Self-Reported Discrimination and Mental Health Status
Among African Descendants, Mexican Americans, and
Other Latinos in the New Hampshire REACH 2010 Initiative:
The Added Dimension of Immigration
American Journal of Public Health, October, 2006
This study examined whether racial discrimination was associated with mental health status
and whether this association varied by ethnicity and immigration status.
The study conducted secondary analysis of a community needs assessment conducted in 2002-2003
for the New Hampshire Racial and Ethnic Approaches to Community Health (REACH) initiative,
surveying African Descendents, Mexican Americans and other Latinos.
Mental health status was assessed with the Mental Component Summary (MCS12) of the SF-12
and discrimination was measured with questions related to goals, discomfort/anger, and health care.
The study found that reports of discrimination were associated with lowered MCS12.
Additionally, the strength of association between reporting of health care discrimination
and MCS12 was strongest for African Descendents, then Mexican Americans, then other Latinos.
This association may be explained by differences in nativity and duration in the United States.
Further, the association of discrimination with MCS12 was stronger for
less recent than more recent immigrants.
Discrimination may be an important predictor of poor mental health status.
Previous findings of decreasing mental health as immigrants acculturate might possibly be related to
experiences of racial discrimination.
[Download
the report: PDF file 163k]
Change for Life/Cambia tu Vida:
A health promotion program based on the stages of change model for
African Descendent and Latino adults in New Hampshire
Preventing Chronic Disease, July, 2006
Studies have shown that diabetes and cardiovascular disease can be controlled and prevented through the modification of behavioral risk factors. The Transtheoretical Model of behavior change, also known as the stages of change model, offers promise for designing behavior change interventions. However, this model has rarely been applied in group settings with minority communities. To address racial and ethnic disparities related to the risk for diabetes and cardiovascular disease, the New Hampshire REACH 2010 Initiative has designed and implemented Change for Life/Cambia tu Vida, a health promotion program based on the stages of change model for African descendent and Latino residents of southern New Hampshire. The program guides participants through the five stages of change and provides resources to support healthy behavior change. We also sponsor periodic class reunions that offer ongoing support to program graduates to help them maintain these healthy habits. This article describes curriculum development, participant feedback, and early pretest and posttest evaluation results from a standardized assessment.
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the report: PDF file 276k]
The Association between Self-Reported
Discrimination, Physical Health and Blood Pressure:
Findings from African Americans, Black Immigrants,
and Latino Immigrants in New Hampshire
Journal of Health Care for the Poor and Underserved, May, 2006
The relationship between perceived racial discrimination and both blood pressure and perceived physical health has been documented among African Americans. However, this association has not been well-studied for Black or Latino immigrants. We used multiple regression analysis with a cross-sectional sample of 666 African Americans, Black immigrants, and Latino immigrants in New Hampshire from the NH REACH 2010 Health Survey to assess the relationship between discrimination and measures of physical health and blood pressure. The study found evidence of a significant U-shaped relationship between discrimination and systolic blood pressure for all three cohorts. Evidence was also found supporting a negative linear relationship between discrimination and physical health. In addition, the association between discrimination and physical health was attenuated for Latinos compared to other the groups. Future research should evaluate how factors associated with acculturation or cumulative exposure to discriminatory stressors may impact the protective resources of immigrants.
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the report: PDF file 209k]
NH REACH 2010 Initiative: Hablemos de Diabetes Pilot Evaluation Report
April 26, 2006
The evaluation of the 2005 pilot of the Hablemos de Diabetes Program has shown its small group sessions
to be effective in educating Latinos about the risk factors associated with diabetes and hypertension.
The program succeeded in recruiting Latinos at risk for diabetes in that 40 percent of participants were
overweight and nearly as many were obese. For the evaluation,
the Latino staff of the NH REACH 2010 Initiative conducted pre-program assessments
with 114 adult participants and again over the telephone three months later.
Because these participants tend to be highly mobile,
the REACH team spent many hours locating just over half of them,
resulting in 64 completed telephone follow-up interviews.
Before the program, most participants already knew that obesity,
an unhealthy diet and family history are important risk factors for developing diabetes.
After attending an Hablemos de Diabetes session,
nearly all knew that one can develop diabetes at any age,
and most also knew that one can reduce their risk of developing diabetes through healthy
eating and exercise habits. The evaluation demonstrated that the Hablemos de Diabetes Program succeeded
in teaching Latinos at risk for diabetes about the disease, and that most participants retained
this knowledge three months after attending the program.
[Download
the report: PDF file 463k]
Disparities in Health:
Diabetes Prevention in New Hampshire
Issue Paper 2, September, 2005
This issue paper demonstrates disparities in risk factors for developing Type 2 Diabetes, as well as in treatment for those already diagnosed with the disease. The paper documents that women in African Descendent and Latino communities in Hillsborough are more likely to be overweight or obese than are women from the state of New Hampshire as a whole. Similarly, both men and women of African or Hispanic descent from are less like to be physically active than NH residents overall. Among those who have Type 2 Diabetes, Latinos are significantly less likely to receive the standard of medical care that can prevent serious complications such as blindness or amputations. The findings in this paper should serve as a wake up call for health care providers in our community,said the author, Chris Smith.
[Download
the report: PDF file 144k]
Disparities in Health:
A Growing Reality for New Hampshire
Issue Paper 1, January 19, 2005
[Download
the report: PDF file 183k]
Data Report
on the Health of African Descendents and Latinos
in Hillsborough County, New Hampshire
April 16, 2004
[Download
the report: PDF file 716k]
| The R & E Group has conducted a series
of successful research and evaluation projects on behalf
of a variety of clients. These projects include: |
|
| CLIENT: REACH 2010 Initiative; A project funded by the Centers of Disease Control and Prevention | PROJECT: Evaluation design, database construction, questionnaire development, data analysis, GIS mapping, data dissemination, and report writing for REACH 2010 Initiative, a project funded by the Centers of Disease Control and Prevention. |
| CLIENT: New Hampshire Bureau of Maternal and Child Health | PROJECT: "Focus Group Study on Minority Women’s Access to Prenatal Health Care in the City of Manchester, New Hampshire" |
| CLIENT: Woman to Woman program of the NHMHC | PROJECT: Evaluation design, database construction, questionnaire development, and data analysis. |
CLIENT: Manchester School Department's Even Start Program |
PROJECT: Evaluation design, database construction, questionnaire development, and data analysis. "Working with the R and E group to evaluate the process and progress of the Manchester Even Start program has been very helpful. The interviews conducted with staff and committee members, data analysis, component summaries and consequent recommendations for improvement have provided me with direction and focus for my efforts." - Kathy Anibal,
Project Coordinator
|
| CLIENT: Cultural Competency Group, program of NHMHC | PROJECT: The evaluation design, database construction, questionnaire development, and data analysis for a Title III cultural competency assessment. |
| CLIENT: Southern New Hampshire Area Health Education Center and the NH Department of Health and Human Services | PROJECT: "Perceptions
of Emergency Preparedness among Minority Communities
in Manchester and Nashua, New Hampshire: Knowledge,
Fear, Trust, and Sources of Information" "The report's recommendations will be extremely valuable in developing a training plan for communicating with providers and consumers about the perceptions about emergency preparedness in minority communities. Issues raised through this process will be used in prioritizing activities and allocating funding." -Paula
Smith, Director |