This study explored how first and second generation Puerto Rican female headed households residing in Springfield, Massachusetts, utilize the extended family network in childrearing responsibilities. The study will examine how the process of acculturation to the mainland culture has influenced the structure and the dynamics between single-parent families and the extended Puerto Rican family. More specifically, it explored in what ways the traditional shared childrearing responsibilities between single-parent families and extended family have been adapted to fit with the mainland culture. In addition, it explored the aspects of the traditional shared childrearing responsibilities that remain functional. The results suggest that first generation and second generation Puerto Rican female heads of household are quite similar in how the extended family network is involved in the shared child-rearing practices.

The relationship of culture and healthcare plays an important role in the success of health care access for everyone. In recent decades, the United States has opened its door to welcome not only refugees and immigrants from Europe, but also from other countries all over the world. Coming to the United States, these ethnic groups must overcome many problems to adjust to the American healthcare system. Meanwhile, American health providers not only misunderstand their refugees and immigrant clients' culture, but also want them to conform to the requirement of purely biomedical treatment. The result is that access to healthcare for immigrant groups in the United States is likely to be difficult because of significant cultural differences between the clients and healthcare provider. This research used in depth-interviews, participant observations, and a case study to explore the interaction between culture and healthcare for Vietnamese refugee and immigrant adults and elderly living in the Greater Springfield, Massachusetts area; the level of their involvement in the American healthcare and in traditional healthcare; the extent of integration of American healthcare and traditional healthcare; the obstacles they face in accessing and using American healthcare; and the importance of health education in successful healthcare access. Theories of acculturation, such as Models of Acculturation (Padilla, 1980) and Health Care System Model (Kleinman, 1978a) were used to process the study data to determine the extent of the influence of culture on the effectiveness of healthcare. Finally, based on data analysis, I explain how Vietnamese refugee and immigrant adults and elderly acculturate to the American healthcare system, and make recommendations for improving healthcare for them, as well as for other ethnic groups throughout America.

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