SPOTLIGHTS

ELVA ARREDONDO

Meet a member of the Salud America! National Advisory Committee

When she was just a teenager, Elva Arredondo got a first-hand taste of acculturation when her family moved from her native Mexico to Seattle.

Her mother worked two jobs and had little time for the healthy homemade meals they had traditionally cooked in Mexico—so fast food picked up the slack.

Watching TV helped teach them English—and many unhealthy food messages, too.

“I remember being so thrilled my mother took us to McDonald’s, it felt like we were living the American life,” Arredondo said. “But we all gained a little bit of weight. I’ve seen how acculturation can impact your health.”

Arredondo’s experience spurred her to get her PhD and become a professor dedicated to preventing obesity and its health complications among foreign-born and U.S.-born monolingual Spanish-speaking and bilingual populations.

Today, Dr. Arredondo works at San Diego State University and studies the cultural influences and psychosocial mediators of preventive behaviors, such as physical activity and dietary practices among Latinos.

“One way to make a difference in the world is to improve people’s health,” she said.

One of her programs, Caminando Con Fe (Walking with Faith), promotes more physical activity among church-going Latinos and advocates for environmental changes that facilitate physical activity.

Dr. Arredondo also is involved with Aventuras Para Niños (Adventures with Children), to promote healthy eating and exercise in many culturally appropriate ways—teaching parents effective ways to engage their family in healthy behaviors, training teachers to deliver healthy messages to students, and hiring community health workers to advocate for better parks and more fruits and vegetables in grocery stores.

“It’s important to involve researchers, community leaders, etc., to really address Latino childhood obesity at many levels,” said Dr. Arredondo, a member of the Salud America! National Advisory Committee. “That’s the most effective ways to tackle the epidemic.”

ROBERT DUDLEY

Meet Salud America! Grantee Robert Dudley

As early as high school, Robert Dudley wanted to be a scientist—white coat, goggles, test tubes, the whole lab experience.

He even started working at a blood lab during college.

But the lab's educational director got Dudley involved in helping local high-school teachers learn about immunology and design projects for their classes.

"The experience gave me a love for education and the effect that science can have at the human level that moved me to go into medicine," said Dudley, who got his medical degree from the University of Pennsylvania and now is a pediatrician at the Community Health Center, Inc., a nonprofit that provides affordable health care in Connecticut.

Today Dudley is still using science to help people for his new Salud America!-supported pilot project, an evaluation of his center's Healthy Tomorrows for Teens (HTT) program and its ability to help teen girls at Connecticut’s largest high school, New Britain. More than half of New Britain students are Latino.

HTT is an existing program that encourages healthy lifestyles among New Britain girls with nutrition counseling, YWCA fitness programs and community service projects.

But so far, Latinas haven’t consistently participated in HTT.

So Dudley's pilot project, one of 20 funded by the Robert Wood Johnson Foundation through Salud America! for $75,000 over two years, aims to evaluate HTT’s strengths and weaknesses to spawn new knowledge of what spurs participation by Latinas and improve the program’s ability to engage Latina teens in healthy lifestyles.

"We want to understand and overcome barriers to consistent engagement by Latina teens," said Dudley.

In a recent survey of New Britain ninth-graders, Latinas were more likely to be obese and dissatisfied with their weight than their white or black counterparts. Latinas also were the least likely to be physically active.

More than half of Latinas at the school fail P.E. class, compared to 19 percent of whites.

"The magnitude of the obesity epidemic has really pushed us to target at-risk children and come up with innovative interventions," Dudley said.

Dudley's pilot project will conduct: focus group/interviews/Photovoice with five Puerto Rican teen girls; five focus groups with at least 35 Latino parents; five focus groups with at least 35 Latina teens, three with HTT participants and two with non-HTT participants; and exit interviews with at least four long-term HTT participants.

Dudley hopes the results will improve and sustain the existing HTT program, make P.E. more acceptable to Latinas and help the school engage girls in other activities that may help address school P.E. failure and high pregnancy rates.

It will also help the Spanish Speaking Center in downtown New Britain better serve low-income Latinos, as well as help the local YWCA target its services to Latinos.

MYRIAM TORRES

Meet Salud America! Grantee Myriam Torres

Myriam Torres, a South Carolina researcher who has a strong record of improving minority health, knows the critical situation of Latino health in her state.

South Carolina's Latino population surged 342 percent from 1990 to 2005.

Most Latinos here have spent less than eight years in the U.S. and many aren’t English proficient and are uninsured.

More than 17 percent of Latino children here are obese, compared to less than 12 percent of whites, and they don’t meet physical activity recommendations.

These factors make obesity prevention a top priority, Torres said.

And that's why, thanks to Salud America! pilot funding, Torres and her colleagues created Juntas Podemos (Together We Can), in which Latina mothers will photograph the neighborhoods their children live in, in order to convince civic leaders to make healthier environments in West Columbia, S.C.

"As a Latina, I cannot have peace seeing all the needs around me and doing nothing, so we thought about effective ways to help prevent the obesity epidemic among children," said Torres, a clinical assistant professor of epidemiology at the University of South Carolina. "We thought that empowering the mothers is the best way to attack any problem."

Torres is one of 20 pilot researchers funded by the Robert Wood Johnson Foundation through Salud America! for $75,000 over two years.

Torres' pilot project, Juntas Podemos, began in July 2009.

Juntas Podemos will: set up an advisory group of mothers, researchers and city/school officials; give mothers cameras to document children's play and barriers to play; interview school officials about children's play behaviors; analyze results in focus groups; and present the findings and recommend policies to city/school officials.

"We believe Latina mothers will generate policy recommendations about opportunities for physical activity for children," Torres said.

Torres sees her project as a new part of her already vast experience trying to improve the health of Latinos in South Carolina.

As a PhD student at the University of South Carolina, she first got involved in Latino issues by helping on a Latino-focused research grant led by her mentor, Caroline Macera.

Today she directs the University of South Carolina's Consortium for Latino Immigration Studies. The consortium, created in 2004, promotes and coordinates interdisciplinary and transnational research on the experiences of Latinos in South Carolina and the Southeast.

Her research has included: a statewide Latino health needs assessment; a study on the use of preventive health services among different Latino populations; a perinatal HIV prevention program for Latinas; a study on the economic impact of Latinos on South Carolina; and a study looking at the effects of the economic recession and South Carolina’s 2008 immigration law on Mexicans living in the state.

She is a member of many local, regional and state Latino community groups, and often brings her research findings to these venues. She also provides cultural competency training where needed.

And now Torres hopes Juntas Podemos can reduce Latino childhood obesity rates.

"We think our project will empower Latino families," she said, "and help them think about childhood obesity and develop solutions that can work for them."

NANCY BUTTE

Meet a Member of the Salud America! National Advisory Committee

At 3:04 a.m. February 4, 1976, a 7.5-magnitude earthquake rocked Guatamala, killing and injuring thousands, leaving millions homeless and burying food stores.

Nancy Butte, startled but unhurt by the quake, knew what to do.

Butte, a Peace Corps volunteer at the time who just happened to be assigned to Guatamala’s Institute of Nutrition of Central America and Panama, capitalized on her fledgling experience as a nutritionist to set up soup kitchens and coordinate food service at camps for quake victims, a much-needed effort in the disaster response.

"My time in the Peace Corps showed me the importance of public health and care," said Butte, who went on to get degrees in nutritional sciences. "Ever since then, I've strived to improve the health of children through research, education and advocacy."

Dr. Butte has built a strong career in child health and nutrition as an educator and investigator on the Baylor College of Medicine faculty since 1982.

Her research focuses on the environmental and genetic determinants of childhood obesity. She also examines the contribution of food intake, total energy expenditure, basal metabolic rate, substrate utilization, physical activity, and fitness on the development of obesity in children, especially Latino children.

One of her studies is testing the efficacy of a community-centered childhood weight management program among low-socioeconomic-status, ethnically diverse children.

Butte believes that it takes a multi-level approach to respond to the challenges posed by childhood obesity, just as disaster aid also must occur on many levels.

"Addressing socioeconomic barriers at the family, school and community level to healthcare, education, healthy diet and recreation would go a long way to reducing childhood obesity among Latinos," she said.

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