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Objectives: This paper provides new estimates of disability prevalence for the archipelago and mainland-residing Puerto Rican populations ages 40 and above and compares disability by place of birth and place of residence to investigate drivers of middle and older age health. Methods: Large nationally representative samples from 2013 to 2017 American Community Survey and Puerto Rico Community Survey data are used to estimate age-specific disability prevalence for archipelago-born/archipelago-residing, archipelago-born/mainland-residing, mainland-born/mainland-residing Puerto Ricans. Results: Mainland-born/mainland-residing Puerto Ricans have the lowest age-adjusted disability rates and archipelago-born/archipelago-residing Puerto Ricans have the highest rates. Differences in education explain part of this disparity. Discussion: Similarities in disability prevalence are strongest based on where one was born as opposed to current residence, pointing to early life as a critical period in the disablement process for later-life health. Early life socio-economic disadvantage on the archipelago may have an enduring impact on later-life disability prevalence for archipelago-born Puerto Ricans. [ABSTRACT FROM AUTHOR]

This mixed-methods paper describes the development and preliminary validation of the Behavioral Intentions Questionnaire (BIQ), a multi-scale questionnaire developed to assess determinants influencing Puerto Rican adolescents' intentions to engage in abusive behaviors in dating relationships. Items were developed qualitatively, and face and content validity were established by expert and target population judges via semi-structured interviews (n = 48), discussions, and four focus groups (n = 6 each). The questionnaire was pilot tested twice. An initial pilot test was conducted with students aged 13 to 17 from a private alternative education program in San Juan, Puerto Rico (n = 32). A second pilot test was conducted with a sample of students from the same site (n = 22), in addition to students in the same age range from a private school (n = 88) in San Juan. Confirmatory and Exploratory factor analysis was used to determine construct validity and Cronbach's coefficient alpha determined the subscales internal consistency reliability. Correlations between subscales were examined. Thematic content analysis was used to analyze qualitative data. Qualitative data suggested the need to revise or eliminate items and instructions and incorporate a social desirability measure. Factor analyses yielded a unidimensional structure for each subscale and each subscale demonstrated high internal consistency. Preliminary analysis on the factor structure, internal reliability, and validity of the BIQ were encouraging. However, further psychometric testing is needed before this measure can be considered a useful tool for measuring intentions to engage in abusive behaviors in dating relationships. [ABSTRACT FROM AUTHOR]

ObjctivesSelf-rated health (SRH) is an important indicator of overall health, predicting morbidity and mortality. This paper investigates what individuals incorporate into their self-assessments of health and how acculturation plays a part in this assessment. The relationship of acculturation to SRH and whether it moderates the association between indicators of health and SRH is also examined. DesignThe paper is based on data from adults in the Boston Puerto Rican Health Study, living in the greater Boston area (n=1357) mean age 57.2 (SD = 7.6). We used multiple regression analysis and testing for moderation effects. ResultsThe strongest predictors of poor SRH were the number of existing medical conditions, functional problems, allostatic load and depressive symptoms. Poor SRH was also associated with being female, fewer years of education, heavy alcohol use, smoking, poverty, and low emotional support. More acculturated Puerto Rican adults rated their health more positively, which corresponded to better indicators of physical and psychological health. Additionally, acculturation moderated the association between some indicators of morbidity (functional status and depressive symptoms) and SRH.Self-assessments of overall health integrate diverse indicators, including psychological symptoms, functional status and objective health indicators such as chronic conditions and allostatic load. However, adults' assessments of overall health differed by acculturation, which moderated the association between health indicators and SRH. The data suggest that when in poor health, those less acculturated may understate the severity of their health problems when rating their overall health, thus SRH might thus conceal disparities. Using SRH can have implications for assessing health disparities in this population. [ABSTRACT FROM AUTHOR]

This paper is about naming illnesses--about who determines what categories are used and the implications of these determinations. The central concerns of medical/psychiatric anthropology have been to understand popular categories of and systems for classification of illness, to examine the relationship of illness categories to cultural understandings of the body, and to interpret the role of categories of illness in mediating between the personal and social spheres. At the same time, the paper also discusses the interplay of popular categories and psychiatric diagnoses. This paper examines the multiple experiences of nervios among Puerto Ricans in Puerto Rico and New York City. Our contention is that nervios is more than a diffuse idiom of distress, and that there are different categories and experiences of nervios which provide insights into how distress is experienced and expressed by Puerto Ricans and point to different social sources of suffering. The data in this paper come from the responses to a series of open-ended questions which tapped into people's general conceptions of nervios and ataques de nervios. These questions were incorporated into follow-up interviews to an epidemiological study of the mental health of adults in Puerto Rico. The results suggest ways to incorporate these different categories of nervios into future research and clinical work with different Latino groups in the United States and in their home countries. [ABSTRACT FROM AUTHOR]

Social discourses regarding gender are responsible for molding people's cognitions, perceptions, behaviors, and interactions with others. Approaching and understanding gender socialization is an important strategy that must be included in the development of HIV/AIDS prevention interventions efforts targeting male-to-female (MTF) transgender people. This paper represents an effort to identify the influence of gender construction among a group of MTF transgenders in Puerto Rico. Using combined methodology, authors examined results from a questionnaire and in-depth interviews with a convenience sample of MTF transgenders living in the San Juan metropolitan area. Quantitative analysis demonstrated that this sample is composed of young, unemployed, and under educated population. Many participated in the sex industry. Participants reported need for basic health and social services and alienation from social networks. Qualitative analysis confirmed their traditional social construction of the 'feminine.' Their discourse underlines their need to reinforce their identity by the construction of a female self which undermine their possibilities for negotiating safer sex, as happens to most females in Latino societies. Social vulnerability, institutional exclusion, and gender construction issues are obstacles for the HIV prevention efforts among these communities. [ABSTRACT FROM AUTHOR]

To systematically study and document regional variations in descriptions of nervios, we undertook a multisite comparative study of the illness among Puerto Ricans, Mexicans, Mexican Americans, and Guatemalans. We also conducted a parallel study on susto (Weller et al. 2002, Culture, Medicine and Psychiatry 26(4): 449-472), which allows for a systematic comparison of these illnesses across sites. The focus of this paper is inter- and intracultural variations in descriptions in four Latino populations of the causes, symptoms, and treatments of nervios, as well as similarities and differences between nervios and susto in these same communities. We found agreement among all four samples on a core description of nervios, as well as some overlap in aspects of nervios and susto. However, nervios is a much broader illness, related more to continual stresses. In contrast, susto seems to be related to a single stressful event. [ABSTRACT FROM AUTHOR]

Aim: To assess the validity of the translated Spanish Cancer Symptom Scale. Background: Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. Methods: The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test‐retest reliability) was evaluated. Results: All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from the Functional Assessment of Cancer Therapy‐General. Discriminant validity was demonstrated between those receiving chemotherapy and those from post treatment. The Spanish Cancer Symptom Scale internal consistency reliability was 0.98. Conclusion: The Spanish Cancer Symptom Scale has excellent evidence of validity and reliability for assessing cancer‐therapy‐related symptoms. SUMMARY STATEMENT: What is already known about this topic? The Cancer Symptom Scale English version has proven to be useful for symptom management research and is currently being used as a method to evaluate the effectiveness of interventions or palliative treatments in ameliorating cancer‐therapy related symptoms. What this paper adds? The Spanish Cancer Symptom Scale is a valid and reliable instrument for determining the symptom profile of Hispanic Puerto Rican patients undergoing cancer treatments. The implications of this paper: The Spanish Cancer Symptom Scale is an easy to answer numeric rating instrument that has the potential to be included in clinical practice settings to achieve a more comprehensive and objective assessment of the symptom experience. [ABSTRACT FROM AUTHOR]