Differences in dietary patterns of Vietnamese, white, African-American, and Hispanic adolescents in Worcester, Mass.
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Adolescent↗
Biomedical subjects
J M Wiecha
Publications and source records attributed to J M Wiecha.
Differences in knowledge of hepatitis B among Vietnamese, African-American, Hispanic, and white adolescents in Worcester, Massachusetts.
OBJECTIVE: To assess the level of knowledge about hepatitis B of Vietnamese adolescents, a group at high risk for hepatitis B, and compare it to the knowledge of adolescents of other races and ethnicities. METHODS: A sample of 2816 adolescents was surveyed in 1993 in 2 middle schools and 2 high schools in Worcester, Massachusetts, using a self-administered multilingual questionnaire. RESULTS: Knowledge of hepatitis B was low overall. Vietnamese respondents were more likely than were other students to know that hepatitis B affects the liver (35.6% vs 22.6%). However, they were much less likely than were other students to correctly identify sex with an infected person as a risk factor for infection (13.7% vs 32. 8%). Independent predictors of this knowledge were: white race; older age; attending high school versus middle school; having been taught about hepatitis B in school; knowing the definition of hepatitis B; reporting better grades; having a family member with hepatitis B; and being more highly acculturated. CONCLUSIONS: Adolescent knowledge about risk of infection was low in this study. Attention should be directed at providing health education on hepatitis B to adolescents, particularly to Vietnamese. Health care providers, community health educators, and others engaged in the effort to control and eradicate hepatitis B should be sensitive to the unique educational and cultural needs of high-risk southeast Asian adolescent populations.
Adolescent↗
Patterns of smoking, risk factors for smoking, and smoking cessation among Vietnamese men in Massachusetts (United States).
OBJECTIVES: To measure the prevalence and patterns of, and risk factors for, smoking and other tobacco use among Vietnamese men in Massachusetts (United States). METHODS: Data were obtained via a telephone interview of 774 Vietnamese men in 1994. DESIGN: Cross-sectional survey administered via telephone in 1994. SETTING: Massachusetts, United States. SUBJECTS: Randomly selected Vietnamese men (n = 774). MAIN OUTCOME MEASURES: Present and past use of tobacco products, knowledge and attitudes regarding tobacco, and risk factors for tobacco use. Results were compared with data from the Massachusetts general population. RESULTS: Vietnamese men smoked at a rate 1.9 times that of the Massachusetts general men's rate (43% vs 24%). The smoking rate did not decrease with increasing length of residence in the United States. In a logistic regression, risk factors for current smoking were: age in the thirties; history of parental smoking; lower educational level; higher depression score; low level of exercise; lack of health insurance; and geographical origin from the south coast of Vietnam. Smoking cessation declined with increasing depression score. Most smokers (76%) had no plans to quit smoking. CONCLUSIONS: Vietnamese men smoke at much higher rates than the general population, and are much less likely to be planning cessation. High rates of depression and sociocultural barriers to smoking cessation must be addressed in efforts to reduce tobacco use among this high-risk population.
Acculturation↗
Diet measurement in Vietnamese youth: concurrent reliability of a self-administered food frequency questionnaire.
Dietary patterns of Asian Americans change with increasing acculturation, leading to increased consumption of Western foods including those high in fat. Strategies to preserve the healthy aspects of traditional diets need to be developed and dietary assessment methods evaluated. Little is known about reliability of brief dietary measures in the general population or among minority youth. The concurrent reliability of a brief food frequency questionnaire (FFQ) was determined among Vietnamese youth using diet reports. Students in a bilingual high school program were given a FFQ. Students then completed daily diet reports one day each week over seven weeks. The data from the FFQ were compared to the daily food reports. The reliability of the FFQ was highest for frequently eaten food types like rice (r = 0.626, P < 0.01), fruit (r = 0.513, P < 0.01), meat (r = 0.525, P < 0.01) and vegetables (r = 0.474, P < 0.01) and was lower for less commonly eaten types including fish/shellfish (r = 0.227, P = 0.20) and fried foods (r = 0.310, P = 0.07). These results suggest that a few simple FFQ items, particularly for indicator foods such as rice, are reliable for dietary assessment in this population.
Adolescent↗
Does maternal prenatal care use predict infant immunization delay?
BACKGROUND: The proportion of infants in the United States adequately immunized with DTP (Diphtheria, Tetanus and Pertussis) vaccine is below other industrialized nations and lowest among infants living in urban areas. At present, predictors of poor immunization are not well developed. In particular, the relationship between prenatal care utilization and childhood vaccination is not clearly defined. METHODS: Using medical record data, we measured associations between prenatal variables and adequacy of immunization (three DTP vaccines by age 10 months) in 163 mother-infant pairs who received prenatal and child care at a neighborhood community health center. RESULTS: At the end of 10 months' follow-up, 29.4% of infants had not received three DTP immunizations. Logistic regression identified the following independent risk factors for immunization delay: multiparity, being an English-speaking Hispanic mother, and failing to attend scheduled prenatal care appointments. In the regression model, interactions also existed between having a high proportion of missed visits to total prenatal visits scheduled (> or = 25%) and receiving social services, with the highest risk existing for women with a high proportion of missed appointments who also received social services, and the lowest for those with < 25% missed appointments who received social services. CONCLUSIONS: Maternal demographics and health care utilization predict infant immunization rates. Use of these variables may permit early identification and case management of mothers of infants at high risk for immunization delay.
Adolescent↗
Tine test cards for TB screening: rates of return and associated factors.
OBJECTIVE: Screening for tuberculosis in children can be done with the multiple-puncture Tine test. Determination of the extent of induration following the test may be reported by a child's caregiver via a mailed Tine card. We report the rate of return of these cards, and factors associated with return, in a family medicine health center. METHODS: Retrospective review of the medical charts of 152 mother and child pairs seen in the health center over a two-year period. RESULTS: Of the 98 children who had received a Tine test by age one, 16.3% of their Tine cards were returned to the health center. Children whose delivery was insured by Medicaid were less likely to have a Tine card returned than were those without Medicaid (OR for non-return = 4.3, 95% CI = 1.2, 15.4). Physicians often documented a tuberculosis screening result without a Tine card. CONCLUSIONS: Given the low return rates, health care professionals responsible for tuberculosis screening should be cautious when relying on caregivers to interpret, record and return tuberculosis screening results, particularly in the most disadvantaged populations. More valid data are likely to be obtained from a clinical reading of tuberculosis tests.
Data Interpretation, Statistical↗
Provider confidence in breast examination.
Many physicians have reported interest in further training in clinical breast examination, and it has been speculated that health care providers may lack confidence in their breast examination skills. At a multisite family practice residency, we surveyed a group of physicians and nurse practitioners about confidence in clinical breast examination. Forty-three percent of respondents reported impairment of the clinical breast examination by lack of confidence in skills, and 50% reported feeling only "somewhat" or "moderately" confident in their clinical breast examination skills. Residents often reported encountering few patients with breast lumps; experience with breast lumps was associated with reported confidence in the clinical breast examination. To improve and maintain breast palpation confidence and skills, residents and practicing physicians need longitudinal educational programs.
Breast Neoplasms↗
Holistic health: implications for physicians in a changing world.
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Holistic Health↗
Differences in patterns of tobacco use in Vietnamese, African-American, Hispanic, and Caucasian adolescents in Worcester, Massachusetts.
Reduction of cigarette smoking among Southeast Asian men is a national health promotion objective for the year 2000. Early onset of cigarette smoking is known to be a risk factor for later nicotine addiction, yet little is known about tobacco patterns among Southeast Asian youths. Using questionnaire items from the Youth Risk Behavior Survey (YRBS) translated into Vietnamese and Spanish, this article reports such data on a school-based sample of Vietnamese adolescents in Worcester, Massachusetts, and compares smoking and other tobacco use among Caucasian, African-American, and Hispanic adolescents. A sample of 2,816 adolescents was surveyed in two public middle and two public high schools. Prevalence of cigarette smoking among Vietnamese boys (27.9%) was similar to that for Caucasian boys (28.3%) and was higher than that for Hispanic boys (19.7%) or African-American boys (18.9%). Vietnamese girls smoked rarely (3.7%). Vietnamese boys were less likely to smoke in middle school than were other students, and more likely to report smoking in high school than were non-Vietnamese. They were also significantly less likely than others to have smoked their first cigarette at age 12 years or younger (odds ratio (OR) = 0.2, 95 percent confidence interval (CI) = 0.1, 0.4). In multivariate analyses, older age, male gender, smoking by friends, and carrying of a weapon were independent risk factors for current cigarette smoking. Vietnamese subjects differed from others with respect to factors associated with smoking, perceived susceptibility to cancer, and belief in the importance of not smoking for preventing cancer. Among Vietnamese adolescents over age 16, increasing length of time in the United States was associated with decreasing smoking prevalence. The prevalence of smokeless tobacco use among Vietnamese boys (12.0%) was similar to that among other minority boys but was rare among Vietnamese girls. This study is the first to document the rates of tobacco use among Vietnamese adolescents, and the findings suggest that Vietnamese boys should be targeted in efforts to achieve the goal of reducing smoking among Southeast Asian men. Medical Subject Headings (MeSH): adolescent behavior, health surveys, smoking, health promotion, tobacco, smokeless, Asians, Asian Americans, Vietnam.
Adolescent↗