ACCULTURATION AND CHILD HEALTH OUTCOMES IN LATINOS

社会健康状况通常由婴幼儿健康状况来衡量。尽管美国儿童健康状况存在种族/民族差异，但我们对拉美裔儿童健康状况的了解非常有限。这项研究的目的是调查拉美裔这一第二大少数群体的儿童健康状况。在这项提案中，我们将分析文化适应和社区因素对拉美裔儿童健康结果的影响。该项目的具体目标是：(1)确定母亲文化适应与儿童健康结果之间的关联程度，以儿童健康状况、生长发育免疫状况和儿科保健利用情况衡量；(2)衡量母亲产前保健利用、免疫状况和儿科保健利用之间的关系；(3)确定是否可以用社区社会经济和文化特征来解释母亲文化适应和儿童健康结果之间的关系。在这项研究中，我们将对旧金山总医院的350名拉丁裔妇女及其婴儿进行为期三年的前瞻性跟踪调查。当孩子一岁、两岁和三岁时，我们将在综合临床研究中心进行三次学习访问。因变量是儿童健康状况、生长发育、免疫状况和儿科保健利用情况。主要的自变量是母亲的文化适应和社区的社会经济和文化特征。利用结构化访谈、生物测量和社区评估相结合的方式，我们将前瞻性地获得影响儿童健康结果的因素的信息，重点是文化适应和其他社会文化因素的独立影响。我们假设，母亲文化适应增加对儿童健康结果有不利影响；产前保健利用不足与未进行最新免疫接种和儿童保健利用不足有关；母亲文化适应增加与儿童健康结果不良之间的关系部分由社区的社会经济和文化特征解释。

Societal health status is commonly measured by infant and child health status. Although there is racial/ethnic variation in child health outcomes in the United States, our knowledge of the health or Latino children is very limited. The purpose of this study is to investigate child health outcomes in Latinos, the second largest minority group. In this proposal we will analyze the influence of acculturation and community factors on child health outcomes in Latinos. The specific aims of the project are: (1) To determine the strength of the association between maternal acculturation and child health outcomes, as measured by child health status, growth and development immunization status, and utilization of pediatric care; (2) to measure the relationship between maternal utilization of prenatal care, immunization status, and utilization of pediatric care; and (3) To determine whether the relationship between maternal acculturation and child health outcomes can be explained by community socioeconomic and cultural characteristics. In this study we will prospectively follow a cohort of 350 Latino women and their infants at San Francisco General Hospital over a three year period. We will conduct three study visits in the General Clinical Research Center when the child on one, two, and three years old. The dependent variables are child health status, growth and development, immunization status,, and utilization of pediatric care. The primary independent variables are maternal acculturation and community socioeconomic and cultural characteristics. Using a combination of structured interviews, biological measures and community assessments, we will prospectively obtain information on factors that influence child health outcomes, with an emphasis on the independent influence of acculturation and other sociocultural factors. We hypothesize that increased maternal acculturation has an adverse effect on child health outcomes; that inadequate utilization of prenatal care is associated with non-up to date immunizations and inadequate utilization of pediatric care; and that the relationship between increased maternal acculturation and adverse child health outcomes is partially explained by the socioeconomic and cultural characteristics of the community.