Suzanna M. Martinez

Individual, social, and environmental barriers to and facilitators of physical activity among Latinas living in San Diego County: focus group results.

The purpose of this study was to examine the barriers to and facilitators of physical activity (PA) relevant to a faith-based community living in a border region. Two focus groups were conducted with 25 Latina churchgoers. Latinas identified barriers to PA that included individual (eg, lack of motivation and time, language, economics, social support, family/household responsibilities), sociocultural (eg, fear of border patrol, machismo, and neighborhood safety), and environmental barriers (eg, traffic-related and dogs). Facilitators of PA were PA knowledge, child care, time management, and advocacy skills. The authors concluded that a church-based multilevel intervention targeting Latinas may be ideal for promoting PA and facilitating environmental changes.

A Review of Physical Activity Measures Used Among US Latinos: Guidelines for Developing Culturally Appropriate Measures

BackgroundAs the US population continues to grow and diversify, there is a need for progressive physical activity measurement and cross-cultural research. Studies suggest that US Latinos are among the most sedentary of ethnic groups compared to others; however, study findings may be biased given that some measures may not be culturally sensitive for assessing behaviors that are not characterized as leisure time physical activity.PurposeThe primary objective of this review was to identify and evaluate measures used to quantify physical activity among US Latinos.MethodsA review of the literature was performed and studies examining levels of physical activity among Spanish and English speaking Latinos were documented. This process involved identifying existing guidelines for the purpose of culturally adapting and/or translating (into Spanish) physical activity measures for the Latino population. These guidelines were used as the minimal criteria for the evaluation of the 13 identified measures of physical activity.ResultsOf these 13 measures, four were available in English and nine were available in Spanish. One English measure met the guidelines for being culturally adapted for assessing physical activity among Latinos. There were no Spanish measures that met all the guidelines for physical activity assessment among Spanish-speaking Latinos. Lastly, the identified guidelines for developing culturally appropriate measures were improved to advance physical activity measurement among ethnic and cultural groups.ConclusionFuture research should merit the use of culturally appropriate guidelines to increase the understanding of physical activity patterns in the USA.

Developmental Scores at 1 Year With Increasing Gestational Age, 37–41 Weeks

OBJECTIVE: To examine the relationship between gestational age and mental and psychomotor development scores in healthy infants born between 37 and 41 weeks. METHODS: The cohort included 1562 participants enrolled during infancy in an iron deficiency anemia preventive trial in Santiago, Chile. All participants were healthy, full-term (37–41 weeks) infants who weighed 3 kg or more at birth. Development at 12 months was assessed using the Bayley Scales of Infant Development. Using generalized linear modeling, we analyzed the association between gestational age and 1-year-old developmental status, taking into account potential confounders including birth weight percentile, gender, socioeconomic status, the home environment, iron status, and iron supplementation. RESULTS: For each additional week of gestation, the Mental Development Index increased by 0.8 points (95% confidence interval = 0.2–1.4), and the Psychomotor Development Index increased by 1.4 points (95% confidence interval = 0.6–2.1) controlling for birth weight percentile, gender, socioeconomic status, and home environment. CONCLUSIONS: In a large sample of healthy full-term infants, developmental scores obtained using the Bayley Scales of Infant Development at 12 months increased with gestational age (37–41 weeks). There is increasing evidence that birth at 39 to 41 weeks provides developmental advantages compared with birth at 37 to 38 weeks. Because cesarean deliveries and early-term inductions have increased to 40% of all births, consideration of ongoing brain development during the full-term period is an important medical and policy issue.

Associated pathways between neighborhood environment, community resource factors, and leisure-time physical activity among Mexican-American adults in San Diego, California.

Purpose. To examine pathways between individual, social, and environmental factors associated with leisure-time physical activity (LTPA) among Mexican-American adults. Design. Cross-sectional design using random-digit dialing to administer a structured telephone interview. Setting. Mexican-American adults living in a U.S.-Mexican border community in San Diego, California (N = 672). Measures. Data were collected on LTPA, demographic characteristics, acculturation, and other psychosocial and environmental factors associated with LTPA. Analysis. Structural equation modeling to test an a priori model of LTPA. Results. Participants were mostly female (71%) with a mean age of 39 years (SD = 13). Only 32% of participants met PA guidelines in their leisure time, with men (39%) meeting the guidelines more than women (29%). Using structural equation modeling, neighborhood factors, both social and environmental, showed indirect relationships with meeting PA guidelines through community resource factors. Significant covariates included marital status and age. Conclusion. Individual, social, and environmental factors were associated with LTPA in this sample of Mexican-American adults. These findings can inform intervention studies that aim to increase LTPA in this population.

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.

Active transportation and acculturation among Latino children in San Diego County

OBJECTIVES To examine multiple measures of acculturation and their association with walking to school in a large population-based sample in San Diego, California. METHODS The sample consisted of predominantly Latino children and their parents (n=812) who participated in a study to maintain healthy weights from kindergarten through 2nd grade (2004-2007). Acculturation and walking/driving to and from school were assessed through parent-proxy surveys. RESULTS Children of foreign-born child-parent dyads walked to school more frequently than their counterparts (F=7.71, df=5, 732, p<.001). Similarly, parents who reported living in the U.S. for less than or equal to 12 years reported more walking to school by their children compared with parents living in the U.S. for more than 12 years (F=10.82, df=4, 737, p<.001). Finally, English-speaking females walked to school more frequently than Spanish-speaking and bilingual females. CONCLUSION This study explores Latino childrens walking to and from school using four measures of acculturation. In this cross-sectional study, being less acculturated was associated with more walking to school among children living in South San Diego County.

Mother-reported sleep, accelerometer-estimated sleep and weight status in Mexican American children: sleep duration is associated with increased adiposity and risk for overweight/obese status

We know of no studies comparing parent‐reported sleep with accelerometer‐estimated sleep in their relation to paediatric adiposity. We examined: (i) the reliability of mother‐reported sleep compared with accelerometer‐estimated sleep; and (ii) the relationship between both sleep measures and child adiposity. The current cross‐sectional study included 303 Mexican American mother–child pairs recruited from Kaiser Permanente Northern California. We measured sleep duration using maternal report and accelerometry and child anthropometrics. Concordance between sleep measures was evaluated using the Bland–Altman method. We conducted zero‐ordered correlations between mother‐reported sleep, accelerometer‐estimated sleep and child BMI z‐scores (BMIz). Using linear regression, we examined three models to assess child BMIz with mother‐reported sleep (model 1), accelerometer‐estimated sleep (model 2) and both sleep measures (model 3). Children had an average age of 8.86 years (SD = 0.82). Mothers reported that their child slept 9.81 ± 0.74 h [95% confidence interval (CI): 9.72, 9.89], compared to 9.58 ± 0.71 h (95% CI: 9.50, 9.66) based on accelerometry. Mother‐reported sleep and accelerometer‐estimated sleep were correlated (r = 0.33, P < 0.001). BMIz outcomes were associated negatively with mother‐reported sleep duration (model 1: β = −0.13; P = 0.02) and accelerometer‐estimated sleep duration (model 2: β = −0.17; P < 0.01). Accounting for both sleep measures, only accelerometer‐measured sleep was related to BMIz (model 3: β = −0.14, P = 0.02). Each sleep measure was related significantly to adiposity, independent of covariates. Accelerometry appeared to be a more reliable measure of childrens sleep than maternal report, yet maternal report may be sufficient to examine the sleep–adiposity relationship when resources are limited.

Satiety responsiveness and eating behavior among Chilean adolescents and the role of breastfeeding

Objective:To determine patterns of satiety responsiveness and its relationship to eating in the absence of hunger (EAH), in a cohort of adolescents. We also assessed whether sex, body mass index and duration of breastfeeding, during infancy, predicted satiety responsiveness and eating behavior at 16 years.Methods:Adolescents (n=576) from a longitudinal cohort, which began as an iron deficiency anemia preventive trial, participated in an unlimited breakfast after an overnight fast, and reported satiety response on a visual analog scale after the meal, followed by an EAH procedure. Height, weight and body composition were measured before breakfast. Latent profile analysis generated profiles that captured individual differences in satiety responsiveness. Multivariable regressions, adjusted for potential confounders, evaluated the association between: (1) satiety responsiveness and EAH, and (2) breastfeeding in infancy, satiety responsiveness and EAH in adolescence.Results:Participants were on average 16.7-year old, 48% female, 37% overweight/obese and 76% were breastfed as the sole source of milk for <6 months. We found three latent profiles of satiety responsiveness: 1: ‘responsive’ (49%); 2: ‘not responsive’ (41%); 3: ‘still hungry’ (10%). Participants in the ‘not responsive’ or ‘still hungry’ profile were more likely to eat during the EAH procedure (odds ratio (OR)=2.5, 95% confidence interval (CI)=1.8–3.6). Being breastfed for <6 months was related to higher odds of being in the ‘not responsive’ or ‘still hungry’ profile (OR=1.8, 95% CI=1.2–2.6) and EAH (OR=2.2, 95% CI=1.4–3.3). Satiety responsiveness was not influenced by sex and overweight/obesity.Conclusion:After an ad libitum meal, we found varied satiety responses, which related to EAH. Furthermore, shorter breastfeeding duration was associated with poorer satiety response and higher consumption during an EAH procedure. Understanding if breastfeeding influences the development of satiety responsiveness and eating behavior may be important in an era characterized by abundant calorie-dense foods and a plethora of environmental cues promoting consumption.

Physical activity promotion among churchgoing Latinas in San Diego, California: Does neighborhood cohesion matter?

This study examined the reciprocal relationship between Latinas’ leisure-time physical activity and neighborhood cohesion following the implementation of a 6-month promotora-delivered pilot intervention. A one-group study design was used to promote leisure-time physical activity and build neighborhood cohesion among 143 churchgoing Latinas in San Diego, California. Using a three-wave autoregressive cross-lagged panel model, leisure-time physical activity and neighborhood cohesion (assessed at baseline, 3 and 6 months) were analyzed. Leisure-time physical activity and neighborhood cohesion increased across time. Neighborhood cohesion at 3 months predicted leisure-time physical activity at 6 months. A promotora model in the context of a faith-based setting may be appropriate to promote Latinas’ leisure-time physical activity and make socioenvironmental improvements.

Longitudinal effects of parental, child and neighborhood factors on moderate-vigorous physical activity and sedentary time in Latino children.

BackgroundModerate-vigorous physical activity (%MVPA) confers beneficial effects on child musculoskeletal health, cardiovascular fitness, and psychosocial well-being; in contrast, sedentary time (%SED) is emerging as a risk factor for health. This study aimed to identify parental, child and neighborhood factors influencing longitudinal assessments of body mass index (BMI) and activity patterns among Latino children, and to estimate lagged and cross-lagged effects between child BMI, %MVPA and %SED.MethodsA longitudinal design with assessments at baseline, 1 and 2 years follow-up (FU) was used to evaluate the effects of maternal and paternal factors (BMI, age, education level, acculturation, household income and household size), child factors (gender, age, BMI, pubertal status) and neighborhood factors (disorder, victimization) on child BMI, %MVPA and %SED, expressed as a percent of awake time, in 282 Latino children ages 8-10 y and their parents. This study was restricted to families with a mother and biological father or father figure in the childs life.ResultsAcross time, total daily accelerometer counts (p = 0.04) and steps decreased (p = 0.0001), %SED increased (p = 0.0001), and %MVPA decreased (p = 0.02). Moderate lagged effects or tracking was seen for %MVPA and %SED (p = 0.001). %MVPA varied by gender (5.5% higher in boys than girls, p = 0.0001); child age (-0.4% per year, p = 0.03), and child BMI in boys only (-0.22%, p = 0.0002). Negative effects of paternal age, maternal education and maternal changes in BMI on %MVPA also were seen. %SED increased with child age (2.5% higher per year, p = 0.0001). Positive effects of paternal acculturation, maternal change in BMI, paternal age, and negative effects of household size on %SED were observed. A cross-lagged positive effect of BMI at FU1 on %SED at FU2 was observed for boys and girls (p = 0.03). Neighborhood disorder and victimization were not significant predictors of child BMI, %MVPA or %SED.ConclusionThe major child determinants of physical activity (age, gender and BMI) and minor parental influences (maternal BMI and education, paternal age and acculturation) should be considered in designing interventions to promote %MVPA and reduce %SED among Latino children as they approach adolescence.