+ Latinos and Weight loss: Evidence-based Strategies for Culturally Competent Care Presented By:...
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Transcript of + Latinos and Weight loss: Evidence-based Strategies for Culturally Competent Care Presented By:...
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Latinos and Weight loss: Evidence-based Strategies for Culturally Competent Care
Presented By: Laura Rubalcava, MA
+
+Objectives
1. Gain deeper understanding of Latino culture: food, health/illness beliefs, personalismo, role of family in weight loss
2. Provide easy to implement strategies for healthcare professionals to effectively treat obesity in Latinos
3. Know the barriers to treatment for Latinos
4. Increase awareness of the personal well-being of the healthcare professional
5. Understand treatment options for referring to a obesity treatment specialist
+Background: Latinos vs. Hispanics Latino
“Latino/a” is a term growing in popularity among US-born Latinos Represents a political consciousness Sense of ethic pride More often used in research Used in this presentation
Hispanic “Term created by federal order in 1978 by the Office of Management and
Budget. Hispanic is defined as, “person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture of origin (Marin & Marin, 1991, p.20).”
Primary purpose of this label- categorize a group of people not by a specific country or origin with unique history, religion, indigenous roots, cultural traditions, and foods but rather by a common language, namely Spanish. The term “Hispanic” leads to people to believe Spanish-speaking individuals
from these countries have one common culture and that the term refers to a racial category (Santiago-Rivera, p21).
+Background: Latinos
Latinos constitute 16% of the US population (US Census Bureau, 2011), largest ethnic minority group in the US…the U.S. Latino population for July 1, 2050 is estimated to reach 132.8 million, constituting approximately 30% of the U.S. population by that date.
Approximately 64% of the Latinos in the US are of Mexican origin (Falicov, 1998).
According to U.S. Census Bureau population estimates as of July 1, 2011, there are roughly 52.0 million Latinos living in the United States, representing approximately 16.7% of the U.S. total population, making people of Latino origin the nation's largest ethnic minority.
+ 1.Latino Culture and Weight loss
Food, family, tradition Family support is significant in recovery of those with disordered eating behavior “A Latino patient can only get as well as the family will allow them” (Lambert, 2011).
Health/ Illness beliefs Internal/ external forces Curanderos/ santeros/espiritisa- can be viewed as having more power than a physician, this
can result in Latinos noncompliance with medical treatments prescribed by professionals who have different beliefs about the etiology of illness” (Santiago- Rivera, Arredondo, Gallardo- Cooper, 2002).
Latinos are highly traditional in their healthcare practices
Personalismo with physician/staff “The valuing of warm, friendly, and personal relationships has important implications for how Latinos
perceive and respond to environments (e.g., hospitals, mental health agencies)that are quite often impersonal and formal” (Santiago- Rivera, Arredondo, Gallardo- Cooper, 2002).
Role of family in weight loss Collectivistic orientation/ Familismo
Gender role Fulfill role of Marianismo, “girls must grow up to be women and mothers who honor the
model of the Virgin Mary… they must be pure, long-suffering, nurturing, and pious. Mothers are viewed as selfless, self-sacrificing, and nurturing individuals (Lopez- Baez, 1999, Santiago- Rivera, Arredondo, Gallardo- Cooper, 2002).
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+2.Evidence-based Strategies to Improve Weight Loss in Latinos
Motivation for change assessment Focus more time on those ready to change
Urge parent/ child to choose desired physical activity Exercise as routinely as you brush your teeth
Emphasize overall health- teeth, bones, immune system, psychological/ self esteem, hair, skin The more we focus on only weight loss/obesity the more it wont change
Ask about exercise environment/ tools for exercise (indoor/outdoor) Ipod motivational songs, tennis shoes, nintendo wii, as a family Buy during tax season Place value on health/wellness, plan for future instead of present
Social identity threat- “psychological state when people feel at risk of being devalued or negatively stereotyped because of social identity” (Major, B., 2011).
+3.Barriers to Treatment for Latinos
Effects of healthcare professional bias Take the blame off the parent and patient Cultural attitudes to health and wellness
(Santiago- Rivera, Arredondo, Gallardo- Cooper, 2002).
Language proficiency/ translating concerns Insufficient financial resources Obesity is commonplace in America- less likely to
seek treatment Lack of awareness- signs & symptoms of obesity
Unable to adjust to life changes Physician understanding of diagnosing Binge Eating
Disorder (Hudson JI, Hiripi E, Pope HG, Kessler RC, 2007).
Self-care of the healthcare professional- Role model Environment of the clinic/hospital/treatment center
Magazines, chairs, scales (privacy)
+ 4. Well-being of the Healthcare Professional
Physician self-care Self sacrificing-eat, sleep to accommodate
others
Addressing your relationship with food Increase self awareness, we all live in the
same toxic food environment
Address personal biases towards obesity
Encourage healthy eating/ exercise in the workplace environment Meatless Mondays Potluck lunches Walk during lunch Bring lunch to work
+5. Who are the Obesity Treatment Specialists
Primary doctors Bariatricians
General doctors, family medicine, psychiatry, endocrinology
Dietician/ Nutritionist ( MA in nutrition) Supervised medical weight loss Exercise physiologists- especially for morbidly
obese Bariatric surgeons Psychologists/ bariatric psychologists Counselors/ social workers Weight watchers Health education coaches Specialty clinics- Ex: National Center for Weight
and Wellness, University Clinics/ Research centers
+References
Hudson JI, Hiripi E, Pope HG, Kessler RC. (2007). The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61: 348-358.
Lambert, S. (2012, February 15). Providing treatment across different cultures. [National Public Radio]. Retrieved from: http://www.npr.org/2012/02/15/146936181/providing-treatment-across-different-cultures
CDC 2013. Health United States, 2012. Retrieved from:http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html - See more at: http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=537&ID=6459#sthash.YPxva3Vh.dpuf
Major, B. (2011, November 11). Weight Stigma [The Rudd Report]. Retrieved from:http://itunes.apple.com
2012 National Healthcare Disparities Report. Retrieved http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html - See more at: http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=537&ID=6459#sthash.YPxva3Vh.dpuf
Santiago-Rivera, A., Arredondo, P., & Gallardo-Cooper, M. Counseling Latinos and La Familia: A Practical Guide. Thousand Oaks, California: Sage Publications, Inc.