School of Public Health
Permanent URI for this communityhttp://hdl.handle.net/1903/1633
The collections in this community comprise faculty research works, as well as graduate theses and dissertations.
Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.
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Item Examining the Food-Insecurity Obesity Paradox among Latino Immigrants(2019) Amador, Maria Aileen; Garza, Mary A; King-Marshall, Evelyn C; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Obesity is linked to chronic illnesses such as type 2 diabetes, cardiovascular disease, and some cancers (breast, kidney, and liver). Food insecurity refers to lack of access to nutritious and safe food. Latinos are a rapidly growing population in the US with higher levels of food insecurity than the national average, and higher obesity rates than non-Latino white adults. The “food insecurity-obesity” is a paradoxical relationship seen in rising obesity and correspondingly high food insecurity rates. We examined demographic factors, acculturation, stress, dietary habits, and food access among Latina immigrants to understand this paradox. This sub-analysis (n=128) found that education level (p=0.03) and marital status (p=0.08) were significantly and marginally significantly associated with food security level. Additionally, this analysis helped to better describe a population that lacks research. A better understanding of the “food insecurity-obesity” paradox and related factors will inform future culturally-tailored interventions to address obesity among Latina immigrants.Item Birth Outcomes of Immigrant and Native-born Hispanic Women: Role of Prenatal Care Utilization and Participation in the Women, Infants and Children (WIC) Program(2015) Sana, Hoda; Koblinsky, Sally; Hofferth, Sandra; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)In recent years, immigration to the U.S. from Central America and Mexico has increased substantially. This trend is evident in Prince George’s County, Maryland, which has growing numbers of both Hispanic immigrants and native-born Hispanic Americans. From 2011 to 2012, the infant mortality rate among Hispanics in Prince George’s County rose from 3.0 to 5.5 per 1,000 live births. The County lacked information about how birth outcomes were related to immigrant/native-born status and utilization of maternal health services, including receipt of adequate prenatal care and participation in the Women, Infants and Children (WIC) program. Previous studies have found that immigrant Hispanic women have better birth outcomes than native-born women (the “Hispanic Paradox”), but it is not known whether this pattern occurs in Prince George’s County. This study examined the association between immigrant status and two birth outcomes: preterm birth and infant low birth weight (LBW). It focused on how Hispanic women’s immigrant status (immigrant/native-born) was related to their use of prenatal care and WIC participation, as well as the association between these maternal health services and two infant birth outcomes. A major goal of the study was to assess whether or not adequate prenatal care and WIC participation mediated the relationship between women’s immigrant status and birth outcomes. Data from the 2011-2012 birth certificates of 4,971 Hispanic women in Prince George’s County were used to test study hypotheses. Findings revealed that native-born Hispanic women were significantly more likely to obtain adequate prenatal care than their immigrant peers, while immigrants were significantly more likely to enroll in WIC. Adequate prenatal care failed to predict either preterm birth or infant LBW, but WIC enrollment was significantly associated with lower likelihood of infant LBW. Consistent with the Hispanic Paradox, immigrant Hispanic women had significantly better birth outcomes than their native-born peers. WIC participation partially mediated the relationship between immigration status and infant LBW. Approximately 7% of the association between being an immigrant and reduced infant LBW was explained by WIC participation. Findings may assist policymakers and practitioners in designing interventions to reduce negative birth outcomes in Prince George’s County, Maryland, and the nation.Item "Sin Querer Queriendo": Exploring The Factors Associated With Pregnancy Prevention And Pregnancy Intention Among Latino Youth In Montgomery County(2010) Martinez-Garcia, Genevieve; Atkinson, Nancy; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)This study seeks to determine the factors that influence pregnancy desire and pregnancy prevention behavioral intentions among Latino youth. One out of two Latino girls in the U.S. will become pregnant before they turn 20. A pregnancy significantly hinders a teen's ability to pursue an education and develop professionally, and places an undue economic burden on the family. In order to appropriately address the factors that fuel teen birth rates, it is imperative to study behavioral, social, and cultural dynamics associated with pregnancy prevention and sexual behavior in the local Latino community. This study utilized the Theory of Planned Behavior (TPB) to explore factors associated with pregnancy prevention behaviors, namely abstinence, condom use, and birth control pill use. The study specifically addresses attitudes, subjective norms, and perceived behavioral controls of Latino adolescents/teens regarding three pregnancy prevention behaviors. The Pregnancy Wantedness Scale was designed to specifically measure pregnancy attitudes among youth. The study answered three main questions: 1) What are the characteristics of Latino youth who desire a pregnancy during their adolescent years?; 2) Are pregnancy prevention behavioral intentions associated with pregnancy wantedness?; and 3) Are attitudes, subjective norms and perceived behavioral control associated with pregnancy prevention behavioral intentions? A questionnaire was designed in English and Spanish using input from local community stakeholders. A total of 949 Latino youth were recruited using a central location intercept approach. Univariate and multiple linear regression analyses were used to answer the three research questions. Analyses were conducted separately for males and females with some and no sexual experience. Psychometric studies and factor analysis were conducted to assess the reliability and underlying structure of the scale. This study found that multiple demographic, familial and acculturation factors influenced youth's pregnancy intentions. For most groups, pregnancy wantedness was mostly influenced by youth's religion salience, acculturation level and living with a parent. Only condom use intention was associated with lower pregnancy wantedness for males. Perceived behavioral control and parental norms was positively associated with increased behavioral intentions across all three behaviors for most groups. This study suggests that practitioners should be aware of the gender, sexual experience and acculturation level of Latino youth when designing education interventions. Moreover, the findings of this study suggest that strengthening parental role and communication will protect youth from desiring a pregnancy and motivate them to use contraception effectively.Item The Prevalence and Role of Avoidance Coping Methods for Latinos in the United States(2009) Stevenson, Tiffani Debra; Leslie, Leigh A; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Current research concerning Latinos in the United States has indicated that they are at a higher risk for mental illness (e.g., PTSD) than other racial/ethnic groups. The purpose of this study was to understand the possible function a culturally normative coping style plays in the occurrence of depression for Latinos when compared to other racial/ethnic groups. The prevalence of avoidance coping methods and the relationship of depression and avoidance coping was examined for a sample (N=429) of Latino (n=129) White (n=150) and Black (n=150) clients. Results indicated that the frequency with which Latinos engaged in avoidance coping was no different than other groups. However, Black participants were significantly more likely to use avoidance coping that White participants. Furthermore, the use of defensive avoidance coping was linked to high depression; however there was no race/ethnicity by avoidance coping interaction. The empirical and clinical implications of these findings are discussed.