Vice Dean of the School of Global Public Health
Professor of Social and Behavioral Sciences
Dr. Ana Abraído-Lanza's research interests include studying the cultural, psychological, social, and structural factors that affect health, psychological well-being, and mortality among Latinos; health disparities between Latinos and non-Latino whites; and the health of immigrant Latinos. Her major publications on the Latino mortality paradox and on acculturation have contributed to national and international debates on the mental and physical health of Latinos specifically, and on general factors that influence immigrant health.
Dr. Abraído-Lanza is engaged in several important professional activities. These include (among others) serving on the Editorial Boards of Health Education and Behavior, the Annals of Behavioral Medicine, the International Journal of Behavioral Medicine, and Preventing Chronic Disease. She has served as a committee or Board member on numerous scientific, professional and non-profit organizations and groups, including (among others) the Hispanic Serving Health Professions Schools, the Community Task Force on Preventive Services of the Centers for Disease Control and Prevention, and several National Institutes of Health review groups.
Prior to joining NYU, Dr. Abraído-Lanza was Professor of Sociomedical Sciences at the Mailman School of Public Health of Columbia University. She was the director of the Initiative for Maximizing Student Development (IMSD) at Columbia’s Mailman School, an education project funded by the National Institutes of Health, which aims to increase the number of under-represented researchers who enter biomedical and behavioral research careers in the field of public health. Dr. Abraído-Lanza’s honors and awards include being selected as a Columbia University Provost Leadership Fellow. She also received a Teaching Excellence Award from the Mailman School of Public Health of Columbia University, a Dalmas A. Taylor Distinguished Contributions Award from the Minority Fellowship Program of the American Psychological Association, and the Student Assembly Public Health Mentoring Award from the American Public Health Association.
BA, Psychology, New York University, New York, NYMA, Psychology, City University of New York, New York, NYPhD, Psychology, City University of New York, New York, NYPostdoctoral Fellow, Columbia University, New York, NY
AcculturationBehavioral Determinants of HealthBehavioral ScienceCommunity HealthCultural Determinants of HealthHealth of Marginalized PopulationLatino cultureLatino HealthMinoritiesMinority HealthPopulation HealthPsychologySocial BehaviorsSocial Determinants of Health
A Commentary on the Latin American ParadoxAbraído-Lanza, A. F., Mendoza-Grey, S., & Flórez, K. R.
Journal titleJAMA network open
Are you better off? Perceptions of social mobility and satisfaction with care among Latina immigrants in the U.S.Mendoza, S., Armbrister, A. N., & Abraído-Lanza, A. F.
Journal titleSocial Science and Medicine
Page(s)54-60AbstractAlthough the reasons for immigrating to the U.S. vary by Latino groups, many Latinos cite economic or political motivations for their migration. Once in the United States, Latino immigrants may face many challenges, including discrimination and blocked opportunities for social mobility, and difficulties in obtaining health services and quality health care. The purpose of this study was to explore how changes in social mobility from the country of origin to the U.S. may relate to Latina women's health care interactions. We examined whether self-reported social mobility among 419 Latina women immigrants is associated with satisfaction with health care. We also examined the association among social mobility and self-rated health, quality of care, and medical mistrust. Upward social mobility was associated with greater number of years lived in the U.S., and downward social mobility was associated with more years of education. Those who reported no changes in social class (stable social mobility) were older and were the most satisfied with their medical care. Multiple regression analyses indicated that downward social mobility was associated with less satisfaction with care when controlling for demographic covariates, quality of care, and medical mistrust. Results suggest that perceived social mobility may differentially predict Latina immigrants’ satisfaction with the health care system, including their trust in U.S. medical institutions. We conclude that perceived social mobility is an important element in exploring the experiences of immigrant Latinas with health care in the United States.
Community engagement in academic health centers: A model for capturing and advancing our successesVitale, K., Newton, G. L., Abraido-Lanza, A., Aguirre, A. N., Ahmed, S., Esmond, S. L., Evans, J., Gelmon, S. B., Hart, C., Hendricks, D., McClinton-Brown, R., Young, S. N., Stewart, M. K., & Tumiel-Berhalter, L. M.
Journal titleJournal of Community Engagement and Scholarship
Personalized medicine and Hispanic health: Improving health outcomes and reducing health disparitiesAviles-Santa, L., Abraido-Lanza, A., Bull, J., Falcon, A., Guerrero-Preston, R., Heintzman, J., Lindberg, N. M., McBurnie, M. A., Moy, E., Papanicolaou, G., Pina, I. L., Popovic, J., Ramos, K., Suglia, S. F., & Vazquez, M. A.
Journal titleBMC Proceedings
Segmented assimilation: An approach to studying acculturation and obesity among Latino adults in the United StatesFlórez, K. R., & Abraído-Lanza, A.
Journal titleFamily and Community Health
Page(s)132-138AbstractSegmented assimilation theory posits that immigrants experience distinct paths of assimilation. Using cluster analysis and data from the National Latino and Asian American Survey, this study sought to apply this theory in relation to obesity among Latinos. Four clusters emerged: a "second-generation classic," a "thirdgeneration classic," an "underclass," and a "segmented assimilation" pattern. In analyses controlling for sociodemographic confounders (eg, age), second-generation classic individuals had higher odds of obesity (odds ratio = 2.70, 95% confidence interval = 1.47-4.93) relative to the segmented pattern. Similarly, third-generation classic individuals had higher odds of obesity (odds ratio = 3.23, 95% confidence interval = 1.74-6.01) compared with segmented assimilation individuals.
Social Norms, Acculturation, and Physical Activity Among Latina WomenAbraído-Lanza, A. F., Shelton, R. C., Martins, M. C., & Crookes, D. M.
Journal titleJournal of Immigrant and Minority Health
Page(s)285-293AbstractPhysical activity promotes health and is important for preventing chronic conditions, such as obesity and cardiovascular disease. Little is known about factors associated with different types of PA among Latina women, particularly Dominicans, who now constitute the fifth largest group of Latinos in the United States. The purpose of this study was to examine whether occupational physical activity, acculturation, familism, and norms held by family and friends are associated with three types of PA: vigorous and moderate leisure-time physical activity (LTPA), and resistance training. Interviews were conducted with 418 Dominican women. We assessed self-reported PA using standardized measures. Data were collected between July 2010 and July 2012 in New York City. Most women reported no vigorous LTPA or resistance training (74.5 and 73.1 %, respectively); about half (52.1 %) reported no moderate LTPA. After adjusting for sociodemographic factors, occupational physical activities were associated with greater LTPA. Acculturation was not associated with any outcome. Positive family norms about exercise were associated with increased LTPA and resistance training. Family norms may play a critical role in PA and should be included in programs to increase PA among Latina women.
The Intersection of Fatalismo and pessimism on depressive symptoms and suicidality of Mexican descent adolescents: An attribution perspectivePiña-Watson, B., & Abraído-Lanza, A. F.
Journal titleCultural Diversity and Ethnic Minority Psychology
Page(s)91-101AbstractObjectives: The purpose of the present study is to examine the role fatalismo beliefs and pessimistic attributions on depressive symptoms, hopelessness, and suicidality of Mexican descent adolescents. The major premise of this study is that it is the interaction between the level of negative attribution and fatalismo beliefs that explains the relationship with mental health outcomes, not the fatalistic belief itself. Method: A sample of 524 Mexican descent adolescents from a midsized city in south Texas was surveyed (age range = 14-20 years; M = 16.23 years; SD = 1.10 years). Results: Linear and logistic multiple regression analyses demonstrate that pessimism is independently and positively related to depressive symptoms, hopelessness, suicidal ideation, plans, and attempts. Predetermination and luck beliefs were not found to be independently related to any outcomes; however, there were significant interaction effects between pessimism and predetermination beliefs on suicidal ideation and plans. Conclusions: The findings of this study highlight the need to study fatalismo multidimensionally, use culturally relevant measures, and account for attributions to understand the affect of fatalismo on mental health outcomes.
Acculturation and physical activity among LatinosAbraído-Lanza, A. F., Flórez, K. R., & Shelton, R. C. In The Oxford Handbook of Acculturation and Health.
Page(s)343-355AbstractDespite the many health benefits of physical activity (PA), the majority of Latinos do not meet recommended levels of PA. This chapter provides an overview of research on acculturation and PA among adult Latinos in the United States. It identifies gaps in knowledge concerning the association between acculturation and different types of PA, the joint effects of socioeconomic position and acculturation on PA, and research on gender. It suggests several areas for further research related to acculturation and PA, including an exploration of norms, social networks, and broader social contexts. It concludes that although the bulk of evidence indicates that greater acculturation is associated with increased PA, more complex research designs and greater methodological and conceptual rigor are needed to move forward research in this area.
Latino Immigrants, Acculturation, and Health: Promising New Directions in ResearchAbraído-Lanza, A. F., Echeverría, S. E., & Flórez, K. R.
Journal titleAnnual Review of Public Health
Page(s)219-236AbstractThis article provides an analysis of novel topics emerging in recent years in research on Latino immigrants, acculturation, and health. In the past ten years, the number of studies assessing new ways to conceptualize and understand how acculturation-related processes may influence health has grown. These new frameworks draw from integrative approaches testing new ground to acknowledge the fundamental role of context and policy. We classify the emerging body of evidence according to themes that we identify as promising directions - intrapersonal, interpersonal, social environmental, community, political, and global contexts, cross-cutting themes in life course and developmental approaches, and segmented assimilation - and discuss the challenges and opportunities each theme presents. This body of work, which considers acculturation in context, points to the emergence of a new wave of research that holds great promise in driving forward the study of Latino immigrants, acculturation, and health. We provide suggestions to further advance the ideologic and methodologic rigor of this new wave.
Revisiting unequal treatmentArmbrister, A. N., & Abraido-Lanza, A. In P. Nicassio (Ed.), Psychosocial FActors in Arthritis: Disparities in access to and quality of care for arthritis.
The joint contribution of neighborhood poverty and social integration to mortality risk in the United StatesMarcus, A. F., Echeverria, S. E., Holland, B. K., Abraido-Lanza, A. F., & Passannante, M. R.
Journal titleAnnals of Epidemiology
Page(s)261-266AbstractPurpose: A well-established literature has shown that social integration strongly patterns health, including mortality risk. However, the extent to which living in high-poverty neighborhoods and having few social ties jointly pattern survival in the United States has not been examined. Methods: We analyzed data from the Third National Health and Nutrition Examination Survey (1988-1994) linked to mortality follow-up through 2006 and census-based neighborhood poverty. We fit Cox proportional hazards models to estimate associations between social integration and neighborhood poverty on all-cause mortality as independent predictors and in joint-effects models using the relative excess risk due to interaction to test for interaction on an additive scale. Results: In the joint-effects model adjusting for age, gender, race/ ethnicity, and individual-level socioeconomic status, exposure to low social integration alone was associated with increased mortality risk (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.28-1.59) while living in an area of high poverty alone did not have a significant effect (HR: 1.10; 95% CI: 0.95-1.28) when compared with being jointly unexposed. Individuals simultaneously living in neighborhoods characterized by high poverty and having low levels of social integration had an increased risk of mortality (HR: 1.63; 95% CI: 1.35-1.96). However, relative excess risk due to interaction results were not statistically significant. Conclusions: Social integration remains an important determinant of mortality risk in the United States independent of neighborhood poverty.
The Power of Place: Social Network Characteristics, Perceived Neighborhood Features, and Psychological Distress Among African Americans in the Historic Hill District in Pittsburgh, PennsylvaniaFlórez, K. R., Ghosh-Dastidar, M. B., Beckman, R., De La Haye, K., Duru, O. K., Abraído-Lanza, A. F., & Dubowitz, T.
Journal titleAmerican journal of community psychology
Page(s)60-68AbstractAfrican American neighborhoods have been historically targeted for urban renewal projects, which impact social composition and resident's health. The Hill District in Pittsburgh, PA is such a neighborhood. This research sought to investigate the extent to which social networks and perceived neighborhood social cohesion and safety were associated with psychological distress among residents in an African American neighborhood undergoing urban renewal, before the implementation of major neighborhood changes. Findings revealed a modest, significant inverse association between social network size and psychological distress (β = −0.006, p <.01), even after controlling for age, employment, education, and income. Perceived neighborhood safety predicted decreased psychological distress (β = −1.438, p <.01), but not social cohesion, which is consistent with past research. Findings suggest that social networks protect against psychological distress, but neighborhood perceptions are also paramount.
Breast Cancer Screening Among Dominican Latinas: A Closer Look at Fatalism and Other Social and Cultural FactorsAbraído-Lanza, A. F., Martins, M. C., Shelton, R. C., & Flórez, K. R.
Journal titleHealth Education and Behavior
Page(s)633-641AbstractWith the marked increase of the Latino population in the United States during the past 20 years, there has been growing interest in the social, cultural, and structural factors that may impede breast cancer screening among Latino women, especially among those subgroups that have been understudied. Acculturation and fatalism are central cultural constructs in these growing fields of research. However, there is great debate on the extent to which acculturation and fatalism affect breast cancer screening among Latinas relative to other social or structural factors or logistical barriers. Moreover, little theoretical work specifies or tests pathways between social, structural, and cultural determinants of screening. This study tests a theoretical model of social and structural (socioeconomic status and access to health care) and cultural factors (acculturation and fatalism) as correlates of mammography screening among Dominican Latinas, a group that has been understudied. The study expands prior work by examining other factors identified as potential impediments to mammography screening, specifically psychosocial (e.g., embarrassment, pain) and logistical (e.g., not knowing how to get a mammogram, cost) barriers. Interview-administered surveys were conducted with 318 Latinas from the Dominican Republic aged 40 years or older. Fatalistic beliefs were not associated with mammogram screening. Greater acculturation assessed as language use was associated with decreased screening. The strongest predictor of decreased screening was perceived barriers. Results highlight the importance of assessing various self-reported psychosocial and logistical barriers to screening. Possible avenues for screening interventions include intensifying public health campaigns and use of personalized messages to address barriers to screening. Results add to a limited body of research on Dominicans, who constitute the fifth largest Latino group in the United States.
Effect of physical activity, social support, and skills training on late-life emotional health: A systematic literature review and implications for public health researchSnowden, M. B., Steinman, L. E., Carlson, W. L., Mochan, K. N., Abraido-Lanza, A. F., Bryant, L. L., Duffy, M., Knight, B. G., Jeste, D. V., Leith, K. H., Lenze, E. J., Logsdon, R. G., Satariano, W. A., Zweiback, D. J., & Anderson, L. A.
Journal titleFrontiers in Public Health
Volume2AbstractPurpose: Given that emotional health is a critical component of healthy aging, we undertook a systematic literature review to assess whether current interventions can positively affect older adults' emotional health. Methods: A national panel of health services and mental health researchers guided the review. Eligibility criteria included community-dwelling older adult (aged≥50 years) samples, reproducible interventions, and emotional health outcomes, which included multiple domains and both positive (well-being) and illness-related (anxiety) dimensions.This review focused on three types of interventions - physical activity, social support, and skills training - given their public health significance and large number of studies identified. Panel members evaluated the strength of evidence (quality and effectiveness). Results: In all, 292 articles met inclusion criteria.These included 83 exercise/physical activity, 25 social support, and 40 skills training interventions. For evidence rating, these 148 interventions were categorized into 64 pairings by intervention type and emotional health outcome, e.g., strength training targeting loneliness or social support to address mood. 83% of these pairings were rated at least fair quality. Expert panelists found sufficient evidence of effectiveness only for skills training interventions with health outcomes of decreasing anxiety and improving quality of life and self-efficacy. Due to limitations in reviewed studies, many intervention-outcome pairings yielded insufficient evidence. Conclusion: Skills training interventions improved several aspects of emotional health in community-dwelling older adults, while the effects for other outcomes and interventions lacked clear evidence. We discuss the implications and challenges in moving forward in this important area.
Effects of mental health benefits legislation: A community guide systematic reviewSipe, T. A., Finnie, R. K., Knopf, J. A., Qu, S., Reynolds, J. A., Thota, A. B., Hahn, R. A., Goetzel, R. Z., Hennessy, K. D., McKnight-Eily, L. R., Chapman, D. P., Anderson, C. W., Azrin, S., Abraido-Lanza, A. F., Gelenberg, A. J., Vernon-Smiley, M. E., & Nease, D. E.
Journal titleAmerican journal of preventive medicine
Page(s)755-766AbstractContext Health insurance benefits for mental health services typically have paid less than benefits for physical health services, resulting in potential underutilization or financial burden for people with mental health conditions. Mental health benefits legislation was introduced to improve financial protection (i.e., decrease financial burden) and to increase access to, and use of, mental health services. This systematic review was conducted to determine the effectiveness of mental health benefits legislation, including executive orders, in improving mental health. Evidence acquisition Methods developed for the Guide to Community Preventive Services were used to identify, evaluate, and analyze available evidence. The evidence included studies published or reported from 1965 to March 2011 with at least one of the following outcomes: access to care, financial protection, appropriate utilization, quality of care, diagnosis of mental illness, morbidity and mortality, and quality of life. Analyses were conducted in 2012. Evidence synthesis Thirty eligible studies were identified in 37 papers. Implementation of mental health benefits legislation was associated with financial protection (decreased out-of-pocket costs) and appropriate utilization of services. Among studies examining the impact of legislation strength, most found larger positive effects for comprehensive parity legislation or policies than for less-comprehensive ones. Few studies assessed other mental health outcomes. Conclusions Evidence indicates that mental health benefits legislation, particularly comprehensive parity legislation, is effective in improving financial protection and increasing appropriate utilization of mental health services for people with mental health conditions. Evidence was limited for other mental health outcomes.
How Neighborhood Poverty Structures Types and Levels of Social IntegrationMarcus, A. F., Echeverria, S. E., Holland, B. K., Abraido-Lanza, A. F., & Passannante, M. R.
Journal titleAmerican journal of community psychology
Page(s)134-144AbstractSocial integration is fundamental to health and well-being. However, few studies have explored how neighborhood contexts pattern types and levels of social integration that individuals experience. We examined how neighborhood poverty structures two dimensions of social integration: integration with neighbors and social integration more generally. Using data from the United States Third National Health and Nutrition Examination Survey, we linked study participants to percent poverty in their neighborhood of residence (N = 16,040). Social integration was assessed using a modified Social Network Index and neighborhood integration based on yearly visits with neighbors. We fit multivariate logistic regression models that accounted for the complex survey design. Living in high poverty neighborhoods was associated with lower social integration but higher visits with neighbors. Neighborhood poverty distinctly patterns social integration, demonstrating that contexts shape the extent and quality of social relationships.
Latino Health: A Snapshot of Key IssuesAbraído-Lanza, A. F.
Journal titleHealth Education and Behavior
Effects of full-day kindergarten on the long-term health prospects of children in low-income and racial/ethnic-minority populations: A community guide systematic reviewHahn, R. A., Rammohan, V., Truman, B. I., Milstein, B., Johnson, R. L., Muntañer, C., Jones, C. P., Fullilove, M. T., Chattopadhyay, S. K., Hunt, P. C., & Abraido-Lanza, A. F.
Journal titleAmerican journal of preventive medicine
Page(s)312-323AbstractContext Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity. This systematic review assesses the extent to which full-day kindergarten (FDK), compared with half-day kindergarten (HDK), prepares children, particularly those from low-income and minority families, to succeed in primary and secondary school and improve lifelong health. Evidence acquisition A meta-analysis (2010) on the effects of FDK versus HDK among U.S. children measured educational achievement at the end of kindergarten. The meta-analysis was concordant with Community Guide criteria. Findings on the longer-term effects of FDK suggested "fade-out" by third grade. The present review used evidence on the longer-term effects of pre-K education to explore the loss of FDK effects over time. Evidence synthesis FDK improved academic achievement by an average of 0.35 SDs (Cohen's d; 95% CI=0.23, 0.46). The effect on verbal achievement was 0.46 (Cohen's d; 95% CI=0.32, 0.61) and that on math achievement was 0.24 (Cohen's d; 95% CI=0.06, 0.43). Evidence of "fade-out" from pre-K education found that better-designed studies indicated both residual benefits over multiple years and the utility of educational boosters to maintain benefits, suggesting analogous longer-term effects of FDK. Conclusions There is strong evidence that FDK improves academic achievement, a predictor of longer-term health benefits. To sustain early benefits, intensive elementary school education is needed. If targeted to low-income and minority communities, FDK can advance health equity.
Havens of risks or resources? A study of two Latino neighborhoods in New York CityMartins, M. C., Diaz, J. E., Valiño, R., Kwate, N. O. A., & Abraido-Lanza, A. F.
Journal titleJournal of Urban Health
Page(s)477-488AbstractResearch has been mixed on the potential risks and resources that ethnic enclaves may confer upon residents: whereas some authors characterize racial and ethnic minority neighborhoods through the lens of segregation and risk, others argue that these minority neighborhoods are ethnic enclaves that can improve the availability of resources to residents. In this study, we sought to assess two predominantly Latino New York City neighborhoods (one enclave neighborhood and one comparison) in the areas of structural resources (e.g., grocers, parks), cultural resources (e.g., botanicas, hair salons), and risks (e.g., empty lots, bars) by street-level coding in 20 census tracts (streets N∈=∈202). We used Poisson generalized linear models to assess whether enclave status of a neighborhood predicted the numbers of risks and resources on streets within those neighborhoods. Enclave status did not predict the number of risks (Rate ratio∈=∈1.08(0.83,∈1.42),∈χ 2(1, ∈N∈=∈202)∈=∈0.35,∈p∈=∈n.∈s.) or cultural resources (Rate ratio∈=∈0.87(0.54,∈1.40),∈χ 2(1,∈N∈=∈202)∈=∈0.34,∈p∈=∈n. ∈s.), yet it was associated with a higher number of structural resources (Rate ratio∈=∈1.90(1.48,∈2.43),∈χ 2(1, ∈N∈=∈202)∈=∈25.74,∈p∈<∈0.001). The results suggest that while living in an ethnic enclave may not reduce risks, it may help residents cope with those risks through an increased number of structural resources. These findings support theories that conceptualize ethnic enclaves as neighborhoods where greater resources are available to residents. The focus on resources within this work was instrumental, as no difference would have been found if a solely risk-focused approach had been employed.
Religion, fatalism, and cancer control: A qualitative study among Hispanic CatholicsLeyva, B., Allen, J. D., Tom, L. S., Ospino, H., Torres, M. I., & Abraido-Lanza, A. F.
Journal titleAmerican Journal of Health Behavior
Page(s)839-849AbstractObjectives: To assess cancer perceptions among churchgoers and to examine the potential influence of fatalism and religious beliefs on the use of cancer screening tests. Methods: Eight semi-structured focus groups were conducted among 67 Hispanic Catholics in Massachusetts. Results: In this sample, there were few references to fatalistic beliefs about cancer and nearly universal endorsement of the utility of cancer screening for cancer early detection. Most participants reported that their religious beliefs encouraged them to use health services, including cancerscreening tests. Although participants agreed that God plays an active role in health, they also affirmed the importance of self-agency in determining cancer outcomes. Conclusions: Our findings challenge the assumption that fatalism is an overriding perspective among Hispanics. Catholic religious beliefs may contribute to positive health attitudes and behaviors.
Clashing paradigms: An empirical examination of cultural proxies and socioeconomic condition shaping Latino healthEcheverría, S. E., Pentakota, S. R., Abraído-Lanza, A. F., Janevic, T., Gundersen, D. A., Ramirez, S. M., & Delnevo, C. D.
Journal titleAnnals of Epidemiology
Page(s)608-613AbstractObjective: Much debate exists regarding the role of culture versus socioeconomic position in shaping the health of Latino populations. We propose that both may matter for health and explicitly test their independent and joint effects on smoking and physical activity. Methods: We used the 2010 National Health Interview Survey, a population-based survey of the U.S. population, to estimate the prevalence of smoking and physical activity by language use (cultural proxy) and education among Latino adults (n=4929). We fit log binomial regression models to estimate prevalence ratios and test for interaction. Results: English-language use and educational attainment were each independently associated with smoking and physical activity. Joint effect models showed that individuals with both greater use of the English language and low levels of education were nearly three times more likely to smoke (prevalence ratio, 2.59; 95% confidence interval,1.83-3.65) than those with low English language use and high education (referent group); high acculturation and high education were jointly associated with increased activity (prevalence ratio 2.24, 95% confidence interval, 1.79-2.81). Conclusions: Cultural proxies such as language use and educational attainment are both important determinants of health among Latinos. Their joint effect suggests the need to simultaneously consider Latinos' socioeconomic position and their increased risk of adopting health-damaging behaviors while addressing culturally-specific factors that may mitigate risk.
Opening a Window on Systems Science Research in Health Promotion and Public HealthMabry, P. L., Milstein, B., Abraido-Lanza, A. F., Livingood, W. C., & Allegrante, J. P.
Journal titleHealth Education and Behavior
Secular trends in the association between nativity/length of US residence with body mass index and waist circumference among Mexican-Americans, 1988-2008Albrecht, S. S., Diez Roux, A. V., Aiello, A. E., Schulz, A. J., & Abraido-Lanza, A. F.
Journal titleInternational Journal of Public Health
Page(s)573-581AbstractObjectives: We investigated whether associations between nativity/length of US residence and body mass index (BMI) and waist circumference (WC) varied over the past two decades. Methods: Mexican-Americans aged 20-64 years from the National Health and Nutrition Survey (NHANES) III (1988-1994), and NHANES (1999-2008). Sex-stratified multivariable linear regression models further adjusted for age, education, and NHANES period. Results: We found no evidence of secular variation in the nativity/length of US residence gradient for men or women. Foreign-born Mexican-Americans, irrespective of residence length, had lower mean BMI and WC than their US-born counterparts. However among women, education modified secular trends in nativity differentials: notably, in less-educated women, nativity gradients widened over time due to alarming increases in BMI among the US-born and little increase in the foreign-born. Conclusions: Associations between nativity/length of US residence and BMI/WC did not vary over this 20-year period, but we noted important modifications by education in women. Understanding these trends is important for identifying vulnerable subpopulations among Mexican-Americans and for the development of effective health promotion strategies in this fast-growing segment of the population.
Collaborative care to improve the management of depressive disorders: A community guide systematic review and meta-analysisThota, A. B., Sipe, T. A., Byard, G. J., Zometa, C. S., Hahn, R. A., McKnight-Eily, L. R., Chapman, D. P., Abraido-Lanza, A. F., Pearson, J. L., Anderson, C. W., Gelenberg, A. J., Hennessy, K. D., Duffy, F. F., Vernon-Smiley, M. E., Nease, D. E., & Williams, S. P.
Journal titleAmerican journal of preventive medicine
Page(s)525-538AbstractContext: To improve the quality of depression management, collaborative care models have been developed from the Chronic Care Model over the past 20 years. Collaborative care is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists. In addition to case management support, primary care providers receive consultation and decision support from mental health specialists (i.e., psychiatrists and psychologists). This collaboration is designed to (1) improve routine screening and diagnosis of depressive disorders; (2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and (3) improve clinical and community support for active client/patient engagement in treatment goal-setting and self-management. Evidence acquisition: A team of subject matter experts in mental health, representing various agencies and institutions, conceptualized and conducted a systematic review and meta-analysis on collaborative care for improving the management of depressive disorders. This team worked under the guidance of the Community Preventive Services Task Force, a nonfederal, independent, volunteer body of public health and prevention experts. Community Guide systematic review methods were used to identify, evaluate, and analyze available evidence. Evidence synthesis: An earlier systematic review with 37 RCTs of collaborative care studies published through 2004 found evidence of effectiveness of these models in improving depression outcomes. An additional 32 studies of collaborative care models conducted between 2004 and 2009 were found for this current review and analyzed. The results from the meta-analyses suggest robust evidence of effectiveness of collaborative care in improving depression symptoms (standardized mean difference [SMD]=0.34); adherence to treatment (OR=2.22); response to treatment (OR=1.78); remission of symptoms (OR=1.74); recovery from symptoms (OR=1.75); quality of life/functional status (SMD=0.12); and satisfaction with care (SMD=0.39) for patients diagnosed with depression (all effect estimates were significant). Conclusions: Collaborative care models are effective in achieving clinically meaningful improvements in depression outcomes and public health benefits in a wide range of populations, settings, and organizations. Collaborative care interventions provide a supportive network of professionals and peers for patients with depression, especially at the primary care level.
Demystifying peer reviewSimons-Morton, B., Abraido-Lanza, A. F., Bernhardt, J. M., Schoenthaler, A., Schnitzer, A., & Allegrante, J. P.
Journal titleHealth Education and Behavior