Becky Marquez | University of California, San Diego (original) (raw)
Papers by Becky Marquez
American Journal of Health Behavior, 2021
Objective: In this study, we examined the contribution of individual- (acculturation, body mass i... more Objective: In this study, we examined the contribution of individual- (acculturation, body mass index, and body size satisfaction) and family- (maternal weight-related messages and disordered eating patterns) level factors in predicting bulimic and dieting behaviors in young Mexican-American women with overweight or obesity. Methods: We recruited adult Mexican- American mother-daughter dyads from the community. We conducted correlational analysis and hierarchical regression. Results: Daughters who were less satisfied with their body size reported higher symptoms of bulimic (r = -.34, p < .01) or dieting behavior (r = -.36, p < .01). Daughters who received more positive maternal messages on eating and weight had mothers with lower symptoms of bulimic (r = -.43, p < .01) or dieting behavior (r = -.30, p < .05). Maternal symptoms of bulimic behavior were the strongest predictor of daughters' bulimic behavior (ß = .379, p = .007), and body size satisfaction was the stron...
Family & Community Health, 2023
Family-level interventions have the potential to address intergenerational obesity among Mexican ... more Family-level interventions have the potential to address intergenerational obesity among Mexican American women. Given that poor family functioning is associated with worse weight loss outcomes, this study tested a weight management program aimed at improving relational functioning in mothers and daughters with obesity. Mexican American mothers and their adult daughters were randomly assigned to participate in a 16-week group-based standard behavioral (SB) weight loss program without or with relationship skills training (SRT). Relational functioning was assessed via observational behavioral coding using the Global Structural Family Rating Scale. General relational functioning and specifically positive alliance patterns and conflict avoidance improved significantly more in the SRT group than in the SB group. Average weight changes included percent weight loss of −5.6% in the SRT group versus −3.9% in the SB group and body mass index reduction of −2.2 kg/m 2 in the SRT group versus −1.2 kg/m 2 in the SB group. More participants in the SRT group (75%) than in the SB group (40%) tended to achieve at least 3% weight loss. Greater changes in positive alliance patterns increased the likelihood of losing 3% of body weight. Improving relational functioning in motherdaughter dyads may promote favorable outcomes in a behavioral weight loss intervention.
Journal of Immigrant and Minority Health, 2021
Little is known of how intergenerational acculturation discrepancy relates to communication skill... more Little is known of how intergenerational acculturation discrepancy relates to communication skills differences that may influence relationship quality among parents and adult children. Mexican–American mother–daughter dyads (n = 59) were studied using the Actor Partner Interdependence Model to examine dyadic associations of acculturation and communication competence with family functioning and mediation analysis to determine the indirect effect of acculturation discrepancy on family functioning through communication competence differences. Communication competence of mothers exerted significant actor and partner effects on daughter-perceived cohesion and closeness. Higher acculturation discrepancy predicted greater communication competence difference which in turn was associated with lower cohesion and closeness. There was a significant indirect effect of acculturation discrepancy on daughter-perceived cohesion through communication competence difference. Communication competence of...
American Journal of Health Behavior, 2021
In this study, we examined the contribution of individual-(acculturation, body mass index, and bo... more In this study, we examined the contribution of individual-(acculturation, body mass index, and body size satisfaction) and family-(maternal weight-related messages and disordered eating patterns) level factors in predicting bulimic and dieting behaviors in young Mexican-American women with overweight or obesity. Methods: We recruited adult Mexican-American mother-daughter dyads from the community. We conducted correlational analysis and hierarchical regression. Results: Daughters who were less satisfied with their body size reported higher symptoms of bulimic (r =-.34, p < .01) or dieting behavior (r =-.36, p < .01). Daughters who received more positive maternal messages on eating and weight had mothers with lower symptoms of bulimic (r =-.43, p < .01) or dieting behavior (r =-.30, p < .05). Maternal symptoms of bulimic behavior were the strongest predictor of daughters' bulimic behavior (ß = .379, p = .007), and body size satisfaction was the strongest predictor of daughters' dieting behavior (ß =-.372, p = .008) in adjusted models. Conclusion: Mexican-American women who are less satisfied with their body size and have mothers with elevated symptoms of bulimic behavior are at risk for disordered eating patterns. Intervening at the individual level on body image and family level on maternal modeling of eating behavior may help support healthy weight management behaviors.
Health Psychology, 2018
Objective: Shared behaviors have been implicated in the clustering of obesity among socially conn... more Objective: Shared behaviors have been implicated in the clustering of obesity among socially connected people. This study determined how weight and weight control behaviors of participants and their social ties are related and how these factors are associated with weight change in participants. Method: Adult Latinas participating in a lifestyle intervention completed an egocentric network measure of weight and weight control behaviors. Participant weight was objectively measured at baseline and 12 months. Multivariable regression models determined the relationship between weight and weight control behaviors of participants and their social ties. Results: Participants and their social ties shared similarities in weight control behaviors and weight change. Participants who reported social ties that had lost weight were more likely to eat small portions and low-fat foods, but those with social ties that had gained weight were more likely to use herbal supplements. Participants who reported more social ties who exercised, drank liquid meal replacements, took herbal supplements, and self-weighed were more likely to lose weight whereas those with fewer social ties that exercised were more likely to gain weight. Weight loss and weight gain by social ties predicted participant weight loss and weight gain, respectively. Conclusions: Given that weight and weight control behaviors of Latinas reflect that of their social ties, targeting existing social networks for lifestyle interventions may more effectively improve and sustain health-promoting behaviors and outcomes.
PLOS ONE, 2018
Objective Despite data linking the social environment to physical inactivity in Latinas, research... more Objective Despite data linking the social environment to physical inactivity in Latinas, research on social network predictors of physical activity (PA) is limited. This study examined social network predictors of PA change in Latinas. Methods Egocentric network data were collected from 102 adult Latinas (egos) participating in a randomized controlled PA intervention trial for underactive women. Moderate-to-vigorous PA (MVPA) was measured in minutes per week using the 7-Day PA Recall Interview and accelerometers at baseline and 12 months. Analyses characterized social network structure, composition, tie strength, homogeneity, and support for PA and determined the relationship between network characteristics and PA outcomes. Results Networks had an average of four social ties (alters). Networks were high in density and transitivity and low in components, indicating high cohesion. Networks were primarily composed of females, Latinos, Spanish-speakers, and family members. Relationship ties were strong as evidenced by close living proximity, in-person contact, high emotional closeness, and long relationship duration. There was high homogeneity in demographics and PA behaviors. Multivariate analyses revealed that network size, familial ties, contact frequency, and egoalter dissimilarities in age and running but similarities in walking, were associated with increased MVPA. Networks high in support for PA in the form of complimenting ego on exercise, taking over chores to allow ego to exercise, and co-participating with ego in exercise were also associated with greater MVPA. Conclusion These findings contribute to better understanding interpersonal processes that may influence behavior change in a group with especially low levels of PA.
Contemporary clinical trials, Jan 26, 2018
Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lif... more Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lifetime risk of developing type 2 diabetes necessitates a culturally appropriate lifestyle intervention. Unidas por la Vida is a novel dyadic intervention that capitalizes on the centrality of family in Latino culture to mobilize an existing family dyad as a resource for health behavior change. The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. Participants (N = 460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic participation (mothers-daughters) in a lifestyle intervention; 2) individual participation (mothers alone; unrelated daughters alone) in a lifestyle intervention; and 3) mother-daughter dyads in a minimal intervention control group. The primary outcome is weight los...
American Journal of Health Behavior, 2020
Objectives: We developed a comprehensive measure to evaluate 11 domains of maternal social suppor... more Objectives: We developed a comprehensive measure to evaluate 11 domains of maternal social support for physical activity (PA) among Latina adolescents. Methods: The 26-item questionnaire included a version for mothers to rate how often they engaged in behaviors supporting their daughters' PA, and a version for daughters to rate how often their mothers engaged in the same behaviors. Bivariate correlations examined associations between mother-daughter perceived support for daughter's moderate-to-vigorous PA (MVPA), and associations between daughter's perceived support for PA and current MVPA. Results: Twenty-one Latina adolescents, which included 20 adolescent-mother dyads, enrolled in the study. Mother-daughter ratings of support showed significant positive correlations for reminders (r = .573, p = .01), watching daughters' sports (r = .566, p = .01), limit-setting (r = .564, p = .01), encouragement (r = .561, p = .01), transportation (r = .544, p = .02). We found sta...
Journal of the Academy of Nutrition and Dietetics, 2017
Background-Dieting, exercising, and seeking professional help have been associated with intention... more Background-Dieting, exercising, and seeking professional help have been associated with intentional weight loss among adults. Objective-This study examined the use of diet (e.g. ate less, ate less fat, switched to low calorie foods), exercise, diet and exercise, and professional help (e.g. weight loss program, prescribed diet pills) for weight loss among non-Hispanic Whites, Mexican-Americans, and non-Hispanic Blacks. Design-Cross-sectional data from the 2007-2012 National Health and Nutrition Examination Survey (NHANES) were used. Participants-Males and females (n=9,046) aged 20-65 years were included. Main outcome measure-The weight history questionnaire assessed weight loss attempt and use of weight loss strategies in the past year. Statistical analyses performed-Multivariate logistic regression models were used to estimate associations of race/ethnicity with strategies to lose weight. Models controlled for age, sex, education, and body mass index. In fully adjusted models, interactions of race/ethnicity by sex were tested. Results-Lower proportions of Mexican-Americans (35%) and non-Hispanic Blacks (35%) than non-Hispanic Whites (39%) reported trying to lose weight. Among those who tried to lose weight, non-Hispanic Blacks were less likely than non-Hispanic Whites to use diet (OR: 0.
Health Psychology, 2016
Objective-Family responsibilities and poor social support are barriers to physical activity among... more Objective-Family responsibilities and poor social support are barriers to physical activity among Latinas. This study evaluated the effects of a home-and print-based intervention on social support, moderating effects of familial ties on support and moderate-to-vigorous physical activity (MVPA), and mediating effects of support on MVPA. Methods-Participants were randomized to receive through the mail either individually tailored physical activity intervention or general wellness print materials. Familial ties and social support were assessed by marital and child status and the social support for physical activity measure, respectively. MVPA was measured using the 7-day Physical Activity Recall Interview and accelerometer. Assessments were conducted at baseline, 6 months post-treatment, and 12 months follow-up. Results-Participants (n=266; 40.6 ± 9.9 years old) were mostly immigrant and Spanishspeaking Latinas. The intervention group achieved greater increases in family and friend support compared to the wellness control group from baseline to post-treatment and follow-up (p<0.05). Intervention changes in support did not depend on marital or child status. The intervention also increased minutes per week of MVPA more than the wellness control (p<0.05) and the effect did not depend on marital or child status. There were significant indirect effects of treatment, indicating the intervention achieved greater increases in MVPA by increasing family (ab=5.21, SE=2.94, 95% CI=0.91-14.11) and friend (ab=6.83, SE=5.15, 95% CI=0.16-20.56) support. Conclusions-The intervention improved and sustained support from family and friends and MVPA irrespective of familial ties. Social support mediated increases in MVPA.
Obesity (Silver Spring, Md.), 2016
Little is known about the effects of social support on weight loss in Latinos. This study determi... more Little is known about the effects of social support on weight loss in Latinos. This study determined whether sex moderated and treatment adherence mediated the association between social support and weight loss. Data from 278 Latino males and females with type 2 diabetes in the Intensive Lifestyle Intervention of the Look AHEAD trial were analyzed. Multivariable modeling tested for moderation and parallel multiple mediator modeling simultaneously tested the mediating effects of adherence to physical activity, diet, and session attendance on the relationship between baseline social support and percent weight loss at 1 year. Social support for physical activity (having family and friends join in physical activity) was related to weight loss. Adherence to physical activity was related to both social support for physical activity and weight loss. Sex did not moderate these relationships. Adherence to physical activity completely mediated the relationship between social support for physi...
This study examined the relationship between social network characteristics and health promoting ... more This study examined the relationship between social network characteristics and health promoting behaviors (having a routine medical checkup , consuming no alcohol, consuming no fast food, and meeting recommendations for leisure-time physical activity and sleep duration) among Latinos to identify potential targets for behavioral interventions. Method: Personal network characteristics and health behavior data were collected from a community sample of 393 adult Latinos (73% women) in San Diego County, California. Network characteristics consisted of size and composition. Network size was calculated by the number of alters listed on a name generator questionnaire eliciting people with whom respondents discussed personal issues. Network composition variables were the proportion of Latinos, Spanish-speakers, females, family, and friends listed in the name generator. Additional network composition variables included marital status and the number of adults or children in the household. Results: Network members were predominately Latinos (95%), Spanish-speakers (80%), females (64%), and family (55%). In multivariate logistic regression analyses, gender moderated the relationship between network composition, but not size, and a health behavior. Married women were more likely to have had a routine medical checkup than married men. For both men and women, having a larger network was associated with meeting the recommendation for leisure-time physical activity. Conclusion: Few social network characteristics were significantly associated with health promoting behaviors, suggesting a need to examine other aspects of social relationships that may influence health behaviors.
American journal of health behavior, Jul 1, 2016
We examined whether social networks and resource awareness for physical activity may mediate the ... more We examined whether social networks and resource awareness for physical activity may mediate the relationship between civic group participation and physical activity. This is a cross-sectional study of a randomly selected sample of 335 Latinos (mean age 42.1 ± 16.4 years) participating in the San Diego Prevention Research Center's 2009 Household Community Survey. Serial multiple mediation analysis tested the hypothesis that civic group participation is associated with meeting physical activity recommendations through an indirect mechanism of larger social networks followed by greater knowledge of physical activity community resources. The indirect effects of level of civic group participation as well as religious, health, neighborhood, or arts group participation on meeting national physical activity recommendations were significant in models testing pathways through social network size and physical activity resource awareness. The direct effect was only significant for health g...
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 2014
Purpose This study examined communication between mothers and overweight daughters on weight or w... more Purpose This study examined communication between mothers and overweight daughters on weight or weightrelated behaviors through the perspective of adult daughters. Methods Qualitative thematic analysis was used to analyze in-depth individual interviews conducted with 15 adult daughters. Results Mothers who actively engaged in weight management behaviors, such as dieting and exercising regularly, transmitted these behaviors through modeling and served as continuous sources of verbal guidance on the topic. Weight management was discussed frequently and explicitly. Daughters relied on mothers for motivation in the form of supportive statements consisting of specific recommendations on weight management practices, encouragement to attempt or continue weight management practices, empathy with the struggle of managing weight, and affirmation of practices conducive to weight management. Mothers who did not engage in weight management behaviors were not viewed as credible sources for advice on diet and exercise. Daughters did most of the advice giving and modeling on weight management behaviors. Weight management was discussed infrequently and cautiously. Daughters perceived weight-related messages from mothers as unsolicited and critical. Conclusion The results suggest that shared lifestyle goals among family members are important for facilitating supportive communication and engagement in health-promoting behaviors and have implications for family-based weight management interventions.
Journal of Immigrant and Minority Health, 2013
This study examined the relationship between indicators of acculturation and weight loss strategi... more This study examined the relationship between indicators of acculturation and weight loss strategies among Latinas. Latinas residing in the United States longer had more experience with various weight loss strategies (r = 0.24, p = 0.05). Controlling for demographic factors and BMI, years of U.S. residence was related to whether increased physical activity (OR 1.18, 95 % CI 1.01-1.39, p = 0.04) and reduced portion sizes (OR 1.39, 95 % CI 1.02-1.91, p = 0.03) were used as strategies for weight loss. More English spoken at home was associated with use of reducing calories as a strategy for weight loss (OR 4.13, 95 % CI 1.06-16.09, p = 0.04). Regardless of acculturation level, less empirically supported methods such as using herbal products and a girdle were more prevalent than commonly recommended methods such as using meal replacement products and commercial weight loss programs. Behavioral weight loss interventions for Latinas should consider acculturation to more effectively target subgroups, address cultural practices, and teach lifestyle-appropriate strategies.
Journal of the Academy of Nutrition and Dietetics, 2013
Shaping network members into sources of support for healthy eating and exercise behaviors may be ... more Shaping network members into sources of support for healthy eating and exercise behaviors may be an effective strategy to enhance obesity treatment outcomes. This pilot study examined the feasibility and preliminary efficacy of a behavioral weight loss intervention adapted for Latinas with a social network component. Twenty-seven Latinas (43.0±10.2 years and body mass index 36.9±5.7) participated in a 24-week randomized controlled intervention study. Participants attended group-based treatment either individually (Individual Lifestyle Group [ILG]) or with a weight loss partner selected from their existing network (Partner Lifestyle Group [PLG]). Repeated measures analysis of variance was conducted to compare ILG and PLG participants on changes in weight or psychosocial variables. Participants in both intervention groups attended 70% of treatment sessions; 96% and 100% completed assessment at post-treatment (12 weeks) and follow-up (24 weeks), respectively. Significant weight loss (P...
BMC Public Health, 2018
Background: Even though Latinos have become a priority population for the promotion of physical a... more Background: Even though Latinos have become a priority population for the promotion of physical activity in the United States, several widely used scales in physical activity promotion research have not been validated among this population, particularly in Spanish. This study aims to assess the validity and other psychometrics of the Self-Efficacy for Physical Activity scale among a sample of Spanish-speaking Latina women who participated in the Pasos Hacia La Salud intervention. We also explored alternatives for scale simplification. Methods: Data from 205 women corresponding to baseline, 6-month, and 12-month time points were analyzed. Internal consistency was assessed. A series of Spearman correlations, t-tests, linear regressions, and logistic regressions were used to assess the concurrent and predictive validity of the Self Efficacy for Physical Activity scale against both self-report and accelerometer-measured physical activity, using both continuous and categorical outcome data. Item Response Theory and factor analysis methods were used to explore alternatives to simplify the scale. Psychometric tests were repeated with the simplified scale. Results: Cronbach's alpha for the original scale was .72, .76, and .78 for baseline, 6-month, and 12-month data respectively. All concurrent validity tests conducted with 6-month and 12-month data, but not with baseline data, were statistically significant. Self-efficacy at 6 months was also predictive of physical activity at 12 months for all tests except one. Based on plots of Option Characteristic Curves, a modified version of the scale was created. Psychometric results of the modified scale were similar to those of the original scale. Conclusions: This study confirmed the scale's reliability and validity, and revealed that the scale's accuracy improves when some response items are collapsed, which is an important finding for future research among populations with low literacy levels.
Women's Health, 2013
Latinas are the largest, fastest growing female ethnic minority group in the USA, and also report... more Latinas are the largest, fastest growing female ethnic minority group in the USA, and also report the lowest levels of physical activity. Following the framework of the social ecological model, this review examines unique social and environmental factors that influence physical activity in Latinas. Research shows that Latinas receive little social support for activity despite having large, close-knit social networks. Interventions incorporating social support components are generally efficacious. Latinas also face many environmental barriers, including crime, heat, traffic, lack of facilities and a fear of immigration enforcement, and there have been few attempts to address environmental barriers in Latino communities. Successful future interventions will need to consider unique social and environmental barriers affecting Latinas, and help Latinas learn to incorporate social networks into physical activity participation.
Health Education & Behavior, 2022
Background: Only 17% of Latinas meet national physical activity (PA) guidelines for both moderate... more Background: Only 17% of Latinas meet national physical activity (PA) guidelines for both moderate-to-vigorous aerobic and muscle-strengthening PA. Additional health benefits are derived from the combination of aerobic and muscle-strengthening PA (vs. aerobic alone), yet there is paucity in research on muscle-strengthening activity in Latinas. The aim of this study was to examine changes in muscle-strengthening activity from baseline to 6 and 12 months in Seamos Saludables, a 12-month PA randomized controlled trial for Latinas. Methods: A secondary data analysis was conducted among 131 Latinas ages 18–65 years, who were randomized to either a PA Intervention or a Wellness Control. Self-reported muscle-strengthening exercise was measured at baseline, 6 months, and 12 months via adapted muscle-strengthening questions from the Behavioral Risk Factor Surveillance System. Results: There was a 16-minute/week difference in median minute/week of muscle-strengthening activity between Interven...
Journal of women's health (2002), 2017
Most women report not receiving information about gestational weight gain (GWG) from prenatal pro... more Most women report not receiving information about gestational weight gain (GWG) from prenatal providers, but less is known about other sources of information and their potential impacts on GWG. The purpose of this study was to investigate sources of information about diet, physical activity, and weight control during pregnancy, and the impact of information sources on maternal GWG. Participants were 183 women with normal weight and 172 women with overweight/obesity who had enrolled in a prenatal lifestyle intervention trial. At 6 weeks postpartum, women were asked whether they had received information about "diet, physical activity, or weight control" from 12 sources uninvolved in the trial (e.g., physician, Internet, and friend) and, if received, the extent to which they followed the advice. Information sources were examined in relation to odds of exceeding Institute of Medicine (IOM) GWG guidelines based on measured weights. Most women reported receiving information from...
American Journal of Health Behavior, 2021
Objective: In this study, we examined the contribution of individual- (acculturation, body mass i... more Objective: In this study, we examined the contribution of individual- (acculturation, body mass index, and body size satisfaction) and family- (maternal weight-related messages and disordered eating patterns) level factors in predicting bulimic and dieting behaviors in young Mexican-American women with overweight or obesity. Methods: We recruited adult Mexican- American mother-daughter dyads from the community. We conducted correlational analysis and hierarchical regression. Results: Daughters who were less satisfied with their body size reported higher symptoms of bulimic (r = -.34, p < .01) or dieting behavior (r = -.36, p < .01). Daughters who received more positive maternal messages on eating and weight had mothers with lower symptoms of bulimic (r = -.43, p < .01) or dieting behavior (r = -.30, p < .05). Maternal symptoms of bulimic behavior were the strongest predictor of daughters' bulimic behavior (ß = .379, p = .007), and body size satisfaction was the stron...
Family & Community Health, 2023
Family-level interventions have the potential to address intergenerational obesity among Mexican ... more Family-level interventions have the potential to address intergenerational obesity among Mexican American women. Given that poor family functioning is associated with worse weight loss outcomes, this study tested a weight management program aimed at improving relational functioning in mothers and daughters with obesity. Mexican American mothers and their adult daughters were randomly assigned to participate in a 16-week group-based standard behavioral (SB) weight loss program without or with relationship skills training (SRT). Relational functioning was assessed via observational behavioral coding using the Global Structural Family Rating Scale. General relational functioning and specifically positive alliance patterns and conflict avoidance improved significantly more in the SRT group than in the SB group. Average weight changes included percent weight loss of −5.6% in the SRT group versus −3.9% in the SB group and body mass index reduction of −2.2 kg/m 2 in the SRT group versus −1.2 kg/m 2 in the SB group. More participants in the SRT group (75%) than in the SB group (40%) tended to achieve at least 3% weight loss. Greater changes in positive alliance patterns increased the likelihood of losing 3% of body weight. Improving relational functioning in motherdaughter dyads may promote favorable outcomes in a behavioral weight loss intervention.
Journal of Immigrant and Minority Health, 2021
Little is known of how intergenerational acculturation discrepancy relates to communication skill... more Little is known of how intergenerational acculturation discrepancy relates to communication skills differences that may influence relationship quality among parents and adult children. Mexican–American mother–daughter dyads (n = 59) were studied using the Actor Partner Interdependence Model to examine dyadic associations of acculturation and communication competence with family functioning and mediation analysis to determine the indirect effect of acculturation discrepancy on family functioning through communication competence differences. Communication competence of mothers exerted significant actor and partner effects on daughter-perceived cohesion and closeness. Higher acculturation discrepancy predicted greater communication competence difference which in turn was associated with lower cohesion and closeness. There was a significant indirect effect of acculturation discrepancy on daughter-perceived cohesion through communication competence difference. Communication competence of...
American Journal of Health Behavior, 2021
In this study, we examined the contribution of individual-(acculturation, body mass index, and bo... more In this study, we examined the contribution of individual-(acculturation, body mass index, and body size satisfaction) and family-(maternal weight-related messages and disordered eating patterns) level factors in predicting bulimic and dieting behaviors in young Mexican-American women with overweight or obesity. Methods: We recruited adult Mexican-American mother-daughter dyads from the community. We conducted correlational analysis and hierarchical regression. Results: Daughters who were less satisfied with their body size reported higher symptoms of bulimic (r =-.34, p < .01) or dieting behavior (r =-.36, p < .01). Daughters who received more positive maternal messages on eating and weight had mothers with lower symptoms of bulimic (r =-.43, p < .01) or dieting behavior (r =-.30, p < .05). Maternal symptoms of bulimic behavior were the strongest predictor of daughters' bulimic behavior (ß = .379, p = .007), and body size satisfaction was the strongest predictor of daughters' dieting behavior (ß =-.372, p = .008) in adjusted models. Conclusion: Mexican-American women who are less satisfied with their body size and have mothers with elevated symptoms of bulimic behavior are at risk for disordered eating patterns. Intervening at the individual level on body image and family level on maternal modeling of eating behavior may help support healthy weight management behaviors.
Health Psychology, 2018
Objective: Shared behaviors have been implicated in the clustering of obesity among socially conn... more Objective: Shared behaviors have been implicated in the clustering of obesity among socially connected people. This study determined how weight and weight control behaviors of participants and their social ties are related and how these factors are associated with weight change in participants. Method: Adult Latinas participating in a lifestyle intervention completed an egocentric network measure of weight and weight control behaviors. Participant weight was objectively measured at baseline and 12 months. Multivariable regression models determined the relationship between weight and weight control behaviors of participants and their social ties. Results: Participants and their social ties shared similarities in weight control behaviors and weight change. Participants who reported social ties that had lost weight were more likely to eat small portions and low-fat foods, but those with social ties that had gained weight were more likely to use herbal supplements. Participants who reported more social ties who exercised, drank liquid meal replacements, took herbal supplements, and self-weighed were more likely to lose weight whereas those with fewer social ties that exercised were more likely to gain weight. Weight loss and weight gain by social ties predicted participant weight loss and weight gain, respectively. Conclusions: Given that weight and weight control behaviors of Latinas reflect that of their social ties, targeting existing social networks for lifestyle interventions may more effectively improve and sustain health-promoting behaviors and outcomes.
PLOS ONE, 2018
Objective Despite data linking the social environment to physical inactivity in Latinas, research... more Objective Despite data linking the social environment to physical inactivity in Latinas, research on social network predictors of physical activity (PA) is limited. This study examined social network predictors of PA change in Latinas. Methods Egocentric network data were collected from 102 adult Latinas (egos) participating in a randomized controlled PA intervention trial for underactive women. Moderate-to-vigorous PA (MVPA) was measured in minutes per week using the 7-Day PA Recall Interview and accelerometers at baseline and 12 months. Analyses characterized social network structure, composition, tie strength, homogeneity, and support for PA and determined the relationship between network characteristics and PA outcomes. Results Networks had an average of four social ties (alters). Networks were high in density and transitivity and low in components, indicating high cohesion. Networks were primarily composed of females, Latinos, Spanish-speakers, and family members. Relationship ties were strong as evidenced by close living proximity, in-person contact, high emotional closeness, and long relationship duration. There was high homogeneity in demographics and PA behaviors. Multivariate analyses revealed that network size, familial ties, contact frequency, and egoalter dissimilarities in age and running but similarities in walking, were associated with increased MVPA. Networks high in support for PA in the form of complimenting ego on exercise, taking over chores to allow ego to exercise, and co-participating with ego in exercise were also associated with greater MVPA. Conclusion These findings contribute to better understanding interpersonal processes that may influence behavior change in a group with especially low levels of PA.
Contemporary clinical trials, Jan 26, 2018
Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lif... more Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lifetime risk of developing type 2 diabetes necessitates a culturally appropriate lifestyle intervention. Unidas por la Vida is a novel dyadic intervention that capitalizes on the centrality of family in Latino culture to mobilize an existing family dyad as a resource for health behavior change. The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. Participants (N = 460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic participation (mothers-daughters) in a lifestyle intervention; 2) individual participation (mothers alone; unrelated daughters alone) in a lifestyle intervention; and 3) mother-daughter dyads in a minimal intervention control group. The primary outcome is weight los...
American Journal of Health Behavior, 2020
Objectives: We developed a comprehensive measure to evaluate 11 domains of maternal social suppor... more Objectives: We developed a comprehensive measure to evaluate 11 domains of maternal social support for physical activity (PA) among Latina adolescents. Methods: The 26-item questionnaire included a version for mothers to rate how often they engaged in behaviors supporting their daughters' PA, and a version for daughters to rate how often their mothers engaged in the same behaviors. Bivariate correlations examined associations between mother-daughter perceived support for daughter's moderate-to-vigorous PA (MVPA), and associations between daughter's perceived support for PA and current MVPA. Results: Twenty-one Latina adolescents, which included 20 adolescent-mother dyads, enrolled in the study. Mother-daughter ratings of support showed significant positive correlations for reminders (r = .573, p = .01), watching daughters' sports (r = .566, p = .01), limit-setting (r = .564, p = .01), encouragement (r = .561, p = .01), transportation (r = .544, p = .02). We found sta...
Journal of the Academy of Nutrition and Dietetics, 2017
Background-Dieting, exercising, and seeking professional help have been associated with intention... more Background-Dieting, exercising, and seeking professional help have been associated with intentional weight loss among adults. Objective-This study examined the use of diet (e.g. ate less, ate less fat, switched to low calorie foods), exercise, diet and exercise, and professional help (e.g. weight loss program, prescribed diet pills) for weight loss among non-Hispanic Whites, Mexican-Americans, and non-Hispanic Blacks. Design-Cross-sectional data from the 2007-2012 National Health and Nutrition Examination Survey (NHANES) were used. Participants-Males and females (n=9,046) aged 20-65 years were included. Main outcome measure-The weight history questionnaire assessed weight loss attempt and use of weight loss strategies in the past year. Statistical analyses performed-Multivariate logistic regression models were used to estimate associations of race/ethnicity with strategies to lose weight. Models controlled for age, sex, education, and body mass index. In fully adjusted models, interactions of race/ethnicity by sex were tested. Results-Lower proportions of Mexican-Americans (35%) and non-Hispanic Blacks (35%) than non-Hispanic Whites (39%) reported trying to lose weight. Among those who tried to lose weight, non-Hispanic Blacks were less likely than non-Hispanic Whites to use diet (OR: 0.
Health Psychology, 2016
Objective-Family responsibilities and poor social support are barriers to physical activity among... more Objective-Family responsibilities and poor social support are barriers to physical activity among Latinas. This study evaluated the effects of a home-and print-based intervention on social support, moderating effects of familial ties on support and moderate-to-vigorous physical activity (MVPA), and mediating effects of support on MVPA. Methods-Participants were randomized to receive through the mail either individually tailored physical activity intervention or general wellness print materials. Familial ties and social support were assessed by marital and child status and the social support for physical activity measure, respectively. MVPA was measured using the 7-day Physical Activity Recall Interview and accelerometer. Assessments were conducted at baseline, 6 months post-treatment, and 12 months follow-up. Results-Participants (n=266; 40.6 ± 9.9 years old) were mostly immigrant and Spanishspeaking Latinas. The intervention group achieved greater increases in family and friend support compared to the wellness control group from baseline to post-treatment and follow-up (p<0.05). Intervention changes in support did not depend on marital or child status. The intervention also increased minutes per week of MVPA more than the wellness control (p<0.05) and the effect did not depend on marital or child status. There were significant indirect effects of treatment, indicating the intervention achieved greater increases in MVPA by increasing family (ab=5.21, SE=2.94, 95% CI=0.91-14.11) and friend (ab=6.83, SE=5.15, 95% CI=0.16-20.56) support. Conclusions-The intervention improved and sustained support from family and friends and MVPA irrespective of familial ties. Social support mediated increases in MVPA.
Obesity (Silver Spring, Md.), 2016
Little is known about the effects of social support on weight loss in Latinos. This study determi... more Little is known about the effects of social support on weight loss in Latinos. This study determined whether sex moderated and treatment adherence mediated the association between social support and weight loss. Data from 278 Latino males and females with type 2 diabetes in the Intensive Lifestyle Intervention of the Look AHEAD trial were analyzed. Multivariable modeling tested for moderation and parallel multiple mediator modeling simultaneously tested the mediating effects of adherence to physical activity, diet, and session attendance on the relationship between baseline social support and percent weight loss at 1 year. Social support for physical activity (having family and friends join in physical activity) was related to weight loss. Adherence to physical activity was related to both social support for physical activity and weight loss. Sex did not moderate these relationships. Adherence to physical activity completely mediated the relationship between social support for physi...
This study examined the relationship between social network characteristics and health promoting ... more This study examined the relationship between social network characteristics and health promoting behaviors (having a routine medical checkup , consuming no alcohol, consuming no fast food, and meeting recommendations for leisure-time physical activity and sleep duration) among Latinos to identify potential targets for behavioral interventions. Method: Personal network characteristics and health behavior data were collected from a community sample of 393 adult Latinos (73% women) in San Diego County, California. Network characteristics consisted of size and composition. Network size was calculated by the number of alters listed on a name generator questionnaire eliciting people with whom respondents discussed personal issues. Network composition variables were the proportion of Latinos, Spanish-speakers, females, family, and friends listed in the name generator. Additional network composition variables included marital status and the number of adults or children in the household. Results: Network members were predominately Latinos (95%), Spanish-speakers (80%), females (64%), and family (55%). In multivariate logistic regression analyses, gender moderated the relationship between network composition, but not size, and a health behavior. Married women were more likely to have had a routine medical checkup than married men. For both men and women, having a larger network was associated with meeting the recommendation for leisure-time physical activity. Conclusion: Few social network characteristics were significantly associated with health promoting behaviors, suggesting a need to examine other aspects of social relationships that may influence health behaviors.
American journal of health behavior, Jul 1, 2016
We examined whether social networks and resource awareness for physical activity may mediate the ... more We examined whether social networks and resource awareness for physical activity may mediate the relationship between civic group participation and physical activity. This is a cross-sectional study of a randomly selected sample of 335 Latinos (mean age 42.1 ± 16.4 years) participating in the San Diego Prevention Research Center's 2009 Household Community Survey. Serial multiple mediation analysis tested the hypothesis that civic group participation is associated with meeting physical activity recommendations through an indirect mechanism of larger social networks followed by greater knowledge of physical activity community resources. The indirect effects of level of civic group participation as well as religious, health, neighborhood, or arts group participation on meeting national physical activity recommendations were significant in models testing pathways through social network size and physical activity resource awareness. The direct effect was only significant for health g...
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 2014
Purpose This study examined communication between mothers and overweight daughters on weight or w... more Purpose This study examined communication between mothers and overweight daughters on weight or weightrelated behaviors through the perspective of adult daughters. Methods Qualitative thematic analysis was used to analyze in-depth individual interviews conducted with 15 adult daughters. Results Mothers who actively engaged in weight management behaviors, such as dieting and exercising regularly, transmitted these behaviors through modeling and served as continuous sources of verbal guidance on the topic. Weight management was discussed frequently and explicitly. Daughters relied on mothers for motivation in the form of supportive statements consisting of specific recommendations on weight management practices, encouragement to attempt or continue weight management practices, empathy with the struggle of managing weight, and affirmation of practices conducive to weight management. Mothers who did not engage in weight management behaviors were not viewed as credible sources for advice on diet and exercise. Daughters did most of the advice giving and modeling on weight management behaviors. Weight management was discussed infrequently and cautiously. Daughters perceived weight-related messages from mothers as unsolicited and critical. Conclusion The results suggest that shared lifestyle goals among family members are important for facilitating supportive communication and engagement in health-promoting behaviors and have implications for family-based weight management interventions.
Journal of Immigrant and Minority Health, 2013
This study examined the relationship between indicators of acculturation and weight loss strategi... more This study examined the relationship between indicators of acculturation and weight loss strategies among Latinas. Latinas residing in the United States longer had more experience with various weight loss strategies (r = 0.24, p = 0.05). Controlling for demographic factors and BMI, years of U.S. residence was related to whether increased physical activity (OR 1.18, 95 % CI 1.01-1.39, p = 0.04) and reduced portion sizes (OR 1.39, 95 % CI 1.02-1.91, p = 0.03) were used as strategies for weight loss. More English spoken at home was associated with use of reducing calories as a strategy for weight loss (OR 4.13, 95 % CI 1.06-16.09, p = 0.04). Regardless of acculturation level, less empirically supported methods such as using herbal products and a girdle were more prevalent than commonly recommended methods such as using meal replacement products and commercial weight loss programs. Behavioral weight loss interventions for Latinas should consider acculturation to more effectively target subgroups, address cultural practices, and teach lifestyle-appropriate strategies.
Journal of the Academy of Nutrition and Dietetics, 2013
Shaping network members into sources of support for healthy eating and exercise behaviors may be ... more Shaping network members into sources of support for healthy eating and exercise behaviors may be an effective strategy to enhance obesity treatment outcomes. This pilot study examined the feasibility and preliminary efficacy of a behavioral weight loss intervention adapted for Latinas with a social network component. Twenty-seven Latinas (43.0±10.2 years and body mass index 36.9±5.7) participated in a 24-week randomized controlled intervention study. Participants attended group-based treatment either individually (Individual Lifestyle Group [ILG]) or with a weight loss partner selected from their existing network (Partner Lifestyle Group [PLG]). Repeated measures analysis of variance was conducted to compare ILG and PLG participants on changes in weight or psychosocial variables. Participants in both intervention groups attended 70% of treatment sessions; 96% and 100% completed assessment at post-treatment (12 weeks) and follow-up (24 weeks), respectively. Significant weight loss (P...
BMC Public Health, 2018
Background: Even though Latinos have become a priority population for the promotion of physical a... more Background: Even though Latinos have become a priority population for the promotion of physical activity in the United States, several widely used scales in physical activity promotion research have not been validated among this population, particularly in Spanish. This study aims to assess the validity and other psychometrics of the Self-Efficacy for Physical Activity scale among a sample of Spanish-speaking Latina women who participated in the Pasos Hacia La Salud intervention. We also explored alternatives for scale simplification. Methods: Data from 205 women corresponding to baseline, 6-month, and 12-month time points were analyzed. Internal consistency was assessed. A series of Spearman correlations, t-tests, linear regressions, and logistic regressions were used to assess the concurrent and predictive validity of the Self Efficacy for Physical Activity scale against both self-report and accelerometer-measured physical activity, using both continuous and categorical outcome data. Item Response Theory and factor analysis methods were used to explore alternatives to simplify the scale. Psychometric tests were repeated with the simplified scale. Results: Cronbach's alpha for the original scale was .72, .76, and .78 for baseline, 6-month, and 12-month data respectively. All concurrent validity tests conducted with 6-month and 12-month data, but not with baseline data, were statistically significant. Self-efficacy at 6 months was also predictive of physical activity at 12 months for all tests except one. Based on plots of Option Characteristic Curves, a modified version of the scale was created. Psychometric results of the modified scale were similar to those of the original scale. Conclusions: This study confirmed the scale's reliability and validity, and revealed that the scale's accuracy improves when some response items are collapsed, which is an important finding for future research among populations with low literacy levels.
Women's Health, 2013
Latinas are the largest, fastest growing female ethnic minority group in the USA, and also report... more Latinas are the largest, fastest growing female ethnic minority group in the USA, and also report the lowest levels of physical activity. Following the framework of the social ecological model, this review examines unique social and environmental factors that influence physical activity in Latinas. Research shows that Latinas receive little social support for activity despite having large, close-knit social networks. Interventions incorporating social support components are generally efficacious. Latinas also face many environmental barriers, including crime, heat, traffic, lack of facilities and a fear of immigration enforcement, and there have been few attempts to address environmental barriers in Latino communities. Successful future interventions will need to consider unique social and environmental barriers affecting Latinas, and help Latinas learn to incorporate social networks into physical activity participation.
Health Education & Behavior, 2022
Background: Only 17% of Latinas meet national physical activity (PA) guidelines for both moderate... more Background: Only 17% of Latinas meet national physical activity (PA) guidelines for both moderate-to-vigorous aerobic and muscle-strengthening PA. Additional health benefits are derived from the combination of aerobic and muscle-strengthening PA (vs. aerobic alone), yet there is paucity in research on muscle-strengthening activity in Latinas. The aim of this study was to examine changes in muscle-strengthening activity from baseline to 6 and 12 months in Seamos Saludables, a 12-month PA randomized controlled trial for Latinas. Methods: A secondary data analysis was conducted among 131 Latinas ages 18–65 years, who were randomized to either a PA Intervention or a Wellness Control. Self-reported muscle-strengthening exercise was measured at baseline, 6 months, and 12 months via adapted muscle-strengthening questions from the Behavioral Risk Factor Surveillance System. Results: There was a 16-minute/week difference in median minute/week of muscle-strengthening activity between Interven...
Journal of women's health (2002), 2017
Most women report not receiving information about gestational weight gain (GWG) from prenatal pro... more Most women report not receiving information about gestational weight gain (GWG) from prenatal providers, but less is known about other sources of information and their potential impacts on GWG. The purpose of this study was to investigate sources of information about diet, physical activity, and weight control during pregnancy, and the impact of information sources on maternal GWG. Participants were 183 women with normal weight and 172 women with overweight/obesity who had enrolled in a prenatal lifestyle intervention trial. At 6 weeks postpartum, women were asked whether they had received information about "diet, physical activity, or weight control" from 12 sources uninvolved in the trial (e.g., physician, Internet, and friend) and, if received, the extent to which they followed the advice. Information sources were examined in relation to odds of exceeding Institute of Medicine (IOM) GWG guidelines based on measured weights. Most women reported receiving information from...