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Depression and Anxiety Mediate the Relationship between Discrimination and Well-Being in a Sample of Latinx Adults with Type 2 Diabetes: Results from a Dual Mediation Analysis. 抑郁和焦虑对 2 型糖尿病拉丁裔成人样本中歧视与幸福感之间关系的中介作用:双重中介分析的结果。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-01-20 DOI: 10.1007/s10903-024-01582-w
Kevin A Matlock, Rafael Pérez-Escamilla, Julie Wagner

Latinxs experience greater risk for type 2 diabetes, discrimination, and poor mental health. The pathways linking these factors, however, are not well understood. This study tested whether depression and anxiety mediated the relationship between discrimination and well-being. Bootstrapped mediation tests were conducted using a sample of Latinx adults with type 2 diabetes (n = 121) and regression models adjusted for demographic and health covariates. Depression and anxiety fully and jointly mediated the effect of discrimination on well-being; everyday discrimination was linked to elevated symptoms of depression and anxiety which were, in turn, independently linked to reduced emotional well-being. Moreover, the effect size for the anxiety pathway (β=-0.13) was 60% larger than for depression (β=-0.08). Dual mediation suggests depression, and especially anxiety, may be important targets for interventions seeking to mitigate the deleterious effects of discrimination. Findings have important implications for psychotherapeutic treatments and public health policy.

拉美裔罹患 2 型糖尿病、遭受歧视和心理健康状况不佳的风险更大。然而,人们对这些因素之间的联系途径还不甚了解。本研究测试了抑郁和焦虑是否能调节歧视与幸福感之间的关系。通过对患有 2 型糖尿病的拉美裔成人样本(n = 121)以及根据人口统计学和健康协变量调整的回归模型,进行了引导中介测试。抑郁和焦虑完全共同调节了歧视对幸福感的影响;日常歧视与抑郁和焦虑症状的升高有关,而抑郁和焦虑症状的升高又独立地与情绪幸福感的降低有关。此外,焦虑途径的效应大小(β=-0.13)比抑郁途径的效应大小(β=-0.08)大 60%。双重中介表明,抑郁,尤其是焦虑,可能是寻求减轻歧视有害影响的干预措施的重要目标。研究结果对心理治疗和公共卫生政策具有重要意义。
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引用次数: 0
An Innovative Approach to Promote Weight Loss Among Mexican Immigrants: A Pilot Study. 促进墨西哥移民减肥的创新方法:一项试点研究。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2023-11-07 DOI: 10.1007/s10903-023-01562-6
Jennifer Leng, Florence Lui, Bharat Narang, Jacqueline Cabral, Jacqueline Finik, Minlun Wu, Josana Tonda, Francesca Gany

Mexican Americans are among the highest risk groups for obesity and its associated health consequences, including diabetes, heart disease, and cancer. 154 overweight/obese Mexican Americans recruited from the Mexican Consulate in New York City were enrolled in COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), a 12-week Spanish-language lifestyle intervention that included a dietary counseling session, weight-loss resources, and thrice-weekly text messages. Participants' weight (primary outcome); dietary intake, physical activity, and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Of the 109 who completed follow-up, 28% lost ≥ 5% of their baseline body weight. Post-intervention, participants consumed more fruit and less soda, sweet pastries, fried foods and red meat; increased physical activity; and evidenced greater nutrition knowledge. A community-based lifestyle intervention with automated components such as text messaging may be a scalable, cost-effective approach to address overweight/obesity among underserved populations.

墨西哥裔美国人是肥胖及其相关健康后果的高危人群之一,包括糖尿病、心脏病和癌症。从墨西哥驻纽约领事馆招募的154名超重/肥胖的墨西哥裔美国人参加了COMIDA(Consmo de Opciones Más Ideales de Alimentos)(吃更理想的食物选择),这是一项为期12周的西班牙语生活方式干预,包括饮食咨询、减肥资源和每周三次的短信。参与者的体重(主要结果);干预前后对饮食摄入、体育活动和营养知识(次要结果)进行评估。在109名完成随访的患者中,28%的患者 ≥ 其基线体重的5%。干预后,参与者多吃水果,少喝苏打水、甜糕点、油炸食品和红肉;增加体力活动;并证明了更多的营养知识。基于社区的生活方式干预,包括短信等自动化组件,可能是解决服务不足人群超重/肥胖问题的一种可扩展、成本效益高的方法。
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引用次数: 0
The Cantril Ladder as a Measure of Well-Being and Life Satisfaction Among Refugee Youth Experiencing Symptoms of Post-Traumatic Stress. 坎特里尔阶梯作为衡量经历创伤后应激症状的难民青年的幸福感和生活满意度的指标。
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2023-10-26 DOI: 10.1007/s10903-023-01563-5
Salma Elmukashfi Eltahir Mohammed, Georgina Warner

Given the number of refugee youth whom require mental health support, there is a need to provide community-based interventions that can be easily scaled-up at a low cost. Yet, safety procedures associated with community-based intervention require careful consideration. The Cantril Ladder is a visual scale used to assess life satisfaction. It could be a useful tool to track the well-being of participants throughout an intervention. However, concerns have been raised about the validity of single-item life satisfaction measures and it is recommended they are tested when used in specific populations. This is particularly relevant to the refugee youth population who experience ongoing stress due to concern for family, friends, housing, and schooling and whose perceptions of life satisfaction may differ to the cohorts the Cantril Ladder has previously been tested with. The purpose of this study was to explore the validity of the Cantril Ladder as a measure of well-being and life satisfaction in refugee youth experiencing post-traumatic stress symptoms by exploring the relationship between how the youth scored on the Cantril Ladder with their scores on measures of depression and self-efficacy. Hierarchical multiple linear regression was applied to self-reported survey data in order to test how refugee youth experiencing post-traumatic stress symptoms (n = 51) score on the Cantril Ladder compared with Patient Health Questionnaire-9 (PHQ-9) and General Self Efficacy Scale (GSE) scores. The mean Cantril Ladder score in the present sample was 5.33 (SD = 2.77). The PHQ-9 and GSE total scores together explained 19.1% of the variability in the Cantril Ladder score. The Cantril Ladder showed moderate concurrent validity with validated measures of depression and self-efficacy. These findings have important implications for intervention programs designed to support refugee youth experiencing post-traumatic stress, as the Cantril Ladder offers a promising way to track well-being throughout the program as part of a wider safety protocol procedure. Additional research is required to not only confirm these findings, but also to test the face validity of the Cantril Ladder for a more complete validation of life satisfaction.

鉴于需要心理健康支持的难民青年人数众多,有必要提供以社区为基础的干预措施,以低成本轻松扩大规模。然而,与社区干预相关的安全程序需要仔细考虑。Cantril Ladder是一种用于评估生活满意度的视觉量表。它可能是一个有用的工具,可以在整个干预过程中跟踪参与者的幸福感。然而,人们对单项生活满意度测量的有效性表示担忧,建议在特定人群中使用时进行测试。这与难民青年群体尤其相关,他们因关心家人、朋友、住房和学校教育而持续承受压力,他们对生活满意度的看法可能与Cantril Ladder之前测试过的人群不同。本研究的目的是通过探索青年在Cantril Ladder上的得分与他们在抑郁和自我效能方面的得分之间的关系,来探索Cantril梯形图作为衡量经历创伤后应激症状的难民青年幸福感和生活满意度的有效性。将分层多元线性回归应用于自我报告的调查数据,以测试难民青年如何经历创伤后应激症状(n = 51)评分与患者健康问卷-9(PHQ-9)和一般自我效能感量表(GSE)评分进行比较。本样本中Cantril Ladder的平均得分为5.33(SD = 2.77)。PHQ-9和GSE总分共同解释了Cantril Ladder评分19.1%的可变性。Cantril Ladder与经验证的抑郁和自我效能感指标显示出适度的同时有效性。这些发现对旨在支持经历创伤后应激的难民青年的干预计划具有重要意义,因为作为更广泛的安全协议程序的一部分,Cantril Ladder提供了一种很有前途的方法来跟踪整个计划的幸福感。需要进行更多的研究,不仅要证实这些发现,还要测试Cantril Ladder的面部有效性,以更完整地验证生活满意度。
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引用次数: 0
Increasing Access to Medical Care for Hispanic Women Without Insurance: A Mobile Clinic Approach. 增加没有保险的西班牙裔妇女获得医疗服务的机会:流动诊所方法。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-01-03 DOI: 10.1007/s10903-023-01575-1
Suzanne Phelan, Marilyn Tseng, Anita Kelleher, Erin Kim, Cristina Macedo, Vicki Charbonneau, Irebid Gilbert, David Parro, Luke Rawlings

The purpose of this study was to describe the health status and barriers of people who sought care on a free mobile health clinic for women without insurance in California. Participants were 221 women who attended the Salud para Mujeres (Women's Health) mobile medical clinic between 2019 and 2021. Medical chart abstractions provided data on sociodemographic factors, medical history, barriers to care, depressive symptoms, and dietary factors. Anthropometric measure, blood pressure, and biomarkers of cardiometabolic disease risk were also abstracted. Participants were young adult (29.1 [SD 9.3] years), Hispanic (97.6%), farm-working (62.2%) women from Mexico (87.0%). Prevalent barriers to accessing (non-mobile) medical care included high cost (74.5%), language (47.6%), hours of operation (36.2%), and transportation (31.4%). The majority (89.5%) of patients had overweight (34.0%) or obesity (55.5%), and 27% had hypertension. Among those (n = 127) receiving a lipid panel, 60.3% had higher than recommended levels of low-density lipoprotein and 89% had lower than recommended levels of high-density lipoprotein. Point-of-care HbA1c tests (n = 133) indicated that 9.0% had diabetes and 24.8% had prediabetes. Over half (53.1%) of patients reported prevalent occupational exposure to pesticides and 19% had moderate to severe depressive symptoms. Weekly or more frequent consumption of sugar sweetened beverages (70.9%) and fast food (43.5%) were also prevalent. Mobile health units have potential for reaching women who face several barriers to care and experience major risk factors for cardometabolic disease. Findings suggest a compelling need to assure that Hispanic and Indigenous women and farmworkers have access to healthcare.

本研究旨在描述加利福尼亚州无保险妇女在免费流动医疗诊所就医时的健康状况和障碍。参与者是在 2019 年至 2021 年期间参加过 Salud para Mujeres(妇女健康)流动医疗诊所的 221 名妇女。病历摘要提供了有关社会人口因素、病史、就医障碍、抑郁症状和饮食因素的数据。此外,还摘录了人体测量数据、血压和心脏代谢疾病风险生物标志物。参与者均为年轻成年人(29.1 [SD 9.3]岁)、西班牙裔(97.6%)、农场工人(62.2%)、墨西哥妇女(87.0%)。获得(非流动)医疗服务的普遍障碍包括费用高(74.5%)、语言(47.6%)、工作时间(36.2%)和交通(31.4%)。大多数患者(89.5%)超重(34.0%)或肥胖(55.5%),27%患有高血压。在接受血脂检查的患者(127 人)中,60.3% 的患者低密度脂蛋白高于建议水平,89% 的患者高密度脂蛋白低于建议水平。护理点 HbA1c 检测(133 人)显示,9.0% 的人患有糖尿病,24.8% 的人患有糖尿病前期。半数以上(53.1%)的患者表示曾在工作中接触过杀虫剂,19%的患者有中度至重度抑郁症状。每周或更频繁地饮用含糖饮料(70.9%)和食用快餐(43.5%)也是普遍现象。流动医疗站有可能帮助那些在获得医疗服务方面面临多种障碍,并面临心血管代谢疾病主要风险因素的妇女。研究结果表明,有必要确保西班牙裔和土著妇女以及农场工人能够获得医疗保健服务。
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引用次数: 0
Ethnic Minority Participation in Clinical Trials from Latin America and the Caribbean: A Scoping Review. 拉丁美洲和加勒比地区少数民族参与临床试验的情况:范围界定综述》(Ethnic Minority Participation in Clinical Trials from Latin America and the Caribbean: A Scoping Review)。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-01-31 DOI: 10.1007/s10903-023-01578-y
Percy Herrera-Añazco, Jerry K Benites-Meza, Brenda Caira-Chuquineyra, Daniel Fernandez-Guzman, Enrique A Hernandez-Bustamante, Vicente A Benites-Zapata

We summarize the clinical trials (CTs) main characteristics, including members of ethnic minorities from Latin America. We carried out a systematic search in six databases. We made a descriptive synthesis of CTs, summarizing the characteristics, interventions, main findings, results, and conclusions reported. 4411 studies were acquired in search strategy, leaving 24 CTs in the final selection. Of these, ten were randomized, four were non-randomized, and the remainder had other designs. Most of the studies were carried out in the population of infants and children (08), ten of the studies included only women, and two studies included men. Nine studies were conducted in Mexico, with the Mayan ethnic minority being mostly evaluated (05). In only 15 it was mentioned that their research was approved by a research ethics committee. Finally, half of the CTs reported funding from international agencies and third reported funding from government agencies. Our results show that that CTs in ethnic minorities are limited and reduced to a few native peoples of the continent.

我们总结了包括拉丁美洲少数民族成员在内的临床试验 (CT) 的主要特点。我们在六个数据库中进行了系统检索。我们对临床试验进行了描述性综合,总结了临床试验的特点、干预措施、主要发现、结果和结论。在搜索策略中获得了 4411 项研究,最终筛选出 24 项 CT。其中,10 项为随机研究,4 项为非随机研究,其余为其他设计。大多数研究是在婴幼儿群体中进行的(08 项),10 项研究只包括女性,2 项研究包括男性。有 9 项研究是在墨西哥进行的,评估对象主要是玛雅少数民族(05 项)。只有 15 项研究提到其研究获得了研究伦理委员会的批准。最后,一半的 CT 报告资金来自国际机构,三分之一的 CT 报告资金来自政府机构。我们的研究结果表明,少数民族的 CT 数量有限,而且仅限于非洲大陆的少数原住民。
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引用次数: 0
Socio-Demographic and Disability Disparities in Stroke by Citizenship Status: A Cross-Sectional Analysis. 公民身份在中风中的社会人口统计学和残疾差异:一项横断面分析。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2023-12-02 DOI: 10.1007/s10903-023-01572-4
Heather Marie Dixon, Daudet Ilunga Tshiswaka

This study aims to assess relationships between previous stroke diagnosis and demographic or disability status variables, stratified by U.S. citizenship status. The 2019 and 2021 National Health Interview Survey data were analyzed for both descriptive statistics and logistic regression models. Age, sex, income level, race/ethnicity, health insurance status, and indicators of disability common after stroke were predictor variables of interest. For each disability predictor variable, higher odds of having stroke were seen regardless of citizenship status, except for the 'difficulty remembering' variable. For U.S. citizens, increasing age corresponded with higher odds of stroke diagnosis. For noncitizens, odds ratios decreased from 40.3 (95% CI 38.88-41.82) for the 40-65 age group to 29.6 (95% CI 28.38-30.77) in the 80 + group, when compared with the 18-39 age reference group. Female noncitizens had higher odds of stroke, while male citizens had higher odds. Non-Hispanic Black citizens had higher odds of stroke, while the other racial/ethnic groups had higher odds for noncitizens. The results indicated the existence of several socio-demographic disparities in stroke. Notably, noncitizens experienced stroke at a younger age and reported more severe disability outcomes after stroke diagnosis than citizens.

本研究旨在评估先前中风诊断与人口统计学或残疾状态变量之间的关系,并按美国公民身份分层。采用描述性统计和逻辑回归模型对2019年和2021年全国健康访谈调查数据进行分析。年龄、性别、收入水平、种族/民族、健康保险状况和中风后常见残疾指标是感兴趣的预测变量。对于每一个残疾预测变量,除了“记忆困难”变量外,无论公民身份如何,患中风的几率都更高。对于美国公民来说,年龄的增长与中风诊断的高几率相对应。对于非公民,与18-39岁参照组相比,比值比从40-65岁年龄组的40.3 (95% CI 38.88-41.82)降至80岁以上年龄组的29.6 (95% CI 28.38-30.77)。女性非公民患中风的几率更高,而男性公民患中风的几率更高。非西班牙裔黑人公民患中风的几率更高,而其他种族/民族的非公民患中风的几率更高。结果表明,在中风中存在一些社会人口差异。值得注意的是,非公民经历中风的年龄更小,在中风诊断后报告的残疾结果比公民更严重。
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引用次数: 0
Variations in the Prevalence of Childhood Anemia by Ethnicity Before and During the COVID-19 Pandemic in Peru. 秘鲁 COVID-19 大流行之前和期间不同种族儿童贫血患病率的变化。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-01-27 DOI: 10.1007/s10903-023-01579-x
Agueda Muñoz-Del-Carpio-Toia, Jerry K Benites-Meza, Percy Herrera-Añazco, Vicente A Benites-Zapata

We aimed to determine the variations in the prevalence of childhood anemia according to the ethnic group before and during the COVID-19 pandemic in Peru. Secondary analysis of the Demographic and Family Health Survey during 2016-2021. The outcome variable was anemia, and the exposure variable was maternal ethnicity. Also, we included sociodemographic and clinical confounding variables. We constructed generalized linear models of the Poisson family with a logarithmic link function. We evaluated 85,905 records; 30.34% had anemia, 50.83% were mestizo, 25.98% were Quechua, and 2% were Aymara. Compared with mestizos, Quechua children (PR: 1.11; 95% CI: 1.07-1.15; p < 0.001), Aymara (PR: 1.35; 95% CI: 1.27-1 .44; p < 0.001), natives of the Amazon (PR: 1.20; 95% CI: 1.12-1.28; p < 0.001) and those who belonged to other indigenous peoples (PR: 1.29; 95% CI: 1.05-1.57; p = 0.013) had a higher prevalence of childhood anemia. On the contrary, compared to mestizos, white children had a lower prevalence of anemia (PR: 0.93; 95% CI: 0.89-0.99; p = 0.019). During the COVID-19 pandemic, compared to mestizos, only Quechua (PR: 1.15; 95% CI: 1.08-1.23; p < 0.001) and Aymara (PR: 1.38; 95% CI: 1.23-1.55; p < 0.001) had a higher prevalence of childhood anemia. Except for Afro-descendants, children from 6 to 59 months of age who belong to an ethnic minority had a higher probability of having childhood anemia than mestizos. However, only Quechua and Aymara children had higher odds of anemia during the COVID-19 pandemic than mestizos.

我们旨在确定在秘鲁 COVID-19 大流行之前和期间,不同种族群体的儿童贫血患病率的变化情况。对 2016-2021 年人口与家庭健康调查进行了二次分析。结果变量为贫血,暴露变量为母亲种族。此外,我们还纳入了社会人口学和临床混杂变量。我们构建了具有对数链接函数的泊松系广义线性模型。我们评估了 85905 份记录,其中 30.34% 患有贫血,50.83% 为混血儿,25.98% 为克丘亚人,2% 为艾马拉人。与混血儿相比,克丘亚儿童(PR:1.11;95% CI:1.07-1.15;p
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引用次数: 0
African American and Hispanic Cancer Survivors' and Caregivers' Experiences in Nebraska. 内布拉斯加州非裔美国人和西班牙裔癌症幸存者及护理者的经历。
IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-01 Epub Date: 2024-01-05 DOI: 10.1007/s10903-023-01570-6
Kendra L Ratnapradipa, Krishtee Napit, Keyonna M King, Athena K Ramos, Lady Beverly L Luma, Danae Dinkel, Tamara Robinson, Jolene Rohde, Laura Schabloske, Tatiana Tchouankam, Shinobu Watanabe-Galloway

Racial and ethnic minority populations experience poorer cancer outcomes compared to non-Hispanic White populations, but qualitative studies have typically focused on single subpopulations. We explored experiences, perceptions, and attitudes toward cancer care services across the care continuum from screening through treatment among African American and Hispanic residents of Nebraska to identify unique needs for education, community outreach, and quality improvement. We conducted four focus groups (N = 19), April-August 2021 with people who were aged 30 or older and who self-identified as African American or Hispanic and as cancer survivors or caregivers. Sessions followed a structured facilitation guide, were audio recorded and transcribed, and were analyzed with a directed content analysis approach. Historical, cultural, and socioeconomic factors often led to delayed cancer care, such as general disuse of healthcare until symptoms were severe due to mistrust and cost of missing work. Obstacles to care included financial barriers, transportation, lack of support groups, and language-appropriate services (for Hispanic groups). Knowledge of cancer and cancer prevention varied widely; we identified a need for better community education about cancer within the urban Hispanic community. Participants had positive experiences and a sense of hope from the cancer care team. African American and Hispanic participants shared many similar perspectives about cancer care. Our results are being used in collaboration with national and regional cancer support organizations to expand their reach in communities of color, but structural and cultural barriers still need to be addressed.

与非西班牙裔白人相比,少数种族和少数族裔人群的癌症治疗效果较差,但定性研究通常只关注单一亚人群。我们探讨了内布拉斯加州非裔美国人和西班牙裔居民在从筛查到治疗的整个护理过程中对癌症护理服务的体验、看法和态度,以确定在教育、社区外联和质量改进方面的独特需求。我们在 2021 年 4 月至 8 月期间进行了四次焦点小组讨论(N = 19),参与者年龄在 30 岁或以上,自我认同为非洲裔美国人或西班牙裔美国人,以及癌症幸存者或护理者。会议遵循结构化的促进指南,进行了录音和转录,并采用定向内容分析法进行了分析。历史、文化和社会经济因素通常会导致癌症护理的延迟,例如由于不信任和误工费用,在症状严重之前一般不使用医疗保健。获得医疗服务的障碍包括经济障碍、交通、缺乏支持团体和语言适宜的服务(针对西班牙裔群体)。对癌症和癌症预防的认识差异很大;我们发现在城市西班牙裔社区需要更好的癌症社区教育。参与者从癌症护理团队中获得了积极的体验和希望感。非裔美国人和西班牙裔参与者对癌症护理有许多相似的看法。我们的研究结果正被用于与全国性和地区性癌症支持组织合作,以扩大其在有色人种社区的影响力,但结构性和文化性障碍仍有待解决。
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引用次数: 0
Nativity Disparities in Colorectal Cancer Screening Among Hispanics in the United States 美国拉美裔人结肠直肠癌筛查中的种族差异
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-18 DOI: 10.1007/s10903-024-01590-w
Victor H. Albornoz Alvarez, Trisha L. Amboree, Parker Mitchell, Hoda J. Badr, Jane R. Montealegre

Hispanics in the United States (U.S.) have previously exhibited lower guideline-concordant colorectal cancer (CRC) screening uptake than non-Hispanic (NH) Whites, with disparities accentuated in foreign-born Hispanics, however it is unclear whether nativity-related CRC screening disparities have changed in the last two decades and whether these disparities are attenuated after adjusting for socioeconomic and demographic characteristics. We evaluated CRC screening adherence in foreign- and U.S.-born Hispanics compared to U.S.-born NH Whites. We used 2019 National Health Interview Survey data to compare the prevalence of up-to-date CRC screening per the 2019 U.S. Preventive Services Task Force recommendations among Hispanic nativity subgroups (i.e., foreign- and U.S.-born) and U.S.-born NH Whites using unadjusted and adjusted weighted log-linked binomial regression. Foreign- and U.S.-born Hispanics had a significantly lower unadjusted prevalence of up-to-date screening than U.S.-born NH Whites (47.18% and 64.18% versus 70.70%; p < 0.0001 and p = 0.0109, respectively). After adjusting for socioeconomic and demographic differences, the prevalence of up-to-date screening was lower in foreign-born Hispanics compared to U.S.-born NH Whites [adjusted prevalence ratio 0.80 (95% confidence interval 0.70–0.91)]; however, no statistically significant difference was observed between U.S.-born Hispanics and NH Whites. Our results suggest a low screening uptake in foreign-born Hispanics independent of socioeconomic and demographic differences. Future interventions should target foreign-born Hispanics to address disparities and promote early detection and prevention of CRC regardless of socioeconomic factors.

与非西班牙裔(NH)白人相比,美国的西班牙裔接受符合指南要求的结直肠癌(CRC)筛查的比例较低,而在国外出生的西班牙裔接受筛查的比例差距更大,但目前还不清楚在过去二十年中与出生地相关的 CRC 筛查比例差距是否发生了变化,也不清楚在对社会经济和人口特征进行调整后这些比例差距是否会缩小。与在美国出生的新罕布什尔州白人相比,我们评估了在外国和美国出生的西班牙裔美国人坚持进行 CRC 筛查的情况。我们利用 2019 年全国健康访谈调查数据,采用未调整和调整后的加权对数二项式回归法,比较了西班牙裔原籍亚组(即外国和美国出生)与美国出生的新罕布什尔州白人根据 2019 年美国预防服务工作组建议进行最新 CRC 筛查的流行率。与美国出生的新罕布什尔州白人相比,外国和美国出生的西班牙裔美国人未经调整的最新筛查率明显较低(分别为 47.18% 和 64.18% 对 70.70%;p < 0.0001 和 p = 0.0109)。在对社会经济和人口统计学差异进行调整后,与在美国出生的新罕布什尔州白人相比,在国外出生的西班牙裔美国人的最新筛查率较低[调整后的筛查率比值为 0.80(95% 置信区间为 0.70-0.91)];然而,在美国出生的西班牙裔美国人与新罕布什尔州白人之间未观察到统计学上的显著差异。我们的研究结果表明,在国外出生的西语裔接受筛查的比例较低,这与社会经济和人口统计学差异无关。未来的干预措施应以外国出生的西班牙裔人为目标,以解决差异问题,并促进 CRC 的早期发现和预防,而不受社会经济因素的影响。
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引用次数: 0
BMI Growth Profiles Among Black Children from Immigrant and US-Born Families 移民家庭和美国出生家庭黑人儿童的 BMI 增长曲线
IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-04-15 DOI: 10.1007/s10903-024-01596-4
Alexandra Ursache, Brandi Y. Rollins, Alicia Chung, Spring Dawson-McClure, Laurie Miller Brotman

A large body of research has documented racial/ethnic disparities in childhood obesity in the United States (US) but less work has sought to understand differences within racial groups. Longitudinal studies are needed to describe BMI trajectories across development, particularly for Black children from immigrant families who have been underrepresented in childhood obesity research. The current study utilizes BMI data collected longitudinally from ages 5 to 8 years and growth mixture modeling to (1) identify and visualize growth patterns among Black children from primarily Caribbean immigrant families, and (2) to compare these patterns to growth trajectories among Black children from US-born families. First, we identified four classes or trajectories of growth for Black children from immigrant families. The largest trajectory (70% of the sample) maintained non-overweight throughout the study period. A second trajectory developed overweight by age 8 (25%). Two small trajectory groups demonstrated high rates of moderate and severe obesity–i.e., specifically, a trajectory of accelerated weight gain ending in moderate/severe obesity (3%), and a trajectory of early severe obesity with BMI decreasing slightly with age (2%). We identified a very similar four class/trajectory model among Black children from US-born families, and compared the model to the one for children from immigrant families using multi-group growth mixture modeling. We found that the patterns of growth did not differ significantly between the populations, with two notable exceptions. Among Black children from immigrant families, ∼ 5% were classified into the two heavier BMI trajectories, compared to ∼ 11% of children from US-born families. Additionally, among children with an accelerated weight gain trajectory, children from immigrant families had lower BMIs on average at each time point than children from US-born families. These findings describe the multiple trajectories of weight gain among Black children from immigrant families and demonstrate that although these trajectories are largely similar to those of Black children from US-born families, the differences provide some evidence for lower obesity risk among Black children from immigrant families compared to Black children from US-born families. As this study is the first to describe BMI trajectories for Black children from immigrant families across early and middle childhood, future work is needed to replicate these results and to explore differences in heavier weight trajectories between children from immigrant and US-born families.

大量研究记录了美国儿童肥胖症的种族/族裔差异,但试图了解种族群体内部差异的研究较少。需要进行纵向研究来描述整个成长过程中的体重指数轨迹,尤其是来自移民家庭的黑人儿童,他们在儿童肥胖症研究中的代表性不足。本研究利用纵向收集的 5 至 8 岁 BMI 数据和生长混合模型,(1) 识别和直观显示主要来自加勒比海移民家庭的黑人儿童的生长模式,(2) 将这些模式与来自美国出生家庭的黑人儿童的生长轨迹进行比较。首先,我们确定了来自移民家庭的黑人儿童的四个等级或成长轨迹。最大的轨迹(占样本的 70%)在整个研究期间保持不超重。第二个轨迹在 8 岁时出现超重(25%)。两个小的轨迹组显示出较高的中度和重度肥胖率--即,具体来说,一个轨迹是体重加速增长,最终导致中度/重度肥胖(3%),另一个轨迹是早期重度肥胖,BMI 随年龄略有下降(2%)。我们在美国出生家庭的黑人儿童中发现了一个非常相似的四类/轨迹模型,并利用多组生长混合模型将该模型与移民家庭儿童的模型进行了比较。我们发现,除两个明显的例外情况外,不同人群的成长模式并无明显差异。在来自移民家庭的黑人儿童中,有 5%的儿童被归入两种较重的体重指数轨迹,而在来自美国出生家庭的儿童中,这一比例仅为 11%。此外,在体重加速增长轨迹的儿童中,来自移民家庭的儿童在每个时间点的平均体重指数都低于来自美国出生家庭的儿童。这些研究结果描述了来自移民家庭的黑人儿童体重增加的多种轨迹,并表明尽管这些轨迹与来自美国出生家庭的黑人儿童的轨迹基本相似,但这些差异提供了一些证据,证明与来自美国出生家庭的黑人儿童相比,来自移民家庭的黑人儿童肥胖风险较低。由于本研究首次描述了来自移民家庭的黑人儿童在童年早期和中期的体重指数轨迹,因此今后的工作需要复制这些结果,并探索移民家庭和美国出生家庭的儿童在体重增加轨迹方面的差异。
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引用次数: 0
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Journal of Immigrant and Minority Health
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