CI, 0.15–0.69), or attended religious services (OR=0.41; 95% CI, 0.41–0.72). Conclusion Social environmental factors appeared to be the most important factors related to physical activity in this group of Latino women. Physical environment and personal factors, although not statistically significant, showed trends in expected directions and should be explored further.

Prenatal and Postpartum Depression among Low-Income Dominican and Puerto Rican Women

This longitudinal study examined depression symptoms among pregnant, low-income, urban Latinas, primarily Puerto Ricans and Dominicans, receiving obstetrical services in community health centers. In all, 106 women were interviewed in late pregnancy, 47 were interviewed again 2 to 3 weeks postpartum, and 42 three months postpartum. Elevated levels of depressive symptoms were evident in 53% of the original sample. Across time, depressive symptoms decreased significantly; however, a decreased score was strongly related to number of negative life events. Social support scores were minimally related to depressive symptomatology. Service recommendations based on these findings include conducting third-trimester assessments of life events experienced during the past year and screening for depression to better identify women at risk of late pregnancy to postpartum–persistent depressive symptoms. More research and clinical attention on dysphoric states in pregnant Latinas and understanding the consequences of impaired perinatal mental health on maternal well-being and infant outcomes are needed.

Lessons learned from urban Latinas with type 2 diabetes mellitus.

This study focused on Latinas (female Hispanics) with Type 2 diabetes because this disease has a high prevalence and incidence among this population and cultural norms may affect women's experiences with diabetes. The study used a descriptive phenomenology design with a purposive sample of 13 Latina volunteers recruited from a local community health center in southern New England. Data were collected via interviews in English or Spanish. Six themes emerged from the analysis: stress as a cause and effect; too little, too late; profound sadness, diabetic anger, and loss of control; obsession with diet; life under a magnifying glass; and religion as a lifeline. Further research should pursue development of a culturally relevant approach to the health care management of Latinos.