Dataset Information

Refining acculturation measures for health research: Latina/o heterogeneity in the National Latino and Asian American Study.

ABSTRACT: Objectives: This study factor analyzes six scales relating to acculturation and related experiences among a nationally representative sample of United States-residing Latina/os (n = 2,541) from the National Latino and Asian American Study (NLAAS), using measurement invariance (MI) testing to explore differences in latent constructs by Latina/o subgroup.

Methods: Factor Analysis (FA) within an Exploratory Structural Equation Modeling framework was used to analyze the factor structure of six scales measuring acculturation and related experiences (i.e., acculturation [language use and preference], enculturation [ethnic identity], discrimination, neighborhood context, and family environment). We tested for MI by two important Latina/o subgroups: ethnic heritage and generational status.

Results: The underlying latent factors resulting from FA strongly aligned with the NLAAS subscales. No scale achieved full MI, yet the degree to which MI held varied greatly by scale and by subgroup.

Conclusions: Findings show that Latina/os are heterogeneous, but that this often depends on the construct and subgrouping of interest. Future research should use these scales in a latent framework, accounting for the lack of MI, to ensure that the underlying acculturative constructs of interest are validly measured when investigating their association with mental health outcomes in this population.

SUBMITTER: Roth KB

PROVIDER: S-EPMC7723201 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Refining acculturation measures for health research: Latina/o heterogeneity in the National Latino and Asian American Study.

Roth Kimberly B KB Musci Rashelle J RJ Eaton William W WW

International journal of methods in psychiatric research 20200826 4

<h4>Objectives</h4>This study factor analyzes six scales relating to acculturation and related experiences among a nationally representative sample of United States-residing Latina/os (n = 2,541) from the National Latino and Asian American Study (NLAAS), using measurement invariance (MI) testing to explore differences in latent constructs by Latina/o subgroup.<h4>Methods</h4>Factor Analysis (FA) within an Exploratory Structural Equation Modeling framework was used to analyze the factor structure ...[more]

PMID: 32845559

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Project description:This cross-sectional study aims to better understand the heterogeneous associations of acculturation level on CV risk factors among disaggregated Asian subgroups. We hypothesize that the association between acculturation level and CV risk factors will differ significantly by Asian subgroup. We used the National Health Interview Survey (NHIS), a nationally representative US survey, years 2014-18. Acculturation was defined using: (a) years in the US, (b) US citizenship status, and (c) level of English proficiency. We created an acculturation index, categorized into low vs. high (scores of 0-3 and 4, respectively). Self-reported CV risk factors included diabetes, high cholesterol, hypertension, obesity, tobacco use, and sufficient physical activity. Rao-Scott Chi Square was used to compare age-standardized, weighted prevalence of CV risk factors between Asian subgroups. We used logistic regression analysis to assess associations between acculturation and CV risk factors, stratified by Asian subgroup. The study sample consisted of 6,051 adults ≥ 18 years of age (53.9% female; mean age 46.6 [SE 0.33]). The distribution by race/ethnicity was Asian Indian 26.9%, Chinese 22.8%, Filipino 18.1%, and other Asian 32.3%. The association between acculturation and CV risk factors differed by Asian subgroups. From multivariable adjusted models, high vs. low acculturation was associated with: high cholesterol amongst Asian Indian (OR=1.57, 95% CI: 1.11, 2.37) and other Asian (OR=1.48, 95% CI: 1.10, 2.01) adults, obesity amongst Filipino adults (OR= 1.62, 95% CI: 1.07, 2.45), and sufficient physical activity amongst Chinese (OR= 1.54, 95% CI: 1.09, 2.19) and Filipino adults (OR=1.58, 95% CI: 1.10, 2.27). This study demonstrates that acculturation is heterogeneously associated with higher prevalence of CV risk factors among Asian subgroups. More studies are needed to better understand these differences that can help to inform targeted, culturally specific interventions.

Project description:BackgroundEthnic minorities with depression are more likely to seek mental health care through primary care providers (PCPs) than mental health specialists. However, both provider and patient-specific challenges exist. PCP-specific challenges include unfamiliarity with depressive symptom profiles in diverse patient populations, limited time to address mental health, and limited referral options for mental health care. Patient-specific challenges include stigma around mental health issues and reluctance to seek mental health treatment. To address these issues, we implemented a multi-component intervention for Asian American and Latino American primary care patients with depression at Massachusetts General Hospital (MGH).Methods/designWe propose a randomized controlled trial to evaluate a culturally appropriate intervention to improve the diagnosis and treatment of depression in our target population. Our goals are to facilitate a) primary care providers' ability to provide appropriate, culturally informed care of depression, and b) patients' knowledge of and resources for receiving treatment for depression. Our two-year long intervention targets Asian American and Latino American adult (18 years of age or older) primary care patients at MGH screening positive for symptoms of depression. All eligible patients in the intervention arm of the study who screen positive will be offered a culturally focused psychiatric (CFP) consultation. Patients will meet with a study clinician and receive toolkits that include psychoeducational booklets, worksheets and community resources. Within two weeks of the initial consultation, patients will attend a follow-up visit with the CFP clinicians. Primary outcomes will determine the feasibility and cost associated with implementation of the service, and evaluate patient and provider satisfaction with the CFP service. Exploratory aims will describe the study population at screening, recruitment, and enrollment and identify which variables influenced patient participation in the program.DiscussionThe study involves an innovative yet practical intervention that builds on existing resources and strives to improve quality of care for depression for minorities. Additionally, it complements the current movement in psychiatry to enhance the treatment of depression in primary care settings. If found beneficial, the intervention will serve as a model for care of Asian American and Latino American patients.

Dataset Information

Refining acculturation measures for health research: Latina/o heterogeneity in the National Latino and Asian American Study.

Publications

Refining acculturation measures for health research: Latina/o heterogeneity in the National Latino and Asian American Study.

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