Factor structure, internal consistency, and construct validity of the Caregiver strain questionnaire in Latinx families

Caregiver strain or stress directly related to caring for a youth with emotional and/or behavioral problems may be an important and understudied cultural factor associated with mental health disparities among Latinx families. Caregiver strain is a highly relevant construct for research questions focused on the identification of youth's mental health needs, family-level impacts of youth mental health problems, and utilization of youth mental health services. Unfortunately, there is a dearth of research on measures of caregiver strain and the psychometric properties of existing measures in Latinx samples. This study examined the structural and construct validity of the English version of the Caregiver Strain Questionnaire (CGSQ) with a sample of United States-based Latinx caregivers of youths ages 6-18 (N = 598). Confirmatory factor analysis showed that the original three-factor model of caregiver strain was evidenced in this sample. Internal consistency analyses and a poor factor loading led to the elimination of one item. The factor structure held after item removal. Significant associations between each dimension of caregiver strain with youth internalizing/externalizing symptom severity and utilization of youth mental health services provided evidence of construct validity (i.e., psychological counseling, telepsychology, parenting classes). Results provide important evidence of the psychometric properties of the English CGSQ in a Latinx sample and support its use in future research aimed at unpacking mental health disparities among Latinx youth and families. Researchers should translate and validate the CGSQ in Spanish to increase the utility of this measure for research with Latinx families.

Maternal Feeding Styles and Child Appetitive Traits: Direction of Effects in Hispanic Families With Low Incomes

Feeding styles of parents have been associated with dietary quality/intake and weight outcomes; however, much of the research to date has been cross sectional and the direction of influence unclear. This prospective longitudinal study evaluated the direction of effects between feeding styles and child appetitive traits over time in a sample of 129 Hispanic parent/child dyads that participated in a larger study. Data analyzed for the current study were collected when the children were 4–5 years old and again at ages 7–9 years. Parents (all mothers) reported on their feeding styles and children's appetitive traits using well-established questionnaires. Cross-lagged panel analyses were used to examine the direction of effects. Fully adjusted models revealed that a number of children's appetitive traits at baseline predicted later feeding styles. A bi-directional relationship was found between authoritarian feeding and satiety responsiveness such that higher satiety responsiveness was associated with authoritarian feeding and vice versa. Lower satiety responsiveness was associated with indulgent feeding, whereas higher food responsiveness was associated with authoritarian feeding. Results show preliminary evidence that children's appetitive traits may shape mothers' approach to child feeding. There is also preliminary support for the protective role of an authoritarian feeding style in the self-regulatory processes around child appetitive traits among this population of Hispanic families with low-income levels. These results warrant continued research given that other studies have shown beneficial outcomes for authoritarian feeding among ethnically diverse families with low incomes.

Reducing Obesogenic Eating Behaviors in Hispanic Children through a Family-Based, Culturally-Tailored RCT: Abriendo Caminos

Family-based interventions that incorporate culturally-tailored multi-component curricula and are grounded on evidence-based information and theoretical frameworks can help reduce the prevalence of obesity among Hispanic children. Abriendo Caminos: Clearing the Path to Hispanic Health is a multi-site culturally-tailored randomized control trial that aims to reduce obesity rates in Hispanic families by delivering education on nutrition, family wellness, and physical activity. This study evaluated the effect of the Abriendo Caminos six-week intervention on dietary behaviors of Hispanic children (6–18 years). Mothers (n = 365) reported their child’s eating behavior intake using the U.S. Department of Education’s Early Childhood Longitudinal Study protocol (ECLS). Pre/post dietary changes were evaluated using separate generalized estimating equation models adjusted for site, child sex, and child age group. Findings indicate a reduction in the frequency of sugar-sweetened beverages (OR 0.55, 95% CI 0.35, 0.87, p = 0.01), French fries (OR 0.56, 95% CI 0.36, 0.86, p = 0.009), and fast food (OR 0.55, 95% CI 0.36, 0.84, p = 0.006) consumption among children in the intervention arm. Additionally, children in the intervention arm increased their frequency of vegetable consumption (OR 1.84, 95% CI 1.08, 3.12, p = 0.03). The Abriendo Caminos intervention effectively improved four of eight eating behaviors in a short-term intervention.

Experiences of Hispanic Families with Social Services in the Racially Segregated Southeast: Views from Administrators and Workers in North Carolina

North Carolina-as a state in the racially segregated Southeast-offers a unique context to understand access to social services for Hispanic families and children. Theories of administrative burden posit that Hispanic families likely face high learning, compliance, and psychological costs. Hispanic families face challenges that compound these costs: limited English language and literacy proficiency, complex household composition, and citizenship status of family members and other household members. With new survey results and qualitative data on social service administrators and front-line workers, we examine how these costs may affect access to programs for Hispanic families who reside in a state with a history of racial divisions that have shaped local policy implementation. Some workers noted transportation barriers and complex application processes as limiting access. While we expected to find that Hispanic families may be disadvantaged by decentralized service delivery in a manner that is similar to the experiences of African American families, workers instead note significant resources that help facilitate Hispanic families' access to programs. Workers view national anti-immigrant policies and rhetoric, rather than state and local policy rules or resource constraints, as limiting their capacity to serve Hispanic families.

Maternal feeding style and child weight status among Hispanic families with low-income levels: a longitudinal study of the direction of effects

BACKGROUND

The home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child's role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children.

METHODS

The goals of this study were: 1) to examine if parental feeding styles during preschool (4-5 years) predict child weight status at 7-9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4-5), Time 2 (ages 5 ½-6 ½), and at Time 3 (ages 7-9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim.

RESULTS

An indulgent parental feeding style at ages 4-5 was associated with increased child BMI z-score at ages 7-9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3.

CONCLUSIONS

Indulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.

The experiences of Hispanic families of children with autism spectrum disorder regarding physical activity

BACKGROUND

Researchers seldom focus on the services needed for Hispanic children with ASD, especially in regard to physical activity (PA).

PURPOSE

The purpose of this study was: (a) to explore why Hispanic families with children with ASD seek out and participate in PA, and (b) to describe the strategies and supports needed by Hispanic families of children with ASD to improve PA participation.

METHODS

Participants in this descriptive-qualitative study were Hispanic parents of children with ASD (n = 9) who participated in one-on-one semi-structured telephone interviews. Interviews were transcribed and then analyzed using thematic line-by-line analysis.

RESULTS

Two major themes emerged from the data: 1) Personal Responsibility and 2) "Every Day is a Different Challenge". Parents were motivated to engage in PA because of perceived health benefits for themselves and their children. Parents faced famililal and external barriers that impacted their participation. Participants commented on the role of culture (e.g., customs, lack of family support after immigration) in the context of these barriers.

IMPLICATIONS

Further research is needed regarding culturally responsive PA interventions for Hispanic families with children with ASD.

Mealtime resistance: Hispanic mothers' perspectives on making healthy eating changes within the family

Several perceived barriers to healthy eating within the family (e.g., cost, lack of time, energy, accessibility) are documented. However, few studies have assessed Hispanic mothers' perceived barriers and strategies in implementing healthy eating changes in the family's meals. The primary goal of this qualitative study was to investigate Mexican and Puerto Rican mothers' barriers and strategies to creating healthy eating changes within the family at home. A sample of 46 Mexican-American and Puerto Rican mothers in California, Illinois, and Texas participated in this study. An average of 5 mothers participated in a focus group session in Spanish and completed a demographic survey. Focus group thematic analysis revealed that major barriers to implementing healthy eating changes within the family include child and spouse resistance as well as meal preparation time. The resistance mothers reported encountering magnify their meal preparation workload. Mothers shared that they sometimes prepared multiple meals in a single mealtime to please family members. Several strategies to promote healthy eating at home, including serving as role models, providing easy access to healthy food items at home, and not purchasing, or hiding, unhealthy food at home, were also discussed. The current study expands the existing literature by emphasizing the need to empower parents to make healthy changes within their family and the importance of taking fathers and children into account in programming so that the whole family is involved in making healthy changes.

Implementation and Evaluation of the Abriendo Caminos Program: A Randomized Control Trial Intervention for Hispanic Children and Families

OBJECTIVE

To describe the methodology of a family-focused, culturally tailored program, Abriendo Caminos, for the prevention of excess weight gain in children.

DESIGN

Randomized control trial with outcome assessment at pretest, posttest, and 6 months after intervention or abbreviated-attention control group.

SETTING

Community setting across 5 sites (Illinois, California, Iowa, Texas, and Puerto Rico).

PARTICIPANTS

Mexican American and Puerto Rican families (parent and 1 child aged 6-18 years). A sample size of 100 families (50 intervention and 50 control) per site (n = 500) will provide adequate power to detect intervention effects.

INTERVENTION

Families will participate in 6 weekly, 2-hour group workshops on nutrition education through combined presentations and activities, family wellness, and physical activity.

MAIN OUTCOME MEASURES

The primary outcome is prevention of excess weight gain in children; secondary outcomes include changes in child diet, specifically fruit, vegetable, and sugar-sweetened beverage consumption, and changes in parents' diets and improvement of family routines. Measures will be collected at baseline, postintervention, and 6 months after.

ANALYSIS

Modeling to assess changes within and between experimental groups will be checked using standard methods including assessment of model fit, influence diagnostics, adjusted R², and multicollinearity. Significance of effects will be examined using Type III tests.

Effects of Culturally Tailored Nutrition Education on Dietary Quality of Hispanic Mothers: A Randomized Control Trial

OBJECTIVE

To assess whether participation in a culturally tailored nutrition education program increases diet quality of Hispanic mothers.

DESIGN

A randomized controlled trial.

SETTING

Community centers and universities.

PARTICIPANTS

Sixty-five mothers (35 in experimental group, 30 in control group) completed pre- and postworkshop surveys. Eligibility criteria included being of Mexican or Puerto Rican descent and having a child between the ages of 6 and 18 years who could participate in the workshops with the parent.

INTERVENTION

Families in the experimental group participated in a 6-week workshop series that included weekly nutrition education classes.

MAIN OUTCOME MEASURE

Diet quality was assessed by the Rate Your Plate questionnaire.

ANALYSIS

Repeated measures ANOVA was used to compare differences between the experimental and control groups. A Wilcoxon signed rank test was conducted to test for significant shifts in categorization pre- and postprogram.

RESULTS

There was a significant change in diet quality categorization after participating in the workshops (P < .001, effect size 0.39). No changes were found in the control group.

CONCLUSIONS AND IMPLICATIONS

Abriendo Caminos was effective at increasing the diet quality of Hispanic mothers who participated the most in the program. More research is needed in this at-risk population to determine the relationships among nutrition knowledge, diet quality, and achievement of healthy weight.

The Benefits and Challenges of Managing Asthma in Hispanic Families in South Texas: A Mixed-Methods Study

Background

Understanding the experience of Hispanic parents of children diagnosed with asthma can be useful in the delivery of effective and meaningful asthma education. In order to assess the needs of Hispanic families with asthmatic children in South Texas, investigators utilized a combination of qualitative and quantitative research methods.

Objectives

This study aimed (1) to assess the impact of asthma in the quality of life of Hispanic children and their families and (2) to identify barriers and challenges to asthma management as perceived by parents of children diagnosed with asthma.

Methods

A mixed-methods study included a quality-of-life survey and focus group discussions. The Children’s Health Survey for Asthma (CHSA) was completed by 90 parents of children with asthma. Three focus groups were conducted with 15 low-income, Hispanic parents of asthmatic children to assess their needs and experience in managing the disease.

Results

Results from the CHSA showed that asthma significantly affects the quality of life of children with asthma and their families, particularly the emotional dimensions and the child’s physical health. Fifty-three percent of the children had visited the emergency room, and 51% had been hospitalized due to asthma. One out of five parents had missed work, and 27% of children had missed school in the past 2 weeks due to the child’s asthma. In the focus group discussions, the key themes emerging included lack of asthma knowledge, the burden of disease for asthmatic children and their families, and the importance of asthma education and self-management behaviors for asthma control.

Conclusion

One of the main challenges faced by Hispanic families with asthmatic children is the lack of asthma-related knowledge to help understand and control their children’s disease. Lack of knowledge and self-management skills lead to significant stress and anxiety among children with asthma and their parents. Results highlight that while asthma has an effect on the quality of life of children and their families, particularly on the emotional health domain, a wide dissemination of asthma management education in different settings might help prevent asthma attacks and improve symptom control among those suffering from this disease along the US–Mexico border.