Elena Flores

Perceived Discrimination, Perceived Stress, and Mental and Physical Health Among Mexican-Origin Adults

This study provided a test of the minority status stress model by examining whether perceived discrimination would directly affect health outcomes even when perceived stress was taken into account among 215 Mexican-origin adults. Perceived discrimination predicted depression and poorer general health, and marginally predicted health symptoms, when perceived stress was taken into account. Perceived stress predicted depression and poorer general health while controlling for the effects of perceived discrimination. The influence of perceived discrimination on general health was greater for men than women, and the effect of perceived stress on depression was greater for women than men. Results provide evidence that discrimination is a source of chronic stress above and beyond perceived stress, and the accumulation of these two sources of stress is detrimental to mental and physical health. Findings suggest that mental health and health practitioners need to assess for the effects of discrimination as a stressor along with perceived stress.

Perceived Racial/Ethnic Discrimination, Posttraumatic Stress Symptoms, and Health Risk Behaviors among Mexican American Adolescents.

Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact.

Marital Conflict and Acculturation Among Mexican American Husbands and Wives.

This study examined the relationship between acculturation and multiple dimensions of marital conflict among Mexican American husbands and wives. Participants were 151 husbands and wives who were recruited from a health maintenance organization in northern California and individually interviewed. More acculturated husbands and wives engaged in less avoidance of conflict and were more expressive of their feelings in an argument. Husbands who were more acculturated reported more conflict concerning sex and consideration for the other. Bicultural and more acculturated husbands reported that their wives were more verbally and physically aggressive, compared with mono-Mexican husbands. The findings provide evidence that more acculturated husbands and wives are involved in more direct expressions of conflict in their marriages, compared with less acculturated husbands and wives.

Infidelity, Trust, and Condom Use among Latino Youth in Dating Relationships

Background: Latino youth in the United States are at greater risk for contracting sexually transmitted infections (STIs) in comparison with non-Hispanic white youth. Methods: Sexually active heterosexual Latino youth aged 16 to 22 years (N = 647) were recruited for interviews through a large health maintenance organization or community clinics. Results: Adjusting for gender, age, ethnic heritage, and recruitment method, woman’s consistent use of hormonal contraceptives, ambivalence about avoiding pregnancy, longer length of sexual relationship, and greater overall trust in main partner were independently associated with inconsistent condom use and engagement in a greater number of sexual intercourse acts that were unprotected by condom use. Perception that one’s main partner had potentially been unfaithful, but not one’s own sexual concurrency, was associated with consistent condom use and fewer acts of unprotected sexual intercourse. Sexually concurrent youth who engaged in inconsistent condom use with other partners were more likely to engage in inconsistent condom use and a greater number of unprotected sexual intercourse acts with main partners. Conclusions: Increasing attachment between youth may be a risk factor for the transmission of STIs via normative declines in condom use. Perception that one’s partner has potentially been unfaithful may result in greater condom use. However, many Latino adolescents and young adults who engage in sexual concurrency may not take adequate steps to protect their partners from contracting STIs. Some youth may be more focused on the emotional and social repercussions of potentially revealing infidelity by advocating condom use than the physical repercussions of unsafe sex.

Sociocultural Beliefs Related to Sex among Mexican American Adolescents

This exploratory study examines the cultural content of two domains related to antecedents of sexual behavior among Mexican American adolescents: preferred partner qualities and reasons to have or not have sex. Domain analysis, a qualitative research methodology drawn from anthropology, was employed. The methodology involved two phases. First, male andfemale adolescents listed positive and negative items in each of these two domains; second, 16 male and 21 female adolescents classified these items using a simple pile-sort procedure. Results suggest that partner qualities and reasons to have sex expressed by the adolescents are reflective of important Mexican American cultural values and gender-specific expectations. The study provides an understanding of cultural and gender-specific beliefs related to sexual decision making among Mexican American adolescents.

Condom negotiation strategies and actual condom use among Latino youth.

PURPOSE To examine which condom negotiation strategies are effective in obtaining or avoiding condom use among Latino youth. METHOD Interviews were conducted with 694 Latino youth, 61% female, aged 16-22. Participants reported on their condom negotiation strategies, perceptions of whether their sexual partner wanted to use condoms, and actual condom use. Three strategies to obtain condom use (risk information, direct verbal/nonverbal communication, insist) and four strategies to avoid condom use (emotional coercion, ignore condom use, dislike condoms, seduction) were examined. Data were analyzed using multiple linear regression, and included youth (n = 574) who reported wanting to use or avoid condoms. RESULTS Almost 60% of participants reported wanting to use condoms, and nearly all of these used some strategy to obtain condom use. Young men who wanted to use condoms were more likely to do so, compared with young women. Risk information and direct verbal/nonverbal communication were effective strategies to obtain condom use, even among youth who perceived their sexual partners as not wanting to use condoms. Ignoring condom use was an effective condom avoidance strategy, even when youth thought their partners wanted to use condoms. Unexpectedly, young men who expressed dislike of condoms had higher rates of condom use than young men not using this condom avoidance strategy. CONCLUSIONS This research identified condom negotiation strategies that are effective among Latino youth, even when they believe their partners do not want to use condoms. Health care providers could encourage Latino youth to use such condom negotiation strategies.

Parental feeding practices in Mexican American families: initial test of an expanded measure.

BackgroundAlthough obesity rates are high among Latino children, relatively few studies of parental feeding practices have examined Latino families as a separate group. Culturally-based approaches to measurement development can begin to identify parental feeding practices in specific cultural groups. This study used qualitative and quantitative methods to develop and test the Parental Feeding Practices (PFP) Questionnaire for use with Mexican American parents. Items reflected both parent’s use of control over child eating and child-centered feeding practices.MethodsIn the qualitative phase of the research, 35 Latino parents participated in focus groups. Items for the PFP were developed from focus group discussions, as well as adapted from existing parent feeding practice measures. Cognitive interviews were conducted with 37 adults to evaluate items. In the quantitative phase, mothers and fathers of 174 Mexican American children ages 8–10 completed the PFP and provided demographic information. Anthropometric measures were obtained on family members.ResultsConfirmatory factor analyses identified four parental feeding practice dimensions: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. Factorial invariance modeling suggested equivalent factor meaning and item response scaling across mothers and fathers. Mothers and fathers differed somewhat in their use of feeding practices. All four feeding practices were related to child body mass index (BMI) percentiles, for one or both parents. Mothers reporting more positive involvement had children with lower BMI percentiles. Parents using more pressure to eat had children with lower BMI percentiles, while parents using more restriction had children with higher BMI percentiles. Fathers using food to control behavior had children with lower BMI percentiles.ConclusionsResults indicate good initial validity and reliability for the PFP. It can be used to increase understanding of parental feeding practices, children’s eating, and obesity among Mexican Americans, a population at high risk of obesity.

Violence involvement, substance use, and sexual activity among Mexican-American and European-American adolescents.

PURPOSE This study examined longitudinal associations between violence involvement, substance use, and sexual activity. METHODS A total of 302 urban Mexican-American and European-American adolescents were randomly selected and recruited from the membership lists of a large health maintenance organization. Data were obtained from interviews conducted when the mean ages of adolescents were 15, 18, and 19 years. RESULTS Independent of age, gender, ethnicity, family socioeconomic status, and previous levels of health risk behavior, adolescents who had been victimized by violence at age 15 were more likely to use tobacco at age 19. Adolescents who had been victimized by or perpetrated violence at age 18 had a greater number of sexual partners and were more likely to use marijuana at age 19. In addition, adolescents who had perpetrated violence at age 18 engaged in greater alcohol use at age 19. A second set of analyses showed that independent of demographics and previous violence involvement, adolescents who had used marijuana at age 15 were more likely to report violence involvement at age 19. Adolescents who had used tobacco or who had a greater number of sexual partners at ages 15 or 18 were more likely to report violent victimization at age 19. CONCLUSIONS Associations between violence involvement and other forms of health risk behavior are bidirectional. Adolescents involved with violence are at risk for increases in substance use and sexual behavior over time. Adolescents who engage in substance use and sexual behavior with multiple partners are also at risk for later violence involvement.

Cognitive Coping Moderates the Association between Violent Victimization by Peers and Substance Use among Adolescents

OBJECTIVE This study tested whether violent victimization by peers was associated with alcohol and tobacco use among adolescents, and whether adaptive coping styles moderated associations. METHODS A total of 247 urban Mexican-American and European-American adolescents aged 16-20 years were interviewed. RESULTS Independent of demographics and violent perpetration, adolescents victimized by violence reported greater alcohol and tobacco use. Adolescents who engaged in higher levels of behavioral coping (e.g., problem solving) reported less substance use, independent of violence variables. Interaction effects showed that violent victimization was associated with greater substance use only among adolescents who engaged in lower levels of cognitive coping (e.g., focusing on positive aspects of life). Substance use was relatively low among adolescents who engaged in higher levels of cognitive coping, regardless of whether they had been victimized. CONCLUSIONS Enhancement of cognitive coping skills may prevent engagement in substance use as a stress response to violent victimization.

Is it time for bed? Short sleep duration increases risk of obesity in Mexican American children

OBJECTIVE Cross-sectional studies show that sleep is related to childhood obesity. We aimed to examine the longitudinal impact of sleep on the risk of obesity in Mexican American children. DESIGN AND METHODS We evaluated 229 Mexican American 8-10-year-olds and their mothers at baseline and at 12- and 24-month follow-ups. Sleep duration and anthropometrics were collected. Age- and gender-specific body mass index (BMI) z-scores (BMIz) were calculated based on Centers for Disease Control and Prevention guidelines. Sleep duration was estimated using accelerometry. Children were also categorized as long or short sleepers, using the National Sleep Foundations recommendation to define adequate sleep duration (10-11 h for 5-12-year-olds). Using linear regressions, we examined whether sleep duration predicted BMIz, waist-to-height ratio (WHtR), and weight gain at 24 months. RESULTS Children were mostly short sleepers (82%). Children who slept less were more likely to have a higher BMIz, WHtR, and weight gain at the 24-month follow-up (β = -0.07, P = 0.01; β = -0.11, P <0.01; and β = -0.14, P = 0.02, respectively), after controlling for baseline weight status, child gender, maternal BMI, and occupation. CONCLUSION In Mexican American children, shorter sleep duration at baseline was associated with increased weight status over 24 months.