Physical Activity and Risk of Small-for-Gestational-Age Birth Among Predominantly Puerto Rican Women

To estimate the association between multiple domains of physical activity and risk of small-for-gestational-age (SGA) birth. We utilized data from 1,040 participants in the Latina Gestational Diabetes Mellitus Study, a prospective cohort of predominantly Puerto Rican prenatal care patients in Massachusetts. Physical activity was assessed by bilingual interviewers using a modified version of the Kaiser physical activity survey in early (mean = 15 weeks) and mid pregnancy (mean = 28 weeks). Physical activity (i.e., sports/exercise, household, occupational, and active living) in pre, early and mid pregnancy was categorized in quartiles. SGA was classified as <10th percentile of birth weight for gestational age. Pre- and early-pregnancy physical activity were not associated with SGA. In multivariable analyses, women with high total activity in mid-pregnancy had a decreased risk of SGA [risk ratio (RR) = 0.42; 95% confidence interval (CI) 0.21–0.82; p _trend = 0.003] as compared to those with low total activity. Findings were similar for high household activity (RR = 0.69; 95% CI = 0.34–1.40; p _trend = 0.26), active living (RR = 0.63; 95% CI = 0.35–1.13; p _trend = 0.04), and occupational activity (RR = 0.79, 95% CI = 0.47–1.34; p _trend = 0.26). High levels of sports/exercise were associated with an increased SGA risk without a significant dose–response association (RR = 2.14, 95% CI 1.04–4.39; p _trend = 0.33). Results extend prior studies of physical activity and SGA to the Hispanic population.     

Depression During Pregnancy and Adverse Birth Outcomes Among Predominantly Puerto Rican Women

Maternal and Child Health Journal - Objectives To examine associations between depression and preterm birth and small-for gestational age (SGA) among women of predominantly Puerto Rican descent, a...     

Depressive Symptomatology in African-American, Dominican, Irish-American, and Puerto Rican Women

The present study examined the influence(s) of race/ethnicity, socioeconomic status, and substance abuse on depressive symptomatology in a sample of African-American, Dominican, Irish-American, and Puerto Rican women of child-bearing age. While the initial analyses indicated ethnic differences in depressive symptomatology, these differences, with the exception of the difference observed in positive affect, disappeared when socioeconomic status and substance use were controlled. Thus the observed differences between the four groups of women in overall CES-D scores, somatic complaints and negative affect resulted, in large measure, from the divergent socioeconomic circumstances of the four groups.     

A comparison of the fertility of Dominican, Puerto Rican and mainland Puerto Rican adolescents.

Data from three fertility surveys are used to examined the probabilities and determinants of adolescent births among Dominican and Puerto Rican women. Young women in the Dominican Republic are the most likely to have had a child by each year of age from 14 through 24, followed by young women on the Island of Puerto Rico; the probability of an early birth is lowest for Puerto Rican women on the U.S. mainland. Eighteen percent of Dominican women have had a child before their 18th birthday, compared with 13% of women living in Puerto Rico, and 10% of Puerto Rican women in metropolitan New York. The cumulative probabilities that Puerto Rican women will have borne a child before their 20th birthday are almost identical, whether the women live on the island or the U.S. mainland, but the difference between Puerto Rican and Dominican women widens. The order is reversed, however, in the analysis of premarital births: The probability of a premarital birth during adolescence is highest for Puerto Rican women in New York, and lowest for Dominican women. In a separate logistic regression analysis, education and age at first sexual intercourse are shown to be important determinants of adolescent fertility in all three populations.     

Migration and HIV risk behaviors: Puerto Rican drug injectors in New York City and Puerto Rico

OBJECTIVES: We compared injection-related HIV risk behaviors of Puerto Rican current injection drug users (IDUs) living in New York City and in Puerto Rico who also had injected in the other location with those who had not. METHODS: We recruited Puerto Rican IDUs in New York City (n = 561) and in Puerto Rico (n = 312). Of the former, 39% were "newcomers," having previously injected in Puerto Rico; of the latter, 14% were "returnees," having previously injected in New York. We compared risk behaviors within each sample between those with and without experience injecting in the other location. RESULTS: Newcomers reported higher levels of risk behaviors than other New York IDUs. Newcomer status (adjusted odds ratio [OR] = 1.62) and homelessness (adjusted OR = 2.52) were significant predictors of "shooting gallery" use; newcomer status also predicted paraphernalia sharing (adjusted OR = 1.67). Returnee status was not related to these variables. CONCLUSIONS: Intervention services are needed that target mobile populations who are coming from an environment of high-risk behavior to one of low-risk behavior.     

Prenatal and Perinatal Factors Associated with Breast-Feeding Initiation among Inner-City Puerto Rican Women

Objective To identify factors associated with the initiation of breast-feeding in a predominantly Puerto Rican population living in inner-city Hartford, Conn.Design Retrospective study of 144 Latino women (mean±standard deviation age=26.3±5.7 years) with children at least 1 year old but younger than 6 years old (mean±standard deviation age=3.0±1.2 years) at the time of the survey. Women were recruited from agencies sponsoring health programs for mothers and children. They were interviewed in their homes (69%) or at the Hispanic Health Council, Hartford, Conn (31%).Subjects/setting Low-income Latino women who had at least 1 preschooler at the time of the interview. The women lived in inner-city Hartford, and the overwhelming majority were Puerto Rican and received welfare assistance and food stamps. Seventy-eight percent of the women chose to be interviewed in Spanish; the other 22% were interviewed in English.Statistical analyses Explanatory variables that related to breast-feeding initiation (P≤.2) in bivariate χ² analyses were entered into a multivariate logistic regression model that was reduced using backward stepwise elimination procedures.Results Multivariate analyses indicated that breast-feeding the previous child, shorter length of maternal residence in the United States, not receiving prenatal bottle-feeding advice, more recent birth, and higher birth weight were positively associated with breast-feeding initiation. A major reason for choosing not to breast-feed was that women felt socially uncomfortable doing it.Applications Breast-feeding initiation was more likely in Latino women who received prenatal breast-feeding counseling and postpartum support. Mothers of low-birth-weight infants and women breast-feeding for the first time may need additional help. These findings can be used by programs like the Special Supplemental Nutrition Program for Women, Infants, and Children to increase breast-feeding initiation. J Am Diet Assoc. 1998;98:657–663.     

Health and Well-Being of Childbearing Women in Rural and Urban Contexts

As part of the national focus on women's health issues, it is important to identify those health-related characteristics of rural women that distinguish them from women living in urban settings. The aim of this study was to compare rural and urban childbearing women on socioeconomic characteristics, perceived stress, health-related practices, illness symptoms, parenting confidence, and body weight. One hundred sixty-five midwestern women responded to a health survey sent to them six months after childbirth. Rural women were younger and less educationally and economically advantaged compared to urban women. Before adjusting for these differences, rural women were less self-actualized, more interpersonally isolated, and reported less healthy nutrition than urban women. These differences disappeared when socioeconomic differences were adjusted. Rural and urban mothers did not differ in most other areas, including perceived stress, parenting confidence, and body weight. Compared to national norms, the perceived stress levels of both rural and urban mothers were significantly higher than a probability sample of U.S. women. Findings support the role of socioeconomic factors as contributing to risk of poor health promotion among rural childbearing women.     

Substance Use and HIV Risk in a Sample of Severely Mentally Ill Puerto Rican Women

Latinos, and Puerto Ricans in particular, have been disproportionately impacted by HIV/AIDS. Severe mental illness (SMI) is associated with an increase in HIV risk. Relatively little research has focused on the role of SMI among Puerto Rican injection drug users (IDUs) and non-IDUs in susceptibility to and transmission of HIV and there are few published reports on HIV risk among Latina SMI. We conducted a longitudinal mixed methods study with 53 Puerto Rican women with schizophrenia, bipolar disorder, or major depression to examine the cultural context of HIV risk and HIV knowledge, beliefs, and behaviors among a larger study with Puerto Rican and Mexican women with serious mental illness (SMI). There was a high prevalence of past and current substance use and a high prevalence of substance use-associated HIV risk behaviors, such as unprotected sexual relations with an IDU. The violence associated with substance use frequently increased participants’ HIV risk. Choice of substance of abuse depended on cost, availability, and use within the individual participant’s network. Participants attributed their substance use to the need to relieve symptoms associated with their mental illness, ameliorate unpleasant feelings, and deaden emotional pain. HIV prevention interventions for poorer Puerto Rican women with SMI must target the individuals themselves and others within their networks if the women are to be supported in their efforts to reduce substance use-related risk. The content of any intervention must address past and current trauma and its relationship to substance use and HIV risk, as well as strategies to prevent HIV transmission.     

Herbal medicine in the Puerto Rican community.

This article focuses on one aspect of health in the Puerto Rican community in the United States--the continuing utilization of herbal medicine and folk healers in the prevention and cure of illness. In addition to providing a fundamental explanation of this system of healing, the author makes recommendations for increasing the satisfaction of Puerto Rican patients with health care services.     

Factors Associated with Risk of Perinatal Depressive Symptoms Among Puerto Rican Women with Hyperglycemia

Maternal and Child Health Journal - Rates of perinatal depression and pregnancy hyperglycemia are higher in Hispanic women as compared to non-Hispanic white women. In turn, depressive symptoms may...     

Breastfeeding Ambivalence Among Low-Income African American and Puerto Rican Women in North and Central Brooklyn

This study explores low-income African American and Puerto Rican women’s conceptions and practices around breastfeeding. It examines the impact of such diverse factors as social constructions of the body, local mores around infant care, the practicalities of food availability, in the context of interactions with family members and friends, institutions, and others in women’s neighborhoods. The study employed ethnographic methods, including interviews and participant observation, with 28 families in two low-income Brooklyn neighborhoods. While women in this study felt that breastfeeding was the best way to feed their infants, their commitment turned to ambivalence in the face of their perceptions about the dangers of breast milk, the virtues of formula, and the practical and sociocultural challenges of breastfeeding. Women’s ambivalence resulted in a widespread complementary feeding pattern that included breast milk and formula, and resulted in short breastfeeding durations. Findings suggest the critical role of breastfeeding “ambivalence” in driving thought and action in women’s lives. Ambivalence erodes the permanence of breastfeeding intention, and makes feeding practices provisional. Ambivalence challenges breastfeeding promotion strategies, resulting in weakened public health messages and a difficult-to-realize public health goal.     

Diabetes prevalence among Puerto Rican adults in New York City, NY, 2000

This study assessed the prevalence of diagnosed diabetes and associated characteristics among Puerto Rican adults in New York City, NY, with a random-digit-dialed telephone survey with a dual-frame sampling design. Overall, 11.3% (95% confidence interval = 8.7%, 14.0%) had diagnosed diabetes; diabetes was significantly related to age, obesity, and family history; and the prevalence was high among those with the least education. This study showed the ability to obtain critically needed diabetes information from ethnic minorities at the local level.     

Psychosocial Correlates of HIV Sexual Protective Behavior Among Puerto Rican Women Residing in the Bronx,New York

In this study, correlates of HIV sexual protective behavior, in the form of condom use, were examined within a population of urban women identified as at increased heterosexual risk for HIV infection. Hierarchical regression analyses were used to analyze data collected via structured interviews for 187 Puerto Rican women recruited from the waiting areas of a comprehensive health clinic in the Bronx, New York. Increased condom use with primary partners was associated with higher levels of mastery, more non-Hispanic acculturation, and greater adherence to traditional female gender roles. Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self-efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.     

Comparing Two Approaches to Acquiring HIV-Risk Data from Puerto Rican Women with Severe Mental Illness

Renewed interest has been expressed by researchers in mixed-method assessment that employs both quantitative and qualitative techniques in an expansive style that utilizes a variety of tactics to address research questions. Participants consisted of Puerto Rican women with severe mental illness living in Cuyahoga County, Ohio. The women were shadowed over a 2-year period to observe and verify behaviors that were self-reported using standardized instruments in semi-structured interviews. Concurrent criterion-related validity was employed to determine the extent of the correlation between responses obtained from the two approaches. Forty-four percent of the women were diagnosed with major depression and the mean overall GAF score was 58.5 ± 14.5. A comparison of the data collected using the different methodologies revealed that inconsistent and contradictory responses are not uncommon. The mixed-method design provided a more complete way of obtaining HIV-risk behavior data. Researchers and clinicians could benefit from mixed methods research that can provide greater opportunities to obtain data of a sensitive nature.