Mariano Kanamori

Peers, Tobacco Advertising, and Secondhand Smoke Exposure Influences Smoking Initiation in Diverse Adolescents

Purpose. Identify demographic, social, and environmental factors associated with smoking initiation in a large, racially and ethnically diverse sample of underage youth participating in the 2006 Maryland Youth Tobacco Survey. Design. Cross-sectional, multistage, probability sample survey. Setting. Schools (308 middle and high schools) in Maryland. Subjects. Subjects were 12- to 17-year-old adolescents participating in a school-based survey. New smokers and nonsmokers were included in the analysis (n = 57,072). Measures. Social and media influence, secondhand smoke exposure, tobacco product use, and demographic information including age, race/ethnicity, and geographic region. Analysis. Chi-square and multiple logistic regression analyses controlling for clustering. Results. Hispanic and Hawaiian/Pacific Islander youth were most likely and Asian and Black youth were least likely to be new smokers. Smoking initiation was positively associated with higher age, living with a current smoker, secondhand smoke exposure, exposure to advertisements for tobacco products, having more friends that smoke, tobacco products offered by friends, risk perceptions, and use of other tobacco products such as smokeless tobacco and cigars. Multivariate logistic regression results suggested that composite measures of peer influence, advertising exposure, and secondhand smoke exposure were independently associated with smoking initiation. Conclusions. Media, peer influence, and secondhand smoke exposure were the most important factors influencing smoking initiation and were common to all racial/ethnic groups in this study. Interventions combining targeted public awareness, education, and media campaigns directed at parents/guardians should be investigated. (Am J Health Promot 2011;25[3]:e1–e11.)

Barriers and Facilitators to Smoking Cessation Among Latino Adults

BACKGROUND Previous studies have found that Latinos who smoke are less likely than non-Latino white smokers to use pharmaceutical aids such as nicotine replacement therapies or to receive physician advice to stop smoking. This qualitative study further explored barriers and facilitators to smoking cessation among Latino adults in Maryland. METHODS Five Spanish-language focus groups were conducted in September 2008 in Maryland with Latino current smoker and ex-smoker men and women (n = 55). Participants were recruited through flyers, information sheets, and site visits at community health clinics and Latino events, and were predominately of Central American origin. RESULTS Personal health concerns were the main reason to quit smoking; impact on children and family health and role model pressure were frequently mentioned. Barriers to quit smoking included environmental temptation and social factors, emotional pressure, addiction, and habitual behavior. Respondents mostly relied on themselves for cessation, with little use of cessation products or other medications, or awareness of available services. CONCLUSIONS Social influence serves both as a strong motivation for Latinos to quit smoking and as a source of temptation to continue smoking. Favored by both current smokers and ex-smokers, lay health promoters are effective agents to reach Latinos with smoking cessation interventions. In addition, the low use of cessation services could be improved by increasing awareness and availability of Spanish-language cessation services.

Validation of a susceptibility, benefits, and barrier scale for mammography screening among Peruvian women: a cross-sectional study

BackgroundPerceived beliefs about breast cancer and breast cancer screening are important predictors for mammography utilization. This study adapted and validated the Champions scale in Peru. This scale measures perceived susceptibility for breast cancer and perceived benefits and barriers for mammography.MethodsA cross-sectional study was conducted among women ages 40 to 65 attending outpatient gynecology services in a public hospital in Peru. A group of experts developed and pre-tested a Spanish version of the Champions scale to assess its comprehensibility (N = 20). Factor analysis, internal consistency, and test-retest reliability analyses were performed (N = 285). Concurrent validity compared scores from participants who had a mammogram and those who did not have it in the previous 15 months. T-test and multiple regression analysis adjusting for socio-demographic factors, mammography knowledge and other preventive behaviors were performed.ResultsThe construct validity and reliability were optimal. Cronbach-Alpha coefficients were 0.75 (susceptibility), 0.72 (benefits) and 0.86 (barriers). Concurrent validity analysis showed an association between barriers and mammography screening use in bivariate (22.3 ± 6.7 vs. 30.2 ± 7.6; p < 0.001) and multiple regression analysis (OR = 0.28, 95% CI = 0.18-0.43). Ages 50-60 years (OR = 2.35, 95% CI = 1.19-4.65), history of prior Papanicolaou test (OR = 3.69, 95% CI = 1.84-7.40), and knowledge about breast cancer and mammography (OR = 3.69, 95% CI = 1.84-7.40) were also independently associated with mammography screening use.ConclusionConcurrent validity analysis showed that the Champions scale has important limitations for assessing perceived susceptibility for breast cancer and perceived benefits for mammography among Peruvian women. There is still a need for developing valid and reliable instruments for measuring perceived beliefs about breast cancer and mammography screening among Peruvian women.

Immigration Stress and Alcohol Use Severity Among Recently Immigrated Hispanic Adults: Examining Moderating Effects of Gender, Immigration Status, and Social Support.

OBJECTIVE Identifying and understanding determinants of alcohol use behavior among Hispanic immigrants is an increasingly significant public health concern. Although prior research has examined associations of cultural stressors with alcohol use among Hispanics, few studies have tested these associations among recent adult immigrants. As such, this study aimed to examine (a) the association of immigration stress on alcohol use severity among recently immigrated Hispanic adults (≤ 1 year in the United States) and (b) the moderating effects of gender, immigration status, and social support. METHOD A hierarchical multiple regression and moderation analyses were conducted on a sample of 527 participants in South Florida. RESULTS Results indicated that, after controlling for demographic variables, preimmigration drinking behavior, and dimensions of social support, the association of higher immigration stress with higher alcohol use severity was statistically significant. Moderation analyses indicated that immigration stress had a statistically significant association with alcohol use severity among men, but not women. Also, dimensions of social support consistently reduced the deleterious effect of immigration stress on alcohol use severity. CONCLUSION This study adds to the scarce literature on cultural stressors and alcohol use among recent Hispanic immigrants. Findings suggest that it may be important to design gender-specific interventions and that increasing levels of social support may offset the effects of immigration stress on alcohol use.

Workplace Abuse and Economic Exploitation of Children Working in the Streets of Latin American Cities

Abstract This study presents the prevalence of, and factors associated with workplace abuse and economic exploitation among 584 children ages 5 to 17 working in the streets of the Latin American cities of Bogotá, Lima, Quito, and São Paulo. Each additional 10 hours/week of childrens work in the streets increased workplace abuse prevalence by 8% (odds ratio [OR], 1.08; 95% confidence interval [95%CI], 1.01–1.19). Suffering an occupational injury was associated with abuse (OR, 1.70; 95%CI, 1.13–2.57). Participation in begging was associated with an almost five-fold increase in economic exploitation (OR, 4.94; 95%CI, 1.96–12.48). Children residing with their mothers were 2.6 times more likely to experience economic exploitation (OR, 2.61; 95%CI, 1.58–4.33), reflecting our definition of economic exploitation in which a childs income is confiscated by parents, even if used for basic family needs. Increased health care coverage and conditional cash transfer programs are recommended to improve the situation.

Evaluating a Culturally Tailored HIV Risk Reduction Intervention Among Latina Immigrants in the Farmworker Community

Latina immigrants in the farmworker community are a vulnerable and understudied population at risk of acquiring HIV. Employing a CBPR framework, this pilot study was the first to evaluate the efficacy of SEPA, a CDC evidenced-based and culturally tailored HIV risk reduction intervention on a cohort of N = 110 predominantly undocumented Latina immigrants in a farmworker community. Findings revealed SEPA was effective in increasing HIV knowledge and decreasing HIV risk behaviors. However, no changes in self-efficacy were found in the present sample. We posit specific socio-cultural and structural barriers specific to the farmworker community not targeted in the original intervention may have hindered the programs capacity to influence changes in self-efficacy among this less acculturated population. Possible socio-cultural adaptations of the intervention to the target population and policy implications are discussed.

HIV Risk Reduction Interventions Among Substance-Abusing Reproductive-Age Women: A Systematic Review

HIV/AIDS is one of the leading causes of death among reproductive-age women throughout the world, and substance abuse plays a major role in HIV infection. We conducted a systematic review, in accordance with the 2015 Preferred Items for Reporting Systematic Reviews and Meta-analysis tool, to assess HIV risk-reduction intervention studies among reproductive-age women who abuse substances. We initially identified 6,506 articles during our search and, after screening titles and abstracts, examining articles in greater detail, and finally excluding those rated methodologically weak, a total of 10 studies were included in this review. Studies that incorporated behavioral skills training into the intervention and were based on theoretical model(s) were the most effective in general at decreasing sex and drug risk behaviors. Additional HIV risk-reduction intervention research with improved methodological designs is warranted to determine the most efficacious HIV risk-reduction intervention for reproductive-age women who abuse substances.

A Brief Report: Lessons Learned and Preliminary Findings of Progreso en Salud, an HIV Risk Reduction Intervention for Latina Seasonal Farmworkers

Throughout the past decade, HIV rates in Florida—particularly South Florida, where many Latina seasonal farmworkers reside and work—have ranked among the highest in the nation. In this brief report, we delineate important lessons learned and preliminary findings from the implementation of the HIV prevention intervention Progreso en Salud (Progress in Health). Among the 114 Latina seasonal farmworker participants, there were significant increases from baseline to 6-month follow-up in the percentages of overall condom use, HIV testing, HIV/AIDS-related communications with friends, HIV knowledge, condom use self-efficacy, and correct use of condoms. Lessons learned from this study can be used to inform future HIV intervention strategies to improve the adoption and maintenance of HIV risk reduction behaviors among high-risk Latina seasonal workers and other high-risk underserved populations. Future research is needed to support our findings.

Women’s perception of adolescent marijuana use in a hispanic seasonal farm worker community: A qualitative study

ABSTRACT We examined the perception of adolescent children’s marijuana use and its consequences in the Hispanic seasonal farmworking community of South Florida via three focus groups with Hispanic adult female seasonal workers (n = 29). The women described how adolescents’ marijuana use increased over the past five years. Social networks for marijuana use were reported near schools and bus stations. Although participants expressed concern over adolescent marijuana use and involvement in selling marijuana, they reported that their job demands preclude their ability to supervise their children. Participants do not report unlawful marijuana use due to fear of deportation.

Sociocultural determinants of substance misuse among adult Latinas of Caribbean and South and Central American descent: A longitudinal study of a community-based sample.

ABSTRACT Few studies have examined the socio-cultural determinants of alcohol and drug misuse trajectories among adult Latinas. To assess the associations between socio-cultural determinants and alcohol and drug misuse, we used a longitudinal design to follow a sample of adult Latina mother-daughter-dyads (N = 267) for ten years, and collected four waves of data. They were adult Latinas of Caribbean, South and Central American descent. Specifically, this study investigated the effects of the following factors: (1) Individual Determinants (e.g., socioeconomic conditions, mental health, and medical status); (2) Cultural Determinants (e.g., acculturation to US culture); (3) Interpersonal Determinants (e.g., interpersonal support, relationship stress, mother-daughter attachment, intimate partner violence); (4) Community Determinants (e.g., neighborhood related stress); and (5) Institutional Determinants (e.g., religious involvement, involvement with the criminal justice system). Using hierarchical modeling, we found that taking prescribed medication on a regular basis for a physical problem, religious involvement, and mother-daughter attachment were negatively associated with drug misuse, while involvement in criminal activity was positively associated with drug misuse. Regarding alcohol misuse, results showed that age at arrival in the United States, number of years in the United States, and religious involvement were negatively associated with alcohol misuse, while involvement in criminal activity was positively associated with alcohol misuse. Based on our findings, explicit implications are provided for culturally relevant interventions.