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1.  Prevalence of Mental Health Issues in the Borderlands: A Comparative Perspective 
The purpose of this paper is to (a) examine the results of a binational study of two colonias near El Paso, Texas, and Ciudad Juarez, Mexico, focusing on mental health and (b) analyze those results in relation to the existing literature on Hispanic mental health to determine how border regions compare with Hispanic enclaves in nonborder regions. We focus on gender, birthplace, length of residency, and level of acculturation correlated with self-reported diagnoses of depression in our analysis. Our survey instrument incorporates portions of the Behavioral Risk Factor and Surveillance Survey; the SF36, version 2; and the CAGE scale for alcohol use and abuse. We found that birthplace, acculturation, and length of residency at the border did not correlate in the same ways to mental health issues as in nonborder regions.
PMCID: PMC4218741  PMID: 25374480
2.  Utility of the Stanford Brief Activity Survey for physical activity assessment in postpartum Latinas: A validation study of a linguistically translated Spanish version 
This study assessed the concurrent validity of the English and a linguistic Spanish translation of the Stanford Brief Activity Survey (SBAS) with pedometer measured physical activity (PA) among postpartum Latinas. Latinas (n = 97) completed the SBAS in either English (n = 47) or Spanish (n = 50) and wore pedometers seven days at three different assessment periods. The English version demonstrated significant trends (p < .01) for differentiating aerobic walking steps (AWS) and aerobic walking time (AWT) across SBAS intensity categories at two of the three assessment periods. The Spanish version showed marginally significant trends for differentiating AWS (p = .048) and AWT (p = .052) across SBAS intensity categories at only one assessment period. The English version of the SBAS is effective in assessing PA status among Latinas; however, the Spanish version indicates a need for research to further explore cultural and linguistic adaptations of the SBAS.
PMCID: PMC4176775  PMID: 25239211
measurement; pedometers; physical activity assessment; physical activity; Latina/Hispanic; women
3.  Male Circumcision Rates in Patients From a Sexually Transmitted Disease Clinic in Southern Florida and Acceptability of Circumcision Among Hispanics 
The objectives of this study were assessment of the prevalence of male circumcision (MC) among patients attending the Miami-Dade County (MDC) sexually transmitted diseases (STDs) clinic and exploration of attitudes of MC among Hispanic STD clinic attendees.
Prevalence of MC was assessed by a review of 500 clinic records. Attitudes toward MC were explored during focus group sessions. The overall rate of MC was 27%. Men associated acceptability of MC with sexual performance, their partner’s anticipated responses to MC, and scientific proof of STD protection; whereas women focused on experiences with previous partners and hygiene. We found a low rate of circumcision in males attending the MDC STD clinic. Approximately half of the Hispanic men and women in focus groups also found MC acceptable or desirable.
PMCID: PMC4141694  PMID: 25152700
circumcision; HIV prevention; Hispanics; STD
4.  A Cultural Perspective on Sexual Health: HIV Positive and Negative Monolingual Hispanic Women in South Florida 
This study explored feelings and attitudes with regard to HIV and sexual health among 82 monolingual Spanish-speaking, HIV-positive (n = 30) and at-risk women (n = 52), participating in the NOW en Español Project—a cognitive behavioral sexual risk-reduction intervention in Miami, Florida. Hispanic cultural values and beliefs, such as machismo, marianismo, and sexual silence, emerged throughout the intervention as important determinants of sexual behavior. Recommendations for integrating these culture-specific issues in sexual health interventions for Hispanic women are provided.
PMCID: PMC4076779  PMID: 24994949
Hispanic women; culture; beliefs; values; sexual risk; HIV
5.  Life Course Experiences, Pain and Suffering: A Case Study of an Older Mexican American Woman with Mobility Impairment 
There is a dearth of literature examining how adversity shapes the experiences of pain and/or suffering in a middle aged Mexican American women. The purpose of this qualitative descriptive study was to understand pain and suffering from a life course perspective as described by a Mexican American woman aging with early onset mobility impairment. This Hispanic woman experienced episodes of abuse and rejection over the life course, which may have significantly influenced her pain and suffering experience in adulthood. This adds to the literature on how adversity influences later life pain experience and provides insight on why pharmacological treatment alone may not be as successful as a holistic intervention.
Hay escasez de literatura que examine cómo la adversidad da forma a las experiencias de dolor y / o sufrimiento en mujeres mexicana-americana mayores de edad. El propósito de este estudio descriptivo cualitativo fue comprender el dolor y el sufrimiento desde una perspectiva de ciclo de vida como descrito por una mujer mexicana-americana envejeciendo con inicio temprano de deterioro de movilidad. Esta Latina experimentó episodios de maltrato y rechazo, que se percibió haber afectado su experiencia de dolor y sufrimiento luego como adulta. Este estudio aumenta la literatura sobre cómo la adversidad influya la experiencia de dolor más tarde en la vida, y nos permite comprender mejor como el tratamiento farmacológico por sí solo no es tan exitoso como pueda ser una intervención integral.
PMCID: PMC4050448  PMID: 24830728
Pain; Suffering; Mexican American Women; Mobility Impairment
6.  Promotoras de Salud: Roles, Responsibilities, and Contributions in a Multi-Site Community-Based Randomized Controlled Trial 
There is widespread recognition of the cultural and linguistic appropriateness of promotoras de salud (a Spanish term for community health workers) in health education and outreach among Hispanic communities. Yet there are significant gaps in the literature regarding the preparation, implementation and evaluation of promotoras’ engagement in research. To address this gap, we examine promotoras’ research-related training, roles, responsibilities, and contributions in a community-based participatory research project involving a multi-site randomized controlled trial of a physical activity intervention for Mexican-origin women in Texas and South Carolina. We identify both benefits and challenges associated with promotoras’ engagement as community researchers; examine variations and differences in promotora roles and responsibilities related to the research contexts, sites, settings, and individual characteristics; and discuss implications for research and practice.
PMCID: PMC3970723  PMID: 24695944
Promotoras de salud; community health workers; community-based participatory research; community researchers; Hispanics; physical activity
7.  A Community Forum to Assess the Needs and Preferences for Domestic Violence Prevention Targeting Hispanics 
Hispanics are disproportionately affected by the occurrence and consequences of domestic violence when compared to their non-Hispanic counterparts. The Partnership for Domestic Violence used a community-based participatory research approach to assess the needs and preferences for preventing domestic violence (DV) among Hispanics in Miami-Dade County. Researchers conducted a community forum in which data collected from focus groups were presented to approximately 100 community members to gather their feedback regarding the development of DV prevention programs tailored for Hispanics. Participants were in high agreement that a program targeting youth is the highest priority and that specific cultural variables should be incorporated to make the program most effective. Recommendations for DV prevention targeting Hispanics and the use of community forums as a method of research are provided.
PMCID: PMC3528337  PMID: 23268109
community-based participatory research; community forum; teen dating; Hispanic
8.  Predictors of Health Care Use Among a Predominantly Hispanic, Urban Sample of Individuals Seeking IPV Services 
Hispanics, Blacks, and women are disproportionately burdened by intimate partner violence. Barriers to seeking medical care play an important role in victims accessing the full myriad of services they need. A secondary analysis of data collected over a 6-month period at a coordinated domestic violence social agency was completed to assess predictors of seeking medical care after experiencing intimate partner violence. A hierarchical logistic regression was conducted to assess the predictive ability of socioeconomic factors, type of abuse, and severity of abuse. Hispanic victims of intimate partner violence were less likely to seek medical attention compared to non-Hispanic Whites, even after controlling for socioeconomic factors, type of abuse, and severity of abuse, Adjusted Odds Ratio (AOR) = .40, p = .05, 95% CI [.164, .995]. Victims reporting physical abuse were over seven times more likely to seek medical attention, AOR = 8.02, p = .04, 95% CI [2.35, 27.34]. Medical care needs to be incorporated into coordinated social services offered to victims of intimate partner violence.
PMCID: PMC3528338  PMID: 23268315
intimate partner violence; Hispanics; access to medical care; physical abuse; reproductive coercion
9.  The Acceptability of Clean Delivery Kits on the Atlantic Coast of Nicaragua: A Focused Ethnography 
Anecdotal reports suggest rates of puerperal sepsis/umbilical cord infection in the Southern Atlantic Autonomous Region (RAAS) of Nicaragua are high, as maternal/infant mortality rates are. Clean delivery kits (CDKs; sealed containers, clean razor blades, soap, string to tie umbilical cords, and clean plastic sheeting) have been shown to decrease perinatal infection rates in low-income countries. Participant observation, focus groups, and key informant interviews with parties involved in delivery practices and policies were conducted in this focused ethnography to determine the cultural acceptability of CDKs for midwives in the RAAS. The CDKs were acceptable in their contents, although remain controversial. Although evidence points to deliveries taking place at home without the use of sterile equipment, the Ministry of Health policy is for deliveries to take place in hospitals/health clinics.
PMCID: PMC3512193  PMID: 23226103
eastern Nicaragua; midwives; Bluefields; women’s health
10.  Applying Ecodevelopmental Theory and the Theory of Reasoned Action to Understand HIV Risk Behaviors Among Hispanic Adolescents 
HIV/AIDS is listed as one of the top 10 reasons for the death of Hispanics between the ages of 15 and 54 in the United States. This cross sectional, descriptive secondary study proposed that using both the systemic (ecodevelopmental) and the individually focused (theory of reasoned action) theories together would lead to an increased understanding of the risk and protective factors that influence HIV risk behaviors in this population. The sample consisted of 493 Hispanic adolescent 7th and 8th graders and their immigrant parents living in Miami, Florida. Structural Equation Modeling (SEM) was used for the data analysis. Family functioning emerged as the heart of the model, embedded within a web of direct and mediated relationships. The data support the idea that family can play a central role in the prevention of Hispanic adolescents’ risk behaviors.
PMCID: PMC3495617  PMID: 23152718
adolescents; HIV; STIs; ecodevelopmental theory; theory of reasoned action; Hispanics/Latinos
11.  Salud de Corazon: Cultural Resources for Cardiovascular Health among Older Hispanic Women 
The prevalence of cardiovascular disease risk factors in Hispanic women has been substantiated across studies. While many studies have focused on the impact of these risk factors, few qualitative studies have addressed cultural and contextual meanings of cardiovascular health promotion in this population. This research explored cultural resources for cardiovascular health promotion among older Hispanic women. A qualitative descriptive methodological design using focus groups with 7 Hispanic women was used. Culture provided an overarching perspective, guiding identification and choice of resources and supports in order to promote cardiovascular health. Themes included Living Tradition, Caring for Family, Connecting with Friends, Having Faith, and Moving as Life. Data provide an initial step toward generating a more complete understanding of perceived cultural resources for cardiovascular health in older Hispanic women. Researchers and clinicians are increasingly recognizing that individuals, families and communities uniquely define cultural and contextual meaning of cardiovascular health promotion.
PMCID: PMC3459313  PMID: 23024613
Hispanic Women; Cardiovascular Health Promotion; Cultural Resources; Older Adults
12.  Disparidad en Salud: Un Fenómeno Multidimensional 
La Disparidad en Salud (DS) ha llamado la atención pública desde el siglo pasado, ha sido analizada desde diversas perspectivas y enfoques incluso variados términos han sido utilizados como sinónimos pudiendo llevar a confusión e inequidades al momento de su operacionalización. Sin embargo es importante señalar que las publicaciones coinciden en que la DS es uno de las determinantes esenciales a considerar al momento de definir polĺticas públicas. El propósito de esta publicación es analizar la disparidad en salud incorporando; a) los aspectos claves de su conceptualización, b) la evolución histórica del concepto, c) las estrategias que se han generado para enfrentarla, d) los factores considerados determinantes, y e) los aspectos éticos y la contribución de la investigación en la disminución de la DS.
Health Disparities (HD) have been at the center of public attention for the past century. They have been analyzed from diverse perspectives utilizing various terms as synonyms that can lead to confusion and inequality at the moment of operationalization. Despite this, it is important to indicate that publications agree that HD are essential determinants that must be considered in the definition of public policy. The objective of this publication is to analyze health disparities incorporating; (a) key aspects in their conceptualization, (b) the historic evolution of the concept, (c) strategies that have been generated to confront them, (d) determining factors, and (e) ethical aspects and the contribution of research in decreasing HD.
PMCID: PMC3349157  PMID: 22581053
health disparity; inequality; determining factors
13.  Using the Revised Acculturation Rating Scale for Mexican Americans (ARSMA-II) with Older Adults 
Projections for the year 2030 show that Latinos are expected to make the largest population increase. Cultural values create expectation levels about what will happen to the elderly. Acculturation is a concept that has been studied extensively, yet the relationship between age and acculturation has not been a focus of study. The present study has proposed an alternate way of scoring the ARSMA-II based on receiver operating characteristics. Specifically, this approach looks at participants' responses to two individual items to determine the level of acculturation of the older adults. It is a quicker method and one that could save healthcare providers a great deal of time as well as help them better understand their clients' level of acculturation; thus, being able to provide the appropriate educational materials.
PMCID: PMC3190130  PMID: 21998557
Caregiving; ethnicity; acculturation; older adults
14.  Clinical Trail Outcomes of the Mexican American Problem Solving Program (MAPS) 
Depression among Mexican immigrant women and children exceeds national prevalence rates. Given the influence of maternal depression on children, a clinical trial testing the effects of the Mexican American Problem Solving (MAPS) program was designed to address depression symptoms of Mexican immigrant women and their fourth and fifth grade children (302 dyads) through a linked home visiting and after school program compared to peers in a control group. Schools were randomized to intervention and control groups. There were statistically significant improvements in the children’s health conceptions and family problem solving communication, factors predictive of mental health. Improvements in children’s depression symptoms in the intervention group approached statistical significance. These promising results suggest that refined school based nursing interventions be included in community strategies to address the serious mental health problems that Mexican immigrants face.
PMCID: PMC2945364  PMID: 20877438
Mexican American; Mother Child depression; Problem-solving; Intervention; Clinical Trial
16.  Conflict Resolution and Distress in Dementia Caregiver Families: Comparison of Cubans and White Non-Hispanics 
This study investigated the role of family conflict resolution as a mediator of the relationship between ethnicity and psychological distress in dementia caregivers. The sample was composed of the families of 182 caregivers who participated in REACH (Resources for Enhancing Alzheimer’s Caregiver Health). The sample consisted of 84 Cuban American and 98 non-Hispanic White American families. Mediation analyses revealed that both income and conflict resolution partially mediated the relationship between ethnicity and caregiver psychological distress. Specifically, Cuban American families were less likely than non-Hispanic White families to reach a resolution to their disagreements, which may have rendered the caregiver at greater risk for psychological distress. These results suggest that Cuban American caregivers may benefit from interventions that improve the family’s ability to resolve conflicts.
PMCID: PMC2864499  PMID: 20448830
caregivers; conflict; Cuban; dementia; family; Hispanic
17.  Spirituality and Cultural Identification Among Latino and Non-Latino College Students 
The purposes of this study were to examine (a) differences in spiritual perspectives and practices of Latino and non-Latino young adults and (b) the cultural relevance of the Latino Spiritual Perspective Scale (LSPS). Studies indicate that spiritual perspectives are embedded within cultural group norms and vary significantly across ethnic groups. A cross-sectional survey design was used with a convenience sample of 223 Latino and non-Latino university students in the Southwestern United States. The Spiritual Perspective Scale (SPS), the LSPS, the Orthogonal Cultural Identification Scale, and a demographic questionnaire were used. Latinos scored significantly higher than non-Latinos in both measures of spiritual perspectives. Self-reported behavioral measures, such as frequency of personal prayer, were also higher among the Latino group. Latino cultural identification was the only significant predictor of LSPS scores. Findings from this study indicate that spirituality among Latinos has meanings specific to the cultural group context. These findings have implications for nursing research involving the conceptualization and measurement of spirituality among multiethnic groups.
Los propósitos de este estudio eran examinar: (a) diferencias en perspectivas espirituales y prácticas de jóvenes Latinos y no Latinos; y (b) la relevancia cultural de la Escala de la Perspectiva Espiritual Latina. Estudios indican que perspectivas espirituales están incrustadas entre normas culturales del grupo y varían considerablemente entre grupos étnicos. Un diseño transversal y de encuesta fue utilizado con una muestra de conveniencia de 233 estudiantes universitarios Latinos y no Latinos en el Suroeste de los Estados Unidos. La Escala de la Perspectiva Espiritual (EPE), la Escala de la Perspectiva Espiritual Latina (EPEL), la Escala Ortogonal de Identificación Cultural, y un cuestionario demográfico fueron utilizados. Los Latinos calificaron considerablemente más alto que los no Latinos en ambas medidas de perspectivas espirituales. Medidas de comportamiento auto-reportadas, como la frecuencia de oración, también estuvieron más altas en el grupo Latino. La identificación con la cultura Latina fue el único vaticinador de las calificaciones de la EPEL. Los resultados de este estudio indican que la espiritualidad entre Latinos tiene significados específicos al contexto del grupo cultural. Estas conclusiones tienen implicaciones para las investigaciones de enfermería que involucran la conceptualización y medida de la espiritualidad entre grupos multiétnicos.
PMCID: PMC2822391  PMID: 20165566
spirituality; religious practices; cultural identification; instrumentation
18.  Preliminary Study of OCD and Health Disparities at the U.S.-Mexico Border 
The widespread and devastating nature of obsessive compulsive disorder (OCD) sharply contrasts with the paucity of research involving Mexican Americans and Mexicans who suffer from this condition. This mixed-methods preliminary study was intended to provide initial data and to pilot the procedures for a larger investigation of the cultural identification, symptomatology, health concerns, coping mechanisms, and quality of life of Mexican Americans and Mexicans with OCD living in the U.S.-Mexico border region of El Paso, Texas and Ciudad Juarez, Mexico. For the sample of six participants, whose symptoms ranged from moderate to extreme, OCD was associated with marked impairment in quality of life, particularly in terms of social functioning, an area of central importance for many Mexican Americans and Mexicans. Areas of further study were identified, with the aim of developing culturally sensitive interventions to decrease health disparities involving OCD.
PMCID: PMC2000846  PMID: 17917689
obsessive-compulsive disorder (OCD); Hispanics; border; mixed methods

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