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Council for the Advancement of Nursing Science. 2012 National State of the Science Congress on Nursing Research. September 13-15, 2012 Washington Hilton Hotel Washington, DC. Effects of Acculturation and Literacy on Cardiovascular Health of Mexican-American Women.

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council for the advancement of nursing science

Council for the Advancement of Nursing Science

2012 National State of the Science

Congress on Nursing Research

  • September 13-15, 2012
  • Washington Hilton Hotel
  • Washington, DC
effects of acculturation and literacy on cardiovascular health of mexican american women

Effects of Acculturation and Literacy on Cardiovascular Health of Mexican-American Women

Viola G. Benavente, PhD, RN, CNS

Assistant Professor

Boston College Connell School of Nursing, Chestnut Hill, MA

funding disclosures
Funding Disclosures
  • Postdoctoral Fellowship
    • Biobehavioral Nursing Research Training Grant T32 NR007106 NINR/NIH, University of Washington, Seattle
  • Ruth L. Kirschstein National Research Service Award
    • Individual Predoctoral Fellowship to Promote Diversity in Health-Related Research, Grant F31 NR010847 NINR/NIH, University of Pennsylvania, Philadelphia
  • Xi Chapter Research Grant Award
    • University of Pennsylvania, Philadelphia, PA, Sigma Theta Tau International
  • Southeastern Pennsylvania Chapter Research Grant Award
    • American Association of Critical Care Nurses, Philadelphia, PA
purpose
Purpose
  • To identify predictors associated with self-reported health-promoting lifestyle behaviors of Mexican-American women in the US for better cardiovascular health:
    • Coronary heart disease (CHD) Knowledge, Perceived health status, Acculturation level, & Literacy
  • To test a multivariate model of the effects of acculturation and literacy levels on cardiovascular health promotion
slide5

Disease Prevention

Risk Reduction

CARDIOVASCULAR HEALTH PROMOTION

Physical Activity

Hypertension

Heart-Healthy Nutrition

Dyslipidemia

Less Alcohol

Obesity

Weight Management

Diabetes Mellitus Type 2

Smoking Cessation or Abstinence

Lifestyle Modifications

Therapeutic Management

significance of the study
Significance of the Study
  • Higher CHD health risk
    • Linked to being “Mexican-American,” “female” and “obesity”
  • Burden of living with chronic CHD
    • Equal or greater among US Hispanics
  • Treatment disparities
    • Unevenness and injustice for women and underrepresented ethnic minorities

Source: IOM, 2009; Christian, et al. 2007; AHRQ, 2005; OMH, 2006; Mosca, 2004

methods
Methods
  • Descriptive cross-sectional study design
    • Mexican-American women free of CHD diagnosis, but at-risk
  • Data collection protocol
    • 4 Spanish-translated measures & demographics
    • Enrollment from April 2009 to June 2010
    • 6 Roman Catholic Churches in Northeastern US
  • Data analysis plan
    • Correlation analysis
    • Simple linear regression
summary of findings
Summary of Findings
  • Greater tendency for cardiovascular health promotion behaviors in Mexican-American women was associated with:
    • More CHD knowledge
    • Better self-perceived health status
    • Higher acculturation levels
    • Increased literacy
slide11

Correlation Matrixa

a Pearson product moment correlation; * Correlation significant at .05 significance level; ** Correlation significant at 0.01 level (2-tailed).

demographic effects
Demographic Effects
  • Age, income, and education had significant effects on predictor variables:
    • Knowledge differences between older and younger women were evident.
    • Older women were more knowledgeable about CHD.
    • Acculturated women earned higher incomes, were better educated, and had increased literacy.
pearson s correlations
Pearson’s Correlations

CHD Knowledge

Predictor Variables

Perceived Health Status

Outcome Variable

Key Demographic Variables

.311**

.298**

Acculturation Level

Health Promotion Lifestyle Behaviors

Literacy

.355**

.202*

.179*

Age

Income

Education

.416**

.361**

.246**

-.398**

* Correlation significant at .05 significance level; ** Correlation significant at 0.01 level (2-tailed).

cv health promotion model
CV-Health Promotion Model

CHD Knowledge

Predictor Variables

Perceived Health Status

Outcome Variable

Key Demographic Variables

.298**

.311**

.305**

.495**

Acculturation Level

Health Promotion Lifestyle Behaviors

Literacy

.202*

.179*

Income

Age

.416**

.361**

Education

.246**

.188*

-.398**

* Correlation significant at .05 significance level; ** Correlation significant at 0.01 level (2-tailed).

clinical implications
Clinical Implications
  • In non-English-speaking populations, it is important to assess:
    • Language preference and literacy
    • Health knowledge and perceptions
    • Acculturation and related stress
      • Cultural orientation
      • Generational status
      • Length of US Residency
study limitations
Study Limitations
  • Causal inferences
    • Study not designed to identify cause and effect
  • Survey instruments
    • Paucity and quality of Spanish-language tools
  • Self-report
    • Accuracy of reading comprehension and memory recall
  • Group homogeneity
    • Can be a study strength
future research directions
Future Research Directions
  • Further explore causal pathway modeling analysis
  • Instrument refinement/development
    • Non-English-speaking populations
  • Intervention studies
    • Decrease CHD risk and cardiovascular health disparities among Hispanics
    • Culturally-tailored and sex-specific intervention testing
questions
Questions?

Thank You!

¡Gracias!

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