Purpose of the Study: The purpose of this study was to test an investigator-developed culturally relevant eating disorder assessment tool, the Risk Assessment of Eating Disorders (RAED), for eventual clinical application in assessing eating disorders in Hispanic women. This study also examined clinical guidelines, developed by the investigator to guide providers in using culturally appropriate behaviors during the assessment process.Research Questions: 1. What do Hispanic women identify and endorse as relevant areas of assessment for detection of potential eating disorders? 2. What culturally competent questions and provider behaviors or interactions do Hispanic women endorse as enabling them to volunteer specific information about their eating disorders? Background: Although some knowledge exists regarding appropriate and effective assessment questions to detect eating disorders, clinicians lack a culturally relevant and brief tool for use in primary care. Literature on existing assessment instruments and the Theory of Cultural Marginality informed development of the tool and guidelines.Method: Five Hispanic females with diagnosed eating disorders completed the RAED tool and scored items for relevance and clarity. This was followed by interviews and discussions with participants concerning perceptions of provider behaviors that enable or inhibit women reporting specific disordered eating behaviors to providers. Results: The results supported relevance and clarity of a 14-item RAED for assessing eating disorders. Seven clinical guidelines were developed on culturally appropriate provider behaviors to help Hispanic women volunteer specific information on their eating disorder behaviors. Discussion: A shorter assessment was developed for eventual use in advance practice nursing. The participants also identified provider behaviors including empathy, a non-judgmental attitude, and being willing to sit down with the patients, as enabling them to speak up about their eating disorder. The Theory of Cultural Marginality was useful in developing the RAED items and Provider Guidelines for assessment. Continued research of the RAED and clinical guidelines was recommended to provide adequate empirical support for use of the assessment tools and theory by advance practice nurses in primary care of Hispanic women, as well as all women with eating disorders.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.

INTRODUCTION: The importance of prenatal care is a well-established principle in the field of obstetric care. Inconsistent, poor and/or inadequate prenatal care is associated with a wide range of poor health outcomes including, pre-term labor, low-birth weight infants and maternal mortality. Hispanic women, specifically migrant/seasonal farmworkers, face a variety of barriers to early and effective prenatal care including: language barriers, poverty, transportation and frequent mobility. Northeast Tennessee has grown to include a robust Hispanic community. Rural Medical Services (RMS), a provider of primary care in rural Tennessee, has developed and implemented a prenatal care outreach program for the local Hispanic population. Through this program Hispanic pregnant women receive educational and clinical services ranging from prenatal education materials and at-home visits to translation services and Lamaze training. The purpose of the current study was to determine the impact of RMS’ prenatal outreach program on the birth outcomes of regional Hispanic mothers. METHODS: A retrospective medical file review using RMS electronic medical records as well as prenatal outreach program documents, including all patients that gave birth during 2013, was conducted. Independent variables included the mother’s age and ethnicity, identification as migrant/seasonal worker, weeks of gestation at first prenatal visit, number of prenatal visits, and number of prenatal outreach visits/contacts. Dependent variables included infant’s gestational age at birth (weeks), infant’s birth weight (oz.), and APGAR scores. RESULTS: In total, 213 women received care for pregnancies with expected due dates in 2013. Of those, birth outcomes data were available for 180. There was no significant difference in the incidence of low birth weight for infants of non-Hispanic and all Hispanic mothers (9.8% v. 4.3%; p=.14) nor was there a significant difference between Hispanic mothers who did not identify as migrant/seasonal farmworkers and those who did (5.1% v. 3.4%; p=.66). Likewise, there was no significant difference in the incidence of pre-term birth (<37 weeks) between non-Hispanic and Hispanic mothers (12.9% v. 8.5%; p=.35) nor was there a significant difference between Hispanic mothers who did not identify as migrant/seasonal farmworkers and those who did (6.7% v. 10.3%; p=.47). While the number of prenatal visits for Hispanic mothers was significantly correlated with birth weight (r=.35; p<.001) and gestational age at birth (r=.40; p<.001), the number of prenatal outreach visits was not significantly correlated with birth weight (r=.16; p=.08) or (r=.15; p=.10). CONCLUSIONS: The RMS prenatal outreach program has closed the prenatal care disparity gap between their Hispanic and non-Hispanic patients. However, there was no therapeutic advantage to an increased number of outreach visits, indicating RMS could standardize the program with a low frequency of visits.

No description available.

This study investigated significant influences including Hispanicness, traditionalism and demographic characteristics on Hispanic women's purchase behavior when selecting work and social activity apparel. A sample of 114 Hispanic women from a Hispanic professional organization or businesses in the Dallas and El Paso, Texas areas. Surveys were collected by mail or administered to subjects. Analyses included frequencies, percentages, t-tests, and Pearson's product-moment correlations. For both situations, mean scores indicated the most influential information sources were: clothing displays, friends, and female family members, while the most used acquisition sources were: department and specialty stores. In both situations, these women had very feminine appearance attributes and very feminine and fashionable clothing style. Hispanicness, traditionalism, and demographic characteristics made some difference when selecting work and social activity apparel.

Hispanic women in leadership are vastly understudied and little is known as to what factors influence their leadership aspirations and ultimately their career advancement. Mentoring has been found to have a positive influence on women’s perceptions of career advancement and the gender of the mentor plays a role (Tharenou, 2005). The purpose of this study was to examine how career-related mentoring influences the protegee’s career advancement and how the gender of the mentor may change that relationship. Furthermore, the relationship between psychosocial (emotional) support and the protegee’s leadership aspirations were examined, as well as the role of the mentor’s gender and ethnicity. In addition, negative factors, such as barriers to obtain a mentor and work family conflict, were also examined to determine how they may affect their leadership aspirations. Last, we also examined if social support moderates the relationship between work family conflict and leadership aspirations. The results indicated that career-related mentoring is positively related to career advancement and is moderated by the mentor’s gender. However, the relationship between psychosocial mentoring and leadership aspiration is positive, but not moderated by the mentor’s gender or ethnicity. It was found that work family conflict is negatively related to leadership aspirations, but not moderated by social support. A mixed method approach was used and the themes found in the qualitative data aligned with the quantitative findings. Both the theoretical and practical implications of the results for Hispanic women’s career aspirations and advanced are discussed

The purpose of this study was to determine the role of acculturation in the food consumption patterns of low income Hispanic women living in Texas and enrolled in the Women, Infants, and Children (WIC) Program by testing the following hypotheses: a) There are significant differences in consumption of fruit and vegetables by selected socio-demographic variables; and, b) less healthy food consumption patterns are associated with higher levels of acculturation in health-related research involving low-income Hispanic women living in Texas. A secondary-data analysis of the responses to the Texas Food & Nutrition (TEXFAN) questionnaire was performed. TEXFAN is a 122-item survey designed to measure WIC participants' consumption behaviors and to assess the impact of new food packages in Texas' WIC program. A total of 3,336 adult, non-pregnant women self-identified as having Hispanic ethnic background of all races were considered for this study. Analysis of Variance and Kruskal-Wallis tests showed significant differences in nutritional practices among Hispanic women for age, educational attainment, employment status, race, area of residence, and acculturation. Logistic Regression analysis confirmed the hypothesis that lower levels of acculturation are associated with healthier food consumption patterns. The majority of respondents (70.7%, N=2,358) did not consume the recommended five servings of fruits and vegetables a day; therefore, do not have healthy patterns of food consumption. Consequently, the majority of respondents (70.0%, N= 1,709) has a weight statuses above normal and at a higher proportion than women in the State of Texas and the nation. Acculturation continues to interest social and behavioral researchers but variations on conceptualization, definition, operationalization, and measurement negatively impact generalizability and applicability of results. Interventions not considering acculturation are not likely to be successful. Research has to include community, ecological, cultural and contextual factors (e.g., machismo, accessibility to sidewalks, availability of fresh healthy foods, etc.). Development of effective intervention programs should be aimed to increase consumption of healthy food and an adherence to the recommendations of the "Healthy Plate" and the "Dietary Guidelines for Americans 2010" among Hispanics. Also, interventions should generate necessary skills among Hispanics for empowering them to sustain proper nutritional behaviors and overcome barriers.

Few studies apply the Eriksonian model of identity formation to cross-cultural samples (3), even though issues of ethnicity and culture may inform a Hispanic woman’s self-concept (Phinney, 1996). Hispanic women may also be influenced by traditional gender role behaviors such as passivity or dependence that are outlined by marianismo (Stevens, 1973). A recent study of a multiethnic sample of emerging adult women and men found that purpose commitment mediated the effects of identity commitment on hope and life satisfaction (Burrow & Hill, 2011). The current research consists of two studies that replicate and expand upon the work of Burrow and Hill (2011). Study I replicated the work of Burrow and Hill (2011) among a sample of emerging adult Hispanic women, in order to assess the extent to which the original findings would replicate in a culturally distinct sample. Study II examined the role of marianismo, ethnic identity, and acculturation on identity commitment among emerging adult Hispanic women. Both studies utilized a sample of 532 female undergraduate psychology students, age 18 to 25, who self-identified as Hispanic and submitted data via online surveys. Both studies used self-report, quantitative data which was analyzed using structural equation modeling. Results from Study I indicated good model fit and replicated the findings from Burrow and Hill (2011). Specifically, the direct effect of identity commitment on hope was fully contingent upon an individual’s level of purpose commitment, while the effect of identity commitment on life satisfaction was not contingent upon an individual’s level of purpose commitment. Results from Study II indicated that marianismo, Spanish proficiency, familiarity with Latino culture, and familiarity with American culture demonstrated statistically significant direct effects on identity commitment among emerging adult Hispanic women. Results indicated cultural convergence regarding the association of an individual’s identity with well-being through a sense of purpose. Findings also revealed the role of cultural factors in the extent to which Hispanic women commit to a personal identity. Future studies should employ mixed method research designs as a means to better ascertain implications of findings.

A culturally-based theoretical model about how cultural beliefs about cancer and breast cancer screening techniques influence the screening behaviors of women of Mexican descent was developed using grounded theory. Across levels of acculturation and socioeconomic status, 34 women (49 to 81 years old) were interviewed through focus groups. Women who hold more traditional health beliefs about causes, nature, and responsibility with regard to breast cancer are more likely to "feel healthy" and not engage in breast cancer screening. Women who hold more traditional beliefs about propriety of female and health care provider behavior are more likely to "feel indecent" and also not engage in screening. The cultural health belief model is integrated within a sociocultural and a socioeconomic context.

No description available.