Predictors of English Health Literacy among U.S. Hispanic Immigrants: The importance of language, bilingualism and sociolinguistic environment

In the United States, data confirm that Spanish-speaking immigrants are particularly affected by the negative health outcomes associated with low health literacy. Although the literature points to variables such as age, educational background and language, only a few studies have investigated the factors that may influence health literacy in this group. Similarly, the role that bilingualism and/or multilingualism play in health literacy assessment continues to be an issue in need of further research. The purpose of this study was to examine the predictors of English health literacy among adult Hispanic immigrants whose self-reported primary language is Spanish, but who live and function in a bilingual community. It also explored issues related to the language of the instrument. An analysis of data collected through a randomized controlled study was conducted. Results identified English proficiency as the strongest predictor of health literacy (p < 0.001). The results further point to the importance of primary and secondary language in the assessment of heath literacy level. This study raises many questions in need of further investigation to clarify how language proficiency and sociolinguistic environment affect health literacy in language minority adults; proposes language approaches that may be more appropriate for measuring health literacy in these populations; and recommends further place-based research to determine whether the connection between language proficiency and health is generalizable to border communities

Evaluating the disparity of female breast cancer mortality among racial groups - a spatiotemporal analysis

BACKGROUND: The literature suggests that the distribution of female breast cancer mortality demonstrates spatial concentration. There remains a lack of studies on how the mortality burden may impact racial groups across space and over time. The present study evaluated the geographic variations in breast cancer mortality in Texas females according to three predominant racial groups (non-Hispanic White, Black, and Hispanic females) over a twelve-year period. It sought to clarify whether the spatiotemporal trend might place an uneven burden on particular racial groups, and whether the excess trend has persisted into the current decade. METHODS: The Spatial Scan Statistic was employed to examine the geographic excess of breast cancer mortality by race in Texas counties between 1990 and 2001. The statistic was conducted with a scan window of a maximum of 90% of the study period and a spatial cluster size of 50% of the population at risk. The next scan was conducted with a purely spatial option to verify whether the excess mortality persisted further. Spatial queries were performed to locate the regions of excess mortality affecting multiple racial groups. RESULTS: The first scan identified 4 regions with breast cancer mortality excess in both non-Hispanic White and Hispanic female populations. The most likely excess mortality with a relative risk of 1.12 (p = 0.001) occurred between 1990 and 1996 for non-Hispanic Whites, including 42 Texas counties along Gulf Coast and Central Texas. For Hispanics, West Texas with a relative risk of 1.18 was the most probable region of excess mortality (p = 0.001). Results of the second scan were identical to the first. This suggested that the excess mortality might not persist to the present decade. Spatial queries found that 3 counties in Southeast and 9 counties in Central Texas had excess mortality involving multiple racial groups. CONCLUSION: Spatiotemporal variations in breast cancer mortality affected racial groups at varying levels. There was neither evidence of hot-spot clusters nor persistent spatiotemporal trends of excess mortality into the present decade. Non-Hispanic Whites in the Gulf Coast and Hispanics in West Texas carried the highest burden of mortality, as evidenced by spatial concentration and temporal persistence

Estrategias de las tabaqueras para captar fumadores jóvenes en España: una revisión de los documentos internos

Fundamento: Las estrategias de las compañías tabaqueras para promocionar el tabaquismo y bloquear las políticas de control son un factor clave en el consumo de tabaco entre jóvenes. La documentos internos pueden ayudar a identificar estas estrategias, conseguir apoyo social para las políticas de control y planificar actuaciones de salud pública en España. Este estudio identificó y analizó documentos relacionados con las actividades que las tabaqueras realizaron durante los años 80 y 90 para mantener y aumentar el tabaquismo entre los jóvenes españoles. Métodos: Búsqueda electrónica por palabra clave de documentos internos de las compañías tabaqueras en la base de datos digital Legacy Tobacco Documents Library. Resultados: Se identificaron y revisaron más de 1.000 documentos internos, como cartas, mensajes, memorandos y otros documentos. En este análisis se incluyen 17 documentos directamente relacionados con el propósito del estudio. Conclusiones: Las tabaqueras financiaron y ejecutaron actividades de investigación, diseño, propaganda y manipulación política y social con el objetivo de mantener una alta incidencia y prevalencia de fumadores jóvenes en España. Estas actividades pueden haber influido en las actuales cifras de tabaquismo

An Interdisciplinary Theory-Based ESL Curriculum to Teach English as a Second Language

Among Hispanic immigrants in the United States (US), learning English is considered necessary for economic and social achievement. Asa consequence, there is a high demand for English as a Second Language (ESL) classes. Despite the recognized benefits of ESL programs,both at the individual and social levels, more research is needed to identify education strategies that effectively promote all aspects of learningEnglish as a second language. This article describes an ESL curriculum that incorporates a theory-based pedagogical approach specificallydesigned for immigrant Hispanic adults on the US-Mexico border region. The article also describes the implementation of the curriculum aswell as the results of the evaluation, which was conducted using both quantitative and qualitative methods. Quantitative results indicate thatthe participants significantly improved their English proficiency (L2). Qualitative results suggest that participants were positively impactedby both the content and pedagogical approaches used by the curriculum. Their experience with the ESL class was positive in general. It canbe concluded that the curriculum achieved its objective. This approach could serve as a model for second language teaching for adult

Un currículo interdisciplinario de base teórica para enseñar inglés como segunda lengua1

Among Hispanic immigrants in the United States (US), learning English is considered necessary for economic and social achievement. As a consequence, there is a high demand for English as a Second Language (ESL) classes. Despite the recognized benefits of ESL programs, both at the individual and social levels, more research is needed to identify education strategies that effectively promote all aspects of learning English as a second language. This article describes an ESL curriculum that incorporates a theory-based pedagogical approach specifically designed for immigrant Hispanic adults on the US-Mexico border region. The article also describes the implementation of the curriculum as well as the results of the evaluation, which was conducted using both quantitative and qualitative methods. Quantitative results indicate that the participants significantly improved their English proficiency (L2). Qualitative results suggest that participants were positively impacted by both the content and pedagogical approaches used by the curriculum. Their experience with the ESL class was positive in general. It can be concluded that the curriculum achieved its objective. This approach could serve as a model for second language teaching for adults.Para los inmigrantes hispanos de los Estados Unidos (EEUU) aprender inglés (L2) es considerado necesario para progresar y funcionar en la sociedad, y hay una gran demanda de clases de inglés como segunda lengua o English as a Second Language (ESL). A pesar del reconocido beneficio individual y social de los programas de ESL, todavía se debe potenciar la investigación de estrategias educativas eficaces en los diferentes aspectos del aprendizaje del inglés como segunda lengua. Este artículo describe una estrategia pedagógica de base teórica incorporada en un currículo de ESL para hispanos inmigrantes adultos en la frontera entre EEUU y México. Igualmente el presente artículo describe la implementación y evaluación del currículo mediante métodos cuantitativos y cualitativos. Los resultados cuantitativos indican que los participantes mejoraron significativamente su nivel de L2. Además, los resultados cualitativos sugieren que los participantes recibieron satisfactoriamente tanto el contenido como la metodología pedagógica del currículo, y en general declararon haber tenido una experiencia positiva con la clase. Este trabajo podría servir de modelo para la enseñanza de una segunda lengua para adultos

Tobacco control: are we appropriately training future professionals?

http://www.thefreelibrary.com/Tobacco+control%3a+are+we+appropriately+training+future+professionals%3f-a0152885719Information on how health professionals perceive tobacco use as well as their attitudes toward tobacco control is scarce. This study assessed the attitudes and perceptions of public health students toward tobacco use and tobacco control, which constitutes a necessary first step in designing effective training strategies. Although the majority of respondents agreed that tobacco use constitutes a relevant public health problem, they did not perceive tobacco control to be a public health priority. Academic institutions may not be properly training public health students, and may therefore be missing the opportunity to advance tobacco control at the national and global levels

Assessing the Readiness and Training Needs of Non-urban Physicians in Public Health Emergency and Response

Emergency readiness has become a public health priority for United States communities after the 9/11 attacks. Communities that have a less developed public health infrastructure are challenged to organize preparedness and response efforts and to ensure that health care providers are capable of caring for victims of terrorist acts. A survey was used to assess nonurban physicians’ prior experience with and selfconfidence in treating, and preferred training needs for responding to chemical, biologic, radiologic, nuclear, and explosive (CBRNE) cases. Data were collected through a mailed and Web-based survey. Although the response rate was calculated at 30%, approximately one third of the surveys were not able to be delivered. Most respondents reported never having seen or treated CBRNE-inflicted cases and were not confident in their ability to diagnose or treat CBRNE cases, but many were willing to participate in a state-led response plan. Almost half of the individuals had not participated in any related training but expressed interest in receiving training in small group workshops or through CD-ROM. These results provide potential direction for strategic preparedness planning for non-urban health care providers.Texas Department of Healt

Surveillance of the Colorectal Cancer Disparities Among Demographic Subgroups - A Spatial Analysis

To understand the extent of the demographic and geographic disparities, the present study examined colorectal cancer mortality in 15 demographic groups in Texas counties between 1990 and 2001. The study confirmed the excess mortality in some Texas counties found in the literature, identified 13 additional excess mortality regions, and found 4 health regions with persistent excess mortality involving several population subgroups. The study suggested that Health disparities of colorectal cancer mortality continue to exist in Texas demographic subpopulations. Health education and intervention programs should be directed to the at-risk sub-populations in the identified regions

Hispanic physicians' tobacco intervention practices: a cross-sectional survey study

BACKGROUND: U.S. Hispanic physicians constitute a considerable professional collective, and they may be most suited to attend to the health education needs of the growing U.S. Hispanic population. These educational needs include tobacco use prevention and smoking cessation. However, there is a lack of information on Hispanic physicians' tobacco intervention practices, their level of awareness and use of cessation protocols, and the type of programs that would best address their tobacco training needs. The purpose of this study was to assess the tobacco intervention practices and training needs of Hispanic physicians. METHODS: Data was collected through a validated survey instrument among a cross-sectional sample of self-reported Hispanic physicians. Data analyses included frequencies, descriptive statistics, and factorial analyses of variance. RESULTS: The response rate was 55.5%. The majority of respondents (73.3%) were middle-age males. Less than half of respondents routinely performed the most basic intervention: asking patients about smoking status (44.4%) and advising smoking patients to quit (42.2%). Twenty-five percent assisted smoking patients by talking to them about the health risks of smoking, providing education materials or referring them to cessation programs. Only 4.4% routinely arranged follow-up visits or phone calls for smoking patients. The majority of respondents (64.4%) indicated that they prescribe cessation treatments to less than 20% of smoking patients. A few (4.4%) routinely used behavioral change techniques or programs. A minority (15.6%) indicated that they routinely ask their patients about exposure to tobacco smoke, and 6.7% assisted patients exposed to secondhand smoke in understanding the health risks associated with environmental tobacco smoke (ETS). The most frequently encountered barriers preventing respondents from intervening with patients who smoke included: time, lack of training, lack of receptivity by patients, and lack of reimbursement by third party payers. There was no significant main effect of type of physician, nor was there an interaction effect (gender by type of physician), on tobacco-related practices. CONCLUSION: The results indicate that Hispanic physicians, similarly to U.S. physicians in general, do not meet the level of intervention recommended by health care agencies. The results presented will assist in the development of tobacco training initiatives for Hispanic physicians

Correlates of tobacco cessation counseling among Hispanic physicians in the US: a cross-sectional survey study.

BACKGROUND: Physician advice is an important motivator for attempting to stop smoking. However, physicians\u27 lack of intervention with smokers has only modestly improved in the last decade. Although the literature includes extensive research in the area of the smoking intervention practices of clinicians, few studies have focused on Hispanic physicians. The purpose of this study was to explore the correlates of tobacco cessation counseling practices among Hispanic physicians in the US. METHODS: Data were collected through a validated survey instrument among a cross-sectional sample of self-reported Hispanic physicians practicing in New Mexico, and who were members of the New Mexico Hispanic Medical Society in the year 2001. Domains of interest included counseling practices, self-efficacy, attitudes/responsibility, and knowledge/skills. Returned surveys were analyzed to obtain frequencies and descriptive statistics for each survey item. Other analyses included: bivariate Pearson\u27s correlation, factorial ANOVAs, and multiple linear regressions. RESULTS: Respondents (n = 45) reported a low level of compliance with tobacco control guidelines and recommendations. Results indicate that physicians\u27 familiarity with standard cessation protocols has a significant effect on their tobacco-related practices (r = .35, variance shared = 12%). Self-efficacy and gender were both significantly correlated to tobacco related practices (r = .42, variance shared = 17%). A significant correlation was also found between self-efficacy and knowledge/skills (r = .60, variance shared = 36%). Attitudes/responsibility was not significantly correlated with any of the other measures. CONCLUSION: More resources should be dedicated to training Hispanic physicians in tobacco intervention. Training may facilitate practice by increasing knowledge, developing skills and, ultimately, enhancing feelings of self-efficacy