Black and multiracial women seeking care in family planning clinics have a disproportionately high prevalence of RC and UIP. RC may partially explain differences in UIP prevalence, with the effect of race/ethnicity slightly attenuated in RC-adjusted models. However, the impact of RC on risk for UIP was similar for White and Black women. Findings from this study support the need to understand and prevent RC, particularly among women of color. Results are foundational in understanding disparities in RC and UIP that may have implications for refinement of clinical care.
This study aimed at investigating how income, culture, and language affect health care access. Data from a structured questionnaire administered to a random sample of 206 Latinos was analyzed using multivariate logistic regression. Qualitative data served to explain quantitative results. Point estimates for various access measures were similar to national data. In multivariate logistic regression, income and education determined having health insurance (OR 6.8 and 7.4; 95% CI 2.7-17.3 and 2.9-19.0, respectively). Time in the U.S. and health insurance determined having a regular source of care (OR 4.6 and 5.8; 95% CI 1.7-12.8 and 2.1-16.0, respectively). Having a source of care and being female determined visit to the doctor in the past year (OR 6.14 and 6.73; 95% CI 2.3-16.5 and 2.4-19.3, respectively). Language and culture showed no statistically significant effect on access measures, but qualitative data showed they were related to health care barriers.
Low-income and minority women are less likely to be screened for breast and cervical cancer and less likely than others to be diagnosed at an early stage in the cancer's growth. We consulted women and providers to understand how social, economic, and health care environments affect screening among African American, Amish, Appalachian, and Latina women, and to outline possible solutions. Women participated in 31 focus groups. Providers completed a mail survey (n=168) and follow-up interviews (n=12). We identified barriers women face: not always following recommendations; feeling intimidated during appointments; having incorrect information about risks, screening guidelines, and programs; and receiving information in ways they cannot understand or accept. Women indicated a strong desire for accurate information and, like the providers, identified strategies for reducing barriers to screening. In the terms of a social ecological model, our results point to three avenues along which to approach cultural competence: 1) policy, 2) health care provision, and 3) clinical care.
BackgroundLatino preschool children have higher rates of obesity than preschool children from other racial/ethnic groups; however, few effective, culturally appropriate interventions exist targeting this group. The purpose of this study was to test the feasibility of a 10-week, promotora-mediated, home-based intervention to promote a healthy weight in Latino preschool children.MethodsTrained promotoras (community health workers) delivered 10, 90-min weekly interactive and tailored sessions to Latino families living in Allegheny County. Participants were recruited through promotoras’ own social networks and community gatherings, flyers, and word of mouth. Primary outcome measures included child body mass index (BMI) z-score and percentile. Secondary outcome measures included child objectively measured physical activity and dietary intake, and the home social and physical environment (e.g., parent health behaviors, parent self-efficacy, parental support, physical activity equipment in the home). The final analysis sample included 49 of 51 participants who completed both baseline and follow-up assessments.ResultsParticipants included mothers (33.5 ± 6.1 years old) and their preschool-aged children who were primarily 1st generation immigrants from Mexico (65%). The primary analyses of BMI percentile and z-score showed no change post-intervention. However, there was a significant decrease in child BMI percentile for overweight and obese children from baseline to follow-up (p < .05). We also saw significant pre/post increases in child daily fruit and vegetable intake, and parent moderate-to-vigorous physical activity, fruit and vegetable servings per day, and self-efficacy; and significant decreases in child saturated fat and added-sugar intake, and child and parent screen time (p’s < .05).ConclusionsDespite the short duration of the intervention and follow-up, this pilot study showed promising effects of a promotora-mediated intervention to promote a healthy weight in Latino preschool children.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5266-3) contains supplementary material, which is available to authorized users.
Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status.
Background. Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance. Purpose. This study examines the association between social support and compliance with mammogram and Pap test screening guidelines, and whether social support provides added value for women of low education. Method. Data were from a countywide 2009-2010 population-based survey, which included records of 2,588 women 40 years and older (mammogram) and 2,123 women 21 to 65 years old (Pap test). Compliance was determined using the guidelines in effect at the time of data collection. Results. Social support was significantly related to mammogram (adjusted odds ratio = 1.43; 95% confidence interval [1.16, 1.77]) and Pap test (adjusted odds ratio = 1.71; 95% confidence interval [1.27, 2.29]) compliance after controlling for age, race, having a regular health care provider, and insurance status. The interaction between social support and education had a significant effect on Pap test compliance only among women younger than 40; the effect was not significant for mammogram compliance. Conclusion. Social support is associated with breast and cervical cancer screening compliance. The association between education and cancer screening behavior may be moderated by social support; however, results hold only for Pap tests among younger women. Practitioners and researchers should focus on interventions that activate social support networks as they may help increase both breast and cervical cancer screening compliance among women with low educational attainment.
Study Objective To identify sexual health behavior interventions targeting U.S. Latino adolescents. Design A systematic literature review. Setting Peer-reviewed articles published between 1993 and 2011, conducted in any type of setting. Participants Male and female Latino adolescents ages 11–21 years. Interventions Interventions promoting sexual abstinence, pregnancy prevention, sexually transmitted infection (STI) prevention, and/or HIV/AIDS prevention. Main Outcome Measures Changes in knowledge, attitudes, engagement in risky sexual behaviors, rates of STIs, and/or pregnancy. Results Sixty-eight articles were identified. Fifteen were included in this review that specifically addressed Latino adolescent sexual health behavior. Among the reviewed interventions, most aimed to prevent or reduce STI and HIV/AIDS incidence by focusing on behavior change at two levels of the social ecological model: individual and interpersonal. Major strengths of the articles included addressing the most critical issues of sexual health; using social ecological approaches; employing different strategies to deliver sexual health messages; and employing different intervention designs in diverse geographical locations with the largest population of Latino communities. Most of the interventions targeted female adolescents, stressing the need for additional interventions that target Latino adolescent males. Conclusions Latino adolescent sexual health is a new research field with gaps that need to be addressed in reducing negative sexual health outcomes among this population. More research is needed to produce new or validate existing, age-specific, and culturally-sensitive sexual health interventions for Latino male and female adolescents. Further, this research should also be conducted in areas of the U.S. with the newest Latino migration (e.g., North Carolina).
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