Behavioral & Community Health

Permanent URI for this communityhttp://hdl.handle.net/1903/2271

Prior to January 24, 2011, this unit was named the Department of Public & Community Health.

Browse

Now showing 1 - 2 of 2

The association of acculturation, social support, and alcohol use among Mexican American adults
(2008-04-22) McDowell, Margaret Ann; Atkinson, Nancy; Gold, Robert; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Background: The increasing diversity of the U.S. population and the tremendous growth of the elderly population in the U.S. pose a challenge for public health practice. Mexican Americans (MAs) comprise the largest U.S. Hispanic subgroup. Previous research has shown alcohol use among MA adults varies by sex, age, acculturation level, socioeconomic status, and other factors. Purpose: This study explored the association of social, cultural, and demographic factors among MA adults. Berry's acculturation model (1980) and social support theory provided the theoretical underpinnings for this study. Multiple proxy measures of acculturation were used: a 5 item language subscale, generation level, and length of time in the United States. The association of social support and alcohol use among MAs 60 years and older was assessed using NHANES social support interview data. Methods: A secondary data analysis of 1999-2004 National Health and Nutrition Examination Survey data was conducted with a nationally representative sample of 1,682 MAs 40 years of age and older. Psychometric testing was performed with a language use scale and social support index. Descriptive statistics and logistic regression analyses were conducted to examine the predictors of lifetime abstention and current alcohol use. Results: Acculturation was associated with lifetime abstention and current alcohol use among females. Lifetime alcohol abstention rates were higher among less acculturated females, and a majority of female current drinkers were light alcohol users. Among males, lifetime alcohol abstention rates were very low. Light or moderate alcohol use was reported by two-thirds of males. Socioeconomic status and marital status were predictive of heavier alcohol use among males. No association was observed between social support and alcohol use among older adults. Conclusions: The results from this study underscore the complexity of alcohol use behavior among MAs. The strong association of acculturation and alcohol use among MA women suggests that traditional alcohol norms are altered during the acculturation process. Alcohol use among MA men is more common and heavy use was associated with social and economic factors rather than acculturation. The study findings may be used to inform health promotion and alcohol intervention programs for MA adults.
Multilevel Factor Influence on Alternative Tobacco Product Use Among U.S. Foreign-Born Residents
(2022) Roh, Esther Jungmee; Fryer, Craig S; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
Background: In the United States, the use of alternative tobacco products (ATPs), such as e-cigarettes, cigars, little cigars, hookah, or smokeless tobacco, has been rising even as conventional cigarette smoking continues decreasing. Broadly speaking, smoking behaviors are influenced by multiple factors at the intrapersonal, interpersonal, organizational, and community levels, including individual harm perceptions toward ATPs, peer and family use of tobacco products, ATP marketing and promotions targeted at specific races and ethnicities and acculturation. However, data on ATP use among U.S. foreign-born residents are limited and factors influencing ATP use among this population are not yet well understood. The primary purpose of this dissertation was to understand multilevel factors, addressed in Social Ecological Model (SEM), that influence ATP use among U.S. foreign-born residents. Purpose: The aim of study one was to assess the association between acculturation, harm perceptions, and peer and family use of tobacco products, and ATP use among U.S. foreign-born residents using waves 3 and 4 of the Population Assessment of Tobacco and Health (PATH) Study. The aim of study two was to assess the association between acculturation, peer and family use of ATPs and exposure to ATP advertisements, marketing and promotions, and ATP use among U.S. foreign-born residents using the same dataset. The aim of study three was to obtain a deeper understanding of how multilevel factors influence ATP use among non-U.S. citizen Korean residents. Methods: In studies one and two, quantitative data analyses were conducted from 2,507 foreign-born adult residents using PATH waves 3 and 4. Chi-square test and multivariate logistic regressions were used, and moderation and mediation analyses were conducted. In study three, twenty-one non-U.S. citizen Korean residents who currently or formerly smoked or used any ATPs and were aged 18-39 years in District of Columbia (DC), Maryland (MD) or Virginia (VA) completed 60-minute semi-structured in-depth interviews. Interviews were transcribed verbatim, coded, and analyzed thematically. Findings: In study one, findings suggest that certain acculturation factors predicted current and lifetime ATP use among U.S. foreign-born residents. For example, less acculturated foreign-born residents in the U.S. perceived ATPs as very or extremely harmful to their health and were less likely to use ATPs compared to the U.S.-born counterparts. In study two, findings indicated that less acculturated foreign-born residents were less likely to have peer and family who use ATPs and to be exposed to ATP advertisements, marketing and promotions compared to the U.S.-born counterparts. In study three, e-cigarettes were the most popular ATPs with participants, followed by hookahs and heated tobacco products (specifically IQOS). Participants showed more ambivalence or regarded e-cigarettes and hookahs as less harmful than conventional cigarettes. Additionally, smoking initiation was influenced mainly by peers who smoked. Conclusion: Multiple factors at different determinant levels influence tobacco product use behaviors among U.S. foreign-born residents. Acculturation factors, along with harm perceptions, peer and family influence, and ATP advertisements, marketing, and promotions exposure, seem to influence ATP use among U.S. foreign-born residents. Implications: This research calls for culturally tailored interventions and smoking cessations for U.S. foreign-born residents. Future research should investigate multiple tobacco product use among foreign-born residents as well as how the country of origin influences ATP use behaviors.