Aprill Z Dawson1, Rebekah J Walker1, Chris Gregory2, Leonard E Egede3. 1. Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA. 2. College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA. 3. Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA; Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI 53226, USA. Electronic address: legede@mcw.edu.
Abstract
BACKGROUND: Hypertension is responsible for about 12.8% of deaths around the world. Immigrants' risk of developing hypertension increases with length of residency. There is limited work on the role of social determinants of health and blood pressure control in immigrants. We created a theory-based conceptual model for immigrant-specific and general social determinants variables and their relationship to blood pressure. PURPOSE: Use a theory-based model to identify latent variables for immigrant-specific social determinants using confirmatory factor analysis (CFA) and structural equation modeling (SEM) to test theoretical validity and relationship with blood pressure (BP). METHODS: CFA was used to identify latent variables for global socioeconomic status, stressors of immigration, adaptation to immigration, acculturation, and burden of disease. SEM was used to test the structural relationships between latent variables and BP. RESULTS: 181 immigrants were included in the analysis. The final model (chi2 (68, n = 181) = 149.87, p < 0.001, RMSEA = 0.055, CFI = 0.94, TLI = 0.91, CD = 0.99) found burden of disease was significantly related to BP (r = 0.35, p < 0.001). CONCLUSIONS: One latent variable measuring need was significantly associated with BP in an immigrant sample. This suggests that interventions targeting burden of disease are likely to be effective in controlling blood pressure in immigrants.
BACKGROUND:Hypertension is responsible for about 12.8% of deaths around the world. Immigrants' risk of developing hypertension increases with length of residency. There is limited work on the role of social determinants of health and blood pressure control in immigrants. We created a theory-based conceptual model for immigrant-specific and general social determinants variables and their relationship to blood pressure. PURPOSE: Use a theory-based model to identify latent variables for immigrant-specific social determinants using confirmatory factor analysis (CFA) and structural equation modeling (SEM) to test theoretical validity and relationship with blood pressure (BP). METHODS:CFA was used to identify latent variables for global socioeconomic status, stressors of immigration, adaptation to immigration, acculturation, and burden of disease. SEM was used to test the structural relationships between latent variables and BP. RESULTS: 181 immigrants were included in the analysis. The final model (chi2 (68, n = 181) = 149.87, p < 0.001, RMSEA = 0.055, CFI = 0.94, TLI = 0.91, CD = 0.99) found burden of disease was significantly related to BP (r = 0.35, p < 0.001). CONCLUSIONS: One latent variable measuring need was significantly associated with BP in an immigrant sample. This suggests that interventions targeting burden of disease are likely to be effective in controlling blood pressure in immigrants.
Authors: Scott C Carvajal; Cecilia Rosales; Raquel Rubio-Goldsmith; Samantha Sabo; Maia Ingram; Debra Jean McClelland; Floribella Redondo; Emma Torres; Andrea J Romero; Anna Ochoa O'Leary; Zoila Sanchez; Jill Guernsey de Zapien Journal: J Immigr Minor Health Date: 2013-04
Authors: Ding Ding; C Richard Hofstetter; Gregory J Norman; Veronica L Irvin; Douglas Chhay; Melbourne F Hovell Journal: Ethn Health Date: 2011-02 Impact factor: 2.772
Authors: Nathan D Wong; Victor A Lopez; Gilbert L'Italien; Roland Chen; Sue Ellen J Kline; Stanley S Franklin Journal: Arch Intern Med Date: 2007-12-10
Authors: Lisa D Chew; Joan M Griffin; Melissa R Partin; Siamak Noorbaloochi; Joseph P Grill; Annamay Snyder; Katharine A Bradley; Sean M Nugent; Alisha D Baines; Michelle Vanryn Journal: J Gen Intern Med Date: 2008-03-12 Impact factor: 5.128
Authors: Stella S Yi; Lorna E Thorpe; Jennifer M Zanowiak; Chau Trinh-Shevrin; Nadia S Islam Journal: Am J Hypertens Date: 2016-02-17 Impact factor: 2.689
Authors: Elizabeth B Kirkland; Marc Heincelman; Kinfe G Bishu; Samuel O Schumann; Andrew Schreiner; R Neal Axon; Patrick D Mauldin; William P Moran Journal: J Am Heart Assoc Date: 2018-05-30 Impact factor: 5.501