Breastfeeding rates remain low, especially among low-income minority women. The objective of this qualitative study was to assess barriers to breastfeeding and reasons for combination feeding among low-income Latina women and their families. Meetings were held with key informants to inform the sampling plan and develop questions for focus groups. Data were collected from eight qualitative focus groups with primiparous mothers postpartum, mothers breastfeeding at 4 to 6 months, mothers formula feeding at 4 to 6 months, grandmothers and fathers, and 29 individual interviews with formula- and combination-feeding mothers. Transcripts of focus groups and interviews were content coded and analyzed for thematic domains and then compared for concurrence and differences. Four main domains with 15 categories were identified: (a) Best of both: Mothers desire to ensure their babies get both the healthy aspects of breast milk and "vitamins" in formula. (b) Breastfeeding can be a struggle: Breastfeeding is natural but can be painful, embarrassing, and associated with breast changes and diet restrictions. (c) Not in Mother's Control: Mothers want to breastfeed, but things happen that cause them to discontinue breastfeeding. (d) Family and cultural beliefs: Relatives give messages about supplementation for babies who are crying or not chubby. Negative emotions are to be avoided so as to not affect mother's milk. Those counseling Latina mothers about infant feeding should discourage and/or limit early supplementation with formula, discuss the myth of "best of both," understand the fatalism involved in problem-solving breastfeeding issues, and enlist the altruism embedded in the family unit for support of the mother-infant pair.

Culturally competent diabetes self-management for Latinos should incorporate the family and include techniques for stress management as well as diet modification. Information delivery should include a variety of techniques.

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Healthcare providers working with Mexican American families should deliver consistent, culturally specified messages regarding infant feeding and activity practices.

Cultural competence in diabetes care requires attention to the political economy of the disease and advocacy for healthful political and economic change.

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This study explored older, community-dwelling adults' attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥ 60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their "comfort zones" to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success.

This article reviews the contributions of three different kinds of photographs taken in a study of Latino children's health. The three photographic methods were photos of children taken by their mothers who were given disposable cameras, photos taken by research staff during regular home visits, and photos taken in a day-long period of intense observation. Using qualitative and quantitative comparisons of the photos generated by these methods, the authors conclude that the Day in the Life method-although the most expensive-also provided more new information. Specifically, the authors learned more about the children's family relationships, feeding patterns, and the safety and stimulation of their home environments.JohnCollier,Jr.andMalcolmCollier(1986:5)wrotethat"thecriticaleyeof the camera is an essential tool in gathering accurate visual information because we moderns are often poor observers. Its sharp focus might help us see more and with greater accuracy."To accomplish exactly what the Colliers suggested, we added a photographic component to a study of Latino children's health. 1 Rather than aiming for one "truth" about the children's lives and health, we hoped to see more of their home life, see it from different perspectives, and be able to talk about what we saw by having photographs that captured their home environments This project was funded through a grant to Lauren Clark from the National Institutes of Health (R29 HD32366) and a companion grant, called a Minority Graduate Student Supplement, that funded Lorena Zimmer's participation in the study and the photographic component of her independent mentored research. Lisa Hofsess, who was employed on this grant during the same time period, worked with us on this and other research projects and offered valuable insights throughout the study. Kristin Leonardi and JenniferWhalen offered their services in photographic cataloging, and we thank them for their efforts. We also thank Oswald Werner and Margarita Kay, who talked with us about the photographs described in this article and offered suggestions about photographic methods in general and suggested interpretations of the photographs taken by the mothers.