R. Burciaga Valdez

Remittance behavior among Salvadoran and Filipino immigrants in Los Angeles.

This article analyzes the factors that influence remittance behavior (the decision to remit and the amount sent) in the host country of Filipino and Salvadoran immigrants, two groups with high rates of U.S.-bound migration and of remittances. Data for this study come from a multipurpose survey fielded in Los Angeles in 1991 and are analyzed using logistic regressions and OLS. Individual characteristics and financial ability to remit, motivation to migrate, personal investments in the United States, and family obligations in the home and in the host countries are hypothesized to affect remittance behavior. No differences by country of origin in the proportion who send remittances were found, but there were significant differences in the amount remitted. Some variables affect the two country-of-origin groups differently. The size of remittances sent by Salvadorans tends to be relatively insensitive to their characteristics compared with Filipinos. Filipinos’ remittances are more affected by age, family income, having taken English classes in the United States, and living alone than are the remittances of Salvadorans. For both groups, the most consistent factors affecting remittances are family income and the place of residence of close family members.

The effect of cost sharing on the use of antibiotics in ambulatory care: Results from a population-based randomized controlled trial,

Little is known about how generosity of insurance and population characteristics affect quantity or appropriateness of antibiotic use. Using insurance claims for antibiotics from 5765 non-elderly people who lived in six sites in the United States and were randomly assigned to insurance plans varying by level of cost-sharing, we describe how antibiotic use varies by insurance plan, diagnosis and health status, geographic area, and demographic characteristics. People with free medical care used 85% more antibiotics than those required to pay some portion of their medical bills (controlling for all other variables). Antibiotic use was significantly more common among women, the very young, patients with poorer health, and persons with higher income. Use of antibiotics for viral, viral-bacterial, and bacterial conditions did not differ between free and cost-sharing insurance plans, given antibiotics were the treatment of choice. Cost sharing reduced inappropriate and appropriate antibiotic use to a similar degree.

Improving Breast Cancer Control Among Latinas: Evaluation of a Theory-Based Educational Program

The study evaluated a theory-based breast cancer control program specially developed for less acculturated Latinas. The authors used a quasi-experimental design with random assignment of Latinas into experimental (n = 51) or control (n = 37) groups that completed one pretest and two posttest surveys. The experimental group received the educational program, which was based on Banduras self-efficacy theory and Freires empowerment pedagogy. Outcome measures included knowledge, perceived self-efficacy, attitudes, breast self-examination (BSE) skills, and mammogram use. At posttest 1, controlling for pretest scores, the experimental group was significantly more likely than the control group to have more medically recognized knowledge (sum of square [SS] = 17.0, F = 6.58, p < .01), have less medically recognized knowledge (SS = 128.8, F = 39.24, p < .001), greater sense of perceived self-efficacy (SS = 316.5, F = 9.63, p < .01), and greater adeptness in the conduct of BSE (SS = 234.8, F = 153.33,p < .001). Cancer control programs designed for less acculturated women should use informal and interactive educational methods that incorporate skill-enhancing and empowering techniques.

A Review of Instruments Assessing Public Health Preparedness

Objectives. The purpose of this study was to review instruments that assess the level of preparedness of state and local public health departments to respond to health threats such as bioterrorism. Methods. The authors examined 27 published population-based instruments for planning or evaluating preparedness that were mostly unavailable in the peer-reviewed literature. Using the Essential Public Health Services framework, the instruments were evaluated for (1) clarity of measurement parameters, (2) balance between structural and process measures, (3) evidence of effectiveness, and (4) specification of an accountable entity. Results. There was a great deal of overlap but little consistency in what constitutes “preparedness” or how it should be measured. Most instruments relied excessively on subjective or structural measures, lacked scientific evidence for measures assessed, and failed to clearly define what entity was accountable for accomplishing the task or function. Conclusion. Strategies for improvement include measure standardization, better interagency communication, and investment in public health practice research to develop the underlying evidence base required for developing quality measures and assessments.

Are Condom Instructions in Spanish Readable? Implications for AIDS Prevention Activities for Hispanics

Almost haylof the 10,544 cases of AIDS reported among Hispanics are associated with sexual transmission of the human immunodeficiency virus. As a result, the use of condoms has assumed a central role in the prevention of AIDS. In order to determine the readability of Spanish instructions provided with condoms, twentyfive brands were purchased in Los Angeles. Only half of the manufacturers of condoms available in Los Angeles provided instructions in Spanish. Seven different Spanish texts were identified from the thirteen marketed brands. Readability tests indicate that these texts pose difficulties in comprehension for anyone whose reading skills are below the ninth grade level. These instructions inadequately serve the majority of the Hispanic community whose limited reading skills inhibit comprehension of high school level materials. These results suggest the need to modify AIDS education and prevention materials to increase the level of information available to the Hispanic community.