Search

OBJECTIVE:Health literacy is critical for understanding information from health-care providers and correct use of medications and includes the capacity to filter other information in navigating health care systems. Older adults with low health literacy exhibit more chronic health conditions, worse physical functioning, and poorer mental health. This study examined the relationship between sociodemographic variables and health literacy, and the impact of cognitive training on change in health literacy over 10 years in older adults. METHODS:Participants (N = 2,802) aged 65 years and older completed assessments, including reading and numeracy health literacy items, as part of the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study. We evaluated baseline sociodemographic variables and change in health literacy over a 10-year period in individuals exposed to cognitive training in reasoning, processing speed, memory, or a no-contact control condition. RESULTS:Age, sex, race, education level, and general cognitive functioning at baseline were all associated with baseline health literacy in older adults. Predictors of change in health literacy over the 10-year follow-up were age, race, education level, general cognitive functioning, and neighborhood income; disparities in health literacy because of race attenuated over time, while the effect of age increased over time. Health literacy was generally stable across the ACTIVE intervention groups over 10 years. CONCLUSIONS:The present study showed important disparities in health literacy level and change over 10 years. Cognitive training did not significantly impact health literacy, suggesting that alternative approaches are needed to reduce the disparities.

Latinos currently account for 16% of the total U.S. population and are projected to account for 25% by 2050. Despite the growth in population, Latinos continue to experience discrimination based on their ethnicity. Prior research has found that ethnic discrimination is associated with adverse effects on mental health, including increased risk of depression. The present study investigated the relationship between perceived ethnic discrimination and past year depression among U.S.-born and foreign-born Latinos using data from the National Latino and Asian American Survey (NLAAS). It also examined how ethnic identity and family support mediated the relationship between ethnic discrimination and depression. Perceived ethnic discrimination was associated with an increased risk of depression for U.S.-born Latinos, but not for foreign-born Latinos. For U.S.-born Latinos, family support partially mediated the relationship between ethnic discrimination and depression. Although for foreign-born Latinos family support was inversely related to depression, mediation was not observed. However, exploratory analyses suggested that family support moderated this relationship. An effect of ethnic identity on depression was not detected in either subsample. These findings suggest that perceived ethnic discrimination contributes to Latino mental health in a complex manner that varies as a function of nativity. Significant clinical and public health implications are discussed.

Latinos currently account for 16% of the total U.S. population and are projected to account for 25% by 2050. Despite the growth in population, Latinos continue to experience discrimination based on their ethnicity. Prior research has found that ethnic discrimination is associated with adverse effects on mental health, including increased risk of depression. The present study investigated the relationship between perceived ethnic discrimination and past year depression among U.S.-born and foreign-born Latinos using data from the National Latino and Asian American Survey (NLAAS). It also examined how ethnic identity and family support mediated the relationship between ethnic discrimination and depression. Perceived ethnic discrimination was associated with an increased risk of depression for U.S.-born Latinos, but not for foreign-born Latinos. For U.S.-born Latinos, family support partially mediated the relationship between ethnic discrimination and depression. Although for foreign-born Latinos family support was inversely related to depression, mediation was not observed. However, exploratory analyses suggested that family support moderated this relationship. An effect of ethnic identity on depression was not detected in either subsample. These findings suggest that perceived ethnic discrimination contributes to Latino mental health in a complex manner that varies as a function of nativity. Significant clinical and public health implications are discussed.

Cultural adaptation factors likely influence health status and social mobility. Using data from the Corazón Life Journey Studies, cross-sectional interviews of immigrant Latino, U.S.-born Latino, and Non-Hispanic White adults (n=272), we investigated acculturation factors, social mobility, and health outcomes across four time points, elementary school, middle school, high school and current adulthood. Using growth mixture modeling, lifetime segmented assimilation trajectories were developed describing different acculturation and social mobility changes. A four-class model best described the data. Significant differences emerged among the ethnic groups. Family Traditionalism significantly predicted acculturations starting point and change over time. Initial acculturation values predicted social mobility. Differences were also found in health outcomes. Findings have implications for clinical work, research and policy. Early life experiences can influence social mobility later in life, affecting individuals' health. We encourage researchers to employ more complex models in order to reveal mechanisms underlying Latinos' and other ethnic groups' health inequities.

Verbal fluency tasks are used extensively in clinical settings because of their sensitivity to a wide variety of disorders, including cognitive decline and dementia, and their usefulness in differential diagnoses. However, the effects of bilingualism on neuropsychological assessment, and verbal fluency in particular, are currently not completely understood. There is an increasing need to examine bilingualisms role in assessing verbal fluency due to the rapidly growing Hispanic population within the United States. This study investigated the performance of bilingual Hispanics in phonemic fluency compared to monolingual European-Americans using the Controlled Oral Word Association Test (COWAT). Both the standard letters of 'F', 'A', and 'S' and alternative letters were tested in an attempt to find letters that would be linguistically and culturally fair for both monolinguals and bilinguals. Various aspects of bilingualism, such as language dominance and age of acquisition of a second language, as well as acculturative factors, were examined to determine their influences on phonemic fluency. Results revealed that both language dominance and age of acquisition heavily influence phonemic fluency performance for Hispanic bilinguals. Bilingual students who were English dominant or balanced bilingual scored on par with the monolingual students. Also, bilingual students who learned their second language by the age of six performed better than those who learned their second language later. The acculturative factors of social affiliation and ethnic identification affected performance as well. Early age of acquisition bilingual participants who were better acculturated to mainstream society scored higher in phonemic fluency than those who were not as well acculturated. These results pinpoint the clinical importance of obtaining a full linguistic background of a bilingual client in order to interpret verbal fluency performance accurately so that the client may be properly diagno

Cultural adaptation factors likely influence health status and social mobility. Using data from the Corazón Life Journey Studies, cross-sectional interviews of immigrant Latino, U.S.-born Latino, and Non-Hispanic White adults (n=272), we investigated acculturation factors, social mobility, and health outcomes across four time points, elementary school, middle school, high school and current adulthood. Using growth mixture modeling, lifetime segmented assimilation trajectories were developed describing different acculturation and social mobility changes. A four-class model best described the data. Significant differences emerged among the ethnic groups. Family Traditionalism significantly predicted acculturations starting point and change over time. Initial acculturation values predicted social mobility. Differences were also found in health outcomes. Findings have implications for clinical work, research and policy. Early life experiences can influence social mobility later in life, affecting individuals' health. We encourage researchers to employ more complex models in order to reveal mechanisms underlying Latinos' and other ethnic groups' health inequities.

Verbal fluency tasks are used extensively in clinical settings because of their sensitivity to a wide variety of disorders, including cognitive decline and dementia, and their usefulness in differential diagnoses. However, the effects of bilingualism on neuropsychological assessment, and verbal fluency in particular, are currently not completely understood. There is an increasing need to examine bilingualisms role in assessing verbal fluency due to the rapidly growing Hispanic population within the United States. This study investigated the performance of bilingual Hispanics in phonemic fluency compared to monolingual European-Americans using the Controlled Oral Word Association Test (COWAT). Both the standard letters of 'F', 'A', and 'S' and alternative letters were tested in an attempt to find letters that would be linguistically and culturally fair for both monolinguals and bilinguals. Various aspects of bilingualism, such as language dominance and age of acquisition of a second language, as well as acculturative factors, were examined to determine their influences on phonemic fluency. Results revealed that both language dominance and age of acquisition heavily influence phonemic fluency performance for Hispanic bilinguals. Bilingual students who were English dominant or balanced bilingual scored on par with the monolingual students. Also, bilingual students who learned their second language by the age of six performed better than those who learned their second language later. The acculturative factors of social affiliation and ethnic identification affected performance as well. Early age of acquisition bilingual participants who were better acculturated to mainstream society scored higher in phonemic fluency than those who were not as well acculturated. These results pinpoint the clinical importance of obtaining a full linguistic background of a bilingual client in order to interpret verbal fluency performance accurately so that the client may be properly diagno

Like racial and ethnic minorities, sexual minorities (lesbian, gay, and bisexual (LGB) people) are at increased risk for mental (Meyer, 2003; Hatzenbuehler, 2009) and physical (Conran, Mimiaga, & Landers, 2008; Gay and Lesbian Medical Association, 2010; Huebner & Davis, 2007) health problems compared to heterosexuals. The current study attempted to 1) determine if the stress related to discrimination mediated the relationship between discrimination and health and well-being for LGB people, and 2) and identify risk and resilience factors specific to LGB people that might moderate the relationship between discrimination related stress and LGB health, mental health and satisfaction with life. Three hundred and five people who self-identified as LGB completed an online survey. Thirty nine percent of participants self-identified as lesbian, 33% identified as gay male, 16% identified as bisexual female, and 11% identified as bisexual male. Mean age was 42 years (SD=16.04). The racial/ethnic composition of the sample was Caucasian (78%), Hispanic (6%), Black (4%), Asian (3%), Alaskan (1%) and Multiracial (8%). Annual household income was less than $20,000 (17%), $20,000-$39,999 (22%), $40,000-$59,999 (19%), $60,000-79,999 (13%), and over $80,000 (29%). MOS-36 mental health composite scores for the sample were one-half standard deviation below the general population mean. Correlational analysis revealed relationships between mental health outcomes and most of the study variables including discrimination. Significant similarities were found between racial and sexual minority populations experiences of discrimination. Three path analyses investigated whether perceived stress mediated the relationship between lifetime experiences of discrimination and the dependent variables of the study; 1) physical health 2) mental health, and 3) satisfaction with life. Four analyses examined moderating effects of LGB risk and resilience factors (internalized heterosexism , stigma consciousn

Like racial and ethnic minorities, sexual minorities (lesbian, gay, and bisexual (LGB) people) are at increased risk for mental (Meyer, 2003; Hatzenbuehler, 2009) and physical (Conran, Mimiaga, & Landers, 2008; Gay and Lesbian Medical Association, 2010; Huebner & Davis, 2007) health problems compared to heterosexuals. The current study attempted to 1) determine if the stress related to discrimination mediated the relationship between discrimination and health and well-being for LGB people, and 2) and identify risk and resilience factors specific to LGB people that might moderate the relationship between discrimination related stress and LGB health, mental health and satisfaction with life. Three hundred and five people who self-identified as LGB completed an online survey. Thirty nine percent of participants self-identified as lesbian, 33% identified as gay male, 16% identified as bisexual female, and 11% identified as bisexual male. Mean age was 42 years (SD=16.04). The racial/ethnic composition of the sample was Caucasian (78%), Hispanic (6%), Black (4%), Asian (3%), Alaskan (1%) and Multiracial (8%). Annual household income was less than $20,000 (17%), $20,000-$39,999 (22%), $40,000-$59,999 (19%), $60,000-79,999 (13%), and over $80,000 (29%). MOS-36 mental health composite scores for the sample were one-half standard deviation below the general population mean. Correlational analysis revealed relationships between mental health outcomes and most of the study variables including discrimination. Significant similarities were found between racial and sexual minority populations experiences of discrimination. Three path analyses investigated whether perceived stress mediated the relationship between lifetime experiences of discrimination and the dependent variables of the study; 1) physical health 2) mental health, and 3) satisfaction with life. Four analyses examined moderating effects of LGB risk and resilience factors (internalized heterosexism , stigma consciousn

The purpose of this study was to examine the reliability and validity of the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPHS) among Jamaican Americans. The psychometric properties of the ATSPPHS were investigated to identify its appropriateness of measuring attitudes toward seeking mental health services of this Caribbean population. Ninety four Jamaican Americans completed the ATSPPHS which was developed by Fischer and Turner in 1970, and a demographic information form. An estimate of Cronbach's alpha reliability coefficient for the overall ATSPPHS, and the four attitudinal factors were calculated to determine reliability. Principal components analysis was utilized to examine the structure of the factors and validity. An estimated correlation matrix was used to determine facets of both reliability and validity. The estimate of Cronbach's alpha reliability coefficient for the overall ATSPPHS with the Jamaican American sample was α = .87. This result represented strong reliability for the overall scores of the ATSPPHS and shared similar findings with Fischer and Turner's (1970) original standardized population. The principal component analysis revealed only one attitudinal factor differing sharply from Fischer and Turner's (1970) factor analysis producing four independent factors. Validity of the ATSPPHS was not established with the Jamaican American sample. Implications highlighted the potential for helping professionals to greater serve populations that traditionally underutilize mental health services through a more sophisticated understanding of attitudes toward seeking mental health services. Future research concerning potential barriers to receiving help such as economic influences on culture and characteristics of Afro-Caribbean cultural distinctiveness are recommended.