Cardiovascular screening behaviors, acculturation and family cohesiveness in the El Paso Borderland area

Jeffrey S Mohlman, The University of Texas School of Public Health

Abstract

Introduction: Hypertension, diabetes, and hyperlipidemia continue to be major problems for the United States, and for Hispanics living in this nation. Screening for cardiovascular risk factors plays an important role in preventing disease. Acculturation and family cohesiveness have been implicated in health outcomes. This study describes cardiovascular screening behaviors in regards to blood pressure screening, blood glucose screening, and cholesterol screening in the Mexican – United States borderland area and informs the relationship between these screening behaviors and acculturation and family cohesiveness. Materials and Methods: This study uses data from a 1002 person survey conducted in the El Paso area. Answers to questions regarding blood pressure screening, blood glucose screening and cholesterol screening are analyzed along with factors regarding acculturation (Low=LA, and High=HA) and family cohesiveness levels. Fisher’s exact testing and multivariate logistic regression were used to examine associations between variables. Results: Blood sugar (p-value=<0.0001) and cholesterol (p-value=0.0023) screening behaviors showed higher screening rates for high family cohesiveness (HF) compared to low family cohesiveness (LF). Age and gender remained significant variables for each screening behavior in the multivariable regression analysis. With the High Acculturation/Low Family Cohesiveness (HALF) group as the reference there is a significant difference with the High Acculturation/High Family Cohesiveness (HAHF) group in all three cardiovascular screening behaviors. The Low Acculturation/High Family Cohesiveness (LAHF) group was significantly different from the reference group in blood glucose screening and cholesterol screening (p values=0.0051 and 0.0074 respectively). The Low Acculturation/ Low Family Cohesiveness (LALF) group was not significantly different from the reference group in any of the cardiovascular screening behaviors. Conclusions: Public health implications include the need to encourage family cohesiveness which might improve cardiovascular health outcomes as a result of stronger family ties and better cardiovascular screening behaviors. Lower acculturation and higher family cohesiveness levels prevailed, demonstrating the unique demographics of the borderland population. Our data supports starting with an intervention to address blood glucose and blood cholesterol screening behavior in young (ages 18-39) Hispanic males who have low family cohesiveness and directing these interventions to address those in the HALF group. The combination of high acculturation with low family cohesiveness is affecting people negatively and influencing them not to perform any type of cardiovascular screening. Our study also demonstrates the importance of including psychosocial and cultural factors to better understand the heterogeneity of Mexican Americans and its implications to cardiovascular screening behaviors. Finally, our data supports other’s recommendations of opening more clinics across the nation with Spanish speakers on staff to improve cardiovascular screening rates in the LAHF group.^

Subject Area

Behavioral psychology|Public health|Individual & family studies|Hispanic American studies|Epidemiology

Recommended Citation

Mohlman, Jeffrey S, "Cardiovascular screening behaviors, acculturation and family cohesiveness in the El Paso Borderland area" (2015). Texas Medical Center Dissertations (via ProQuest). AAI1597643.
http://digitalcommons.library.tmc.edu/dissertations/AAI1597643

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