![](media/image1.jpeg){width="3.2916666666666665in"
height="3.6354166666666665in"}**NINR Focus:**

**Hispanic Health**

*one in a series of focus papers on research directions and NINR-funded
research advances*

*Comparing the health profile of Hispanic people to that of the general
U.S. population reveals numerous disparities. Disproportionate numbers
of adult Hispanics suffer from high blood pressure, diabetes, arthritis,
and obesity. Children of Mexican descent are at special risk for growth
deficiency and related problems. Investigators funded by the NINR are
finding new ways of safeguarding the health of Hispanic men and women of
all ages, in urban and rural settings across the U.S.*

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## Addressing Hispanic Health Disparities

### Examples of NINR-funded Research Findings

-   **Self-Management of chronic conditions for older Hispanics.**
    Community health care workers led the Tomando Control de su Salud
    (Taking Control of Your Health) program for older Hispanics with a
    variety of chronic conditions. The weekly class sessions focused on
    healthy eating, exercise, relaxation, and family communication.
    Participants reported lower pain, fatigue, and distress, an increase
    in exercise, and a lower rate of physician and ER visits. *Lorig,
    Stanford University, 2003.*

-   Depression in Mexican American women. A survey of Mexican American
    women revealed that over half had depressive symptoms, and 28% were
    at high risk for depression, due mostly to alcohol use, marital
    status, and poverty. Those who had spent their childhoods in Mexico
    had lower levels of depression than those who came to the US during
    their childhood. A sense of mastery, life satisfaction, and
    resilience contributed to lower depression scores. *Lee, University
    of California at San Francisco, 2002.*

-   **HIV prevention for Adolescent Mothers.** Project CHARM, an HIV
    prevention program for minority adolescent mothers, consisted of
    class sessions using videos, role playing, and skill-building
    exercises that addressed HIV knowledge and safe sex practices. Young
    women in the intervention group showed significant gains in AIDS
    knowledge and in their intention to use condoms, and they reported
    fewer sex partners at a six-month follow-up. Including couples in
    the intervention may help sustain the health benefits.
    *Koniak-Griffin, UCLA, 2003.*

-   Delays in reporting Breast Cancer Symptoms. Factors that contribute
    to a delay in reporting self-discovered breast cancer symptoms among
    both Latino and black women included low income and lack of health
    insurance, lower education, and poor breast cancer knowledge.
    Decreasing the delay in reporting symptoms could help reduce breast
    cancer mortality in minority populations. *Facione & Dodd,
    University of California at San Francisco, 2002.*

-   Cultural Support for Mexican American Mothers. A nurse researcher
    who followed 20 Mexican American mothers during their pregnancy, and
    for two years after giving birth, found that strong family and
    cultural support exists for pregnant women regardless of the
    circumstances of the pregnancy. After birth, families tended to band
    together to allow for consistent childcare. Family and community
    support of pregnant women may help explain the higher rate of
    positive birth outcomes noted in this population. *Domain,
    University of Kansas, 2001.*

-   **Antibiotics use in a Hispanic community.** Interviews of over 600
    heads of households in a Hispanic community found that one third of
    the family members had been recently ill, and many took an
    antibiotic. However, most of the reported symptoms were viral in
    nature, for which antibiotics are ineffective. Antibiotics were
    available over-the-counter in local bodegas, and prescription
    medications were often saved and shared among family and friends.
    Teaching the proper use of medications will need to take into
    account language barriers and cultural practices. *Larson, Columbia
    University, 2004.*

-   Pain in children with leukemia. All of a group of Latino children
    with acute leukemia reported having pain, with the most common
    locations being the legs, abdomen, head or neck, and the back. The
    children described the pain as "uncomfortable" or "annoying". Pain
    management strategies of medication, massage, use of hot or cold
    compress, and sleep, helped to lower pain scores, while functional
    status remained high. *Van Cleve, Loma Linda University, 2004.*

-   **Lay health advisers and HIV prevention.** Nurses trained lay
    health advisers (LHAs) in HIV prevention for a Latino community.
    Many of the LHAs talked about HIV with their family and friends,
    helping to clear up misconceptions such as the fear of getting HIV
    through casual contact, and the belief that persons with HIV/AIDS
    are easy to identify. They encouraged the use of condoms, and urged
    testing for those with concerns about HIV exposure. The LHAs also
    helped others make clinic appointments and negotiate the public
    health care system. *McQuiston, University of North Carolina at
    Chapel Hill, 2003.*

-   Menopause beliefs of Latina women. Interviews with older Latina
    women about menopause beliefs revealed three common themes: 1)
    menopause can reorder the harmony and balance in life needed to
    maintain optimal health, 2) the "change of life" is a normal adult
    phase for women, and 3) this period is a time for women to reorient
    their lives to focus more on personal needs and desires. However,
    many lacked basic knowledge about the course of menopause and
    possible ways to manage symptoms. *Villarruel, University of
    Michigan, 2002.*

-   **Hearing protection for Mexican American workers.** Among Mexican
    American manufacturing workers, when hearing protective devices
    (HPDs) were required on the job, three-quarters reported regular
    use, but when HPDs were optional, only 27% used them. Interpersonal
    influences, education, and perceived health status contributed to
    the use of HPDs. Particularly among vulnerable minority populations,
    nurses need to promote occupational safety measures. *Kerr,
    University of Minnesota, 2002.*

-   Sexual Behaviors Among Latino Youths. A survey of Latino youths
    showed that, while 27% reported no forms of intimate contact at all,
    over 60% had kissed or held hands, around 30% had engaged in heavy
    petting, and 24% reported having had sexual intercourse. Second and
    third generation youths reported more intimate behaviors and sexual
    activity than those who were first generation immigrants. This
    exploratory study can help with interventions to delay initiation of
    intercourse and promote safe sex practices. *Villarruel, University
    of Michigan, 2002.*

-   **Nurse Home Visits for Adolescent Latina Mothers.** A group of
    mostly Latina adolescent mothers was followed from early in their
    pregnancy. Half received normal public health care, while the other
    half received an early intervention program (EIP) consisting of
    multiple home visits from a public health nurse to enhance maternal
    caretaking skills and socialization, and improve birth outcomes.
    Infants in the EIP required fewer total days of hospitalization. For
    the mothers, more continued their education, and fewer had repeat
    pregnancies. *Koniak-Griffin, UCLA, 2001.*

-   Translating an Advance Directive Questionnaire. The Life Support
    Preferences Questionnaire (LSPQ), a series of end-of-life vignettes
    to help stimulate discussion on life-support preferences, was
    translated into Spanish. Tests of the resulting LSPQ-S with both
    bilingual and Spanish-only subjects showed that few were aware of
    advance directives or had one in place. The Spanish-speaking
    respondents scored significantly higher for preferring
    life-sustaining treatment than an English--speaking sample. *Froman,
    University of Texas, Galveston, 2003.*

-   Prenatal stress affects pregnancy outcomes. A study of high-risk
    pregnant women, including low-income Hispanics, found that those
    with a pessimistic attitude experienced more stress during their
    pregnancy and delivered infants of lower birth weight. Optimistic
    women reported engaging in health behaviors linked to more positive
    birth outcomes. Maternal disposition may affect birth outcomes and
    fetal health as much as ethnicity or medical risk. *Lobel, State
    University of New York at Stony Brook, 2002.*

Revised 6/2004

The National Institute of Nursing Research (NINR) supports clinical and
basic research to establish a scientific basis for the care of
individuals across the life span. NINR-supported research seeks to
improve the management of patients during illness and recovery, reduce
the risks for disease and disability, promote healthy lifestyles, and
improve the clinical settings in which care is provided, including
problems encountered by families and caregivers. To accomplish its
mission, NINR provides grants to universities and other research
organizations and conducts intramural research and research training on
the campus of the National Institutes of Health. These efforts foster
multidisciplinary collaborations to ensure a comprehensive approach to
research on illness and disabling conditions. NINR emphasizes the
special needs of at-risk and underserved populations, and implementing
knowledge to reduce health disparities is an ongoing goal.

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