Demographics of Latino/Hispanic Community

1. Demographics of Latino/Hispanic Community

2. Statistics • 48,811,000 documented Latinos living in the United States • Average Household Income: $37,759 • Poverty rate: 26.6% (11.5% higher than the national average) • 37% of adult Latinos have not graduated from high school

3. Indicators of Health Status • Poverty • Food Insecurity • Education • Literacy • Immigration Status/Cultural Background • Health Care Access & Insurance Coverage

4. Leading Causes of Death • Cancer (21.1%) • Heart disease (20.9%) • Unintentional injuries (7.5%) • Diabetes (4.5%) • Other various causes (28%)

5. Topic: Childhood Obesity in Latino Community

6. Statistics • Children ages 2-19 at or above the 95th percentile • Mexican American: 20.9% • Non-Hispanic White Children: 14.5%

7. Factors Leading to Disparity in Obesity rates • Acculturation • Literacy & language barriers • Cultural weight perception • Feelings of social isolation • Psychological distress

8. Acculturation • Definition: “the degree to which individuals adopt the values, behaviors, lifestyle, and language of the mainstream culture.” • Evidence shows acculturation adversely affects diet and other healthy lifestyle characteristics. • Children of acculturated Hispanic families tend to have higher rates of overweight and obesity due to the adoption of the American lifestyle.

9. Acculturation Factors • Changes to Dietary Patterns and Behaviors • Media Exposure • Advertising • Sedentary Behavior • School • Traditional Food vs. American Food • Peer Pressure

10. Literacy and Language Barriers • Definition of Barrier: any condition that makes it difficult to make progress or achieve an objective. • Nearly 27 million Latinos in the United States speak Spanish. • 12.4 million report that they speak English less than “very well”. • Many Latino adults have limited Spanish literacy. • Literacy can affect understanding basic nutrition including food labels, medical and food preparation instructions and dietary plans.

11. Literacy and Language Barriers • Vocabulary • Vocabulary growth was much slower in homes where Spanish was the primary language. • Unless a student has a good vocabulary and adequate reading comprehension skills, a successful future in higher education is unlikely. • Communication Challenges • School • Health Care • Requesting Assistance

12. Cultural Weight Perception • Latino parents correlate chubby babies with health. • Overweight and Latino children underestimate their body size. • Overweight children are significantly more likely to become overweight adults. • Body Size Perception Study: • 40% underestimated body size

13. Social Isolation & Psychological Distress • Families usually live close by in their communities, rarely reaching out to others. • Isolation has negative impact on mental health status and quality of life. • Self-Esteem Study (5 Subscales) • Physical characteristics • Talents and skills • Psychological well-being • Relations with family • Relations with others

14. Psychological Distress • Factors • Teasing • Loneliness • Lack of physical activity (embarrassment of body image) • Stressful social experiences • Consequences: • Exacerbated psychosocial distress • Poor emotional well-being • Decreased academic achievement • Dangerous eating behaviors and weight management instability.

15. Mothers’ Child Feeding Practices (LMCFP) Study • Barriers to Healthy Eating • economic constraints • food pricing • food insecurity • lack of time • limited support and social networks • availability and access to healthy food • ease of access to fast food and ethnic restaurants • food advertising • sedentary lifestyles • neighborhood safety • reliance on television as an educational tool and babysitter

16. Multicomponent intervention program • Nutrition Education • Exercise • Gardening • Family Involvement • “Food, Fun, and Fitness” newsletters • Children with stronger parental support displayed lower levels of sedentary behavior after intervention

17. Study Conclusion • There are numerous factors and perceived barriers that have led to an increase in childhood obesity rates among Latinos • Further Studies Needed • Studies and intervention programs should specifically target children in the Latino community, and not the general population

18. PSA Goals & Objectives Goal: Increase intake of fruits, vegetables, and traditional foods among Hispanic children to decrease rates of childhood obesity and overweight. Behavioral Objectives: 1) After the PSA, children will be able to identify 2 fruits and vegetables that are healthy additions to a school lunch. 2) After the PSA, children will be able to select 2 traditional healthy foods that can be incorporated into their daily lunch. 3) After the PSA, children will be capable of packing a lunch with food from various food groups.

19. PSA Overall Nutrition Message: More fruits, vegetables, and traditional foods need to be incorporated into Hispanic children’s diets, in lieu of foods that are high in saturated fat, processed, and high in simple sugars.

20. PSA “Pack the Rainbow”

21. Evaluation Questions Survey Link: Survey Monkey 1. This PSA successfully communicates the overall nutrition message stated above. 2. After watching this PSA, children will be able to identify 2 fruits and vegetables that are healthy additions to a school lunch. 3. After watching this video, I feel that children will be able to select 2 traditional healthy foods that can be incorporated into their daily lunch. 4. After watching this PSA, I feel that children will be capable of packing a lunch with food from various food groups. 5. I feel that this PSA targets the Latino community.

22. Respondent Information • Sent YouTube Video to all Facebook friends and family members, specifically targeting Latino friends and family. • Sent YouTube Video to all Student Dietetic Association members. • Sent SurveyMonkey Link to same people. • Received 40 completed surveys from people of mixed genders, ages, education backgrounds, and ethnicities.

28. PSA Evaluation Results • Positive Feedback • “I loved your PSA and I did do the survey monkey and gave you top marks! Your message was very creatively composed and I feel you absolutely achieved your education goals!” • “So good! You all did great putting this together and I really like the  background music!” • Good job. I was impressed. Survey taken.

29. PSA Evaluation Results • Things to adjust for the “remake” • “I got the overall message to pack the rainbow but there was no explanation of the choices. She said we have rice and beans and just let them select from the table what they wanted but didn't explain what some of the rainbow options were, like broccoli, banana, lettuce, cabbage. I like it though. It was cute.” • “Cool effort! I think showing cooked meals and the veggies and fruits cut into fun and packable shapes would have made it a bit stronger...and the children should be helping to pack their own lunches!”

30. Ideas for “remake” • Have mother give a bit more detail about the food and what food groups the rice and beans fall into. • Have the children name a few of the fruits and vegetables on the counter as they place them directly into the lunch box. • If this were presented to a primarily Spanish speaking group, the majority of the presentation would be in Spanish.

31. References • Carlo, M. S., August, D., McLaughlin, B., Snow, C., Dressler, C., Lippman, D., Lively, T. J., White, C. E. (2008/2009). Closing the gap: addressing the vocabulary needs of English-language learners in bilingual and mainstream classrooms. Journal of Education. 189, (1 & 2). • CDC Grand Rounds: Childhood Obesity in the United States. (2011). MMWR: Morbidity & Mortality Weekly Report, 60(2), 42-46. • Colchamiro, R. & Kallio, J. (2011). Reaching Out to Those at Highest Nutritional Risk. In S. Edelstein (Ed.), Nutrition in Public Health: A Handbook for Developing Programs and Services (67-75). Sudbury, MA: Jones & Bartlett Learning. • Cong, Z., Feng, D., Liu, Y., & Esperat, M. (2012). Sedentary behaviors among Hispanic children: influences of parental support in a school intervention program. American Journal Of Health Promotion, 26(5), 270-280. • Dave, J. M., Evans, A.E., Saunders, K.W., et al. (2009). Associations among food insecurity of acculturation, demographic factors, and fruit and vegetable intake at home in Hispanic children. Journal of the American Dietetic Association, 109(4), 687-701. • Heron, M. (2012). Deaths: Leading Causes for 2009. National Vital Statistics Report, volume 61 (7), 2-90.

32. References • Fitzgerald, N. (2010). Acculturation, socioeconomic status, and health among Hispanics. Napa Bulletin, 34, 28-46. • Fitzgibbon, M. L. & Beech, B.M. (2009). The role of culture in the context of school-based BMI screening.Pediatrics, 124, S50-S62. • Gesell, S. B., Scott, T. A., Barkin, M. D. (2010). Accuracy of perception of body size among overweight Latino preadolescents after a 6-month physical activity skills building intervention. Clincal Pediatrics. 49 (4), 323-329. • Lind, C., Mirchandani, G. G., Castrucci, B., et al. (2012). The effects of acculturation on healthy lifestyle characteristics among Hispanic fourth-grade children in Texas public schools, 2004-2005. Journal of School Health, 82(4), 166-174. • Lindsay, A., Sussner, K., Greaney, M., & Peterson, K. (2009). Influence of social context on eating, physical activity, and sedentary behaviors of Latina mothers and their preschool-age children.Health Education & Behavior, 36(1), 81-96. doi:10.1177/1090198107308375. • Nowicka, P., Höglund, P., Birgerstam, P., Lissau, I., Pietrobelli, A. and Flodmark, C.-E. (2009), Self-esteem in a clinical sample of morbidly obese children and adolescents. ActaPaediatrica, 98: 153–158. doi: 10.1111/j.1651-2227.2008.01061.x • Ogden, C., Carroll, M., & Flegal, K. (2008). High body mass index for age among US children and adolescents, 2003-2006. JAMA: Journal Of The American Medical Association, 299(20), 2401-2405.

33. References • Ogden, C., Carroll, M., Curtin, L., Lamb, M., & Flegal, K. (2010). Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA: Journal Of The American Medical Association, 303(3), 242-249. doi:10.1001/jama.2009.2012 • Rompay, M., McKeown, N. M., Castaneda-Sceppa, C., et al. (2012). Acculturation and sociocultural influences on dietary intake and health status among Puerto Rican adults in Massachusetts. Journal of the Academy of Nutrition and Dietetics, 112(1), 64-74. • Sherrill, W., Crew, L., Mayo, R., Mayo, W., Rogers, B., & Haynes, D. (2005). Educational and health services innovation to improve care for rural Hispanic communities in the USA. Rural & Remote Health, 5(4), • Smith-Adcock, S., Daniels, M., Lee, S., Villalba, J., Indelicato, N. (2006). Culturally responsive school counseling for Hispanic/Latino students and families: The need for bilingual school counselors. Professional School Counseling. 10 (1), 92-101. • Steinsbekk, S., Jozefiak, T., Odegard, R., Wichstrom, L., (2009). Impaired parent-reported quality of treatment-seeking children with obesity is mediated by high levels of psychopathology. Qual Life Res. 18, 1159-1167. • The free dictionary website, http://www.thefreedictionary.com/language+barrier. Accessed 2012. • Windsor , S. W., Crew, L., Mayo R. M., Mayo, W. F., Rogers, B. L. & Haynes, D.F. (2005). Educational and health services innovatin to improve care for rural Hispanic communities in the US. Education for Health, 18 (3), 356-367.