The use of cultural identifications in predicting health behaviors in Hispanic immigrant adolescents

Introduction: Hispanic adolescents in the US experience a disproportionate prevalence of health risk behaviors including hazardous alcohol use, cigarette smoking, and sexual risk taking. However, limited studies include examinations of health-promoting behaviors such as exercise, food intake, and sleep in this population. This study explores how cultural identifications predict health-risk and health-promoting behaviors. Under the heading of cultural identification, we include ethnic identity (identifying with one’s cultural heritage), national identity (identifying with the US or other nationalities), and Bicultural Identity Integration (BII), individual differences in the ability or willingness to combine two cultures into an individualized mosaic.

Methods: Participants include 302 recently immigrated (<5 years in the US) Hispanic adolescents (53% boys; mean age 14.51 years at baseline) drawn from a longitudinal study of acculturation and health outcomes conducted in Miami (N=152) and Los Angeles (N=150). The present analyses use data from the baseline and one year follow up. Cultural identifications were entered as predictors at baseline. Health risk behaviors and health-promoting behaviors were entered as outcomes at one year follow up, controlling for baseline, gender, age, and years in the US. Analyses were conducted using Structural Equation Modeling with a robust maximum likelihood (MLR) estimation in Mplus.

Results: We used a sandwich covariance estimator to adjust the standard errors and account for nesting of participants within schools. BII positively predicted unprotected sex (OR=1.18, p<.01), whereas US identity approached significance as protective predictor of unprotected sex (OR=0.93, p= .06). BII (β=.12, p<.05) and ethnic identity (β=.21, p<.001) were associated with healthy diet. Boys were more likely to engage in exercise (β=.13, p< .05), whereas girls reported better sleep (β=.13, p=.08). An invariance test indicated that path estimates did not significantly differ by site location (Δ-2LL = 32.47, p=.09). However, because this invariance test approached significance, we decided to test path by path to determine if any path significantly differed across site. Results indicated one path significantly differed across site. Specifically, BII significantly predicted sleep solely for participants in Los Angeles (β=.07, p< .05).

Conclusion: The present study innovatively examines both health-risk and health-promoting behaviors in a health disparity burdened population of Hispanic adolescents. Results highlight the need to further examine mediating mechanisms that may explain the links between cultural identifications and health behaviors. Overall, results suggest a need for a larger, more definitive study to investigate how cultural identifications may predict health promoting and health risk behaviors among Hispanic youth.