MEXICAN-ORIGIN CHILDREN'S HEALTH IN CULTURAL CONTEXT

描述：(改编自申请者摘要)流行病学 美国西班牙裔健康研究提出的悖论表明， 拉美裔美国人的结果优势，尽管收入和教育程度较低 成就。健康优势往往随着健康水平的提高而被侵蚀 文化适应。护理墨西哥裔儿童的护士和他们的 最大限度地提高儿童健康水平的家庭需要一种以文化为基础的 与儿童健康的文化背景相关的概念模型 生产对家庭进程和儿童健康结果的影响。使用 最终进行某种类型的医疗改革是必然的，护士们需要 支持有助于儿童健康的文化因素，以及 最大限度地减少墨西哥裔医疗保健的结构性障碍 家庭。在这种背景下，这次聚焦的目的是 人种志是描述儿童健康的文化背景。 墨西哥裔儿童的生产活动和工艺 出生到19个月大。这一目的将通过以下途径实现 五个具体目标。目标1将描述基于家庭的儿童健康 目标2和目标3将描述母亲的看法和 对专业和以家庭为基础的儿童保健的期望；目的 4将研究家庭保健生产中的文化内多样性 和专业的医疗保健观念；目标5将提供 儿童健康家庭生产的叙事和图形模型 在文化背景下。要实现这些目标，需要学习 大约20-25个墨西哥裔家庭，每个家庭22个月，从 从胎儿期到婴儿19个月。家访将是 在产前(怀孕6个月和8个月)、出生时和 当婴儿1、4、7、10、13、16和19个月时。非结构化 人种学访谈将在家访中获得数据。人体测量学 还将收集婴儿在家访中的数据。病历 有关婴儿健康的数据将提供更多的健康结果 信息。第一阶段的妈妈们将拍照进行解释 分析。在第二阶段，将开始进行更有针对性的抽样。焦点小组 还将启动与健康生产有关的主题 母亲社交网络的成员。最后，参与者观察 将为数据收集提供更广泛的文化背景 释义。数据分析将利用母亲和医疗保健 提供者的儿童疾病叙述、访谈话语、焦点小组 主题，并关注家庭健康生产和 儿童健康结果。此外，对样品的描述(以 将提供关于文化适应和社会经济地位的信息。结果是 研究人员和临床医生将获得这项研究的 儿童保健生产的文化背景综合透视 在墨西哥裔家庭中。归根结底， 这项研究中描述的墨西哥裔美国家庭可能是 得到支持和加强，以促进实现最佳健康结果 孩子们。

DESCRIPTION: (Adapted from applicants abstract) The epidemiologic paradox presented by Hispanic health research in the U.S. shows a health outcome advantage for Hispanics, despite lower income and educational attainment. Health advantages often erode with increasing levels of acculturation. Nurses working with Mexican-origin children and their families to maximize child health outcomes need a culture-based conceptual model to relate the cultural context of child health production to household processes and child health outcomes. With eventual health care reform of some type a certainty, nurses need to support the cultural factors contributing to children's health, and minimize structural barriers to health care for Mexican-origin households. Given this background, the purpose of this focused ethnography is to describe the cultural context of child health production activities and processes for Mexican-origin children from birth through 19 months of age. This purpose will be attained through five specific aims. Aim 1 will describe household-based child health processes; Aims 2 and 3 will describe mothers' perceptions and expectations of professional and household-based child health care; Aim 4 will examine intra-cultural diversity in household health production and professional health care perceptions; and Aim 5 will provide narrative and graphic models of the household production of child health in cultural context. Attaining these aims will involve studying approximately 20-25 Mexican-origin households for 22 months each, from the prenatal period to the infant's 19th month. Home visits will be conducted prenatally (at 6 and 8 months of pregnancy), at birth, and when the infant is aged 1, 4, 7, 10, 13, 16 and 19 months. Unstructured ethnographic interviews will elicit data at home visits. Anthropometric data will also be collected on infants at home visits. Medical record data on infant health will provide additional health outcome information. Mothers in Phase 1 will take photographs for hermeneutic analysis. In Phase II, more focused sampling will begin. Focus groups will also be initiated on topics related to health production with members of mothers' social networks. Finally, participant observation will provide a larger cultural context for the data collection and interpretation. Data analysis will utilize mother's and health care providers' child illness narratives, interview discourse, focus group themes, and attend to the patterning of household health production and child health outcomes. In addition, a description of the sample (in terms of acculturation and socioeconomic status) will be provided. The results of this study will be available to researchers and clinicians seeking an integrated perspective on the cultural context of child health production in Mexican-origin households. Ultimately, the unique strengths of the Mexican American family and household described in this research may be supported and enhanced to facilitate optimal health outcomes for children.