Exploring how bicultural and assimilated children of Mexican origin influence their Latina mothers' diet: Perspectives from mothers and children

Social and cultural factors influence dietary intake and behaviors. Research shows that mothers consume a lower quality diet when they have a child who is assimilated to the US culture versus bicultural. The purpose of this study was to qualitatively compare how bicultural and assimilated children influenced their culturally traditional mothers' dietary intake/behaviors. Separate one-on-one interviews with 21 Mexican-origin mothers and their bicultural (n = 11) or assimilated (n = 10) children (10–13 years old) were conducted. We used framework analysis to reduce qualitative data to themes and subthemes. Data were analyzed separately and then compared between mothers of bicultural versus assimilated children. Mothers of bicultural children reported typically having an easier time consuming a better quality diet than mothers of assimilated children. For example, although all children requested non-traditional foods, bicultural children were typically more accepting of their mothers preparing traditional healthier foods than assimilated children. Furthermore, mothers believed their children's food preferences both influenced and were influenced by their own feeding styles. Mothers of bicultural children described using more “Mexican” (i.e., authoritative) feeding styles that they believed shaped their children's palate into preferring traditional foods. Mothers of assimilated children explained that their children's preference for non-traditional foods resulted in their use of more permissive or indulgent feeding styles. Longitudinal research is needed to test and confirm the directionality between feeding styles and child's food preferences. Interventions may need to consider the reciprocal influences between mothers' feeding styles, children's food preferences, and how children influence their mothers' dietary intake/behavior

Effects of Latino children on their mothers' dietary intake and dietary behaviors: The role of children's acculturation and the mother-child acculturation gap

Rationale Research shows that acculturation is important to Latinas' dietary intake and related behaviors. Although evidence suggests children may also play a role, it remains unclear whether children's acculturation is related to mothers' dietary intake/behaviors. Objectives We examined the relationship between Latino children's acculturation and mothers' dietary intake/behaviors. We also examined the mother-child acculturation gap to identify dyad characteristics associated with mothers' diet. Methods Baseline surveys were collected in 2010 from 314 Latino mother-child (7–13 years old) dyads of Mexican-origin enrolled in a family-based dietary intervention in Southern California, USA. Mother's daily intake of fruits, vegetables, and sugary beverages, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were assessed via self-report. Mothers' and children's bidimensional acculturation were examined using acculturation groups (e.g., assimilated, bicultural) derived from Hispanic and non-Hispanic dimensions of language. We also assessed the acculturation gap between mothers and children with the a) difference in acculturation between mothers' and children's continuous acculturation scores and b) mother-child acculturation gap typologies (e.g., traditional mothers of assimilated children). Results Findings show that having an assimilated versus a bicultural child was negatively associated with mothers' vegetable intake and positively associated with mothers' sugary beverage intake, percent of calories from fat, and frequency of away-from-home eating, regardless of mothers’ acculturation. Traditional mothers of assimilated children reported more sugary beverage intake, calories from fat, and more frequent away-from-home eating than traditional mothers of bicultural children. Conclusion Results suggest that children's acculturation is associated with their mothers' dietary intake/behaviors and traditional mothers of assimilated children require more attention in future research

The relationship between patient-provider communication and quality of life for children with asthma and their caregivers

Objective: This study examined whether patient-provider communication is associated with asthma-related quality of life (QOL) and asthma outcomes among children with asthma and their caregivers. Methods: Children ages 8-16 years with asthma and their caregivers (n=296) were recruited at five pediatric practices in North Carolina. Children and caregivers reported demographic and clinical characteristics immediately after an audio-taped medical visit with their health care provider. During a home visit that took place 1 month after the medical visit, children and caregivers reported asthma-related QOL, and caregivers reported child asthma outcomes, including asthma symptom days and missed school days. Generalized estimating equations were used to determine whether patient-provider communication during the medical visit was associated with child and caregiver QOL and child asthma outcomes 1 month later. Results: On average, providers asked caregivers 4.5 questions and asked children 3 questions per visit, whereas caregivers and children asked less than 1 question per visit. Providers asked children more asthma-related questions, caregivers reported better QOL and fewer asthma symptom days 1 month later. Children and caregivers with higher asthma-management self-efficacy at the office visit reported better QOL 1 month later. Conclusions: Mirroring national guideline recommendations, our results suggest that providers should ask children about their asthma during medical visits. Future longitudinal studies should conduct mediation analyses to determine whether asking children asthma-related questions during medical visits increases children's asthma management self-efficacy and ultimately improve outcomes, such as QOL, health care utilization, symptom days and missed school days

Family environment, children's acculturation and mothers' dietary intake and behaviors among Latinas: An autoregressive cross-lagged study

Background: Many Latinos in the U.S. do not meet dietary recommendations for healthy eating. Family systems theory posits that the family environment affects family members' dietary behaviors. Moreover, research suggests that children's acculturation is associated with Latina mothers' dietary intake and behaviors. Purpose: This longitudinal study examined the effect of the family environment on Latina mothers’ dietary intake and behaviors. Further, we examined whether these effects differed between mothers of assimilated versus bicultural children. Methods: Secondary data were collected at three time points (baseline, and four and 10 months' post-baseline) from 162 culturally traditional and bicultural Latina mothers residing in Imperial County, California, U.S. Participants were enrolled in the delayed treatment group of a randomized controlled trial. Mothers' daily fruit, vegetable, and sugary beverages intake, percent of calories from fat, weekly away-from-home eating, and percent of weekly grocery dollars spent on fruits and vegetables were examined. The family environment was measured by family expressiveness and family interactions around food. Separate autoregressive cross-lagged models examined the effects of the family environment on dietary outcomes, adjusting for sociodemographic variables. Interactions between the family environment and children's acculturation were also tested. Results: Less positive family interactions around food at baseline predicted more frequent away-from-home eating four months later among mothers of assimilated children. More family expressiveness at four months predicted more grocery dollars spent on fruits and vegetables at ten months among mothers of bicultural children. Conclusions: Findings suggest the importance of a positive family environment on socially-bound dietary behaviors (e.g., away-from-home eating) exhibited by the mother. Family interventions aimed at improving dietary intake and associated behaviors should promote a positive family environment around food and consider the moderating role of children's acculturation

Examining the Support Peer Supporters Provide Using Structural Equation Modeling: Nondirective and Directive Support in Diabetes Management

Background: Little research has examined the characteristics of peer support. Pertinent to such examination may be characteristics such as the distinction between nondirective support (accepting recipients’ feelings and cooperative with their plans) and directive (prescribing “correct” choices and feelings). Purpose: In a peer support program for individuals with diabetes, this study examined (a) whether the distinction between nondirective and directive support was reflected in participants’ ratings of support provided by peer supporters and (b) how nondirective and directive support were related to depressive symptoms, diabetes distress, and Hemoglobin A1c (HbA1c). Methods: Three hundred fourteen participants with type 2 diabetes provided data on depressive symptoms, diabetes distress, and HbA1c before and after a diabetes management intervention delivered by peer supporters. At post-intervention, participants reported how the support provided by peer supporters was nondirective or directive. Confirmatory factor analysis (CFA), correlation analyses, and structural equation modeling examined the relationships among reports of nondirective and directive support, depressive symptoms, diabetes distress, and measured HbA1c. Results: CFA confirmed the factor structure distinguishing between nondirective and directive support in participants’ reports of support delivered by peer supporters. Controlling for demographic factors, baseline clinical values, and site, structural equation models indicated that at post-intervention, participants’ reports of nondirective support were significantly associated with lower, while reports of directive support were significantly associated with greater depressive symptoms, altogether (with control variables) accounting for 51% of the variance in depressive symptoms. Conclusions: Peer supporters’ nondirective support was associated with lower, but directive support was associated with greater depressive symptoms