title: Acculturation and overweight-related attitudes and behavior among obese Hispanic adults in the United States.
abstract: OBJECTIVE
  US Hispanics bear a disproportionate burden of excess body weight and associated morbidity, making obesity prevention and control in this population a public health priority. Development of culturally appropriate weight loss interventions requires understanding the influence of acculturation on attitudes and behavior related to obesity and weight loss.
  
  
  METHODS
  Using data from the National Health and Nutrition Examination Survey (2001-2004), we analyzed the associations of country of birth and language usage with weight perception, weight dissatisfaction, intention to lose weight, and intended weight loss of clinical significance among obese Hispanic adults (>20 years of age; unweighted n = 675) in multivariable logistic regression analyses.
  
  
  RESULTS
  US birth was significantly associated with correct weight perception (odds ratio [OR], 4.45; 95% confidence interval [CI], 2.16-9.17) and weight dissatisfaction (OR = 2.95; 95% CI = 1.63-5.35). Compared with Spanish-speaking only, obese Hispanics, bilingual, obese Hispanics were more likely to attempt weight loss (OR = 2.78; 95% CI = 1.43-5.40) and achieve clinically significant weight loss (OR = 3.94; 95% CI = 1.51-10.3).
  
  
  CONCLUSIONS
  The findings suggest that lack of acculturation as measured by foreign birth and limited English proficiency may contribute to within-ethnicity health inequality among obese Hispanics, even after controlling for a variety of sociodemographic characteristics, including education and income, differential healthcare access and use, and health status. Further studies should examine the underlying mechanisms, thereby informing culturally competent intervention strategies targeted at obese US Hispanics.
authors.affiliation: Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California, USA; Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA.
authors.forename: Christin
authors.initials: C
authors.lastname: New
authors.forename: Lan
authors.initials: L
authors.lastname: Xiao
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000069:Acculturation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000208:ethnology* / Q000209:etiology* / Q000523:psychology; D050177:Overweight / Q000208:ethnology / Q000209:etiology* / Q000523:psychology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014892:Weight Perception; D055815:Young Adult