Adriana Perez

Using Visual Methods to Uncover Context

The accurate assessment of physical activity and dietary intake is essential for assessing the relationships between physical activity, dietary intake, and health outcomes. However, the measurement of physical activity and dietary intake among women, particularly minority women, poses unique challenges related to gender, ethnicity, and social context. Measures that are not culturally relevant or sensitive to the experiences, traditions, or beliefs of ethnically diverse women might result in data that are unreliable, or which cannot be interpreted. Visual methods show promise for elucidating concepts that are important to refine established measures for assessing dietary intake and physical activity in diverse ethnic groups. Hispanic women, a largely understudied subgroup that experiences long-term health risks associated with dietary and physical activity behaviors, serves as the focal group for this discussion of the potential for visual methods to develop culturally and contextually relevant and valid approaches to outcome assessment.

Exploring Resources for Physical Activity in Hispanic Women, Using Photo Elicitation

Addressing cultural, social, and contextual resources to promote physical activity behavior among Hispanic women is necessary to establish effective intervention approaches. With this research we intended to (a) explore cultural, social, and contextual resources for physical activity among Hispanic women; and (b) evaluate the acceptability of visual methods as an innovative, formative method to enhance intervention relevance. A qualitative descriptive methodological design incorporating photo elicitation was used with 7 Hispanic women, aged 23 to 60 (X = 44.2). Results were varied, and themes captured cultural, social, and contextual resources. Culture provided an overarching perspective, guiding identification and choice of physical activity resources, support, and setting. Themes included being active as a way of life, acknowledging tradition, moving with me, creating place, and building resources. Photo elicitation was evaluated as an acceptable method. Data provide an initial step toward generating a more complete understanding of perceived resources for physical activity in Hispanic women, and support the acceptability of photo elicitation.

The Role of Lay Health Advisors in Cardiovascular Risk Reduction: A Review

Interventions are needed to reduce the negative impact of cardiovascular disease. The combination of health risks for disease, disability, and mortality, particularly among underserved populations, might be best addressed with programs designed to enhance awareness and development of resources within a context of community support. The objectives of this review were to: (1) provide a comprehensive review and evaluation of the roles, evaluation, and effectiveness of LHA in community-based programs with an emphasis on cardiovascular risk reduction; and (2) provide recommendations for future research involving LHA in such programs. Computer and manual searches were conducted of articles in the English-language literature from 1980 to 2007. Twenty articles were evaluated, which emphasized the role of the LHA in cardiovascular risk reduction. A review of research literature provides a starting point for determining salient approaches for intervention and evaluation, issues related to program implementation and sustainability, and strengths and limitations of existing approaches.

Review of intervention studies promoting physical activity in hispanic women

The objectives of this review are to (a) provide a comprehensive review and evaluation of intervention studies designed to promote physical activity among Hispanic women and (b) provide recommendations for future research involving Hispanic women in physical activity intervention research. Computer and manual searches have been conducted of articles in the English-language literature from 1980 to present. Twelve articles are evaluated that emphasize physical activity interventions in Hispanic women. A review of current intervention research provides a starting point for determining salient approaches for intervention and evaluation, issues related to program implementation, and the strengths and limits of existing approaches. During the past 30 years, very few interventions have been conducted that examine physical activity among Hispanic women; those that include Hispanic women across ages support the need for interventions that build on the strengths and address the limitations of this body of research.

Wellness motivation theory in practice.

T he health benefits of physical activity (PA) are well documented, including significant decreases in risk for chronic diseases such as cardiovascular disease (CVD), hypertension, and obesity and a concomitant decrease in mortality. However, an estimated 75% of U.S. adults do not meet the recommended 30 minutes of moderate-intensity PA on most days of the week, and approximately 33% are completely sedentary. Although data on patterns of PA in older adult populations are sparse, there is evidence that these groups have low levels of PA and high levels of consequent health risk compared with younger populations. CVD is the single largest killer of U.S. adults and accounts for 83% of deaths among those aged 65 or older. Factors that contribute to high rates of CVD in Hispanic women include the prevalence of overweight and obesity (71.9%) and a corresponding lack of PA (74%). Older Hispanic women are at particular risk, because after age 60, there are further declines in leisure-time PA. Among older Hispanic women, the prevalence of obesity is 47.9% compared with 21.5% in nonHispanic whites. To reduce disparity in health between Hispanic women and the general population and to provide a basis for the development of relevant interventions, research efforts must better reflect the needs of Hispanic communities. Although interventions targeting Hispanic women have focused on counseling and health education, they may not adequately address the unique cultural needs of Hispanic women. Thus attention to cultural relevance in intervention development, implementation, and evaluation is essential.

Development and implementation of a peer mentoring program for early career gerontological faculty.

PURPOSE The Hartford Gerontological Nursing Leaders (HGNL) formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), in conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), developed and executed a peer mentoring program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of HGNL members. The purpose of this article is to describe key strategies used to develop and execute the peer mentoring program and to present formative program evaluation. DESIGN The program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts. FINDINGS An additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program. CONCLUSIONS Informal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce. CLINICAL RELEVANCE Findings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings.

Social support theoretical perspective.

O verweight and obesity have been noted as major health problems among Hispanics, particularly Hispanic women. Data indicates that approximately 39% of Hispanic women are overweight, with 47% having a body mass index (BMI) .27. Mexican Americans exhibit the highest rate of obesity and the lowest rate of physical activity among Hispanic populations. Physical activity both prevents and helps to treat many established coronary heart disease (CHD) risk factors, including obesity and its associated risks. Healthy People objectives pertaining to adults include increasing the number of adults who participate in physical activity. Data from the National Health Interview Survey showed that Hispanics were 2.09 times more likely to report inadequate levels of physical activity compared with non-Hispanic whites. Given these data, there is growing concern over the substantial public health burden of sedentary lifestyle among Hispanic women. Community-based interventions offer important opportunities to decrease premature morbidity, disability, and enhance the health status of underserved populations. However, the few community-based interventions designed to promote physical activity among Hispanic women have shown varying degrees of effectiveness. Further, culturally relevant, theory-driven interventions designed to foster support systems and supportive environments to promote physical activity are few. The combination of health risks for disease, disability, and mortality, particularly among underserved populations, might be best addressed through programs designed to enhance awareness and develop resources within a context of community support. Integrative, theory-driven designs for community-based interventions have

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.

Dance for Health: An Intergenerational Program to Increase Access to Physical Activity

Purpose The purpose of this study was to evaluate Dance for Health, an intergenerational program to increase access to physical activity in an underserved, high risk urban community. Design and Methods Dance for Health was developed using community‐based participatory research methods and evaluated using an observational study design. The program entailed two hour line dancing sessions delivered by trained dance instructors in the neighborhood recreation center. The weekly sessions were delivered for one month in the spring and one month in the fall from 2012–2016. Nurse practitioner students mentored local high school students to assess outcomes: achievement of target heart rate, Borg Rating of Perceived Exertion, number of pedometer steps during dance session, Physical Activity Enjoyment Scale, and adiposity. Analytic methods included descriptive statistics and mixed effects models. Results From 2012–2016, 521 participants ranging from 2–79 years attended Dance for Health. Approximately 50% of children and 80% of adults achieved target heart rate. Achievement of target heart rate was not related to perceived exertion, though it was related to pedometer steps in adults. All participants rated the program highly for enjoyment. There was no change in adiposity. Conclusions Dance for Health demonstrated high levels of community engagement and enjoyment. It led to adequate levels of exertion, particularly for adults. Our evaluation can inform program refinement and future intergenerational physical activity programs. Practice Implications Dance is an enjoyable, culturally appropriate, low cost method for increasing access to physical activity for children and families. HighlightsAn intergenerational dance program was developed to increase physical activity.The program led to adequate physical exertion and demonstrated high acceptability.Dance can be an enjoyable, culturally‐appropriate, and low cost physical activity.

Using a Cultural Framework to Assess Motivation for Physical Activity among Older Hispanic Women: Application of the PEN-3 Model

Culturally relevant strategies for intervention design and implementation, emphasizing strengths and resources, are essential to address cardiovascular health disparities among older Hispanic women. The purpose of this article is to present the process and results of focus group discussions conducted to understand the meaning of cultural, social, and contextual strengths to promote motivation for physical activity and cardiovascular health in this population. The PEN-3 model guided analysis of focus group data. Fifteen older Hispanic women (mean = 61, SD = 6) participated in 3 focus groups. Three interrelated domains were evaluated: (a) cultural identity, (b) relationships and expectations, and (c) cultural empowerment.