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Council for the Advancement of Nursing Science

Council for the Advancement of Nursing Science. 2012 National State of the Science Congress on Nursing Research. September 13-15, 2012 Washington Hilton Hotel Washington, DC. Effects of Acculturation and Literacy on Cardiovascular Health of Mexican-American Women.

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Council for the Advancement of Nursing Science

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  1. Council for the Advancement of Nursing Science 2012 National State of the Science Congress on Nursing Research • September 13-15, 2012 • Washington Hilton Hotel • Washington, DC

  2. Effects of Acculturation and Literacy on Cardiovascular Health of Mexican-American Women Viola G. Benavente, PhD, RN, CNS Assistant Professor Boston College Connell School of Nursing, Chestnut Hill, MA

  3. Funding Disclosures • Postdoctoral Fellowship • Biobehavioral Nursing Research Training Grant T32 NR007106 NINR/NIH, University of Washington, Seattle • Ruth L. Kirschstein National Research Service Award • Individual Predoctoral Fellowship to Promote Diversity in Health-Related Research, Grant F31 NR010847 NINR/NIH, University of Pennsylvania, Philadelphia • Xi Chapter Research Grant Award • University of Pennsylvania, Philadelphia, PA, Sigma Theta Tau International • Southeastern Pennsylvania Chapter Research Grant Award • American Association of Critical Care Nurses, Philadelphia, PA

  4. Purpose • To identify predictors associated with self-reported health-promoting lifestyle behaviors of Mexican-American women in the US for better cardiovascular health: • Coronary heart disease (CHD) Knowledge, Perceived health status, Acculturation level, & Literacy • To test a multivariate model of the effects of acculturation and literacy levels on cardiovascular health promotion

  5. Disease Prevention Risk Reduction CARDIOVASCULAR HEALTH PROMOTION Physical Activity Hypertension Heart-Healthy Nutrition Dyslipidemia Less Alcohol Obesity Weight Management Diabetes Mellitus Type 2 Smoking Cessation or Abstinence Lifestyle Modifications Therapeutic Management

  6. Significance of the Study • Higher CHD health risk • Linked to being “Mexican-American,” “female” and “obesity” • Burden of living with chronic CHD • Equal or greater among US Hispanics • Treatment disparities • Unevenness and injustice for women and underrepresented ethnic minorities Source: IOM, 2009; Christian, et al. 2007; AHRQ, 2005; OMH, 2006; Mosca, 2004

  7. Methods • Descriptive cross-sectional study design • Mexican-American women free of CHD diagnosis, but at-risk • Data collection protocol • 4 Spanish-translated measures & demographics • Enrollment from April 2009 to June 2010 • 6 Roman Catholic Churches in Northeastern US • Data analysis plan • Correlation analysis • Simple linear regression

  8. Summary of Findings • Greater tendency for cardiovascular health promotion behaviors in Mexican-American women was associated with: • More CHD knowledge • Better self-perceived health status • Higher acculturation levels • Increased literacy

  9. Correlation Matrixa a Pearson product moment correlation; * Correlation significant at .05 significance level; ** Correlation significant at 0.01 level (2-tailed).

  10. Demographic Effects • Age, income, and education had significant effects on predictor variables: • Knowledge differences between older and younger women were evident. • Older women were more knowledgeable about CHD. • Acculturated women earned higher incomes, were better educated, and had increased literacy.

  11. Pearson’s Correlations CHD Knowledge Predictor Variables Perceived Health Status Outcome Variable Key Demographic Variables .311** .298** Acculturation Level Health Promotion Lifestyle Behaviors Literacy .355** .202* .179* Age Income Education .416** .361** .246** -.398** * Correlation significant at .05 significance level; ** Correlation significant at 0.01 level (2-tailed).

  12. CV-Health Promotion Model CHD Knowledge Predictor Variables Perceived Health Status Outcome Variable Key Demographic Variables .298** .311** .305** .495** Acculturation Level Health Promotion Lifestyle Behaviors Literacy .202* .179* Income Age .416** .361** Education .246** .188* -.398** * Correlation significant at .05 significance level; ** Correlation significant at 0.01 level (2-tailed).

  13. Clinical Implications • In non-English-speaking populations, it is important to assess: • Language preference and literacy • Health knowledge and perceptions • Acculturation and related stress • Cultural orientation • Generational status • Length of US Residency

  14. Study Limitations • Causal inferences • Study not designed to identify cause and effect • Survey instruments • Paucity and quality of Spanish-language tools • Self-report • Accuracy of reading comprehension and memory recall • Group homogeneity • Can be a study strength

  15. Future Research Directions • Further explore causal pathway modeling analysis • Instrument refinement/development • Non-English-speaking populations • Intervention studies • Decrease CHD risk and cardiovascular health disparities among Hispanics • Culturally-tailored and sex-specific intervention testing

  16. Questions? Thank You! ¡Gracias! • Email: viola.benavente@bc.edu

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