Maupome G, McConnell W R, Perry B L, Marino R, Wright E R
Indiana University, School of Dentistry and Indiana University Network Science Institute, Indianapolis, IN, USA.
Department of Sociology, Indiana University - Bloomington, Bloomington, IN, USA.
Community Dent Oral Epidemiol. 2016 Dec;44(6):540-548. doi: 10.1111/cdoe.12247. Epub 2016 Aug 1.
We used data from the TalaSurvey study to examine associations between dental health experiences, social network characteristics, and levels of behavioral and psychological acculturation in one location in the American Midwest.
Starting in parishes and community organizations, we identified adults of Mexican origin living in Indianapolis, who were 1st- or 2nd-generation immigrants from Tala, Mexico. Using a social networks methodology and following extensive formative research, we created an egocentric social network survey and administered it via face-to-face interviews. We identified the peers (alters) in interviewees' (egos) personal networks. We asked egos about multiple oral health and dental care variables for self and for alters. Acculturation (psychological and behavioral) was measured with a validated tool. Through logistic and negative binomial regression, we examined the effects of acculturation and network composition on ego's dental insurance status, dental office visits, and the reason for most recent dental office visit.
A total of 332 egos (mean age 36; 63% female) were interviewed: 90% were born in Mexico; 45% had completed elementary school or lower; and most had low income. Each ego named 3.9 (SD±1.9) alters in his/her personal network, for a total of 1299 alters (mean age 39; 61% female). Both behavioral acculturation and psychological acculturation were moderately associated with dental insurance coverage, and greater behavioral acculturation predicted more frequent dental care. More psychologically acculturated egos were more likely to seek preventive care. Further, egos with more highly educated networks sought care more frequently and for preventive purposes, net of ego's own education and acculturation.
This study contextualizes acculturation of Mexican Americans within the personal networks in which oral health discussion takes place. The findings underscore the critical importance of acculturation and social network factors in shaping a subgroup of Latinos' orientation toward dental care.
我们利用塔拉萨调查研究的数据,在美国中西部的一个地点考察牙齿健康经历、社会网络特征与行为和心理文化适应水平之间的关联。
从教区和社区组织入手,我们确定了居住在印第安纳波利斯的墨西哥裔成年人,他们是来自墨西哥塔拉萨的第一代或第二代移民。采用社会网络方法并经过广泛的形成性研究后,我们创建了一个以自我为中心的社会网络调查问卷,并通过面对面访谈进行施测。我们确定了受访者(自我)个人网络中的同伴(他者)。我们询问自我关于自身及他者的多个口腔健康和牙科护理变量。文化适应(心理和行为方面)通过一个经过验证的工具进行测量。通过逻辑回归和负二项回归,我们考察了文化适应和网络构成对自我的牙科保险状况、看牙医次数以及最近一次看牙医原因的影响。
共访谈了332名自我(平均年龄36岁;63%为女性):90%出生在墨西哥;45%完成了小学或更低年级的学业;且大多数人收入较低。每个自我在其个人网络中列出了3.9个(标准差±1.9)他者,共计1299个他者(平均年龄39岁;61%为女性)。行为文化适应和心理文化适应均与牙科保险覆盖情况中度相关,且更大程度的行为文化适应预示着更频繁的牙科护理。心理文化适应程度更高的自我更有可能寻求预防性护理。此外,在排除自我自身的教育程度和文化适应因素后,网络中受教育程度更高的自我更频繁地寻求护理且是出于预防性目的。
本研究将墨西哥裔美国人的文化适应置于进行口腔健康讨论的个人网络背景中。研究结果强调了文化适应和社会网络因素在塑造拉丁裔亚群体对牙科护理的态度方面的至关重要性。