ACCULTURATION AND CHILD HEALTH OUTCOMES IN LATINOS

社会健康状况通常以婴儿和儿童健康状况来衡量。虽然美国儿童健康结果存在种族/民族差异，但我们对拉丁裔儿童健康的了解非常有限。本研究的目的是调查拉丁裔儿童的健康状况，这是第二大少数群体。在本提案中，我们将分析文化适应和社区因素对拉丁美洲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强度，以儿童健康状况、生长和发育免疫状况以及儿科护理的利用来衡量；(2)测量孕产妇产前保健利用、免疫状况与儿科保健利用的关系；(3)确定母亲文化适应与儿童健康结果的关系是否可以用社区社会经济和文化特征来解释。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随访。我们将在孩子1岁、2岁和3岁时在普通临床研究中心进行三次研究访问。因变量是儿童健康状况、生长发育、免疫状况和儿科护理的利用。主要的自变量是母亲文化适应和社区社会经济文化特征。结合结构化访谈、生物测量和社区评估，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。我们假设增加的母亲文化适应对儿童健康结果有不利影响；产前护理利用不足与未进行最新免疫接种和儿科护理利用不足有关；而增加的产妇文化适应和不良的儿童健康结果之间的关系部分是由社区的社会经济和文化特征来解释的。

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.